GOP ACA Replacement Imminent....Predictions

[First]

It should restore choice by increasing the number of options an insurance co can offer. I'm in one of those areas where there is no choice. I have one sorry ass plan to choose from and that's it

I certainly could have missed it, but how does AHCA increase your insurance company options?

 

[First]

That is one ugly thing people aren't willing to address. We often spend hundreds of thousands and in some cases millions of dollars to extend life by a matter of months. Is that a smart thing to do?

Indeed. I remember having to go to the ER in Taiwan, where my wife is from (they have nationalized healthcare). And while I was there care was great, but I learned upon leaving that the gov't makes all end-of-life decisions for patients, in part to control costs I imagine. I couldn't find anything online to confirm this, but I've seen this in other single payer countries as well.

Personally I don't like the idea of anyone but family members making end-of-life decisions, because that is indeed the most important choice a person could possibly make during their life. But ultimately there has to be a balancing act, and spending millions on end-of-life for a mere few months does seem to be out of line fiscally (not morally, of course).

 

[Jhhnn]

It should restore choice by increasing the number of options an insurance co can offer. I'm in one of those areas where there is no choice. I have one sorry ass plan to choose from and that's it

We've been through that before. That's the result of Repubs refusing to provide risk corridor funds. Insurers can't figure out how to price your area so they don't.

 

[Commodus]

If this is from the same article it seems that it's more about warning Ryan not to fuck Trump up because of his own political agenda than anything else.

"If Ryan put forward a healthcare bill that can’t even pass the House or the Senate–or either chamber of Congress–then got the Trump administration’s Health and Human Services Secretary to endorse it, he could be severely hurting the credibility of the Trump administration as part of a fool’s effort to advance his own political agenda. Hurting President Trump is not a wise move for Ryan, as many reports surfaced around the time of the Nov. 8 election that there are already more than enough House Republicans who would vote for a Republican alternative to Ryan as Speaker of the House–but the only reason they called off the rebellion for the time being was because Trump won and Republicans kept majorities in both chambers of Congress. Infuriating Trump with incompetence on the healthcare system–and saddling the president with their issues, since Democrats are already inaccurately calling Ryan’s creation “TrumpCare”–may spark the rebellion again."

If that's the case, it'd be hard not to revel this in a bit, as it's basically the party's (and particularly Ryan's) chickens coming home to roost. When all you care about is more power and money for yourself, don't be surprised if that selfishness leads to infighting and wrecks everything.

And like it or not, the Reps will have to accept that the Trumpcare tag is likely to stick. Can't help but smile at that, too, because if it flounders, it taints the whole party, not just Ryan.

 

[trenchfoot]

The policy does exactly what they want it to, take health care away from poor people and lower taxes for the rich. They can't the rest of the R's to sign on because it doesn't do those things enough.

The Repubs can dance all night and day around these two very hard cold facts about what their version does, but that right there is the backbone, the two main priorities that they're going after. Anything left in this GOP plan for the working class is merely bait and salve meant to lure the unwary gullible fools into signing off on their scheme, just as Trump did with those folks who put him in office.

The GOP, in representing the interests of the very wealthy, are the primary beneficiaries of the for profit health insurance companies and health care industries. They will take care of their benefactors first and foremost before scattering whatever crumbs are left to the working stiffs of America, as the GOP is of the attitude that to keep the nation under their control they have to keep the very wealthy in control of the nation. The two are inseparable and will only survive and prosper if each keeps the other alive.

There's nothing new going on here as to whatever the Repubs do legislatively speaking, there will always be something good in the GOP's legislative agenda for the wealthy to benefit from, and it will always be derived from whatever they can whip off of the backs of the middle class and the poor in order to provide it.

 

[fskimospy]

Indeed. I remember having to go to the ER in Taiwan, where my wife is from (they have nationalized healthcare). And while I was there care was great, but I learned upon leaving that the gov't makes all end-of-life decisions for patients, in part to control costs I imagine. I couldn't find anything online to confirm this, but I've seen this in other single payer countries as well.

Personally I don't like the idea of anyone but family members making end-of-life decisions, because that is indeed the most important choice a person could possibly make during their life. But ultimately there has to be a balancing act, and spending millions on end-of-life for a mere few months does seem to be out of line fiscally (not morally, of course).

