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    Physicians respond to Trump's latest Obamacare action

     

     

    President Donald Trump signed a pair of executive orders late last week. The first eased rules to allow small employers to band together through trade groups to create association health plans that could form across state lines. The second order ends the Affordable Care Act’s cost sharing reduction subsidies, which reduce copays and premiums for low- and middle-income earners. Trump says the payments are illegal because they were never appropriated by Congress, while opponents say it is an attempt to sabotage the law. Here’s what physicians from across the country had to say about the president’s latest moves.

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    • [email protected]
      It is distressing to see the comments were from members of my profession---both those for and against the actions taken by Trump. Any open, well educated and intelligent physician should have recognized the that Affordable Care Act was unsustainable from day one, and it would also drive up costs so high for those in upper middle class that they could no longer afford coverage. While the subsidies have been blessing for the lower and lower middle classes... there was no room for them in the magic accounting used to hide the true cost of the ACA. I do not say the latter as a partisan jab.... both sides play that game. The simple reality is that there is no workable solution for healthcare costs that exceed the affordability of the middle class----and it's been that way for the lower middle for the past 20 years. Now the ACA has extended that to the middle and upper middle. While "competition" would indeed bring down costs for the healthy who could also strip out coverage like rehab, pregnancy, mental health etc., that would drive up the costs for all those who are currently subsidized, the unhealthy and those needing those forms of coverage. Given that the current subsidies to insurers are a violation of the separation of powers, in that congress has not appropriated the funds, those who are outraged by stopping are dangerously advocating for presidents to simply pursue their preferences when they can't get the legislative branch to act. The choices for physicians are to either advocate for national health care, or to pare down the costs this system by 30-40%. (When you think about costs, consider the time spent in charting, "documentation", and the spiraling number of "health care workers" who have nothing to do with direct delivery of care). That is before we engage the issue of the insane costs of non generics, and the astronomical costs ahead for the incredible array of biopharmaceuticals to come.
    • Anonymous
      My health insurance policy for myself and my wife was $1200/month this year, for an HMO with an extremely limited panel accepted in few hospitals in the state, and a $6500 deductible/$13000 family deductible. The IRS ruled our plan to wealthy to qualify for an HSA. The announced premium for next year is $1500/month. That is before the President's announcement. That is unaffordable. So, anything that the President does is going to make this situation better, because left to its own devices the ACA (Obamacare) is going to collapse on its own. I never thought that I'd look forward to the day when I would qualify for Medicare in order to get cheaper premiums. Before the government intervention of ACA we had affordable insurance, relatively low deductibles of $2500, and an HSA, with the ability to go anywhere for healthcare. The ACA has been an unmitigated disaster for everyone except those on Medicaid.

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