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(CNN)Emboldened by Donald Trump's surprise victory, Republican lawmakers vowed after Election Night that they wouldn't waste a single day to pursue their most urgent mission: Kill Obamacare. The President-elect, too, has been in a hurry, declaring that the Affordable Care Act must be repealed and replaced more or less at the same time. "Probably the same day, could be the same hour," Trump said at a news conference last week. But on Capitol Hill, urgency doesn't always translate into speed. In the first two weeks of the new year, Republican leaders have confronted resistance from rank-and-file lawmakers from across the ideological spectrum. Nervous about the potential political fallout of moving too fast on Obamacare repeal, some Republicans are now cautioning restraint -- a stark contrast from their ferocious attacks against President Barack Obama's signature health care law over the past several years. Trump further complicated matters over the weekend when he told The Washington Post that he was nearly finished with his own plan to replace Obamacare and warned that he won't let Congress get in his way. "The Congress can't get cold feet because the people will not let that happen," Trump said. Although he didn't offer much in the way of details, the incoming president's comment that he wants both "insurance for everybody" with "much lower deductibles" sets the stage for a potential clash and drawn out negotiations with Republican lawmakers who have been stressing universal access over universal coverage. "Repeal and replace is a bloody complicated exercise," said Brian Fortune, president of the Farragut Square Group, a health care consulting firm in Washington. "The challenge for the Republicans is, of course, to rework something without getting blamed for all the downstream effects -- quite difficult. Senate Republicans got the ball rolling on Day One of the new session of Congress, introducing a budget resolution whose sole purpose was to repeal the health care law. Following Senate and House approval of the resolution last week, Republicans now get to work on crafting a second measure -- a budget reconciliation bill -- that contains the language to roll back big chunks of Obamacare. But leading up to last week's first procedural vote, Republicans in both chambers expressed deep reservations. The overarching worry among Republicans is that the party will vote to dismantle major portions of a law that covers some 20 million people before there is even a blueprint for an alternative, and be held responsible for widespread disruptions in health insurance. Complicating matters is the reality that several main pillars of the law enjoy broad support, such as the pre-existing conditions rule as well as a provision that allows children under the age of 26 to stay on their parents' health policy. In the House, a mix of conservative and moderate lawmakers was skittish about supporting the budget resolution. They pressed House Speaker Paul Ryan for reassurances that the process of replacing Obamacare would unfold around the same time as the vote to repeal it. GOP Rep. Charlie Dent of Pennsylvania told CNN before the vote on Friday that things were moving too quickly. "I'm very concerned on the policy side specifically, that the replacement occur either simultaneously or as close to simultaneously as possible," Dent said. "If we don't provide a credible replacement plan, my main concern is that there would not be gaps in coverage for people who are currently subsidized. Also concerned about how the insurance markets might react." Dent -- along with eight other House Republicans -- ultimately voted against the budget resolution. And in the Senate, a group of five GOP senators introduced an amendment to the budget resolution to extend the deadline by which to craft the reconciliation bill -- the measure that would repeal Obamacare -- from January 27 to March 3. While that deadline is largely viewed as symbolic and unenforced, the senators were sending a clear message: We need more time to figure out what's next. "We just want to make sure that we get it right," GOP Sen. Susan Collins of Maine, one of the supporters of the amendment, told CNN. "One of the problems with Obamacare is that it was rushed through without input from Republicans for the most part, and we realize that insurance markets are complicated. And we don't want people to fall through the cracks." Asked whether the amendment signaled that Republicans were increasingly less concerned about overhauling Obamacare on the most expedient timeline, Republican Sen. Bill Cassidy of Louisiana, another author of the amendment, pushed back. "My gosh. If you're going to say we're going to fly to the moon but we're going to do it in March instead of next week, would you still feel it's pretty urgent?" Cassidy said. "You'd say, oh my gosh, we've got to get to work!" Under pressure, Ryan has grown increasingly emphatic that there will not be long lag time between a repeal vote and when Congress considers a replacement package or set of measures. At a CNN town hall last week, Ryan went as far as to say that GOP leaders would repeal and replace "at the same time." But other than to say that there would be action within the first 100 days of the Trump administration, he declined to commit to a specific timeline, noting that the whole process would take "a little bit of time." But even while lawmakers in his party are growing wary of acting too quickly, Trump has been ratcheting up the pressure on Republicans to help him deliver on his campaign promise as fast as possible. "The Congress can't get cold feet because the people will not let that happen," Trump said. Although he didn't offer much in the way of details, the incoming president's comment that he wants both "insurance for everybody" with "much lower deductibles" sets the stage for a potential clash and drawn out negotiations with Republican lawmakers who have been stressing universal access over universal coverage. "Repeal and replace is a bloody complicated exercise," said Brian Fortune, president of the Farragut Square Group, a health care consulting firm in Washington. "The