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Arglebargle III
Feb 21, 2006

The upper Midwest and mid Atlantic states are enough to flip all three branches don't be defeatist.

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Reik
Mar 8, 2004

Mr. Nice! posted:

Insurance is going to get dirt cheap for a few people because they'll have garbage plans that don't cover anything. Insurance is just going to go away for a massive chunk of americans because the cost is unreasonably high. The current republicans do not loving care because they're giving themselves/donors a trillion dollars right now and another trillion down the road. They don't give a gently caress about getting brought back in. A couple of trillion dollars lubricates enough pockets that they could lose the house and it not matter. All of this money is just going to fund replacements and without massive nationwide change there's nothing that can really be done to stop it.

If you are at 350% or below the FPL you'll be fine, since the premium you pay for a QHP will be fixed according to your income. If you're healthy you'll be fine since insurance companies will start selling non-QHP underwritten policies as there's no real reason to buy a QHP plan if you're healthy because the amount you can save by going through underwriting will probably be more than your subsidy. If you're not healthy though and you make 351% or more of the FPL you just die.

The Phlegmatist
Nov 24, 2003

Defenestration posted:

They'll say all the healthcare problems people face are Obamacare. AHCA just tried to help

The BCRA is literally designed to kill Medicaid. Changing the growth in federal funding provided to states for Medicaid from CPI-M to CPI-U (hint: one of these grows steadily between 2-5% every year and the other is usually under 1% and even is sometimes negative during a recession) will force states to share more of the cost burden of Medicaid. But states like WV (30% of families are on Medicaid, federal govt. pays around 75% of the cost of the program currently) are not going to magic up enough money to keep Medicaid going at the current rate, so people are going to get kicked off. The other thing is that over half of the individuals on Medicaid in WV are children.

But Obama didn't invent Medicaid. These cuts are much worse than simply rolling back ACA's Medicaid expansion. You can't defend gutting Medicaid with "well Obamacare screwed up the insurance system too badly, we tried but it failed, oh well." This doesn't even have to be an Obamacare issue. Kids are going to die so rich people could get their tax cuts.

Azhais
Feb 5, 2007
Switchblade Switcharoo

Mr. Nice! posted:

I'm talking about the vast empty swaths of this country that are majority republican. There are not enough people in the area refusing to vote to outweigh their influence. They have an effective stranglehold on the nation. Getting another million bums in new york to tally up D isn't going to matter in Montana where the majority of the populace is voting republican anyways.


Ideally, yes, you do get people off the loving couch and at the polls. That's not enough, though.

Montana has like 9 people living in it so that's a bad example. We only had 58% voter turnout in 2016. That other 42% could make a difference if they wanted to (by voting Republican)

Lemming
Apr 21, 2008

Reik posted:

If you are at 350% or below the FPL you'll be fine, since the premium you pay for a QHP will be fixed according to your income. If you're healthy you'll be fine since insurance companies will start selling non-QHP underwritten policies as there's no real reason to buy a QHP plan if you're healthy because the amount you can save by going through underwriting will probably be more than your subsidy. If you're not healthy though and you make 351% or more of the FPL you just die.

Only if you're in a not poo poo state, since Medicaid will be turned into block grants and will be raided to pay for tax cuts in every red state

Zil
Jun 4, 2011

Satanically Summoned Citrus


Lemming posted:

Only if you're in a not poo poo state, since Medicaid will be turned into block grants and will be raided to pay for tax cuts in every red state

I look forward to the race to the bottom of who has the most uninsured as a percentage of their population. I mean Texas is already there by sheer numbers, but maybe some of the other GOP states want to really stick it to the poors

Zil fucked around with this message at 19:01 on Jun 23, 2017

B B
Dec 1, 2005

Arglebargle III posted:

The upper Midwest and mid Atlantic states are enough to flip all three branches don't be defeatist.

show your map (sorry)

Hollismason
Jun 30, 2007
FEEL FREE TO DISREGARD THIS POST

It is guaranteed to be lazy, ignorant, and/or uninformed.
I'd said this before but I think Kansas will be the first to destroy it's Medicaid system. I actually think I got it figured out. What will happen is they'll gut Medicaid then have like 2 to 3 "charity" hospitals where everyone has to go if they don't have health insurance.


