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

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Old 26th June 2017, 09:20 AM   #1
Bob001
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Trump "[health] insurance for everybody," Replacing the ACA Part II

Mod Info The previous thread was getting slow and generating duplicates, so here is a continuation. As is usual the split point was arbitrary and participants can copy and paste from the previous thread to address points raised therein.
Posted By:Agatha







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.
You're kidding, right? Their goal is to reduce taxes. They are against the basic idea of providing government services, and they will cut as much as they can wherever they can. Ryan wants to cut Medicare and Social Security, which have long been considered practically sacrosanct.

And if poor whites get hurt, they will blame blacks, immigrants, "welfare," "foreign aid," etc., never Trump or the Repubs.

Last edited by Agatha; 26th June 2017 at 02:12 PM.
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Old 26th June 2017, 09:24 AM   #2
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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.
Let's just note that the subject is Medicaid, not Medicare. The ACA (Obamacare) expanded Medicaid in the states that chose to accept it; the AHCA wants to reduce funding and eligibility.
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Old 26th June 2017, 12:32 PM   #3
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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.

But it is OK to threaten you with not being able to get insurance for 6 months as an incentive.
Iím also not clear on implementation. When does the waiting period start? If you donít have insurance for 2 years does that count as the waiting period, if so I donít see how it helps solve the problem of people not buying insurance until they are already sick.

Is it a case of you having to buy insurance but not be eligible to avail yourself of it for 6 months? That could be more helpful, or maybe not if it means your condition advances and becomes more expensive to treat while you sit on an un-triaged waiting list. Also, how much does requiring people to pay for insurance they are not allowed to use different than a tax on people who opt out of insurance?
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Old 26th June 2017, 12:36 PM   #4
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Originally Posted by lomiller View Post
Iím also not clear on implementation. When does the waiting period start? If you donít have insurance for 2 years does that count as the waiting period, if so I donít see how it helps solve the problem of people not buying insurance until they are already sick.

Is it a case of you having to buy insurance but not be eligible to avail yourself of it for 6 months? That could be more helpful, or maybe not if it means your condition advances and becomes more expensive to treat while you sit on an un-triaged waiting list. Also, how much does requiring people to pay for insurance they are not allowed to use different than a tax on people who opt out of insurance?
The GOP just handed the Dems their "death panel". They should start referring to the GOP plan as the Affordable Death Care Act.
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Old 26th June 2017, 12:40 PM   #5
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Originally Posted by lomiller View Post
Iím also not clear on implementation. When does the waiting period start? If you donít have insurance for 2 years does that count as the waiting period, if so I donít see how it helps solve the problem of people not buying insurance until they are already sick.

Is it a case of you having to buy insurance but not be eligible to avail yourself of it for 6 months? That could be more helpful, or maybe not if it means your condition advances and becomes more expensive to treat while you sit on an un-triaged waiting list. Also, how much does requiring people to pay for insurance they are not allowed to use different than a tax on people who opt out of insurance?
The wording for the amendment hasn't been released yet that I can find. It sounds like it starts when you start looking for insurance. Something along the lines of, "Insurers can impose a six-month waiting period on those who cannot demonstrate 12 months of continuous creditable coverage."
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Old 26th June 2017, 01:16 PM   #6
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Originally Posted by Kestrel View Post
The belief that corporations will act in the best long term interest of the corporation is common. Reality is that corporations are controlled by insiders who are human. Science has shown us that humans value short term gains over long term gains and personal gains over the welfare of a group. In short they will make decisions that create short term personal profits even if these decisions are bad for the long term survival of a corporation. What happened to Lehman Brothers is a good example.
AKA the Principle-Agent problem.
https://en.wikipedia.org/wiki/Princi...3agent_problem
People who actually controlee corporations are not, ultimately, motivated by the long term best interest of the company but by their own best interests which are invariably driven by short term incentives. CEOís can make a lot of money by doing things that have short term benefits but cost the company enormously in the long run. E.g. many of the problems IBM is suffering from came about exactly this way.

https://www.forbes.com/sites/stevede.../#62182f993e48
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Old 26th June 2017, 01:29 PM   #7
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Originally Posted by lomiller View Post
People who actually control corporations are not, ultimately, motivated by the long term best interest of the company but by their own best interests
How can that be a problem? It's a core principle of Capitalism!

