House Republicans/Ryan Finally Release ACA Repeal (lol) and Replace (lol) Bill

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I just love that this bill brings into clear focus what the GOP actually doesn't like about Obamacare. It raised taxes on rich people and gave too much money to poor people. Otherwise they kept everything else.
 
BrokenIcarus said:
Why do you think the freedom caucus will vote against it?
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Because libertarians think every american is equipped with perfect common sense regarding their healthcare and that bootstraps will fix an unexpected $50,000 bill from a hospital.

Fact is, we are not. And many people in poverty will opt out of healthcare to feed their children.
 
That shit isn't passing the House, and probably not the senate. The most interesting thing is that it makes it clear that establishment republicans have accepted the basic tenets of Obamacare: government assistance to make private insurance affordable*.

I'd imagine Ryan feels that Obamacare is going to implode in a year or two anyway (insurance companies leaving the markets), and they'll kick the can to the 2020 election. If you want Obamacare fixed, vote for the democrat candidate; if you want a new magical replacement plan, vote for Pence (or Trump, if he isn't in jail).
 
malingenie said:
Because libertarians think every american is equipped with perfect common sense regarding their healthcare and that bootstraps will fix an unexpected $50,000 bill from a hospital.

Fact is, we are not. And many people in poverty will opt out of healthcare to feed their children.
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^This!!! My mother in her 70s needed to go to the emergency room ASAP because she couldn't walk and stand without assistance and couldn't talk well at all very suddenly. That emergency room visit turned into a 8 day stay in the hospital and the bill that came was exactly $50,000. My parents are now worrying about if their existing insurance plan will cover the majority of that $50,000 amount because if it doesn't, it means dire financial straits for the entire household.
 
Has Trump commented on this plan? I can't imagine he thinks this plan gets him close to his campaign promises of covering every american.
 
mnannola said:
Has Trump commented on this plan? I can't imagine he thinks this plan gets him close to his campaign promises of covering every american.
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Just twitter

Our wonderful new Healthcare Bill is now out for review and negotiation. ObamaCare is a complete and total disaster - is imploding fast!
 
I guess the real lesson here is that people who are the most deserving of care are the ones who were born into wealth. The real lottery winners.
 
Bluenoser said:
Jason Chaffetz was just on New Day on CNN explaining the new plan, and it didn't sound good. He pulled a Don Mattrick, responding to Alisyn's question about lower income people not being able to afford healthcare, "well maybe they need to prioritize it... if they were looking forward to buying that new expensive iPhone, maybe they have to put that money towards health care instead".

Fair enough Jason, but what about when that becomes "well, instead of going out and buying $200 worth of food for your family, maybe you should put that money towards healthcare".

GOP just.... doesn't.... fucking....get it.
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Especially since that "new expensive iPhone" is now $30 a month. The poor and most middle-lower class aren't buying them outright upfront. They are paying over time at low reasonable monthly payments. Find me an insurance that's $30 a month and maybe make that comparison Chaffetz.
 
mnannola said:
Yes please have the CBO score this, the current ACA with no changes, and then this new Republicare plan.

I would have to think that Medicare for all would be by far the cheapest option once you factor in the premiums and deductibles that people currently pay in addition to their premiums.
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Yeah but it means making rich people pay taxes so it's awful.
 
mnannola said:
Yes please have the CBO score this, the current ACA with no changes, and then this new Republicare plan.

I would have to think that Medicare for all would be by far the cheapest option once you factor in the premiums and deductibles that people currently pay in addition to their premiums.
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I was actually curious to see if the CBO has ever scored any sort of single-payer type plan like Medicare For All, but I can't find anything in my searches. It would certainly make sense for it to be part of the debate
if our government was actually interested in pursuing policies without letting corporate influence and "reasonable" centrists get in the way

edit: first thing I could find is this...from 1993. Whether single-payer or all-payer, cost controls would be needed as well to make things affordable.
 
Anoregon said:
Yeah but it means making rich people pay taxes so it's awful.
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I wonder how much worse off they would be, since I would venture to guess most wealthy people are business owners. How much would businesses save if they didn't have to provide health insurance to their employees? I know our company picks up like 75 percent of the premiums for our healthcare, and is a massive expenditure.
 
