OBAMA/TRUMPCARE MEGATHREAD

[cabiness42]

You mean like setting up exchanges?

 

No, not setting up new exchanges. Using the existing exchange for Federal employees and allowing any American to participate in that exchange.

 

Also, instead of mandating coverage by employers (which is worthless since it creates tons of loopholes), just give tax incentives to businesses to provide coverage to the point where nearly every employer will want to provide coverage. Also, by being able to participate in the Federal employee exchange, the cost to businesses should be lower.

 

[bmags]

No, not setting up new exchanges. Using the existing exchange for Federal employees and allowing any American to participate in that exchange.

 

Also, instead of mandating coverage by employers (which is worthless since it creates tons of loopholes), just give tax incentives to businesses to provide coverage to the point where nearly every employer will want to provide coverage. Also, by being able to participate in the Federal employee exchange, the cost to businesses should be lower.

 

I think the tax on employers was one of the weaker designed parts of the bill, but if anything the country should want to wind down the employer provided health insurance model instead of amp it up. If you were starting from scratch I don't think you could come up with a worse one beside saying insurance is outlawed.

[southsider2k5]

I think the tax on employers was one of the weaker designed parts of the bill, but if anything the country should want to wind down the employer provided health insurance model instead of amp it up. If you were starting from scratch I don't think you could come up with a worse one beside saying insurance is outlawed.

 

That is the whole goal of this plan.

[bmags]

That is the whole goal of this plan.

 

Right, but not explicitly.

[southsider2k5]

Right, but not explicitly.

 

Absolutely.

[Balta1701]

What happens to states' budgets when the federal medicaid subsidy ends in a few years?

 

It doesn't end. They cover 100% of the expansion for the first few years and ~95% forever.

 

Medicaid itself was created as a partially federal, partially state funded program. This expansion is a vastly better deal for the states than the creation of Medicaid itself was.

[Jake]

No, not setting up new exchanges. Using the existing exchange for Federal employees and allowing any American to participate in that exchange.

 

Also, instead of mandating coverage by employers (which is worthless since it creates tons of loopholes), just give tax incentives to businesses to provide coverage to the point where nearly every employer will want to provide coverage. Also, by being able to participate in the Federal employee exchange, the cost to businesses should be lower.

 

The main reason this had to be done because using things like tax incentives changed the math of the law. Requiring employers to provide health insurance doesn't affect the federal budget (at least, not in a direct manner) while giving them tax credits does. Republicans are very keen on the math.

[cabiness42]

The main reason this had to be done because using things like tax incentives changed the math of the law. Requiring employers to provide health insurance doesn't affect the federal budget (at least, not in a direct manner) while giving them tax credits does. Republicans are very keen on the math.

 

I'm not asking what a bunch of corrupt politicians would have approved--I'm asking what would have been a better plan than the current one.

 

[bmags]

Republicans didn't care about that they weren't going to vote for anything, so Dems protected themselves from "too expensive" sniping by coming up with a bizarre round number to say it wouldn't be more expensive then so had a bunch of mechanisms to raise revenue that weren't really important in terms of fixing health care but important to go below the magic round number of CBO scoring.

[Jake]

Republicans didn't care about that they weren't going to vote for anything, so Dems protected themselves from "too expensive" sniping by coming up with a bizarre round number to say it wouldn't be more expensive then so had a bunch of mechanisms to raise revenue that weren't really important in terms of fixing health care but important to go below the magic round number of CBO scoring.

 

President Obama saw how important this law can be (and will be) to the future of the USA and thus bent over very far backwards to try to get it passed with bipartisan support. Unfortunately, he had no idea that the only attempts at cooperation by the right were going to be disingenuous (such as them having basically promoted the current law until Obama capitulated, at which point they no longer liked it). Likewise, he had no idea that this great degree of capitulation would still cause the moderates and other members of competitive districts to lose in the mid-terms.

 

I have a feeling the Dem leadership would have approached things much differently with hindsight, by enacting either a single-payer system or at least implementing the public option.

