HEALTH COACH - In Rare Unity, hospitals, doctors and insurers criticize the health bill

HEALTH COACH - 
 In Rare Unity, hospitals, doctors and insurers criticize the health bill  

 Others were even more direct about the effects of the bill, not only on patients but also on the industry. "For me, this is not a reform," said Michael J. Dowling, managing director of Northwell Health, a comprehensive healthcare system in New York. "This is just a debacle." 
 
 Hospitals serving low-income people "would have drowned completely when this happens," said Dowling, noting that more people would become uninsured at the same time as government payments to cover their costs. Been reduced. 
 
 Unlike groups of hospitals and doctors, insurers had largely kept silent on their reserves, perhaps in the hope of exchanging their low profile in exchange for the " Insurance that billions of dollars of subsidies for low-income coverage would continue. The White House and Congress have gone and returned about their willingness to pay subsidies, sparking anxiety at some companies. Several, including the anthem, have threatened to dramatically increase their prices or leave the markets without funding. 
 
 But a few, including Blue Shield of California, are opposed to the bill before the vote. "We are obliged to oppose it," said Paul Markovich, CEO of the company. "It raises the specter that the sickest and most needy among us will be disproportionately affected by losing access." 
 
 After the House passed the bill on Thursday, the two major trade groups of the sector have urged legislators to increase the tax credits available to help people pay for the coverage and adjust them to help Those who are older live in high-cost areas or have lower incomes. 
 
 But the overriding concern - for insurers, many workers and government officials across health care systems in many states - is the broad proposed reduction for Medicaid. Even for insurers that have largely abandoned the single market, such as UnitedHealth Group and Aetna, a substantial portion of their business provides coverage under Medicaid. The same goes for many local nonprofit projects, said Ceci Connolly, the general manager of the Alliance of Community Health Plans. 
 
 Employers and others expressed concern about the effects on independent freelancers who do not have a traditional employer but who are self-employed or contract workers in the self- So-called economy gig. 
 
 

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Which Republicans turned to authorize the G.O.P. The bill on health care finally passes 


An analysis of how the Republicans of the House voted on the bill. 



 




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 Depending on their income, these workers were transported between Medicaid and the individual insurance market under the Federal Health Care Act, which offered a greater level of stability "Said Nell Abernathy, vice president of research and policy at Roosevelt Institute, a left-wing economic research organization. 
 
 "A large group of Americans are in unstable working arrangements," she said. "This abrogates this level of security, which was not perfect, but it was a step in the right direction. 
 
 Small businesses, heavily divided over the original law, remain mixed in their reply to the Republican bill, and there seemed little doubt that some companies are dropping coverage in the absence of any penalty. The National Federation of Independent Business, which opposed the Affordable Care Act, stated that the House Act was "a critical first step toward health care reform". 

 According to other people, small business employees would lose if Medicaid was spilled or trade was worsened as many small businesses rely on the ability of employees to get coverage through the government program or market individual. 
 
 The main street alliance, a group of small business owners who supported the Affordable Care Act, said that four million small business owners, employees and independent contractors had won the # 39, insurance under the law and that another six million small "Workers of the company were enrolled in Medicaid as part of the expansion of the law. 
 
 "This bill leaves small business owners in a terrible position, of which they were all very familiar before the ACA: Year, uncertain, their employees will be healthy and able to work , And uncertain of the future of their businesses, "said Amanda Ballantyne, National Director of the Main Street Alliance. 
 
 Recent amendments to the bill have also raised questions about coverage of people with pre-existing medical conditions, which has become an emotional flash point for opposition. The bill would allow states to waive some of the current rules prohibiting insurers from charging more to sick people or excluding certain benefits, and these waivers may have broader effects if employers are no longer required to provide Full coverage. Before the Affordable Care Act, many employers capped how much they would pay for care over the lifetime of a person at $ 2 million, said Tracy Watts, a senior partner of Mercer, a benefits consultant social. 
 
 Although it is not clear which states would allow under a waiver or when these waivers come into effect, employers could review the limits and abandon the types of benefits if a state Considered them non-essential. 
 
 A January survey of 666 employers by Benefits Consultant Willis Towers Watson found that while many employers planned to retain most of the mandatory benefits, a significant minority was already considering changes. Even if half indicated that they were not likely to re - enter the limits of life, 15% said they would consider doing so. 
 
 And the employers' groups were generally in favor of the provisions of the bill that would reduce taxes, in particular the so-called Cadillac tax in addition - health plans cost, delayed for several years. The employers are in favor of its overall repeal. 
 
 Some health care groups, such as medical device manufacturers, supported the bill because of specific provisions such as the repeal of a device tax of 2.3 per cent in Under the Affordable Care Act. This tax has been suspended for two years in 2015, but the industry wants a permanent repeal. The Pharmaceutical Research and Manufacturers of America, the largest trade group in the drug industry, said that it had not taken a stand on the bill. 
 
 Unlike doctors and hospitals, which would probably have immediate success if millions of Americans lost insurance, medical device manufacturers and the drug industry would likely feel More calmly. The pharmaceutical industry, for example, could sell fewer products and lose its income. 
 
 "There are fewer patients treated, so it is bad for them, but it is much worse for hospitals and impact on doctors," said Ronny Gal Bernstein analyst who covers the pharmaceutical industry. "They're a little further." 
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