I think it’s reasonable to talk about what would have happen if Congress repeals the Affordable Care Act without replacing it because there is no assurance that anything will replace it. The Republicans can try to reassure people that all these horrible things won’t happen, but there’s no reason to believe they’ll be able to make good on that promise.
For one thing, the reason that horrible things will happen is because they want to get rid of most of the things that make the health care scheme work. In order to make it possible to be profitable while insuring people with pre-existing conditions, you need lots and lots of healthy people paying premiums who don’t actually use much health care. That’s why there is an individual mandate. The subsidies in the individual market and the Medicaid spending are what makes it affordable for millions of people to get coverage, so if you eliminate or drastically reduce those subsidies, tens of millions will lose their health care access. The Republicans’ plan is not fully developed, but we know that they things they don’t like are the things that keep the insurance pool of young and healthy enough that premiums can be kept at an affordable level.
What the GOP is going to attempt to do would be unpopular even if they had better intentions for many of the same reasons that Obamacare has struggled to maintain widespread support. People will be forced to change plans and doctors. Insurance companies will stop serving their market. They’ll get blamed for premium hikes even if, somehow, those hikes are lower than they have been in the past.
To avoid some of this, they’ll need to avoid messing up the scheme, but they can’t do that if they break the scheme apart.
Most importantly, they’ve arranged things so that they need only fifty votes in the Senate to mess things up but still need sixty (and a majority in the House) to fix them. Republicans won’t want to replace what they’ve just repealed, especially the things they hate. So, it looks like an impossible task to replace Obamacare with anything that would work.
Needless to say, they won’t be able or even willing to keep Trump’s promise to provide everyone with health care even if they can’t afford it.
What will they actually do?
I’m not sure that anyone really knows.
And if the news stories I’m seeing are part of a bigger trend, the base is realizing the ACA and Obamacare are the same, and they want their healthcare.
They will beg democrats to help them, and democrats, not wanting to kill tens of millions will do so and thus only millions will die (because the replacement will be worse) and Republicans reap the benefits.
imo, if Republicans ask for help offer them medicare for all and nothing else.
Offer them nothing. If they break it, make them own it.
So far the Dems have been solid on this. I think they understand the politics work against compromise here.
It seems they’re taking the same approach they did in 2005 when opposing Dubya’s self-proclaimed mandate to privatize Social Security.
It worked then, it should work now.
The CBO just released the numbers on the impact of repealing the Affordable Care Act without any replacement, and they’re ugly.
According to the report, 18 million will lose their insurance in the first year, with up to 32 million losing insurance in the years following.
Worse yet, the CBO expects premiums to double under the plan Congress passed last year and President Obama vetoed.
http://crooksandliars.com/2017/01/devastating-cbo-report-aca-repeal-leaves
Since people think Obamacare and the ACA are 2 different things all they have to say is that they repealed and replaced Obamacare with the Affordable Care Act and everyone should to to healthcare.gov to see the new site
They’ll get the benefit of saying they did something and won’t actually have to do anything. Win-win for them and most of their base will buy it.
I don’t know why they wouldn’t do this. Call it TrumpCare. Brag that there wasn’t any problem with their website rollout.
exactly seems right up their alley
I’ve been saying this as well but then it dawns on me that repealing the ACA is as much about stopping the wealth redistribution that’s part and parcel of the plan. That’s really the overarching reason for the repeal efforts, ie., it’s yet another Koch initiative.
Republicans have painted themselves into a corner. Repeal will anger millions, failure to repeal will do the same. Good luck with that.
They will mess it up, and not fix it, because their real priority is to end the medicare tax on next investment income. That’s what they care about.
Remember the old Road Runner cartoons that had the bombs from Acne Corp?
In politics health care is the equivalent of the bombs in the Road Runner cartoon.
The best political strategy for an office holder is to do nothing on health care.
Don’t touch it. Because you don’t go around touching bombs.
Or you wind up like the Wiley E. Coyote.
