Judul : Rhode Island Health Insurance Exchange
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Rhode Island Health Insurance Exchange
what do the proposed health care plan changes mean to us? the "dane yorke's state of mind" program is brought to you in part by lookout rhode island
Rhode Island Health Insurance Exchange, and taco comfort solutions. dan: i don't know. maybe if i put my microphone on,
you would know exactly what they mean to us. they're coming no what? that happens every once in a while on this program. welcome in. some days are better than others. nice to have you.
the republicans may feel that way as well, to be honest with you, they think they've got a big change agency going here and now they are fractured on day one and we will talk to someone who has a real keen understanding about this health care stuff, coming up, professor
john friedman joins us momentarily. nice to have you aboard. in the meantime, this is really fascinating. i don't know that the whole country is talking about this. washington is talking about this.
cable news is talking about but our threshold for pain for donald trump's acting up is so high now, this is an getting a lot of attention. let's show the headline here. republicans aren't supporting they are hoping that this all kind of goes away.
here's the latest. if i should hit an issue that and that is controversial, i should speak to it directly. i'm a new york giants fan. [laughter] the fbi director shrugged off the controversy.
i want to thank the members. there was no comment from the president tuesday on the startling claim that fc13 president obama ones during the election. as i said now -- cap'tis phones during the election.
sean spicer could not avoid it's not up question of new or less proof. he offered no evidence to back up the claim. he said that mr. trump had not asked the fbi director, whether it was true.
no, the president did not. the white house insisted the president had nothing to prove. the obligation was for the house and senate intelligence committees to investigate. they have the resources, clearances, and staff to fully and thoroughly and
comprehensively investigate the republican chairman of those committees described the evidence as thin or nonexistent. i haven't seen that evidence. we have nothing that would send us in that direction. during his confirmation hearing, rod rosenstein, under
jeff sessions, was equally skeptical. that happened in the nixon era. i believe it has happened before nd i don't have any reason to believe it has happened recently and i certainly hope it has not. look at the tweets.
just incredible, on a saturday morning that he would tweet this -- terrible, just found out i -- just found out obama had my wires tapped, nothing found, this is mccarthyism, this is nixon watergate, bad or sick guy. it is amazing to me the donald
trump -- got to get the -- give him credit, i guess, on some level, that he can build this kind of -- i don't know, circus atmosphere to the point where everyone just sort of rolls his eyes -- rolls her eyes . this assertion is incredibly
important and it has to be investigated. he won't do that. stay tuned on that one. this is the day without a woman. look, as a guy who has really -- listen, we don't have to compete for who is staunchly supportive
of gender equity and gender rights. there's estrogen in my family. i have, you know, four sisters, a wife, a daughter. much more estrogen than testosterone. on the ground i've been making this a case for a long time, but
when i see this garbage i just -- you got to be kidding me. i don't have a problem that it is a national cause. listen, you want to wear red and support women with small businesses, that kind o c13 fine, but when it gets to this this guys fishing for any
politically correct poll that he can tie his dog leg to. he's unbelievable, the mayor. female employees to take a personal or sick day today. what happened yesterday? the city council that the invisible court canceled 75 cases because they didn't have
enough employees to run the courthouse. this morning i heard that there was some fledgling work being done at the courthouse, but i don't understand it, i really don't understand. if i'm the mayor and i hear a percolating problem in the city
that i'm not going to have a substantial enough people to run city services because of this thing? sorry, i issue an edict that says -- do what you want, but i'm checking personal and sick days for their credibility and if we have a bunch of sick out
based on this where we can run city services? there will be hacked to pay, discipline for employees. curt schilling, critical of the 38 studios document dump on the internet last week. join the club, kurt. headline here, lawmakers
question the partial release of these documents. they are a partial release and schilling is critical himself, saying that this is ridiculous, where are the key players? the speaker of the house during all of this, gordon fox, and mike corso, the broker who put
the together, and the former speaker, bill murphy, didn't have much to say. murphy at least responded to state police, but fox wasn't talking and murphy is his lawyer, and corso didn't talk. it could be cross wire with the grand jury testimony that is now
under request to the superior court here in rhode island. galvan i raimondo has requested that the attorney general request that the judge authorize this be released. the other thing is, if you look at the list on the state police site, the reps that were
interviewed on that fateful vote, the loan guarantee program that authorized the funding for studio studios cap -- 38 studios, build this on the one side and he was on the list as interview was not there. i don't know what games are going on between the attorney
general and state police, politics are happening that is disgraceful and the state police being nonresponsive to the queries of the media about what's going on with this report , it's embarrassing. the kernel has just taken over.
at least administratively. i say this with fingers crossed, the state police are the last bastion of integrity in this state. she is stinking up the joint. literally. alright, this is a really
interesting conversation that america is going to have with the american health care act. is that what it's called now? it's not the trump care, as governor raimondo called it yesterday. couple of headlines here. yep, they're fighting it.
