Furthermore, almost all of the decrease in the numbers of uninsured has to do with Medicaid expansion, which is technically a state decision rather than a federal one anyways. Likewise, almost every state had laws that allowed children to stay on their parents policy past eighteen. Many even went further than the twenty six that is now the federal law.
At the end of the day Obamacare really is:
- Government regulation of what insurance companies must cover
- Government created insurance exchange sites for said Government regulated insurance options.
- Government subsidies for qualifying people willing to purchase insurance through these exchanges
- An expansion of medicaid
Out of this, what works and what doesn't? Much of the regulation seems mindless. Almost like it was thrown together by a federal task force with little or no market experience in heath care insurance (which of course is what happened). I doubt many people are clinging to those regulations. The exchanges have been a joke, and are well on their way to the dreaded death spiral one way or the other. The subsidies could be easily replaced by a tax credit of some sort. The expansion of medicaid was ultimately a state decision, with the Federal Government paying for much of it (for a limited time period). Since this is in part now and will eventually totally be on the States, it would make sense to let states make those decisions, just like they always have.
Seems to me that some reasonable people in the House and Senate could come up with a plan to throw out the bath water, and still keep whatever baby parts are desirable. Of course, that assumes that we have reasonable people in the House and Senate that actually care "more" about the American people and less about winning the Obamacare argument.
52 comments:
The Tweetesnt Elect proposed a protectionist policy. The cost of consumer goods will increase dramatically. Our esteemed host and the rest of the apologists for The Tweetesnt Elect will be thrilled, until they go shopping at Wal-Mart.
President-elect Donald Trump vowed to whiplash companies that offshore jobs then try to sell goods back into the U.S. with a 35 percent imports tax, in a series of Sunday-morning Twitter posts.
Just hours after using Twitter to complain about the most recent “Saturday Night Live” skit mocking him for his tweeting habits, Mr. Trump turned his account to more serious matters of American business.
He promised to “substantially reduce” regulations and taxes on American corporations, but those companies that have a U.S. presence but build factories or plants elsewhere and then try to sell back here will be punished for that decision.
"There will be a tax on our soon to be strong border of 35 percent for these companies wanting to sell their product, cars, A.C. units etc., back across the border,” he tweeted.
He said companies can move within the U.S. with no penalty, but said woe to those who move outside.
“Please be forewarned prior to making a very expensive mistake!” he said" Tweeted
We are going to be treated to a Presidency of the Tweetreverst for four years.
We will be the laughingstock of the civilized world.
get...
That we survived 230 years with out such a thing as Obamacare.
And what does that prove, genius?????
The skit prompted the President-elect to voice his distaste at the show via Twitter.
Mr Trump posted: “Just tried watching
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Saturday Night Live – unwatchable! Totally biased, not funny and the Baldwin impersonation just get any worse. Sad!”
Mr Baldwin then replied to the President-elect’s tweet saying: “@realDonaldTrump Release your tax returns and I’ll stop. Ha”
Let me guess.
This is brilliance of a political genius on CHT
Opie, The Tweetersent of the United States can do no wrong.
Four years of this is going to be a Tweetaster.
Foreign policy via Twitter. May God have mercy on this Tweetaster of the United States Of TweeterAmerica.
CH believes it is not important for politicians to make good on any campaign promise especially the ta return release. LOL
90% of Americans didn't even have insurance, so how could 90% be happy with it?
Furthermore, some of those "regulations" that seem so mindless are the same ones that Trump and even the Republicans (Price excepted) realize that they have to retain.
90% is a bit of an exaggerated generalization, wp. but fully 80% of those who had insurance before the unaffordable care act were quite satisfied in terms of quality and cost.
http://www.gallup.com/poll/123149/Cost-Is-Foremost-Healthcare-Issue-for-Americans.aspx
and regarding those regulations that trump/pence will have to retain - there are exactly two that fall into this category. keeping your kids on your plan until age 26, and pre-existing conditions. and there already was legislation that addressed the pre-existing conditions, so that could be dismissed as yet another leftist scare tactic, akin to paul ryan pushing wheelchair granny off the social security cliff, or more recently, chuck schumers claim that the GOP has declared war on seniors.
