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

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Old 18th July 2017, 02:46 PM   #321
CapelDodger
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Originally Posted by pgwenthold View Post
This is the thing that I find amusing. Why are they calling this "Trumpcare"? He clearly has almost nothing to do with it.
It's a gift-horse : just accept it. Trump doesn't want to own it, but it so owns him, and it's toxic.
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Old 18th July 2017, 02:55 PM   #322
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Originally Posted by Skeptic Ginger View Post
All the while we hear the utterly dishonest proclamation that Trump and/or the GOP have a better plan with more coverage for less money. It's a bald-faced lie. And even that gets little push-back and rarely is it ever called what it really is, a lie.
To be fair, the story of the GOP's failure is a big one, perhaps historic. With that winding down for summer there'll be room for other aspects to be covered. Which the Russia story might well expand into, of course.

The unpopularity of Trumpcare suggests that the populace has a more reasonable appreciation of the ACA than the GOP is pushing at them.
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Old 18th July 2017, 03:18 PM   #323
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Originally Posted by Skeptic Ginger View Post
Where are all the Democratic talking heads telling us it is not failing or failed, whatever.
They're not there, because ACA IS failing. The Medicaid piece is all fine and dandy, but the Individual market is imploding.
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Old 18th July 2017, 03:29 PM   #324
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Originally Posted by CapelDodger View Post
To be fair, the story of the GOP's failure is a big one, perhaps historic. With that winding down for summer there'll be room for other aspects to be covered. Which the Russia story might well expand into, of course.

The unpopularity of Trumpcare suggests that the populace has a more reasonable appreciation of the ACA than the GOP is pushing at them.


What is unfair about calling the claim the GOP has a better plan a lie? I don't understand your sentence.

Trump himself said he had a better plan. Does anyone recall when the House went to draft a plan they actually thought Trump had one?

The cognitive dissonance in this era of Trumpantics is the best mind boggling, it's more mind boggling than any mind boggling ever.
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Old 18th July 2017, 04:07 PM   #325
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Originally Posted by Emily's Cat View Post
They're not there, because ACA IS failing. The Medicaid piece is all fine and dandy, but the Individual market is imploding.

Is it?
Quote:
We know because every measure of healthcare spending, access and cost has improved since the passage and implementation of the Affordable Care Act.
http://www.latimes.com/business/hilt...104-story.html
Sure, the ACA needs improvements. Those counties without coverage, for example, could be revised by redrawing some borders to merge them with neighboring counties. The subsidies to insurers could be restored. But a return to pre-2009 conditions would be catastrophic.
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Old 18th July 2017, 04:14 PM   #326
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Originally Posted by Emily's Cat View Post
They're not there, because ACA IS failing. The Medicaid piece is all fine and dandy, but the Individual market is imploding.
And why is that? From what I've read its because of the uncertainty created by the whole repeal and replace fiasco.
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Old 18th July 2017, 04:30 PM   #327
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Originally Posted by Emily's Cat View Post
Stack on penalties to ensure that they can't afford either thing, and end up screwed no matter what!

If there were some sort of a savings plan in place, that might make more sense. But there's not - it's not like the money being paid by young people today is going to cover their costs when they're old. This is straight up nothing but intergenerational subsidization. It's bankrupting* young people today with the promise that they'll get to bankrupt younger people at some unspecified point in the future.

*Yes, hyperbole. OMG!!!
Is it really bankrupting young people? I believe it's a 3 to 1 ratio, so they are still paying a third of what us old farts pay.
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Old 18th July 2017, 04:38 PM   #328
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Originally Posted by Skeptic Ginger View Post


What is unfair about calling the claim the GOP has a better plan a lie? I don't understand your sentence.

Trump himself said he had a better plan. Does anyone recall when the House went to draft a plan they actually thought Trump had one?

The cognitive dissonance in this era of Trumpantics is the best mind boggling, it's more mind boggling than any mind boggling ever.
Republicans didn't think they needed a plan because they thought Hillary would win.

It doesn't help that it is literally impossible for the GOP to come up with a better plan.
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Old 18th July 2017, 05:16 PM   #329
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Originally Posted by Skeptic Ginger View Post


What is unfair about calling the claim the GOP has a better plan a lie? I don't understand your sentence.
I was referring to the press coverage, which has concentrated on the GOP's long road to failure rather than their lies. I think we'll see more critique of the "Obamacare is failing" claim over the summer.
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Old 18th July 2017, 05:24 PM   #330
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Originally Posted by Bob001 View Post
Is it?


