Obamacare on Life Support article

[Perspective]

No vote will be held on ACA "repeal." Postmortem time...

 

[peppy]

No vote will be held on ACA "repeal." Postmortem time...

Intrigued about the twitter rant on this one

 

[Perspective]

Trump isn't toning down the rhetoric after this "repeal" failure. He's now using the phrase, "ObamaCare will explode," whatever that means. He actually said, "ObamaCare is imploding, and it's going to explode."  ???

He's blaming the Democrats for not supporting this bill. Nice. Shame on Democrats!

Also, as predicted, he's saying there are parts of the bill he didn't like. Oh, you mean the parts of this bill that break all of your promises on healthcare? Those parts?

 

[nosuchreality]

Trump isn't toning down the rhetoric after this "repeal" failure. He's now using the phrase, "ObamaCare will explode," whatever that means. He actually said, "ObamaCare is imploding, and it's going to explode."  ???

He's also blaming the Democrats for not supporting this bill. Nice. High character dude.

Reporters, if any real one are allowed in, need to pull their pant up and stick him with a simple question of what amendments did they offer to get Democrats on board?

 

[Liar Loan]

Once again, if it so so horrible, catastrophic, and collapsing, why isn't this bill a simple repeal bill that has been promised for years?

The simple answer is because they need something that can pass the senate with 51 votes and an outright repeal would require 60 votes.  Their only option is to repeal using budget reconciliation which doesn't allow repeal of the text of the law, only the funding mechanisms.

A bill very similar to the current one already passed both the House and Senate a couple years back, but Obama vetoed it.  The Freedom Caucus had no serious objections back then, but this time they want all of their demands met.  The problem is a lot of what they are demanding is unreasonable because it has no chance of getting passed in the Senate.  Apparently, the average Tea Partier doesn't get this concept.

 

[Perspective]

Once again, if it so so horrible, catastrophic, and collapsing, why isn't this bill a simple repeal bill that has been promised for years?

The simple answer is because they need something that can pass the senate with 51 votes and an outright repeal would require 60 votes.  Their only option is to repeal using budget reconciliation which doesn't allow repeal of the text of the law, only the funding mechanisms.

A bill very similar to the current one already passed both the House and Senate a couple years back, but Obama vetoed it.  The Freedom Caucus had no serious objections back then, but this time they want all of their demands met.  The problem is a lot of what they are demanding is unreasonable because it has no chance of getting passed in the Senate.  Apparently, the average Tea Partier doesn't get this concept.

Understood, but this is the problem when you use hysteric hyperbole for years, Trump and most Republicans, regarding ACA, and promise a "repeal." Most Republicans have no desire to repeal the ACA, because there are many features of it they, and most folks, like. So why use the term? Now they're stuck with it. They failed to repeal it. Broken promise.

 

[Perspective]

Donald Trump played a game of chicken with House Republicans. Then he blinked.
Bigly.https://www.washingtonpost.com/news/the-fix/wp/2017/03/24/donald-trump-played-a-game-of-chicken-with-house-republicans-then-he-blinked/?tid=hybrid_collaborative_1_na&utm_term=.65c6bba187cf

 

[Perspective]

To tie a bow on this and move on, Trump repeatedly promised completely contradictory things regarding healthcare. He promised to repeal ObamaCare, which would result in fewer folks covered by healthcare insurance. He also promised everyone would get healthcare and it would be better healthcare insurance. This makes no sense, like much of Trump's rhetoric. He promised the impossible, and failed to deliver. No surprise here.

 

[Liar Loan]

The number one negotiating technique is being willing to walk away.  This always gives you the most leverage against the party that needs a deal to happen.  I think he's smart to call it off quickly instead of drag out negotiation with the Freedom Caucus.  Let them own the consequences of this and maybe they will come back to the table.  If not, Trump has already signaled his willingness to work with Democrats to repair Obamacare.  I think either way there's a good chance that something gets passed on healthcare before Trump's term is up.

As far as being boxed in by rhetoric, that's not a problem for Trump.  His entire style is premised on exaggeration and the use of illustrative language.  Most reasonable observers get that.

 

[nosuchreality]

The number one negotiating technique is being willing to walk away.  This always gives you the most leverage against the party that needs a deal to happen.  I think he's smart to call it off quickly instead of drag out negotiation with the Freedom Caucus.  Let them own the consequences of this and maybe they will come back to the table.  If not, Trump has already signaled his willingness to work with Democrats to repair Obamacare.  I think either way there's a good chance that something gets passed on healthcare before Trump's term is up.

