|
Ze Pollack posted:Genuinely interested in your thoughts on this one, because I keep trying to figure out who the hell this is supposed to appeal to and not succeeding. I'm with you in that I don't really "get" it - there doesn't seem to be any kind of cohesive thesis behind what it's supposed to do, unlike the ACA itself and prior republican replacement plans. It looks as if it was designed by elected officials who read a few white papers instead of a wide coalition of experts and lobbyists like literally every other piece of major legislation. The lottery passage in particular stands out as something that looks like a no-name congressman demanded be included. It doesn't really move towards the republican "vision" for health care and doesn't really fix anything. One potential positive that I can see is the offering of subsidies to poor people in states that didn't expand medicaid (if I'm reading it correctly). Doubtful the numbers given will be enough to make insurance a viable choice for them though.
|
#
?
Mar 7, 2017 19:17
|
|
|
|
| # ? Apr 19, 2024 22:18 |
|
|
Concerned Citizen posted:the senate can only pass 1 reconciliation bill a year. a part b and part c bill requires 60 votes. My understanding is that that's part of the plan. Use reconciliation to blow everything up, force the Democrats to capitulate in order to put it all back together. Hostage strategy updated for the majority.
|
|
#
?
Mar 7, 2017 19:19
|
|
|
Discendo Vox posted:I'm genuinely pretty ignorant of Senate rules at this point, but aren't the Republicans now in a position to undo that 60 vote "requirement"? They can if they're unified in doing so, but it's not at all clear that they have 50 votes, particularly not to shove through something as routinely unpopular as healthcare reform. There's plenty of senators who like being able to pass the buck across the aisle on legislation they don't like failing, or who plan to be in the Senate long enough to see the majority switch sides again, and all it takes is three.
|
|
#
?
Mar 7, 2017 19:21
|
|
|
Reconciliation can also only be used strictly for budget matters-so while they can gut Medicaid all they want, allowing insurance to be sold across state lines and other regulations will require 60 votes if they don't blow up the filibuster.
|
|
#
?
Mar 7, 2017 19:40
|
|
|
suburban virgin posted:
The general population of the US would be primed to accept single-payer, since we're all socialized (pun intended) to seeing the MEDICARE TAX WITHHELD line item on every pay stub. Even if that number went up significantly, a lot of people would grumble but they'd accept it if they're getting something concrete out of it. That of course wouldn't fly with the health industrial complex and since bribery is legal every member of Congress is bought & paid for to oppose it.
|
|
#
?
Mar 7, 2017 19:49
|
|
|
FuturePastNow posted:The general population of the US would be primed to accept single-payer, since we're all socialized (pun intended) to seeing the MEDICARE TAX WITHHELD line item on every pay stub. Even if that number went up significantly, a lot of people would grumble but they'd accept it if they're getting something concrete out of it. Unfortunately, dedicated revenue streams and concrete costs are the quickest ways to make things unpopular. This is especially true if it is a "new" cost. Lots of programs continue to exist because they are paid for out of general revenue funds and can't have their funding source zeroed out. They had a poll that showed than 60% of Bernie Sanders supporters would not be in favor of single payer if it meant paying $1,000 more a year in taxes, but if you phrased it as "raised taxes to pay for it" then the opposed dropped down to around 20%.
|
|
#
?
Mar 7, 2017 19:52
|
|
|
So, what happens in the meantime with the ACA? It chugs along and still operates while this 'solution' is hammered out in Congress?
|
|
#
?
Mar 7, 2017 20:00
|
|
|
If they pass the bill, everything breaks. If they don't pass the bill, nothing happens.
|
|
#
?
Mar 7, 2017 20:01
|
|
|
KillHour posted:If they pass the bill, everything breaks. If they don't pass the bill, nothing happens. Eventually, the Cadillac Tax kicks in and it was meant to be 50% of ACA's revenue stream. I don't think it'll zero out ACA but it will make what it adds to the deficit much smaller. I can't imagine how AHCA will beat ACA in that regard. You can't square cutting taxes with additional expenditures and expect it to be deficit neutral. No matter how much you use the dynamic scoring cheat.
|
|
#
?
