House GOP Budget to cut $6.2 Trillion Over Ten Years

[mawilson 2,133]

Again, nothing in the proposal changes the cost trajectory for medicare over the next 10 years. Absolutely nothing.

So if his plan doesn't kick in until 2019, the claim that it saves $4 billion over the next decade is false?

[mawilson 2,133]

Here's the CBO analysis of his proposal.

...

The proposal would modify Medicaid as follows:

• Starting in 2013, the federal share of all Medicaid payments would be converted into block grants to be allocated to the states. The total dollar amount of the block grants would increase annually with population growth and with growth in the CPI-U. <--- this is probably how it saves money over the next 10 years
  
• Starting in 2022, Medicaid block grant payments would be reduced to exclude projected spending for acute care services or Medicare premiums and cost sharing paid by Medicaid.
  
• States would have additional flexibility in designing their programs.
  

The proposal would make several changes to the Patient Protection and Affordable Care Act (or PPACA, Public Law 111-148) and the health care provisions of the Health Care and Education Reconciliation Act of 2010 (P.L. 111-152). In general, it would repeal the provisions of those laws that deal with insurance coverage, including:

• The requirement that most legal U.S. residents obtain health insurance;
  
• The establishment of health insurance exchanges and the provision of subsidies for certain individuals and families who purchase coverage through the exchanges;
  
• The expansion of Medicaid coverage to include most nonelderly people with income below 138 percent of the federal poverty level; <--- this is interesting
  
• The penalties on certain employers if any of their workers obtain subsidized coverage through the exchanges; and
  
• The tax credits for small employers that offer health insurance.
  

[Mr. Big Dog 10,747]

So if his plan doesn't kick in until 2019, the claim that it saves $4 billion over the next decade is false?

I don't see how the plan can not affect the medicare entitlements of those 55 and older and at the same time save a bunch of money over the next decade. Where would those savings come from if not from the benefits currently enjoyed by Medicare recipients and to be enjoyed by those entering the system over the next decade?

[Mr. Big Dog 10,747]

Here's the CBO analysis of his proposal.

...

The proposal would modify Medicaid as follows:

• Starting in 2013, the federal share of all Medicaid payments would be converted into block grants to be allocated to the states. The total dollar amount of the block grants would increase annually with population growth and with growth in the CPI-U. <--- this is probably how it saves money over the next 10 years
  
• Starting in 2022, Medicaid block grant payments would be reduced to exclude projected spending for acute care services or Medicare premiums and cost sharing paid by Medicaid.
  
• States would have additional flexibility in designing their programs.
  

The proposal would make several changes to the Patient Protection and Affordable Care Act (or PPACA, Public Law 111-148) and the health care provisions of the Health Care and Education Reconciliation Act of 2010 (P.L. 111-152). In general, it would repeal the provisions of those laws that deal with insurance coverage, including:

• The requirement that most legal U.S. residents obtain health insurance;
  
• The establishment of health insurance exchanges and the provision of subsidies for certain individuals and families who purchase coverage through the exchanges;
  
• The expansion of Medicaid coverage to include most nonelderly people with income below 138 percent of the federal poverty level; <--- this is interesting
  
• The penalties on certain employers if any of their workers obtain subsidized coverage through the exchanges; and
  
• The tax credits for small employers that offer health insurance.
  

If the requirement to obtain health insurance coverage is lifted, then guaranteed insurance acceptance cannot stand. Pre-exisiting conditions exclusion would be back on the table or health insurance coverage would cease to exist altogether because nobody could afford it anymore and anyone carrying insurance until they actually get sick would be a fool. There is no way that this is feasible. What this means for Seniors is that they may not be able to obtain any coverage once Medicaid is dismantled. You can't force insurers to accept those with pre-existing conditions while allowing the healthy population to get a free ride until they're not healthy anymore. It's like offering after the accident car insurance and after the hurricane home and flood insurance coverage. Won't happen because nobody would carry insurance until they need it and no insurance can offer their product if all they have in terms of a customer base is those with claims already in their hands when they sign up.

[mawilson 2,133]

I don't see how the plan can not affect the medicare entitlements of those 55 and older and at the same time save a bunch of money over the next decade. Where would those savings come from if not from the benefits currently enjoyed by Medicare recipients and to be enjoyed by those entering the system over the next decade?

Good question.