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Noem/TrumpCare to Increase Health Care Costs for South Dakotans

At least Congresswoman Kristi Noem and her fellow Trumpublicans are going big on their upward wealth distribution. Instead of nickel-and-diming us to death, they’re 1,700-dollaring us to death. Noem remains coy about the Republican border adjustment tax, which the Club for Growth says will cost middle-class families $1,700 a year. But Noem is full-throatedly in favor of the GOP health care plan, which will cost people currently covered by the ACA another $1,700 each year:

The House Republican health plan would give consumers in the health insurance marketplace nationally an average of $1,700 less help with premiums in 2020, compared to the ACA’s premium tax credits, according to the Kaiser Family Foundation. The losses would be larger for older and lower-income consumers, and lower-income consumers would also lose help with deductibles and other out-of-pocket costs. Consumers’ costs would probably increase even more than tax credits would fall, since the House plan would likely cause individual market premiums to rise [Aviva Aron-Dine and Tara Straw, “House Tax Credits Would Make Health Insurance Far Less Affordable in High-Cost States,” Center on Budget and Policy Priorities, 2017.03.09].

That’s $1,700 in increased out-of-pocket costs on average. According to the same source, South Dakota is one of eleven high-cost states where Kristi and the Trumpublicans will axe tax credits by more than $3,000.

CBPP TrumpCare tax credit cuts by state

Nineteen of the twenty states losing the most Affordable Care Act assistance in buying individual market insurance all voted for Trump.

And these losses are just the premium tax credits the GOP will cut and redistribute to richer policy buyers. Noem’s health care plan also eliminates the ACA cost-sharing subsidies that reduce out-of-pocket costs for folks earning 100% to 250% of the poverty level, eliminates small-business tax credits, and allows insurers to charge older folks two-thirds more than the ACA allows*. The Trumpublican plan also shifts $370 billion over ten years in Medicaid costs to the states. That’s $253 billion cut from Medicaid expansion, likely forcing most expansion states to drop that ACA benefit, and $116 billion in new per capita caps cutting funding for seniors, people with disabilities, and families with children in all states. The proceeds of these cuts would mostly fund tax cuts for the rich.

The per-capita caps are supposed to make already lean Medicaid more efficient… yet Noem and her Republican colleagues have no problem allowing private insurers to become more inefficient by allowing insurance companies to deduct more of their executive pay and benefits as business expenses. The ACA capped those executive-compensation deductions at $500,000, encouraging insurers to sink their money into more customer-oriented expenses.

I look forward to Congresswoman Noem’s town halls when she explains to real live South Dakotans the merits of paying more for insurance.

Related Reading: Douglas Wiken spotlights conservative commentator David Brooks’s critique of Noem/TrumpCare. Brooks writes in the New York Times that TrumpCare will kick ten million people off their health insurance, increasing “fear, isolation, social tension, chronic illness, suicide and bankruptcy.” Brooks suggests that the failure of the Noem/Trump plan may finally provoke voters to “destroy market mechanisms to get the security they crave.” Bernie Sanders 2020, anyone?

Update 08:46 CST: Charlie the Squirrel and AARP agree that the TrumpCare Age Tax deserves the ax:

35 Comments

  1. Loren 2017-03-11 09:51

    Once again, Noem stays silent until she is handed the Republican daily talking points and then spouts them without conscience or thought. Some “representation”, eh? And just think, she could be your governor! How nice.

  2. Donald Pay 2017-03-11 10:56

    That’s just the beginning, of course, of the impact to South Dakota. The difference between the subsidy levels is going to force people out of the health insurance market, as they won’t be able to afford health care coverage. At best they will be forced into the Republican “fake insurance pool” full of fake insurance policies that take your money, pay off Republican politicians and fail to cover any medical coverage you need. That will return us (Make America Great Again, indeed) to the era of medical bankruptcy and emergency room care. Then will begin the cost shifting that will increase costs to employer-based plans, increase local property taxes to pay for county-based charity care. In South Dakota, what’s left of rural health care will end. Gee, thanks, Noem.

  3. mike from iowa 2017-03-11 11:35

    She’s got nice boots, though, don’t she? What more could you ask of a congressweasel?

  4. Rorschach 2017-03-11 11:41

    When is the GOP Party going to stage “I love Trumpcare” rallies across the US and South Dakota?

  5. jerry 2017-03-11 13:03

    The “access” that NOem blathers about, is the emergency room. You can still go there for the breaks and burns, but not the hospital. You only gain “access” to the hospital in the event you are actually dying. So those without insurance will now be able to just go to the hospital to die. The end of life treatments are very expensive too, so that burden will then be placed on the local taxpayers instead of nationally like it is now.

    Medicaid to disappear in her quest for the grail as well. I will tell you this, if you are a property owner in South Dakota, you are gonna be hit with some huge increases in your tax base. When I say property owner, that is all of us. Even if you rent, you still rent from a property owner. Gonna be spendy but what the hell, vote republican to show you have the money to just ignore those pesky expenses.

