Obamacare on Life Support article

[morekaos]

Here are the principles that should guide the Congress as we move to create a better healthcare system for all Americans:

First, we should ensure that Americans with pre-existing conditions have access to coverage, and that we have a stable transition for Americans currently enrolled in the healthcare exchanges. [Applause]

Secondly, we should help Americans purchase their own coverage, through the use of tax credits and expanded Health Savings Accounts ?- but it must be the plan they want, not the plan forced on them by our Government. [Applause]

Thirdly, we should give our State Governors the resources and flexibility they need with Medicaid to make sure no one is left out. [Applause]
Fourthly, we should implement legal reforms that protect patients and doctors from unnecessary costs that drive up the price of insurance ? and work to bring down the artificially high price of drugs and bring them down immediately. [Applause]

And finally, the time has come to give Americans the freedom to purchase health insurance across state lines ?-  [Applause] ?- which will create a truly competitive national marketplace that will bring cost way down and provide far better care.

 

[jmoney74]

Here are the principles that should guide the Congress as we move to create a better healthcare system for all Americans:

First, we should ensure that Americans with pre-existing conditions have access to coverage, and that we have a stable transition for Americans currently enrolled in the healthcare exchanges. [Applause]

Secondly, we should help Americans purchase their own coverage, through the use of tax credits and expanded Health Savings Accounts ?- but it must be the plan they want, not the plan forced on them by our Government. [Applause]

Thirdly, we should give our State Governors the resources and flexibility they need with Medicaid to make sure no one is left out. [Applause]
Fourthly, we should implement legal reforms that protect patients and doctors from unnecessary costs that drive up the price of insurance ? and work to bring down the artificially high price of drugs and bring them down immediately. [Applause]

And finally, the time has come to give Americans the freedom to purchase health insurance across state lines ?-  [Applause] ?- which will create a truly competitive national marketplace that will bring cost way down and provide far better care.

So the thing with number 2. How about when people who don't have coverage go to the hospital?  The onus goes back to the tax payer (I know because my brother did this). We actually need a cheap hospital only plan that everyone should have to get.

 

[Perspective]

Rand Paul is lighting up Twitter raging against the "Repeal ObamaCare!!!" Republicans:
https://twitter.com/RandPaul

 

[Perspective]

Here are the principles that should guide the Congress as we move to create a better healthcare system for all Americans:

First, we should ensure that Americans with pre-existing conditions have access to coverage, and that we have a stable transition for Americans currently enrolled in the healthcare exchanges. [Applause]

Secondly, we should help Americans purchase their own coverage, through the use of tax credits and expanded Health Savings Accounts ?- but it must be the plan they want, not the plan forced on them by our Government. [Applause]

Thirdly, we should give our State Governors the resources and flexibility they need with Medicaid to make sure no one is left out. [Applause]
Fourthly, we should implement legal reforms that protect patients and doctors from unnecessary costs that drive up the price of insurance ? and work to bring down the artificially high price of drugs and bring them down immediately. [Applause]

And finally, the time has come to give Americans the freedom to purchase health insurance across state lines ?-  [Applause] ?- which will create a truly competitive national marketplace that will bring cost way down and provide far better care.

Those are all reasonable principles with which to begin the process. Actually drafting the legislation, scoring the expected outcomes and externalities, and evaluating the actual outcomes and externalities, is very difficult and complex, full of political nonsense from both parties.

 

[peppy]

Here are the principles that should guide the Congress as we move to create a better healthcare system for all Americans:

First, we should ensure that Americans with pre-existing conditions have access to coverage, and that we have a stable transition for Americans currently enrolled in the healthcare exchanges. [Applause]

Secondly, we should help Americans purchase their own coverage, through the use of tax credits and expanded Health Savings Accounts ?- but it must be the plan they want, not the plan forced on them by our Government. [Applause]

Thirdly, we should give our State Governors the resources and flexibility they need with Medicaid to make sure no one is left out. [Applause]
Fourthly, we should implement legal reforms that protect patients and doctors from unnecessary costs that drive up the price of insurance ? and work to bring down the artificially high price of drugs and bring them down immediately. [Applause]

And finally, the time has come to give Americans the freedom to purchase health insurance across state lines ?-  [Applause] ?- which will create a truly competitive national marketplace that will bring cost way down and provide far better care.

