Healthcare going forward

[KaraBulut]

I'm puzzled by the stories advertising this as "chipping away at Obamacare" because it's unclear who would be buying these policies or which insurers would offer them. This sounds more like the spin of an Administration that is trying to make it look like it's accomplishing something.

The only advantage that these "policies" seem to offer is that they can cross state lines, however there's not much chance that a plan purchased by a New Yorker would have any in-network providers in Kansas which is why network healthcare policies are almost always based in a single state. It also fails to solve one of the key things that the ACA did try to solve- eliminating substandard health insurance policies that aren't worth the money paid for them.

This was a Rand Paul idea that Paul has been pushing for years- substandard insurance through private groups. I'm not sure what about his career as a ophthalmologist made him a subject matter expert on insurance but like most things that come from Rand Paul, it's long on ideology and short on ideas that can actually work. It's doubtful that these policies will get any traction.

I also anticipate that there will be a lawsuit over whether he can do this by executive order. Both parties have been turning a blind eye to executive orders (which are really a symptom of a feckless Legislative branch) because both parties have benefited from executive orders when the Congress is controlled by the opposition party. This might be where the courts are asked to weigh in since it's another example of a President failing to work through the legislative process and trying to subvert legislation that was approved by the Congress in 2010.

 

[KaraBulut]

Something that is worrisome...

The White House
Office of the Press Secretary
For Immediate Release
October 12, 2017
Statement from the Press Secretary
Based upon guidance from the Department of Justice, the Department of Health and Human Services has concluded that there is no appropriation for cost-sharing reduction payments to insurance companies under Obamacare. In light of this analysis, the Government cannot lawfully make the cost-sharing reduction payments. The United States House of Representatives sued the previous administration in Federal court for making these payments without such an appropriation, and the court agreed that the payments were not lawful. The bailout of insurance companies through these unlawful payments is yet another example of how the previous administration abused taxpayer dollars and skirted the law to prop up a broken system. Congress needs to repeal and replace the disastrous Obamacare law and provide real relief to the American people.

So what are Cost Sharing Reductions(CSR)?

The ACA sets up three levels of coverage - Bronze, Silver and Gold. The assumption is that Silver plans are the "standard" and most of the assumptions are based upon a Silver plan purchased by a family that is at 250 percent of the federal poverty level- for a family of 5 that's about $72,000.

The ACA requires insurers to reduce cost sharing for individuals who enroll in silver plans and have household incomes not exceeding 250 percent of the federal poverty level. These provisions reduce the out-of-pocket limit (the copays, deductibles, etc) that you pay before insurance will pay) for the people who buy Silver plans.

The CSR was added when insurers complained that they weren't making a profit on the ACA individual market plans and keep the out-of-pocket limit low. CSR provides additional payments to insurers to keep these plans profitable so that copays and deductibles don't have to be increased.

So what will happen now that the Trump White House has said they are going to stop the CSR payments? The CBO has already done an analysis:

• Federal deficits would increase by $6 billion in 2018, $21 billion in 2020, and $26 billion in 2026
• Insurance premiums will increase- the estimate is 20 percent in 2018 and 25 percent in 2020.
• Insurers will stop offering plans in states where they can no longer make a profit

This is a lose-lose for everyone:

• The insurance companies are hurt because they are losing the CSR payment even though there is a mandate that they keep out-of-pocket costs low for families.
• The states are hurt because there will be fewer policies offered in the market and this will also increase the Medicaid population.
• Middle class families needing insurance will be hurt because their premiums are going tojump substantially.
• The country is hurt by raising the deficit because the government will have to pick up the increased premium cost for poor families (remember: over 80% of people in the individual market receive supplements that cover all or part of their premiums).
• Hospitals and doctors, especially in rural areas, will be hurt as the population of uninsured people will increase which will increase write-offs for charity care for the uninsured.

This is kind of like those guys that try to torch a insect nest and end up burning down their house.