As far as being boxed in by rhetoric, that's not a problem for Trump.  His entire style is premised on exaggeration and the use of illustrative language.  Most reasonable observers get that.

Yes, most reasonable observers recognize him as a blowhard.  Even the diehards are figuring it out.

Too bad all his positions are just blow.

 

[riznick]

Understood, but this is the problem when you use hysteric hyperbole for years, Trump and most Republicans, regarding ACA, and promise a "repeal." Most Republicans have no desire to repeal the ACA, because there are many features of it they, and most folks, like. So why use the term? Now they're stuck with it. They failed to repeal it. Broken promise.

I don't know or think that it is that they necessarily "like" them.  They are now put into a shit position where none of the choices are appealing but some are better than others.  The reality is that Obamacare changed too much and there's no going back without hitting the economy really hard.  It's become an entitlement that people depend on.  People who didn't get subsidies before, now do, and they have adjusted their lives to accommodate for that extra spending money.

Too many people have made adjustments to accommodate for and now require the ACA.  IMO, the only way to repeal Obamacare in a way that benefits most people in both parties is via Universal Health Care.  Republicans will refuse to admit that, though.

My opinions:
- I'd like to see all the employer mandates go away.  Employers should not be forced to pay for this. 
- If healthcare is mandatory, then it should be treated as a tax.
- I'd like to see Universal Healthcare put into place for at least certain critical things.

 

[Perspective]

Understood, but this is the problem when you use hysteric hyperbole for years, Trump and most Republicans, regarding ACA, and promise a "repeal." Most Republicans have no desire to repeal the ACA, because there are many features of it they, and most folks, like. So why use the term? Now they're stuck with it. They failed to repeal it. Broken promise.

I don't know or think that it is that they necessarily "like" them.  They are now put into a shit position where none of the choices are appealing but some are better than others.  The reality is that Obamacare changed too much and there's no going back without hitting the economy really hard.  It's become an entitlement that people depend on.  People who didn't get subsidies before, now do, and they have adjusted their lives to accommodate for that extra spending money.

Too many people have made adjustments to accommodate for and now require the ACA.  IMO, the only way to repeal Obamacare in a way that benefits most people in both parties is via Universal Health Care.  Republicans will refuse to admit that, though.

My opinions:
- I'd like to see all the employer mandates go away.  Employers should not be forced to pay for this. 
- If healthcare is mandatory, then it should be treated as a tax.
- I'd like to see Universal Healthcare put into place for at least certain critical things.

I was referring to favorable polling regarding many of the popular features of ACA: elimination of the ability to deny coverage to folks with pre-existing conditions, requiring insurers to allow kids remain on their parents' health insurance until 26, elimination of coverage caps, requiring certain basic coverage in every plan, and even Medicaid expansion.

These features cost, and most folks hate paying for this, like anything else. It's easy to formulate a much better plan, but that doesn't mean the better plan can get through any Congress. I thought Obama's effort to solely require "rich" households making $250K+ pay for the associated ACA "taxes" was really bad policy. If we're going to expand Medicaid, then why not increase the 1.45%/1.45% Medicare Tax a point or two? But that would've broken one of his campaign promises.

I?m glad ACA repeal failed, but I?m angry about it too
Republicans won three elections on an argument they never took seriously.http://www.vox.com/polyarchy/2017/3/24/15055636/aca-repeal-angry?yptr=yahoo

 

[nosuchreality]

Too many people have made adjustments to accommodate for and now require the ACA.  IMO, the only way to repeal Obamacare in a way that benefits most people in both parties is via Universal Health Care.  Republicans will refuse to admit that, though.

My opinions:
- I'd like to see all the employer mandates go away.  Employers should not be forced to pay for this. 
- If healthcare is mandatory, then it should be treated as a tax.
- I'd like to see Universal Healthcare put into place for at least certain critical things.

The employer mandate going away is a necessary step to a single payer system.  Good employers have been shielding their employees from the ravages of the insurance system for decades.  IMO, the insurance system has created the insanely expensive treatment costs in the USA.

Remove the employer mandate and restrictions and you'll see small employers 50-500 people drop coverage or shift to much larger employee contributions.  Large employers will continue to provide coverage but shift towards HDHP plans and ever increasing employee shares.

The problem is the Republican party really isn't a party any more, it isn't unified, it's really become a coalition of "not democrats".  Thus any Republican Rep may be an anti-tax Rep, small government Rep, hardcore religious Rep, non-interference Rep and so on, depending on how their district is carved out.  They'll sing the tune of a bunch of those, but they're primarily just one.

