Healthcare going forward

[KaraBulut]

Now that the Republican partisan effort has failed perhaps to we can get to doing this the way it should have been done from the start, with McConnell's promise to bring the Democrats in and develop a bipartisan solution.

The terrible irony of all this is that the part of the ACA that is struggling- the Individual Marketplace- is the portion that originated in conservative ideas.

Some of the issues in the Marketplace should have been addressed during the the 2012-2016 Congressional sessions. The market had begun to stabilize and insurers in some markets were beginning to see most profits on the plans. But all these threats of repeal and ill-informed bluster from Trump have spooked insurers.

They're about to leave for August recess. That means that they have 1 month before Open Enrollment starts and they have 3 months before the 2018 benefit year begins to work on issues that they should have been working on for the past 6 years.

This is no way to run a country.

 

[Kulindahr]

^ And the Republican who refused to vote for it.

I saw a news piece where a GOP senator who wanted to remain anonymous said that it was never close, that there were thirty Republicans who would not vote for the bill. The reason he gave is that they were paying attention to their constituents, who pretty much regardless of party feared the result if it passed.

So we can "blame" all the "little people" who made their voices heard.

 

[Kulindahr]

The terrible irony of all this is that the part of the ACA that is struggling- the Individual Marketplace- is the portion that originated in conservative ideas.

Some of the issues in the Marketplace should have been addressed during the the 2012-2016 Congressional sessions. The market had begun to stabilize and insurers in some markets were beginning to see most profits on the plans. But all these threats of repeal and ill-informed bluster from Trump have spooked insurers.

They're about to leave for August recess. That means that they have 1 month before Open Enrollment starts and they have 3 months before the 2018 benefit year begins to work on issues that they should have been working on for the past 6 years.

This is no way to run a country.

It was no way to run a country when they started voting to repeal the ACA without having even an idea of what to put in its place.

The GOP has had twenty-four years to come up with a plan, ever since Hillary failed in producing something that would pass.

 

[vulgar_newcomer]

If you consider a 0.1% tax "heavy", you have serious issues. Really.

I don't always agree with you but you're smart and able to converse. Why, why do waste time dealing with a extreme right wing nutter who has said the same thing over and over years before tRump , or shit filith greedy tea bagging cunts took control? This I don't understand. If I witnessed you speakingly similarly to a sea conch washed up on the shore I would understand but talking to this man makes you appear a lad insane.

 

[Sausy]

The terrible irony of all this is that the part of the ACA that is struggling- the Individual Marketplace- is the portion that originated in conservative ideas.

Some of the issues in the Marketplace should have been addressed during the the 2012-2016 Congressional sessions. The market had begun to stabilize and insurers in some markets were beginning to see most profits on the plans. But all these threats of repeal and ill-informed bluster from Trump have spooked insurers.

They're about to leave for August recess. That means that they have 1 month before Open Enrollment starts and they have 3 months before the 2018 benefit year begins to work on issues that they should have been working on for the past 6 years.

This is no way to run a country.

If I am not mistaken, isn't one of the most contentious problems the far right Republicans have with the ACA also derived from a more conservative strain... the mandate to purchase insurance or be fined a certain portion of one's income in order to make sure there was maximum participation by healthy people so the market wouldn't be skewed to those with more serious health problems?

 

[ballcaphair]

If I am not mistaken, isn't one of the most contentious problems the far right Republicans have with the ACA also derived from a more conservative strain... the mandate to purchase insurance or be fined a certain portion of one's income in order to make sure there was maximum participation by healthy people so the market wouldn't be skewed to those with more serious health problems?

It's only come up once at our clinic and the young lady said the fine was cheaper than the penalty. So there's that too.

 

[KaraBulut]

If I am not mistaken, isn't one of the most contentious problems the far right Republicans have with the ACA also derived from a more conservative strain...

One of the reasons that the whole ACA repeal/replace thing has been such a Keystone Cops event on the Republican side is that the Individual Mandate brings up deep philosophical divisions in the Party that are difficult to bridge.