So, why is Trump doing this?
To make himself look good. Instead of showing leadership like a President and working with Congress to address the problems that required the CSRs, he's pulling the rug out from everyone because he's in a tantrum because Congress didn't repeal the ACA.

It's time to take a closer look at the 25th Amendment. Americans deserve better.

 

[Benvolio]

He was elected by people who do not want Obamacare:its victims who have to pay for it and see their own care degraded.

 

[gsdx]

He was elected by people who do not want Obamacare:its victims who have to pay for it and see their own care degraded.

Nonsense. He was elected by people who hated Obama because he was black. And now they're going to regret what they (and you) did when they find that what you had is gone.

Trump's absolute and undeniable hatred of Obama and his absolute and undeniable bigotry is fucking Americans bigly. Are you tired of so much winning yet?

 

[Benvolio]

Nonsense. He was elected by people who hated Obama because he was black. And now they're going to regret what they (and you) did when they find that what you had is gone.

Trump's absolute and undeniable hatred of Obama and his absolute and undeniable bigotry is fucking Americans bigly. Are you tired of so much winning yet?

Hogwash. Republicans have never wanted big government and socialism. You want to pretend it is about race because it is black and white and you have no grasp of the real issues.
If I regret losing "what I had", it is the freedom that America once had.

 

[ballcaphair]

He was elected by people who do not want Obamacare:its victims who have to pay for it and see their own care degraded.

Nonsense. He was elected by people who hated Obama because he was black. And now they're going to regret what they (and you) did when they find that what you had is gone.

Trump's absolute and undeniable hatred of Obama and his absolute and undeniable bigotry is fucking Americans bigly. Are you tired of so much winning yet?

ACA is not perfect, but as long as he refers to it as Obamacare, it will be something he and "his base" will hate. His winning is disabling, cruel and ugly.

 

[Benvolio]

Here is Ronald Reagan opposing socialized medicine long before anyone heard of Obama. https://en.m.wikipedia.org/wiki/Ronald_Reagan_Speaks_Out_Against_Socialized_Medicine. It is a clear lie to say that Republican opposition is based upon Obama's race.

 

[Kulindahr]

Wrong. It is silly to think US chooses to sell cheaply in Canada so that they can sell for more in the US. A complete lack of logic. What some in congress have suggested is forbidding US companies from submitting to price controls and prohibiting lower prices in controlling countries. If the Canadians insist on lower prices they will not be able to buy the drugs. Raising prices in other countries would allow lower prices in the US so everyone pays the same.

Wow -- now there's a recipe for causing companies to leave the U.S.!

 

[Kulindahr]

That's the old horse I was talking about. I'm conflicted, remember? Do no harm is a horror when the remedy is sitting in the cabinet. First hand is rough.

In this case, "Do no harm" is the priest in the take of the Good Samaritan passing by instead of rendering aid.

Once again, ben is arguing against the Judeo-Christian heritage he has claimed to honor.

 

[Kulindahr]

A tax deduction does not get all or most of the investment back.

That's exactly what a tax deduction does, if it's a full deduction: it removes from your taxable revenue the entire amount you spent.

 

[Kulindahr]

Do you want to end or impede drug research?

It's already been established that research money doesn't come from profit, so profits could be reduced to just one percent and there would be no impeding of research. The only reason a company would not do research would be if they don't want to stay in business.

 

[Kulindahr]

^ You're a font of information and I appreciate it very, very much.

I second that enthusiastically.

 

[Kulindahr]

Will nobody stop this?

http://www.thenewcivilrightsmovemen...premiums_and_all_but_kill_obamacare_exchanges

An alert Congress would impeach him for that -- he has in essence told Congress "Fuck you and the law you passed", which is an intrusion on the separation of powers. His job is to enforce the law, not to change it like a dictator.

 

[Kulindahr]

^ He is killing Americans over his hatred of all things Obama.