Basically, bring back the Charity Hospital system of the 80s

Reik
Mar 8, 2004

Lemming posted:

Only if you're in a not poo poo state, since Medicaid will be turned into block grants and will be raided to pay for tax cuts in every red state

That's true, so it should be if you're above medicaid but below 350% you will be able to buy a plan based on income. That is assuming the insurance companies don't just abandon the exchanges entirely because I've tried to price ACA policies with the mandate and that was hard enough. Pricing them without a mandate would be pretty much impossible.

empty whippet box
Jun 9, 2004

by Fluffdaddy

Mr. Nice! posted:

I'm talking about the vast empty swaths of this country that are majority republican. There are not enough people in the area refusing to vote to outweigh their influence. They have an effective stranglehold on the nation. Getting another million bums in new york to tally up D isn't going to matter in Montana where the majority of the populace is voting republican anyways.


Ideally, yes, you do get people off the loving couch and at the polls. That's not enough, though.

A lot of people, including myself, would love to be off the couch but we also simply can't because we don't have the money required to "get off the couch" and instead must focus on surviving month to month.

evilweasel
Aug 24, 2002

Hollismason posted:

I'd said this before but I think Kansas will be the first to destroy it's Medicaid system. I actually think I got it figured out. What will happen is they'll gut Medicaid then have like 2 to 3 "charity" hospitals where everyone has to go if they don't have health insurance.


Basically, bring back the Charity Hospital system of the 80s

I figure Kansas has had enough of True Conservatism for a little while, actually. They're not sticking their dick back in that electrical socket for at least a year. That should be enough time to forget how completely Brownbeck wrecked their state.

No Butt Stuff
Jun 10, 2004

evilweasel posted:

I figure Kansas has had enough of True Conservatism for a little while, actually. They're not sticking their dick back in that electrical socket for at least a year. That should be enough time to forget how completely Brownbeck wrecked their state.

The only way Kansas figured out how hosed up it is involves health insurance ceasing to cover all the Xanax that every JoCo housewife and househusband are tanked to the loving gills on.

Rad Valtar
May 31, 2011

Someday coach Im going to throw for 6 TDs in the Super Bowl.

Sit your ass down Steve.
I figure Michigan will figure a way to destroy their Medicaid system since Flint STILL doesn't have clean drinking water. At least we are indicting members of government.

Zikan
Feb 29, 2004

https://twitter.com/BraddJaffy/status/878325236294336512

someone really really wants a hall pass

Reik
Mar 8, 2004
If anyone needs a one page summary of the bill for friends/family whatnot this one is pretty succinct:

https://cv.actuary.org/members/alerts/pdf/2017/2017-H-15.pdf

evilweasel
Aug 24, 2002


You should be less worried about a "hall pass" and more worried that "in its current form" actually means "I want to be one of the people credited with an amendment that makes it a tiny bit less mean." They don't really have hall passes to give out: Paul is thought to be a guaranteed no, and Murkowski is relatively independent (though she could be bought off with an Alaska-only bribe). Lee is also pretty freedom-caucsy (so much so he finds ted cruz's presence physically tolerable). What's at risk in the Senate is less division of hall passes and more cooperation about getting an amendment to justify your vote.

However Heller really seems to have gone overboard with the honesty if he's planning on coming back into the fold:

quote:

Heller laid out a laundry list of concerns with the Senate version of the bill, including concerns that rolling back Medicaid eligibility would eventually leave a nearly half-billion dollar hole in the state budget, and wouldn’t do anything to lower premiums. He said revisions that would make him more comfortable with the bill were unlikely to move forward given that conservative factions in the Senate demanding the bill go even further in rolling back the federal insurance law.

“It’s going to be very difficult to get me to a yes,” Heller said.

Nevada's governor also slammed it:

quote:

Sandoval — who has long held concerns about federal efforts to roll back Medicaid eligibility — said the Senate version of the bill would require the state to find approximately $480 million to continue existing levels of coverage, which he said the state “cannot sustain.” The Republican governor said he felt that he had made a “personal commitment” to the newly eligible population, and promised to continue to fight for continuing insurance coverage.

