Tax reform and individual mandate repeal put patients in the crosshairs

  

With the Senate speeding toward a final vote on tax reform legislation, Majority Leader Mitch McConnell (R-KY) and his leadership team are considering the inclusion of two additional health care proposals. Their hope is that these proposals will persuade undecided Senators to vote yes and make up for the fact that the bill includes the misguided decision to repeal the individual mandate. Unfortunately, while these proposals may have merit on their own, they won’t be enough to mitigate the damage caused by individual mandate repeal, which the Congressional Budget Office (CBO) estimates will lead to 13 million Americans losing health coverage.

Proponents of the two proposals have claimed that they would at least mitigate – if not completely undo – the harm of individual mandate repeal. The first, from Sens. Lamar Alexander (R-TN) and Patty Murray (D-WA) would restore cost sharing reduction (CSR) payments through 2019, after the Trump administration unilaterally decided to end the payments earlier this year.

The second, from Sens. Susan Collins (R-ME) and Bill Nelson (D-FL), provides $2.5 billion in both 2018 and 2019 for state reinsurance programs, which reimburse insurers for some or all of the costs associated with highest-cost claims.

However, without the individual mandate, fewer healthy people will sign up for coverage and average costs and premiums across the individual market will rise by 10 percent, according to the CBO; some providers have projected even larger increases. To offset this 10 percent increase, $10 billion in federal reinsurance funds would be needed each year (as opposed to the temporary “solution” offered by Collins-Nelson).

Worse, repealing the individual mandate increases uncertainty and instability about future open enrollment periods, risk pool profiles, and premium rates. Put simply, insurers would be forced to reconsider whether they want to continue taking part in the health insurance marketplace at all, a recipe for further disruption and additional loss of coverage among individual market enrollees.

Finally, while the Alexander-Murray proposal to reinstate CSR payments would be a laudable approach on its own, CBO has found that it would also fail to reverse the coverage reductions that will result from individual mandate repeal. In short, repeal creates a problem far bigger than the one Alexander-Murray was initially intended to address.

With a final vote looming, now is the time to tell your Senators that they should stand with patients and reject this bill. In the absence of substantive debate and expert input, grassroots pressure is the best hope for stopping this harmful legislation once and for all.

Repealing the Individual Mandate is the Worst Tax Reform Idea Out There

  

As the push for tax reform on Capitol Hill moves forward, President Trump continues his misguided calls to repeal the Affordable Care Act’s (ACA) individual mandate as part of the final package. Unfortunately, he isn’t alone.

Despite Congress’s repeated failure to replace the ACA, some Republicans in both the House and Senate still seem convinced that the missing tax reform ingredient is a provision that the Congressional Budget Office (CBO) has estimated would result in 13 million Americans losing coverage, and an overall increase in premiums for health care consumers nationwide.

Experts who have analyzed the ACA have repeatedly found that without the mandate, the health care system the bill implemented simply would not work. With the mandate in place, those who might otherwise be less likely to obtain coverage – such as young adults and those who currently enjoy good health – are incentivized to get covered. This in turn leads to lower premiums across the board by offsetting costs for sicker patients.

Despite the harm this policy proposal would inflict on health care consumers, any serious consideration of the individual mandate repeal is more likely fueled by the fact that the Republican base is dissatisfied with the President and Congress’s inability to advance their overall legislative agenda, perhaps most notably when it comes to health care.

The proposal to repeal the individual mandate is all the more puzzling given recent news that the two week-old Open Enrollment period has seen a surge in consumers signing up for or renewing their health coverage via the federal marketplace, despite the Trump administration’s refusal to adequately promote it. Moreover, voters in Maine voted last Tuesday to expand Medicaid and help an estimated 70,000 low-income residents obtain coverage. These are just the latest indications that voters overwhelmingly support policies that increase access to care, rather than reduce it.

When it comes to the individual mandate and health care reform in general, we continue to urge Congress to listen to nurses when considering the best way to move forward on transforming America’s health care system. Join us and add your voice by clicking here.

Will you #EndNurseAbuse?

  

This guest post is by Alex Wubbels, RN. 

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Back in late July, I was arrested for following my hospital’s policy and protecting an unconscious patient who could not consent to a blood draw. I was wrongfully seized by force in the middle of the emergency department.

Even though my story made national news, most do not. Did you hear about the emergency department nurse who was stabbed by a patient in Massachusetts? Or the Arkansas nurse who was pushed down a flight of stairs? Or the two nurses in Illinois who were taken hostage (one of whom was beaten and raped)? Sadly, the list goes on and on. With one out of every four nurses reporting that they’ve been assaulted at work, you’ve either experienced this personally or know a colleague who has been abused.

The fact that we are more likely to experience violence on the job than prison guards or police officers is unacceptable, and we must work together to #EndNurseAbuse.

As an ANA member, I was fortunate to have the support of my organization, community, and a tribe of fellow nurses during this difficult time.

I truly believe that what happened to me can lead to positive change in our profession. That’s why I decided to speak out: to stop this abuse from happening to others. I’ve teamed up with ANA to ask you to sign our pledge and stop this culture of violence. I am committed to this goal so we are not put in situations where we have to fear for our safety, or have to choose between our jobs and our licenses.

By adding your name, you’re saying you support zero tolerance when it comes to violence against nurses; that you’ll report abuse whenever you safely can; and that you’ll share with others asking them to sign too.

Please join me by adding your name and taking the pledge.

Thank you,
Alex Wubbels, RN