Obamacare Repeal

530RL · Mar 25, 2017

Sleek-Jet said:
I did specifically leave off the double digit percentage premium increases we've all seen over the last few years, and the Cadillac tax that is coming for those of us with employer provided healthcare. And the unfunded zero deductible insurance coverage requirements like birth control.

I can't find the WSJ piece right now, but it was sighted that roughly 6 million people sought relief from the mandate on the IRS taxes last year and about double that only buy insurance because it is required. I'm still looking for that report and I'll link it here when I find it. That is pretty close to the "scare" number put out, though I don't know if the two numbers are correlated.

The ACA is built around the exchanges, because that is the back-stop for people that can't afford $24,000.00 annual insurance premiums. IMHO, if the exchanges fail, so does the ACA. But I'm usually wrong so please, no one offer to wager on that.

We'll have to wait and see who is right.

I completely agree with your point that it is long-term unsustainable, I think our definition of "implode" or "collapse" may just be different. The only long-term solution is either more total spending or less care. There is no such thing as a free lunch. Canada spends roundly 4k per year on healthcare, we spend about 10k. Maybe something in the middle is the real solution.

With respect to your absolutely critical point relating to the increases in premiums and the companies abandoning markets, it is the mandated coverages, pre-existing conditions acceptance, removal of caps, screening coverage and on and on that led to the increases in premiums and/or the increases in deductibles. More services cost more money.

Interesting to me is that Trumpcare kept all of those things that economically led to the premium increases and the deductible increases so I remain scratching my head on how over 200 R's in the House and Trump could believe the ACA was gonna "implode", but Trumpcare would not if the same definition of "implode" was used. They had the same things in them that led to increases in rates and deductibles as well as companies leaving markets. They had identical economic realities that did not add up. :headscratch:

Sleek-Jet · Mar 25, 2017

That's because neither plan takes the insurance companies out of the driver's seat, or makes any systemic changes.

I've heard it said that we don't have health insurance, we have pre-paid healthcare. Something fundamentally needs to change in how we chose and pay for the product (healthcare, not insurance).

Pricing transparency would be a nice place to start, maybe let free market forces come into play.

Grandpa mac · Mar 25, 2017

regor said:
You know what's childish Gramps.........................continually being snowed and supporting this!

That's only $15T, so you can add another third to the stack. :thumbsup:drink

But I bet you want Trump to spend even more money on the military while further reducing your taxes, right?

was thatguy · Mar 25, 2017

Can someone please remind what the purpose of Obamacare was to begin with?

was thatguy · Mar 25, 2017

530RL said:
I completely agree with your point that it is long-term unsustainable, I think our definition of "implode" or "collapse" may just be different. The only long-term solution is either more total spending or less care. There is no such thing as a free lunch. Canada spends roundly 4k per year on healthcare, we spend about 10k. Maybe something in the middle is the real solution.

With respect to your absolutely critical point relating to the increases in premiums and the companies abandoning markets, it is the mandated coverages, pre-existing conditions acceptance, removal of caps, screening coverage and on and on that led to the increases in premiums and/or the increases in deductibles. More services cost more money.

Interesting to me is that Trumpcare kept all of those things that economically led to the premium increases and the deductible increases so I remain scratching my head on how over 200 R's in the House and Trump could believe the ACA was gonna "implode", but Trumpcare would not if the same definition of "implode" was used. They had the same things in them that led to increases in rates and deductibles as well as companies leaving markets. They had identical economic realities that did not add up. :headscratch:

Good post, although I think that the line items you mention are not the sole contributing factors for the obscene hikes that many have seen...they certainly are the contributing factors for millions who saw their policies flat out canceled.

All I can say is thank goodness it was an R proposal...the D's would have just locked the doors and passed it blindly without even fucking reading it...oh wait, they already did that shit which is why it's a fucking mess now.

THAT'S why they OWN this bullshit.
The problems before Ocare could have been addressed many different ways, but no, the asshole had to satisfy his megalomania needs and go legacy building.

530RL · Mar 26, 2017

was thatguy said:
Can someone please remind what the purpose of Obamacare was to begin with?

