Health care reform is complicated, but the reason to worry about the Republican "repeal and replace" legislation is easy. Medicaid pays for long-term care of elderly Americans who run out of money. It goes to nursing homes, assisted-living facilities and sometimes pays for care at home. Medicare pays for almost no nursing home care, only for some short rehab stays. This difference is often misunderstood, so please pass it on: Medicare does not pay for long-term care.
The U.S. House bill will gut Medicaid funding, and the Senate bill will gut it further. These proposals take much more away from Medicaid than Obamacare added to it. This is the worst, meanest and sneakiest part of this legislation.
Except for the 1 percent, we will all have to (a) figure out (soon) who can quit work to care for parent(s) when their money is gone, and (b) figure out who can quit work later, to care for us when our money is gone, or (c) figure out how to set aside money to pay $6,000 to $10,000 per month ($72,000 to $120,000 per year) in today's dollars for parent(s) and for us, for as long as we'll need help to live with any dignity. Cutting Medicaid to fund tax cuts is repeal, replace and redistribution of wealth, pure and simple.
Catherine Lexau, St. Paul
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Many goals of Obamacare have merit and bipartisan support, such as dealing, in some manner, with pre-existing conditions. It was the structure and implementation of the legislation that caused its failure. Regarding a solution, I believe part of our argument involves semantics. I suggest we acknowledge that "repeal and replace" and "fix" take us to a very similar place.
Here's my layman's understanding of the two competing solutions:
• Fix Obamacare: This implies that over the next (fill in the blank) months, each of the various elements of Obamacare, individually and in a logical order, would be changed and replaced with new provisions.
• Repeal and replace Obamacare: This implies that Obamacare would be officially repealed, but with provisions and timing fully planned for replacement. And then, over the next (fill in the blank) months, each of the various elements of the system, individually and in a logical order, would be changed and replaced with new provisions.