Plus there's that whole, Obama did it, it must be bad,  Trump is doing it, it must be bad mindset in very vocal subset of both parties that doesn't have any more rational thought to it than a sports team rivalry, IMO.

 

[riznick]

I was referring to favorable polling regarding many of the popular features of ACA: elimination of the ability to deny coverage to folks with pre-existing conditions, requiring insurers to allow kids remain on their parents' health insurance until 26, elimination of coverage caps, requiring certain basic coverage in every plan, and even Medicaid expansion.

- Elimination of coverage caps - Yes that's something everyone can get behind for most plans.
- Kids remain until 26 is and has been a meh issue.  I don't think people care much either way.  People for the most part still have to pay for it, or their employer has to pay for it.  Obamacare has substantially driven the cost of covering kids up, though. 
- Requiring certain basic coverage in every plan is meh and for the most part crap that adds to the costs that most people didn't want.
- Elimination of the ability to deny coverage for pre-existing conditions is a complicated matter.  This is kind of a NIMBY type of thing.  Most reasonable people can agree that people with pre-existing conditions need options for coverage.  People in insurance pools don't want to add those people to their pools.  I think sould would prefer that there be a more expensive pool for high risk people with pre-existing conditions who didn't get into a low risk pool before their condition appeared.

 

[Perspective]

Questions remaining after this "repeal" effort failure:

1) Will Republicans continue to vilify ACA for every healthcare ill toward electoral success in 2018 and 2020?

2) Will the Trump administration sabotage the individual healthcare exchanges (not enforce the mandate tax, encourage providers to drop-out of the exchanges, etc.)?

3) Could Trump possibly surprise everyone, joining Democrats and moderate Republicans to improve the individual healthcare exchanges?

 

[Perspective]

Trumpcare Exposed the Cruel Apathy of the Republican Partyhttp://www.gq.com/story/trumpcare-exposed-gop-cruelty

I'm genuinely flabbergasted. If things like prescription medicines and preventative care aren't covered, what the fuck is even left to insure anymore? Stop for a minute and think about how ludicrous it is that this gaggle of Ayn Rand-humping rubes were unwilling to support an outrageously irresponsible, universally-loathed health care proposal that would kill people unless they could put their heads to gather and find ingenious ways to ensure that it would kill more people. The Freedom Caucus' insane wish list wouldn't "reform" health care in America. It would destroy it.

The only person not named Donald Trump who comes out of this looking worse than Mark Meadows and his cronies is Paul Ryan, whose astonishing willingness to really consider their demands in a craven attempt to buy votes once again proved that his "repeal and replace" crusade was never about improving health outcomes or promoting "free markets" or finding a #BetterWay. It was about destroying anything and everything remotely related to President Obama, who spent eight years as the primary target of obsessive Republican teeth-gnashing vitriol, regardless of the implications that doing so would have for the lives of their spouses, their children, their families, and the millions of constituents whose interests they so despicably profess to represent.

 

[riznick]

If things like prescription medicines and preventative care aren't covered, what the fuck is even left to insure anymore?

The #1 reason we need insurance is for the very expensive stuff, IMO. 

I would think you would understand that. 

 

[Perspective]

Donald Trump has not faced a challenge like fixing American health care before
No sales pitch can get around the fact that people either do or do not have health insurance
http://www.economist.com/news/unite...d-fact-people-either-do-or-do-not-have-health

Mar 16th 2017

ASK Washington grandees to explain President Donald Trump?s rise, and they often recommend reading ?The Art of the Deal?. One piece of advice from that I-got-rich-quick book, published in 1987, is cited more than any other: Mr Trump?s boast that he built a property empire on ?truthful hyperbole?, playing on the public?s desire ?to believe that something is the biggest and the greatest and the most spectacular?. It is a striking passage to choose, but also a misleading one?implying that Trumpian success, in essence, rests on a talent for bamboozling rubes.

Actually, at the heart of ?The Art of the Deal? lies a more subtle point about human nature: that some of the most profitable bargains are struck not with passive dupes, but with partners who are complicit in their own manipulation. A revealing episode describes Mr Trump tricking investors into thinking that a casino in Atlantic City is almost half-built by cramming the site with bulldozers under orders to look busy. Despite an awkward moment when an investor asks why one builder is refilling a hole that he has just dug, the gambit works. The investors had already been burned once by a project that ran over-budget so now needed a quick success, Mr Trump explains: ?My leverage came from confirming an impression they were already predisposed to believe.?