A neighbor commented to me yesterday that Trump made sure we have no death panels by becoming a panel of one.

We already kill people by making getting medical care an antagonistic bureaucratic process; Trump is just making it worse.

 

[Kulindahr]

I'm puzzled by the stories advertising this as "chipping away at Obamacare" because it's unclear who would be buying these policies or which insurers would offer them. This sounds more like the spin of an Administration that is trying to make it look like it's accomplishing something.

The only advantage that these "policies" seem to offer is that they can cross state lines, however there's not much chance that a plan purchased by a New Yorker would have any in-network providers in Kansas which is why network healthcare policies are almost always based in a single state. It also fails to solve one of the key things that the ACA did try to solve- eliminating substandard health insurance policies that aren't worth the money paid for them.

The whole "in-network" thing strikes me as just another way insurance companies can avoid actually caring for people. Just about every provider I see is out of network because the closest in-network ones are about $60 away in gas money, so there's no point in me going in-network just to get a $30-lower co-pay.

I saw a law proposed that an insurance company in a given state would have to have someone in-network in every country seat or city of 50k or more. I like it -- it would require insurance companies to take a step back toward doing what they're supposedly doing, covering people's medical expenses.

I also anticipate that there will be a lawsuit over whether he can do this by executive order. Both parties have been turning a blind eye to executive orders (which are really a symptom of a feckless Legislative branch) because both parties have benefited from executive orders when the Congress is controlled by the opposition party. This might be where the courts are asked to weigh in since it's another example of a President failing to work through the legislative process and trying to subvert legislation that was approved by the Congress in 2010.

Lawsuit? A Congress aware of its authority would impeach over this.

 

[Benvolio]

An alert Congress would impeach him for that -- he has in essence told Congress "Fuck you and the law you passed", which is an intrusion on the separation of powers. His job is to enforce the law, not to change it like a dictator.

Except that he and the Republicans in Congress promised to end and Obamacare. You should respect a president who keeps his promises, and in 2020, he is going to be able to remind the voters that he kept his promises when those about him did not.

 

[Kulindahr]

He was elected by people who do not want Obamacare:its victims who have to pay for it and see their own care degraded.

That is such pure unadulterated bullshit I'm surprised we can't smell it through the internet.

The result of the ACA, according to every medical person I've talked to, has been improved care for everyone, though especially in the emergency room. The only drawback is increased load on doctors, but that's the fault of the guild called the American Medical Association that deliberately keeps the supply of doctors low.

 

[Kulindahr]

Nonsense. He was elected by people who hated Obama because he was black. And now they're going to regret what they (and you) did when they find that what you had is gone.

Trump's absolute and undeniable hatred of Obama and his absolute and undeniable bigotry is fucking Americans bigly. Are you tired of so much winning yet?

Probably more so by people who listened to Clinton say she was gong to destroy companies and the jobs they provide, such as in mining. I think that the bigots are seriously over-represented in his administration (what there is of it, since he doesn't seem to care if the government actually runs or not).

 

[gsdx]

Wrong. It is silly to think US chooses to sell cheaply in Canada so that they can sell for more in the US. A complete lack of logic. What some in congress have suggested is forbidding US companies from submitting to price controls and prohibiting lower prices in controlling countries. If the Canadians insist on lower prices they will not be able to buy the drugs. Raising prices in other countries would allow lower prices in the US so everyone pays the same.

It Was Your Article!! It Was Your Evidence, and it was almost 20 years old!! It could NOT have been Canada selling drugs for a higher price in the States because Canada was BARRED from selling drugs in the States in the first place. That left the US selling for cheaper prices in Canada (and still making a profit) so they could sell the drugs for a much higher price in the States at a MUCH higher profit.

 

[Alistair]

He was elected by people who do not want Obamacare:its victims who have to pay for it and see their own care degraded.

I think it's already been proven that the morons that voted for Trump have no idea what ACA or Obamacare is.