  6. Ryan Deplorable 2017-03-11 13:06

    Don’t like the new healthcare bill Paul Ryan laid out. The GOP should let Obamacare spiral out of control to it’s death, and blame it on the Dems/Obama. Hold out until the Dems ask the GOP for help and unleash free market policies to save the American healthcare system. Competition and innovation solve a lot of problems. The era of unneeded regulations is over. Though, it’s never that easy.

    Hilarious that Pelosi is calling for GOP leaders to show their healthcare bill, so “everyone can see what’s in it”. Anyone remember when she was quoted as saying, “We have to sign Obamacare to see what’s in it”? You guys are complaining about Noem, imagine living in California and having leaders like Pelosi and Maxine Waters. Yikes!

  7. John Kennedy Claussen, Sr. 2017-03-11 13:27

    The first 23 states, which will be the most negatively impacted by TrumpCare, are states that all voted for Trump last fall accept for Delaware and part of Maine….. Imagine that…. Trump is definitely not making that part of America “Great” or greater “Again,” is he?….. In fact, all 30 of the states that Trump won are on this list at some point in a negative way…….

  8. mike from iowa 2017-03-11 13:39

    Hilarious that Pelosi is calling for GOP leaders to show their healthcare bill, so “everyone can see what’s in it”.

    That isbecause Dems had an actual HC bill. Wingnuts are scrambling to throw something together because they never dreamed they be told to put up or shut up. Word to the wise, Diplorable. You got nothing.

  9. mike from iowa 2017-03-11 13:40

    Remember when Drumpf said everyone would be covered and it would be cheaper?

  10. mike from iowa 2017-03-11 14:21

    Ryan is also on record saying he doesn’t care how many people lose insurance-cutting costs is his main concern. Cutting costs means insuring millions less people so the wealthy get their billions in taxcuts. Nice people wingnuts. NOT!

  11. Darin Larson 2017-03-11 14:34

    mfi, don’t forget Trump said it would be “better” coverage in addition to it being cheaper and covering everyone that was already covered.

  12. Donald Pay 2017-03-11 14:45

    The point that Deplorable misses is that the ACA can be improved, and that is what the Democrats have been calling for while Republicans have been yammering on and on about “repeal and replace” for seven years while having nothing to offer.

    The first point here is that the ACA is not in a “death spiral.” The Ryan plan is keeping much of the ACA in place, which is what some of the Tea Party extremists are clucking about.

    Ryan is trying to keep the parts of the ACA that are popular. He’s also trying to give the rich a huge tax break, which is in keeping with his Ayn Randian philosophy. Further, Ryan is serious when he talks about how “the healthy are paying for the sick.” Ayn Randian Ryan hates that whole concept., so by allowing insurance companies to test your genome, he’s giving the insurance companies the means to cut you off of insurance before you get any pre-existing condition, after which the ACA says they can’t cut you off. See how that head fake works? Ryan keeps the popular part of the ACA that says you can’t be denied coverage for a pre-existing condition, then emasculate that provision by saying that insurance companies can shovel those with genetic predispositions to certain “conditions” into a higher risk pool with much higher premiums, deductibles, etc. Essentially, those folks, are going to be shoveled into a dumpster, where Ayn Randian acolyte Ryan thinks they should be disposed of.

    Who wants to live in a Randian dystopia? That’s where Ryancare takes you. You poor slobs with a genetic condition or a genetic pre-disposition to diabetes or polyps in your colon will be shown the dumpster, and only the select group of folks, like Ryan, get to have themselves covered.

    Ryan, by the way, has always had government health care, and you haven’t, and he wants to keep it that way. His care is too good for you.

  13. mike from iowa 2017-03-11 15:05

    Ryan? Where you at, you rascal. Let’s play some more.

    Darin-Drumpf has said all kinds of things, but I don’t think we are supposed to take them literally. Who knows anymore. This albatross feels like its been around the neck of America for forever over the past couple months.

  14. Darin Larson 2017-03-11 15:17

    mfi, I’m going to take Trump at his word. Deplorables like to take every dumb thing that ever came out of Pelosi’s mouth or Clinton’s mouth or Obama’s mouth at face value. The problem is it took years for the others to accumulate gaffes and dumb sound bites, but it only takes Trump a day and he will happily repeat them for you the next day in case you missed them.

  15. Kim Conlin 2017-03-11 17:44

    Just tried calling the phone number 1-844-617-2688 which transferred me to Noem’s voicemailbox. The message was “this mailbox is full.” No other options given. Anybody actually think she will do a town hall here in South Dakota? I am very lucky to be on my employer’s health insurance.

