Why hasn't the GOP repealed Obamacare and where is their alternative Health plan?

[Sea Ray]

Rand Paul has come out with a plan to replace Obamacare:

https://www.boston.com/news/politic...outline-plan-to-replace-obama-health-care-act

This plan has essentially 3 main areas:

1) Buy insurance across state lines
2) Huge tax breaks for insurance including HSAs
3) Removing all the requirements put on every insurance plan by Obama such as birth control, Maternity, free mammograms, colonoscopies, etc

Obviously this isn't a plan that will survive the Congressional grinding factory but it's a template. Anything is better than Obamacare. A repeal while maintaining a pre existing condition waiver would be preferable over what we've had for 7 years or so.

 

[Fanatical Meat]

Rand Paul has come out with a plan to replace Obamacare:

https://www.boston.com/news/politic...outline-plan-to-replace-obama-health-care-act

This plan has essentially 3 main areas:

1) Buy insurance across state lines
2) Huge tax breaks for insurance including HSAs
3) Removing all the requirements put on every insurance plan by Obama such as birth control, Maternity, free mammograms, colonoscopies, etc

Obviously this isn't a plan that will survive the Congressional grinding factory but it's a template. Anything is better than Obamacare. A repeal while maintaining a pre existing condition waiver would be preferable over what we've had for 7 years or so.

And right after it was announced Trump shit all over it by saying the premiums and deductibles need to be lower without tax credits

 

[Jhhnn]

Rand Paul has come out with a plan to replace Obamacare:

https://www.boston.com/news/politic...outline-plan-to-replace-obama-health-care-act

This plan has essentially 3 main areas:

1) Buy insurance across state lines
2) Huge tax breaks for insurance including HSAs
3) Removing all the requirements put on every insurance plan by Obama such as birth control, Maternity, free mammograms, colonoscopies, etc

Obviously this isn't a plan that will survive the Congressional grinding factory but it's a template. Anything is better than Obamacare. A repeal while maintaining a pre existing condition waiver would be preferable over what we've had for 7 years or so.

That's pretty shallow. What about the 20M people who gained coverage under the ACA?

Let me consult the magic 8 ball.... FYGM is the answer!

 

[emperus]

Rand Paul has come out with a plan to replace Obamacare:

https://www.boston.com/news/politic...outline-plan-to-replace-obama-health-care-act

This plan has essentially 3 main areas:

1) Buy insurance across state lines
2) Huge tax breaks for insurance including HSAs
3) Removing all the requirements put on every insurance plan by Obama such as birth control, Maternity, free mammograms, colonoscopies, etc

Obviously this isn't a plan that will survive the Congressional grinding factory but it's a template. Anything is better than Obamacare. A repeal while maintaining a pre existing condition waiver would be preferable over what we've had for 7 years or so.

So, how do you force insurers to cover those with pre-existing conditions? Wouldn't their insurance plans be astronomically high? Also, how does any of those help with the high cost of health care?

 

[Sea Ray]

And right after it was announced Trump shit all over it by saying the premiums and deductibles need to be lower without tax credits

They will be. That's part of competition and dropping items that are required coverage under Obamacare

 

[Sea Ray]

That's pretty shallow. What about the 20M people who gained coverage under the ACA?

Let me consult the magic 8 ball.... FYGM is the answer!

There's nothing to keep those 20 mill from getting coverage if there's no underwriting...in other words insurers cannot ask about pre-existing conditions. That part will remain the same. Specifically Dr Paul mentioned that there'd be a 2 yr window where you can get in without underwriting.

 

[Grooveriding]

3) Removing all the requirements put on every insurance plan by Obama such as birth control, Maternity, free mammograms, colonoscopies, etc

I take this wording to mean that insurance plans would not be required to cover those above mentioned protocols ? Those are essentials. What sort of health care does not provide routine diagnostics where it's indicated to do so and birth control ?

Do they make these reforms and conclusions in isolation from physicians ?

 

[HomerJS]

They will be. That's part of competition and dropping items that are required coverage under Obamacare

You mean like birth control? That costs less then covering costs of unwanted pregnancies. So what is the real concern there?

 

[Jhhnn]

There's nothing to keep those 20 mill from getting coverage if there's no underwriting...in other words insurers cannot ask about pre-existing conditions. That part will remain the same. Specifically Dr Paul mentioned that there'd be a 2 yr window where you can get in without underwriting.

That doesn't tell me how they're supposed to pay for it.