“These are the people that I’ve talked about, these are the people I have fought for in the last three years,” he said. “Nevada is in a much better place that it was six years ago, four years ago, even two years ago. And I want to keep that momentum going because your health is the base of everything.”

https://thenevadaindependent.com/article/considered-key-swing-vote-heller-comes-out-against-senate-healthcare-overhaul-bill/

PerniciousKnid
Sep 13, 2006

Reik posted:

If anyone needs a one page summary of the bill for friends/family whatnot this one is pretty succinct:

https://cv.actuary.org/members/alerts/pdf/2017/2017-H-15.pdf

I think it's unfortunate it doesn't explain what the short and long term funds are or what the impact would be.

farraday
Jan 10, 2007

Lower those eyebrows, young man. And the other one.

evilweasel posted:

You should be less worried about a "hall pass" and more worried that "in its current form" actually means "I want to be one of the people credited with an amendment that makes it a tiny bit less mean." They don't really have hall passes to give out: Paul is thought to be a guaranteed no, and Murkowski is relatively independent (though she could be bought off with an Alaska-only bribe). Lee is also pretty freedom-caucsy (so much so he finds ted cruz's presence physically tolerable). What's at risk in the Senate is less division of hall passes and more cooperation about getting an amendment to justify your vote.

However Heller really seems to have gone overboard with the honesty if he's planning on coming back into the fold:

I think "In its current form" is more the generic phrasing being used for opposition regardless of your stance while you wait to figure out how many Senators are actually opposed or looking for hand/carve outs. To me the obvious difference is the immediate claim of a 7 figure ad buy against Heller by a conservative pro-administration group. That says to me they are more worried that his 'not in its current form' is more than a negotiating position.

Azhais
Feb 5, 2007
Switchblade Switcharoo

PerniciousKnid posted:

I think it's unfortunate it doesn't explain what the short and long term funds are or what the impact would be.

Yeah, that's a literal "what it does" not "why it's probably bad". Showing that to your average anti-obamacarer would probably end up with them feeling better about the bill "That's exactly what they said they'd do!"

evilweasel
Aug 24, 2002

farraday posted:

I think "In its current form" is more the generic phrasing being used for opposition regardless of your stance while you wait to figure out how many Senators are actually opposed or looking for hand/carve outs. To me the obvious difference is the immediate claim of a 7 figure ad buy against Heller by a conservative pro-administration group. That says to me they are more worried that his 'not in its current form' is more than a negotiating position.

Yeah, that sounds like he told the White House he's not getting to Yes, and they're unleashing the dogs to try to scare anyone else wobbly back into line. I gotta hand it to Ralston, he was saying yesterday that Heller was a clear no and I didn't quite believe him. Guy clearly knows his Nevada poo poo.

The Phlegmatist
Nov 24, 2003
There's already AK-friendly regulations in the bill, at least on the Medicaid cut side. AK/WY/ND/SD/MT are protected from the overspend penalty, where HHS reduces your funding if your Medicaid spending is 25% over the national average.

Students of basic math would be quick to note that the overspend penalty being based on a national average means it's a gently caress you to blue states actually spending money on Medicaid.

With Heller taking a strong stance against BCRA and Pence's PAC apparently loving raising money to spend on negative ads against him I think he's actually gone rogue.

Shimrra Jamaane
Aug 10, 2007

Obscure to all except those well-versed in Yuuzhan Vong lore.
EvilWeasel, based on the assumption that Heller is a No what do you figure are the chances this won't have the votes?

Reik
Mar 8, 2004

PerniciousKnid posted:

I think it's unfortunate it doesn't explain what the short and long term funds are or what the impact would be.

They'll release another statement like they did for the AHCA, they just don't have it put together yet.

evilweasel
Aug 24, 2002

Shimrra Jamaane posted:

EvilWeasel, based on the assumption that Heller is a No what do you figure are the chances this won't have the votes?

I would lean towards betting that it passes 51-50 but I don't really have a good sense of where the three key votes are so that's just a guess. Right now, assuming Paul and Heller are hard No, it's 50-50. You've got two main groups of "wavering" people: the conservatives (Lee, Cruz, Johnson) and the "moderates" (Capuito, Portman, Collins, Murkowski). One more hard no, and it's dead. I think a few others "expressed concerns" but I forget who they were.