challenge for the Republicans is, of course, to rework something without getting blamed for all the downstream effects -- quite difficult. Senate Republicans got the ball rolling on Day One of the new session of Congress, introducing a budget resolution whose sole purpose was to repeal the health care law. Following Senate and House approval of the resolution last week, Republicans now get to work on crafting a second measure -- a budget reconciliation bill -- that contains the language to roll back big chunks of Obamacare. But leading up to last week's first procedural vote, Republicans in both chambers expressed deep reservations. The overarching worry among Republicans is that the party will vote to dismantle major portions of a law that covers some 20 million people before there is even a blueprint for an alternative, and be held responsible for widespread disruptions in health insurance. Complicating matters is the reality that several main pillars of the law enjoy broad support, such as the pre-existing conditions rule as well as a provision that allows children under the age of 26 to stay on their parents' health policy. In the House, a mix of conservative and moderate lawmakers was skittish about supporting the budget resolution. They pressed House Speaker Paul Ryan for reassurances that the process of replacing Obamacare would unfold around the same time as the vote to repeal it. GOP Rep. Charlie Dent of Pennsylvania told CNN before the vote on Friday that things were moving too quickly. "I'm very concerned on the policy side specifically, that the replacement occur either simultaneously or as close to simultaneously as possible," Dent said. "If we don't provide a credible replacement plan, my main concern is that there would not be gaps in coverage for people who are currently subsidized. Also concerned about how the insurance markets might react." Dent -- along with eight other House Republicans -- ultimately voted against the budget resolution. And in the Senate, a group of five GOP senators introduced an amendment to the budget resolution to extend the deadline by which to craft the reconciliation bill -- the measure that would repeal Obamacare -- from January 27 to March 3. While that deadline is largely viewed as symbolic and unenforced, the senators were sending a clear message: We need more time to figure out what's next. "We just want to make sure that we get it right," GOP Sen. Susan Collins of Maine, one of the supporters of the amendment, told CNN. "One of the problems with Obamacare is that it was rushed through without input from Republicans for the most part, and we realize that insurance markets are complicated. And we don't want people to fall through the cracks." Asked whether the amendment signaled that Republicans were increasingly less concerned about overhauling Obamacare on the most expedient timeline, Republican Sen. Bill Cassidy of Louisiana, another author of the amendment, pushed back. "My gosh. If you're going to say we're going to fly to the moon but we're going to do it in March instead of next week, would you still feel it's pretty urgent?" Cassidy said. "You'd say, oh my gosh, we've got to get to work!" Under pressure, Ryan has grown increasingly emphatic that there will not be long lag time between a repeal vote and when Congress considers a replacement package or set of measures. At a CNN town hall last week, Ryan went as far as to say that GOP leaders would repeal and replace "at the same time." But other than to say that there would be action within the first 100 days of the Trump administration, he declined to commit to a specific timeline, noting that the whole process would take "a little bit of time." But even while lawmakers in his party are growing wary of acting too quickly, Trump has been ratcheting up the pressure on Republicans to help him deliver on his campaign promise as fast as possible. And if in fact Trump does release an Obamacare replacement plan of his own, that could present a series of new challenges for Ryan and Senate Majority Leader Mitch McConnell who are under pressure to satisfy an array of ideological priorities from rank-and-file members. At his news conference in New York City last week, Trump said that a plan to repeal and replace the health care law would be submitted "as soon as" Tom Price, his nominee for Health and Human Services secretary, is confirmed. Price, a Georgia congressman, will testify before the Senate Health committee on Wednesday, but the Senate Finance committee, which will vote on his confirmation, has not yet set a hearing date. It's unclear what role Price will have in shaping the GOP's new healthcare system, and a Trump transition official told CNN that the incoming administration is "taking nothing for granted" before the congressman's confirmation. "It's all about the confirmation," the official said. "Nobody's looking past that date." http://www.cnn.com/2017/01/16/politics/trump-obamacare-slow/One of the benefits of being on the other side. Republicans have nobody to point the finger too when they screw this up and make things worse. They need to be careful on how they handle this or things will flip in 2018.
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Trump said, over this past weekend, that he wants all Americans to receive healthcare. Sounds like he wants universal/single payer healthcare by using those words.
(In all reality he knows not if what he talks about)
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Trump said, over this past weekend, that he wants all Americans to receive healthcare. Sounds like he wants universal/single payer healthcare by using those words.
(In all reality he knows not if what he talks about) I see 3 options. 1. Single payer system. 2. Make tweaks to ACA and call it Trumpcare. 3. Go back to how things were before ACA. Which will be political suicide for republicans. I don't think this will happen because you'd have too many nervous republican congressmen in purple states.
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Trump said, over this past weekend, that he wants all Americans to receive healthcare. Sounds like he wants universal/single payer healthcare by using those words.