Corporations only exist so that those who run them can make money. If that goal is met by destroying the corporation then it has served its purpose. And healthy Capitalism requires that poorly performing businesses fail. That's why we like it!
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Old 26th June 2017, 01:53 PM   #8
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Originally Posted by Skeptic Ginger View Post
So the six month wait is not imposed via the state?
Yeah, no, but umm ... something. Freedom, probably.
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Old 26th June 2017, 01:59 PM   #9
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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.
Wow. That's restraint of trade, which is a fundamental evil for the right, but they go there anyway.
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Old 26th June 2017, 02:07 PM   #10
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Originally Posted by Roger Ramjets View Post
How can that be a problem? It's a core principle of Capitalism!
That would be the self-interest of the capitalist - the owner of the capital - not the executive.

Quote:
Corporations only exist so that those who run them can make money.
No, they exist for to make money for the owners.
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Old 26th June 2017, 02:10 PM   #11
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Originally Posted by CapelDodger View Post
That would be the self-interest of the capitalist - the owner of the capital - not the executive.

No, they exist for to make money for the owners.
That may be the theory, but it's not the practice at a lot of companies.
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Old 26th June 2017, 02:12 PM   #12
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Originally Posted by CapelDodger View Post
Wow. That's restraint of trade, which is a fundamental evil for the right, but they go there anyway.
Well yeah, anytime you can screw over the little guy in favor of a big corporation, the GOP is all in.
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Old 26th June 2017, 02:17 PM   #13
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CBO score says 22 million more uninsured by 2026.
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Old 26th June 2017, 02:34 PM   #14
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Originally Posted by Stacko View Post
CBO score says 22 million more uninsured by 2026.
So one million more stay insured than the House bill?

I've yet to see the Democrats, however, address the GOP talking point, are these indeed simply the people who chose not to buy health insurance?

I doubt they are. Rather, it's going to be mostly people who cannot afford the insurance due to withdrawal of a large chunk of the ACA funding in favor of tax breaks for the rich.
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Old 26th June 2017, 02:43 PM   #15
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Originally Posted by Skeptic Ginger View Post
So one million more stay insured than the House bill?

I've yet to see the Democrats, however, address the GOP talking point, are these indeed simply the people who chose not to buy health insurance?

I doubt they are. Rather, it's going to be mostly people who cannot afford the insurance due to withdrawal of a large chunk of the ACA funding in favor of tax breaks for the rich.
Out of pocket expenses are higher. Just what everyone was looking for in an ACA replacement: less coverage combined with higher copays and deductibles.
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Old 26th June 2017, 02:44 PM   #16
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Originally Posted by Bob001 View Post
Let's just note that the subject is Medicaid, not Medicare.
Oops. Thanks, and to Stacko.
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Old 26th June 2017, 02:54 PM   #17
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Originally Posted by Stacko View Post
Out of pocket expenses are higher. Just what everyone was looking for in an ACA replacement: less coverage combined with higher copays and deductibles.
Hard to imagine Trump signing off on that. He promised something very different.

I kid, of course. I doubt this'll be his first veto if it passes Congress. That said, if it is, remember you heard it here first.
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Old 26th June 2017, 03:10 PM   #18
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CBO is predicting 15 million more uninsured next year under this bill. 4 million lose Medicaid, 4 million lose employer insurance and 7 million lose individual market insurance. That's a bad move for an election year.
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Old 26th June 2017, 03:19 PM   #19
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Originally Posted by Stacko View Post
CBO is predicting 15 million more uninsured next year under this bill. 4 million lose Medicaid, 4 million lose employer insurance and 7 million lose individual market insurance. That's a bad move for an election year.
Also, premiums 20% higher next year.
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Old 26th June 2017, 03:34 PM   #20
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Congress seems to have understood that the penalty for not having insurance would be more effective if it was larger. The lower penalties were part of the compromises needed to get the bill passed. As I understand it families with incomes between FPL and 133% of FPL are allowed to buy policies from the exchange. This has helped some of the working poor that live in states that rejected Medicaid expansion.

