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Tags Affordable Care Act , AHCA , donald trump , health care issues , health insurance issues , obamacare , Trumpcare

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Old Yesterday, 04:59 AM   #3521
The Don
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Originally Posted by sts60 View Post
The so-called "moderates" who say they are "uncomfortable" with the bill are playing a cynical game. They get to put on a show of standing up for their unhappy constituents and will get some relatively trivial changes which they can say "address their concerns" so they can vote for it. A couple in the most vulnerable places may even be allowed to vote against it, but under no circumstances will more than two GOP senators vote against it, so that that Michael (spit) Pence can cast the deciding vote. The "can't supporters" on the right are don't the same thing, but from a different direction.

All the talk about how they're "concerned" is absolute BS. They don't care about how awful the bill is, they don't care about the rotten and anti-democratic the process is, and they don't care how many of their nominal constituents are going to lose healthcare as a result. The only things they care about are getting their base to vote again for them, even if they are dying of manageable chronic conditions, and giving fat tax breaks to their real constituency, the richest 1% of Americans.
I tend to agree with this. The GOP are nothing if not well marshaled.
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Old Yesterday, 05:33 AM   #3522
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The Times has outlined the winners of the wealthcare bill.

Quote:
Who benefits? It’s all about the tax cuts, almost half of which will go to people with incomes over $1 million, the great bulk to people with incomes over 200K.

So, is this bill good for you? Yes, if you meet the following criteria:

1.Your income is more than $200,000 a year
2.You have a job that comes with good health insurance
3.You can’t imagine any circumstances under which you lose that job or income
4.You don’t have any family members or friends who don’t meet those criteria
5.You have zero empathy for anyone else
I don't understand the GOP's intense desire to pass this bill since the voters they added to win in November are going to be harmed the most by it.
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Old Yesterday, 06:23 AM   #3523
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Originally Posted by Stacko View Post
I don't understand the GOP's intense desire to pass this bill since the voters they added to win in November are going to be harmed the most by it.
Their desire to pass this is driven by their need to repeal the ACA. They have to repeal quickly because they've said time and again how bad it is and how it's going to collapse under its own weight but it's becoming more and more popular so they have to do it before it becomes un-repealable.

In order to repeal they have to offer an alternative and it seems that the current bill may be able to pass the Senate and then they may be able to crowbar it back through the House. That will be a campaign promise fulfilled.

Of course tens of millions will be worse off and millions will lose their healthcare altogether but that's fine because many (if not most) of those people who voted GOP but who will suffer under this bill:
  • Won't be hurt immediately - so the pain can be blamed on later administrations
  • Will not connect their suffering to the ACA repeal and instead it will be put down to something else
  • Will think they're better off even if they are paying more and/or have more or less worthless coverage
  • Will think it's good regardless because the GOP did it
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Old Yesterday, 09:46 AM   #3524
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Originally Posted by The Don View Post
Their desire to pass this is driven by their need to repeal the ACA. They have to repeal quickly because they've said time and again how bad it is and how it's going to collapse under its own weight but it's becoming more and more popular so they have to do it before it becomes un-repealable.

In order to repeal they have to offer an alternative and it seems that the current bill may be able to pass the Senate and then they may be able to crowbar it back through the House. That will be a campaign promise fulfilled.

Of course tens of millions will be worse off and millions will lose their healthcare altogether but that's fine because many (if not most) of those people who voted GOP but who will suffer under this bill:
  • Won't be hurt immediately - so the pain can be blamed on later administrations
  • Will not connect their suffering to the ACA repeal and instead it will be put down to something else
  • Will think they're better off even if they are paying more and/or have more or less worthless coverage
  • Will think it's good regardless because the GOP did it

they probably will be paying less - until they need the insurance. My understanding is that a lot of the plans that were lost under the ACA were pretty worthless
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link is 2015 data (2013 Data below):
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US 16.4% of GDP of which 48.2% is public expenditure - 7.9% of GDP is public spending
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Old Yesterday, 09:58 AM   #3525
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Originally Posted by Stacko View Post
The Times has outlined the winners of the wealthcare bill.