Mar 7, 2017 21:00
|
|
|
Bueno Papi posted:Eventually, the Cadillac Tax kicks in and it was meant to be 50% of ACA's revenue stream. I don't think it'll zero out ACA but it will make what it adds to the deficit much smaller. I can't imagine how AHCA will beat ACA in that regard. You can't square cutting taxes with additional expenditures and expect it to be deficit neutral. No matter how much you use the dynamic scoring cheat. Republiland works like this tho - cut taxes, increase spending. All checks out.
|
|
#
?
Mar 7, 2017 21:02
|
|
|
Electric Phantasm posted:Is it a possible for ACA to get repealed and not have replacement? The ACA turned a full on poo poo storm into a shart. Repealing the ACA without a replacement would unleash a shitpocalypse. So yes, it's possible. I also didn't think Brexit was possible but here we are.
|
|
#
?
Mar 7, 2017 21:33
|
|
|
Paul Ryan will soon be giving a live statement on the Republican healthcare bill. Not sure what the actual start time is, but the feed is live. https://www.youtube.com/watch?v=B6OjKD33YxU
|
|
#
?
Mar 7, 2017 21:42
|
|
|
My hope is Paul Ryan has a meltdown and blames everyone for not appreciating his Randian dream. Reality will be generic Ryan platitudes masking the truth with not being able to afford health care is a choice, checkmate.
Bueno Papi fucked around with this message at 22:09 on Mar 7, 2017 |
|
#
?
Mar 7, 2017 21:58
|
|
|
Bueno Papi posted:My hope is Paul Ryan has a meltdown and blames everyone for not appreciating his Randian dream. Reality will be generic Ryan platitudes masking the truth that not being able to afford health care is a choice, checkmate. Everyone except Trump, at least.
|
|
#
?
Mar 7, 2017 22:08
|
|
|
Qu Appelle posted:So, what happens in the meantime with the ACA? It chugs along and still operates while this 'solution' is hammered out in Congress? The exchanges will probably continue to offer very few options in certain regions, that's about it though.
|
|
#
?
Mar 7, 2017 22:09
|
|
|
Since we don't have the CBO analysis, here's S&P's. https://goo.gl/ST44OQ 
|
|
#
?
Mar 7, 2017 22:13
|
|
|
I am wondering if this could actually lead to a economic crisis. Okay, so we know less uninsured means a lower employment rate for the healthcare industry which is 5 times the size of the auto industry. We also know that killing Medicaid will cause hospitals to close. That's not even a question a good example of this is look up what happened to Baton Rouge General hospital in Louisiana. If then Gov Bobby had accepted it then this hospital could have kept it's ER open. It's now struggling to stay open a tremendous amount of rural hospitals are as well. So if a lot of these hospitals which are operating at barely a loss lose those insured people the close we could see a spike in unemployment which would stress the market even more because they wouldn't be able to get health insurance. It seems to me a similar situation to the auto industry debacle.
|
|
#
?
Mar 7, 2017 22:37
|
|
|
Ze Pollack posted:Genuinely interested in your thoughts on this one, because I keep trying to figure out who the hell this is supposed to appeal to and not succeeding. It's a desperate attempt to satisfy a promise they can't satisfy. It's easiest to think of this in terms of the Senate. They need 50 votes, and you can roughly arrange Republican Senators into three groups: (a) conservative true believers, who hate Obamacare because it is a redistribution of money from the rich to the poor and fervently believe that it is wrong for the government to expand health insurance to people; (b) senators who ran on opposition to obamacare because it was politically helpful but have no strong feelings either way and don't feel vulnerable; (c) 'Moderate' Republicans who either have enough of a soul to wince at the idea of throwing millions off health insurance for no good reason, or who are fine with it but think they'll lose their next election if they do. For a long time "repeal and replace!" satisfied everyone. Group (a) got the repeal and figured the replace would be a token replacement or nothing. (b) has never cared what the end result was, they want credit for repealing Obamacare but don't really care if it's replaced. (c) wanted a legitimate replacement. There has never been a "replace" because groups A and C can't agree on anything. You can't keep Obamacare's expansion of health care without spending money. Group A wants to use that money for tax cuts, Group C wants a real replacement with that money. But as long as you don't present a replacement, you can run on repeal and replace forever. But, now they can. And they're stuck. The plan is trying to thread the needle: it murders some of the poor so group A gets tax cuts, but tries to keep some of the health care expansion for Group C. The hope is that its close enough for both groups they can bluster but won't dare vote against it. It's not like its a well thought out plan. It's desperately trying to satisfy all the bullshit promises they made about how everyone was going to get a unicorn with the replacement - or, if it goes down in flames, that it is someone else's fault, not leadership. It appears that the death2poors wing isn't getting enough in this bargain though and may actually revolt.
|
|
#
?