(In all reality he knows not if what he talks about) I see 3 options. 1. Single payer system. Right now the behavior of the LEft for the past decade or so prevents them from finding any allies from "across the aisle" when they make these claims about trump being crooked or whatever. But if he were to do this you'd see a massive movement to have him impeached on the next scandal that came out no matter how minor. Single payer will not be accepted for the same reasons Obamacare has been rejected: people don't want to be forced to pay for crappy healthcare.2. Make tweaks to ACA and call it Trumpcare. The only tweaks that would have any meaning would actually unravel it anyway: getting rid of the individual mandate, changing the structure of the markets to one that actually resembles something of a free market. 3. Go back to how things were before ACA. Which will be political suicide for republicans. I don't think this will happen because you'd have too many nervous republican congressmen in purple states. I wouldn't be so sure about that. Obamacare has never had a majority favorability rating that I've heard or seen. The only claim to success is that millions of people have coverage that didn't before. Three problems with that: 1) even if you take the inflated number of 20 million covered, it's still short of the 30 million it was supposed to cover.2) Nearly a 3rd of that 20 million HAD insurance and were kicked off of it because of Obamacare. 3) With the decrease in choice and quality and the massive increases in premiums many if not most people have experienced since it's passage, it would be an extremely difficult arguement to make that had the ACA not been passed, people would be paying more for less than they are now.
I don't believe we'll see Obamacare dropped in one fell swoop. I think it will be incremental and they'll see what kind of attrition happens naturally at first with the repeal of the individual mandate. The mandate has artificially inflated the number of people on it by including people who don't need or want it. Couple this with stripping out some of the insurance company bailouts, they'll have to find their revenue in other areas i.e. customers. Allowing companies to sell across state lines will help drive costs back down. Ideally costs will get down low enough that it will be cheaper than what you would be getting on Obamacare and so people will naturally transition.
And politically don't forget that right now Republicans are claiming to want to keep the 2 things idenitifieda s the biggest concerns: keeping your kid on until 26 and coverage for pre-existing conditions. If they manage to actually do that it's wholly possible the repeal could end up being a very big political win.
"Hey, I'm a reasonable guy. But I've just experienced some very unreasonable things." -Jack Burton
-It looks like the Harvard Boys know what they are doing after all.
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They are looking for a way to pass it off as tax credits, but that won't keep the insurance companies from raising premiums again and again. These dogs can't quit chasing their own tails long enough to see that they have to hurt somebody. Either their donors take the hit or the people do.
They should just enact a single payer system like the rest of the major countries and take the fame instead of the blame... But they are slaves to the donor class which includes insurance companies.
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I'd bet my life savings if they abolish ACA and go back to how things were before, Dems will control everything but the Oval Office in 2018. That's the optimistic republican in you saying that.
The only reason (a bit hyperbole) why Obama won and you guys got smoked in 2008 was because of healthcare being a mess.
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Hope they have something viable to replace it with.
Cause the premiums were sky rocketing before the ACA came along, the ACA slowed that bleeding down from what it was.
So the republicans better replace it with something better, because it they just revert back to the old system, this will be the quickest 4 years for them...ever.
Republicans have control of everything. Don't screw it up.
“To announce that there must be no criticism of the President, or that we are to stand by the President, right or wrong, is not only unpatriotic and servile, but is morally treasonable to the American public.”
- Theodore Roosevelt
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I would like to see the government get out of healthcare except for Medicare/Medicaid. Let the private sector do it with government oversight. Set the rules for preexisting conditions and such then get out of the way.
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I would like to see the government get out of healthcare except for Medicare/Medicaid. Let the private sector do it with government oversight. Set the rules for preexisting conditions and such then get out of the way. Yes because corporations and rich men are so well known for doing the right thing... What planet are you from really?
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I would like to see the government get out of healthcare except for Medicare/Medicaid. Let the private sector do it with government oversight. Set the rules for preexisting conditions and such then get out of the way. The government was out of healthcare. And people were demanding reform because of it. Now you want to go back to corporations having complete control over it, with no price caps? I feel bad for those with preexisting conditions.
“To announce that there must be no criticism of the President, or that we are to stand by the President, right or wrong, is not only unpatriotic and servile, but is morally treasonable to the American public.”
- Theodore Roosevelt
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I keep rereading what I said and I can't find "No price caps" anywhere.
The last thing we need is another welfare program. The Private sector will do this best. The government will oversee them.
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So healthcare is welfare?
Man.... conservatives really hate America.
“To announce that there must be no criticism of the President, or that we are to stand by the President, right or wrong, is not only unpatriotic and servile, but is morally treasonable to the American public.”
- Theodore Roosevelt
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Man.... conservatives really hate America.
Conservative hate big government.
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Man.... conservatives really hate America.
Conservative hate big government. But love big business. A corporate state. Fascism.
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Man.... conservatives really hate America.