Johnson is dumb as a brick and just wants attention so he'll get to Yes (his ask was "more information"). Collins strikes me as someone who is going to vote Yes once she gets some cover (probably opioid funding). Capuito and Portman had McConnell not put any opioid funding in and will get to yes once their pre-planned amendment to increase opioid funding is added in, probably with Collins. Maybe with a slightly lengthened phase-out as well.

I think you're most likely looking for the third hard no vote as one of Lee/Murkowski/Cruz. Lee would be my bet as the most likely tipping point: he is the sort of true-believer drat reality freedom caucuser guy that Cruz pretends to be and I can see him simply not getting what he wants and killing it. Murkowski will probably demand a heavy price for Alaska and may (though I doubt it) draw a red line on the PP funding. Cruz, I think, wants to get to yes but be seen to get conservative concessions for his vote. However he's such a tremendous rear end in a top hat he may never get there and may draw his line in the sand in a place he finds he can't get and refuses to look stupid by backing down.

The other enormous unknown is the "no subsidies for abortion plans" clause. I think that's likely to get struck by the Senate parliamentarian. Once that happens, I think there is a good chance everything blows up. McConnell at that point can (a) overrule her, and effectively end the filibuster for good, or (b) not overrule her. Neither makes passage easy. I think people assume he's going to go (a) but I think that's less likely than people believe. But, assume it is. The problem with doing that is, tons of stuff that conservatives want was axed because it wouldn't comply with reconciliation. Suddenly, you've abandoned that excuse. That risks blowing up the fragile compromises and making conservatives demand additional concessions. Now, they may not - McConnell and Pence may have made it understood that they have the votes for that one specific thing but don't have the votes for any other overruling, and this is the only deal on the table. If they don't overrule the parliamentarian there's a very big risk Lee and other conservatives defect. They can't vote for abortion coverage. I say that I think it's less likely that McConnell overrules the parliamentarian because he and Pence spent a long, long, long time telling the House they weren't going to do that and I think they made the calculation that they can't please the conservatives and the moderates without blaming it on reconciliation rules. I think they'll try to thread the needle by promising that the no-abortion language will be attached to some other must-pass legislation so the Democrats have to shut down the government or vote to restrict abortion coverage. Open question if that is good enough, because they've been unable to score those wins in the past and may not be trusted far enough.

If the caucus realizes there are three hard no votes I think its likely some "moderates" don't do their whole song and dance with the amendments and actually vote against it, but that they will never be the deciding vote.

Shimrra Jamaane
Aug 10, 2007

Obscure to all except those well-versed in Yuuzhan Vong lore.
Thanks for the explanation. drat this poo poo is complicated. Are we really sure that even the Republicans know how this procedural poo poo works?

DaveWoo
Aug 14, 2004

Fun Shoe

Shimrra Jamaane posted:

Thanks for the explanation. drat this poo poo is complicated. Are we really sure that even the Republicans know how this procedural poo poo works?

McConnell absolutely does, yes.

axeil
Feb 14, 2006

evilweasel posted:

I would lean towards betting that it passes 51-50 but I don't really have a good sense of where the three key votes are so that's just a guess. Right now, assuming Paul and Heller are hard No, it's 50-50. You've got two main groups of "wavering" people: the conservatives (Lee, Cruz, Johnson) and the "moderates" (Capuito, Portman, Collins, Murkowski). One more hard no, and it's dead. I think a few others "expressed concerns" but I forget who they were.

Johnson is dumb as a brick and just wants attention so he'll get to Yes (his ask was "more information"). Collins strikes me as someone who is going to vote Yes once she gets some cover (probably opioid funding). Capuito and Portman had McConnell not put any opioid funding in and will get to yes once their pre-planned amendment to increase opioid funding is added in, probably with Collins. Maybe with a slightly lengthened phase-out as well.