We will be the laughingstock of the civilized world.
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0linsky already took care of that rog.
The individual OOP maximum is another one. There are more, but we don't really associate them with the ACA - but Americans will howl when Price dustbins them.
We need to abolish the mandate and let the free market price the policies. At the same time, we need regulations with enough teeth to curtail the unethical price gouging from some elements of the health care industry.
We need to abolish the mandate and let the free market price the policies. At the same time, we need regulations with enough teeth to curtail the unethical price gouging from some elements of the health care industry.
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introduction of true competition across state lines solves the gouging problem quickly. when a customer only has those companies available to them that have been approved by their state insurance dept., they have no mechanism by which to avoid bad behavior such as gouging.
You might think Trump would stop tuning in to a show he believes is “unwatchable.” But Trump has previously used that insult against CNN, Fox’s Megyn Kelly and MSNBC’s “Morning Joe” – programs he continues to watch and respond to.
Trump feels a need to hear for himself what people are saying about him. As The Washington Post’s Jenna Johnson reported this week, he still regularly watches cable television, and often bases his decisions on what he sees. It’s common for his advisers to attempt to sway his opinion by expressing their views on TV, knowing he will watch and hear them.
What a fucking mess.
i honestly thought that it would take at least until AFTER the inauguration for trump to start driving you mad, rog.
A federal appeals court on Monday brought to an end President Barack Obama's bid to overturn a ruling that threatens to gut his signature healthcare law by putting the case on hold until after President-elect Donald Trump, who aims to repeal Obamacare, takes office.
http://www.reuters.com/article/us-usa-court-healthcare-idUSKBN13U2A8?feedType=RSS&feedName=politicsNews&utm_source=Twitter&utm_medium=Social
introduction of true competition across state lines solves the gouging problem quickly.
It does not, and that's a big part of the problem here. When a person needs medical help, and it feels urgent, they normally don't stop to negotiate the doctor's bill, or the medicine. People don't even know that it's possible, and I've seen cash prices quoted two or three times more than what the practice will charge someone with insurance. On some instances, five and ten times the price. It is analogous to a "contract of adhesion" where one party is in such a poor position that he is unable to negotiate a good faith contract. And those contracts are illegal, unenforceable. Laws addressing that are necessary to ensure free market pricing and there is no reason that medical care should be any different.
Blogger Roger Amick said.. Trump feels a need to hear for himself what people are saying about him.
Wouldn't you, if a cable station had devoted itself to badmouthing you?
Advisers among Trump's staff will take it upon themselves to become conduits of information to the President, just as with every other President. At that point you won't see as much of this, although his tweeting might not diminish.
It does not, and that's a big part of the problem here. When a person needs medical help, and it feels urgent, they normally don't stop to negotiate the doctor's bill, or the medicine.
By the time you need medical help, it's too late to negotiate health insurance which is what we are talking about in the first place.
However the ability to cross state lines can create far larger insurance pools with far greater selection of health insurances plans.
That is what competition will do.
CS, what we - I - were talking about that triggered this byway in the discussion is medical care costs. Competition among insurance companies will do precisely zero to improve that, and without regulation may even lead to price fixing of medical care.
As I said, At the same time, we need regulations with enough teeth to curtail the unethical price gouging from some elements of the health care industry. My key point is that when you HAVE insurance, the insurance company does that for you. They negotiate the prices, and they do not lack for bargaining position the way the cash payer does. If you abolish the mandate, many will choose not to have insurance as is their right. We need to ensure that those who do not have insurance are protected from the price gouging, which even now is prevalent.
When high school kids can recreate a drug for $2 that a US pharmaceutical company is charging $750 for there's a real price control problem.
I fully expect that company to sue those kids for patent infringement or some such. To protect their stockholders, not the sick people that drug will help.
C.H.,
I would add to your list that Obamacare requires everyone to carry insurance or pay a penalty (tax) for electing not to. This benefits medical providers, especially emergency rooms, that no longer have to worry that they will eat the costs of providing care to people with neither insurance nor the means to pay for medical care.
Obamacare also allows people with existing medical conditions to change jobs without fear of being denied coverage afterwards. That's a huge improvement over the status quo ante.