See below:
In all seriousness here is what I would do if I was the GOP:
Greatly loosen the requirements for the benefit package. Or put another way, allow crappier insurance.
The simple goal is to reduce the premiums. This allows you to claim success, avoid the comparison on percentage covered, and since most people DON’T use the exchanges, they won’t know the difference anyway.
Then you expand Medicaid and combine it with state flexibility like Pence was given in Indiana, and red states adopt the medicaid expansion.
Ha ha ha. K Street says, “No”.
Many have said the right is like the dog that catches the car. Well, I had a dog that caught the car. He broke his right front leg. They will repeal Obamacare.
Everyone talks about the number of people that will loose their insurance but there is no discussion of the destruction of the health care work force repeal will bring. Low estimate is 2.5 million up to 5 million.
There is no way for them to undo the ACA that isn’t politically calamitous. And they know it.
Of course, they’ve whipped much of their base into a frenzy about it too.
Their only solution is to “repeal” the ACA and replace it with a bill that is 90-95% similar — they’ll get rid of Al Franken’s piece on medical loss ratios, etc. Then they re-brand it, and call the job done.
Dems will not vote for it on principle. But neither will they filibuster it, because it’s 90-95% similar to the ACA.
If the GOP tries to make it worse, Dems filibuster. And they can’t make it any better without violating conservative principles.
If they just repeal, they get seriously punished, pure and simple. I think this is the solution that both sides will want.
The thing is the GOP is just so damned contrary and short-sighted they are going to take the text of some ALEC bill and cut-and-paste it. Lobbyist bingo.
Then they light the fuse and run.
It’s unlikely in the extreme that GOPers will enact something that anyone here would think “works” (i.e., at least accomplishes all the major goals Obamacare accomplished, especially making it possible for tens of millions to afford decent health insurance who couldn’t before). For all the reasons you laid out.
But isn’t it predictable what they’ll do about that? Simply declare whatever they manage to pass “will work”, and then once in place, that it “is working”, never mind any and all evidence to the contrary. (It’s how they roll! It’s over a decade since Rove disdainfully declared “the Reality-Based Community” obsolete, and for the most part, they remain fully on board with that).
Because, aside from the blatant dishonesty inherent in Reality-Denial, they mostly thought the pre-Obamacare healthcare “system” “worked” just fine! Which it did . . . for them. They had access as fed employees to gold-plated health insurance at very reasonable cost, courtesy U.S. taxpayers. Who cares about anybody else?!
But there are going to be a LOT of people seriously hurt by any change they’re likely to make. Remember how incredibly hard it was to find somebody hurt by Obamacare?
. . . be “hurt”.
It almost seems like political malpractice to me that the current Dem “messaging” is anything other than or short of
“PEOPLE WILL DIE!!!”
when they otherwise wouldn’t have if GOPers are permitted to do as they’ve promised, now that we’re about to be under Total Republican Rule.
On loud, continuous loop, 24/7/365.
Because it’s true.
Because it’s politically smart.
Because it’s the only thing that might work in the absence of any legislative control.
Yes but their constituents have had a taste; hard to gas-light them when they can remember something that made their lives more tolerable. Health insurance is a necessity for survival; certainly to protect one’s assets from looting. Exposing their constituents to the wolves now will not be quite as easy.
any/all consequences.
With any luck, doing what they’ve promised will come back to bite them, the harder the better.
Just predicting from painful past experience how they’re likely to try to propagandize it all.
Enjoyed that outburst. Thanks for sharing. It will be so much fun to watch more of these incidents.
tactics, except using the truth.
More like this, please!
The reality is that the GOP has the votes to repeal the ACA and the votes to pass “TrumpCare” that preserves whatever pieces of the ACA that politically would cost them too much to do away with.
Here’s the current status on expanded Medicaid. Nineteen states continue to opt out of that. Trump carried seventeen of those states and ME-CD2. Clinton carried Maine and Virginia.
