GOP ACA Replacement Imminent....Predictions

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agent00f

Lifer
Jun 9, 2016
12,203
1,242
86
What's sad (not comical) is that folks like you think requiring more things to be covered leads to lower premiums.

Sure, I do think that not covering women's stuff would lead to lower premiums in that respect for you, and basically identically higher premiums for your wife. And vice versa for men's stuff.

Perhaps true it's sad that half the population lack the mental faculties to think this through.
 
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Jhhnn

IN MEMORIAM
Nov 11, 1999
62,365
14,681
136
It's all about tax cuts for billionaires & a hearty FYGM from the top of the economic heap.

I was struck last night by a comment that I heard made by Speaker Ryan, where he called this repeal bill 'an act of mercy.' With all due respect to our speaker, he and I must have read different Scripture…The one I read calls on us to feed the hungry, to clothe the naked, to shelter the homeless, and to comfort the sick. It reminds us that we are judged not by how we treat the powerful, but by how we care for the least among us. There is no mercy in a system that makes health care a luxury. There is no mercy in a country that turns their back on those most in need of protection: the elderly, the poor, the sick, and the suffering. There is no mercy in a cold shoulder to the mentally ill. This is not an act of mercy. It is an act of malice.

http://www.esquire.com/news-politics/politics/news/a53731/paul-ryan-mercy/

Seems to be what Repub "Value Voters" want, too. Imagine that.
 
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senseamp

Lifer
Feb 5, 2006
35,787
6,197
126
Is the tax credit contingent on buying actual insurance or one can just take it and stick it into an HSA? From what I understood from listening to Paul Ryan's power point is you can just keep it and not buy insurance. Of course that would cause an instant death spiral as healthy individuals will simply set that money aside and pay out of pocket, and when they get sick, use the HSA to pay the 30% penalty for 1 year, which is basically peanuts compared to potential medical bills.

OK, read the relevant part of the bill, looks like you only get credit up to whatever you spend on premiums.
 
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First

Lifer
Jun 3, 2002
10,518
271
136
These essential items required in a health plan that makes the plans more expensive can be dropped by the HHS:

HHS might also be able to alter the language on "essential benefits" that the law requires insurance plans to cover, which include trips to the emergency room, maternity and newborn care, and mental health services, Monk said.

"The law requires they have to cover 10 essential health benefit categories, but how that gets defined, a lot of that is interpretative," Monk said. "And of course, everything the Obama administration interpreted was more, more, more, more expensive coverage, and all these things lead to premium increases."

http://www.newsweek.com/gop-attack-obamacare-regulations-520445

It's got nothing to do with reconciliation. Over 1400 regulations can be dropped by executive order of the dept of HHS. That's the kooky way this legislation was written by Pelosi, Harry Reid and Co. Still don't believe me? Well, it's articles like this that I'm going by:

“It’s got two or three pieces,” Collins said. “Repeal and some part of replace can be in reconciliation. There’s 1,400 different items within Obamacare that can be done by [Health and Human Services Secretary-designee Tom Price] once he’s in, in that group, and then there will be other potential replacement pieces that aren’t appropriate in the reconciliation that can roll out one by each.” -

http://www.rollcall.com/news/politi...day-congressional-agenda#sthash.PcwfSGz6.dpuf

I can find more sources if you'd like.
I can't tell if you're kidding or just really bad at reading. Your first link is just an analyst who said HHS might be able to remove essentials benefits. Might (in reality, ain't ever going to happen because it would immediately be challenged in court). So not sure why you believe this supports your case. There's literally a history here of the Senate parliamentarian rejecting the Republican's minimum benefits regulatory repeal language in their 2015 Obamacare reconciliation repeal bill, so they had to rewrite it before passing it (and getting it vetoed by Obama of course). See below: http://www.politico.com/story/2017/03/obamacare-conservatives-senate-rules-235896

Republicans tried to gut the law’s so-called essential health benefits in the 2015 reconciliation bill, but the parliamentarian said it would not comply with the rules, according to Republican sources.

The benefits requirement is the top item Republicans would like to get into the reconciliation bill. Several Republicans say they hope Health and Human Services Secretary Tom Price can tweak the list of mandatory items through the regulatory process.

So you're literally banking on "hopes" and "maybes". The reason is because they'll never happen. Sorry it don't work that way.