  16. Shirley Harrington-Moore 2017-03-11 18:01

    And she wants our vote for governor when she votes to take away our PERSONAL PROTECTIONS of health care? After all, Trump said everyone would have health care. He did not say “if you can afford it”. TrumpCare is just another Trump lie. I especially have issues with men who say they shouldn’t have to pay for pre-natal and maternity coverage. That said, women should not have to pay for Viagra or having men’s “package” checked for cancer, STDs or infections.

  17. Rorschach 2017-03-11 19:10

    Of course the primary focus of healthcare reform has to be cutting taxes on millionaires. Right? That’s what the public is clamoring for. We don’t want no stinking health insurance. We want tax cuts for millionaires even if we have to take insurance away from 10 million of the working poor.

    Does the GOP Party do anything that doesn’t involve cutting taxes on millionaires?

    http://money.cnn.com/2017/03/11/news/economy/obamacare-repeal-wealthy/index.html

  18. Cory Allen Heidelberger Post author | 2017-03-11 19:27

    I’m willing to go along with Ryan D. above. Drop the GOP plan. Leave the ACA in place. Let it play out for another few years, see what “havoc” it wreaks.

    I’m also with Ror: cutting taxes for millionaires does nothing to increase the number of Americans with health insurance, increase the quality of health care, or decrease the cost of health care.

  19. Rorschach 2017-03-12 07:28

    Nice cartoon, Mike From Iowa. It doesn’t get any more accurate than that.

  20. jerry 2017-03-12 07:51

    When hospitals close, then what? When Medicare fails, then what? http://www.beckershospitalreview.com/finance/joint-committee-on-taxation-puts-600b-price-tag-on-gop-healthcare-plan.html NOem and company will cost the United States 600 Billion with Republicancare. NOem will destroy the safety net for all just to give that 600 Billion to the wealthy.

    And, to top it off, the insurance premiums will increase drastically for republicans as well as Democrats and Independents, all of us; regardless of party will get stuck with higher premiums from the insurance companies.

  21. jerry 2017-03-12 08:08

    When hospitals sell, who buys them? China, buys them for one, take that EB5. http://www.reuters.com/article/community-health-m-a-apollo-global-idUSKCN11P2C0

    In private hands, as a for profit hospital, you can bet that your treatments there are gonna be the best they can squeeze out of you, right down to the last drop of that blood pack. If NOem had the intelligence to do so, she would be arguing those facts to her insane colleagues. Fix healthcare so it does its job of delivering healthcare with compassion and professionalism, not for profits do the job very well. For profit hospitals are just a slot machine with no pay out.

  22. barry freed 2017-03-12 09:39

    It goes beyond the ACA.

    When they say: “forgo that iPhone and get health insurance”, it shows their cruel inclinations and likely attitude about States that consume more Taxes than they pay in. The iPhone statement could easily be applied by a State such as California as they tell SD to: “get a job and pull your own weight”.

    I agree that we need to be self-sufficient, so let us abolish the PUC, enact Net Metering, and see the South Dakota work ethic cause a boom in alternative energy.

  23. Buckobear 2017-03-12 09:53

    Ther’s also no mention of keeping the 80% restriction on insurance providers (80% of premiums must be directed towards care; not salaries,bonuses, advertising,etc). Healthcare insurance has nothing to do with healh, or care. Funny how Medicare can operate with 3% overhead.

  24. barry freed 2017-03-12 10:05

    The plan for these cars is for them to be built, driven, and recycled where they are used, with small factories employing people, spread far and wide.
    https://www.youtube.com/watch?v=uRpxhlX4Ga0

  25. jerry 2017-03-12 11:19

    NOem and Rounds blather that ACA/Obamacare raises premiums. Rounds remembers the olden days when there were 17 carriers for health insurance in South Dakota, true that. What he fails to say is that before 2010, there were 5 carriers. Those other 12 left the state starting in the mid 90’s. What is NOem’s plan to lower premiums for the health insurance? The truth is, there is no plan. The only plan they have is to raise the premiums another 40% for starters. More corruption and theft courtesy of the republican party.

  26. mike from iowa 2017-03-12 11:49

    http://talkingpointsmemo.com/livewire/paul-ryan-number-who-will-lose-coverage-up-to-people

    Compassionate conservatism at its finest. The people that want insurance will buy it-unless they can’t-like most Americans- afford it. Not our fault sez wingnuts. We made it available. That is freedumb-wingnut style.

    http://www.rawstory.com/2017/03/rep-jim-jordan-on-coverage-for-11-million-i-dont-view-success-as-keeping-americans-on-medicaid/

    more compassionate conservatism

  27. dicta 2017-03-13 09:08

    Gonna be tough to blame the dems with folks like Tom Cotton leading the charge against the bill. Should be interesting to watch Trump lambast the CBO as a liberal entity when its report drops.

  28. Rorschach 2017-03-13 09:51

    I’m still waiting for the GOP Party to announce “I Love Trumpcare” rallies nationwide and in SD. Should be fun to see who shows up to rally for replacing health insurance for the poor with massive tax cuts for millionaires.

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