Sure, the ACA needs improvements. Those counties without coverage, for example, could be revised by redrawing some borders to merge them with neighboring counties. The subsidies to insurers could be restored. But a return to pre-2009 conditions would be catastrophic.
This sums it up pretty well, I think :
Quote:
"The Republican effort has been hobbled by a split between moderates concerned about Medicaid cuts and conservatives who want more radical changes. The party has also faced the stark, politically unpalatable possibility that the ACA is a genie that cannot be wished back into the bottle."
https://www.theguardian.com/us-news/...cans-obamacare

If Obamacare really was a disaster the GOP wouldn't have this problem.
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Old 18th July 2017, 05:26 PM   #331
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Originally Posted by Emily's Cat View Post
They're not there, because ACA IS failing. The Medicaid piece is all fine and dandy, but the Individual market is imploding.


Care to back that up with a cite that isn't lacking devoid of supporting data and straight from the right-wing echo-chamber?

I have individual coverage and I assure you it is not imploding.

There are a few marketplaces where insurers have pulled out because they have no assurance the GOP isn't going to pull the rug out from under them in the area of subsidies.

WA Po: The Affordable Care Act is neither imploding nor collapsing
Quote:
The individual marketplace is stabilizing: The most common motivation for claims of collapse is the individual market. Importantly, most Americans get coverage through their employer or the government (Medicare, Medicaid). The Kaiser Family Foundation notes that the “individual market is where just 7% of the U.S. population gets their insurance (and thus also represents a small share of most health insurers’ business),” but it also correctly notes that “the stability of the market and willingness of insurers to continue to participate is essential to the ACA’s success.”

The problem in this part of the market is that too many private insurers have pulled out of the exchanges, leaving some parts of the country with too few coverage options. However, this problem, initially caused by the insurers pricing coverage too low to maintain profitability, is improving. Metrics of their profitability that showed earlier deterioration, including medical loss ratios (the share of premiums insurers are paying out in claims) and profit margins, are correcting, thanks in part to premium increases for 2017. One careful analysis of major insurers finds that they “… have now largely recovered from initial underpricing for the ACA marketplaces, and their individual-market premiums are now generally in line with costs.”

Last edited by Skeptic Ginger; 18th July 2017 at 05:30 PM.
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Old 18th July 2017, 07:03 PM   #332
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When they say that they will just have to let the ACA fail, what they really mean is that they will sabotage the ACA so that if fails. Remember this, as they've already taken a few actions that have caused premiums to increase dramatically and insurers to pull out of a few markets.
I expect that their budget and tax policies will target key funds for the ACA to further degrade the ACA.

The classic strategy of the GOP is to make government programs fail and then say "see, government programs never work."
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Old 18th July 2017, 08:09 PM   #333
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Originally Posted by ponderingturtle View Post
So flip flopping. You really think the republicans have lost enough control to let something that bad come up for a vote?

The problem is that they have gained enough control.

Their problem is that their voting block in the Senate isn't as obedient as they thought.

They have enough control that they thought that a handful of top ranked Senators can lock themselves into a room and churn out an outrageous bill that they thought would just be accepted blindly by their rank and file. Most of that rank and file had no more idea of what that bill contained than anyone else, and when they found out they weren't all willing to toe (or tow) the party line.

It only needed three who had the guts to tell their bosses "Hell, no" and stick to it.
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Old 18th July 2017, 10:19 PM   #334
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Sensible politics for the Democrats would see them having a new healthcare act that fixes the problems with the current legislation and give it to the Republicans and say "here is a plan with X votes in the bag". That would preempt the accusations it is the Democrats causing the problem.
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Old 18th July 2017, 10:32 PM   #335
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Originally Posted by Darat View Post
Sensible politics for the Democrats would see them having a new healthcare act that fixes the problems with the current legislation and give it to the Republicans and say "here is a plan with X votes in the bag". That would preempt the accusations it is the Democrats causing the problem.
I think that the Democrats should absolutely put forth a credible reform plan. If it was any good, I think that some of the more vocal Republicans would massively distort it - think "death panels" and the like - so the Democrats would have to put in extreme effort to not only sell the plan to the general public but also to make sure that the plan was accurately understood. Of course that's assuming that the Democrats' plan was actually any good.
Republicans wouldn't support a Democrat plan in any event, but voters might take notice.
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Old 18th July 2017, 11:40 PM   #336
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It's not surprising that republicans were unable to repeal and replace obamacare simply because their motivations were based overwhelming upon false and misleading claims. Moreover, the real serious problems would've continued to exist.