1) To force the insurance companies to continue coverage and not cancel once someone has a major condition such as cancer at their annual renewal.

2) To force the insurance companies to accept people with pre-existing conditions that want to change jobs or start a business.

3) To allow dependents to stay on insurance up to the age of 26.

4) To confiscate via higher taxes more tax dollars to subsidize people who could not pay for coverage and/or had pre-existing conditions.

5) To force companies/employers to provide health insurance.

6) To eliminate caps on total benefits (a real policy cost buster).

7) To expand medicare to a greater pool of people.

All these things naturally resulted in higher costs. No shit right? And as a result premiums rose and insurance companies tried to find a way out of insuring the highest risks as well as pass higher costs onto existing policy holders. End result, higher costs for those who pay, more coverage for those who could not pay, and insurance companies doing their duty and trying to drop out of markets that were high risk such as individual plans for people with pre-existing conditions.

As long as any plan encompasses items 1 - 6, it is simply the same problem. As was Trumpcare.

The ACA gave more people coverage that did not have it before or could not keep their coverage. The result was higher total costs as more services were provided and you and I as well as other people who were paying before got the bill as well as a bunch of other natural market reactions such as you and I losing our old policies.

The only way to put the genie back in the bottle is to tell some people they will not have care. That is a tough vote to take back to the people regardless of their party.

As Trump said and many nervously laughed, "healthcare is a lot more complicated than I thought".

JD D05 · Mar 26, 2017

530RL said:
1) To force the insurance companies to continue coverage and not cancel once someone has a major condition such as cancer at their annual renewal.

2) To force the insurance companies to accept people with pre-existing conditions that want to change jobs or start a business.

3) To allow dependents to stay on insurance up to the age of 26.

4) To confiscate via higher taxes more tax dollars to subsidize people who could not pay for coverage and/or had pre-existing conditions.

5) To force companies/employers to provide health insurance.

6) To expand medicare to a greater pool of people.

All these things naturally resulted in higher costs. No shit right? And as a result premiums rose and insurance companies tried to find a way out of insuring the highest risks as well as pass higher costs onto existing policy holders. End result, higher costs for those who pay, more coverage for those who could not pay, and insurance companies doing their duty and trying to drop out of markets that were high risk such as individual plans for people with pre-existing conditions.

As long as any plan encompasses items 1 - 5, it is simply the same problem. As was Trumpcare.

The ACA gave more people coverage that did not have it before or could not keep their coverage. The result was higher total costs as more services were provided and you and I as well as other people who were paying before got the bill as well as a bunch of other natural market reactions such as you and I losing our old policies.

The only way to put the genie back in the bottle is to tell some people they will not have care. That is a tough vote to take back to the people regardless of their party.

As Trump said and many nervously laughed, "healthcare is a lot more complicated than I thought".

All but one of your 5 points are false. They either never happened or still aren't. I have 200 plus companies insured and own an HR company.

530RL · Mar 26, 2017

JD Dearden said:
All but one of your 5 points are false. They either never happened or still aren't. I have 200 plus companies insured and own an HR company.

Happy to go through them one by one.

JD D05 · Mar 26, 2017

530RL said:
Happy to go through them one by one.

I don't really have the interest or patience to educate or more likely argue with a new insurance professional.

Pick one.

was thatguy · Mar 26, 2017

JD Dearden said:
All but one of your 5 points are false. They either never happened or still aren't. I have 200 plus companies insured and own an HR company.

One is actually completely backwards...:rolleyes

530RL · Mar 26, 2017

JD Dearden said:
I don't really have the interest or patience to educate or more likely argue with a new insurance professional.

Pick one.

Which one was correct, lets eliminate that first....

JD D05 · Mar 26, 2017

was thatguy said:
One is actually completely backwards...:rolleyes

Yep

JD D05 · Mar 26, 2017

530RL said:
Which one was correct, lets eliminate that first....

4 and possibly 7 I don't deal with medicare or medsups

Edit. Also 6, some carriers were already doing this but ACA made it law. Probably the best aspect of ACA.

530RL · Mar 26, 2017

JD Dearden said:
4 and possibly 6 I don't deal with medicare or medsups

Let's take 3.

