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It's not a good thing that Obama & co. made their disastrous healthcare plan so hard to repeal, but don't let that stop you from celebrating while premiums continue to skyrocket.
THE last time President Barack Obama counted, congressional Republicans had tried to repeal parts of the Affordable Care Act (ACA), his health-care law, more than 60 times. Donald Trump’s election victory means their efforts will no longer be in vain. Yet despite Republicans’ confidence in Obamacare’s shortcomings, what exactly will happen to the law when Mr Trump takes office remains something of a mystery.
Because Republicans lack the 60 votes necessary to overcome a filibuster in the Senate, they will be unable to pass a comprehensive health-care bill without Democratic votes. Instead, they must rely on a process dubbed “budget reconciliation”, which allows a simple majority to pass tax-and-spending measures. Republicans used this process to send a law repealing parts of Obamacare to the president’s desk. Mr Obama vetoed it early this year. Next year, President Trump will probably sign it.
That will be the beginning, rather than the end, of the Republicans’ task. On its own, the reconciliation bill is best described as a wrecking effort. It would remove the subsidies currently available to poor buyers on the ACA’s insurance exchanges. It would nix the individual mandate, which fines Americans who can afford health insurance but go without it. Both moves would reduce the number of healthy people buying coverage. But a rule banning insurers from turning away those with pre-existing medical conditions would remain. As a result, premiums, already up by an average of 22% this year, would rise further, deterring yet more healthy customers. The “death spiral” that some say already afflicts the exchanges would thus accelerate.
Eventually, there would be no market left to serve those who are not covered through their employers or by other government programmes. This includes 12m people who currently buy on the exchanges, and 9m who purchase directly from insurers. As well as killing the individual market, the bill would also undo the expansion of Medicaid, government-provided insurance for the poorest, which was largely responsible for the fall in the number of uninsured Americans after the ACA was passed. Such a painful death for Obamacare would not reflect well on the executioners.
But congressional Republicans are betting that, with the individual market likely to crumble, Democrats would have no choice but to support a full replacement. The best guess as to what that might look like is a somewhat vague plan penned by Paul Ryan, Speaker of the House. This includes replacing Obamacare’s targeted subsidies for the poor with a universal tax credit increasing with age.
You might think that replacing means-tested help for poor buyers with a universal benefit would raise costs for the government. But Republicans insist that with enough deregulation, premiums will fall dramatically. For instance, the ACA forces all plans to include certain benefits, such as preventive care, and limits the extent to which insurers can vary prices with risk.
Freed from regulation, insurers are likely to design plans which appeal only to healthy buyers. Mr Ryan’s fix is to put unhealthy people into “high-risk pools” with higher premiums and big subsidies. States have tried high-risk pools in the past, notes Gary Claxton of the Kaiser Family Foundation, a think-tank. Typically, premiums were capped at 150-200% of standard rates. But because that was too expensive for many folk, only the very sickest people—say, those with HIV—bought coverage. This pushed up the average subsidy per enrollee. Mr Claxton says big subsidies concentrated on few people could sap the political will to support the pools.
Whatever Congress decides to do, it must move quickly. Few insurers will want to remain in a wobbly market with an uncertain future. Mr Trump’s changeable views complicate matters. He now says that he wants to retain the rules on pre-existing conditions, which Mr Ryan would phase out. Having spent so long diagnosing the ills of the ACA, the Republicans must now agree on a cure.
http://www.economist.com/news/united...are-obamasnare
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I will enjoy watching the GOP now try to actually come up with ideas. I sense a lot of "transaction declined" messages when they hit the ol' GOP intellectual bank account.
I wonder how the Defendant in Chief will explain to 12 million voters why they don't have health insurance anymore.
It's not a good thing that Obama & co. made their disastrous healthcare plan so hard to repeal, but don't let that stop you from celebrating while premiums continue to skyrocket.
Last edited by RandomGuy; 11-20-2016 at 07:11 PM. Reason: nah
RG celebrating that Obamacare is such a show that it will be hard to fix.
I guess it hasn't dawned on RG yet that Obamacare is basically Obama's entire legacy, and it's a disaster. The harder it is to repeal and the longer it takes to get rid of it all, the worse the Democrats look and the harder it becomes for them to win elections.
And don't kid yourself, the fallout from Obamacare's failure will only reflect poorly on the Dems. That piece of was forced through without a single Republican vote. The GOP correctly predicted what was going to happen, and they were called "racist" and accused of "wanting to let Grandma die in the streets" by the "intellectual" left.