Mar 7, 2017 22:39
|
|
|
KillHour posted:If they pass the bill, everything breaks. If they don't pass the bill, nothing happens. Not quite, insurance companies need to decide if they're participating next year very soon - and this bill, if it passes, probably creates a death spiral (the 30% markup if your coverage lapses has the perverse effect of, of you trigger it, making it so you don't get insurance until you need it making the insured population sicker). I don't know they have time to wait to see if this fails.
|
|
#
?
Mar 7, 2017 22:42
|
|
|
KFF has a good summary on AHCA. http://files.kff.org/attachment/Proposals-to-Replace-the-Affordable-Care-Act-Summary-of-the-American-Health-Care-Act
|
|
#
?
Mar 7, 2017 22:42
|
|
|
It's really just old white people angry that African American families can get Medicaid that they don't have to " pay for". That was literally what one of my family members told me why they supported kicking millions off. " The people who need it will still get it but they'll get rid of hanger ons"
|
|
#
?
Mar 7, 2017 22:43
|
|
|
esquilax posted:I'm with you in that I don't really "get" it - there doesn't seem to be any kind of cohesive thesis behind what it's supposed to do, unlike the ACA itself and prior republican replacement plans. It looks as if it was designed by elected officials who read a few white papers instead of a wide coalition of experts and lobbyists like literally every other piece of major legislation. Yeah that is basically it. It's not a health care plan. Its a "politically, how do we tick the box that says 'repealed obamacare'" plan. I don't actually think it's going to work. I'm cautiously optimistic, but optimistic. I don't think they can thread this needle and I think that instead of pleasing both sides just enough they'll both vote against.
|
|
#
?
Mar 7, 2017 22:45
|
|
|
evilweasel posted:Yeah that is basically it. It's not a health care plan. Its a "politically, how do we tick the box that says 'repealed obamacare'" plan. Bill seems to be really pissing off the True Believers at least
|
|
#
?
Mar 7, 2017 22:51
|
|
|
Monkey Fracas posted:Bill seems to be really pissing off the True Believers at least They're being very loud about being pissed off, but I don't know that the "moderates" are any less pissed off about $600b in medicaid cuts and the replacement being garbage. But I think they'd rather the True Believers sink the ship first.
|
|
#
?
Mar 7, 2017 22:57
|
|
|
evilweasel posted:Yeah that is basically it. It's not a health care plan. Its a "politically, how do we tick the box that says 'repealed obamacare'" plan. They may not agree on replacement but there is unanimity for repealing all of the taxes and that can be done with reconciliation. Even then, they have a debt ceiling vote that needs to happen and it will occur during all this healthcare reform debate. Republicans really do suck at governing. https://twitter.com/AARPadvocates/status/838847647033274369 AARP: shots fired.
|
|
#
?
Mar 7, 2017 22:57
|
|
|
Bueno Papi posted:They may not agree on replacement but there is unanimity for repealing all of the taxes and that can be done with reconciliation. Even then, they have a debt ceiling vote that needs to happen and it will occur during all this healthcare reform debate. Republicans really do suck at governing. There is not unanimity for repealing the taxes. The "moderates" won't vote to repeal the taxes without replacement because they know they're not getting any replacement then. That was kiboshed when repeal and replace, maybe, sometime in the future got kiboshed.
|
|
#
?
Mar 7, 2017 22:58
|
|
|
evilweasel posted:There is not unanimity for repealing the taxes. The "moderates" won't vote to repeal the taxes without replacement because they know they're not getting any replacement then. That was kiboshed when repeal and replace, maybe, sometime in the future got kiboshed. Fair enough. Hospital industry is none too pleased with AHCA. https://twitter.com/adamcancryn/status/839225163568799744
|
|
#
?