Did the ACA require group plans to allow dependent children to stay on until the age of 26?

And 2,

In the individual market, did the ACA require insurance companies to accept pre-existing conditions that they were not required to accept before?

And 5,

Did the ACA require more employers to provide medical benefits than the rules prior to the ACA specifically regarding number of hours worked and number of employees?

was thatguy · Mar 26, 2017

530RL said:
Let's take 3.

Did the ACA require group plans to allow dependent children to stay on until the age of 26?

And 2,

In the individual market, did the ACA require insurance companies to accept pre-existing conditions that they were not required to accept before?

And 5,

Did the ACA require more employers to provide medical benefits than the rules prior to the ACA specifically regarding number of hours worked and number of employees?

And what was the real result of #5?

JD D05 · Mar 26, 2017

530RL said:
Let's take 3.

Did the ACA require group plans to allow dependent children to stay on until the age of 26.

And 2,

In the individual market, did the ACA require insurance companies to accept pre-existing conditions that they were not required to accept before?

And 5,

Did the ACA require more employers to provide medical benefits than the rules prior to the ACA specifically regarding number of hours worked and number of employees?

3- Every carrier I was working with already did this. It was always if they are still an overall dependent or age 26- 30.

2- Yes, but this one is complicated. The limited window opened up new hurdles when it comes to access outside of open enrollment. This also removed the one key component to any insurance product and thats underwriting. Your statement stated someone starting a new company or changing jobs and thats what I disagreed with. A business can start a new health plan at anytime assuming they have 2 employees etc. I suppose I / we are splitting hairs here.

5 - no full time is almost always considered over 30 hours and that is still the threshold for benefits. The penalty is still much lower in most cases than the premiums. I don't think it has had to much of an effect on access though. You have seen a lot of innovation into "self funding" though.

JD D05 · Mar 26, 2017

was thatguy said:
And what was the real result of #5?

Less hours...happens all the time.

JD D05 · Mar 26, 2017

During the ACA discussions and also the latest discussions we just shake our heads. So many of the major talking points have always been happening. It is really frustrating to watch the real solutions never even addressed. My dad was even invited with a select others to discuss all this in DC. I really don't think they are very interested in a real fix.

530RL · Mar 26, 2017

JD Dearden said:
All but one of your 5 points are false. They either never happened or still aren't. I have 200 plus companies insured and own an HR company.

JD Dearden said:
4 and possibly 7 I don't deal with medicare or medsups

Edit. Also 6, some carriers were already doing this but ACA made it law. Probably the best aspect of ACA.

JD Dearden said:
3- Every carrier I was working with already did this. It was always if they are still an overall dependent or age 26- 30.

2- Yes, but this one is complicated. The limited window opened up new hurdles when it comes to access outside of open enrollment. This also removed the one key component to any insurance product and thats underwriting. Your statement stated someone starting a new company or changing jobs and thats what I disagreed with. A business can start a new health plan at anytime assuming they have 2 employees etc. I suppose I / we are splitting hairs here.

5 - no full time is almost always considered over 30 hours and that is still the threshold for benefits. The penalty is still much lower in most cases than the premiums. I don't think it has had to much of an effect on access though. You have seen a lot of innovation into "self funding" though.

So I have gone from only one was part of the law to 4 or 5 and we haven't even really started yet.......

I never said it worked, or was effective, I stated it was in the text and the purpose of the ACA. I am certain all points are in the law regardless of how people were behaving previously as I, like you have had to deal with it and comply with it.

I agree it is a cluster fuck. But given 7 years, those now in power have not come up with any reasonable changes and that is pretty pathetic.

Off to dinner in a fucking tux......

JD D05 · Mar 26, 2017

530RL said:
So I have gone from only one was part of the law to 4 or 5 and we haven't even really started yet.......

I never said it worked, or was effective, I stated it was in the text and the purpose of the ACA. I am certain all points are in the law regardless of how people were behaving previously as I, like you have had to deal with it and comply with it.

I agree it is a cluster fuck. But given 7 years, those now in power have not come up with any reasonable changes and that is pretty pathetic.

Off to dinner in a fucking tux......