as opposed to the american affordable care act. whatever. it's a lot of a's in that. i don't know how anybody is going to work this whole thing john friedman , professor of economics, brown university.
you have been in the midst of this for quite some time with trump before and i welcome you back, think you for having me. dan: the affordable care act, did we talk about this last time? i think that if we could take the politics of the name
obamacare off of the affordable care act, the temperature might come down and we might not be so heck bent on concepts of repeal and replace and just touch up or renovate something that is in part working ok. does that make sense? john: i
think that's right. part of the way that is reflected in what you have seen from the republicans this week is that it looks a lot more like obamacare that i think many people expected when the process started. it
becomes the politics and i think the conservatives are more upset about what they have released because they really thought they would be going in a different direction and they are not. what would that different direction be?
some people have proposed actually repealing and shutting down the exchanges for the medicaid expansion that the large coverage increase in obamacare rests on. they haven't done that. they switched around the subsidies of it.
they switched up the way that medicaid will get funded. but the core architecture, support for states covering health care for individuals above the poverty line, individuals getting tax credits to buy health care these exchanges, is still there.
dan: all right, we are going to break this all down here, momentarily, and then have the professor go p spy piece and solve the whole thing for you before the end of the show. in the meantime i want to let you go that -- let you know that the folks at nava can credit
union urge you to try the card valet app you've got no problem if you're a member, just download it. if you are not, all you have to do is open an account, get yourself a debit card and have it managed. the technology on your smart
phone is phenomenal. the ease of service, being able to just evaluate everything you're doing, banking wise, literally from your smart phone, even more than online banking, is only relieved when you see it.
all right, here's what's happening, sort of up-to-date, t on health care. republicans are pushing their health care bill on capitol hill, touting it as a cure-all for the affordable care act. we need to move health care decisions out of washington and
send them back to the states, patients, families, and their doctors. the gop proposal eliminates the individual mandate, employer mandate, and most taxes. it is replaced with a massive expansion of health savings accounts and refundable taxes
for low and middle income americans who don't get coverage from their jobs, ranging from $2000 to $14,000 per year. the legislation would cover pre-existing conditions, dependent coverage until age 26, and wait until 2020 to roll back medicaid expansion.
democrats say that millions of people who just gained medicaid coverage under obamacare will lose it. this is a -- this is a tax cut for the wealthy with some health insurance provisions tacked alongside of it.
it's not just generalized -- democrats criticizing. conservative republicans have their own objection. they are leaving taxes, subsidies, and a form of individual mandate. that sounds
like obamacare like to me. the trump administration is calling it a work in progress. this is the beginning of the process and we look forward to working with them. republicans need 218 votes to
pass the bill in the house. democrats say they won't be providing any of them. an: this is interesting. two key things that the report -- the public loved about the i don't want to say obamacare because my thought is that if we stop calling it obamacare,
reasonability would enter. having said that, obamacare had the 26-year-old sticking on the plan and pre-existing condition protection. those were the two principal foundational identifiable pleasures that i think america felt good with.
they remain, correct? that's right. dan: so, repeal, repeal would take is off the table, too. i think the repeal thing is a little overblown. the medicaid thing is probably the biggest fluctuation here.
i want you to dig in and really explain that to me. the other thing that i've noticed in this thing is that the mandate and the tax penalties for not signing up for health care are going to go away.
on that one , what's the motive? to keep people in the plan? if you don't have people in the plan that is health -- that are healthy, how does it survive? to start with the mandate, they removed how it was before where you paid a penalty every
year if you are not covered. they have replaced that with a system where you don't pay a penalty for not encumbered, but when you want to get covered again, you have to pay more. dan: 30%. what's the incentive question mark if you are not on a plan
and have to get on a plan, you are 30% search it -- are charged. why would you get on another plan? john: except if you're really sick.ple on the plan are not just going to be the people are kind of sick who wanted to get
insurance, they are going to be e who are really sick. that could make the set of people in the insurance pool increasing premiums and destabilizing the whole system. dan: coming clean here, you worked with the obama administration with this stuff.
