Republicans put in bind over preexisting conditions

[jnug]

The ACA was passed in 2010. I go a lot further back the that. My memory is fine. I never had a problem getting covered for pre-existing conditions. Early on there was a short waiting period. Ofcourse by the time that insanely stupid Obamacare was passed, that waiting period had grown to a year.

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Anecdotal at best....in fact likely ancient history anecdotal.

 

[jnug]

Yes, Democrats won this election on health care. The dirty little secret folks like you can't quite seem to grasp yet is that somewhere along the way Obamacare got popular. And Dems are finally getting competent at using it to cudgel hapless GOP candidates over the head.

Oh its worse than that. The ACA was never suggested to be a finished product at inception. It was presented by its proponents as a vital first step out of the lunacy of the US Healthcare Delivery System that the GOP promptly tried to kill and continued to try to kill all the way up to now as opposed to building upon it. IT STILL SURVIVED and grew popular. Trying to kill it finally came home to roost on the GOP this year, in the mid-terms. Could not have happened to a "nicer bunch a' guys". SARCASM alert for section in quotes.

 

[Greenbeard]

And no matter how you attempt to spin it, you did not win the House on Healthcare.

You seem quite invested in denying the obvious. And the inevitable.

 

[MAGAnificent]

Anecdotal at best....in fact likely ancient history anecdotal.

Point is, pre existing conditions were not always an issue with private sector health insurance. And health insurance has not always been unaffordable. Anyone who thinks its affordable under the ACA is living in an alternate universe.

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[MAGAnificent]

Oh its worse than that. The ACA was never suggested to be a finished product at inception. It was presented by its proponents as a vital first step out of the lunacy of the US Healthcare Delivery System that the GOP promptly tried to kill and continued to try to kill all the way up to now as opposed to building upon it. IT STILL SURVIVED and grew popular. Trying to kill it finally came home to roost on the GOP this year, in the mid-terms. Could not have happened to a "nicer bunch a' guys". SARCASM alert for section in quotes.

You are only right in that it was never intended to be a finished product. That's why the Democrats attempted to load it with a clause that would take us to single payer when it failed. The ACA was actually designed to fail. Unfortunately for the Democrats, the Republicans were able to stop the single payer clause though the courts. Since then, the Democrats in Congress are simply protecting it because it was "Hussein" Obama's signature piece of legislation that they all backed. They do not give a damn whether it actually works or not. As for the ACA surviving, I suppose that depends on what you call survival. The individual mandate is gone, the premiums and deductibles are still rising, and over 8 years it has devastated your party. And Unlike you, I do not take a handful of cherry picked exit polls as a gauge of what is or is not popular. I do not believe that the ACA is suddenly popular. I simply do not believe that the majority of Americans or even the majority of Democrats is that insanely stupid. Who thinks paying more for your health insurance premiums then you pay on your monthly home mortgage is good policy?

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[jnug]

You are only right in that it was never intended to be a finished product. That's why the Democrats attempted to load it with a clause that would take us to single payer when it failed. The ACA was actually designed to fail. Unfortunately for the Democrats, the Republicans were able to stop the single payer clause though the courts. Since then, the Democrats in Congress are simply protecting it because it was "Hussein" Obama's signature piece of legislation that they all backed. They do not give a damn whether it actually works or not. As for the ACA surviving, I suppose that depends on what you call survival. The individual mandate is gone, the premiums and deductibles are still rising, and over 8 years it has devastated your party. And Unlike you, I do not take a handful of cherry picked exit polls as a gauge of what is or is not popular. I do not believe that the ACA is suddenly popular. I simply do not believe that the majority of Americans or even the majority of Democrats is that insanely stupid. Who thinks paying more for your health insurance premiums then you pay on your monthly home mortgage is good policy?

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Which:
a) gives any politician more credit than he deserves. Show me a President that could have strategized his way into what you are suggesting Obama strategized into and THAT is the guy I would drop the term limits rule for and elect to perpetuity, not the Bozo in the WH today.
b) It completely ignores the fact that our Healthcare Delivery System based on private company healthcare insurance was entirely and utterly broken before the ACA.