On one hand, you have the business-oriented conservatives who have an aversion to "free rides" and therefore believe that everyone should be required to have health insurance. This means that everyone who shows up at an emergency room should be a paying patient; no more free care that the hospital has to write off. This also means that there is a larger pool of healthy and sick people paying into the insurance plan so that the fund is solvent and able to provide for those who need healthcare.

...the mandate to purchase insurance or be fined a certain portion of one's income in order to make sure there was maximum participation by healthy people so the market wouldn't be skewed to those with more serious health problems?

And on the other hand, you have the libertarian wing of the Republican party (i.e. Rand Paul, Mike Lee) who believe that the government shouldn't be mandating that people have insurance. The more libertarian (and the Tea Party) wing has tried to weaken the mandate or eliminate it all together. This means that older people and people who have health issues are buying insurance but younger and healthier people are hedging their bets...

It's only come up once at our clinic and the young lady said the fine was cheaper than the penalty. So there's that too.

...because the penalty is assessed by the IRS and it's something like $700 for the year. So, a healthy 22 year old person who is not on their parents' policy weighs the cost of paying $150 per month ($1800 per year) for health insurance vs paying $700 at the end of the year as a penalty. Many of them may not be aware that the government subsidies would probably cover the monthly cost of the insurance, making their out-of-pocket next to zero.

The result of having a weak mandate and a small penalty for not having insurance means that some people are still uninsured. It also means that when these people need an emergency appendectomy or have an accident that results in injury, their hospital care is free to them but results in higher costs for the rest of us since we pick up the tab for the uninsured's "free" healthcare.

The idea behind the mandate is to get rid of the cost of uncompensated care which was cited as one of the reasons that drives up the costs in the system. It's not something that the Democrats just came up with. On the contrary, several of the hybrid social-private health systems in Europe have an absolute mandate- everyone must have health insurance of some form. It's one of the key pieces of the Massachusetts equivalent of the ACA (aka Romneycare). It was part of the conservative think tank alternatives to the public option (e.g. Hillarycare) in the 1990s.

In another of his continuing ill-informed pandering to the base, Trump signed an Executive Order his first week in office that guts the mandate.

Until there's a compromise between the libertarians, the business Republicans and the Democrats to enforce the mandate and make penalties more unpleasant, the financial model underlying the Individual Market is going to remain unstable.

 

[Benvolio]

One of the reasons that the whole ACA repeal/replace thing has been such a Keystone Cops event on the Republican side is that the Individual Mandate brings up deep philosophical divisions in the Party that are difficult to bridge.

On one hand, you have the business-oriented conservatives who have an aversion to "free rides" and therefore believe that everyone should be required to have health insurance. This means that everyone who shows up at an emergency room should be a paying patient; no more free care that the hospital has to write off. This also means that there is a larger pool of healthy and sick people paying into the insurance plan so that the fund is solvent and able to provide for those who need healthcare.



And on the other hand, you have the libertarian wing of the Republican party (i.e. Rand Paul, Mike Lee) who believe that the government shouldn't be mandating that people have insurance. The more libertarian (and the Tea Party) wing has tried to weaken the mandate or eliminate it all together. This means that older people and people who have health issues are buying insurance but younger and healthier people are hedging their bets...


...because the penalty is assessed by the IRS and it's something like $700 for the year. So, a healthy 22 year old person who is not on their parents' policy weighs the cost of paying $150 per month ($1800 per year) for health insurance vs paying $700 at the end of the year as a penalty. Many of them may not be aware that the government subsidies would probably cover the monthly cost of the insurance, making their out-of-pocket next to zero.

The result of having a weak mandate and a small penalty for not having insurance means that some people are still uninsured. It also means that when these people need an emergency appendectomy or have an accident that results in injury, their hospital care is free to them but results in higher costs for the rest of us since we pick up the tab for the uninsured's "free" healthcare.

The idea behind the mandate is to get rid of the cost of uncompensated care which was cited as one of the reasons that drives up the costs in the system. It's not something that the Democrats just came up with. On the contrary, several of the hybrid social-private health systems in Europe have an absolute mandate- everyone must have health insurance of some form. It's one of the key pieces of the Massachusetts equivalent of the ACA (aka Romneycare). It was part of the conservative think tank alternatives to the public option (e.g. Hillarycare) in the 1990s.

