The Senate health bill: poor people pay more for worse insurance

Here’s what I think we can say about the
health care bill Senate Republicans released today. You’re always going to hear ‘healthcare’
as ‘complicated.’ It’s something that people say to make you
turn away from it, to let them do what they want. “Nobody knew that health care could be so
complicated.” It’s not that complicated. This bill has a lot of moving parts, but you
can really get down to what it does in 140 characters. Health care expert Larry Levitt did it today. That is the core of this bill. That is what so many of the policies in it
do. The first thing the bill does, the biggest
thing is does, the main way it changes American health care, is it guts medicaid. So beginning in 2021, Obamacare’s medicaid
expansion begins to phase out. That medicaid expansion was responsible for
11 of the roughly 20 million people who got covered with insurance under Obamacare From 2021 to 2024, that expansion phases out
entirely. Beginning in 2025, all that’s left is the
medicaid we had before Obamacare, and then the bill takes aim at that. It moves that medicaid onto a growth rate
that doesn’t keep up with how much healthcare actually costs. So year by year, Medicaid is getting cut pretty
deeply against what it actually needs to spend to cover people. Now, why do you need to do all this? Why do you need to put hundreds of billions,
and over time even trillions of dollars, in cuts, to the health insurance that the poorest
people in this country rely on? There’s actually a reason, and you can see
it right here in the bill: Those couple of words, that is a huge tax
cut. It’s a capital gains tax cut. Capital gains is investment income. And in Obamacare, investment income on rich
people got taxed a little bit more to pay for health insurance for poor people. That Obamacare tax increase is repealed. And in order to fund the repeal of it, the
Republican party needs to gut Medicaid, they need to find a way to pay for this huge tax
cut for rich people. How big of a tax cut to rich people is this? A similar version of this in the house bill
got looked at by the center on budget and policy parties. The 400 richest families in America would
get a $33 billion tax cut. That is about as much as it would cost to
keep the medicaid expansion going in 4 states that are covering 700 thousand people. Back to the point about insurance that covers
less. You’ll see on page 41 some language about
essential health benefits. This recurs at different points in the bill. What this does is it changes the very definition
of what insurance has to cover, in order to count as insurance under the law. One thing Obamacare did was to define what
qualified as real insurance. It had to cover things like pregnancy, like
mental health, like hospitalization. The Republican bill lets states waive out
of the essential health benefits clause. So you can have insurance that doesn’t cover
hospitalization. You can have insurance that doesn’t cover
pregnancy, which was very often the case before Obamacare. This is important for a reason people don’t
always realize. In addition to meaning insurers can rip you
off, with insurance that really doesn’t cover what you need it to cover, it’s also
a backdoor way of making it possible to discriminate against people with pre-existing conditions. If you have an expensive condition, insurance
that doesn’t cover anything related to that condition is not worth anything to you. And you won’t sign up for it. Another really telling policy in the bill
that gets at the same idea in a different way, on page 5 they change what the bill defines
as ‘an applicable median cost benchmark plan’. That is obviously a beautiful turn of phrase,
but what it means is that when you get subsidies under Obamacare, it’s not just tied to how
much money you make. It’s tied to how much a good plan costs
in your area. And the way the law defines a good plan is
a plan that is about 70% of your expected health care costs. The Republican bill changes that benchmark
plan, it brings it down to 58%. That is lower than the lowest plan that most
people can buy under Obamacare right now. What’s remarkable about all this is that
Republicans actually knew what people didn’t like about Obamacare. Listen to Mitch McConnell, the guy who wrote
this bill, talking about Obamacare just a few months ago: “Well, what you need to understand is that
there are 25 million Americans who aren’t covered now. If the idea behind Obamacare was to get everyone
covered, that’s one of the many failures. In addition to premiums going up, co-payments
going up, deductibles going up. And many Americans who actually did get insurance
when they did not have it before, have really bad insurance that they have to pay for and
the deductibles are so high that it’s really not worth much to them.” He’s right. Those were the problems with Obamacare. The bill didn’t cover enough people. It did have too high deductibles, it did have
too much cost-sharing. It did mean that people ended up sometimes
buying insurance they couldn’t use because it cost them too much to use it. He understood that people were angry about
it and that they wanted something better. And he promised them that he would give them
something better, and then he’s created a bill that is going to make every single
one of those problems worse. “We’d love to have some Democrat support but they’re obstructionists – they’ll never support. We won’t get one no matter how good it is. But we will hopefully get something done and it will be something with heart. And very meaningful.