And come on, your 2nd link is a quote from some Republican giving his opinion, literally nothing more than that.

Honestly, if that's the best you can do I can only assume you're just conceding you don't really follow this stuff closely.
 
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sactoking

Diamond Member
Sep 24, 2007
7,583
2,818
136
The essential health benefits mandate is part of the non-budgetary provisions of the ACA, it cannot be repealed by reconciliation. The definition of what constitutes each individual essential health benefit was done by administrative regulation. It can be changed through a new administrative regulation but not through an executive order. Any change through the regulatory process must have comment and response and the responses and results are subject to judicial review of the reasoning is specious. I believe it is unlikely but not impossible for the essential health benefits to change dramatically without new legislation.

In theory there could be an executive order to not enforce the essential health benefit provisions, similar to other non-enforcement executive orders. I think that would ultimately fail for at least two reasons:
  1. Very few, if any, states have completely abdicated their regulatory authority to the federal government, meaning that insurers would still be subject to state regulatory enforcement of the federal rules on essential health benefits.
  2. Unlike non-enforcement orders on something like immigration, which is technically just a matter between the individual and the government, this is a matter between the individual and insurer with the government providing oversight. This means that even if the government abdicates it is still a civil matter between the individual and insurer. I doubt the judicial branch will allow insurers to shirk their legal responsibilities even when the executive branch fails to enforce.
 
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senseamp

Lifer
Feb 5, 2006
35,787
6,197
126
I think another issue is that 30% penalty is mandatory, not at discretion of insurer (which would require medical underwriting that can't be re-allowed through reconciliation). In this case, a young healthy individual who lets coverage lapse for financial reasons, will be given a strong disincentive from rejoining the ranks of the insured once his financial situation improves. So he'll keep waiting until he gets really sick and can justify paying the higher premiums for his expected health costs. This is basically a death spiral in the making.
 
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VRAMdemon

Diamond Member
Aug 16, 2012
7,017
8,550
136
I'm puzzled with the whole "sell health insurance across state lines" solution. How then would you prevent every health insurance company from moving its headquarters to the states with the least amount of regulations? Isn't this just inviting a race to the bottom, where every insurance plan in the country would be negatively effected and real choice would be eliminated since people will have to get insurance from whatever state is most profitable to the insurance companies? How do you prevent that from happening? Or is that actually the point? A race for the lowest regulations. What "minimum standards" do you see the current legislative and executive branch implementing nation wide? wouldn't this neuter the states from being able to set up their own regulations on health care?

Sorry, I just don't want my Health insurance being controlled by the politicians in Alabama, or whatever state would first rush to eliminate as much regulation as possible.
 
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Bitek

Lifer
Aug 2, 2001
10,676
5,238
136
Looks like Ryan is getting way over his skis on this one and is getting blasted for it.

http://thehill.com/homenews/administration/323297-right-targets-ryan-not-trump-on-obamacare-plan#

This is the problem when you have a disengaged president who has made unrealistic promises and offers no concrete ideas on how to deliver them.

This is seen as Ryan's bill and Trump is being treated as a Robopen.

This will be interesting to see the next moves, if Ryan pulls back publicly and let's Trump step up and be the public face of this. His current trajectory seems to be headed out of office...
 
Reactions: DarthKyrie
Feb 4, 2009
35,254
16,725
136
I'm puzzled with the whole "sell health insurance across state lines" solution. How then would you prevent every health insurance company from moving its headquarters to the states with the least amount of regulations? Isn't this just inviting a race to the bottom, where every insurance plan in the country would be negatively effected and real choice would be eliminated since people will have to get insurance from whatever state is most profitable to the insurance companies? How do you prevent that from happening? Or is that actually the point? A race for the lowest regulations. What "minimum standards" do you see the current legislative and executive branch implementing nation wide? wouldn't this neuter the states from being able to set up their own regulations on health care?

Sorry, I just don't want my Health insurance being controlled by the politicians in Alabama, or whatever state would first rush to eliminate as much regulation as possible.

Smart point!
 
Feb 4, 2009
35,254
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Again back to my serious question, does anyone on this thread think it is a good plan? Does anyone think its better than what we have in its current form?

This could be a rare moment in time where we all agree for different reasons but still all agree.
 