Vixdean said:
I just love that this bill brings into clear focus what the GOP actually doesn't like about Obamacare. It raised taxes on rich people and gave too much money to poor people. Otherwise they kept everything else.
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The simplest way to figure out Republicans is to realize that their #1 priority is to cut taxes on rich people*; moreso than any other of their other policy priorities. That's why they're trying to move on Obamacare so fast - they want to lower the government revenue from Obamacare taxes, so that when they do the budget in a few months they can cut taxes and still have it be deficit-neutral. Due to arcane Senate rules, being deficit-neutral would make the tax cuts permanent, instead of expiring in 10 years like the Bush tax cuts did.

*Except for John McCain. That guy's overriding life priority is to figure out how to bomb more people.
 
PopcornMegaphone said:
To be clear - past this year they don't actually say how they are going to fund this do they?
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ZMbYDr8.png


https://housegop.leadpages.co/healthcare/
 
johnny956 said:
The increase in HSA amounts is the only thing I like about this plan. Every thing else is just embarrassingly bad
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I personally can benefit from this, but you kind of have to already have money for this to work. It does nothing to help the poor. If we are getting this in place of medicaid funding then I'll take the latter.
 
If this actually made it through I'd be extremely concerned, but I really don't think it has any chance.
 
This bill seems dead already. I'm seeing a lot of oppositions from republicans too.

the ACA was the ultimate compromise on both sides.
 
Ziltoidia 9 said:
Can you give me some background on HSA limits, please? I don't know much about them.
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HSAs are ostensibly meant to let you save just enough money to cover your deductible on a HDHP (which is why you can only have an HSA if you have a HDHP)

Because of that, if your insurance covers one person you can contribute $3,400 and if it covers more than one person you can contribute $6750. The limit includes any amount an employer might put in

In reality, its a tax shelter for people who can afford to front the money to cover the deductible and doesn't really do anything for people who don't have money to save
 
mnannola said:
Yes please have the CBO score this, the current ACA with no changes, and then this new Republicare plan.

I would have to think that Medicare for all would be by far the cheapest option once you factor in the co-pays and deductibles that people currently pay in addition to their premiums.
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What would be the point of that? Laws aren't enacted simply because they make the most sense. You know that right?
 
soul creator said:
I was actually curious to see if the CBO has ever scored any sort of single-payer type plan like Medicare For All, but I can't find anything in my searches. It would certainly make sense for it to be part of the debate
if our government was actually interested in pursuing policies without letting corporate influence and "reasonable" centrists get in the way

edit: first thing I could find is this...from 1993. Whether single-payer or all-payer, cost controls would be needed as well to make things affordable.
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It was brought up during PPACA. Not sure it made it to the CBO.
 
sangreal said:
HSAs are ostensibly meant to let you save just enough money to cover your deductible on a HDHP (which is why you can only have an HSA if you have a HDHP)

Because of that, if your insurance covers one person you can contribute $3,400 and if it covers more than one person you can contribute $6750
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Why are there caps right now on how much you can put in them?

Thanks for the response btw.
 
Ziltoidia 9 said:
Why are there caps right now on how much you can put in them?

Thanks for the response btw.
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because its a huge tax shelter

it's a 401k that is also exempt from payroll taxes, and if you can afford not to use the funds you can save them for years and then reimburse yourself from the gains, tax free (there is no time limit on claiming reimbursement from your HSA). When you turn 65 it basically becomes a traditional IRA where you can withdraw funds for any reason if you pay income tax on the withdrawal (you can still withdraw for healthcare tax free)

traditional IRAs have a relatively low income limit where you can't deduct contributions and roth IRAs have a low income limit for even contributing to them. HSA has none of these restrictions

edit: if it wasn't clear, you can invest money in your HSA, so that is where the (tax free) gains come from
 
Oh fuck, public health is also affected by this Obamacare repeal and replace bill: http://www.vox.com/policy-and-politics/2017/3/7/14842090/republican-health-plan-public-health

The Republican health insurance plan slashes funding for vaccines and public health
The ACA’s Prevention and Public Health Fund is poised to disappear by 2019.

The American Health Care Act makes a number of changes to the Affordable Care Act that’ll likely disadvantage poorer and sicker Americans, and result in fewer people covered. But the plan also includes a subtler but very significant move for American health: the elimination of the largest fund for disease prevention in the federal budget, along with 12 percent of the budget for the Centers for Disease Control and Prevention, by 2019.