The centerpiece of private healthcare insurance is employer participation for one thing and that was predicated on good employees remaining in their jobs a far longer than they have in the 21st century compared to the 20th. That is gone, died with my generation of workers. People have to be transient to be able to stay employed for a career. They not only have to change employer, they often have to pull up stakes and move themselves bag and baggage. So beyond the fact that the Healthcare Delivery System with its dependence on Private Healthcare Insurance companies was broken to pieces on its own merits, societal changes, employers depending on contract labor being another of them have simply unmasked the failings and the cost of the system greatly dependent on for profit, private healthcare insurance companies. Companies go out of their way to satisfy their labor requirements without offering benefits.

Frankly, the simple truth of it is that its the Healthcare Delivery System itself that reaps most of the benefits of for profit, private healthcare insurance companies, not individual recipients of Healthcare Services. So we get to pay the bill, the Delivery System gets the benefit. Nice work for the Healthcare Delivery System if you can pull the wool over enough people's eyes. Private Company Healthcare Insurance is an entity without a benefit to those that foot the bill, us. That is the case for all Protection based insurance which is a scam. Just ask organized crime which has a racket called the Protections Racket.

As for healthcare cost, the for profit private healthcare insurance industry drives cost ...OBVIOUSLY, because it fits their business models. So we have a component of the US Healthcare Delivery System that does not really provide a benefit to people footing the bill, us that also has a vested profit motive in driving up cost. Insurance business is based on actuarial tables. They are the cornerstone of the Insurance Business which is fine in the environment they were designed for, Liability Based Coverage. Turn them loose in a protection based environment and you are walking around with a big sign around your neck that reads "SUCKER".

All protection based Insurance is a racket because the policy holder whether he knows it or not is convinced that he can beat the house, that he will beat the insurer's actuarial tables. It is a racket because it does not include the value inherent to Liability Based Coverage, like Property Insurance or Life Insurance or Auto Insurance.

 

[manofknowledge]

You are only right in that it was never intended to be a finished product. That's why the Democrats attempted to load it with a clause that would take us to single payer when it failed.

What clause? No such clause exists in the law.

The ACA was actually designed to fail. Unfortunately for the Democrats, the Republicans were able to stop the single payer clause though the courts.

No court has ruled about single payer and single payer is not in the ACA. The fact is, we already have single payer for everyone over 65 years of age.

Since then, the Democrats in Congress are simply protecting it because it was "Hussein" Obama's signature piece of legislation that they all backed. They do not give a damn whether it actually works or not. As for the ACA surviving, I suppose that depends on what you call survival. The individual mandate is gone, the premiums and deductibles are still rising, and over 8 years it has devastated your party.

The ACA is quite affordable for people whose family income qualifies for subsidies. The number of people insured is way higher than it used to be. Medicaid should have been expanded in all states. Instead half the states refused to expand as a stunt even though their citizens still had to pay for the expansion through their Federal taxes.

And Unlike you, I do not take a handful of cherry picked exit polls as a gauge of what is or is not popular. I do not believe that the ACA is suddenly popular. I simply do not believe that the majority of Americans or even the majority of Democrats is that insanely stupid. Who thinks paying more for your health insurance premiums then you pay on your monthly home mortgage is good policy?

Much of the increased cost of health insurance is because of the Republican campaign against the ACA which was packed with false representations and hyperbole. Not enough people participated and Medicaid was not implemented as designed. The destruction of the Mandate without implementing an alternative, forced insurance companies to raise rates to continue covering pre-existing conditions. Health insurance is based on the risk pool it covers. If your family is the risk pool then you will never get affordable insurance if someone in the family has a chronic or expesive medical issue. You used to have to take a physical to get health insurance. Of course health insurance is less expensive if it only covers healthy people, has a maximum payout, benefits from denying claims, excludes coverage for expensive health problems, and includes trash policies like mini-med plans. The ACA ended all of that.

Now health insurance is not based on the health of anyone, it's guaranteed to all at the same rates. It's based on the overall cost of care in a geographical region, your age and whether or not you smoke. Plenty of people get health insurance through the exchanges and insurance companies now have more actuarial data regarding the cost of that risk group, so competition is beginning to kick in regarding consumer costs of insurance.

Republicans have no alternative plan. Going back to pre-ACA conditions is already politically unpopular and will never happen. The only way forward is either to support the ACA with sensible modifications or go to single payer.

 

[ttwtt78640]

What clause? No such clause exists in the law.



No court has ruled about single payer and single payer is not in the ACA. The fact is, we already have single payer for everyone over 65 years of age.