 

There is another, not often spoken about aspect to this law: voter registration. Per federal law, Obamacare exchanges and other providers must give citizens the opportunity to register to vote (ala DMVs). I believe this is a huge, unspoken aspect to the Republican opposition to this law. This makes voter registration much easier for a lot of folks that are currently struggling to get registered and thus not turning out. These people will also presumably like having healthcare and will vote to keep/enhance the institutions that provide them with healthcare. The current Republican establishment hates when people vote and they really hate it when people like a government service.

 

Unlike voter ID and other voter-suppressive movements from the right, there is no good way to talk openly about the aforementioned issue. They can't complain that people can register to vote, because that is the process that helps to prevent the fraud they are so worried about. There have been a few cries about identity theft, but these haven't been picked up by mainstream voices because they don't make sense.

[Texsox]

I don't know who you are referring to here. The people that can't afford healthcare now go to doctors/clinics that still get paid by someone (medicaid/non-profits, etc.). So nothing changes there.

 

And what business do you know of that will drop their prices when their demand goes up?

 

The problem area are the working poor whose employers do not offer benefits. They do not qualify for medicaid, etc. They clog ERs and never pay. Their medical bills become so big they could never pay. Someone making $10 an hour, $20,00 or so annually can barely afford food, clothing, transportation, and shelter. A $6,000 medical bill, even if it is a co-pay never gets paid.

[Texsox]

I wish we had these sorts of budget debates before say dropping bombs on Iraq. We always have monoey for weapons of mass destruction, but not for our own people.

[bmags]

President Obama saw how important this law can be (and will be) to the future of the USA and thus bent over very far backwards to try to get it passed with bipartisan support. Unfortunately, he had no idea that the only attempts at cooperation by the right were going to be disingenuous (such as them having basically promoted the current law until Obama capitulated, at which point they no longer liked it). Likewise, he had no idea that this great degree of capitulation would still cause the moderates and other members of competitive districts to lose in the mid-terms.

 

I have a feeling the Dem leadership would have approached things much differently with hindsight, by enacting either a single-payer system or at least implementing the public option.

 

There is another, not often spoken about aspect to this law: voter registration. Per federal law, Obamacare exchanges and other providers must give citizens the opportunity to register to vote (ala DMVs). I believe this is a huge, unspoken aspect to the Republican opposition to this law. This makes voter registration much easier for a lot of folks that are currently struggling to get registered and thus not turning out. These people will also presumably like having healthcare and will vote to keep/enhance the institutions that provide them with healthcare. The current Republican establishment hates when people vote and they really hate it when people like a government service.

 

Unlike voter ID and other voter-suppressive movements from the right, there is no good way to talk openly about the aforementioned issue. They can't complain that people can register to vote, because that is the process that helps to prevent the fraud they are so worried about. There have been a few cries about identity theft, but these haven't been picked up by mainstream voices because they don't make sense.

 

I followed the health care bill closer than any legislation in my lifetime. The single payer option would not have had 30 votes, let alone 50, and while the public option may have had 50, they needed all 60 votes. This is the bill that could get passed. And all of the "why didn't they think of this stuff" that's out there now, well, it didn't have the support. This bill wasn't perfect, but the better options people throw out couldn't have gotten passed. Even as I make fun of them for the dumber parts of the bill to lower the cost, they probably needed those to get the senators from Nebraska and Arkansas on board.

 

And 2010 saw major losses in the house, who actually did vote for a bill with the public option, which obviously was not included when reconciled.

[EvilMonkey]

President Obama saw how important this law can be (and will be) to the future of the USA and thus bent over very far backwards to try to get it passed with bipartisan support. Unfortunately, he had no idea that the only attempts at cooperation by the right were going to be disingenuous (such as them having basically promoted the current law until Obama capitulated, at which point they no longer liked it). Likewise, he had no idea that this great degree of capitulation would still cause the moderates and other members of competitive districts to lose in the mid-terms.

 

I have a feeling the Dem leadership would have approached things much differently with hindsight, by enacting either a single-payer system or at least implementing the public option.