Mar 7, 2017 23:05
|
|
|
evilweasel posted:They're being very loud about being pissed off, but I don't know that the "moderates" are any less pissed off about $600b in medicaid cuts and the replacement being garbage. But I think they'd rather the True Believers sink the ship first. Not a surprise that they have to do a bit more of a PR hedge than the Tea Party bomb throwers I guess.
|
|
#
?
Mar 7, 2017 23:16
|
|
|
 AHA is the 4th largest lobbying group in America. AARP is top-20, and controls a lot of the info that gets out to the greyhairs. Them spiking this deal means it is a legendarily bad bill.
|
|
#
?
Mar 7, 2017 23:21
|
|
|
So how much time before this passes? How quickly is it being forced through?
|
|
#
?
Mar 7, 2017 23:22
|
|
|
Hieronymous Alloy posted:So how much time before this passes? How quickly is it being forced through? Great question. Ryan wants it fast-tracked as hard as possible because the longer people have to look at it, the longer they'll have to find the part of it that's a slap in the face to them personally. However, since Ryan doesn't have a lot of friends even within his own party, this is not an easy sell; the Freedom Caucus, among other things, know they were elected to grandstand about how Obamacare Must Die and aren't going to knock it off any time soon.
|
|
#
?
Mar 7, 2017 23:26
|
|
|
Dr. Angela Ziegler posted:
Biggest lobbying group I could find that supports AHCA is american retail federation. Sure makes it easier for them if they don't have to give their employees health insurance. Unfortunately for Paul Ryan, ARF hates the DBCFT.
|
|
#
?
Mar 7, 2017 23:32
|
|
|
Dr. Angela Ziegler posted:
One of the things that often gets missed is Obamacare made a lot of cuts to things - like hospital reimbursements - that were made up for elsewhere so that all stakeholders were ok with it. Without fail, Republican proposals pocket the cuts and abolish where it was made up elsewhere, and that's one of the things the AHA is furious about. Democrats have wanted to to health care reform for over half a century and failed every time before Obamacare. Republicans don't even want to do it. They just want to oppose it.
|
|
#
?
Mar 7, 2017 23:33
|
|
|
I've been looking and have not seen an explanation: why isn't the selling across state lines thing in the bill? Were there House members pushing back against that?
|
|
#
?
Mar 7, 2017 23:45
|
|
|
eviltastic posted:I've been looking and have not seen an explanation: why isn't the selling across state lines thing in the bill? Were there House members pushing back against that? It would require statutory changes and reconciliation can't do that.
|
|
#
?
Mar 7, 2017 23:48
|
|
|
eviltastic posted:I've been looking and have not seen an explanation: why isn't the selling across state lines thing in the bill? Were there House members pushing back against that? It's gonna be in the sequel, sez Trump  They lost Heritage, the Kochs, AARP, and the Freedom Caucus in less than 24 hours. I do relish the idea of Paul Ryan gamely charging down the track toward the oncoming light, though.
|
|
#
?
Mar 7, 2017 23:50
|
|
|
Bueno Papi posted:It would require statutory changes and reconciliation can't do that. Derp, yeah, makes sense. Thanks.
|
|
#
?
Mar 7, 2017 23:52
|
|
|
Not sure if this was asked and answered already, I didn't see it mentioned. With the 30% premium increase if you go two months without insurance, does that still apply if I go from one employer based plan to another? Just thinking that if I lose my job, and don't get insurance for a few months, and then find another job, would my new employer actually end up paying more for my insurance? I could honestly see companies taking that into effect when hiring someone if so.
|
|
#
?
Mar 7, 2017 23:54
|
|
|
eviltastic posted:Derp, yeah, makes sense. Thanks. As mdemone said, Trump wants to revisit healthcare reform a second or even third time to get what he wants. The idea that congress is going to revisit this during a midterm election year is kinda nuts. If they get 60 in the senate after 2018, then they'll be able to do it but all the opposition in their party will still be there strangling any plan. Bueno Papi fucked around with this message at 00:00 on Mar 8, 2017 |
|
#
?
Mar 7, 2017 23:57
|
|
|
|
| # ? Apr 19, 2024 22:18 |
|
|
Speaking of the Senate: https://twitter.com/costareports/status/839242378435313665 https://twitter.com/costareports/status/839242744539283456
|
|
#
?
Mar 8, 2017 00:00
|
|