In fact I'm amazed things went this far.
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Old 19th July 2017, 12:11 AM   #337
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Originally Posted by Arcade22 View Post

In fact I'm amazed things went this far.
Inertia, mostly.
Plus the big stick of Trump's nutjob followers.
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Old 19th July 2017, 12:21 AM   #338
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Originally Posted by Civet View Post
I think that the Democrats should absolutely put forth a credible reform plan. If it was any good, I think that some of the more vocal Republicans would massively distort it - think "death panels" and the like - so the Democrats would have to put in extreme effort to not only sell the plan to the general public but also to make sure that the plan was accurately understood. Of course that's assuming that the Democrats' plan was actually any good.
Republicans wouldn't support a Democrat plan in any event, but voters might take notice.
IMO the Democratic Party is going to have to develop some attractive policies and become very adept at communicating them if they're going to make the necessary headway in the 2018 elections.

Healthcare seems like an ideal policy area for them to start with. Despite the GOP's general incompetence at managing the economy (deficits invariably soar as they cut taxes and start wars) and the President's terrible financial history, the GOP seems to be more trusted on financial matters. OTOH I can see that the Democratic Party have opportunities with respect to healthcare, the environment, welfare and social matters.

I really do hope they manage to do this but I'm concerned that they will just rely on being "not Trump" or that anything they do suggest will be twisted out of all recognition by right wing pundits - and to prove that they are "balanced", left wing pundits and comedians will feel obligated to have a dig too
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Old 19th July 2017, 02:55 AM   #339
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I was about to post that despite Trump's "not going to own it" pleadings, he sits in the big chair in the round-ish office, and it's his problem whether he likes it or not.

But then I got to thinking...is it?

There's nothing in the Constitution (as far as I'm aware) about Healthcare, so is there any statutory obligation to provide it? Not that I'm advocating stepping away from Healthcare in any way (if anything, I advocate a move in the opposite direction), but if it came down to it, who has ultimate responsibility?

Basic question I know, but I'm often surprised by how the US system works. When I thought it was obvious, it turns out not to be.
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Old 19th July 2017, 03:22 AM   #340
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Originally Posted by pgwenthold View Post
This is the thing that I find amusing. Why are they calling this "Trumpcare"?
It is the antiquated notion at least among republicans that the leadership is ultimately responsible for the outcomes of the actions of the whole. But as the republican party is the party of personal enrichment and personal irresponsibility you can't expect them to ever accept any responsibility for their actions. That was why it was so easy for them to vote against the ACA and vote to strip 30 million people of their healthcare when they knew they would never be held responsible for it. Now they might be and that terrifies them.
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Old 19th July 2017, 03:24 AM   #341
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Originally Posted by Bob001 View Post
Is it?


Sure, the ACA needs improvements. Those counties without coverage, for example, could be revised by redrawing some borders to merge them with neighboring counties. The subsidies to insurers could be restored. But a return to pre-2009 conditions would be catastrophic.
Everyone was better off when there was no real individual market. They knew they couldn't afford to get sick and so they didn't. Now people think that they can be self employed and get health insurance, total crazy talk.
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Old 19th July 2017, 06:42 AM   #342
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Originally Posted by The Don View Post
IMO the Democratic Party is going to have to develop some attractive policies and become very adept at communicating them if they're going to make the necessary headway in the 2018 elections.
I think they should develop said policies and sit on them. Say they have an alternative, say the alternative is much better than anything the GOP has, but give out absolutely no details for Fox to poison the well with, until the pendulum swings back and it can be presented for actual debate. Informed voters are already with them. Emotional voters won't be swayed by details anyway.

In other words, they should do the same thing the GOP did, only actually have a good plan and not half-ass it at the last minute when their bluff gets called.
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Old 19th July 2017, 07:30 AM   #343
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Originally Posted by Beelzebuddy View Post
I think they should develop said policies and sit on them. Say they have an alternative, say the alternative is much better than anything the GOP has, but give out absolutely no details for Fox to poison the well with, until the pendulum swings back and it can be presented for actual debate. Informed voters are already with them. Emotional voters won't be swayed by details anyway.