Indy - I believe if you take the time to look into it, you will find that there was already laws in place that protected people from loosing insurance for simply switching jobs. I believe that the law required new insurance to pick up newly hired (regardless of preexisting conditions) if there had been no "gaps" in insurance coverage.
Ummmmm. No. Except maybe in Massachusetts, where RomneyCare was in place before Obamacare.
Indy - I have some experience working in the Business Office of a Hospital. I did it the last three years of College.
Look up the "Federal" HIPAA laws that existed prior to ACA... If you are talking employer group health insurance plans, those laws were already in place (as long as your coverage was considered "continuous").
Much like the laws that allows children to stay on their parents policies... supporters of ACA were giving Americans a false bill of sale. Much of these things were already in place.
Ummmm. Again, no. Insurers were not required to cover your preexisting condition if you changed jobs. Maybe Minnesota had local laws that required that, or maybe it had some sort of high risk pool someone could get added to if they changed jobs while having a preexisting condition. But those pools were not employer insurance policies. If you had a prexisting condition at company X and took a job at company Y, most states would allow company Y's insurance to deny you coverage.
Apparently you didn't look up the HIPAA laws.... it's a federal (not Minnesota) law.
Twitter President Elect.
AP On Monday, White House spokesman Josh Earnest said progress with the Chinese could be "undermined" by a flare-up over the sovereignty of Taiwan, the self-governing island the U.S. broke diplomatic ties with in 1979. That split was part of an agreement with China, which claims the island as its own territory, although the U.S. continues to sell Taiwan billions in military equipment and has other economic ties.
China:
China: The biggest foreign holder of U.S. government debt had $1.22 trillion in bonds, notes and bills in July, down $22 billion from the prior month, in the biggest drop since 2013, according to U.S. Treasury Department data released Friday in Washington and previous figures compiled by Bloomberg.
The portfolio of Japan, the largest holder after China, rose $6.9 billion to $1.15 trillion. Saudi Arabia’s holdings of Treasuries declined for a sixth straight month, to $96.5 billion.
In short, China could wreak havoc if they called in our debt. Russia is a key trade partner with China. Who will the Russians stand with? And bashing on China’s controversial South China Sea bases? On Twitter? Donald Trump is pushing into uncharted and very dangerous waters with his Twitter account…..and he hasn’t even taken the oath of office yet. He may do more than wreck the U.S. economy. He may drag us into full-scale military confrontation.
On Twitter the Twitter in Chief claimed that the call to Taiwan months in advance. If he had done so, he would have known that the Chinese government could call in our debt, and if we did not comply, the US Dollar would become little more than the paper it's printed on. With the falling prices of crude oil, the Russian government, already facing serious economic problems, high unemployment, and perhaps if it gets worse, domestic descent. Putin isn't afraid to use force, he's done so in the past. But if the big money people who have supported him, may start to distance themselves from him. So the Putin/ Trump love affair might just move towards separation or divorce.
It's well known that my biggest problem with Trump is his willingness to lie and is able to get away with it. And that from reports inside the board room, the people there, speaking anonymously to reporters like Chuck Todd. He is perhaps the most respected journalist in the political field today, so his reports, that I posted yesterday were disturbing. He tends to go with his last impulse, that is not necessarily based on factual analysis, but his gut feelings.
hey rog, you forgot the link again...
http://www.dailykos.com/story/2016/12/4/1607243/-China-launches-Sunday-Twitter-tirade-against-China-this-is-NOT-going-to-end-well
We need to ensure that those who do not have insurance are protected from the price gouging, which even now is prevalent.
It has been my experiance that providers charge about half the fee to uninsured individuals that they would otherwise billed an insurance company.
Simply because they don't have to fill out the paperwork.
Be careful what you ask for.
Obamacare is a disaster, it delivered on nothing and ran up that National Debt the liberals are all of a sudden concerned about by trillions.
Do not be so stupid as to believe the cost of ObamaCare is solely the cost paid out by the US Government. It is the cost of paperwork, look at your 1040 IRS Return for that fact and there are countless others.
Cold is correct HIPPA prevents carriers from imposing prex conditions if you had uninterrupted coverage, which a job change would be.
Anonymous caliphate4vr said...