The ACA is quite affordable for people whose family income qualifies for subsidies. The number of people insured is way higher than it used to be. Medicaid should have been expanded in all states. Instead half the states refused to expand as a stunt even though their citizens still had to pay for the expansion through their Federal taxes.



Much of the increased cost of health insurance is because of the Republican campaign against the ACA which was packed with false representations and hyperbole. Not enough people participated and Medicaid was not implemented as designed. The destruction of the Mandate without implementing an alternative, forced insurance companies to raise rates to continue covering pre-existing conditions. Health insurance is based on the risk pool it covers. If your family is the risk pool then you will never get affordable insurance if someone in the family has a chronic or expesive medical issue. You used to have to take a physical to get health insurance. Of course health insurance is less expensive if it only covers healthy people, has a maximum payout, benefits from denying claims, excludes coverage for expensive health problems, and includes trash policies like mini-med plans. The ACA ended all of that.

Now health insurance is not based on the health of anyone, it's guaranteed to all at the same rates. It's based on the overall cost of care in a geographical region, your age and whether or not you smoke. Plenty of people get health insurance through the exchanges and insurance companies now have more actuarial data regarding the cost of that risk group, so competition is beginning to kick in regarding consumer costs of insurance.

Republicans have no alternative plan. Going back to pre-ACA conditions is already politically unpopular and will never happen. The only way forward is either to support the ACA with sensible modifications or go to single payer.

That (bolded above) makes no sense. Why are age and tobacco use deemed to be valid (politically correct?) pre-existing conditions (aka actuarial risk factors) while obesity and (other) recreational drug abuse no longer deemed to be valid pre-existing conditions for premium rate increases?

 

[manofknowledge]

That (bolded above) makes no sense. Why are age and tobacco use deemed to be valid (politically correct?) pre-existing conditions (aka actuarial risk factors) while obesity and (other) recreational drug abuse no longer deemed to be valid pre-existing conditions for premium rate increases?

Smoking is proven to cause detrimental health issues and is a behavior of choice. Even so, you have a point about political correctness. That part of the law might be validly subject to change. Implementing cost increases for personal activities is a slippery slope. For example, should a motorcycle rider pay more for health insurance? A marathon runner? A skydiver? What if you smoke, then stop, then start again. What if your sedentary? There are many devils in the details of any health insurance system and many policy decisions are made at a corporate level not covered in law.

Obesity is difficult to define, is not a behavior of choice in all cases and is sometimes a symptom of underlying health issues. If your goal is to prevent illness then obesity and related health conditions must be covered.

Most health insurance does not cover illegal drug use issues at all. In fact it could invalidate a policy. It's true they don't check for it unless the claim directly relates to it, but it should probably be covered.

Mental health in general is under insured in the health system as is Dental coverage. No doubt covering them increases the cost of policies. Even a single payer system probably would not cover those areas of health care.

Health care must be structured and regulated and the government is the the best way to do it. The private market only addresses what is profitable and by design ignores anything that is not profitable. In addition, the government has a vested interest in regulating health care since it pays for most of it even before the ACA. It's irresponsible to the taxpayers to not regulate it and essential to getting a system in place that supports civil society in an optimal way. How many doctors do we need? How many nurses? How many Hospitals? What emergency services? Where should they be located? What services are most needed? How can you have an efficient, effective and equitable system without regulation?

There is too much lack of education and consideration of health care in the general population. It comes from the fact that most people are healthy and don't want to pay for it in advance. That forces the system into inefficiency and waste. Emergency care is the most expesive type of care and ironically it is the only type of care that is accessible to all.

 

[cabse5]

SIAP. Has there been any acknowledgement of the lack of activity and ideas from the left on healthcare? Now that the left has gained the majority in the house, we'll, maybe, see some suggestions of how to fix healthcare?

 

[MAGAnificent]

Which:
a) gives any politician more credit than he deserves. Show me a President that could have strategized his way into what you are suggesting Obama strategized into and THAT is the guy I would drop the term limits rule for and elect to perpetuity, not the Bozo in the WH today.
b) It completely ignores the fact that our Healthcare Delivery System based on private company healthcare insurance was entirely and utterly broken before the ACA.