Ha I admit I didn't read your original post in detail before I posted. I noticed some errors and got excited. And you edited and added.

regor · Mar 26, 2017

Grandpa mac said:
But I bet you want Trump to spend even more money on the military while further reducing your taxes, right?

I want Trump to spend less money on illegals, subsidies and bloated government agencies. I think we spend more than enough on defense already, just poorly.

As far as taxes, you're damn right I want taxes cut. I'd like to hire more people and create more opportunities not only for my current employees, but for some new ones also. Now before you call bullshit, keep in mind I now pay close to 300K a year for my employees' medical/dental. I don't have too, but I do.......because it's the right thing to do AND I respect the work they do for me.

All DC and the state legislatures do is piss it away, stuff it in their's or their friend's pocket anyways.

Wombat · Mar 26, 2017

regor said:
I want Trump to spend less money on illegals, subsidies and bloated government agencies. I think we spend more than enough on defense already, just poorly.

As far as taxes, you're damn right I want taxes cut. I'd like to hire more people and create more opportunities not only for my current employees, but for some new ones also. Now before you call bullshit, keep in mind I now pay close to 300K a year for my employees' medical/dental.:thumbup: I don't have too, but I do.......because it's the right thing to do AND I respect the work they do for me.

All DC and the state legislatures do is piss it away, stuff it in their's or their friend's pocket anyways.

You're a good man regor.:thumbsup

was thatguy · Mar 26, 2017

JD Dearden said:
Ha I admit I didn't read your original post in detail before I posted. I noticed some errors and got excited. And you edited and added.

Yeah, he's tricky like that!

Grandpa mac · Mar 26, 2017

530RL said:
1) To force the insurance companies to continue coverage and not cancel once someone has a major condition such as cancer at their annual renewal.

2) To force the insurance companies to accept people with pre-existing conditions that want to change jobs or start a business.

3) To allow dependents to stay on insurance up to the age of 26.

4) To confiscate via higher taxes more tax dollars to subsidize people who could not pay for coverage and/or had pre-existing conditions.

5) To force companies/employers to provide health insurance.

6) To eliminate caps on total benefits (a real policy cost buster).

7) To expand medicare to a greater pool of people.

All these things naturally resulted in higher costs. No shit right? And as a result premiums rose and insurance companies tried to find a way out of insuring the highest risks as well as pass higher costs onto existing policy holders. End result, higher costs for those who pay, more coverage for those who could not pay, and insurance companies doing their duty and trying to drop out of markets that were high risk such as individual plans for people with pre-existing conditions.

As long as any plan encompasses items 1 - 6, it is simply the same problem. As was Trumpcare.

The ACA gave more people coverage that did not have it before or could not keep their coverage. The result was higher total costs as more services were provided and you and I as well as other people who were paying before got the bill as well as a bunch of other natural market reactions such as you and I losing our old policies.

The only way to put the genie back in the bottle is to tell some people they will not have care. That is a tough vote to take back to the people regardless of their party.

As Trump said and many nervously laughed, "healthcare is a lot more complicated than I thought".

Great post- thanks!

SNiC Jet · Mar 26, 2017

530RL said:
.....The only way to put the genie back in the bottle is to tell some people they will not have care. That is a tough vote to take back to the people regardless of their party.....

Actually, this is the VERY premise in which Trump won and the GOP won House and Senate numbers in 14 and 16....
Biggest mistake GOP continues to make is fearing politics and running scared from the very things and promises that got them elected....... They need to repeal this ACA mother fucker as promised and move on to better days.....they seem to forget who sent them there as soon as the votes are counted.....

Grandpa mac · Mar 26, 2017

regor said:
I want Trump to spend less money on illegals, subsidies and bloated government agencies. I think we spend more than enough on defense already, just poorly.

As far as taxes, you're damn right I want taxes cut. I'd like to hire more people and create more opportunities not only for my current employees, but for some new ones also. Now before you call bullshit, keep in mind I now pay close to 300K a year for my employees' medical/dental. I don't have too, but I do.......because it's the right thing to do AND I respect the work they do for me.

All DC and the state legislatures do is piss it away, stuff it in their's or their friend's pocket anyways.

