Response to TrumpCare not so great

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anonymous_coward
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Response to TrumpCare not so great

https://www.washingtonpost.com/powerpost/house-leaders-brace-for-the-tas...

The House bill was released, to very weak fanfare. GOP hardliners are calling it, "ObamaCare 2.0" and "ObamaCare Lite". Meanwhile, Dems are panning it for cutting Medicaid recipients.

Remember, to pass it, the GOP can only give up 2 senate votes. Right now Murkowski (R-AK), Portman (R-OH), Cory Gardner (R-CO) and Shelley Moore Capito (R-WV) are "raising concerns" as they all have states that took the Medicaid money.

Some more details:

  • No individual mandate, but insurers can apply a 30% penalty for people that go off insurance for more than 2 months and then try to get back on.
  • Old customers can be charged up to 5 times as much as young customers (under ObamaCare, the limit is 3x). I'm not sure how this helps the GOP in 2018, old people tend to vote and don't like paying for anything beyond the early bird special at Denny's.
  • As stated before, refundable tax credits (i.e. the government gives you money) to help with premiums if you are buying your own insurance (that is, if your employer is not buying it for you). Start at $2000/year at age 30, go up to $6000/year at age 60.
  • States that opted in for Medicaid will continue to get money until 2019, but then it would be phased out.
  • As stated before, preexisting conditions still covered (formally known as "guaranteed issue").
  • Selling across state lines is *not* in this.

I'll be honest, I just don't see how this is going to work, even if it does somehow get passed by some miracle.

First of all, the hardline right is going to at least complain about it, if not directly oppose it. And you still need enough senators from the Medicaid states to get on board, too.

Finally, if it does pass, tons of people will probably just drop coverage, since there's no penalty. Old people will get charged more in premiums. So now you have bankrupt insurance companies, angry poor people, angry old people... say hello to a Democratic congress in 2018!

Tom C
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You know what response "wasn

You know what response was "not so great"?

The response to Obamacare.

Cost the dems the House, Senate, 1000 seats on state legislatures, the Presidency and probably a couple of seats on the Supreme Court.

Dem wish this would happen to Republicans.

Not a chance.

Mike G
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I imagine the 100s of

I imagine the 100s of thousands of young people who won't be fined or required to buy health care that they won't use are tickled pink. If ever there was age discrimination in a program and ignored it was obamacare.

Young people paying for the care of old and state welfare people, wasn't FICA withholding enough?

The corporate whore media not so much excited about it, what a surprise?

Bruce Libby
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So far the best word on this

So far the best word on this was on Laura Ingraham (sp)show this am. Outlining process of changing regulations attached to original
legislation beyond what politicians do. It is a little premature to see a definitive end result IMO before both houses get done with it.

Tom C
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Obamacare was a huge gift to

Obamacare was a huge gift to the medical industry, and poured gasoline on rising medical costs.

Joe Blow getting 95% credit and only paying $50 a month for cr@ppy medical insurance isn't getting a whole lot out of the deal.

anonymous_coward
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@Tom C: So I assume you hate

@Tom C: So I assume you hate TrumpCare too, since it has many of the ObamaCare elements?

Here's Pauli Walnuts on TrumpCare:
http://stateandcapitol.bangordailynews.com/2017/03/07/lepage-rips-gop-he...

Tom C
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I might hate Trump care. I

I might hate Trump care. I might like it.

Who knows?

Mainelion
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We'll have to pass it to find

We'll have to pass it to find out what's in it. Right?

johnw
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As long as insurance ,

As long as insurance , pharmaceutical and for profit hospital executives and administrative staffs are grossly over paid there will never be a reduction in health care costs. They continue to treat the symptoms not the disease.....our "leaders" never seem to truly ask why does health care cost so much , but only and always how can we pay the ever escalating premiums they demand........
They throw down a few little bones and somehow think it fixes the problem......Politicians in reality, they just kick the can a little further down the road while they get their share of the plunder.....
Personally I think "health care savings accounts " are the biggest slap in the face going....... How the hell does that guy working for $600 a week with a kid , rent , car payment and all the other little necessities find enough money to put in a health savings account top amount to more than a piss hole in the snow ??The politicians on both sides in the swamp are so far removed from reality it's scary....