you have been intimate on the stuff. would you call yourself a fan of obamacare? john: i think it meets a big steps in the right direction. there are elements that you could continue to improve on and if the republicans would set
aside their obsession with repeal and replace and just here's a system, how can we make it at her, there are some real improvements that they could make. not every idea that they put out in this particular package is a bad one, but i think that they
are very concerned about not just changing obamacare but actually making changes to medicaid. these are people that have never had any contact with obamacare. even the people that were already covered by medicaid before obamacare came in will be
hugely affected. the reason is that they are going to change medicaid from something that basically cost shares with the state, gets a little bit more expensive, the federal government kicks in more to a system where the government will give you a fixed amount per
person. and it is going to depend on whatever it cost in 2016. if costs go up a lot, the states are just on the hook. if a lot of valuable treatments come online and it costs more, the states are on the hook. thinking about rhode
island, we already spend a billion dollars per year on medicaid. that's just the state money. not counting the money that comes out of the federal government. we will have to step up another $300 million in order to keep
covering the people who are on medicaid now. that's only going to get worse over time. remind everybody, people on medicaid are on disability. it sometimes confuses people. it's the health care plan for those who are 65 and older,
healthy or not. john: that's right. dan: medicaid is for the lower income or disabled. john: basically, the health insurance program put out by the government for low in families. what these changes will resultt either rhode island
has to stump up another $300 million per year by the time this goes into effect , or not the people at the very bottom, but the people earning maybe $25,000 per year in rhode island are going to have to pay a 3 lot more for coverage and, in
many cases, that won't be feasible for them. we haven't had a formal estimate, because the bill is so new, but across the country people are suggesting that maybe 10 million people would lose coverage as a result of these
proposed changes. i guess i will ask you this dan: so, the -- this is a fascinating exercise, both the politics of promising something in an election, finding ourselves having been elected, now having to actually deliver on the promises you are making
with a system that is probably the most intricate and complicated, expensive, and hard to figure out thing you could ever try to handle. it's going to be a fascinating thing. even down to the idea that subsidies for low income people
are going to go away, but tax credits will be introduced. those who don't earn a lot of money, i don't kn6 c13 going to be like the earned income tax credit, where they get a check back for more than they paid -- john: they will, this is a huge
contention for people on the right. it's called the refundable tax credit. as you said, you are allowed to get more money back from the government than you know. if i'm trying to subsidize you to my health care and i d3
make that much money, i don't know that much tax. i can only cancel out little bits of tax, i won't be able to provide much of a subsidy, enough to make it refundable. this proposal keeps the refundable tax credit -- they call it something different, but
it is the same refundable tax credit they had under obamacare. it's just that they give a little bit more to the young into the rich relative to obamacare, which had more for the old in the poor -- and the poor. it reshuffles the chairs, it
doesn't really fundamentally change was going on. all right. this philosophy on the medicaid change, you heard it in the package, john cornyn there, talking about putting responsibility back on the states.
i guess it really does? rhode island had a $200 million, $300 million hit. $8.6 billion in totality, but really about $3 billion that is raised every year. dan: an incredible amount of
money. john: you exactly pointed out the trade-off. what conservatives are going to like about this is, they say, they want to offer more coverage , if they want to offer more services, that is up them, they can make the decision
correctly because they bear 100% of the cost. what liberals fear is that that is gone to lead to cutbacks in practice either because the states are not used to paying that much out of their budget and they are required to cut back on other stuff, or just
because the states aren't going to be able to deal with big surges. maybe there is something new and expensive that we really need to pay for another federal government is no longer there to help the states through the lean times.
what does this do to the insurance industry? more flush, less flush, what? john: fewer people will be covered. productions go either way. some people think that because it will be a safer pool, they will make more money.
dan: safer pool, meaning? less sick people getting health insurance because the poor people who tend to have larger health problems will be forced out because they can't afford it.
dan: listen to what you just said. from a, on a moral basis -- look, i don't position myself as a lefty liberal by any stretch, a of folks this year have thought the because i'm not a big trump guy i have gone to the left.
there is a draconian aspect to john:9 the -- john: the united y developed country in the world where for tens of millions of people, they are one car accident away from bankruptcy. because they don't have health
insurance. by the way, bankruy minutes no one gets paid. you can't get a credit card, you can't get a loan. we can all disagree about how much care someone can get, but the notion that health insurance insurance
is out of reach for tens of millions of people is fundamentally unsettling. dan: the quick thin3 like me, working for a living, high deductible, most things won't change, right? when you have a private relationship with your insurance
company. dan: it's just a question of how healthy is your insurance company and the costs that they will generate to the people with that direct relationship. john: most things won't change for the people that get coverage from
their employer. things that won't change, the most hated part from the original obamacare, the cadillac tax is there, they didn't repeal they needed the money to pay for the changes. john: for a higher value plan, there is a 40% surcharge for the
companies that they have to pay. they keep putting it back, but it's still there, one more thing that conservatives have found not to like in this plan. on the other hand you have a bunch of moderate republicans from states like ohio that have taken up the medicaid expansion
and are upset that so many people will get thrown off medicaid because the states don't have enough money. there's no winning here. dan: impossible task, 30 seconds, your production question mark -- production? john: i do you
will get more conservatives as a goes to the house and they run into problems in the senate, which is a more moderate body and where you just need to lose a few republicans in order to not get 50 votes. dan: really get change this year?
john: i don't know, hard call. 50:50 pick. dan: already. -- all righty i'm really perplexed over what will happen with the repeal and replace of obamacare. you know what is really missing in this equation?
other than the politics of repeal obamacare and replace it with something that is -- what? more afford more accessible? all those things? we've never had a clear 5.1 nation on the s good and the stuff that needs to be
changed. you know why? because that analysis isn't going to happen because the politics cover it up. see you tomorrow. on the radio, too.
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