Sometimes I wonder if you f olks have any idea where your tax money really goes so here's a link. More than half is non discretionary spending- Social security, Medicare, and interest on the debt. About half of what remains is military and veteran benefits. That means everything else is about a quarter of the budget. If you want to lower debt, and I do, you raise more money and reduce your biggest expenses. For a household that means a second job and getting rid of expensive mortgage and car payments. For America it has to mean raising taxes on the richest 5% and reducing military spending. Let's revisit the Eisenhower age we were following that prescription and America was booming.

Https://www.google.co.uk/search?ie=...-vR8gezrY74Ag#gfe_rd=cr&imgrc=aZKoWgEilLVVXM:

regor · Mar 27, 2017

Grandpa mac said:
Sometimes I wonder if you f olks have any idea where your tax money really goes so here's a link. More than half is non discretionary spending- Social security, Medicare, and interest on the debt. About half of what remains is military and veteran benefits. That means everything else is about a quarter of the budget. If you want to lower debt, and I do, you raise more money and reduce your biggest expenses. For a household that means a second job and getting rid of expensive mortgage and car payments. For America it has to mean raising taxes on the richest 5% and reducing military spending. Let's revisit the Eisenhower age we were following that prescription and America was booming.

Https://www.google.co.uk/search?ie=...-vR8gezrY74Ag#gfe_rd=cr&imgrc=aZKoWgEilLVVXM:

Thanks for the tax lesson Gramps!

Military spending should be seriously looked at. It's just another form of crony capitalism.

530RL · Mar 27, 2017

SNiC Jet said:
Actually, this is the VERY premise in which Trump won and the GOP won House and Senate numbers in 14 and 16....
Biggest mistake GOP continues to make is fearing politics and running scared from the very things and promises that got them elected....... They need to repeal this ACA mother fucker as promised and move on to better days.....they seem to forget who sent them there as soon as the votes are counted.....

So at the end of the day, who really are the fools?

RodnJen · Mar 27, 2017

regor said:
I want Trump to spend less money on illegals, subsidies and bloated government agencies. I think we spend more than enough on defense already, just poorly.

As far as taxes, you're damn right I want taxes cut. I'd like to hire more people and create more opportunities not only for my current employees, but for some new ones also. Now before you call bullshit, keep in mind I now pay close to 300K a year for my employees' medical/dental. I don't have too, but I do.......because it's the right thing to do AND I respect the work they do for me.

All DC and the state legislatures do is piss it away, stuff it in their's or their friend's pocket anyways.

Sounds like a single payer system is your friend. You can focus more on business and less on benefits.

thetub · Mar 27, 2017

RodnJen said:
Sounds like a single payer system is your friend. You can focus more on business and less on benefits.

hes gonna have to focus on his business to flip bill on the soaring cost of a single payer system...

RodnJen · Mar 27, 2017

thetub said:
hes gonna have to focus on his business to flip bill on the soaring cost of a single payer system...

As opposed to the soaring cost of the free market?

regor · Mar 27, 2017

RodnJen said:
Sounds like a single payer system is your friend. You can focus more on business and less on benefits.

A single payer is the system for people who don't want to/can't pay for top of the line care. They can have theirs, I want mine.

Classic Daycruiser · Mar 27, 2017

Grandpa mac · Mar 27, 2017

regor said:
A single payer is the system for people who don't want to/can't pay for top of the line care. They can have theirs, I want mine.

At the end of your life when you need it most, you will likely be on a single payer system (Medicare) anyway. My wife tells me that something like 30-40% of American Medical spending cones during the final two months of life.

JD D05 · Mar 27, 2017

Grandpa mac said:
At the end of your life when you need it most, you will likely be on a single payer system (Medicare) anyway. My wife tells me that something like 30-40% of American Medical spending cones during the final two months of life.

I don't know how accurate it is but I have heard a higher percentage than that.

JD D05 · Mar 27, 2017

RodnJen said:
Sounds like a single payer system is your friend. You can focus more on business and less on benefits.

Still does nothing to address the real problem of cost. Until someone takes a haircut nothing happens.

regor · Mar 27, 2017

Grandpa mac said:
At the end of your life when you need it most, you will likely be on a single payer system (Medicare) anyway. My wife tells me that something like 30-40% of American Medical spending cones during the final two months of life.

