The US Healthcare Mass Debate

[pErvinalia]

Nah, it's just that "hopeless Pocahontas" shooting off her mouth again.

She's the one who falsely claimed to be a native American

How do you know it is false?

She doesn't have a single identified ancestor who is native American. Her argument is to say "see, we have high cheekbones." Come on, man.

So you don't actually know it is false. Come on, indeed. Her claims are more than "see, we have high cheekbones".

[pErvinalia]

If the deal was related only to covering the poor, then we'd just fucking raise the income level at which someone is entitled to Medicaid, or do a means-tested subsidy. But you will notice that they didn't do that.

Bullshit.

"Medicaid and the Affordable Care Act"

[The ACA] modifies how income is calculated for most Medicaid applicants, including those in the new eligibility group. Starting in 2014, states must use Modified Adjusted Gross Income (MAGI) for eligibility determination for most applicants. This is adjusted gross income as defined in the Internal Revenue Code, modified by applying a 5 percent “disregard.” This method eliminates resource tests. The combined effect of requiring coverage up to 133 percent of poverty and then use of MAGI budgeting effectively raises the income level for most Medicaid applicants to 138 percent of poverty.

[Emphasis mine.]

Loving your work, L'Emmy. I'm glad someone has the energy to debunk FortyTwo's seemingly never ending stream of nonsense.

[Tero]

Nearly useless plans now to be allowed through asaorted state "waivers"

Even though the bill explicitly prohibits waivers for preexisting conditions, health analysts say waiving the essential health benefits package and eliminating the three guardrail requirements could weaken the types of services covered for people with preexisting conditions.

If states aren’t required to ensure that their coverage is as comprehensive as the essential health benefits package, insurers can redesign plans that do not include certain services that otherwise would have been required under the ACA. These services may be ones that people with preexisting conditions need. So even if they have the insurance, they may end up paying out-of-pocket costs for certain services that are not covered under their new plan. However, ultimately, it will be up these states to decide the services they want to cover, and how comprehensive they will be.

Insurers won’t be able to single out a person for a preexisting condition. But indirectly, insurers could design policies that could affect people with preexisting conditions

https://www.washingtonpost.com/news/fac ... 5f44cc7440

[Brian Peacock]

Some context fom the CBO...

Private Health Insurance Premiums and Federal Policy
February 11, 2016
...
Although premiums for private insurance have grown relatively slowly in recent years, they have usually grown faster than the economy as a whole and thus faster than average income. Over the period from 2005 to 2014, premiums for employment-based insurance grew by 48 percent for single coverage and by 55 percent for family coverage. CBO and JCT expect them to grow at similar rates over the next decade—by about 5 percent per year, on average, or about 2 percentage points faster than income per capita. As a result of that growth, average premiums for employment-based coverage are projected to be about $10,000 for single coverage and about $24,500 for family coverage in 2025, nearly 60 percent higher than they were in 2016.
...
Together, the ACA’s regulations increase premiums noticeably in the nongroup market and have more limited effects in the other markets. However, the nongroup market represents a relatively small fraction of the total private insurance market, and according to CBO’s projections, it will continue to do so—accounting for about 15 percent in 2025. As a result, CBO expects that premium increases stemming from the ACA’s regulations will have a relatively small effect on the overall average of private health insurance premiums.
...
Competition also affects premiums. On average, premiums are lower in markets with more insurers. The reason is that those insurers have a stronger incentive to keep premiums low, because otherwise they might lose enrollees to their competitors. Premiums are also lower in markets with more hospitals and physicians, because insurers there have an easier time negotiating lower payment rates or excluding high-cost providers from their networks. The available evidence, however, indicates that many insurance markets are quite concentrated; that is, a small number of insurers account for the bulk of enrollment. Many markets for hospital care and some markets for physicians’ services are concentrated as well. As a result, efforts to increase competition among insurers, like other efforts to reduce insurance premiums, may have complex effects....

https://www.cbo.gov/publication/51130

How Repealing Portions of the Affordable Care Act Would Affect Health Insurance Coverage and Premiums
January 17, 2017

... 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.
...
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.
...
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.
...
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.
...
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).
...
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...

https://www.cbo.gov/publication/52371

H.R. 1628, Better Care Reconciliation Act of 2017
June 26, 2017

The Congressional Budget Office and the staff of the Joint Committee on Taxation (JCT) have completed an estimate of the direct spending and revenue effects of the Better Care Reconciliation Act of 2017, a Senate amendment in the nature of a substitute to H.R. 1628. CBO and JCT estimate that enacting this legislation would reduce the cumulative federal deficit over the 2017-2026 period by $321 billion. That amount is $202 billion more than the estimated net savings for the version of H.R. 1628 that was passed by the House of Representatives.

The Senate bill would increase the number of people who are uninsured by 22 million in 2026 relative to the number under current law, slightly fewer than the increase in the number of uninsured estimated for the House-passed legislation. By 2026, an estimated 49 million people would be uninsured, compared with 28 million who would lack insurance that year under current law.