The ACA established the Prevention and Public Health Fund, which provides $14.5 billion over 10 years. The goal of the fund was simple: Boost public-health money, much of it for the US Centers for Disease Control and Prevention (CDC), to support activities that keep people from becoming sick with preventable chronic ailments like diabetes, heart disease, and cancer and infectious diseases that can be staved off with vaccines. (At a time when more Americans would be gaining insurance, keeping people healthy and out of the health care system carried extra appeal for lawmakers.)

Over the years, the fund has become a prime target for Republicans, who generally regard public health as paternalistic and have called the program a “slush fund for jungle gyms.” Congress has subjected it to a slew of cuts. So it’s not a surprise that the American Health Care Act plans to sever the fund altogether.

But, according to John Auerbach, president and CEO of the public health nonprofit the Trust for America’s Health, “Losing the fund will result in a significant increase in preventable illnesses and injuries.” Here are the details on a few of the key programs the bills would affect:

1) The federal vaccines program. The Section 317 vaccines program has been called “the backbone of our nation’s immunization infrastructure.” It ensures doctors get the vaccination doses they need, helps people who can’t afford vaccines gain access to them, and mobilizes responses to outbreaks like measles, among other things. It would lose half its funding, which is frightening at a time when vaccination rates are already down in some states.

2) Programs to prevent heart disease, the number one cause of death in America. Eighty percent of the funding for evidence-based education and health programs about reducing the risk of heart disease would disappear.

3) Programs to reduce the risk of health care-associated infections at hospitals. Patients who go to hospitals and clinics to be treated too often end up picking up nasty or deadly bugs. That’s why the CDC has made a major push in recent years to work with hospitals to reduce these risks. Because 100 percent of the money for this program comes from the fund, the program to reduce health care-associated infections would die with the fund.

4) More than a tenth of the CDC’s budget. Over the years, several items in the CDC’s core budget have been shifted over to the fund. With the fund’s disappearance, $890 million (or about 12 percent) of the CDC’s annual budget would be lost. Within the next five years, states will lose more than $3 billion, according to a recent analysis by the Trust for America’s Health.

So in addition to the potential fallout for individuals’ health care with changes to Obamacare, we are likely to see public health fallout, too.

“A simple 50 votes could have a significant deleterious impact on public health in the country, and that’s a major concern,” Auerbach said. And public health funding has already been decreasing: Today there are 50,000 fewer public health jobs at the federal, state, and local levels compared with 2008.

At a time when life expectancy in the US has declined for the first time in decades, chronic diseases are affecting millions of Americans, and we are facing the risk of a new pandemic, America could use a strong public health force more than ever. Instead, Republicans are hoping to weaken public health.
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sangreal said:
because its a huge tax shelter

it's a 401k that is also exempt from payroll taxes, and if you can afford not to use the funds you can save them for years and then reimburse yourself from the gains, tax free (there is no time limit on claiming reimbursement from your HSA). When you turn 65 it basically becomes a traditional IRA where you can withdraw funds for any reason if you pay income tax on the withdrawal (you can still withdraw for healthcare tax free)

traditional IRAs have a relatively low income limit where you can't deduct contributions and roth IRAs have a low income limit for even contributing to them. HSA has none of these restrictions

edit: if it wasn't clear, you can invest money in your HSA, so that is where the (tax free) gains come from
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So are the contribution limits of $3,400 and $6750/family for a year? I think thats where I am confused.
 
Ziltoidia 9 said:
So are the contribution limits of $3,400 and $6750/family for a year? I think thats where I am confused.
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yeah, per year

so the appeal is that you get an HSA when you're 20 and when you're 30 and need more trips to the doctor you've got 30000 + investment returns saved up for healthcare

but first you need money to put in your HSA, so it does nothing for low income people
 
johnny956 said:
The increase in HSA amounts is the only thing I like about this plan. Every thing else is just embarrassingly bad
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Pretty much. As someone w/ employer health insurance it's nice to get a tax shelter for money to help cover co-pays and deductibles but there's no way it's going to help a poor person who is living paycheck to paycheck.
 