In other words, they should do the same thing the GOP did, only actually have a good plan and not half-ass it at the last minute when their bluff gets called.
Agree with everything but the bolded part. Fox will poison the well regardless of whether or not there are any details. That is their job, to act as a propaganda mill for conservatives. Hide the details and only their version will be available. Considering how nuts they got with Obamacare and its relatively open process, hoping they will behave when there are no facts to contradict their lies is a pipe dream.
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Old 19th July 2017, 08:07 AM   #344
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Twitterer-in-chief: "The Republicans never discuss how good their healthcare bill is"

Perhaps because the good part is tax breaks for the rich?
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Old 19th July 2017, 08:21 AM   #345
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Originally Posted by ponderingturtle View Post
Everyone was better off when there was no real individual market. They knew they couldn't afford to get sick and so they didn't. Now people think that they can be self employed and get health insurance, total crazy talk.
And if they did want to get sick, they made sure to get a job with insurance first!
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Old 19th July 2017, 10:09 AM   #346
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And the hard-core right wing of the GOP have changed their talking point to "we were elected to repeal Obamacare".

Just drop 'replace' and pretend repeal is what you campaigned on all along. Pretend you never claimed to have a magical replacement plan. Pretend the public hates the ACA despite the fact 50% support it and that number is even higher if you ask about the ACA rather than Obamacare despite the fact they are one in the same.
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Old 19th July 2017, 10:28 AM   #347
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The GOP agenda:

"we don't like this car, so we are going to drive it off a cliff and wait for the Democrats to make us a new one we like better."
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Old 19th July 2017, 10:29 AM   #348
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Originally Posted by Skeptic Ginger View Post
And the hard-core right wing of the GOP have changed their talking point to "we were elected to repeal Obamacare".

Just drop 'replace' and pretend repeal is what you campaigned on all along. Pretend you never claimed to have a magical replacement plan. Pretend the public hates the ACA despite the fact 50% support it and that number is even higher if you ask about the ACA rather than Obamacare despite the fact they are one in the same.
one and the same. /pedant
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Old 19th July 2017, 12:28 PM   #349
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Trump challenges senators to resurrect Obamacare repeal effort: ‘We’re close’

Hoping to avoid a humiliating political defeat, President Trump on Wednesday demanded that Republican senators resume their efforts to approve a plan to repeal and replace the Affordable Care Act, insisting that lawmakers are “very close.”

https://www.washingtonpost.com/power...=.5b6811843b60

So we're back to repeal and replace, evidently. Fool can't make up his minf
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Old 19th July 2017, 12:49 PM   #350
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Trump now thinks he's a schoolmaster and can give the Senators detention?
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Old 19th July 2017, 01:16 PM   #351
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Originally Posted by The Great Zaganza View Post
Trump now thinks he's a schoolmaster and can give the Senators detention?
He thinks he's the boss, and can demand that his underlings stay working late in order to make progress / punish them for their indolence.

I thoroughly approve of him bullying his own party. Maybe it will help some of them find their spine.
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Old 19th July 2017, 02:42 PM   #352
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I sure would like to attend some of the Republican meetings that are going on right now in Washington, D.C.

The number of charges and counter-charges being thrown around that lot of stupid, idiotic, liars would be most amusing to watch.
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Old 19th July 2017, 02:53 PM   #353
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As much as I dislike Trump,this "all Republicans are either evil or stupid or both' routine is getting annoying.
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Old 19th July 2017, 03:00 PM   #354
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Originally Posted by Bob001 View Post
Is it?
Yes, it is.

Wow, that is an interesting article. Most of it focuses on the change in the uninsured rate. But as I've said already, that is almost all coming from Medicaid expansions, not from the individual market. There's been no perceptible change in the non-Medicaid-eligible uninsured volume.

Beyond that, a lot of their stats are misleading. And there's a whole lot of knowledge lacking in it. A comparison of a 10 year period (2000-2010) versus a 5 year period in which the actual effect of ACA was only felt for 2 years is really misleading. Underlying cost trend has been steady since 2014 - when ACA actually took effect in the marketplace. It was highest in the early 2000s, and the health insurance industry was already taking massive steps to bring those costs down:
https://www.pwc.com/us/en/health-ind...e-numbers.html

Originally Posted by Bob001 View Post
Sure, the ACA needs improvements. Those counties without coverage, for example, could be revised by redrawing some borders to merge them with neighboring counties. The subsidies to insurers could be restored. But a return to pre-2009 conditions would be catastrophic.
A return to pre-ACA Medicaid would be catastrophic, definitely. A return to pre-ACA Individual market wuld be problematic for some, but for others would be a massive improvement. Either way, it's irrelevant. ACA is very slightly better than what we had before... but it's still not sustainable and it's still not successful.
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Old 19th July 2017, 03:22 PM   #355
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Originally Posted by Worm View Post
There's nothing in the Constitution (as far as I'm aware) about Healthcare, so is there any statutory obligation to provide it?
No. Pre Obamacare, health care is not a right but a privilege.