Following the overview, this document provides details about the major provisions of this legislation, the estimated costs to the federal government, the basis for the estimate, and other related information, including a comparison with CBO’s estimate for the House-passed act...

Read on...

[Scot Dutchy]

What a fucking mess but that is how the orange scrotum works, well not him he never works but his team of billionaires. Create as much confusion as possible with claim and counter claim say it is all happening when nothing is while slowly eroding any help to the poor. The plan is simple killing off the mushrooms while feeding them the wrong shit. They dont want to solve poverty just increase it. The 'middle' class American is a dying breed. The gulf between rich and poor is going to be massive and unbridgeable. The 1% wont just be building walls along the southern border but walls around their communities and the rest of America will turn into the worst disaster sci-fi film ever.

[Forty Two]

If the deal was related only to covering the poor, then we'd just fucking raise the income level at which someone is entitled to Medicaid, or do a means-tested subsidy. But you will notice that they didn't do that.

Bullshit.

"Medicaid and the Affordable Care Act"

[The ACA] modifies how income is calculated for most Medicaid applicants, including those in the new eligibility group. Starting in 2014, states must use Modified Adjusted Gross Income (MAGI) for eligibility determination for most applicants. This is adjusted gross income as defined in the Internal Revenue Code, modified by applying a 5 percent “disregard.” This method eliminates resource tests. The combined effect of requiring coverage up to 133 percent of poverty and then use of MAGI budgeting effectively raises the income level for most Medicaid applicants to 138 percent of poverty.

[Emphasis mine.]

You're missing the point. If the issue was to "cover the poor" then you don't have to do anything other than means test for Medicaid. If you want to cover the poor, and the poor aren't covered, then cover the poor. There is no need to upset the entire system and force people who aren't buy insurance at $x per month to buy insurance at quadruple $x per month.

[Forty Two]

So what you're saying here is that there's no proof she isn't Native American, either by culture or ancestry?

There is. The lack of identifiable ancestors who are native American is good evidence that a person is not Native American. That's pretty much the proof everyone has that they are "not" a given ethnicity or race. It's the same proof I have that I'm not African-American. There are no African Americans identifiable in my lineage/ancestry. It's the same proof I have that I'm not Inca or Aztec.

Again, if Ted Cruz claimed to be Native American, and people saw that his ancestry had no native Americans in it, and he said the reason he thinks that is that there is some blurb of family lore that says that four generations ago there may have been one person who was native American, and that they have high cheekbones, I can pretty much guarantee that there would be a lot of people laughing their heads off at him.

[Tero]

[Brian Peacock]

You're only saying that coz she's Black.

[Forty Two]

You are still stuck in your ridiculous tu quoque / red herring partisan way of thinking. Obamacare has absolutely nothing to do with whether the Republicans give a fuck about poor people.

You are still doing your ridiculous "move the goalposts" and "argue by ambiguity" mode. The question was whether Republicans want people to die, not whether they give a fuck about poor people. You are the one who brought that up after I addressed the issue of people dying. You just said something like "oh, come on, like Republicans care about poor people..." -- I then asked if you wanted to talk about the point you first made, or the new point about their overall concern for poor people.

If you wanted to help "the poor" - all you'd have to do is raise the Medicaid level to scoop up 12 million Americans without affordable options.

Exactly. Thanks for making my argument for me. This is a classic example of how you can't see past your partisan bias. You have literally just made my point for me.

The point was that the Democrats were not "helping the poor" by passing Obamacare, because if they really wanted to help the poor, they'd help the poor, rather than create a monstrous bureaucracy which compels people who are not poor to buy insurance they didn't want before at 1/4 the price they are being forced to buy it for now.

I don't think either party gives much of an overall fuck about the poor, other than to get their votes. And, I think the Democrats are worse for the poor because their policies, whether intended or not, tend to trap people into poverty and dependency.

Note, we have skyrocketing health care costs. When Obamacare was being sold, we were told it was to reduce health care costs, and we were compared to the rest of the world in news articles saying how we pay so much more than every other industrialized nation. Obamacare made that comparison worse, which is why you never see articles and reports on CNN about it. They have to give some space between Obama's administration, and then -- mark my words - you'll start hearing about it. As soon as it can be blamed on Trump, it will come out again.

Obamacare has absolutely nothing to do with whether Republicans generally hate the poor and disadvantaged.

This conversation was not about whether Republicans generally hate the poor and disadvantaged. That's the diversion you created to move the discussion from what was being talked about to the issue of whether the Republicans hate the poor or disadvantaged. I don't care if they do or don't. I don't care if the Democrats do or don't. I think, by and large, neither of them care, as groups. And, I think that the Democrat policies are and have been worse for the poor, trapping them in dependency. The War on Poverty failed miserably, despite the trillions spent on it.