Tom C
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johnw, you've hit the nail on

johnw, you've hit the nail on the head. Politicians of both stripes are playing this game, and getting fat in the process.

Ugenetoo
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Let's face it.

Let's face it.
The only thing that is fair would be single payer, which takes the insurance industry completely out of the picture.
Make sure the elites who are in charge of this have no other recourse for their own healthcare than what's available for everyone else.
The government has screwed with the HC system so badly over the years that it would have to go through a catastrophic failure and then be rebuilt in order for it to work.
We can't weather that kind of storm.

Roger Ek
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Sure we can. Ryan and

Sure we can. Ryan and McConnell are not going to repeal Obamacare. They are going to grow it with a new name, just like the repeal of LURC in Maine. It was not repealed. It was just renamed and they made it bigger, stronger and meaner.

Mainelion
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It's the same as the higher

It's the same as the higher education scam. None of the precious snowflakes ever asks why the liberal professors and the administrators are overpaid. They just cry that we all should be paying for their useless gender studies degrees.

Roger Ek
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Don't blame Trump for this

Don't blame Trump for this Ryan/McConnell debacle. It is just an extension of Obamacare. Donald's name should not be on tis fraud. The Democrats named it.

Just kill Obamacare and let people choose their coverage. Government should not be in the medicine or insurance business.

johnw
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The current model is actually

The current model is actually systematic extortion of the middle class . If you don't purchase insurance you run the risk of losing everything you may have acquired , your home , savings, investment to pay for medical costs. The only way to protect those assets is to have insurance , and basically pay whatever they demand. If you are wealthy you can pay health insurance even catastrophic illness out of pocket , if you are poor it's free or close to it and you have little net worth that can be taken.........denying that is like thinking you own your home , if you think it's yours just stop paying your taxes and see what happens....... The working/ middle class in this country is being systematically robbed every single day....... Insurance companies, banks, for profit health care , investment groups and politicians are just one big incestous crime synduicate.......

Bruce Libby
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Roger

Roger
#14 above I assume that includes the VA ?

anonymous_coward
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@Roger: "Just kill Obamacare

@Roger: "Just kill Obamacare and let people choose their coverage. Government should not be in the medicine or insurance business."

Ok so should insurance companies be allowed to charge people whatever is best for their business model?

Because the most profitable business model is to charge anyone with cancer/who is related to someone with cancer/who smokes/who drinks/who has a BMI over 27 a $10,000,000 per year premium, and everyone else $7,000 a year and sit back and rake it in.

anonymous_coward
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@johnw: "As long as insurance

@johnw: "As long as insurance , pharmaceutical and for profit hospital executives and administrative staffs are grossly over paid there will never be a reduction in health care costs. "

This is not why medical costs have gone up.

Medical costs have gone up because there are more technologies and treatments, and there is no downward pricing pressure on them.... why?

Because no patient ever says, "no" to a procedure because of cost.

Why? Because the cost is borne by the other people paying for insurance.

Trump promised both pricing transparency and a better system for drug pricing pre-election, and I have yet to see any glimpse of either one of those since he took office.

anonymous_coward
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Update: Here is a handy cheat

Update: Here is a handy cheat sheet for what different conservative groups think of TrumpCare (spoiler alert: they're not very fond of it):
https://www.axios.com/the-conservatives-against-the-gop-repeal-plan-2304...

Roger Ek
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"Ok so should insurance

"Ok so should insurance companies be allowed to charge people whatever is best for their business model?"

They always have, just like any business. If they can't compete, they go out of business. If they deliver at a reasonable price, they prosper.

A scheduled MRI in Maine can cost $600 or $8,000 depending on who you choose. If you are paying out of pocket you are going to choose the lower cost service, even if you have to drive a few more miles. If you are on public assistance, you would go to the nearest facility, even if it is the $8,000 zap.

My wife needed an MRI at midnight once. They didn't call in a Doc to read it. They sent the MRI to New Zealand where it was lunch time and it was read there. That is much more economical.

This guy gets it:

Rep. Dave Brat (VA): "Now [they] are saying we're going to do repeal and replace but the bill does nothing of the sort."

The same establishment that set up the spending limit that expires on March 15, set up this EXPANSION of Obamacare.