 

[Franz316]

Really the only part of their plan that remotely addresses the cost of premiums is praying to the free market god that cross state availability will lead to lower costs. That is not guaranteed and you will most definitely see plans that are nearly worthless for their cost.

 

[ivwshane]

Really the only part of their plan that remotely addresses the cost of premiums is praying to the free market god that cross state availability will lead to lower costs. That is not guaranteed and you will most definitely see plans that are nearly worthless for their cost.

Not only is it not guaranteed to lower costs but it's already available as an option and insurance companies aren't taking advantage of it because it's not practical.

 

[nisryus]

They will need to figure out how selling across state lines really works as each state will have their own policy and guideline, even among insurance companies they have different rate and policy among states. If I live in Texas and I want to buy in Ohio, which state policy will be followed and would my providers here accept the policy from Ohio? A large pool of local providers must be here in order to drive down the costs for the insurance company to be willing to cover my area. If the ROI is too low and too expensive to enroll Texans for Ohio plan, then there is no incentive to sell to Texans, even with the block grant that are given as subsidies. It is easier to say on paper then actually doing it.

 

[trenchfoot]

So long as there is a profit incentive in the mix, there ain't gonna be "affordable health care for all". The profit motive requires the profiteer to maximize profits or they're not doing their job and will be replaced by someone who can. Ergo, the privatized health care industry will refuse to give up their one and only reason to be in the business and they will exert, as they are at this very minute, every ounce of their powerful influence to keep things as profitable as possible in a manner that's way above and beyond what your average corporate influence peddler could muster.

The industry wants their share of the action, and seeing as if the GOP has been their champion and savior in this regard, I really don't see how the Repubs will ever bite the hands that feeds them their daily ration of gourmet food and future well paying jobs as lobbyists and prestigious board members.

This conundrum is, IMO, THE sticking point that is preventing the Repubs from coming up with a viable gov't sponsored health care plan that's "much much better than Obamacare".

And Trump's proclivity for making grandiose promises that he never intended to keep is another huge problem that the GOP can't ever keep from popping out of the box on a painfully regular basis.

 

[ch33zw1z]

Hsa plans suck. I had one, it was not fun

 

[fskimospy]

They will need to figure out how selling across state lines really works as each state will have their own policy and guideline, even among insurance companies they have different rate and policy among states. If I live in Texas and I want to buy in Ohio, which state policy will be followed and would my providers here accept the policy from Ohio? A large pool of local providers must be here in order to drive down the costs for the insurance company to be willing to cover my area. If the ROI is too low and too expensive to enroll Texans for Ohio plan, then there is no incentive to sell to Texans, even with the block grant that are given as subsidies. It is easier to say on paper then actually doing it.

Republicans have been saying that selling insurance across state lines is the answer for years but they haven't seemed to notice that you can ALREADY sell across state lines. Companies don't do it because the cost of building provider networks is too high. It has nothing to do with imagined legal barriers.

Rand Paul's plan is indicative of someone who has put next to no thought into how it would actually work. It's another fantasy piece.

 

[soulcougher73]

Because the Heritage Foundation thought it was a great plan they put together?

 

[dullard]

Hsa plans suck. I had one, it was not fun

You did it wrong.

HSAs are fantastic if you have a bit of spare cash (best legal tax dodge ever created). Now, it is true that not everyone has spare cash. But that is where your "suck" comment should be applied, not towards HSAs.

 

[Sea Ray]

I take this wording to mean that insurance plans would not be required to cover those above mentioned protocols ? Those are essentials. What sort of health care does not provide routine diagnostics where it's indicated to do so and birth control ?

Do they make these reforms and conclusions in isolation from physicians ?

Physicians most certainly should be a part of the process. I know a lot them and whether they're Republican or Democrat, liberal or conservative, they all have this in common: They HATE HATE HATE Obamacare.

Up until Obamacare, there were many insurance plans that did not cover routine diagnostics free of deductibles or co-pays. I buy insurance for myself. I know how this works. Prior to OC, I priced plans that had free diagnostics with others that had co-pays and the one with co-pays were far less expensive. I want that freedom returned to me. I don't want the gov't telling me what I can and cannot buy from Aetna or whoever.

As for birth control, it should be covered just like any other Rx drug. It should not get special protection from our gov't. If insurance plans decide that it's cheaper for them to include it for free then I'll likely buy that plan because it's cheaper...but I don't believe that'll be the case. Regardless I want these options returned to me. Say what you want about OC, what's not debatable is that it's taken away our freedom of choice in choosing which health care plan you wish to purchase

 

[Sea Ray]

You did it wrong.