I think you're most likely looking for the third hard no vote as one of Lee/Murkowski/Cruz. Lee would be my bet as the most likely tipping point: he is the sort of true-believer drat reality freedom caucuser guy that Cruz pretends to be and I can see him simply not getting what he wants and killing it. Murkowski will probably demand a heavy price for Alaska and may (though I doubt it) draw a red line on the PP funding. Cruz, I think, wants to get to yes but be seen to get conservative concessions for his vote. However he's such a tremendous rear end in a top hat he may never get there and may draw his line in the sand in a place he finds he can't get and refuses to look stupid by backing down.

The other enormous unknown is the "no subsidies for abortion plans" clause. I think that's likely to get struck by the Senate parliamentarian. Once that happens, I think there is a good chance everything blows up. McConnell at that point can (a) overrule her, and effectively end the filibuster for good, or (b) not overrule her. Neither makes passage easy. I think people assume he's going to go (a) but I think that's less likely than people believe. But, assume it is. The problem with doing that is, tons of stuff that conservatives want was axed because it wouldn't comply with reconciliation. Suddenly, you've abandoned that excuse. That risks blowing up the fragile compromises and making conservatives demand additional concessions. Now, they may not - McConnell and Pence may have made it understood that they have the votes for that one specific thing but don't have the votes for any other overruling, and this is the only deal on the table. If they don't overrule the parliamentarian there's a very big risk Lee and other conservatives defect. They can't vote for abortion coverage. I say that I think it's less likely that McConnell overrules the parliamentarian because he and Pence spent a long, long, long time telling the House they weren't going to do that and I think they made the calculation that they can't please the conservatives and the moderates without blaming it on reconciliation rules. I think they'll try to thread the needle by promising that the no-abortion language will be attached to some other must-pass legislation so the Democrats have to shut down the government or vote to restrict abortion coverage. Open question if that is good enough, because they've been unable to score those wins in the past and may not be trusted far enough.

If the caucus realizes there are three hard no votes I think its likely some "moderates" don't do their whole song and dance with the amendments and actually vote against it, but that they will never be the deciding vote.

Your analysis on this has been really helpful, thanks.

evilweasel
Aug 24, 2002

Also, everything I've seen makes it likely Paul is a no on anything that can pass, but it's always possible that he's gettable if they really need him. It's definitely less certain he's a hard no than the guy who Trump is lashing out at.

evilweasel
Aug 24, 2002

The fury against Heller might be that he is really blowing up their messaging here.

https://twitter.com/sahilkapur/status/878337013472165888

He's being so blunt about it that it's going to make it more awkward for the other "moderates." Most only pretend to have a soul, but it will make the pretending harder.

Flip Yr Wig
Feb 21, 2007

Oh please do go on
Fun Shoe

evilweasel posted:

Also, everything I've seen makes it likely Paul is a no on anything that can pass, but it's always possible that he's gettable if they really need him. It's definitely less certain he's a hard no than the guy who Trump is lashing out at.

I still subscribe to the theory that he opposes it from the right rhetorically and from the left pragmatically. WV's electorate seems to be dominantly driven by Medicaid recipients, rather than suburban FYGMs. But I'm also pretty ignorant.

Edit:
I done confused West Virginia and Kentucky.

Flip Yr Wig fucked around with this message at 22:44 on Jun 23, 2017

Shimrra Jamaane
Aug 10, 2007

Obscure to all except those well-versed in Yuuzhan Vong lore.

evilweasel posted:

The fury against Heller might be that he is really blowing up their messaging here.

https://twitter.com/sahilkapur/status/878337013472165888

He's being so blunt about it that it's going to make it more awkward for the other "moderates." Most only pretend to have a soul, but it will make the pretending harder.

Sounds potentially promising?

HashtagGirlboss
Jan 4, 2005

Flip Yr Wig posted:

I still subscribe to the theory that he opposes it from the right rhetorically and from the left pragmatically. WV's electorate seems to be dominantly driven by Medicaid recipients, rather than suburban FYGMs. But I'm also pretty ignorant.

Ignorant enough to confuse WV with KY, even :D

Flip Yr Wig
Feb 21, 2007

Oh please do go on
Fun Shoe

xrunner posted:

Ignorant enough to confuse WV with KY, even :D

Yeop. I'm bone dumb.

evilweasel
Aug 24, 2002

Shimrra Jamaane posted:

Sounds potentially promising?

