OBAMA/TRUMPCARE MEGATHREAD

[StrangeSox]

BREAKING: Sen. Rand Paul says he and three other Republican senators oppose health bill as written, putting passage in jeopardy

 

AP Politics @AP_Politics

now

Police making arrests at Capitol of health bill protesters: apne.ws/2t00rRH

 

 

Senate Republicans are actually lifting caps on insurance company execs while cutting Medicaid and defunding Planned Parenthood

 

 

more Americans being arrested for protesting

https://twitter.com/sparksjls/status/877945753162792960

Edited June 22, 2017 by StrangeSox

[ptatc]

It's looking more and more like the Senate bill will actually be even more harmful than the House bill, surprisingly.

 

 

 

 

 

 

 

 

It might make too many changes and fall victim to Byrd Rules, though.

I'm all for giving the states more authority on these issues. different state have different medical issues and should have leeway on how they are allocate resources.

[StrangeSox]

"Giving states more authority" means a fun race to the regulatory bottom (see: why all of your credit cards come from SD or Delaware) for large employers in multiple states and people living in a waiver state getting screwed, and block-granting Medicaid means massively cutting Medicaid.

 

Different states have different medical issues to some extent, but it's not like some states don't actually have a need to cover pre-existing conditions or maternity or for insurers to make sure they spend a certain minimum percentage of premiums on actually paying for medical care.

 

These are the Essential Health Benefits that Republicans would like to allow insurance companies to not provide:

 

Ambulatory patient services. [outpatient care]

Emergency services.

Hospitalization. [inpatient care]

Maternity and newborn care

Mental health and substance use disorder services, including behavioral health treatment.

Prescription drugs.

Rehabilitative and habilitative services and devices.

Laboratory services

Preventive and wellness services and chronic disease management;

Pediatric services, including oral and vision care.

 

In what state would these not be routine and necessary services?

 

on that same note:

Nicholas Bagley‏

@nicholas_bagley

Waivers are not only supercharged under the new Senate bill. Governors can seek waivers *without* going to their legislatures.

Edited June 22, 2017 by StrangeSox

[caulfield12]

Punting all the problems into the future and retaining large parts of ACA while not fundamentally fixing anything, great plan if you can get away with it.

Edited June 22, 2017 by caulfield12

[knightni]

Could you elaborate or provide your source?

What's to elaborate? It was an idea to balance things for people.

 

The cost of premiums and out of pocket expenses hurt the lower income sick and poorer families with medical needs.

The average person who makes $30,000 a year can pay almost 1/3 of that in insurance costs if they have a major illness in the family.

 

You make $600.00 gross a week, you pay $90.00 for your health insurance premium every week.

 

You make $250,000 gross a week, you pay $37,500 a week.

 

 

 

[StrangeSox]

Call your Senators and tell them to:

 

1) vote no if they're republican

2) do everything they possibly can to stop this if they're democrat

[Quin]

So insurance companies can cover whatever or whomever they want, no matter what premiums have been paid? Yikes. Them about to get rich(er)!

 

Source? Trying to verify.

[LittleHurt05]

So insurance companies can cover whatever or whomever they want, no matter what premiums have been paid? Yikes. Them about to get rich(er)!

 

That's basically what they have done to me the past few years, it's brutal.

[ptatc]

"Giving states more authority" means a fun race to the regulatory bottom (see: why all of your credit cards come from SD or Delaware) for large employers in multiple states and people living in a waiver state getting screwed, and block-granting Medicaid means massively cutting Medicaid.

 

Different states have different medical issues to some extent, but it's not like some states don't actually have a need to cover pre-existing conditions or maternity or for insurers to make sure they spend a certain minimum percentage of premiums on actually paying for medical care.

 

These are the Essential Health Benefits that Republicans would like to allow insurance companies to not provide:

 

 

 

In what state would these not be routine and necessary services?

 

on that same note:

It's not that they don't need to offer it but can reallocate where needed. for your examples, alaska may want to put more in the the alcohol and drug rehab issues more than another state. States with an older population may need it more in chronic diseases etc. each state has different needs and they should have more say in it.

 

I agree with the regulatory bottom.

[StrangeSox]

It's not a question of state funding, though. It's a question of what insurance providers need to offer on private insurance markets.

[StrangeSox]

Obama's response

 

Our politics are divided. They have been for a long time. And while I know that division makes it difficult to listen to Americans with whom we disagree, that’s what we need to do today.