Ryan's plan does not "phase out" pre-existing conditions - it has always continued pre-existing conditions as long as one maintains continuous coverage (like employer-sponsored insurance does) and kids staying on parents' insurance up to 26. Here it is if you'd like to read it:THE last time President Barack Obama counted, congressional Republicans had tried to repeal parts of the Affordable Care Act (ACA), his health-care law, more than 60 times. Donald Trump’s election victory means their efforts will no longer be in vain. Yet despite Republicans’ confidence in Obamacare’s shortcomings, what exactly will happen to the law when Mr Trump takes office remains something of a mystery.
Because Republicans lack the 60 votes necessary to overcome a filibuster in the Senate, they will be unable to pass a comprehensive health-care bill without Democratic votes. Instead, they must rely on a process dubbed “budget reconciliation”, which allows a simple majority to pass tax-and-spending measures. Republicans used this process to send a law repealing parts of Obamacare to the president’s desk. Mr Obama vetoed it early this year. Next year, President Trump will probably sign it.
That will be the beginning, rather than the end, of the Republicans’ task. On its own, the reconciliation bill is best described as a wrecking effort. It would remove the subsidies currently available to poor buyers on the ACA’s insurance exchanges. It would nix the individual mandate, which fines Americans who can afford health insurance but go without it. Both moves would reduce the number of healthy people buying coverage. But a rule banning insurers from turning away those with pre-existing medical conditions would remain. As a result, premiums, already up by an average of 22% this year, would rise further, deterring yet more healthy customers. The “death spiral” that some say already afflicts the exchanges would thus accelerate.
Eventually, there would be no market left to serve those who are not covered through their employers or by other government programmes. This includes 12m people who currently buy on the exchanges, and 9m who purchase directly from insurers. As well as killing the individual market, the bill would also undo the expansion of Medicaid, government-provided insurance for the poorest, which was largely responsible for the fall in the number of uninsured Americans after the ACA was passed. Such a painful death for Obamacare would not reflect well on the executioners.
But congressional Republicans are betting that, with the individual market likely to crumble, Democrats would have no choice but to support a full replacement. The best guess as to what that might look like is a somewhat vague plan penned by Paul Ryan, Speaker of the House. This includes replacing Obamacare’s targeted subsidies for the poor with a universal tax credit increasing with age.
You might think that replacing means-tested help for poor buyers with a universal benefit would raise costs for the government. But Republicans insist that with enough deregulation, premiums will fall dramatically. For instance, the ACA forces all plans to include certain benefits, such as preventive care, and limits the extent to which insurers can vary prices with risk.
Freed from regulation, insurers are likely to design plans which appeal only to healthy buyers. Mr Ryan’s fix is to put unhealthy people into “high-risk pools” with higher premiums and big subsidies. States have tried high-risk pools in the past, notes Gary Claxton of the Kaiser Family Foundation, a think-tank. Typically, premiums were capped at 150-200% of standard rates. But because that was too expensive for many folk, only the very sickest people—say, those with HIV—bought coverage. This pushed up the average subsidy per enrollee. Mr Claxton says big subsidies concentrated on few people could sap the political will to support the pools.
Whatever Congress decides to do, it must move quickly. Few insurers will want to remain in a wobbly market with an uncertain future. Mr Trump’s changeable views complicate matters. He now says that he wants to retain the rules on pre-existing conditions, which Mr Ryan would phase out. Having spent so long diagnosing the ills of the ACA, the Republicans must now agree on a cure.
http://www.economist.com/news/united...are-obamasnare
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I wonder how the Defendant in Chief will explain to 12 million voters why they don't have health insurance anymore.
https://abetterway.speaker.gov/_asse...olicyPaper.pdf
I blame the House for not having this plan in legislative form and ready for Trump to sign on day 1 (so that people can get some relief starting in 2018). But like most, no one actually believed that Trump would win. RG, I hope that you will at least acknowledge that Obamacare is one crappy law and something must be done.
Repugs have had SIX YEARS to define their alternative to ACA, and they still don't a plan.
Ryancare will certainly drop mandatory insurance, which means insufficient revenues to pay the sick and old, which means Ryancare will fail.
Trashing ACA, like ETERNAL immigration hating, has been nothing but campaign tactic to inflame to stupid Repugs off supporters.