A Candidate Trump supporter supported the following positions that Trump espoused:
-Broader coverage, lower deductibles, no cuts to medicare or medicaid
-A de-escalation of foreign military conflicts, especially in Syria
-Higher taxes on the wealthy
A President Trump supporter would support the following positions:
-Less coverage, higher deductibles, and sharp cuts to medicaid to justify LOWER taxes on the wealthy
-A massive escalation in Syria
WHO ARE THE PEOPLE THAT supported candidate Trump and now support President Trump? It makes no sense. How can you be both for more and less coverage, more and less taxation on the wealthy, and more and less intervention in Syria?????? What is going on? Is this entirely a cult of personality effect?

Thank you for involving the disabled in this. We are the most hurt and least recognized in regards to this bill. Please, if you can, donate to the funds for the people shown here who were pulled out of their wheelchairs and arrested for protesting. They have tons of lawyer bills/bail fees/etc. and I can assure you the majority are not even being given/making a living wage, especially since it's completely legal to pay us less (cents per hour, literally). 💜

ACA was a total disaster for tax payers. Give poor healthcare through medicaid and leave health insurance alone. Let the market decide prices. The tax payers, who pay for healthcare, lives matter too.

Idk why Democrats are against this. With more old people off Medicaid, the more will die. Meaning less Republicans, meaning less opposition. Ezpz

Correction: poor people pay their fair share of their own healthcare so everyone who actually works for a living doesn't have to pay much higher premiums to cover for them.

"you can get raped and can't get an abortion, but if you get sick and are poor, then yeah you can just die"
– Republicans

Aren't medicare and medicaid going bankrupt? I read that insurance companies are completely pulling out of some states because they can't afford Obamacare, is that not happening?

I know I'm going to get lacerated for this but it seems like the GOP is more hellbent of revenge and scoring political points than actually helping people. The most simple act of helping people, your own people, by giving them good healthcare is being turned into an act of aggression against the former administration. Yes the ACA isn't perfect but it has helped people and wouldn't it be better to focus on improving it rather than "repealing and replacing" it for the sake of making good on a campaign promise. I don't live in the US, not anymore, but at present it looks like a country tearing itself apart from the top down. Godspeed you guys.

Man I wish there was a show that was un-biased. This guy just goes through everything and points out every little detail that's wrong/not right about republican actions. He should do a vid about anything besides republican failures. I mean it's not like democrats never failed

I currently have with my insurance, what you are warning about in you gloom and doom scenario. I am forced by law to spend a large percentage of my weekly pay, on insurance with a deductible that is high enough to make it useless. There are no office copay's, which is now standard for most insurance. that makes it useless. In essence Obamacare is forcing me to by a product from a company that is absolutely useless. The insurance company's that were in the "market place" are all getting out, because they can't afford to stay in it. so there is no option of shopping around for something better. The Democrats broke the american health care system.

Why do I care so much about US health care if I don't even live in the US and you guys don't even seem to care as much?!?!?!?

Explaining healthcare in 5 minutes..yep,only Vox can do it.This guy hasn't read the entire bill yet is here talking us though it.Vox propaganda is the best! 😀

The REPUBLICAN PARTY must be PURIFIED from anti Trump corrupted swamp type senators! Obama care was something that WE THE PEOPLE VOTE AGAINST and gave Trump our VOTE.
the way I see it, the new BILL is not going to get 50 votes and it's Okay… On 2018 we must VOTE OUT those weak Republican senators and vote new PRO-TRUMP ones interested in moving forward OUR AGENDA and not their personal political ones!

You'll understand why people distrust the media, when they lie about something or someone you know about.

Speaking as a British guy, it's keeps amazing me that the American Republican party get ANY votes at all. The only thing I can come up with is massive and willful ignorance.

Want a system for America? Look to Singapore. Their healthcare system covers everyone, and yet it thrives in the capitalist utopia that is Singapore. Seriously Donald, you want to make America Great again? Look to Singapore.

our representative dont represent US

Drain the sink of dirt water and fill the sink back up with clean water.

