Republicans pull healthcare legislation plan in blow to Trump
reuters.com
reuters.com
> To the maximum extent permitted by law, the Secretary of Health and Human Services (Secretary) and the heads of all other executive departments and agencies (agencies) with authorities and responsibilities under the Act shall exercise all authority and discretion available to them to waive, defer, grant exemptions from, or delay the implementation of any provision or requirement of the Act that would impose a fiscal burden on any State or a cost, fee, tax, penalty, or regulatory burden on individuals, families, healthcare providers, health insurers, patients, recipients of healthcare services, purchasers of health insurance, or makers of medical devices, products, or medications.
https://www.whitehouse.gov/the-press-office/2017/01/2/execut...
Does anyone know what to expect when renewing insurance in 2017?
Trump Issues Executive Order Scaling Back Parts of Obamacare | Jan 20, 2017 https://www.nytimes.com/2017/01/20/us/politics/trump-executi...
What Does Trump's Executive Order Against Obamacare Actually Do? | Jan 21, 2017 https://www.nytimes.com/2017/01/21/upshot/what-does-the-orde...
Get a digital subscription to the Washington Post or the New York Times. There's a lot happening that affects the little guy.
I've read both of those and neither contains much information. But I haven't seen the news mention anything more recently. Surely we've learned something about the actual impact in two months, but the news has moved on.
I'm a pretty free-market guy and can get behind healthcare reform in general, but this bill had holes big enough to drive trucks through from the right and left simultaneously with plenty of room to spare. I could believe it coming from Trump, but I have no idea what Paul Ryan was thinking... the guy is supposed to be a policy wonk.
If insurance companies aren't solvent and profitable, products won't be offered. And that's exactly what happens when you force unfunded / unbalanced mandates on them. Congress can easily legislate the country into a market where no one wants to offer insurance because there's no way to do so sustainably.
That said, one of the best things that ACA did was finally target some of the inefficiency in as conservative of a business as insurance. The provision capping administrative costs did a lot to jolt companies into streamlining their operations and investing in modern, more efficient technologies.
That's what "insurance" is. I also don't get why people don't seem to understand that.
IMO, a big part of a solution has to be to stop conflating "health insurance" with "healthcare".
Think of the $3000 subsidy towards health insurance as a $3000 penalty if you don't buy health insurance.
http://edition.cnn.com/2016/01/06/politics/house-obamacare-r...
Now that Republicans have the power, they can't agree on anything anymore. What a miserable bunch of phonies.
They didn't prepare for a replacement because they never intended to actually replace the ACA with anything comprehensive, as comprehensive healthcare reform is philosophically anathema to them, and any language to the contrary was just lip-service to keep moderates and Democrats quiet. The Republicans probably never even expected the public backlash they got over this, but to simply strike it down and then be greeted in the streets as liberators.
Torpedoing essential benefits without a more fundamentally comprehensive replacement was like strapping engines to a car and expecting it to turn into a plane.
There was no right way; the only way to win was not to play the game. Anything that destroyed the basic model of the ACA—except to move to a stronger public guarantee which basically no Republican members are interested in—was never going to attract significant Democrstic support; the initial version of the AHCA had substantial opposition from both hard-line conservatives and moderates in the Republican Party, and anything that did more to appeal to either of those groups expanded opposition on the other side.
America is too diverse to be represented by just two parties.
But I saw nothing from the Republicans that indicated they were fixing or improving anything.
I think a number of dissenting House Republicans know that premiums are going to go up no matter what and decided they'd rather see Obamacare go down the drain with his name on it than step up and fix what needs fixing.
In actuality, because of twisted Republican orthodoxy combined with the reality of politics, at the end of the day the approach would have resulted in $600 billion in deficit spending.
Also, I think a fundamental problem with any Republican healthcare plan is that the opposition to it doesn't have a politically coherent set of principles that they could bargain with. For example, one of the features of the ACA is that it subsidises all elderly people regardless of wealth through the 3:1 cap on age-based premium differences. This is indirectly taxpayer-funded through subsidies to buy the insurance plans that subsidise it (for people who often can't afford to use their insurance), but the trick used to hide who's being subsidised also makes insurance unaffordable for young people. So Republicans want to replace the whole mess with a straightforward taxpayer-funded, age-based subsidy. Cue press attacks about how the evil moustache-twirling Republicans want to send seniors' insurance rates skyrocketing and hand out subsidies to people regardless of wealth.
https://www.healthcare.gov/coverage/what-marketplace-plans-c...