HSAs are fantastic if you have a bit of spare cash (best legal tax dodge ever created). Now, it is true that not everyone has spare cash. But that is where your "suck" comment should be applied, not towards HSAs.

Everyone who's getting cheaper health insurance will have spare cash compared to now. For example, I'm currently paying $1450/mo with a $13K family deductible. Lower that to $1000/mo and I've got $450/mo to throw into my HSA.

 

[Sea Ray]

That doesn't tell me how they're supposed to pay for it.

Well you have stumbled upon the elephant in the room. It isn't about Trump taking away anyone's health care. It's about who's going to pay for the healthcare. That's how it should be presented but the liberal media doesn't put it that way.

Now let's get realistic here. The Rand Paul plan will not get enough votes to pass as it stands now. Certain Republicans and Democrats alike will insist on some sort of gov't program to pay for some American's healthcare. That'll have to be added. Politically speaking, it won't fly to remove someone's gov't goodies that they're already receiving.

 

[Fardringle]

Hsa plans suck. I had one, it was not fun

I love my HSA. I get lower tax liability due to the pre-tax contributions to the account, I have money specifically set away for health care needs that can stay there earning interest (also tax free) until I need it, or until I die and it transfers to my kids, and my premium on the companion health care plan is very low compared to most other options but still covers everything I need, including 100% preventative care, with a deductible for bigger procedures that isn't much higher than significantly more expensive non-HSA plans.

If yours sucked, then you had a bad plan.

 

[glenn1]

The GOP HAS an alternative: Get sick and die. That's their plan

I'm good with that plan. :beer:

 

[Jhhnn]

Everyone who's getting cheaper health insurance will have spare cash compared to now. For example, I'm currently paying $1450/mo with a $13K family deductible. Lower that to $1000/mo and I've got $450/mo to throw into my HSA.

Which means that your family income is above the subsidy cutoff, currently ~$95K for a family of 4, well above median. You're also pulling numbers out of your ass.

You still haven't explained how median families & below can afford coverage w/o subsidies.

 

[Sea Ray]

Which means that your family income is above the subsidy cutoff, currently ~$95K for a family of 4, well above median. You're also pulling numbers out of your ass.

You still haven't explained how median families & below can afford coverage w/o subsidies.

Let's assume your numbers are correct. To make it easy let's use an income of $100K. Remember that's a gross income. I'm already paying FICA of 15.3% plus FED taxes of up to 28% on some of that money. I'm out $17,500 for premiums. My family deductible is about $13K. I'm vulnerable for $30K of health care bills before I get a dime of coverage. Anthem also does not guarantee coverage outside of the state of Ohio. The network is small. Out of network docs mean an even higher deductible. Wonder why my plan sucks so bad? Answer: because in my state of Ohio, I have only one choice. Seriously, I can't tell Anthem to go pound sand 'cause they're the only one that offers insurance on the individual market. I'm not pulling these numbers out of my ass. I just went through this process two months ago. I've been forced to do this 3 yrs in a row 'cause one by one insurance companies are dropping out.

Yet here you are telling me that I need to help pay for someone else's health care. Bull shit. I got my own problems.

 

[Jhhnn]

Let's assume your numbers are correct. To make it easy let's use an income of $100K. Remember that's a gross income. I'm already paying FICA of 15.3% plus FED taxes of up to 28% on some of that money. I'm out $17,500 for premiums. My family deductible is about $13K. I'm vulnerable for $30K of health care bills before I get a dime of coverage. Anthem also does not guarantee coverage outside of the state of Ohio. The network is small. Out of network docs mean an even higher deductible. Wonder why my plan sucks so bad? Answer: because in my state of Ohio, I have only one choice. Seriously, I can't tell Anthem to go pound sand 'cause they're the only one that offers insurance on the individual market. I'm not pulling these numbers out of my ass. I just went through this process two months ago. I've been forced to do this 3 yrs in a row 'cause one by one insurance companies are dropping out.

Yet here you are telling me that I need to help pay for someone else's health care. Bull shit. I got my own problems.

Bullshit. Several providers are offering exchange plans in Ohio-

http://www.insurance.ohio.gov/Consumer/Pages/FederalHealthReformFAQs.aspx

People can enroll regardless of income. Individual plans & exchange plans are different in name only.