 

I recognize that repealing and replacing the Affordable Care Act has become a core tenet of the Republican Party. Still, I hope that our Senators, many of whom I know well, step back and measure what’s really at stake, and consider that the rationale for action, on health care or any other issue, must be something more than simply undoing something that Democrats did.

 

We didn’t fight for the Affordable Care Act for more than a year in the public square for any personal or political gain – we fought for it because we knew it would save lives, prevent financial misery, and ultimately set this country we love on a better, healthier course.

 

Nor did we fight for it alone. Thousands upon thousands of Americans, including Republicans, threw themselves into that collective effort, not for political reasons, but for intensely personal ones – a sick child, a parent lost to cancer, the memory of medical bills that threatened to derail their dreams.

 

And you made a difference. For the first time, more than ninety percent of Americans know the security of health insurance. Health care costs, while still rising, have been rising at the slowest pace in fifty years. Women can’t be charged more for their insurance, young adults can stay on their parents’ plan until they turn 26, contraceptive care and preventive care are now free. Paying more, or being denied insurance altogether due to a preexisting condition – we made that a thing of the past.

 

We did these things together. So many of you made that change possible.

 

At the same time, I was careful to say again and again that while the Affordable Care Act represented a significant step forward for America, it was not perfect, nor could it be the end of our efforts – and that if Republicans could put together a plan that is demonstrably better than the improvements we made to our health care system, that covers as many people at less cost, I would gladly and publicly support it.

That remains true. So I still hope that there are enough Republicans in Congress who remember that public service is not about sport or notching a political win, that there’s a reason we all chose to serve in the first place, and that hopefully, it’s to make people’s lives better, not worse.

 

But right now, after eight years, the legislation rushed through the House and the Senate without public hearings or debate would do the opposite. It would raise costs, reduce coverage, roll back protections, and ruin Medicaid as we know it. That’s not my opinion, but rather the conclusion of all objective analyses, from the nonpartisan Congressional Budget Office, which found that 23 million Americans would lose insurance, to America’s doctors, nurses, and hospitals on the front lines of our health care system.

 

The Senate bill, unveiled today, is not a health care bill. It’s a massive transfer of wealth from middle-class and poor families to the richest people in America. It hands enormous tax cuts to the rich and to the drug and insurance industries, paid for by cutting health care for everybody else. Those with private insurance will experience higher premiums and higher deductibles, with lower tax credits to help working families cover the costs, even as their plans might no longer cover pregnancy, mental health care, or expensive prescriptions. Discrimination based on pre-existing conditions could become the norm again. Millions of families will lose coverage entirely.

 

Simply put, if there’s a chance you might get sick, get old, or start a family – this bill will do you harm. And small tweaks over the course of the next couple weeks, under the guise of making these bills easier to stomach, cannot change the fundamental meanness at the core of this legislation.

 

I hope our Senators ask themselves – what will happen to the Americans grappling with opioid addiction who suddenly lose their coverage? What will happen to pregnant mothers, children with disabilities, poor adults and seniors who need long-term care once they can no longer count on Medicaid? What will happen if you have a medical emergency when insurance companies are once again allowed to exclude the benefits you need, send you unlimited bills, or set unaffordable deductibles? What impossible choices will working parents be forced to make if their child’s cancer treatment costs them more than their life savings?

 

To put the American people through that pain – while giving billionaires and corporations a massive tax cut in return – that’s tough to fathom. But it’s what’s at stake right now. So it remains my fervent hope that we step back and try to deliver on what the American people need.

 

That might take some time and compromise between Democrats and Republicans. But I believe that’s what people want to see. I believe it would demonstrate the kind of leadership that appeals to Americans across party lines. And I believe that it’s possible – if you are willing to make a difference again. If you’re willing to call your members of Congress. If you are willing to visit their offices. If you are willing to speak out, let them and the country know, in very real terms, what this means for you and your family.

 

After all, this debate has always been about something bigger than politics. It’s about the character of our country – who we are, and who we aspire to be. And that’s always worth fighting for.

[knightni]

I just don't see how anyone that has medical insurance can support this new healthcare.

 

It's just so bad.

 

If you have ever had to pay thousands of dollars out of your own pocket for doctor visits and emergency services that other countries don't pay as much to get, then you'll understand.

 

Once you have children and start developing medical conditions, you'll also understand.

 

The cost of getting sick is ridiculously high.

 

People don't choose to get sick or injured. Why should they be punished?

[Brian]

That's basically what they have done to me the past few years, it's brutal.

 

Ditto.