 

There is another, not often spoken about aspect to this law: voter registration. Per federal law, Obamacare exchanges and other providers must give citizens the opportunity to register to vote (ala DMVs). I believe this is a huge, unspoken aspect to the Republican opposition to this law. This makes voter registration much easier for a lot of folks that are currently struggling to get registered and thus not turning out. These people will also presumably like having healthcare and will vote to keep/enhance the institutions that provide them with healthcare. The current Republican establishment hates when people vote and they really hate it when people like a government service.

 

Unlike voter ID and other voter-suppressive movements from the right, there is no good way to talk openly about the aforementioned issue. They can't complain that people can register to vote, because that is the process that helps to prevent the fraud they are so worried about. There have been a few cries about identity theft, but these haven't been picked up by mainstream voices because they don't make sense.

Voter registration isn't easy NOW? f*** it all, why not just have them be able to vote when they go to the doctor as well? And screw you and your supposed racism in every damn thing that happens. Republican didn't bipartisan support the program because they think it is a BAD PROGRAM. Not because Obama is black, or a Democrat or that they want to put registration in it. However much you think he 'gave in', the bill still sucks. If all his 'capitulation' still caused moderates and such to lose, maybe it is because the bill still sucks.

[Soxbadger]

Does it really matter if the bill is good or bad, if they didnt want universal health care in the first place?

 

Lets call a spade a spade. Im sure that many politicians, including Obama, would be open to discussing how to change the law for the better....

 

 

[Balta1701]

Lets call a spade a spade. Im sure that many politicians, including Obama, would be open to discussing how to change the law for the better....

Actually, there are a few issues that have come up with implementation that we'd really like to tweak by passing small laws through Congress, but the party with the majority in the House is refusing to do anything which could improve the bill on the grounds that they want as many people to hate it as possible. For example, the way the bill was written it wound up excluding clergy members from receiving subsidies to purchase insurance through their churches. A simple, couple-line legislative fix would fix that. However, the Republicans will not allow any such fix to come up for a vote, demanding that clergy must suffer in order to demonstrate that the bill is a bad bill.

 

As a consequence, several hundred thousand clergy members could be forced to make purchases on the exchanges and drop their current coverage as a consequence.

 

We'd be happy to fix this and could do so without a problem if the bill were allowed to come up for a vote. One party will not allow any such things to happen.

[EvilMonkey]

However both sides managed to make it so that they and their workers aren't subject to it. Too bad they get to miss out from the awesomeness that is Obamacare!

[Balta1701]

However both sides managed to make it so that they and their workers aren't subject to it. Too bad they get to miss out from the awesomeness that is Obamacare!

This actually isn't true, it's just a talking point completely ignorant of the actual law.

 

The law required Obamacare options to be open to Congress and their staffers as well. However, the law also does not open the exchanges to large employers until 2017, and I think you'll probably agree the Federal Government is something of a large employer.

 

Consequently, the Office of Personnel Management had to pass a rule allowing the federal government to contribute to plans in the exchanges which otherwise would not have been authorized until 2017 in order to follow the spirit of the law.

 

Otherwise, the combination of these 2 competing claims would have effectively banned the government from providing insurance to its employees.

 

So yes, federal workers get special treatment...they get special treatment by being allowed into the exchanges. Their special treatment is getting the health plans created on the Obamacare exchanges.

[Soxbadger]

Maybe if everyone would have been gung ho on universal health care we could have all gotten great health care!

 

But unfortunately a group of people dont want everyone to get health benefits, so instead we have "the best we could pass".

 

If only the word "compromise" would have been invented.

[Jenksismyhero]

The problem area are the working poor whose employers do not offer benefits. They do not qualify for medicaid, etc. They clog ERs and never pay. Their medical bills become so big they could never pay. Someone making $10 an hour, $20,00 or so annually can barely afford food, clothing, transportation, and shelter. A $6,000 medical bill, even if it is a co-pay never gets paid.

 

Roughly $16k/year is the cutoff for medicaid. At that point the person we're talking about isn't going to be able to afford the ACA rates of coverage anyway.

[Jenksismyhero]

Maybe if everyone would have been gung ho on universal health care we could have all gotten great health care!

 

But unfortunately a group of people dont want everyone to get health benefits, so instead we have "the best we could pass".

 

If only the word "compromise" would have been invented.