Cold is correct HIPPA prevents carriers from imposing prex conditions if you had uninterrupted coverage, which a job change would be.
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correct me if i'm wrong but i think that at the very least if there is cobra available to cover a person changing jobs in the event of a somewhat typical 90 probationary period on a new hire.
COBRA is available on all group's with 20 or more employees, but HIPPA also says the probationary period doesn't count. so you could go bare during the probatiobnary period and the new carrier still could not impose a prex exclusion.
The gotcha is that your policy cost just doubled or more as soon as you're unemployed, and if it takes more than 90 days to find a new job then all bets are off.
People shouldn't have to deal with this kind of thing. If you had, and paid for, insurance while having whatever condition it is, then it should not be a "pre-existing condition" no matter what the time frame. There should be no arbitrary rules, no gotchas, no loopholes to shove a person further down a hole after he suffers a setback. That was one of the goals of the ACA and we should not lose sight of it.
And before someone says "That's because your employer pays half of it, you idiot", yes I know that. I don't really like it, because it's literally part of your salary - you pay do it out of the compensation that your employer pays you - but for years you only see a portion of it on your pay stub and that's what we think of with "cost of insurance".
WP - bottom line is most people prefer employer based insurance, and most people are happy with it. Almost nobody I work with "chooses" to go outside and purchase insurance on their own. Our company doesn't pay for our insurance, but the rates are mush lower than the would be anywhere else individually.
Secondly - I think the point with the HIPAA laws is that many people just assume laws like this didn't exist prior to ACA. Like assuming there were not already laws in place (in nearly all states) that allowed children over the age of 18 to stay on their plan... not to mention that many insurers can "choose" to provide such coverage. We both know that "forcing an insurance company to cover something" doesn't mean they eat the cost. It just makes insurance more expensive overall.
Bottom line: supporters of ACA love to take "credit" for laws that already were in place... when all they really did was slightly expand, or create a more unified definition of these plans. Not saying that there isn't value in the expansion of unification of laws... just saying that supporters take credit for "more" than they should.
Trump Just Announced that a very rich Japanees business man with be investing $50 Billion dollars and creating 50,000 jobs in the USA.
Liberals, tell us what is wrong with this?
Why is it that the Sitting President has not been this good at creating jobs, The Art of the DEAL a must read for idiot liberals.
Donald Trump said on Monday that Japan's SoftBank agreed to invest $50 billion in the U.S., aiming to create 50,000 jobs.
He announced the deal after meeting with SoftBank CEO Masayoshi Son, a Japanese billionaire and technology investor, at Trump Tower in New York. On Twitter, Trump claimed that Son said he "would never do this" if Trump had not won the presidential election."
I love it, jobs, wealth and the deal.
Obamacare is one of the great political disasters in recent American history. It is partly responsible for the wide-ranging losses of the Democratic Party over four consecutive elections, not to mention a fraying of the political order. You wouldn’t know this if you only listened to liberals, who are still trying to dictate the contours of the debate.
Blogger C.H. Truth said...
WP - bottom line is most people prefer employer based insurance, and most people are happy with it.
Sure, but therein lies the point. The ACA governs employer based insurance as well. It's not just the exchange plans that we're talking about, far from it.
What we really need is not repeal and replace, repeal or replace, or any combination thereof, but to go beyond where the ACA left off to address the problems that ACA should have addressed, but failed.
"The blue states of America are in a depression. ... Here is an amazing statistic courtesy of the just-released 2016 edition of 'Rich States, Poor States,' which I co-authored with Reagan economist Arthur Laffer and economist Jonathan Williams: Of the 10 blue states that Democrats won by the largest percentage margins ... every single one of them lost domestic migration (excluding immigration) between 2004 and 2014. Nearly 2.75 million more Americans left California and New York than entered these states."
—Stephen Moore
no wonder they need open borders. they need illegals to backfill those who are fleeing their state.
Bottom line: supporters of ACA love to take "credit" for laws that already were in place.
Such as?
The ACA age is 26, not 18. That example is invalid - so to what laws do you refer? I've got to tell you, this is the first I've ever heard this.
but to go beyond where the ACA left off to address the problems that ACA should have addressed, but failed.