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sactoking

Diamond Member
Sep 24, 2007
7,583
2,818
136
Impossible to tell until we see prices and deductibles.

Given that conservative publications like Fortune and Business Insider have run articles saying the insurers don't like the proposal it's probably safe to say that prices and deductibles wouldn't be going down. I'd link but I'm on my phone.
 
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Sea Ray

Golden Member
May 30, 2013
1,459
31
91
I can't tell if you're kidding or just really bad at reading. Your first link is just an analyst who said HHS might be able to remove essentials benefits. Might (in reality, ain't ever going to happen because it would immediately be challenged in court). So not sure why you believe this supports your case. There's literally a history here of the Senate parliamentarian rejecting the Republican's minimum benefits regulatory repeal language in their 2015 Obamacare reconciliation repeal bill, so they had to rewrite it before passing it (and getting it vetoed by Obama of course). See below: http://www.politico.com/story/2017/03/obamacare-conservatives-senate-rules-235896



So you're literally banking on "hopes" and "maybes". The reason is because they'll never happen. Sorry it don't work that way.

And come on, your 2nd link is a quote from some Republican giving his opinion, literally nothing more than that.

Honestly, if that's the best you can do I can only assume you're just conceding you don't really follow this stuff closely.

I see you're still not convinced. You obviously need to read up on the law. Here's something from back when it was passed:

As Democrats in Congress rushed to pass a health care overhaul of stunning scope, they didn’t bother working out key details about how the new law would be implemented. Instead, they left many crucial decisions in the hands of one woman: Secretary of Health and Human Services Kathleen Sebelius.

There are more than 2,500 references to the secretary of HHS in the health care law (in most cases she’s simply mentioned as “the Secretary”). A further breakdown finds that there are more than 700 instances in which the Secretary is instructed that she “shall” do something, and more than 200 cases in which she “may” take some form of regulatory action if she chooses. On 139 occasions, the law mentions decisions that the “Secretary determines.” At times, the frequency of these mentions reaches comic heights. For instance, one section of the law reads: “Each person to whom the Secretary provided information under subsection (d) shall report to the Secretary in such manner as the Secretary determines appropriate.”

The powers given to Sebelius are wide ranging. In the coming years, if she remains in office, the former Kansas governor will be able to determine what type of insurance coverage every American is required to have.

This quote comes straight from the wording of the law:

But as for the details, the law states that “the Secretary shall define the essential health benefits…”

https://spectator.org/39516_empress-obamacare/

I don't know how I can make it much clearer than that. If you want to continue to stick your head in the sand and stay ignorant on the subject then that's up to you.

Paul Ryan has outlined the Republican plan and it consists of 3 parts. Part 2 entails the HHS Sec repealing many parts of Obamacare w/o Congress. I am opining that they may opt to jump to part 2 if part 1 doesn't pass Congress
 
Feb 4, 2009
35,254
16,725
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Steve Scalise (spelling) is coming on Morning Joe in moments to explain the difference of healthcare for all and healthcare available to all.
This should be good.
 
Reactions: DarthKyrie
Feb 4, 2009
35,254
16,725
136
Scalese just said the losers of this bill are people who want less choice and more regulation. He completely brushed off the question of what to say to people who will be losing stuff.
 

Majes

Golden Member
Apr 8, 2008
1,164
148
106
I'm puzzled with the whole "sell health insurance across state lines" solution. How then would you prevent every health insurance company from moving its headquarters to the states with the least amount of regulations? Isn't this just inviting a race to the bottom, where every insurance plan in the country would be negatively effected and real choice would be eliminated since people will have to get insurance from whatever state is most profitable to the insurance companies? How do you prevent that from happening? Or is that actually the point? A race for the lowest regulations. What "minimum standards" do you see the current legislative and executive branch implementing nation wide? wouldn't this neuter the states from being able to set up their own regulations on health care?

Sorry, I just don't want my Health insurance being controlled by the politicians in Alabama, or whatever state would first rush to eliminate as much regulation as possible.

Ideally you would then not sign up for the insurance from Alabama. You would choose another company with better business practices. If no such company exists then you would note the market for one, create and advertise accordingly solve the problem that way.

I'm fully aware the above is a "perfect capitalism" example and rarely works in the real world. I also have no idea how I would ever start my own insurance company. But I did want to point out that business is not always a race to the bottom line. Often times companies are built on providing better service for higher prices.
 