The KY experiment KyNect No More only did away with the state health insurance exchange. Approximately 74,000 have to use healthcare.gov to purchase a subsidized health insurance policy. The KyNect website is now healthinsurance.org/KY and handles on-line enrollments for Medicaid (traditional and expanded) and KCHIP. This had no impact on the 2016 presidential election in KY. (Trump 62.5% compared to Romney 60.5%.)
In Texas (didn’t expand Medicaid), more than 900,000 people have purchased subsidized health insurance policies through HealthCare.gov. and in Florida (also no expanded Medicaid) 1.5 million purchased coverage. Trump won Texas by 810 thousand votes; so, the GOP could probably safely blow off the HealthCare.gov there. The winning vote margin in Florida was only 113 thousand; so, it looks like a high stakes gamble for the GOP there. It could also have put Georgia in play. (This assumes that some portion of those purchasing health insurance through HealthCare.gov voted for Trump, a third party, or didn’t vote.)
Would the double whammy of eliminating expanded Medicaid and HealthCare.gov impact voting preference in “red states?”
This is why my guess is the push will be to block grant medicaid in a way that the states that don’t take it do now (worth noting Rick Scott was for taking medicaid). Essentially it looks like something Pence implemented when got the waiver from Obama to.
By far the most interesting dynamic is the Republican Governors versus Tea Party Congressman.
What kills any replacement plan GOP-style is that replacement drives toward treating health care as part of infrastructure and stripping employers of responsibility beyond cash compensation for employees. That is the message of the successful developed countries’ health care. Britain is the low-cost leader because they nationalized the practitioners of basic health service and left private practice to luxury niches. They cannot escape that cost-benefit structure.
They could go back to the original Heritage Foundation plan and tweak it with (1) a nationalized market; (2) limitations on medical liability without accountability for malpractice; (3) moar health savings accounts; (4) reinstitution of reasonable medical loss ratio and possibly a few other “free market” bells and whistles. Only the restricted medical loss ratio (say, 85% of costs must be for care) will deliver passable results. And they still have no way of squeezing out the insurer-provider merry-go-round of billing and collecting.
We also could end up with an inadvertent clinical trial of conventional and various forms of alternative medicine with a total sample population of 333 million.
Employers want the golden handcuffs on employees that health care benefits provide without paying the price of actual healthcare.
And many aspects of conventional medicine are in a budget caused crisis that actually tends to make a non-trivial number of patients sicker. Meanwhile the CEOs and executives in insurer and provider large organizations are raking in higher and higher salaries.
There are any number of schemes they can think up. I cannot help but feel this never would have happened if Joe the Lip and gang were not around in 2009 and the plan was medicare for all and not some for profit plan with high deductibles and narrow networks. Health care may be gone for our lifetimes now. Sour grapes, I know.
First off, the Republicans donors don’t give a shit about what their base will say/do when they repeal Obamacare.
Because they aren’t going to repeal working people with benefits insurance. They are going to end ‘welfare insurance for Medicaid takers.’
And the dumbasses in the red states will be very happy to die earlier knowing that the blacks and browns will be dying even earlier.
They’ll wrap it up with Planned Parenthood and claim that the sluts are cut off too.
They’re just working out the communication details with Frank Lantz on how to frame it up so it doesn’t sound evil for working white people while being mercilessly evil to blacks and lower class folks.
Anyone who thinks differently didn’t pay attention during the sequester and underestimates how evil these people willfully want to act toward minorities, loose women, and white trash losers who don’t have ‘real jobs’ with company paid benefits, that corporations are stepping away from their employees anyway.
It’s a great time to be an independently wealthy American who hates everything and everybody except their money.
Hate to say it but that strikes me as the most accurate assessment of GOP motivations, intentions and objectives.
He understood them. Reagan made breakfast, lunch and dinner out of this.
I don’t see it. Even Saint Reagan was never able to cut Social Security or Medicare. I think Republicans will ultimately fold with some face saving measures added in. Either that or they’ve gone insane, thinking they can get away with anything. Would not surprise me if that sociopath Ryan was in this camp. That SOB has no shame. We’re living in a time when it’s hard to predict anything with certainty anymore.