I don't understand the GOP's intense desire to pass this bill since the voters they added to win in November are going to be harmed the most by it.
If I put my 'politician' hat on, I can see a roadmap that includes misrepresenting the content of the bill to constituents through expensive and sophisticated information campaigns.

Deny there are any tax cuts.
Emphasize that they've protected Americans from Death Panels.

Not working? Get maskirovka help from the Kremlin. Kushner has them on speed dial.
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Old Yesterday, 10:00 AM   #3526
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Originally Posted by newyorkguy View Post
McConnell unveiled the secret healthcare bill yesterday to a decidedly mixed review.


Four major Republican senators -- Rand Paul of Kentucky, Ted Cruz of Texas, Mike Lee of Utah and Ron Johnson of Wisconsin -- immediately announced they cannot support the bill as written. Even Donnie seems uncomfortable with the billions of dollars in cuts to Medicaid, calling them "mean." Another controversial feature of the Republican program is a prohibition against using federal tax credits to buy healthcare plans that include abortion coverage.

The problem facing Republicans has not changed: How to draft a bill that is extreme enough that Tea Party members will support it, without making it so severe more moderate Republicans will not.
If you were depending on any of those four to vote no for deciding vote, you're going to be disappointed. However, in a crushing blow for the bill, Dean Heller has come out as a no. The GOP can only lose one more and pass it which is a problem with moderates Lisa Murkowski and Susan Collins already signalling they're already most likely nos.
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Old Yesterday, 10:01 AM   #3527
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Originally Posted by blutoski View Post
Not working? Get maskirovka help from the Kremlin. Kushner has them on speed dial.
In Putin's Russia, Jared comes to you!
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Old Yesterday, 10:10 AM   #3528
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Originally Posted by Stacko View Post
If you were depending on any of those four to vote no for deciding vote, you're going to be disappointed. However, in a crushing blow for the bill, Dean Heller has come out as a no. The GOP can only lose one more and pass it which is a problem with moderates Lisa Murkowski and Susan Collins already signalling they're already most likely nos.
I've said it repeatedly, I'll believe it when I see it.

Like as not it will turn out as sts60 suggested it will in another thread:

Some minor concessions will be made, or at least be seen to be made so that some senators can loudly proclaim that they have worked hard in the interests of their constituents (and pass a bill that will screw them over) and up two GOP senators will be allowed to dissent with the Vice President breaking the tie if needs be.
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Old Yesterday, 10:41 AM   #3529
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Yep. Murkowski and Collins in particular keep repeating this bit of pretend political courage, orchestrated by one of the worst Americans ever to infest Congress, Mitch (spit) McConnell. No one should ever fall for it again, but somehow we keep seeing the same breathless stories about how certain Senators - usually including but not limited to those two - are concerned and "can't vote for the bill in its present form".
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Old Yesterday, 11:11 AM   #3530
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Originally Posted by sts60 View Post
Yep. Murkowski and Collins in particular keep repeating this bit of pretend political courage, orchestrated by one of the worst Americans ever to infest Congress, Mitch (spit) McConnell. No one should ever fall for it again, but somehow we keep seeing the same breathless stories about how certain Senators - usually including but not limited to those two - are concerned and "can't vote for the bill in its present form".
Murkowski has stated that defunding Planned Parenthood is a nonstarter for her so that needs to come out before she'll support the bill in any form. Removing the defunding of Planned Parenthood might cause them to lose the support of Christian supremacists Lee and/or Cruz. This blindside from Heller might actually cause the bill to at least be debated in the Senate in order for the Republicans to figure out which two purple state Senators are going to get the seat saving no votes.
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Old Yesterday, 01:07 PM   #3531
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I think the above posts, most of them, are pretty realistic, and they also make a broader point. That for healthcare, as for many other programs, Republican politicians are concerned most of all with what's best for the Republican Party. The American people come in a distant second. I know the obvious (partisan) counter to this is to respond, "Yes they're just like Democrats!" but I really don't see that's true to the same extent.