I would say it is a moral judgment either way. Those thousands or millions of dollars could be spent to save all sorts of other lives.

It is a really tough area to tread, but the whole 'death panel' thing should be real. At some point we have to draw the line as to how much the government will spend to extend your life for a few, likely suffering-filled weeks.

 

[woolfe9998]

The GOP is squeezed between their conservative and (smaller) moderate wings. I don't see how they get this passed. Moving it farther left will harden the Tea Partiers, while moving it farther right will probably cause them to lose enough votes from moderates in the Senate that it won't pass. It will also increase public blow back as millions of people lose coverage.

Healthcare reform is hard. Damn hard. And I mean politically. It's nigh impossible to please everyone. Now it's the GOP's turn. I suspect it will be even worse for them than it was for the dems, because this time we already have people benefiting from existing legislation who may lose that benefit.

However this turns out, it's a near certainty it won't turn out well for the GOP. This is a lose-lose situation for them. If only they hadn't promised to repeal so loudly and for so long. If only.

 

[Jhhnn]

And not just lower taxes for the rich a little, this will be a HUGE tax cut for the top 1%. The average American will see functionally nothing in tax cuts from its repeal.

I fully expect republicans to talk up all the taxes they are repealing despite the fact that if you make less than $250,000 a year your tax cut is probably zero.

The old tax cut shell game? Say it ain't so!

 

[agent00f]

The 30% surcharge doesn't do anything to encourage people to stay in the market if they are healthly since preexisting conditions are still covered. You are still better off not buying insurance, waiting until you get sick, then having your preexisting conditions covered while you pay a small surcharge.

As long as you are covering preexisting conditions people don't need to buy insurance until they are actually sick.

It's pretty obvious that an only 30% surcharge is complete fantasy and will be the first line cut.

With only 30% upcharge not even private employers (large enough) will buy insurance for healthier employees, since it's cheaper for them to just pay out of pocket and get any new conditions covered when they manifest.

 

[fskimospy]

The GOP is squeezed between their conservative and (smaller) moderate wings. I don't see how they get this passed. Moving it farther left will harden the Tea Partiers, while moving it farther right will probably cause them to lose enough votes from moderates in the Senate that it won't pass. It will also increase public blow back as millions of people lose coverage.

Healthcare reform is hard. Damn hard. And I mean politically. It's nigh impossible to please everyone. Now it's the GOP's turn. I suspect it will be even worse for them than it was for the dems, because this time we already have people benefiting from existing legislation who may lose that benefit.

However this turns out, it's a near certainty it won't turn out well for the GOP. This is a lose-lose situation for them. If only they hadn't promised to repeal so loudly and for so long. If only.

I guess it depends on how you look at it from their perspective. If you think their primary, almost only goal is to decrease taxes for the rich then I think what they did was effective. Demagoguing the ACA probably has helped them achieve the unified control of government that would be necessary to keep cutting taxes for the ultra rich in a time of unprecedented income inequality.

 

[woolfe9998]

The old tax cut shell game? Say it ain't so!

There was an article on CNN today about who are the "winners and losers" in this new GOP healthcare bill. I think this approach should be applied to all legislation, asking the question: who wins and who loses? There's a clear cut pattern with republican legislation, whether it is healthcare, tax reform, financial regulation, environmental protection, you name it. The winners are always the wealthy and corporations. It boggles the mind that non-wealthy conservatives don't see this. It isn't hidden at all.

 

[agent00f]

Indeed. I remember having to go to the ER in Taiwan, where my wife is from (they have nationalized healthcare). And while I was there care was great, but I learned upon leaving that the gov't makes all end-of-life decisions for patients, in part to control costs I imagine. I couldn't find anything online to confirm this, but I've seen this in other single payer countries as well.

Personally I don't like the idea of anyone but family members making end-of-life decisions, because that is indeed the most important choice a person could possibly make during their life. But ultimately there has to be a balancing act, and spending millions on end-of-life for a mere few months does seem to be out of line fiscally (not morally, of course).

These decisions are the same as in all other areas of life, for example the cops aren't going to go out of their way to specifically protect your family to the detriment of all their other duties, nor your manager in your particular employment affairs.

The government responsibility is setting some reasonable and realistic baseline of care, not ensure everyone gets what they want.