Those are all reasonable principles with which to begin the process. Actually drafting the legislation, scoring the expected outcomes and externalities, and evaluating the actual outcomes and externalities, is very difficult and complex, full of political nonsense from both parties.

1. "Access" to coverage is different than a guarantee to get it. The wording here is crucial.

2. Tax credits are a big no-no in the freedom caucus so that one is DOA. HSA is useless for the majority of people since they don't have disposable income to put in there. These are usually used in conjunction with high deductible plans. Affordable when it comes to your monthly premium, not so much when you actually need care.

3. Flexibility is code for block grants, leaving the state to cover the fluctuations between grants. Again, the devil is in the details on this one but given what the Heritage Foundation has been pushing, it means fewer dollars for Medicaid recipients.

4. Isn't Medical tort reform something that should be done at the state level? CA already went through that and it seems that this is not going to drastically lower cost.

5. Buying from across state lines is something that is possible today but you have to conform to state regulations in the products that are being offered. If the proposal is to eliminate state regulations on insurance product then that's what it should be called. What happened to state's rights? This wouldn't result in better care, it would result in insurance companies settling in the state with the least regulations and offering a product that would be comparatively worse. As an example, look at credit companies and how they have all settled in DE which has the laxest regulations.

 

[Perspective]

We're going to see how intra-party obstructionist the "Freedom" caucus intends to be to fight for their beliefs. This is the group of Republicans empowered by the Tea Party movement to argue forcefully for limited federal government power/meddling and spending (excluding social issues where they very much want Big Guv to meddle). This Trump administration is promising to spend a ton increasing annual deficits and the debt. Will the "Freedom" caucus acquiesce?

The "Freedom" caucus has an ACA repeal bill:https://www.congress.gov/bill/115th-congress/house-bill/1072/text

The stratospheric cost of Trump?s economic planhttps://finance.yahoo.com/news/the-stratospheric-cost-of-trumps-economic-plan-201922465.html

 

[nosuchreality]

1. "Access" to coverage is different than a guarantee to get it. The wording here is crucial.

IMHO, this is just silly.  I not a Trump fan, but the chronic interpretation of everything in the worst possible scenario is just tiresome.

He has repeatedly said pre-existing conditions coverage is something they want to keep.

And for a speech written at the 7th grade level, splitting word hairs at the level just confirms the biases of the person posting it.

 

[Perspective]

1. "Access" to coverage is different than a guarantee to get it. The wording here is crucial.

IMHO, this is just silly.  I not a Trump fan, but the chronic interpretation of everything in the worst possible scenario is just tiresome.

He has repeatedly said pre-existing conditions coverage is something they want to keep.

And for a speech written at the 7th grade level, splitting word hairs at the level just confirms the biases of the person posting it.

Hmm, while these are just guiding principles, words matter. The devil will be in the details of the bill and will define what type of "access" is ensured.

Folks with pre-existing conditions prior to ACA, who were shopping for healthcare insurance outside of an employer, had "access" to insurance. The cost was prohibitive.

 

[peppy]

1. "Access" to coverage is different than a guarantee to get it. The wording here is crucial.

IMHO, this is just silly.  I not a Trump fan, but the chronic interpretation of everything in the worst possible scenario is just tiresome.

He has repeatedly said pre-existing conditions coverage is something they want to keep.

And for a speech written at the 7th grade level, splitting word hairs at the level just confirms the biases of the person posting it.

The current proposal is to only cover pre-existing conditions IF there has not been a lapse in insurance coverage at all. This is not a chronic interpretation in the worst possible way. This is how they are defining "access". We are not splitting hairs here; this phrasing has been in place for a while by the repeal/replace crowd.

 

[Perspective]

Rand Paul is reporting that the TrumpCare bill includes the individual mandate.