There's been a number of Democratic politicians who have worked pretty hard over the past two decades to try and gain greater access to healthcare for more Americans. To try and end the situation where many people do not have a primary care doctor, and can only get health services (public) when they become too sick to turn away.
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Old Yesterday, 01:10 PM   #3532
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The knives are out.
AMERICA FIRST POLICIES, the pro-Trump/Pence outside group that Pence has been raising for, is preparing a seven-figure ad buy against HELLER
Looks like the Senate bill is the GOP position. It would be hard to pick a worse policy to define your party.
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Old Yesterday, 01:16 PM   #3533
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Passing an atrocious bill and having the main effects take place after 2020, well isn't that special. They get to pretend they replaced the ACA while making sure the negative consequences will be blamed on the Democratic administration which is sure to replace Trump if Trump runs for a second term.

Ron Paul of the libertarian four who claim the can't support the bill couldn't keep a straight face saying he would vote against the bill as is, but hint hint, give him something in return and he will.

And Susan Collins, as middle of the aisle as she seems is also easily manipulated by her GOP colleagues. She doesn't sound like she has the guts to vote against the Wealthcare Act. We're doomed.
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Old Yesterday, 01:19 PM   #3534
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Originally Posted by Stacko View Post
Murkowski has stated that defunding Planned Parenthood is a nonstarter for her so that needs to come out before she'll support the bill in any form. Removing the defunding of Planned Parenthood might cause them to lose the support of Christian supremacists Lee and/or Cruz. This blindside from Heller might actually cause the bill to at least be debated in the Senate in order for the Republicans to figure out which two purple state Senators are going to get the seat saving no votes.
Ah, but they only defunded it for one year. Or something like that.
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Old Yesterday, 01:21 PM   #3535
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Originally Posted by Skeptic Ginger View Post
Passing an atrocious bill and having the main effects take place after 2020, well isn't that special. They get to pretend they replaced the ACA while making sure the negative consequences will be blamed on the Democratic administration which is sure to replace Trump if Trump runs for a second term.
I think that makes the wealthcare bill a central issue of the 2020 election since if you elect a Democratic congress and President those cuts could be stopped.
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Old Yesterday, 03:26 PM   #3536
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Originally Posted by Emily's Cat View Post
Prior to ACA, several actuarial organizations provided expert opinion and advice to congress. The didn't really listen very well
Can you name the groups you're referring to and what advice and/or changes they recommended that were not listened to? More importantly, who exactly wasn't listening?

This group is a 19,000 member actuary group (link) and this is from their website:
Quote:
  • Although the ACA has dramatically reduced uninsured rates, enrollment in the individual market has been lower than initially expected and enrollees have been less healthy than expected.
  • The uncertain and changing regulatory environment—including legal challenges to the ACA, allowing individuals to retain pre-ACA coverage, and constraints on risk corridor payments—contributed to adverse experience among insurers. As a result of these and other factors, insurer participation and consumer plan choice declined in 2016 and is declining further in 2017.
  • In recent years, health care spending has been growing relatively slowly compared with historical averages, but there are signs that growth rates are increasing.

Last edited by newyorkguy; Yesterday at 03:29 PM.
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Old Yesterday, 03:38 PM   #3537
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Originally Posted by newyorkguy View Post
That for healthcare, as for many other programs, Republican politicians are concerned most of all with what's best for the Republican Party. The American people come in a distant second.
I doubt if the "American people" are that high on the priority list.

I really don't know what Republican politicians are thinking. Few people/interest groups seem to actually like this bill. In some ways I'd rather see a straight-up repeal of the ACA. At least that wouldn't foster the illusion that the GOP did something constructive.

Last edited by Minoosh; Yesterday at 03:43 PM.
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Old Yesterday, 04:11 PM   #3538
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This is from a business analysis regarding large managed care companies. Apparently they've been crying "wolf!":
Quote:
“If Obamacare has been bad for the managed care stocks, why have they performed so well under it?” asked Paul Hickey, a founder of Bespoke Investment Group. “And do they really need to be rescued by Congress?” The answers are complex but boil down to this: Basically, several analysts on Wall Street and in Washington said, the underlying businesses of the big managed care companies have actually done extremely well under Obamacare. They have run into some problems but are hardly in need of a rescue. Link
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Old Yesterday, 04:16 PM   #3539
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Originally Posted by Stacko View Post
Looks like the Senate bill is the GOP position. It would be hard to pick a worse policy to define your party.
Having picked the policy of being against the AHA to define the party they've pretty much trapped themselves.
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Old Yesterday, 04:24 PM   #3540
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Originally Posted by CapelDodger View Post
Having picked the policy of being against the ACA to define the party they've pretty much trapped themselves.
Simply repealing the ACA would be a better position. The AHCA does more which is cruel. This is a massive tax cut at the expense of Medicaid recipients.