Conservative hate big government. You only hate big government when it comes to corporations. Conservatives have shown that they are more than happy to use big government to control the people, trying to legislate morals.
“To announce that there must be no criticism of the President, or that we are to stand by the President, right or wrong, is not only unpatriotic and servile, but is morally treasonable to the American public.”
- Theodore Roosevelt
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Trump said, over this past weekend, that he wants all Americans to receive healthcare. Sounds like he wants universal/single payer healthcare by using those words.
(In all reality he knows not if what he talks about) I see 3 options. 1. Single payer system. 2. Make tweaks to ACA and call it Trumpcare. 3. Go back to how things were before ACA. Which will be political suicide for republicans. I don't think this will happen because you'd have too many nervous republican congressmen in purple states. I think #2 is the only viable option, though I really hope they don't go with Trumpcare.  the question is going to be in the order and magnitude of those tweaks. I really did appreciate the Presidents comments the other day that if they can tweak it and make it better, that he will publicly support those changes. This is where I differ from those in politics and why I guess I could never hold higher office... my first call as a Republican President, on the issue of Obamacare, would be to... Obama.. I would love to sit down with him and say, "Looking back at what you wanted to accomplish with this law, and seeing how it's turned out, the good and the bad, what do you wish you had done differently?" But there is way too much ego in DC for that kind of cooperation....
yebat' Putin
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So healthcare is welfare?
You need to face a hard reality of life... If you were born in this country and you are poor, you are most likely an underachieving idiot because people come here from other countries, with nothing, can't even speak the language, yet they are doing as well as you.
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Easily one of the dumbest things you've ever said.
“To announce that there must be no criticism of the President, or that we are to stand by the President, right or wrong, is not only unpatriotic and servile, but is morally treasonable to the American public.”
- Theodore Roosevelt
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copy of an interview with Republican Steve King on NPR a couple days ago.
Rep. Steve King Pushes Ahead On Obamacare Repeal Before Replacement
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Transcript
January 12, 2017·4:32 PM ET
Heard on All Things Considered On the first day of this Congress, Rep. Steve King of Iowa introduced a bill to repeal the Affordable Care Act in its entirety. Now some Republicans say they want to wait until there's a replacement plan. NPR's Audie Cornish asks Rep. King why he wants to push ahead on repeal first.
ROBERT SIEGEL, HOST:
Donald Trump said this yesterday about repealing and replacing Obamacare. As soon as his nominee for Secretary of Health and Human Services is confirmed, he said his administration will submit a plan to replace the law. He said it will be repeal and replace. It'll be done, in Trump's words, essentially simultaneously.
Republican Congressman Steve King of Iowa isn't waiting. King is a staunch conservative, and as soon as Congress convened, he proposed a repeal bill. I asked him why.
STEVE KING: It's my opinion that if we repealed Obamacare and did nothing, we're still far better off. Almost everybody I know would be happier if Obamacare had never been passed and we hadn't made any changes in health care.
But what we've missed is the last seven years or so of an opportunity to make the prudent changes so that our system, our health insurance and our health care delivery system could have been improved during that period of time.
SIEGEL: Donald Trump's adviser Kellyanne Conway recently told an interviewer, we don't want anyone who currently has insurance to not have insurance. Would that be for you the test of a new law or the test of what happens after Obamacare is repealed - no one who's gotten health insurance through Obamacare losing it under its repeal and replacement?
KING: I think that's a fine and shining ideal, but it wouldn't be my standard. We have about 20 million people that they say would be pushed off of Obamacare if we just repealed it and did nothing. I look at the numbers on the 20 million. It's about 10.8 million that were pushed onto Medicaid, and so I don't really look at Medicaid as a health insurance policy that you own.
I would argue there is no constitutional - you have no right to a health insurance policy. Whatever our hearts tell us, we can provide those things, but there's not a right to them. The roughly 9.2 million people that are insured under Obamacare that would presumably lose their insurance if it were repealed - they're living under a subsidized premium, and that subsidized premium is paid for almost a hundred percent by the taxpayers.
So we can do some things like a full deductibility of everybody's health insurance premium. That picks up some of them in that 9.2 million group. Under Obamacare, they always envisioned that 4 percent of the population would be uninsured even if it were fully implemented. So I wouldn't want to be bogged down on that, but I would want to do the best thing we can for the maximum number of American people.
SIEGEL: But you mentioned the approximately 10 million who are covered by the expansion of Medicaid, I guess around 90,000 of them in your state of Iowa. Should they just be considered out of luck? That is, would you simply repeal the Medicaid expansion outright?
KING: No, I would block grant Medicaid to the states and let each state make their decisions on that. The best decisions are made as close to the people as possible. That's why we have a federalist system.
SIEGEL: Should insurance companies be required to offer insurance to people regardless of a prior condition? Should that provision of Obamacare survive, whatever the Congress does?