Originally Posted by Worm View Post
Not that I'm advocating stepping away from Healthcare in any way (if anything, I advocate a move in the opposite direction), but if it came down to it, who has ultimate responsibility?
The individual.

Originally Posted by Worm View Post
Basic question I know, but I'm often surprised by how the US system works. When I thought it was obvious, it turns out not to be.
If you have a full-time job your employer probably offers membership in a pool for your immediate family (not free, but probably cheaper than individual plans). If you are 65 or older, you're eligible for Medicare. If you're 26 or younger you can qualify on your parents' plan (again, not free, but probably cheaper than an individual plan). If you're absolutely indigent, you probably qualify for Medicaid (for now).

Under a repeal and at least one Senate replacement bill, if you are under 65, working but not in a job with benefits, you're pretty much on your own. For example, if you have 2 part-time jobs there is no obligation for an employer to cover you. If you have an emergency you can show up at an ER and probably get treatment, but for anything major the hospital will start going after your assets. Once your assets are gone, you go bankrupt and may qualify for Medicaid.

That's my understanding of the old system.
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Old 19th July 2017, 03:42 PM   #356
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Watching a Stephen Colbert clip and he brought up the fact that the Republicans voted 60 times to repeal the ACA when Obama was in the White House. As soon as you have Republican President they can't muster the votes to get a repeal measure through. It seems like it was all just theatre to keep the tea-party crowd happy but their terrified of the prospect of an actual repeal.
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Old 19th July 2017, 03:54 PM   #357
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Originally Posted by dudalb View Post
As much as I dislike Trump,this "all Republicans are either evil or stupid or both' routine is getting annoying.
It would help a lot if some of those smart, non-evil Republicans (and I know for a fact that they're out there) asserted themselves within the party a bit more and started getting more of their own kind in leadership positions. To relate it to the thread topic, healthcare reform seems like exactly the type of issue the lends itself to moderate reform. I remember Sen. Bill Cassidy making some noises that sounded coherent and non-diabolical. Don't think too many folks listened to him.
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Old 19th July 2017, 03:58 PM   #358
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Originally Posted by Minoosh View Post
No. Pre Obamacare, health care is not a right but a privilege.

The individual.

If you have a full-time job your employer probably offers membership in a pool for your immediate family (not free, but probably cheaper than individual plans). If you are 65 or older, you're eligible for Medicare. If you're 26 or younger you can qualify on your parents' plan (again, not free, but probably cheaper than an individual plan). If you're absolutely indigent, you probably qualify for Medicaid (for now).

Under a repeal and at least one Senate replacement bill, if you are under 65, working but not in a job with benefits, you're pretty much on your own. For example, if you have 2 part-time jobs there is no obligation for an employer to cover you. If you have an emergency you can show up at an ER and probably get treatment, but for anything major the hospital will start going after your assets. Once your assets are gone, you go bankrupt and may qualify for Medicaid.

That's my understanding of the old system.
I just note that the 26-or-under provision was an ACA innovation. Before that, insurance companies could cut children off at 21.

And one alternative under the old system was to rack up huge medical bills, then declare bankruptcy. That was one of the primary causes of bankruptcy under the old system. Of course, that person would never get insurance again, unless he found a job that provided it, and maybe not even then.
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Old 19th July 2017, 04:04 PM   #359
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Latest report:
Quote:
Congressional budget analysts estimated Wednesday that a Senate plan to repeal part of the Affordable Care Act with no immediate replacement would increase the number of people without health coverage by 17 million next year and 32 million at the end of a decade.
https://www.washingtonpost.com/power...=.f58e5b972644
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Old 19th July 2017, 04:56 PM   #360
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Funny typo on CNN.com for a story on the CBO projection if the Repeal Only is passed.

Originally Posted by CNN
The bill is modeled after the 2015 bill that passed both chambers of Congress, but was vetoed by then-President Obamacare. Nearly all of today's current Republican senators voted for the 2015 bill.
*bold added by me


Sure, let's just rename the President
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