 

[woolfe9998]

I guess it depends on how you look at it from their perspective. If you think their primary, almost only goal is to decrease taxes for the rich then I think what they did was effective. Demagoguing the ACA probably has helped them achieve the unified control of government that would be necessary to keep cutting taxes for the ultra rich in a time of unprecedented income inequality.

Possibly, but this healthcare thing might just end up being their "Waterloo" in the end. They own healthcare reform now, and the political fallout from it is going to be bad. There is almost no way it could be otherwise. They either won't be able to get anything passed, or whatever they pass will alienate a large bloc of voters, possibly even some of their own base. They have enough problems being tied to Trump without adding the morass of politically impossible healthcare reform to it.

Tax laws can be changed when power tilts to the other side. Dems are powerless for the moment which means they also aren't responsible for the sludge that is emanating from Congress and the White House right now. Time to break out the popcorn and enjoy the view as the GOP self-destructs.

 

[First]

I would say it is a moral judgment either way. Those thousands or millions of dollars could be spent to save all sorts of other lives.

Well yeah, that assumes the thousands/millions couldn't otherwise but added to the debt.

It is a really tough area to tread, but the whole 'death panel' thing should be real. At some point we have to draw the line as to how much the government will spend to extend your life for a few, likely suffering-filled weeks.

Yup.

 

[ch33zw1z]

It should restore choice by increasing the number of options an insurance co can offer. I'm in one of those areas where there is no choice. I have one sorry ass plan to choose from and that's it

This again? You have the choice to not enroll. You're self employed, correct? Shop around, there's other companies that will insure you. Or maybe you did, and ACA is still your cheapest option?

 

[Ns1]

It is a really tough area to tread, but the whole 'death panel' thing should be real. At some point we have to draw the line as to how much the government will spend to extend your life for a few, likely suffering-filled weeks.

assisted suicide, abortion, marijuana = bad
death panels = good

 

[fskimospy]

assisted suicide, abortion, marijuana = bad
death panels = good

I actually think all of those things are good.

 

[Ns1]

I actually think all of those things are good.

Unfortunately you are not attorney general.

 

[fskimospy]

Possibly, but this healthcare thing might just end up being their "Waterloo" in the end. They own healthcare reform now, and the political fallout from it is going to be bad. There is almost no way it could be otherwise. They either won't be able to get anything passed, or whatever they pass will alienate a large bloc of voters, possibly even some of their own base. They have enough problems being tied to Trump without adding the morass of politically impossible healthcare reform to it.

Tax laws can be changed when power tilts to the other side. Dems are powerless for the moment which means they also aren't responsible for the sludge that is emanating from Congress and the White House right now. Time to break out the popcorn and enjoy the view as the GOP self-destructs.

You never do know. I agree that tax changes are among the least permanent changes that can happen so maybe their plan is short-sighted.

As far as who is alienated it seems to be more of a question of what base is more enraged.

 

[First]

These decisions are the same as in all other areas of life, for example the cops aren't going to go out of their way to specifically protect your family to the detriment of all their other duties, nor your manager in your particular employment affairs.

The government responsibility is setting some reasonable and realistic baseline of care, not ensure everyone gets what they want.

Yeah, except end-of-life decisions are pretty subjective, and gov't making the ultimate decision there is one choice most people don't want to give up (and I don't blame them).

 

[First]

http://www.cnbc.com/2017/03/07/repu...ement-hike-health-premiums-by-30-percent.html

The leading Republican plan to replace Obamacare could cause health plan premiums to rise by 30 percent or more in 2018 — and even higher in future years, an insurance company CEO said Tuesday.

J. Mario Molina also warned in a Wall Street Journal interview that enrollment in Obamacare plans could decrease by 75 percent or more, with the remaining customers being sicker overall

"You're going to see big rate increases, and you're going to see insurers exit markets," the chief executive of Molina Healthcare told the Journal.

"This is going to destabilize the marketplace," said Molina, whose company sells Obamacare plans in nine states.

Molina says the big rate hikes next year would come as a result of the GOP plan to kill the Obamacare mandate that requires most people to have some form of health coverage or pay a tax penalty.

That move would lead to many healthy people deciding not to buy insurance.

Bigger rate hikes, Molina said, would come in future years, once the Republican plan's tax credits take effect.