FireAndBlood said:
Kind of amazing thinking how Dems got ACA passed with 60 Senate votes.
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What's ironic is the ACA was actually a Republican idea (essentially based off of former Massachusetts Governor and Presidential candidate Mitt Romney's healthcare plan that he successfully implemented in Massachusetts), that's why it had support from Republicans: https://en.wikipedia.org/wiki/Patient_Protection_and_Affordable_Care_Act

In 2006, an insurance expansion bill was enacted at the state level in Massachusetts. The bill contained both an individual mandate and an insurance exchange. Republican Governor Mitt Romney vetoed the mandate, but after Democrats overrode his veto, he signed it into law.[131] Romney's implementation of the 'Health Connector' exchange and individual mandate in Massachusetts was at first lauded by Republicans. During Romney's 2008 presidential campaign, Senator Jim DeMint praised Romney's ability to "take some good conservative ideas, like private health insurance, and apply them to the need to have everyone insured". Romney said of the individual mandate: "I'm proud of what we've done. If Massachusetts succeeds in implementing it, then that will be the model for the nation."[132]

In 2007, a year after the Massachusetts reform, Republican Senator Bob Bennett and Democratic Senator Ron Wyden introduced the Healthy Americans Act, which featured an individual mandate and state-based, regulated insurance markets called "State Health Help Agencies".[121][132] The bill initially attracted bipartisan support, but died in committee. Many of the sponsors and co-sponsors remained in Congress during the 2008 healthcare debate.[133]

By 2008 many Democrats were considering this approach as the basis for healthcare reform. Experts said that the legislation that eventually emerged from Congress in 2009 and 2010 bore similarities to the 2007 bill[124] and that it was deliberately patterned after Romney's state healthcare plan.
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Did paul ryan and a room-full of aides just make shit up under the vague guidelines of "fuck poor people, cut taxes?" If all these conservative groups are really against the bill, who the hell consulted on writing it?
 
The Albatross said:
The 30% coverage thing... That would probably break even with the penalty for not having insurance under the ACA for most people right? My GF (now wife) didn't have insurance for about 2 months between jobs and I believe it was like $570 penalty.

So, the average monthly premium for Americans is $235 on the individual market. So... if you take 30% of that, it's $70 or so. So worse case, you'd pay $700 more a year (that is, if you don't have insurance for Jan and Feb, and then have it at that premium for the rest of the year). So it looks like worst case you could pay like $130 more, though if it's one month later, then it breaks about even with the current penalty.

BUt, that's just my guess based on reading the text, I'm no expert.
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No worst case is more than 700 in the future as its tied to your premiums. If premiums increase, the penalties increase. Outside of the initial Obamacare push, there hasn't been a year where the premiums increased less than 10% since 1990. So that 700 will be 770 next year, over 800 the next, over 900 the next.
 
BlastProcessing said:
Yeah, this thing is dead.

@ddale8
Daniel Dale Retweeted Frank Thorp V
The big-name right-wing groups are coming out against Trump's chosen bill: now AFP, Club for Growth, Heritage Action, FreedomWorks.

@mattyglesias
This is so amateur hour.

Workshop the bill with conservative groups before releasing the draft. What is happening?

Paul Ryan's incompetence constantly amazes me. I keep thinking he has found the absolute bottom and then he breaks on through to a fresh new basement.
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Wow!!!! So the ACA is actually OK with conservative groups such as AFP, Club for Growth, Heritage Action and FreedomWorks, that actually says something about the successes that the ACA has had.
 
FireAndBlood said:
Kind of amazing thinking how Dems got ACA passed with 60 Senate votes.
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This was after every Democratic president since FDR - Truman, Kennedy, Johnson, Carter, and Clinton tried to do universal healthcare and all failed.

And after Obama bribed drug companies, health insurance companies, and hospitals to not oppose the bill due to the increased profits that they would get under Obamacare.

And that to win the 59th and 60th votes, the Democrats stripped out a bunch of good things from the bill, most critically the public option.

And that even then it passed the House by 1 vote and only passed the Senate with 59 votes due to some legislative chicanery.

Basically...healthcare policy in America is impossibly hard, and that was even with a party that was committed to the goal of universal healthcare for its whole existence and had many, many lawmakers that were willing to vote for Obamacare even at great risk to their careers. Contrast this to Republicans, for whom healthcare policy has never been a real 'problem'; if you've never considered healthcare as a fundamental right for the poor and sick, then you don't know what you want to do when you craft a healthcare bill and you end up with this monstrosity.
 
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