In another of his continuing ill-informed pandering to the base, Trump signed an Executive Order his first week in office that guts the mandate.

Until there's a compromise between the libertarians, the business Republicans and the Democrats to enforce the mandate and make penalties more unpleasant, the financial model underlying the Individual Market is going to remain unstable.

The purpose of the mandate it to require young healthy people to pay huge premiums, out of proportion to their risk, to finance those with preexisting illness. Obviously, you cannot charge those with preexisting enough to pay for their healthcare. If they had that kind of money they would not need insurance. So the scheme is to gouge the young, and then to impose socialist medicine, your "single payer" with subsidies to help out those who cannot afford the premiums.

 

[rareboy]

 

[rareboy]

Trump still didn't even have a clue that the bill didn't need 60 votes. It only needed 52.

And the Democrats didn't kill it.

The Republicans couldn't come up with enough votes.

Instead, this infantile ignoramus is playing trucks.

 

[ballcaphair]

Trump still didn't even have a clue that the bill didn't need 60 votes. It only needed 52.

And the Democrats didn't kill it.

The Republicans couldn't come up with enough votes.

Instead, this infantile ignoramus is playing trucks.

At what point will enough ignorance be enough?

 

[gsdx]

The purpose of the mandate it to require young healthy people to pay huge premiums, out of proportion to their risk, to finance those with preexisting illness. Obviously, you cannot charge those with preexisting enough to pay for their healthcare. If they had that kind of money they would not need insurance. So the scheme is to gouge the young, and then to impose socialist medicine, your "single payer" with subsidies to help out those who cannot afford the premiums.

It's almost as though you don't have a clue how insurance works. Not a clue.

 

[ballcaphair]

It's almost as though you don't have a clue how insurance works. Not a clue.

Ben thinks insurance pools are a socialist conspiracy. He does not have a clue.

 

[Benvolio]

Ben thinks insurance pools are a socialist conspiracy. He does not have a clue.

No. But the government subsidies are socialism.

 

[BigChicken]

"Oh my God - they killed [STRIKE]Kenn[/STRIKE] healthcare! You bastards!" - Tronald Dump

Thanks for that South Park reference. That gave me a chuckle.

 

[KaraBulut]

The purpose of the mandate it to require young healthy people to pay huge premiums...

We pause our regularly scheduled thread for a brief fact check.

The typical 27 year old enrolled in the Individual Market has a $200/month premium before subsidies. Since about 85% of of enrollees qualify for a subsidy that covers all or part of their premium, their out-of pocket is next-to-nothing.

As is so often the case, your post is your opinion, not based in fact.

 

[Stardreamer]

Oh, Spirits the bill is alive again retitled the Obamacare Repeal and Reconciliation Act (ORRA) which will kill the Medicaid expansion and taxes while leaving all the regulations in place since they can't be repealed through reconciliation.

 

[Kulindahr]

I don't always agree with you but you're smart and able to converse. Why, why do waste time dealing with a extreme right wing nutter who has said the same thing over and over years before tRump , or shit filith greedy tea bagging cunts took control? This I don't understand. If I witnessed you speakingly similarly to a sea conch washed up on the shore I would understand but talking to this man makes you appear a lad insane.

I do it for the lurkers.

 

[Kulindahr]

Until there's a compromise between the libertarians, the business Republicans and the Democrats to enforce the mandate and make penalties more unpleasant, the financial model underlying the Individual Market is going to remain unstable.

The problem with libertarians is that only two varieties ever make it to D.C.: the ivory tower types who hold to their theories regardless of reality and the propertarians who are just manipulating the movement to make certain that property has more rights than people. Rational libertarians rarely make it out of their home states.

 

[Kulindahr]

We pause our regularly scheduled thread for a brief fact check.

The typical 27 year old enrolled in the Individual Market has a $200/month premium before subsidies. Since about 85% of of enrollees qualify for a subsidy that covers all or part of their premium, their out-of pocket is next-to-nothing.

As is so often the case, your post is your opinion, not based in fact.

Hey, it's missing fourteen states!