The centerpiece of private healthcare insurance is employer participation for one thing and that was predicated on good employees remaining in their jobs a far longer than they have in the 21st century compared to the 20th. That is gone, died with my generation of workers. People have to be transient to be able to stay employed for a career. They not only have to change employer, they often have to pull up stakes and move themselves bag and baggage. So beyond the fact that the Healthcare Delivery System with its dependence on Private Healthcare Insurance companies was broken to pieces on its own merits, societal changes, employers depending on contract labor being another of them have simply unmasked the failings and the cost of the system greatly dependent on for profit, private healthcare insurance companies. Companies go out of their way to satisfy their labor requirements without offering benefits.

Frankly, the simple truth of it is that its the Healthcare Delivery System itself that reaps most of the benefits of for profit, private healthcare insurance companies, not individual recipients of Healthcare Services. So we get to pay the bill, the Delivery System gets the benefit. Nice work for the Healthcare Delivery System if you can pull the wool over enough people's eyes. Private Company Healthcare Insurance is an entity without a benefit to those that foot the bill, us. That is the case for all Protection based insurance which is a scam. Just ask organized crime which has a racket called the Protections Racket.

As for healthcare cost, the for profit private healthcare insurance industry drives cost ...OBVIOUSLY, because it fits their business models. So we have a component of the US Healthcare Delivery System that does not really provide a benefit to people footing the bill, us that also has a vested profit motive in driving up cost. Insurance business is based on actuarial tables. They are the cornerstone of the Insurance Business which is fine in the environment they were designed for, Liability Based Coverage. Turn them loose in a protection based environment and you are walking around with a big sign around your neck that reads "SUCKER".

All protection based Insurance is a racket because the policy holder whether he knows it or not is convinced that he can beat the house, that he will beat the insurer's actuarial tables. It is a racket because it does not include the value inherent to Liability Based Coverage, like Property Insurance or Life Insurance or Auto Insurance.

A lot to respond to. Too much for tapatalk on a cell phone. Will get to it tonight.

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[MAGAnificent]

What clause? No such clause exists in the law.



No court has ruled about single payer and single payer is not in the ACA. The fact is, we already have single payer for everyone over 65 years of age.



The ACA is quite affordable for people whose family income qualifies for subsidies. The number of people insured is way higher than it used to be. Medicaid should have been expanded in all states. Instead half the states refused to expand as a stunt even though their citizens still had to pay for the expansion through their Federal taxes.



Much of the increased cost of health insurance is because of the Republican campaign against the ACA which was packed with false representations and hyperbole. Not enough people participated and Medicaid was not implemented as designed. The destruction of the Mandate without implementing an alternative, forced insurance companies to raise rates to continue covering pre-existing conditions. Health insurance is based on the risk pool it covers. If your family is the risk pool then you will never get affordable insurance if someone in the family has a chronic or expesive medical issue. You used to have to take a physical to get health insurance. Of course health insurance is less expensive if it only covers healthy people, has a maximum payout, benefits from denying claims, excludes coverage for expensive health problems, and includes trash policies like mini-med plans. The ACA ended all of that.

Now health insurance is not based on the health of anyone, it's guaranteed to all at the same rates. It's based on the overall cost of care in a geographical region, your age and whether or not you smoke. Plenty of people get health insurance through the exchanges and insurance companies now have more actuarial data regarding the cost of that risk group, so competition is beginning to kick in regarding consumer costs of insurance.

Republicans have no alternative plan. Going back to pre-ACA conditions is already politically unpopular and will never happen. The only way forward is either to support the ACA with sensible modifications or go to single payer.

Will respond tonight

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[ttwtt78640]

Smoking is proven to cause detrimental health issues and is a behavior of choice. Even so, you have a point about political correctness. That part of the law might be validly subject to change. Implementing cost increases for personal activities is a slippery slope. For example, should a motorcycle rider pay more for health insurance? A marathon runner? A skydiver? What if you smoke, then stop, then start again. What if your sedentary? There are many devils in the details of any health insurance system and many policy decisions are made at a corporate level not covered in law.

Obesity is difficult to define, is not a behavior of choice in all cases and is sometimes a symptom of underlying health issues. If your goal is to prevent illness then obesity and related health conditions must be covered.

Most health insurance does not cover illegal drug use issues at all. In fact it could invalidate a policy. It's true they don't check for it unless the claim directly relates to it, but it should probably be covered.

Mental health in general is under insured in the health system as is Dental coverage. No doubt covering them increases the cost of policies. Even a single payer system probably would not cover those areas of health care.