The Senate bill’s tax cuts for the richest 400 families are the equivalent of ending Medicaid expansion in Alaska, Arkansas, Nevada and WV.
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Old Yesterday, 05:29 PM   #3541
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Gee, what do those states have in common?
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Old Yesterday, 07:01 PM   #3542
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For some of them, it's probably just a way of signalling they need some pork added in order to get their nod.

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Old Today, 03:25 AM   #3543
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Here's what he promised even after he was elected:
Quote:
"We’re going to have insurance for everybody,” Trump told The Washington Post’s Robert Costa and Amy Goldstein during an interview less than a week before his inauguration...The plan would have “lower numbers, much lower deductibles.”...What’s more, people could “expect to have great health care” that would be “in a much simplified form. Much less expensive and much better.” Link
This is Atlantic City all over again. Only now he's doing it to the whole country.
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Old Today, 05:27 AM   #3544
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Wisconsin holdout can be lumped with Cruz abd Rand Paul. They want to deny sick people insurance:
Johnson raised his concerns about Medicaid funding levels with President Donald Trump at a White House meeting with other lawmakers last week. His other major beef is that the bill won’t do enough to reduce premiums — a chief complaint among Cruz, Lee and Paul. They would like the bill to repeal Obamacare’s requirement that insurance companies accept everyone regardless of a pre-existing condition — a political non-starter with many other Republicans. The Senate conservatives say there are other ways to protect people with medical problems, such as high-risk pools.

“The primary driver of premium increases is guaranteed issue,” Johnson said, referring to the Obamacare protection for pre-existing conditions. “We really should be talking about providing individuals the freedom to purchase the kind of health care products they want to buy not being dictated by the federal government.”

http://www.politico.com/story/2017/0...re-bill-239922
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And we are going right back to the Hillary/Obama progression of things once we get rid of Trump. The last Republican president this century. Face it, with population growth and more urban people, the future is more Sesame Street than Little House on The Prairie.
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Old Today, 05:49 AM   #3545
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Will the GOP ever understand the mistake they're making? They are taking health care away from sick people. Kind of like taking food from hungry children: It does not take a lot of explaining; the reality can be captured in one sentence. Congress seems oblivious to any connection to even their own electorate. Constituents aren't clamoring for the passage of the AHCA and I doubt many are clamoring to repeal the AHA. The anti-Obama impetus has largely run out of steam and the advantages to having everyone insured are gradually sinking in with the health care industry. Cut access to health care and you cut health-care jobs.

So who exactly is Congress hoping to please with their health-care bill? "The rich" is a facile answer and doesn't explain much. Politicians have the whole tax reform issue coming up to craft cuts. To do this in the guise of a replacement bill that is literally worse than nothing seems horribly misguided. Congressional leadership has bent over backwards to keep people from learning the bill's impact, hoping that ideally no one even reads the damn thing. Trump certainly won't, and no one in his administration seems likely to take the time or effort to brief him on this measure's toxic potential. Maybe he can feel like a big boy by vetoing it. I don't think it jibes with what he wants in his heart of hearts. He wants to be liked. How will that go down in coal country? Double whammy: The jobs aren't coming back and now your health insurance is gone. Who benefits? The rich, kind of, but that doesn't explain the House and Senate's desperate rush.

How is this even good for the insurance industry? I'm likely to be one of those appeased, an underemployed baby boomer with a pre-existing condition. I'm a captive consumer, unless I just decide to take my chances while waiting for Medicare to kick in. But how are insurers going to react to losing healthier, younger customers in droves?