Republicans in Congress could have proposed some of these changes or done other things to fix the known problems with the ACA. But that would assume they were actually interested in anything but tax cuts for rich people and hating Obama.


I know people that are in this situation, between 100% and 133% so not eligible for Obamacare and can't get insurance, so this bit is an improvement. Can't say I hope the bill will pass though, I don't.

ETA- Top two paragraphs quoted from Kestrel in the old thread

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Old 26th June 2017, 04:39 PM   #21
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Just saw a post on Facebook, all caps naturally, blaming DEMOCRATS for NOT WOKING WITH REPUBLICANS and that's why the deathcare bill is doomed.

??

Bizarre. What is going on in these people's heads? That's the exact opposite of what happened.

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Old 26th June 2017, 04:40 PM   #22
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Originally Posted by Stacko View Post
CBO is predicting 15 million more uninsured next year under this bill. 4 million lose Medicaid, 4 million lose employer insurance and 7 million lose individual market insurance. That's a bad move for an election year.
Originally Posted by Stacko View Post
Also, premiums 20% higher next year.
I thought it wasn't to go into effect until 2020?
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Old 26th June 2017, 04:43 PM   #23
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Originally Posted by Emily's Cat View Post
I thought it wasn't to go into effect until 2020?
It phases in over time. Things get really bleak for Medicaid after 2026.
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Old 26th June 2017, 05:03 PM   #24
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Originally Posted by Darat View Post
I'm going to start a new insurance company in the USA, it's all going to be done by an app (have a fella in Thailand who can knock something up for a couple of dollars) so it will be all trendy and part of the gig-economy. There will be two price plans, the Republican! and the Republican Plus!!. The Republican! will be $150 a month, the Republican Plus!! $200 a month and it will cover you for any health care eventuality as long as you remain healthy!
Bonus points if the legal terms and conditions are only viewable as an animated GIF that's 72 pixels high and 1920 pixels wide, with vertically scrolling text in a 6pt font. Double-secret bonus if the "I Accept" button is the only one enabled and auto-selects after a 5-second timer.
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Old 26th June 2017, 07:15 PM   #25
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I know I'm kind of asking for trouble here, but can anyone point me toward a good, reasonably concise argument in support of this Republican proposal?
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Old 26th June 2017, 07:19 PM   #26
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Originally Posted by Civet View Post
I know I'm kind of asking for trouble here, but can anyone point me toward a good, reasonably concise argument in support of this Republican proposal?
It saves the government $$$ and gives a tax break to the job creators.....
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Old 26th June 2017, 07:30 PM   #27
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Originally Posted by Stacko View Post
CBO is predicting 15 million more uninsured next year under this bill. 4 million lose Medicaid, 4 million lose employer insurance and 7 million lose individual market insurance. That's a bad move for an election year.

Trump's idea for making America great again is sick!
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Old 26th June 2017, 07:42 PM   #28
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This seems like literally choosing to kill poor people so that the ultra rich can pay less in taxes.

http://www.rollingstone.com/politics...usands-w489867

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But then there's that 26,500 figure Ė the conservative estimate of the number of Americans who would die every year under an Obamacare repeal plan like the one currently before the Senate. (Other studies put the number even higher.) We know this because of research conducted in the mid-2000s in Massachusetts, which was the first state to enact a program designed to insure everyone. After the program was fully implemented, researchers determined that for every 830 people who gained health insurance, there was one less death per year.
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Old 26th June 2017, 07:53 PM   #29
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And we should add, the GOP used the false narrative in their relentless campaign against the Democrats so to be honest, they have now painted themselves into an impossible corner. The only way out is walk all over the painted floor, ruining it.
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Old 26th June 2017, 07:53 PM   #30
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Originally Posted by Stacko View Post
Out of pocket expenses are higher. Just what everyone was looking for in an ACA replacement: less coverage combined with higher copays and deductibles.