Health care must be structured and regulated and the government is the the best way to do it. The private market only addresses what is profitable and by design ignores anything that is not profitable. In addition, the government has a vested interest in regulating health care since it pays for most of it even before the ACA. It's irresponsible to the taxpayers to not regulate it and essential to getting a system in place that supports civil society in an optimal way. How many doctors do we need? How many nurses? How many Hospitals? What emergency services? Where should they be located? What services are most needed? How can you have an efficient, effective and equitable system without regulation?

There is too much lack of education and consideration of health care in the general population. It comes from the fact that most people are healthy and don't want to pay for it in advance. That forces the system into inefficiency and waste. Emergency care is the most expesive type of care and ironically it is the only type of care that is accessible to all.

The problem is that any one size fits all solution is not optimal - certainly not having insurance premiums (converted to taxes?) based on 'household' income alone. The post to which I replied noted "regional differences" and insurance, by its very nature, should be based on actuarial risk. The more that one tries to make income more important than actuarial risk then the less like insurance and the more like simple income redistribution that the UHC scheme becomes.

Folks all need "access to" food, clothing, shelter, medical care, transportation and utilities but once you have decided that should be 'equal to all' and not based on ability to pay (from personal income) you have created an odd system where "from each according to their ability (to pay more taxes?), to each according to their need (for more public subsidies?)" is the new law of the land.

What we have now is a collection of systems where folks are treated differently based on their group identity: the elderly/disabled get Medicare, the veterans get VA care, the very poor get Medicaid, the sort of poor (not quite rich enough?) get expanded Medicaid/PPACA subsidies and most either get (tax free?) employer based subsidies or self pay for medical insurance/care. That leaves out the EMTALA 'deal' where even illegal immigrants are 'covered' at public expense. Private charity care is also in the mix somewhere but is far from reliable.

 

[manofknowledge]

The problem is that any one size fits all solution is not optimal - certainly not having insurance premiums (converted to taxes?) based on 'household' income alone. The post to which I replied noted "regional differences" and insurance, by its very nature, should be based on actuarial risk. The more that one tries to make income more important than actuarial risk then the less like insurance and the more like simple income redistribution that the UHC scheme becomes.

Folks all need "access to" food, clothing, shelter, medical care, transportation and utilities but once you have decided that should be 'equal to all' and not based on ability to pay (from personal income) you have created an odd system where "from each according to their ability (to pay more taxes?), to each according to their need (for more public subsidies?)" is the new law of the land.

What we have now is a collection of systems where folks are treated differently based on their group identity: the elderly/disabled get Medicare, the veterans get VA care, the very poor get Medicaid, the sort of poor (not quite rich enough?) get expanded Medicaid/PPACA subsidies and most either get (tax free?) employer based subsidies or self pay for medical insurance/care. That leaves out the EMTALA 'deal' where even illegal immigrants are 'covered' at public expense. Private charity care is also in the mix somewhere but is far from reliable.

Actuarial risk is a function of the size of the risk pool. Individual risk is irrelevant when the risk pool is large enough. The ACA is not based on income, it is based on overall cost of care in a region which varies by region. Only assistance is based on income. The ACA primarily addressed accessiblilty through insurance because it was politically expedient. The ACA contains much more that people are not even aware of but should improve the overall health care system.

My contention is that health care development and delivery is infrastructure and the proper realm of government. Government is the way we do communally what the private enterprise cannot or will not do. We have a graduated revenue collection system already. Medicare is funded from an income tax (FICA). We award goverment regulated monopolies to provide electricity. We fund roads and highways through a fuel tax. We fund public education communally. Pure capitalism is law of the jungle. The strong eat the weak then they eat each other. The most effective government is one with a mixture of capital enterprise and communal enterprise to enhance the quality of life of a whole community. Walled enclaves of wealth surrounded by fetid slums are not conducive to quality of life.

Thinking of health care cost only at the point of delivery (as insurance does) is both short sighted and guarantees failure. Almost all medical schools in this country are either at public institutions or government subsidized. All hospitals are either built and run by local government agencies or heavily dependent on government to pay for services rendered. Most would go out of business if that revenue source was removed. Emergency services are either local government agencies or heavily subsidized by government. Everyone over 65 has single payer health care available for a reason. They are the worst actuarial risk of any demographic. Federal agencies manage pharmacological commerce for a reason. The CDC protects the country from mass infectious disease outbreaks. Most basic research in medicine is government subsidized.