 

[nosuchreality]

1. "Access" to coverage is different than a guarantee to get it. The wording here is crucial.

IMHO, this is just silly.  I not a Trump fan, but the chronic interpretation of everything in the worst possible scenario is just tiresome.

He has repeatedly said pre-existing conditions coverage is something they want to keep.

And for a speech written at the 7th grade level, splitting word hairs at the level just confirms the biases of the person posting it.

The current proposal is to only cover pre-existing conditions IF there has not been a lapse in insurance coverage at all. This is not a chronic interpretation in the worst possible way. This is how they are defining "access". We are not splitting hairs here; this phrasing has been in place for a while by the repeal/replace crowd.

IF people choose or let their insurance lapse for more than 60 days, THEN for a limited time, insurance companies can charge either a higher rate or exclude certain coverage.  Both of which are yet to be defined.


Yes, splitting hairs and interpreting as worse case. 

 

[Perspective]

Is it unfair or inappropriate to consider worst case healthcare insurance scenarios, when the one thing Republicans agree on, and direct most of their fury toward, is repealing the ACA?

 

[nosuchreality]

Is it unfair or inappropriate to consider worst case healthcare insurance scenarios, when the one thing Republicans agree on, and direct most of their fury toward, is repealing the ACA?

No its just trite.  Especially when done ad nauseam.  When its presented as "words are important" instead of admitting, it's worse case interpretation.

 

[Perspective]

Is it unfair or inappropriate to consider worst case healthcare insurance scenarios, when the one thing Republicans agree on, and direct most of their fury toward, is repealing the ACA?

No its just trite.  Especially when done ad nauseam.  When its presented as "words are important" instead of admitting, it's worse case interpretation.

Got it. That's a fair criticism. I think getting serious tax reform consensus within the Republican party is difficult enough. Corralling consensus for revising the ACA is even more difficult.

No sympathy here though. When you over-simplify these extremely complex very personal issues (healthcare) with hyperbolic rhetoric, you reap what you sew. The Republicans are in a no-win situation.

 

[peppy]

Is it unfair or inappropriate to consider worst case healthcare insurance scenarios, when the one thing Republicans agree on, and direct most of their fury toward, is repealing the ACA?

No its just trite.  Especially when done ad nauseam.  When its presented as "words are important" instead of admitting, it's worse case interpretation.

It's not a worst case interpretation. It's factual on what would happen if you get rid of the ACA. HIPPA does not apply to the individual insurance market and as such there won't be any provisions to provide a plan to someone who's had pre-existing conditions and/or lapses in coverage. The ACA extended this to the individual market . This is what they talk about when it comes to "access". It is not a guarantee the way it was under the ACA. They have not used the guarantee terminology, instead of opting for access instead. Keep in mind that this guarantee was probably the most expensive portion of the ACA.

 

[nosuchreality]

Is it unfair or inappropriate to consider worst case healthcare insurance scenarios, when the one thing Republicans agree on, and direct most of their fury toward, is repealing the ACA?

No its just trite.  Especially when done ad nauseam.  When its presented as "words are important" instead of admitting, it's worse case interpretation.

It's not a worst case interpretation. It's factual on what would happen if you get rid of the ACA. HIPPA does not apply to the individual insurance market and as such there won't be any provisions to provide a plan to someone who's had pre-existing conditions and/or lapses in coverage. The ACA extended this to the individual market . This is what they talk about when it comes to "access". It is not a guarantee the way it was under the ACA. They have not used the guarantee terminology, instead of opting for access instead. Keep in mind that this guarantee was probably the most expensive portion of the ACA.

So, ACA has fully been in place since 2014.  If you have a pre-existing condition and make under 400% of FPL, ACA will help you pay for your insurance. 

Worst case scenario, you're 64 a year short on medicare and you need coverage,  CoveredCA will give you  a plan (granted, they're kind of sucky) for $594/mo.  That's a chunk of change if you're making $50K a year.