This isn’t a Medicare or Social Security issue.
This is ‘welfare insurance’ for people who are on Medicaid and the undeserving who could not afford insurance and/or didn’t have a ‘real job’ that provided benefits.
With a message custom crafted for the deplorables they won’t bat an eye when the Republicans let them know that it’s just a hard fact of life that the country can’t afford to pay for these deadbeats.
They won’t lose a single midterm voter in 2018 over it if they execute it without radically disturbing the market, I.e. Employed folks see their premiums go up (what else is new) but can continue with their current company coverage plans.
Nobody ever lost an election by underestimating the intelligence of white supremacist driven voters or old voters who don’t think twice about screwing over the next generation or any group that makes them nervous.
I agree with you that the GOP is going to do this but I also think it is going to bite them hard later.
Reagan did cut Social Security in 1983. First, the age for full benefits was increased from 65 years to as high as 67 years of age. Also, people who worked at jobs covered by Social Security but also worked at a job like teaching, that is not covered by Social Security, see their benefits cut. My Social Security benefits are cut 55% as a result of this combination of employment. It’s called the Windfall Elimination Provision.
https://www.ssa.gov/pubs/EN-05-10045.pdf
Yep, it is going to be all about the message. But everyone knows the feds can’t do anything right. Only the states can do this. It is a local matter, blah blah blah. And guess what? It works for medicare just as well. Social security is next.
I read recently that one scheme is to pass this thing off to the states to handle. They will provide incentives maybe even where they are today but it will be the states problem, if they choose to take it. After all it ain’t our fault if your state won’t do anything.
Each state can try any scheme they like even single payer. So there could be fifty different plans. Who knows if any of it works or for how long it works but not my problem.
There will be 10 plans, tops.
Vermont, Massachusetts, CA, NY and I don’t even know how you get to 10.
The ACA is going to disappear into the ether in less time than it took the Democrats to get destroyed in 2010.
So the scheme can go like this. First repeal Obamacare on a delay timing like two years. During that time each state must come up with their own plan. After all these things should be handled on a local basis. Health care in Wyoming may be different than in California. They could even devote extra money for some time. But the stink will be on the states, if at all, cause you know we made a better plan and looky how good Indiana did it.
This is disturbing:
Unverified that this is the plan but we suspect Flynn Jr is the provocateur source. From a 1933 perspective such a move would trigger the ‘game-over’ klaxon.
From The Sacramento Bee, Opinion Page, Monday 1/16/17, Letters to the Editor:
The height of Social Darwinism; the chickens are being driven to the slaughterhouse and they just cluck away like the brainless boobs they are.
Wow! Dougie gets around.
these serial-letter-writing rightwing cranks.
I know mine does.
Lincoln, CA is about 30 miles N.E. of Sacramento. As you get into the California hinterlands (away from the coast), the state gets pretty red, so yes, Doug does believe that crap.
Hey Carlo, I’m in Sac. Where be you?
Southeast of Placerville — about 2,500′ in the foothills.
Just as the reddest armpits still have significant sub-populations of good liberals*, so the most liberal enclaves still have more than their fair share of rubes, boobs, and loons.
*experience-based reporting: I survived over a decade in OKC — which was viewed as a liberal hotbed by the rest of OK!
As soon as insurance can be sold across state borders and the Health Savings Accounts are in place, Doug Hinchley will have been persuaded he was proven prescient. He will be so proud.
And medicare replaced with 500.00 CVS cards.
This meme will be employed every day for the next years. Hopefully, as few years as possible.
Dammit. How do you do that with the word and the link?
After many offers of advice by Frog ponders, this diagram finally taught me how to execute these links correctly.
Like this?
Thanks.
Because this is also a good one.
http://www.lawyersgunsmoneyblog.com/wp-content/uploads/2016/12/butheremails.png
That is an excellent one.