Leadership has to know all of this.
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Old Today, 01:47 PM   #3546
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https://www.vox.com/platform/amp/201...waiting-period

Apparently the GOP's reaction to criticism of the bill is to make it worse. They're now considering adding a provision that would lock customers out of the individual market for six months if they fail to maintain continuous insurance coverage.
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Old Today, 02:42 PM   #3547
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Originally Posted by Stacko View Post
https://www.vox.com/platform/amp/201...waiting-period

Apparently the GOP's reaction to criticism of the bill is to make it worse. They're now considering adding a provision that would lock customers out of the individual market for six months if they fail to maintain continuous insurance coverage.
Which may not pass the Byrd Rule. Byrd is on everybody's lips these days, I've heard. One might almost say ...

But of course I won't.

I read that piece, and followed up on the Senate Parliamentarian (who knew?), and was reminded why Democracy is such a hard sell in parts not already blessed with it. In principle it sounds great : people decide on who governs them, they govern, and if they don't do it well people replace them. Fine, people say, but how does that work in practice? Well, take the Byrd Rule for example ...
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Old Today, 02:45 PM   #3548
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For clarity : are the AHA and the expansion of Medicare separate issues? I get that impression from Stacko's post

Quote:
Simply repealing the ACA would be a better position. The AHCA does more which is cruel. This is a massive tax cut at the expense of Medicaid recipients.
I had assumed they were a package.
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Old Today, 02:47 PM   #3549
CapelDodger
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Originally Posted by Minoosh View Post
Leadership has to know all of this.
You'd think so, wouldn't you?
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Old Today, 04:03 PM   #3550
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Originally Posted by Stacko View Post
https://www.vox.com/platform/amp/201...waiting-period

Apparently the GOP's reaction to criticism of the bill is to make it worse. They're now considering adding a provision that would lock customers out of the individual market for six months if they fail to maintain continuous insurance coverage.
An interesting concept, it's not OK to fine you for not carrying health insurance, as an incentive.

But it is OK to threaten you with not being able to get insurance for 6 months as an incentive.
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Old Today, 04:23 PM   #3551
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Originally Posted by Skeptic Ginger View Post
An interesting concept, it's not OK to fine you for not carrying health insurance, as an incentive.
That is an imposition on you by the state.

Quote:
But it is OK to threaten you with not being able to get insurance for 6 months as an incentive.
You can still get insurance, just not under advantageous terms. That is removing an imposition by the state on insurance companies.

Very different things.
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Old Today, 05:18 PM   #3552
Stacko
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Originally Posted by CapelDodger View Post
You can still get insurance, just not under advantageous terms. That is removing an imposition by the state on insurance companies.

Very different things.
Nope, you can't use the individual market so it's employer insurance or if you qualify Medicaid. They would be barred for six months from purchasing a plan for themselves. It's cruel solution to the problem of healthy people only buying insurance once they get sick.
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Old Today, 05:23 PM   #3553
Stacko
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Originally Posted by CapelDodger View Post
For clarity : are the AHA and the expansion of Medicare separate issues? I get that impression from Stacko's post



I had assumed they were a package.
They came as a package but there's nothing stopping them from separating them. Well tax cuts for the rich and a desire to cut Medicaid to the bone are a reason but most first world countries view denying access to healthcare to citizens in order to enrich the top 1% as a bad thing. 'Murica!
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Old Today, 05:37 PM   #3554
Skeptic Ginger
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Originally Posted by CapelDodger View Post
That is an imposition on you by the state.

You can still get insurance, just not under advantageous terms. That is removing an imposition by the state on insurance companies.

Very different things.
So the six month wait is not imposed via the state?
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Old Today, 05:41 PM   #3555
Skeptic Ginger
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Originally Posted by Stacko View Post
Nope, you can't use the individual market so it's employer insurance or if you qualify Medicaid. They would be barred for six months from purchasing a plan for themselves. It's cruel solution to the problem of healthy people only buying insurance once they get sick.
It's also the original method the ACA was trying to improve on. If insurers are mandated to cover pre-existing conditions, it doesn't work to let people wait to get insurance only after they need it.

I doubt a 6 month wait will meet the insurer's needs, thereby leading to a smaller pool and skyrocketing premiums as we all have to cover pre-existing conditions while the burden is not evenly shared.
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