So, exactly the opposite of what Trump promised (and continues to promise)?

That sounds about right.

For Trump.
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Old 26th June 2017, 07:59 PM   #31
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Originally Posted by quadraginta View Post
So, exactly the opposite of what Trump promised (and continues to promise)?

That sounds about right.

For Trump.
And about right for the GOP.
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Old 26th June 2017, 08:03 PM   #32
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Originally Posted by The_Animus View Post
This seems like literally choosing to kill poor people so that the ultra rich can pay less in taxes.
Nobody's 'killing' poor people. If they don't have enough money to stay alive that's their fault.
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Old 26th June 2017, 08:10 PM   #33
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Originally Posted by skyeagle409 View Post
Trump's idea for making America great again is sick!
Trump may be a turd but let's be fair - this wasn't actually his idea.

Truth is, Trump bought into the lies about 'Obamacare' and figured that with his business acumen he could do much better. So the idea was great, but the reality is sick.
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Old 26th June 2017, 08:15 PM   #34
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Originally Posted by Roger Ramjets View Post
Trump may be a turd but let's be fair - this wasn't actually his idea.

Truth is, Trump bought into the lies about 'Obamacare' and figured that with his business acumen he could do much better. So the idea was great, but the reality is sick.
That's because nobody has the guts to tell him his businesses acumen sucks bad. He thinks he's brilliant.
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Old 27th June 2017, 01:45 AM   #35
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Originally Posted by Emily's Cat
Suggestions included increasing the penalty for mandatory coverage, changing the subsidy to be age-adjusted to reduce the dramatic cliff experienced by older consumers when they hit 400%, changing the age scale to be 5:1 instead of 3:1 to allow for lower rates for younger people, removing the minimum FPL requirement for individual market that excluded people with incomes under 133%FPL and allow for less disruptive transitioning between Medicaid and Individual markets, revisions to the risk adjustment methodology to even out the disparate preference for older/sicker individuals over younger/healthier ones and create a more stable environment, creation of an invisible high risk pool to mitigate the impact from sicker than average new entrants, and a few others I don't recall.
What are these organizations suggesting for AHCA, the current bill?
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Old 27th June 2017, 02:20 AM   #36
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Originally Posted by Stacko View Post
CBO is predicting 15 million more uninsured next year under this bill. 4 million lose Medicaid, 4 million lose employer insurance and 7 million lose individual market insurance. That's a bad move for an election year.
Originally Posted by Stacko View Post
Also, premiums 20% higher next year.
That pre-supposes that people can, and/or want to, join the dots. Many (most ?) people will not blame Trump or the GOP for this, instead it will have been the Democrats' fault for implementing such a horrible system as "Obamacare" in the first place.
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Old 27th June 2017, 03:37 AM   #37
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Originally Posted by The Don View Post
That pre-supposes that people can, and/or want to, join the dots. Many (most ?) people will not blame Trump or the GOP for this, instead it will have been the Democrats' fault for implementing such a horrible system as "Obamacare" in the first place.

I'm not so sure: by (probably) passing this bill this early, voters have enough time to see the changes take effect before 2018 and 2020, even with the "delayed-action" provisions.
It might not be enough for Republicans to actually lose the Red States, but double-digit drops would be a massive warning signal to the party as a whole.
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Old 27th June 2017, 03:44 AM   #38
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Oh problems with health-care bill - oh look over there at the flashy missiles!! Sorry but can't help but be cynical.
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Old 27th June 2017, 05:02 AM   #39
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Originally Posted by The_Animus View Post
This seems like literally choosing to kill poor people so that the ultra rich can pay less in taxes.

http://www.rollingstone.com/politics...usands-w489867
That is exactly what it is about. Killing the worthless parts of society to make it more efficient. Basic euthanasia really.
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Old 27th June 2017, 06:17 AM   #40
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Originally Posted by ponderingturtle View Post
That is exactly what it is about. Killing the worthless parts of society to make it more efficient. Basic euthanasia really.
Well it's not killing, so I guess we are fine then?
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