It's not fixable. You can't expect people not to be rational. For unhealthy people the risk adjusted price would be more than they can afford. To cover the cost of unhealthy people and keep it marginally affordable they have to spread the cost of covering unhealthy people to healthy people. Then healthy people realize insurance is not a good investment.
insurance isn't an investment
I see that BigPharma's $100M+ defeated the CA proposition to hold all BigPharma's exorbitant prices down to those of Medicare.
Of course it is an investment.You agree to pay X amount every month to cover your medical expenses no matter what happens. If you knew you weren't going to need it you would never buy it. It's an investment to balance risk.
I think Barrycare stinks, but this is a pretty bad read on the situation, tbh... now with full control of Congress, the Executive and potentially the SCOTUS, the onus will be on the GOP to defund, and potentially repeal Barrycare and replace it with "something". We'll see what that looks like and how people feel about it. It could be a plus for the GOP going forward too. I think repealing the individual mandate will be popular, but what are they going to replace that with? That's the question.
Generally speaking though, it's difficult to argue that Barrycare cost the Dems election wins. Romney pretty much ran on repeal and got bulldozed by Barry, and IIRC, Dems actually still won seats in the Senate this time around.
Romney did run on repealing it, but it wasn't believable coming from someone who forced the exact same plan on Massachusetts residents as governor.
Obamacare is RomneyCare, and even HeritageCare from the early 90s.
The main problem for the Repugs with Obamacare is that the Dems implemented a Repug program.
The ACA has been in effect for several years. Surely the GOP isn't waiting until now to build a marketable alternative.
No, Romneycare was a state wide program unlike Obamacare which was federally mandated. Big difference. Federal government wasn't mean to deal with healthcare the way states or local government are supposed to. The federal government's main job is defense/security, public safety, and infrastructure. Adding a bloated program like Obamacare takes away from more important matters for the federal government.
False distinction.
What's "more important" that people's access to health care?
"We're gonna keep MIC corporate welfare boondoggles, and keep increasing inequality through a rigged tax code, we're going to bull you about Make America Strong Again. And we're not even sorry Americans, including babies, have to suffer and die for want of health care"
I've seen a mish-mash of proposals from the House, and yet, it's hard to know whether it's in-line with Trump's thinking on the matter (or what that is).
We do know they don't need filibuster-proof majority to largely defund Barrycare, and without funding, we know it will collapse. Then comes finger-pointing, and then we'll see what follows and when...
Based strictly on economics, it actually makes much more sense it's the federal than state governments that run those programs (if you're going to have government run it at all). The discussion of a national healthcare program dates back to almost the start of the 20th century with Roosevelt, far from being a novelty, and it was LBJ (not LeBron James) that eventually got Medicare started. But what changed more dramatically throughout that time is the healthcare industry itself.
Ryan LIES that ACA has hurt Medicare, when the TRUTH is actually the opposite.
He intends to destroy both ACA and Medicare by privatizing them, with insufficient vouchers to buy for-profit insurance, which will cause citizens' costs to increase greatly, forcing people to go without health insurance.
In USA, access to health care is an expensive privilege, not a right.
Too poor to pay for the fleecing? then you suffer and die.
Don The Con will sign every Repug bill, and NOT after forcing his own changes. He won't even threaten to veto.
...or so successful, that getting rid of it will be hard to justify.
I noticed you dodged my question about Trumps conflict of interest. Why is that?
Health care and health insurance are literally life and death issues. Seems quite like what the federal government should be doing, given that the states fail utterly to do anything.
It should have gone much further. It works at getting people into health insurance, and that cuts cost shifting a lot.
I would point out that the GOP has had YEARS to think of what comes after, but NONE of them have come up with anything even remotely plausible that they could present.
What makes you think that will change?
The thing is that you never know how much healthcare you are going to need, and there are always accidents that happen to healthy people.
The risk is socialized anyway. We should just acknowledge that reality and deal with it.
LOLeftist Logic Fallacy: It is NOT OK to kill babies if we can force them into unwanted, piss-poor quality insurance to add a few more pennies into our Partner's coffers. It IS OK to kill babies SECONDS before they are delivered and it IS OK TO DEMAND OTHERS PAY FOR IT.
Love how you can use what you deem as "disposable commodities" to fit your narrative at every turn. Just turn down the hypocrisy just a notch or two so you can border on re ed instead of clinically brain dead.
Trump is going to look at what's already in writing before he sets out to reinvent the wheel. The caveat emptor is that he might want his name attached to it. That seems popular now.
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