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the net result of which would be government run single payer.
in other words, the VA/medicaid for everyone.
thanks, but no thanks.
wp, the fundamental naivete of this entire debate is that the government actually cares about us and wants us to have quality health care. nothing could be further from the truth. the government only cares about controlling the populace. not helping. since the 'great society' we've pissed away about $20 TRILLION on entitlements. have we won the war on poverty? hell no. what we've done is create a reliable democrat voting bloc.
the ACA was never anything more than an extension of the war on poverty. not designed to actually help anyone. simply designed to addict people to government and lure them to the polls every two years. fortunately for all of us, it backfired big time.
if you want to cover the poor then cover the poor. expand medicaid and set thresholds that address the truly indigent. but do not drag the remaining 80+% of us into the scheme. that's dishonest at it's core.
americans are the most charitable people on earth. but point a gun at our heads and tell us that we must comply with some phony government-sponsored altruism, and what you can expect is revolt...
...and PRESIDENT DONALD TRUMP.
The ACA age is 26, not 18.
It was to the 19th birthday or threw age 25 if a full-time student. My previous employer would allow children to be on the plan indefinite, 32 living in the basement fine, we charged for it. And BTW that's what happening now as a child turns 21 they no longer get a child rate but an adult rate. All carriers price kids 0-20 at one rate and 21 and up a different rate.
But I think more your issue is transparency in pricing which I completely agree with, while someone negotiating to pay in cash probably can't get the pricing a covered person gets do to the negotiated rates. I personally don't care who my primary care doc is, I just pray they have small hands
WP - I wrote a post on this... showing all of the States that already had laws in place that require insurers allow customers to be able to insure their children past 18. In a couple of cases, the laws went further than 26.
Secondly, as mentioned... HIPAA laws already were in place to require group insurance plans to cover someone with preexisting insurance, as long as they did not have a coverage gap (of a certain time period). (which was the argument Indy made that you would loose coverage for switching jobs).
Necropsy has been ordered for the Dem Party.
Will they except the results or continue to hurl insults?
CH - COBRA is only for a couple of months, so it falls far short of pre-existing condition coverage.
HIPAA protections were expanded by the ACA, not replaced by similar provisions.
The so-called "coverage gap" should have nothing at all to do with denying coverage, no matter what condition existed before the gap. The only thing that HIPAA does for this were the portability provisions, (Special Enrollment) which are more restrictive than you may realize.
WP
I would agree that ACA "expanded" on HIPAA laws.
But most of the public believed that these laws were completely new and that people with preexisting conditions would lose coverage just for switching jobs (as an example)... when the HIPAA laws already protected that.
In many ways, the ACA simply "expanded" and "consolidated" on existing federal and state laws when it comes to some of those regulations. At least the popular ones were already law (to some degree in most states). The lesser popular ones (such as the coverage minimums) could be easily dispatched.
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Bottom line:
Repealing ACA wouldn't automatically mean that people would lose insurance because of a job shift or would automatically lose the ability to insure a child over the age of 18. These things were covered by existing laws for the most part (again, in the latter at the state level). But that is the bill of goods people are selling.
A lot of people really would lose their insurance because of a job shift. They are right about that. Most people would lose the ability to cover their grown children. People who believe that are right about it.
Repeal ACA, and if you don't have insurance now you're not going to get it if, for example, you're diabetic and self-employed. Oh, it may be possible if you're willing to spend $25K or $30K in premiums and can afford that AND your medical bills. But that's not a realistic scenario for most people, is it?
Well WP -
If anyone lost their insurance for a simple job switch (that did not break continuous coverage)... then that insurance company was in violation of federal law.
Period.
There is a whole list of exclusions in that law, and you also had to get signed up again before the COBRA period ran out. And what if your wife has a preexisting condition, or developed one, but wasn't signed up on the original policy? With ACA she can get insurance, repeal it and she cannot.
First of all COBRA isn't a couple of months, it's 18, you might be confusing state continuation, which applies to businesses with under 20 employees.
And I'd love to know the exclusions you speak of, because the federal law that is HIPPA only excludes those that are fired 'with cause'.
WP -
HIPAA has nothing to do with COBRA - They are different laws that effect different things.
Please "google" HIPAA - and look for yourself.
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