Not that this wasn't somewhat obvious. Of course to be fair this isn't a final bill, but the fact that this draft is the best they've come up with after 7 years....boy, you gotta be disappointed if you're a true red conservative. Though it isn't like pretty much everyone sober saw this coming. GOP has no credibility on healthcare, basically they were bluffing. Like with Trump, some people are just really, really easily conned.

 

[Jhhnn]

The GOP is squeezed between their conservative and (smaller) moderate wings. I don't see how they get this passed. Moving it farther left will harden the Tea Partiers, while moving it farther right will probably cause them to lose enough votes from moderates in the Senate that it won't pass. It will also increase public blow back as millions of people lose coverage.

Healthcare reform is hard. Damn hard. And I mean politically. It's nigh impossible to please everyone. Now it's the GOP's turn. I suspect it will be even worse for them than it was for the dems, because this time we already have people benefiting from existing legislation who may lose that benefit.

However this turns out, it's a near certainty it won't turn out well for the GOP. This is a lose-lose situation for them. If only they hadn't promised to repeal so loudly and for so long. If only.

They're squeezed between ruthless, radical right, don't give a fuck mega rich backers & a delusional base. They've made a lot of promises that are fundamentally contradictory.

They can't deliver to their donors & the American people at the same time because somebody has to pay for it, one way or another, and a lot of American families can't do that w/o taxation & redistribution. Mere fact. OTOH, their donors won't be happy until only the little people pay taxes.

This is where they have to show that their basic trickle down free market pamper the Rich ideology is incompatible with the welfare of the People.

 

[First]

So based on the initial, predictable reaction, only two scenarios I can envision.

1. They don't pass repeal or replace. Disaster ensues for Repubs politically from there.
2. Somehow they pass repeal & replace, and Trump signs it like a fool with both the GOP and Trump blaming the ensuing insurance market disaster on Obama/Dems.

As of now, I still see #1 as the most likely outcome. I just don't see them agreeing on anything, you've got too many Freedom Caucus kooks who don't want gov't to do almost anything to solve everyday problems because it's "intrusive". So only way #2 happens is if they repeal ACA now and then delay the replacement many years out, which Trump ruled out weeks ago but maybe they'll revisit out of desperation given that Trump contradicts himself on an almost daily basis. Trump'll need to backtrack in a major way if they have any hope of "replacing" ACA.

 

[agent00f]

Yeah, except end-of-life decisions are pretty subjective, and gov't making the ultimate decision there is one choice most people don't want to give up (and I don't blame them).

Not really that subjective to doctors who evaluate it for a living, and in any case less subjective than not as medically informed insurance reviews.

Healthcare like most resources is not an unlimited one, and in such cases resource allocation is necessary and it's the role of enlightened people to understand this so as to do it in the most sound manner.

 

[VRAMdemon]

It seems it's hard for them to just realize or accept that for people who really need help the most, giving it to them in the way of 'tax credits' and 'health savings accounts' are useless. Most poor\low income people are not going to magically have the money to pay for insurance premiums each month just because they know they will get a (small) credit once a year. Many don't even have a regular savings accounts, let alone one dedicated to health care. Their ideology leads them to believe this is better left to the states, that as much money should go directly to insurers as possible, and then the faults and short-sightedness will eventually kill the program. Their overriding concern is that Washington DC has no involvement at all. Tax credits, accounts, choice are all code words for eviscerating a government program. My favorite part is the 30% surcharge that will go directly into insurer's pockets for a year if you go two months without coverage. But I do understand the problem of healthy people not participating until they get sick. The Obamacare solution is the mandate, and that mandate was too weak resulting in premium increases.

Their proposals will lead to people opting to avoid the individual market because it is too expensive to participate. This effectively returns this aspect of the law to pre-ACA days. In the meantime, for the suckers who try to participate, the 30% surcharge they pay for the bottom of the barrel insurance they can afford will go straight to insurer's profits. They will eventually cancel their insurance when they realize it doesn't do anything for them. They are ideologically opposed to ACA, but that won't stop them from crafting legislation that simultaneously kills it and allows their backers to profit from it off the backs of the poor.

I would like universal Medicare, but there is something really odd going on with how expensive American healthcare is and I would like to see honest efforts to get the costs under control. I hate to say it but I seem to remember reading an article about the Medicaid block grants. I think they were implemented in Maryland, if I remember correctly, and it seems to have been successful in reducing costs.