Which ones do you see as the least helpful for patients?
edit: There are several that aren't particularly insurable, but they are generally useful services.
And the _real_ dilemma in the GOP is that most Republicans don't think the government should be subsidizing any of this at all. If you gave all the Republicans a chance to pass a bill free from any kind of political consequence, they'd repeal the ACA along with all the entitlements and taxes. But that's not politically tenable for a million different reasons. This fundamental mismatch between Republican policy preferences and the reality of modern political and economic life means Republicans are incapable of governing in a sane manner. Even _if_ their various political-economic theories were correct, you can't arrange the system into a state where those theories could be applied. Reality is path dependent, and your available solutions are limited by the past.
But the thing is, when you and your constituents are convinced that the modern bureaucratic state is fundamentally irredeemable[1], there's always a convenient excuse for why things never pan out. It's like an employee who never gets anything done, always has an explanation about how somebody else is thwarting his designs, and can talk endlessly about all the changes he would make to improve things. His excuses may be individually defensible, and his ideas may be interesting, but they're irrelevant.
[1] And I don't just mean favoring small government. I've never met a person, liberal or conservative, rich or poor, who doesn't express a nominal preference for smaller government.
I'd be interested to hear why anyone on here feels either of those emotions.
For me, it looks like I'll have to continue paying the Obamacare penalty for the foreseeable future, and it will be impossible to find an insurance plan that makes sense for my family.
Had this morning's version of Trumpcare been made law, the odds of me being able to afford useful insurance would've been slim to none. So, I am ecstatic about this news.
To not go bankrupt and share the risk.
He may have been actively trying to get this bill passed, but it seems at least as likely to me that he merely intended to be seen as doing so.
Right now healthcare is shelved and the far right reps lose steam, having failed to work with their own party and a President far more popular with their constituents than they are.
Honestly I don't think he care whether it passed or not. He's not playing the game we see.
Current polling data to support the claim that any far right Republicans are far less popular with their own constituents than Trump is would be welcome. Given his cratering approval numbers, including with Republicans, I kind of doubt that is true in general.
On the other end of the spectrum, you have a family of five that makes too much money to qualify for a subsidy. They live in a red state that didn't expand Medicaid, uses the federally-managed exchange, and suffers from a lack of competition because there's only one insurer on that exchange. An HDHP for the family would cost $1,300/mo, which they can't afford, so they pay the penalty and go without insurance. They vote Republican because as they see it the government is forcing them to buy something they can't afford, and they want it to be better... or at least go back to the way it was.
A lot of people and families had plans and doctors they liked before the ACA was passed, and one of two things happened:
1. because year-over-year premium increases are regulated by the government per the ACA, insurers were forced to make their plans more efficient by reducing the size of their networks in one way or another. This meant that a lot of people lost access to their doctors and had to find another, often having to travel further and/or wait longer to see their new doctor.
2. they had terrible insurance before the ACA was passed, but didn't realize it. Perhaps they had unreasonably high deductibles, or access to few essential services, or ridiculously low lifetime limits, or punitive coinsurance rates, or... Perhaps they'd refuse to cover something because it was a "preexisting condition." Perhaps they'd drop you mid-treatment, making it impossible to get further treatment without going into severe debt. This insurance wouldn't have been much use to anyone in the event of cancer, or a heart attack, or a broken leg, but they were paying the premiums anyway, and it sure helped them feel insured. ACA made all of these practices illegal, or at least put some controls on them to ensure a baseline quality of insurance. These plans went away or became as expensive as other plans.
These people vote Republican because from their point of view ACA took away their plans and their doctors, and Obama had stupidly promised them that wouldn't happen. They had it good, or so they thought, and it was taken away from them.
Everyone else is experiencing rising deductibles and premiums with no end in sight. What most people fail to realize is that deductibles and premiums would be rising with or without ACA—as they were before the passage of ACA—at a greater rate! ACA bent the curve, so they're still increasing, but less so. Yes, your insurance cost $300/mo last year, and it costs $400/mo this year, but how much would it cost if ACA hadn't been passed seven years ago? Would you even be able to get insurance? Do you or a family member have a preexisting condition? Our minds aren't wired to think like this, though... all we see is a higher bill and want someone to blame, so we vote Republican.
I could go on. ACA did a lot, but it didn't do enough to encourage competition and control costs. Clearly. A public option and "death panels" would have helped a lot, but of course these were dropped to encourage bipartisan support for the bill... which it didn't get. Oh well.