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Healthcare (EPFA)

Right about now you're going..."What? You're a writer of fantasy, why are you talking about healthcare? Well, for those of you who do not know, I've worked in the healthcare industry for over 17 years and so I speak Insurance like others speak a second language. That said, when I saw a post on Facebook about Tom Price, the man Trump had tagged to be the Secretary of Health and Human Services, I looked up what his detailed concept was to replace the ACE. It's called the Empowering Patients First Act (EPFA). I have copy/pasted from the main article I found on below for you and have highlighted by bolding, underlining, or changing color of areas you need to focus on.

Price’s Plan with the EPFA:

•incentives for people to contribute to health savings accounts

•age-based tax credits for health insurance coverage

•federal grants to help states subsidize insurance for “high risk” populations

•a provision to allow insurance providers to sell plans across state lines easily

•reforms that make bringing lawsuits against doctors harder, which is intended to “reduce the costly practice of defensive medicine.”

Critics of the plan have pointed out and Vox explained that many features will benefit the rich and healthy at the expense of the poor and sick.

For instance, the age-based tax credits get bigger as a person ages—and likely see increases in their income. Under the plan, Americans would get incentives of:

•$900 when they’re under age 18

•$1,200 between 18 to 35 years of age

•$2,100 between 35 and 50 years of age

•$3,000 at 50 years and older

If you’re middle-aged, middle-class, and in good health, you might be fine under the Empowering Patients First Act and able to afford health insurance regardless. But if you’re, say, a college graduate who’s just starting a career and has a serious medical condition, insurance may not be affordable.

Under the ACA, tax credits are based on income, not age, allowing those with low incomes to get more help.

Price’s plan also eliminates the ACA’s mandates for large, comprehensive coverage plans. Erin Trish, a researcher at the USC Schaeffer Center for Health Policy and Economics, told Ars that Republicans have long grumbled about this feature of the ACA. “One of the criticisms is that the premiums are high because policies are required to cover a lot,” she explained. But, she added, “it’s a trade-off.”

Insurance companies may be able to offer lower prices for more meager plans. And that could attract more young and/or low-income healthy people to sign up for coverage. But offering cheap, bare-bones plans to young, healthy people would likely drive up the prices of large, comprehensive plans that sick and older people need. This is because the affordability of those comprehensive plans is buoyed by healthy people buying into them and not needing all of their coverage.

The Empowering Patients First Act, like other Republican plans, also muddies one of the ACA’s more popular features: preventing insurance companies from denying coverage or discriminating based on a pre-existing condition. Price’s plan would uphold this feature only for people who have continuous coverage. If, however, someone with a pre-existing condition went for a period without health coverage—like if they lost their job and couldn’t pay for insurance during their employment gap—insurance companies could deny them coverage or dramatically raise their prices.

Unlike other Republicans’ plans, Price’s says nothing about the ACA’s Medicaid expansion, which could leave the more than 15 million Americans who gained coverage this way scrambling to find affordable coverage.

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Also...hearing the word Medicaid will trigger most to think of Medicare...they are different programs, obviously, but they tend to be lumped together often because they both are medical assistance programs for those in need, like those who do not make enough money but have health issues OR those who are past the age of 65 and are also in need of assistance due to likely being retired, on a fixed income, or on a low income all while dealing with the health issues of being older.

Because of that, I went to find information about Paul Ryan's Medicare plan without buying into all the hype websites on THE LIST of bad news sites. I found an article on about Paul Ryan's Medicare plan and you can go HERE to read it! OR...just wait a few minutes and I'll have it up for you to read. LOL!

I plan to try and keep people as informed as I can and help those who get overwhelmed with insurance issues as we transition into this new presidency. Reach out to me if you wish.


Tamsin :)

P.S. Oh, and btw...I had a short story come out on Monday...go check it out HERE! :)

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