KING: When I was in state government, I managed the high-risk pool. We used state tax dollars to buy down expensive premiums so we could provide guaranteed issue to those who had preexisting conditions. I think that's a far better solution. It keeps the federal government out of the insurance business and the regulation of the insurance business.
If we guarantee people that we will - that there will be a policy issued to them regardless of them not taking the responsibility to buy insurance before they were sick, that's the equivalent of waiting for your house is on fire and then buying property and casualty insurance. And that defeats the insurance concept of it, and it defeats the personal responsibility requirements necessary to have an efficient health care system.
SIEGEL: Do you sense that there's a majority in the House, that the overwhelming majority of the Republican caucus is with you on what should replace Obamacare? Or are there still arguments to be had and debates to be had about what happens after Obamacare?
KING: Let me go out on a limb here, Robert. I think most of the Republicans agree with me, but there's probably a majority of them that don't have the political will because they're afraid of the criticism that will come. And as I listen to their dialogue, they're afraid of the criticism.
They're - when I say let's repeal Obamacare and be done with that, and let's march down through these changes one at a time, not one big bill but one at a time - and I don't want to have a Republican bill that we have to pass to find out what's in it. I think at this point, they need to have more will. But I think if you take them down to where their heart of hearts is and their logical brain is, the majority of them will agree with me.
SIEGEL: Congressman Steve King of Iowa, thanks for talking with us about your thoughts on repealing and replacing Obamacare.
KING: Thank you, Robert. I appreciate it.
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healthcare shouldn't be a business.
my god...
all well, this is what conservatives wanted. let's see what happens.
“To announce that there must be no criticism of the President, or that we are to stand by the President, right or wrong, is not only unpatriotic and servile, but is morally treasonable to the American public.”
- Theodore Roosevelt
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healthcare shouldn't be a business.
my god...
all well, this is what conservatives wanted. let's see what happens. So every aspect of healthcare should be run like a business but the final result should be controlled by the government and free to everybody? The great technology companies in this country should spend millions and millions trying to create the next greatest thing like more advanced MRI machines or prosthetics and after being the most successful company in that arena, they should be forced to essentially give it away for whatever the government says they are allowed to make? I swear I don't think most people fully understand what is going to happen to healthcare research if the profit incentive is removed.
yebat' Putin
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healthcare shouldn't be a business.
my god...
all well, this is what conservatives wanted. let's see what happens. Below is a Congressional Budget Office review of HR 3762 (partial repeal) submitted by Rep Price-R of Georgia that almost passed but would have been vetoed by President Obama. A little more than a year ago, the Congressional Budget Office and the staff of the Joint Committee on Taxation (JCT) estimated the budgetary effects of H.R. 3762, the Restoring Americans’ Healthcare Freedom Reconciliation Act of 2015, which would repeal portions of the Affordable Care Act (ACA) eliminating, in two steps, the law’s mandate penalties and subsidies but leaving the ACA’s insurance market reforms in place. At that time, CBO and JCT offered a partial assessment of how H.R. 3762 would affect health insurance coverage, but they had not estimated the changes in coverage or premiums that would result from leaving the market reforms in place while repealing the mandate penalties and subsidies. This document—prepared at the request of the Senate Minority Leader, the Ranking Member of the Senate Committee on Finance, and the Ranking Member of the Senate Committee on Health, Education, Labor, and Pensions provides such an estimate. In brief, CBO and JCT estimate that enacting that legislation would affect insurance coverage and premiums primarily in these ways: •The number of people who are uninsured would increase by 18 million in the first new plan year following enactment of the bill. Later, after the elimination of the ACA’s expansion of Medicaid eligibility and of subsidies for insurance purchased through the ACA marketplaces, that number would increase to 27 million, and then to 32 million in 2026. •Premiums in the nongroup market (for individual policies purchased through the marketplaces or directly from insurers) would increase by 20 percent to 25 percent—relative to projections under current law—in the first new plan year following enactment. The increase would reach about 50 percent in the year following the elimination of the Medicaid expansion and the marketplace subsidies, and premiums would about double by 2026. The ways in which individuals, employers, states, insurers, doctors, hospitals, and other affected parties would respond to the changes made by H.R. 3762 are all difficult to predict, so the estimates in this report are uncertain. But CBO and JCT have endeavored to develop estimates that are in the middle of the distribution of potential outcomes. In an effort to make this information more useful, CBO and JCT have updated their estimates of H.R. 3762’s effects on health insurance coverage and premiums using CBO’s most recent baseline projections, which were released in March 2016, and adjusted the effective dates in the legislation to reflect an assumption that enactment would occur one year later. The Restoring Americans’ Healthcare Freedom Reconciliation Act of 2015 H.R. 3762 would make two primary sets of changes that would affect insurance coverage and premiums. First, upon enactment, the bill would eliminate penalties associated with the requirements that most people obtain health insurance (also known as the individual mandate) and that large employers offer their employees health insurance that meets specified standards (also known as the employer mandate). Second, beginning roughly two years after enactment, the bill would also eliminate the ACA’s expansion of Medicaid eligibility and the subsidies available to people who purchase health insurance through a marketplace established by the ACA. H.R. 3762 also contains other provisions that would have smaller effects on coverage and premiums. Importantly, H.R. 3762 would leave in place a number of market reforms—rules established by the ACA that govern certain health insurance markets. Insurers who sell plans either through the marketplaces or directly to consumers are required to: •Provide specific benefits and amounts of coverage; •Not deny coverage or vary premiums because of an enrollee’s health status or limit coverage because of preexisting medical conditions; and •Vary premiums only on the basis of age, tobacco use, and geographic location. Analysis of H.R. 3762 Relative to CBO’s March 2016 Baseline According to CBO and JCT’s analysis, upon enactment, H.R. 3762 would reduce the number of people with insurance; and in the first new plan year, premiums in the nongroup market would rise and participation by insurers in that market would decline. Starting in the year following the elimination of the expansion of Medicaid eligibility and the marketplace subsidies, the increase in the number of uninsured people and premiums would be greater, and participation by insurers in the nongroup market would decline further. Estimated Changes Before the Elimination of the Medicaid Expansion and Subsidies Following enactment but before the Medicaid expansion and subsidies for insurance purchased through the marketplaces were eliminated, the effects of H.R. 3762 on insurance coverage and premiums would stem primarily from repealing the penalties associated with the individual mandate. Effects on Insurance Coverage. CBO and JCT expect that the number of people without health insurance coverage would increase upon enactment of H.R. 3762 but that the increase would be limited initially, because insurers would have already set their premiums for the current year, and many people would have already made their enrollment decisions for the year. Subsequently, in the first full plan year following enactment, by CBO and JCT’s estimates, about 18 million people would become uninsured. That increase in the uninsured population would consist of about 10 million fewer people with coverage obtained in the nongroup market, roughly 5 million fewer people with coverage under Medicaid, and about 3 million fewer people with employment-based coverage. Most of those reductions in coverage would stem from repealing the penalties associated with the individual mandate. However, CBO and JCT also expect that insurers in some areas would leave the nongroup market in the first new plan year following enactment. They would be leaving in anticipation of further reductions in enrollment and higher average health care costs among enrollees who remained after the subsidies for insurance purchased through the marketplaces were eliminated. As a consequence, roughly 10 percent of the population would be living in an area that had no insurer participating in the nongroup market. Effects on Premiums. According to CBO and JCT’s analysis, premiums in the nongroup market would be roughly 20 percent to 25 percent higher than under current law once insurers incorporated the effects of H.R. 3762’s changes into their premium pricing in the first new plan year after enactment. The majority of that increase would stem from repealing the penalties associated with the individual mandate. Doing so would both reduce the number of people purchasing health insurance and change the mix of people with insurance—tending to cause smaller reductions in coverage among older and less healthy people with high health care costs and larger reductions among younger and healthier people with low health care costs. Thus, average health care costs among the people retaining coverage would be higher, and insurers would have to raise premiums in the nongroup market to cover those higher costs. Lower participation by insurers in the nongroup market would place further upward pressure on premiums because the market would be less competitive. Estimated Changes After the Elimination of the Medicaid Expansion and Subsidies The bill’s effects on insurance coverage and premiums would be greater once the repeal of the Medicaid expansion and the subsidies for insurance purchased through the marketplaces took effect, roughly two years after enactment. Effects on Insurance Coverage. By CBO and JCT’s estimates, enacting H.R. 3762 would increase the number of people without health insurance coverage by about 27 million in the year following the elimination of the Medicaid expansion and marketplace subsidies and by 32 million in 2026, relative to the number of uninsured people expected under current law. (The number of people without health insurance would be smaller if, in addition to the changes in H.R. 3762, the insurance market reforms mentioned above were also repealed. In that case, the increase in the number of uninsured people would be about 21 million in the year following the elimination of the Medicaid expansion and marketplace subsidies; that figure would rise to about 23 million in 2026.) The estimated increase of 32 million people without coverage in 2026 is the net result of roughly 23 million fewer with coverage in the nongroup market and 19 million fewer with coverage under Medicaid, partially offset by an increase of about 11 million people covered by employment-based insurance. By CBO and JCT’s estimates, 59 million people under age 65 would be uninsured in 2026 (compared with 28 million under current law), representing 21 percent of people under age 65. By 2026, fewer than 2 million people would be enrolled in the nongroup market, CBO and JCT estimate. According to the agencies’ analysis, eliminating the mandate penalties and the subsidies while retaining the market reforms would destabilize the nongroup market, and the effect would worsen over time. The ACA’s changes to the rules governing the nongroup health insurance market work in conjunction with the mandates and the subsidies to increase participation in the market and encourage enrollment among people of different ages and health statuses. But eliminating the penalty for not having health insurance would reduce enrollment and raise premiums in the