 

Had surgery 5 years ago. Called Humana ahead of time to approve everything. It was out of network so they said I would owe $8,000 out of pocket. Expensive but I was going to AZ for the surgery so expected.

Get my bill and they didn't cover what they said. My bill was $46,000.

I appealed and they admitted to quoting me the $8000 but said they determined they weren't going to cover what they promised. Even had the conversation with the rep recorded for viewing.

Luckily, Mayo Clinic was VERY understanding and after filling out the financial aid, they only charged me the $8000 that Humana quoted.

 

If I ever win Powerball, I'll be donating to Mayo Clinic for sure.

[StrangeSox]

Yeah health care in this country under the ACA is still a bit of a trainwreck for a lot of people. Turns out actually insuring health cradle-to-grave is expensive and not particularly profitable. The ACA is an improvement on a still pretty flawed system while the AHCA is deliberately taking a wrecking ball to the system and replacing it with upper class tax cuts.

[ptatc]

It's not a question of state funding, though. It's a question of what insurance providers need to offer on private insurance markets.

i guess I wasn't clear. If there any regulations place upon the insurance companies to offer any of the services, the state should decide them because each state is different and have a better idea than the federal government.

 

When I said paid, I was referring to what the insurance companies need to offer in relative coverage. more in certain areas than others for specific states.

 

I would prefer there not be regulations but if there are, the states should decide them.

[Soxbadger]

Your comment was very vague so certainly there's plenty to elaborate - especially on a subject as expansive as health care. I can do the math on the percentages.

 

I am just not sure what you're advocating for. It seems like you're advocating for the ACA while your primary concern is premium costs. The incredible increases in premiums are a huge problem and I am with you there. That being said, the ACA has giant premium increases this year (ex. ~43% increase estimated for ACA Silver Plan in Illinois) and significant increases next year. That's not even touching the dastardly effect of the ACA's high deductible plans. I guess I am just confused as to how you want lower premiums and ACA at the same time when ACA is the reason premiums are going to be skyrocketing regardless of whether ACA is kept, healthcare is in limbo, or the ACHA is adopted.

 

I am in no way a fan of the AHCA plan, it just runs at odds to be a proponent of ACA and be upset premiums are ridiculous.

 

The reason for the increase in premiums is because congress wont pass laws that restrict premiums.

 

Of course insurance companies are going to do whatever they can to make the most money possible.

 

The question is, do we as a society feel that people should be getting rich off the health of others?

[StrangeSox]

The reason for the increase in premiums is because congress wont pass laws that restrict premiums.

 

Of course insurance companies are going to do whatever they can to make the most money possible.

 

The question is, do we as a society feel that people should be getting rich off the health of others?

 

Some of it is also due to the GOP not promising to make the federal reimbursements to the insurers, creating a lot of uncertainty. They've been pretty explicit about that this year, as have the GOP about sabotaging the exchanges.

 

Premiums were still rising too much under the ACA, but they were actually rising more slowly than they were pre-ACA.

Edited June 22, 2017 by StrangeSox

[StrangeSox]

i guess I wasn't clear. If there any regulations place upon the insurance companies to offer any of the services, the state should decide them because each state is different and have a better idea than the federal government.

 

When I said paid, I was referring to what the insurance companies need to offer in relative coverage. more in certain areas than others for specific states.

 

I would prefer there not be regulations but if there are, the states should decide them.

 

I live and work in IL but my insurance is through FL because my employer chose that. I don't want to be subject to the whims of state-by-state policy and a race to the bottom for the worst legally required health insurance. That doesn't actually benefit anyone but health insurers.

 

What state doesn't have people that would be harmed by the removal of the EHB requirements? Why should that basic level of care be decided on a state-by-state basis? What benefit to citizens gain from that?

[caulfield12]

Right now, there are four Senators publicly against it...and surely Murkowski and Heller. (McCain's for but hasn't even read much more than a synopsis, someone please put him out to pasture.)

 

They tack too far to appease the right and Rand Paul, they lose the middle.

 

Not to mention it could never get through the House unless all those cherished Republican principles are thrown out the window just to move on to tax reform and the budget, where the poor/middle class will continue to get screwed over again and again.

Edited June 22, 2017 by caulfield12

[ptatc]

I just don't see how anyone that has medical insurance can support this new healthcare.

 

It's just so bad.

 

If you have ever had to pay thousands of dollars out of your own pocket for doctor visits and emergency services that other countries don't pay as much to get, then you'll understand.

 

Once you have children and start developing medical conditions, you'll also understand.

 

The cost of getting sick is ridiculously high.