 

 

"If people would just do what I say we wouldn't be in this mess! Guh. Come on guys, let's compromise!"

[Balta1701]

Roughly $16k/year is the cutoff for medicaid. At that point the person we're talking about isn't going to be able to afford the ACA rates of coverage anyway.

Actually, first of all yes they would. The plans have generally been coming in at about 15% lower costs than the CBO projected a couple years ago. That means the typical bronze level plan would, on its own, cost in the range of $1200 per year. For health coverage on its own, that isn't bad. I'd have paid that happily when I was below the poverty line.

 

However, there is a substantial tax subsidy piled on top of that for low income earners. Using yoru $16k a year example, the subsidy the federal government would pay to purchase insurance, for a "silver" level plan, would be $1500, with the person's out of pocket yearly expenses being ~$500. (used this subsidy calculator)

 

At $16000 per year, buying private insurance in the exchanges will cost $500 for your person (non-smoker assumed). Man I wish this existed 8 years ago, you have no idea.

[EvilMonkey]

This actually isn't true, it's just a talking point completely ignorant of the actual law.

 

The law required Obamacare options to be open to Congress and their staffers as well. However, the law also does not open the exchanges to large employers until 2017, and I think you'll probably agree the Federal Government is something of a large employer.

 

Consequently, the Office of Personnel Management had to pass a rule allowing the federal government to contribute to plans in the exchanges which otherwise would not have been authorized until 2017 in order to follow the spirit of the law.

 

Otherwise, the combination of these 2 competing claims would have effectively banned the government from providing insurance to its employees.

 

So yes, federal workers get special treatment...they get special treatment by being allowed into the exchanges. Their special treatment is getting the health plans created on the Obamacare exchanges.

They get subsidies, special treatment.

http://www.nationalreview.com/corner/35937...jonathan-strong

 

Under Obamacare, members of Congress and their staffs were required to purchase health insurance in the exchange markets. Last month, after President Obama personally intervened in the matter, the Office of Personnel Management decided the federal government will continue to subsidize staffers’ health insurance at the cost of thousands of dollars per year per employee. “They’re going to be the only people in America who get these subsidies,” DeSantis says.

[Balta1701]

So yes, federal workers get special treatment...they get special treatment by being allowed into the exchanges. Their special treatment is getting the health plans created on the Obamacare exchanges.

 

 

They get subsidies, special treatment.

http://www.nationalreview.com/corner/35937...jonathan-strong

H. Christ, My last sentence says "Their special treatment is getting the health plans created on the Obamacare exchanges". You then reply "they get subsidies, special treatment" as though somehow you' think you're making an intelligent point.

 

I JUST SAID THAT.

 

Is it your contention that the PPACA required the federal government to not offer health benefits to any employees anywhere?

[Jenksismyhero]

Actually, first of all yes they would. The plans have generally been coming in at about 15% lower costs than the CBO projected a couple years ago. That means the typical bronze level plan would, on its own, cost in the range of $1200 per year. For health coverage on its own, that isn't bad. I'd have paid that happily when I was below the poverty line.

 

However, there is a substantial tax subsidy piled on top of that for low income earners. Using yoru $16k a year example, the subsidy the federal government would pay to purchase insurance, for a "silver" level plan, would be $1500, with the person's out of pocket yearly expenses being ~$500. (used this subsidy calculator)

 

At $16000 per year, buying private insurance in the exchanges will cost $500 for your person (non-smoker assumed). Man I wish this existed 8 years ago, you have no idea.

 

For the bronze package they also have to pay 40% of their healthcare costs. I assume silver is 30% So yeah, you pay the low premium, but if you have basically any sort of medical issue in a year you're on the hook for quite a bit of money. Random fender benders could cost you 10-15k in medical bills. Does that person have an extra 3-6k laying around? Nope. So, the doctors/clinics overcharge other patients (me) to cover the loss. Again, where's the savings for your average American? There is none. This is all coming out of your paycheck.

 

Edit: Pssh, according to that site there's a cap on how much you would spend in a year. $2250 for a silver plan. What a joke. Again, we're all paying the bill.

Edited September 25, 2013 by Jenksismybitch