[Hermit]

There is no need to upset the entire system and force people who aren't buy insurance at $x per month to buy insurance at quadruple $x per month.

Just as well thuis isn't what happened.

[Forty Two]

If the deal was related only to covering the poor, then we'd just fucking raise the income level at which someone is entitled to Medicaid, or do a means-tested subsidy. But you will notice that they didn't do that.

Bullshit.

"Medicaid and the Affordable Care Act"

[The ACA] modifies how income is calculated for most Medicaid applicants, including those in the new eligibility group. Starting in 2014, states must use Modified Adjusted Gross Income (MAGI) for eligibility determination for most applicants. This is adjusted gross income as defined in the Internal Revenue Code, modified by applying a 5 percent “disregard.” This method eliminates resource tests. The combined effect of requiring coverage up to 133 percent of poverty and then use of MAGI budgeting effectively raises the income level for most Medicaid applicants to 138 percent of poverty.

[Emphasis mine.]

Loving your work, L'Emmy. I'm glad someone has the energy to debunk FortyTwo's seemingly never ending stream of nonsense.

Look, if Medicaid was raised to cover the 12,000,000 who did not have affordable options before....what was the need for individual mandate and the quadrupling of insurance rates? Why not just cover the fucking poor and leave it at that? That was the point I was making. If you want to give poor people food stamps or a stipend to pay for food, you give them the fucking money -- you don't impose a national program that requires everyone, even those who can afford their own food, to participate.

[pErvinalia]

You are still stuck in your ridiculous tu quoque / red herring partisan way of thinking. Obamacare has absolutely nothing to do with whether the Republicans give a fuck about poor people.

You are still doing your ridiculous "move the goalposts" and "argue by ambiguity" mode. The question was whether Republicans want people to die, not whether they give a fuck about poor people. You are the one who brought that up after I addressed the issue of people dying. You just said something like "oh, come on, like Republicans care about poor people..." -- I then asked if you wanted to talk about the point you first made, or the new point about their overall concern for poor people.

Huh? I haven't moved any goalposts. You are the one who started talking about something (Obamacare) that has nothing whatsoever to do with Republicans.

If you wanted to help "the poor" - all you'd have to do is raise the Medicaid level to scoop up 12 million Americans without affordable options.

Exactly. Thanks for making my argument for me. This is a classic example of how you can't see past your partisan bias. You have literally just made my point for me.

Note, we have skyrocketing health care costs. When Obamacare was being sold, we were told it was to reduce health care costs, and we were compared to the rest of the world in news articles saying how we pay so much more than every other industrialized nation. Obamacare made that comparison worse, which is why you never see articles and reports on CNN about it. They have to give some space between Obama's administration, and then -- mark my words - you'll start hearing about it. As soon as it can be blamed on Trump, it will come out again.

Obamacare has absolutely nothing to do with whether Republicans generally hate the poor and disadvantaged.

This conversation was not about whether Republicans generally hate the poor and disadvantaged. That's the diversion you created to move the discussion from what was being talked about to the issue of whether the Republicans hate the poor or disadvantaged.

It's a hell of a lot closer than Obamacare.

I don't care if they do or don't. I don't care if the Democrats do or don't. I think, by and large, neither of them care, as groups. And, I think that the Democrat policies are and have been worse for the poor, trapping them in dependency. The War on Poverty failed miserably, despite the trillions spent on it.

You're still talking about Democrats. FFS.

[Forty Two]

You're only saying that coz she's Black.

She identifies as a Native American who identifies as black.

Anyone who won't at least say: "On the native American claim, Elizabeth Warren is full of crap" is exposing his bias. No Republican would be allowed to get away with that shit here without it being called out and to become the subject of ridicule, laughter and scorn, and rightly so. But, because it's Warren, we have posts about how there isn't any proof she's "not" Native American. And, articles in The Atlantic and such take her familial lore claim seriously, and point out that the real, important issue is not that she lied and is full of crap, but that there really isn't any evidence that she for sure got a career boost from making the claim. She made the claim, she published it, she worked under the rubric of being a minority, native American professor at Harvard, but we can't prove she was given advancement just because of that claim. Lol. That's the important issue. I'm sure it would be the important issue if Trump, or Ted Cruz or whoever, made a similar claim.

[Tero]

And he was wrong about FREEDOM as well

"What they're basically saying at the Congressional Budget Office is, if you're not going to force people to buy Obamacare, if you’re not going to force people to buy something they don’t want, then they won't buy it. So it's not that people are getting pushed off a plan. It's that people will choose not to buy something they don't like or want."

Ryan added that ending the expansion of Medicaid also played a role in the relative drop in the insured.

We went back to the CBO report to see if in fact, it "basically" said that people will choose not to buy insurance.

In terms of 22 million fewer insured, the CBO did not.

http://www.politifact.com/truth-o-meter ... -would-be/