nongroup market. Eliminating subsidies for insurance purchased through the marketplaces would have the same effects because it would result in a large price increase for many people. Not only would enrollment decline, but the people who would be most likely to remain enrolled would tend to be less healthy (and therefore more willing to pay higher premiums). Thus, average health care costs among the people retaining coverage would be higher, and insurers would have to raise premiums in the nongroup market to cover those higher costs. CBO and JCT expect that enrollment would continue to drop and premiums would continue to increase in each subsequent year. Leaving the ACA’s market reforms in place would limit insurers’ ability to use strategies that were common before the ACA was enacted. For example, insurers would not be able to vary premiums to reflect an individual’s health care costs or offer health insurance plans that exclude coverage of preexisting conditions, plans that do not cover certain types of benefits (such as maternity care), or plans with very high deductibles or very low actuarial value (plans paying a very low share of costs for covered services). Effects on Participation by Insurers. In CBO and JCT’s estimation, the factors exerting upward pressure on premiums and downward pressure on enrollment in the nongroup market would lead to substantially reduced participation by insurers and enrollees in many areas. Prior experience in states that implemented similar nongroup market reforms without a mandate penalty or subsidies has demonstrated the potential for market destabilization. Several states that enacted such market reforms later repealed or substantially modified those reforms in response to increased premiums and insurers’ departure from the market. After weighing the evidence from prior state-level reforms and input from experts and market participants, CBO and JCT estimate that about half of the nation’s population lives in areas that would have no insurer participating in the nongroup market in the first year after the repeal of the marketplace subsidies took effect, and that share would continue to increase, extending to about three-quarters of the population by 2026. That contraction of the market would most directly affect people without access to employment-based coverage or public health insurance. Effects on Premiums. In total, as a result of reduced enrollment, higher average health care costs among remaining enrollees, and lower participation by insurers, CBO and JCT project that premiums in the nongroup market would be about 50 percent higher in the first year after the marketplace subsidies were eliminated—relative to projections under current law—and would about double by 2026. Comparison With CBO and JCT’s 2015 Cost Estimate This analysis differs in a number of respects from the one CBO and JCT did in December 2015. In particular, the projected increase in the number of uninsured people is now greater largely because, at that time, the agencies had not estimated the changes in coverage from leaving the ACA’s insurance market reforms in place while repealing the mandate penalties and subsidies. Moreover, the current estimates of how H.R. 3762 would affect coverage are measured relative to CBO’s March 2016 baseline, rather than the March 2015 baseline, which was the basis for the earlier estimates. Those baselines differ in part because CBO and JCT have reduced their projections of the number of people with health insurance coverage through the marketplaces and increased their projections of the number of people with coverage through Medicaid under current law. Future Legislation If the Congress considers legislation similar to H.R. 3762 in the coming weeks, the estimated effects could differ from those described here. In particular, the response of individuals, insurers, and states would depend critically on the particular specifications contained in such legislation. https://www.cbo.gov/publication/52371
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who said anything about free?
can you show me where i said free?
healthcare companies should not be allowed to deny people based on preexisting conditions.
healthcare companies should not be allowed to charge whatever the hell they want. there needs to be price caps.
i feel that healthcare should be a right. i dunno what you're going on about "free" and "run like a business". maybe you replied to the wrong person, cause Swish never said anything about free.
you're using extreme rhetoric right now.
so using your own tactic, i guess that means you were cool with the epipen price hike.
cause those profits. need more profits. screw the actual lives of humans, right?
“To announce that there must be no criticism of the President, or that we are to stand by the President, right or wrong, is not only unpatriotic and servile, but is morally treasonable to the American public.”
- Theodore Roosevelt
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healthcare shouldn't be a business.
my god...
all well, this is what conservatives wanted. let's see what happens. So every aspect of healthcare should be run like a business but the final result should be controlled by the government and free to everybody? The great technology companies in this country should spend millions and millions trying to create the next greatest thing like more advanced MRI machines or prosthetics and after being the most successful company in that arena, they should be forced to essentially give it away for whatever the government says they are allowed to make? I swear I don't think most people fully understand what is going to happen to healthcare research if the profit incentive is removed. Perhaps they think the Government should take over technology in America so everyone gets the latest!
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Every time I get a scan it costs me 1000 dollars. I am about sick of it.
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When discussion of the ACA began in earnest, I was all for it. But the result, the way it came down, disappointed me. That should tell you that I'm not against repealing it as long as they replace it. Tax credits won't work....
My Mom and Mom in Law were (and still are) on Medicare. Mom has a supplimental plan provided by my fathers former employer, General Motors. My Mom in law has a Supp plan through an AARP sponsored plan by United HealthCare.