Now, if you have a pre-existing condition and have chosen to not pay the $600 (or less) to have coverage, frankly, why should I care anymore?  Seriously, if you have a condition and haven't picked up and maintained insurance during the last three years, WTF?

Yea, anecdotally, I'm sure someone somewhere has hit hard times and literally couldn't make the payment, bu we're not talking millions of people. 

 

[peppy]

Is it unfair or inappropriate to consider worst case healthcare insurance scenarios, when the one thing Republicans agree on, and direct most of their fury toward, is repealing the ACA?

No its just trite.  Especially when done ad nauseam.  When its presented as "words are important" instead of admitting, it's worse case interpretation.

It's not a worst case interpretation. It's factual on what would happen if you get rid of the ACA. HIPPA does not apply to the individual insurance market and as such there won't be any provisions to provide a plan to someone who's had pre-existing conditions and/or lapses in coverage. The ACA extended this to the individual market . This is what they talk about when it comes to "access". It is not a guarantee the way it was under the ACA. They have not used the guarantee terminology, instead of opting for access instead. Keep in mind that this guarantee was probably the most expensive portion of the ACA.

So, ACA has fully been in place since 2014.  If you have a pre-existing condition and make under 400% of FPL, ACA will help you pay for your insurance. 

Worst case scenario, you're 64 a year short on medicare and you need coverage,  CoveredCA will give you  a plan (granted, they're kind of sucky) for $594/mo.  That's a chunk of change if you're making $50K a year.

Now, if you have a pre-existing condition and have chosen to not pay the $600 (or less) to have coverage, frankly, why should I care anymore?  Seriously, if you have a condition and haven't picked up and maintained insurance during the last three years, WTF?

Yea, anecdotally, I'm sure someone somewhere has hit hard times and literally couldn't make the payment, bu we're not talking millions of people.

The ACA doesn't just help you pay for it. It GUARANTEES that there will be a plan for you. In the past, in the individual marketplace, such an individual would probably have been seen as too expensive with no chance of getting on a plan. Even if they are willing to pay 14% of their income on insurance (as in your case). This only extend the gap in coverage making that particular case essentially uninsurable. So, what happens when they fall sick? They go to the ER, go broke and declare bankruptcy. Take a guess who is paying for that care?

All I'm saying is that without the guarantee of coverage, individuals with expensive pre-existing conditions are going to be out of luck in whatever shape TrumpCare takes. There's no way of lowering the cost and also provide this level of coverage. Of course, this is not a good selling point so it's being phrased as "access".

 

[nosuchreality]

If you've carried insurance (available to everyone for the last three years). It's a non-issue.


Reading your posts are like reading articles on the ACA financial rule change the house passed back in January where the articles used phrases 'first step in gutting ACA' half dozen times in the first three paragraphs.  Of course, buried in paragraph 30 was the admission that the funding rule literally didn't change a single mandate of the law.

 

[peppy]

If you've carried insurance (available to everyone for the last three years). It's a non-issue.


Reading your posts are like reading articles on the ACA financial rule change the house passed back in January where the articles used phrases 'first step in gutting ACA' half dozen times in the first three paragraphs.  Of course, buried in paragraph 30 was the admission that the funding rule literally didn't change a single mandate of the law.

Again, without the guarantees of the ACA even having had no lapse in insurance is not enough to get coverage in the individual marketplace. Right now there is only talk about a provision for guarantee with "continuing coverage" in TrumpCare but even that is seeing some resistance.

I'm just trying to figure out how things will look like going forward. The ACA will certainly have to go as this has been a core promise by everyone in the GOP. That's pretty much a certainty. What it will be replaced with is what remains to be seen but it will need the full support of all the Rs in the Senate and Congress.

 

[Perspective]

It'll be interesting to see the budget office' score of the cost of this new plan. For political reasons (are there any other reasons?), the Democrats should hope this bill gets through the House and Senate. They can then use hyperbolic language for the next three years, highlighting anecdotal families (supported by stats this time) who've been negatively affected. They can blame every real and manufactured healthcare problem on TrumpCare too. We've seen this movie before. Rinse and repeat to electoral success.