That variety of leverage has been key to Mr Trump?s success, in business and now in politics. He is an unusual sort of tycoon. He has no life-changing invention to his name. He did not build a globally significant corporation (worth about $4bn, the Trump Organisation would be America?s 833rd-largest firm if it were listed). Instead he turned himself into a brand. He is a salesman whose greatest product is himself, slapping his name on everything from skyscrapers to hotels, casinos, golf courses or the series of high-priced, hard-sell property seminars dubbed Trump University. He boasts of how many deals involve other people?s money, whether that involves picking up distressed assets for a song or luring gamblers to his casinos??I?ve never gambled in my life,? he bragged back in 1987, adding: ?I prefer to own slot machines. It?s a very good business being the house.?

Mr Trump?s business model offers him an unusual advantage. Whenever customers buy into his brand, they have a vested interest in his continued success. When buyers complain about corner-cutting in the construction of a Trump-branded apartment complex (?value engineering?, he calls such penny-pinching in ?The Art of the Deal?), they harm the value of their own asset. Unhappy students of Trump University extracted $25m from the businessman, as he settled class-action lawsuits without admitting wrongdoing. Their satisfaction was hard-won: the world now knows their ?qualifications? are worthless.

Mr Trump has worked to forge similar bonds of complicity with voters. His pledges to put America First, to deport ?criminal aliens? or to bring back millions of manufacturing jobs make supporters feel empowered, heeded, safe and hopeful. Critics question such pledges at their peril: millions of Americans have invested a good deal in believing this president.

So much for Mr Trump?s success. Now, not two months into his presidency, he faces the hardest test of his political life to date, as he and Republicans in Congress wrangle over how to repeal and replace the Obamacare health law, more formally known as the Affordable Care Act (ACA).

On the campaign trail Mr Trump pledged to abolish what he called the ?disaster? that is the ACA, and to ?come up with a new plan that?s going to be better health care for more people at a lesser cost.? He promised to scrap things that the public dislikes about Obamacare, starting with its government mandate to buy health insurance or pay a penalty, while keeping things that are popular, such as protections for people with pre-existing conditions.

As a candidate Mr Trump proudly broke with Republican orthodoxy and said that?unlike other rival conservatives with White House ambitions?he would preserve ?without cuts? the Medicare and Social Security safety-nets that mostly serve the elderly, as well as the Medicaid system of health insurance for the poor and disabled. The ACA offered federal funding to states that agreed to expand Medicaid, adding 12m people to its rolls.

Repeal, replace and reap what follows

On March 13th the Congressional Budget Office (CBO), which ?scores? new laws for probable costs and impacts, concluded that under an ACA replacement proposed by House Republicans, 14m more Americans will be uninsured in 2018 compared with current law, while by 2026 the ranks of those without health cover will swell by 24m as Medicaid is cut back. This will hit some core Trump supporters: the CBO estimates that while the young would gain from the Republican plan, those in their early 60s on low incomes, as well as rural folk, would see costs rocket.

Republican responses have been cacophonous. Party leaders like Paul Ryan, the Speaker of the House of Representatives, defend the new health plan for cutting spending and call the cover offered by Medicaid so skimpy as to be worthless. Conservative House members call the new plan Obamacare-lite, saying its system of tax credits is too generous. Some Senate Republicans, especially those from states which expanded Medicaid, call the new plan too harsh. White House aides have rubbished the CBO and promise that Mr Trump?s dealmaking skills will save the day.

But even for Americans predisposed to believe that Mr Trump is their champion and that his critics are lying, the question of whether they can or cannot afford health insurance is starkly binary. Being unable to buy treatment for a loved one is not empowering, it is frightening. Health care is an area in which voters have little incentive to forgive broken promises: even if their first instinct may be to blame those around the president, not Mr Trump. The president is in perilous territory. He needs a product that does an almost impossible job. Sales patter will not do.

 

[morekaos]

I've said this for years. This was a planned disaster, designed to fail so implementation of single payer becomes the only option....check mate

Like I said a year and  half ago and like I said the day it was enacted.  Gotta give em props.

 

[nosuchreality]

I've said this for years. This was a planned disaster, designed to fail so implementation of single payer becomes the only option....check mate

Like I said a year and  half ago and like I said the day it was enacted.  Gotta give em props.

Left on it's own, the prior system would have collapsed too.  Employers were losing the premium fight and people not covered by an employer plan were increasingly SOOL.