Tom C
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The problem isn't the

The problem isn't the insurance companies, and the Dem regular two-minute hate for them is a distraction. Insurance companies are actually in more of a competitive market than most of the medical industry, and in some places, like Maine, their profits are limited by statute.

What single-payer will do is put the government in charge of reimbursements, and how much the government puts in the trough will be determined solely by politics.

Ugenetoo
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Can anyone tell me of one

Can anyone tell me of one instance where an insurance company diagnosed, treated, and cured any patient?

johnw
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What I do know is I'm one of

What I do know is I'm one of the people they are talking about when referencing sky high deductibles....After I paid my $83 per week premium..... and I reach the $6450 deductible then the insurance kicks in....So for little old me it comes to$10,766 per year .........and there are no copays on any prescriptions,no free yearly physical, no nothing until I reach the deductible ...Oh yeah I'm on an employer covered plan , they are kicking a larger sum weekly as their portion of the premium......... My insurance used to be $63 a week for me and family and a $500 deductible and a co-pay on medicine...... Oh yeah I do have an HSA but the max is $4350 which comes out pretax...... but gee whiz.... it still doesn't pay the deductible........Yeah I know the Ryan plan will allow you to double the HSA amount only one small problem ...at some point you need to take home enough money to pay the other bills......Okay I'll stop whining all I know is who ever's plan it is in the end working folks will still get the shaft.............

Roger Ek
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"Can anyone tell me of one

"Can anyone tell me of one instance where an insurance company diagnosed, treated, and cured any patient?"

Nope. They just guarantee to pay the bills so the Doc will treat you.

Ugenetoo
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So, what's the difference

So, what's the difference between a for profit insurance company guaranteeing to pay your bills, or the Federal Government doing the same?
Either way it seems we are under somebodies control.

johnw
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I'm waiting to hear " Rates

I'm waiting to hear " Rates and deductibles won't be going down if the ryan bill passes but they won't be increasing at the same rates we've seen under obama care , you know that's a real reduction in costs".....The usual bet Mortimer?A dollar?

JackStrawFromWichita
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J. Mario Molina, chief

"J. Mario Molina, chief executive of Molina Healthcare Inc., a major managed-Medicaid company that also offers ACA plans in nine states, said he believes that striking the coverage mandate penalties could help push individual-plan premiums up by 30% or more next year—and more in the future, when the reduced subsidies kick in."

https://www.wsj.com/articles/what-insurers-like-and-dread-about-gops-pla...

I read another insurance company executive quoting 20-25%...

anonymous_coward
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@Ugenetoo: "So, what's the

@Ugenetoo: "So, what's the difference between a for profit insurance company guaranteeing to pay your bills, or the Federal Government doing the same?"

Well for one, the federal government is less efficient, so there will be more waste.

On the other hand, the ability to negotiate drug prices has everything to do with how big you are (which is why single payer nations tend to pay a lot less for drugs).

Finally (and the reason why I'm against single payer), what is covered becomes a political question instead of a market-based one. It's already very much political in the sense that the ACA mandates a lot of things that must be covered. But single payer would be 10x worse.

anonymous_coward
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@Jack: Yeah, removing the

@Jack: Yeah, removing the mandates would induce a death spiral for sure. The 30% premium penalty won't be enough to offset the loss of people opting out.

I think the GOP is in a tough position. Their options are:
1) strip everything away, get hammered in the midterms by the angry mob of people who lost their coverage
2) pass a very slightly modified version of Obamacare (what we have proposed today), and get hammered by conservatives
3) argue about it and eventually do nothing, somehow try to blame it on the Democrats

3 is probably the best option for retaining control of congress through the midterms. But none of those options is very good, even with 3, they're vulnerable to, "you've had two years, you didn't repeal the ACA" in the primaries.

Tom C
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"J. Mario Molina, chief

"J. Mario Molina, chief executive of Molina Healthcare Inc., a major managed-Medicaid company that also offers ACA plans in nine states, said he believes that striking the coverage mandate penalties could help push individual-plan premiums up by 30% or more next year—and more in the future, when the reduced subsidies kick in."

An insurance company trying to scare us into thinking that getting rid of a law that requires to buy what they are selling will result in the sky falling?

I put the creditability of that claim at....

... zero.

Matt
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Tom c is right. I'm sure that

Tom c is right. I'm sure that shrinking the pool of people paying for insurance will make premiums go down.

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