 

People don't choose to get sick or injured. Why should they be punished?

Being in the medical field, I completely understand this point. However, there is also the other point that others are making is that should others be punished be paying higher taxes for people they don't know.

 

It's a dilemma. no system is perfect. go to canada and wait 6 months for an "elective" surgery such as a meniscus tear or have it here in two weeks but have it cost 3 times as much. Got to Norway where it's a good model but they are far fewer people using the system and where people are taxed much heavily than they are here.

[caulfield12]

I live and work in IL but my insurance is through FL because my employer chose that. I don't want to be subject to the whims of state-by-state policy and a race to the bottom for the worst legally required health insurance. That doesn't actually benefit anyone but health insurers.

 

What state doesn't have people that would be harmed by the removal of the EHB requirements? Why should that basic level of care be decided on a state-by-state basis? What benefit to citizens gain from that?

 

 

The only argument that's logical is a reallocation providing Even MORE funding in states dealing with opioids, which are mostly Trump states.

 

But what creates the impression that someone like Paul Ryan or Tom Price or Mick Mulvaney gives a flying f--- about those people?

Edited June 22, 2017 by caulfield12

[StrangeSox]

Right now, there are four Senators publicly against it...and surely Murkowski and Heller. (McCain's for but hasn't even read much more than a synopsis, someone please put him out to pasture.)

 

They tack too far to appease the right and Rand Paul, they lose the middle.

 

Not to mention it could never get through the House unless all those cherished Republican principles are thrown out the window just to move on to tax reform and the budget, where the poor/middle class will continue to get screwed over again and again.

 

They've all expressed "concerns" with the bill "as written," but McConnell apparently specifically left things out of the bill. This gives these Senators the cover to offer a specific amendment and then vote for the bill saying "it was the best deal we could get."

 

Word from the House is that House R's will pass whatever the Senate does unchanged, avoiding a potentially messy reconciling of the two bills and then re-votes in both chambers.

 

We're going to get this god-awful bill that blows up a big chunk of our healthcare industry and leaves thousands of dead Americans a year in its wake to fund nearly a trillion dollars in upper class tax cuts. That's where this country's political priorities are these days.

 

e: I have no doubt that this will actually work

 

Dave Weigel ✔ @daveweigel

Talked to a GOP strategist today who laid out how the party will campaign against Obamacare in 2018 even if AHCA passes. Ambitious.

Dave Weigel ✔ @daveweigel

The gist: Rs will say that any problems with HC come November 2018 are the aftershock of Obamacare. Vote for Rs, who will keep fixing it!

4:04 PM - 22 Jun 2017

Edited June 22, 2017 by StrangeSox

[Soxbadger]

1.) So when Obama was still in office and everyone was 100% sure HRC was the heir to the presidency why were there estimates of the huge increases in premiums? Certainly the . probability of increases in premiums is increased by inaction in congress but this isn't something we didn't know was coming. Everyone knew once Obama left office premiums for ACA would skyrocket.

 

2.) That is not the question at all. It seems like you're just virtue signaling that you have incredibly moral beliefs.

 

1) Because the President doesnt pass laws. So unfortunately the President cant pass a law that would regulate premiums. But congress could have definitely passed a law that stated that insurance companies can only increase premiums x amount a year. It could be similar to rent control in San Fran. If you live in same unit your rent can only increase by X%.

 

2) It actually is a question. Just because you dont like the answer, doesnt mean its not a question.

[ptatc]

I live and work in IL but my insurance is through FL because my employer chose that. I don't want to be subject to the whims of state-by-state policy and a race to the bottom for the worst legally required health insurance. That doesn't actually benefit anyone but health insurers.

 

What state doesn't have people that would be harmed by the removal of the EHB requirements? Why should that basic level of care be decided on a state-by-state basis? What benefit to citizens gain from that?

I don't think it would work that way. If the states don't need to pay for it, they will regulate the heck out of insurance companies to gain favor with the voters. The citizens benefit by having more of their interests decided by people more familar with their situations. The Federal government doesn't need to make a blanket policy for everyone in the entire US when each state can do it much easier.

[StrangeSox]

I'm fairly sure that the ACA actually has a provision requiring premium increases to be approved by HHS. It's similar to utility companies needing approval before a rate hike.

 

The problem is that the response to "no, you can't raise premiums that much" is "fine, since it won't be profitable for shareholders, we'll just pull out of the market entirely." Actually insuring everyone healthy or sick from cradle to grave is incredibly expensive and not all that profitable.