I think it falls into the category of "its good that it happened, but it doesn't mean that much." It makes things a little more awkward for other moderates, but things are plenty awkward for them already and I doubt it's going to be the tipping point. It's just something that will make them more irritated at him.

It does make it harder to back down from his "no" though and that is always good.

Yadoppsi
May 10, 2009

Mr. Nice! posted:

I'm talking about the vast empty swaths of this country that are majority republican. There are not enough people in the area refusing to vote to outweigh their influence. They have an effective stranglehold on the nation. Getting another million bums in new york to tally up D isn't going to matter in Montana where the majority of the populace is voting republican anyways.

Last governor election 33% of eligible voters voted GOP. In the last Senate election 32% of eligible voters went GOP. The majority of eligible voters in NO sates are voting for Democrats or Republicans.

Rhesus Pieces
Jun 27, 2005

Remember that 30% surcharge in the house bill? Not cruel enough!

https://twitter.com/ASlavitt/status/878632015360380929

Yeowch!!! My Balls!!!
May 31, 2006
which, BTW, is the way they're appeasing insurance companies in more ways than one. as a replacement for the mandate, it's impotent and awful, but as a handout to insurance companies it is magnificent.

that bit effectively relegalizes rescission. "whoops we didn't get that payment, you cant get back on for six months, please don't mind that per our actuarial tables you will be dead by then."

Rhesus Pieces
Jun 27, 2005

Ze Pollack posted:

which, BTW, is the way they're appeasing insurance companies in more ways than one. as a replacement for the mandate, it's impotent and awful, but as a handout to insurance companies it is magnificent.

that bit effectively relegalizes rescission. "whoops we didn't get that payment, you cant get back on for six months, please don't mind that per our actuarial tables you will be dead by then."

Yup, expect lots of phantom "missed payments" from really expensive patients. Somehow automated monthly payments will end up getting "lost in the mail" followed by extremely prompt cancellation notices with no warning whatsoever.

Thread: https://twitter.com/AlderFish/status/878638783033430018

BirdOfPlay
Feb 19, 2012

THUNDERDOME LOSER
Anybody care to hear the thoughts of a secret committee member? Here's Sen Pat Toomey's OpEd statement about the new bill and how the changes are meant to help poor Pennsylvanians.

quote:

Despite inaccurate reports to the contrary, the Senate draft bill keeps Obamacare’s expansion of Medicaid, the program for low-income Americans. Obamacare created a new category of eligibility: working age, able-bodied, childless adults. Under the Senate bill, both the 700,000 Pennsylvanians who signed up for this expansion and future expansion enrollees will retain their federal eligibility for the program. In fact, the federal government will pay at least 90 percent of their costs through 2020, with states paying the balance. Then, over a four-year phase-in period, states wishing to cover this new category of recipients will be required to pay their fair share — only 48 percent in Pennsylvania — for the Medicaid expansion. This is the same amount states currently pay for every traditional Medicaid category: the aged, disabled, children, and families.

See, the Medicaid expansion isn't being cut; we're just making it so that states have to fund it of their own accord. Totally different. Shut up Gov. Tom Wolf, you don't know anything about PA's budget issues and how that will, inevitably, cause cuts to the stat's Medicaid program if Federal funding is cut.

Also, HSA's, eliminating Obamacare taxes (which taxes?), and cutting regulations are the best way to lower premiums, because those have always lead to lower prices for consumers.

I know this is a touch PA specific, but I hadn't seen that any of the other Senators in the "Healthcare Working Group" had issued such complete statements about the Senate's bill.

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Bueno Papi
May 10, 2009

Ze Pollack posted:

which, BTW, is the way they're appeasing insurance companies in more ways than one. as a replacement for the mandate, it's impotent and awful, but as a handout to insurance companies it is magnificent.

that bit effectively relegalizes rescission. "whoops we didn't get that payment, you cant get back on for six months, please don't mind that per our actuarial tables you will be dead by then."

Biggest win for the health insurance industry is the removal of the cap on executive compensation tax deduction. If they can extract millions today, then they're ok with their industry imploding in 10 years.

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