Both have had serious issues (given their ages, it's expected) that would have strained the budget of just about any middle class retiree.
But with the combination of Medicare and their supps, they virtually paid nothing out of pocket. No deductible, no copays......
In other words, both have damn fine plans overall. No issues getting the doctors they wanted and service was quick.
So after seeing this, I got to thinking, use an enhanced form of Medicare. Naturally, at a much higher premium than a person like the Moms pay. (about $134.00 per month, and another $150.00 or so per month for the supp plans)
I don't have a clue how much the premiums would have to be, but the entire infrastructure is in place. We may have needed to add some staff to cover the extra work load..
I'd investigate that if I were in a position to do so.
Just a thought
#GMSTRONG
“Everyone is entitled to his own opinion, but not to his own facts.” Daniel Patrick Moynahan
"Alternative facts hurt us all. Think before you blindly believe." Damanshot
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Trump voters (not just liberals) want 2 things from the ACA or they will riot:
1. Not to be discriminated against for pre-existing conditions. 2. Their kids under 26 to be on their healthcare plan.
Those are the 2 most popular and universally well liked parts of ACA. If 1 or both go, it's going to be really ugly for republicans in 2018.
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My 2 cents...If your in healthcare or public education to make a profit then you're in the wrong business. You should go into other types of insurance, banking, rea lestate, or MFG to make your profits. JMHO.
"The tree of liberty must be refreshed from time to time with the blood of patriots and tyrants." Thomas Jefferson.
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How very Socialist of you. Why don't you take your ideas and $500 bucks to Venezuela and buy a loaf of bread?
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Selling across state lines is being held up as a good improvement. It may reduce prices and encourage competition. But it also permits weaker or lousy plans to expand.
This repeal and replace sound byte is stupid. Why is this some pig in a poke proposition. Snake oil. Trot out the alternative and let voters see it. Let them see it as a good or better replacement that stands on its own merits and that will bear scrutiny. This haste to waste is ignorant. We all get "life, liberty, and pursuit of happiness." I want to see it first. Not taking it on faith from those whose priority has been to repeal. Show me some frenzy to improve it. If it is a secret, rammed through, well, if you want it to be a secret, something is wrong. Single payer sounds better all the time.
"Every responsibility implies opportunity, and every opportunity implies responsibility." Otis Allen Glazebrook, 1880
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Except the evidence stands against you, 40 Many countries in Europe run their healthcare as a socialized system, and their rankings sit way above ours.
But hey, don't feelings trump any sort of facts for you?
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I seem to remember everyone comparing auto insurance to health insurance. Mostly this was done by liberals to excuse the mandate to buy insurance. Why not allow me to buy health insurance like I would auto insurance? I can buy what I want and pay what I want from the insurance company I want.
I don't need certain government mandated health care like maternity care, or port wine stain coverage. I could eliminate all that for me and my wife. I could save a ton of money just by personalizing my insurance and being allowed to shop for my insurance.
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Except the evidence stands against you, 40 Many countries in Europe run their healthcare as a socialized system, and their rankings sit way above ours.
But hey, don't feelings trump any sort of facts for you? Yes they live in a Socialist Utopia where life is wonderful all the time unless Russia decides they no longer exist and destroys them. For you see, THEY ARE DINKS WHO COULDN'T DEFEND THEMSELVES FROM A HERD OF PAPER BAGS!!! We can protect our way of life, and we also protect them and their way of life, FROM ANNIHILATION!!! Why? Because they agree with us no matter what we say in order to not lose our friendship or anger the Bear. You see, they are only as free as we allow them to be because we are a Capitalist Democracy and can afford to protect our freedom, and luckily for them, theirs.
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Who's everyone?
I never made that comparison in my life
“To announce that there must be no criticism of the President, or that we are to stand by the President, right or wrong, is not only unpatriotic and servile, but is morally treasonable to the American public.”
- Theodore Roosevelt
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Who's everyone?
I never made that comparison in my life Back to picking nits again, I see. Let's try, "a lot of people". Happy now? Hope you sleep tonight.
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Oh, I was sleeping regardless, thanks.
You complain a ton about me making generalizations. Just holding you to the same standard.
“To announce that there must be no criticism of the President, or that we are to stand by the President, right or wrong, is not only unpatriotic and servile, but is morally treasonable to the American public.”
- Theodore Roosevelt
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healthcare shouldn't be a business.
my god...
all well, this is what conservatives wanted. let's see what happens. Why not?
If everybody had like minds, we would never learn. GM Strong
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Health care as a right guaranteed by a single payer system. This is the only real solution.
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Health care as a right guaranteed by a single payer system. This is the only real solution. A lot of people in the UK would disagree.
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DawgTalkers.net
Forums DawgTalk Everything Else... What is the alternative to
Obamacare?
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