When is it going be enough? These people sitting in their ivory towers are going to destroy so many lives, what can be done to stop this? I genuinely hate the people who voted these criminals into power, I hope conservative media are happy with themselves, you've brainwashed enough people to destroy all of us.

So he says the Obama Care capital gains tax increase is really small, then almost in the same breath, he said getting rid of this tax would be a huge tax cut for the rich. Democrats agenda is to steal people's money to shore up their population.

Look here Vox, I am a loyal fan of the channel and I do see where you are going. However, what you guys are trying to do is just simply pinpointing the problem with the recent healthcare bill and criticising it. That is what anybody can do and is simply feckless if you do not come out with SOLUTION or suggest improvements to the bill. If this continues, I am starting to feel that Vox is just a typical left-wing news coverage centre.

Stop be honest, I do not need health insurance. I need healthcare. There is a huge difference between insurance and care.

Your whole healthcare thing in the United States is it incredible joke in the whole world is laughing at you. Single-payer healthcare is the only way for any country to go. Come on Americans get your head out of your butt.

Question: I live in Mexico, our economy is falling apart and our goverment hates us. Why then can I go to the hospital for free but not the people from the USA?

Something else everyone forgets is that the flaws in Obamacare were due to compromises insisted upon by…the Republicans.

They nasty.

If Abortion is a Constitutional right and should be subsidized shouldn't my other Constitutional rights be subsidized as well? What about gun ownership?

The Haves spend way too much so the have-nots can have. You can't pay you will still get treatment but guess what…… you will have to pay them back lol.

My mother needed a cochlear implant and Obamacare denied her coverage even though it is a condition that affects her work ability to provide. So many hard working Americans were destroyed because of Obamacare. What's the point in buying insurance if you can just buy it once you get hurt. That's not insurance and it isn't a successful business model so it only costs everyone more money.

I can't wait for 2021 when parasites on the Healthcare system will actually have to pay for what they consume. The less Welfare usage, the less economic redistribution, the better. Why is Vox not celebrating this move toward individual responsibility?

Of course the government screws the poor and gives to the rich who don't need it.
Trump is supposed to be for the little man not the rich. Angers me people have to die from diseases that can be treated so the rich can have more money

I know Obama care is flawed but if it is so bad how are 23 million people going to lose the healthcare they got through it???

I know i should be paying attention to the words he's saying… but…
Did anyone else notice how his glasses made the area around his eyes not line up with the rest of his face?

Republicans seem to care more about the tax cut for the rich,  the possibility of a serious health crisis breaking out in poorer areas!

RUN…. RUN … down and vote for the Republicans and set back and watch them tell you one thing and do the complete opposite ,GGGG
All you poor people go vote republican so the rich can get richer,GGG

The premise of the bill as repeated by McConnell is a lie. The ACA, "Obamacare" is not collapsing. It is not failing. Whatever difficulties the program is having is entirely due deliberate brazen GOP sabotage efforts- both by refusing the Medicare expansion, and by destabilizing the insurance markets through Trump's threats, and the AHCA legislation.

What did anyone expect from Republicans? Help? Only if you're already filthy rich and don't need any more help from anybody; then Republicans are your friends, otherwise no so much (all right, none!)

Yep, Obama and the Democrats gave us the worst health care bill in the history of the planet. Now, after the democrats health care bill has fallen apart and devastated the country, President Trump is trying to pick up the pieces, clean up the democrats mess, and do something for us, but its hard given the democrats continued obstruction of our government.

"Democrats are obstructionists" yeah ok look in a mirror jackass. Now look in a mirror that shows your ugly mug through the last eight years that Obama was president

This is such blatant propaganda. "It takes what most people don't like about Obamacare and makes it much, much worse". What a tool. Medicare finance reform is wise.

Nothing is diffiult when dealing with healthcare. Just stop dealing with it and dismantle that damn scam!

No, it's the individual mandate…where ppl who work have to take out a mortgage to use their insurance…that's the current Obama bill

95% of comments here are totally unaware of getting fooled. Not one person noticed 99% of comments are older than 6 months. This is typical for you tube comment sections. Where are the recent comments I can talk to? No comment over 5 months old ever replies. Do you all like talking and not hearing rebuttals? Wake up and start noticing the detail.

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