Like JD I not sure about the numbers, although they are enormous, but I want the option to pay for better healthcare until the end or the option to say F it, pull the plug.

End of life is the killer for sure and if you personally have the money to keep it going, more power to you. If not, sorry you're toast. I don't want to spend my money for end of life care and I sure as hell don't want the government doing it either.

Bring on fiscal sanity and the death squads!!! :drink

rrrr · Mar 29, 2017

Faceaz said:
Ryan & Trump were making deals all day yesterday to try and pull in more republican support & made no effor to pull in support from the left - but of course that's who he would like to blame.

How many times did Boner vote to repeal the ACA? Today proved they had no ability to fix it all along. The problem is Republicans stick to their guns and aren't flexible. They are idealists and won't settle for anything less than their idea of perfection. Till they learn to work together, we will see this circle jerk over and over.

The so called Freedom Caucus held a gun to Ryan's head. They demanded concession after concession, which they got for the most part. But when their demands became just ridiculous, Ryan said fuck it, we aren't going to let these people dictate how we enact the new health care law.

So a group of thirty or so militant Republicans are responsible for the failure, not the Republican party. I think it's a good thing that Ryan didn't cave in. Their demands would have added hundreds of billions in costs.

Old Texan · Mar 29, 2017

rrrr said:
The so called Freedom Caucus held a gun to Ryan's head. They demanded concession after concession, which they got for the most part. But when their demands became just ridiculous, Ryan said fuck it, we aren't going to let these people dictate how we enact the new health care law.

So a group of thirty or so militant Republicans are responsible for the failure, not the Republican party. I think it's a good thing that Ryan didn't cave in. Their demands would have added hundreds of billions in costs.

From what I heard from a Ted Poe interview, those tactics are the reason he left the Caucus. The media is not painting a clear picture of how this is working. The point of getting the bill passed was more about how future bills can be voted upon than the content of the bill itself. Politics again are mucking up more then is being fixed.:thumbsdown

pronstar · Mar 29, 2017

Old Texan said:
The point of getting the bill passed was more about how future bills can be voted upon than the content of the bill itself. Politics again are mucking up more then is being fixed.:thumbsdown

If true, there's the problem.
The point of passing the bill should be to improve healthcare in America.

regor · Mar 29, 2017

rrrr said:
The so called Freedom Caucus held a gun to Ryan's head. They demanded concession after concession, which they got for the most part. But when their demands became just ridiculous, Ryan said fuck it, we aren't going to let these people dictate how we enact the new health care law.

So a group of thirty or so militant Republicans are responsible for the failure, not the Republican party. I think it's a good thing that Ryan didn't cave in. Their demands would have added hundreds of billions in costs.

Old Texan said:
From what I heard from a Ted Poe interview, those tactics are the reason he left the Caucus. The media is not painting a clear picture of how this is working. The point of getting the bill passed was more about how future bills can be voted upon than the content of the bill itself. Politics again are mucking up more then is being fixed.:thumbsdown

I understand Trump needed to pass something, but relying on the RINO's to do what they say, doesn't really have a good track record. Cocksuckers had years to deal with this and all they could muster was Ryan on one knee offering a hummer. :thumbsdown

I measured this bill by one thing and one thing only.............Rand Paul said it blows and therefore I applauded the Freedom Caucus for standing strong against the establishment whores! :thumbsup

Old Texan · Mar 29, 2017

regor said:
I understand Trump needed to pass something, but relying on the RINO's to do what they say, doesn't really have a good track record. Cocksuckers had years to deal with this and all they could muster was Ryan on one knee offering a hummer. :thumbsdown

I measured this bill by one thing and one thing only.............Rand Paul said it blows and therefore I applauded the Freedom Caucus for standing strong against the establishment whores! :thumbsup

Good point about Rand.

And it's sad the R's didn't have a better bill at least outlined to present. Bottomline though is this bill was not ready and Congress needs to be patient and do a bill correctly that can pass muster with the majority.

Politics are still too much the driving force of trying to solve important issues.

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