Feb 4, 2009
35,254
16,725
136
Ideally you would then not sign up for the insurance from Alabama. You would choose another company with better business practices. If no such company exists then you would note the market for one, create and advertise accordingly solve the problem that way.

I'm fully aware the above is a "perfect capitalism" example and rarely works in the real world. I also have no idea how I would ever start my own insurance company. But I did want to point out that business is not always a race to the bottom line. Often times companies are built on providing better service for higher prices.

Are you willing to literally bet your life on that prediction?
 
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Majes

Golden Member
Apr 8, 2008
1,164
148
106
Are you willing to literally bet your life on that prediction?
There are too many factors for a prediction. I do honestly think that if companies begin to take egregious advantage of consumers then there is a market to create a new company to provide that service. Whether that company is successful often depends on how much other companies are allowed to pressure and/or slander the start up. There has to be some sort of regulation somewhere...
 

sactoking

Diamond Member
Sep 24, 2007
7,583
2,818
136

I'm not addressing the whole "EHB by regulation" thing with this post because I did that several posts back. I'm just taking this opportunity to point out that "spectator.org" may not be the best source of information. For example the article quoted says:
As Democrats in Congress rushed to pass a health care overhaul of stunning scope

Yet it can be proven that the House had 79 hearings, 181 witnesses and considered 239 amendments over the course of a year. That's not rushed.

The article then says:
they didn’t bother working out key details about how the new law would be implemented.

That shows that the author either doesn't understand or intentionally ignores the role of administrative regulations. I won't cross-post but I have a write-up about it in the "Trump's a-gonna eliminate regulations on a 2:1 ratio" thread.

It then goes on to derp about silly things like "It says the Secretary shall do things three times in one sentence!" again not understanding or ignoring that putting reporting requirements that change annually due to many factors, such as technology, into statute instead of regulation is just idiotic.
 
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sactoking

Diamond Member
Sep 24, 2007
7,583
2,818
136
There are too many factors for a prediction. I do honestly think that if companies begin to take egregious advantage of consumers then there is a market to create a new company to provide that service. Whether that company is successful often depends on how much other companies are allowed to pressure and/or slander the start up. There has to be some sort of regulation somewhere...

First off, the idea about buying/selling across states lines is off. You can't say that "If the insurers selling from state X are bad then just don't buy from them" will work. That ignores how insurer domestication works. Each insurer has a state that it is domiciled in. That home state regulates the financial solvency of the insurer as well as its operations in that state. If the insurer wishes to do business in another state it registers as a foreign insurer. It does not become subject to the solvency regulation of the new state but it does become subject to the operational regulation of the new state. In "sell across state lines" talk we're discussing that an insurer choosing to do business in another state, one in which they currently would be required to register as a foreign insurer and be subject to operational regulation, would no longer be required to register as a foreign insurer and would not be subject to operational regulation. It would only be subject to regulation from it's home state.

In that scenario every insurer would just redomesticate to state X and there would be no other insurers to choose from.

Now, for your point above, do you have any idea how hard it is to start an insurance company? Don't you think there's a reason that almost every every ACA co-op failed despite being given almost every advantage in the book? It's really tough. It would be even more so if there were an unlevel playing field like a state with exceptionally lax regulatory requirements domiciling the big insurers while new ones tried to form locally.
 
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Sea Ray

Golden Member
May 30, 2013
1,459
31
91
I'm not addressing the whole "EHB by regulation" thing with this post because I did that several posts back. I'm just taking this opportunity to point out that "spectator.org" may not be the best source of information. For example the article quoted says:


Yet it can be proven that the House had 79 hearings, 181 witnesses and considered 239 amendments over the course of a year. That's not rushed.

The article then says:


That shows that the author either doesn't understand or intentionally ignores the role of administrative regulations. I won't cross-post but I have a write-up about it in the "Trump's a-gonna eliminate regulations on a 2:1 ratio" thread.

It then goes on to derp about silly things like "It says the Secretary shall do things three times in one sentence!" again not understanding or ignoring that putting reporting requirements that change annually due to many factors, such as technology, into statute instead of regulation is just idiotic.

Well it states that the law clearly says that the HHS Secretary gets to "define the essential health benefits" that insurance companies have to provide. Do you dispute that ?
 
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