Do you have a better solution other than don't get sick or injured unless you're rich? Do we do credit checks before we aid a person in medical distress. Let people die on street corners and clean them up like road kill? Kick them out of emergency rooms if they cannot demonstrate ability to pay?

Either we organize a system that is comprehensive, equitable and accessible or you wind up with no effective modern health care and go back to only having the skill of a local doctor to rely on who may or may not be qualified and may or may not be close by. Who does not have a surgical theater, an intensive care unit, radiology equipment or an emergency room. Even the wealthy would suffer under this arrangement.

 

[MAGAnificent]

You seem quite invested in denying the obvious. And the inevitable.

It's you that's ignoring the obvious. Your party won the House only and it was not due to anything more then a new president traditionally loses seats in his first midterm. Any healthcare driven blue wave, your party would have likely taken the Senate as well. Or do you think ACA fans only vote in House races?

 

[MAGAnificent]

Which:
a) gives any politician more credit than he deserves. Show me a President that could have strategized his way into what you are suggesting Obama strategized into and THAT is the guy I would drop the term limits rule for and elect to perpetuity, not the Bozo in the WH today.
b) It completely ignores the fact that our Healthcare Delivery System based on private company healthcare insurance was entirely and utterly broken before the ACA.

Under the ACA it is considerably more broken. and it is still based on private company healthcare insurance, only with insanely stupid regulations and mandates added.

The centerpiece of private healthcare insurance is employer participation for one thing and that was predicated on good employees remaining in their jobs a far longer than they have in the 21st century compared to the 20th. That is gone, died with my generation of workers. People have to be transient to be able to stay employed for a career. They not only have to change employer, they often have to pull up stakes and move themselves bag and baggage. So beyond the fact that the Healthcare Delivery System with its dependence on Private Healthcare Insurance companies was broken to pieces on its own merits, societal changes, employers depending on contract labor being another of them have simply unmasked the failings and the cost of the system greatly dependent on for profit, private healthcare insurance companies. Companies go out of their way to satisfy their labor requirements without offering benefits.

Point is that the ACA doubled down on stupid by making it an absolutely requirement that employers offer health insurance. I have no problem with employers offering health insurance, however it should have remained 100% voluntary. Employer provided health insurance started out as simply a means of employers competing for good job prospects.

Frankly, the simple truth of it is that its the Healthcare Delivery System itself that reaps most of the benefits of for profit, private healthcare insurance companies, not individual recipients of Healthcare Services. So we get to pay the bill, the Delivery System gets the benefit. Nice work for the Healthcare Delivery System if you can pull the wool over enough people's eyes. Private Company Healthcare Insurance is an entity without a benefit to those that foot the bill, us. That is the case for all Protection based insurance which is a scam. Just ask organized crime which has a racket called the Protections Racket.

As for healthcare cost, the for profit private healthcare insurance industry drives cost ...OBVIOUSLY, because it fits their business models. So we have a component of the US Healthcare Delivery System that does not really provide a benefit to people footing the bill, us that also has a vested profit motive in driving up cost. Insurance business is based on actuarial tables. They are the cornerstone of the Insurance Business which is fine in the environment they were designed for, Liability Based Coverage. Turn them loose in a protection based environment and you are walking around with a big sign around your neck that reads "SUCKER".

Oh my! Are you against capitalism and free enterprise for all forms of commerce? Or just health insurance? Why are you so against insurance providers making a profit? They are providing a service. If healthcare services and risk of the need for greater need for healthcare services was not costly, there would be no market for health insurance.

All protection based Insurance is a racket because the policy holder whether he knows it or not is convinced that he can beat the house, that he will beat the insurer's actuarial tables. It is a racket because it does not include the value inherent to Liability Based Coverage, like Property Insurance or Life Insurance or Auto Insurance.

Actually the real racket is the ACA and those big bad insurance providers that you are so against are in on it. The ACA with it's mandates at least until the repeal of the individual mandate created a captive customer base for those insurance providers. No more need to seriously compete for customers.

 

[MAGAnificent]

What clause? No such clause exists in the law.

I did not say such a clause exists in the law now. It was included in the original framework of the bill.



No court has ruled about single payer and single payer is not in the ACA. The fact is, we already have single payer for everyone over 65 years of age.

And how is that single payer Medicare working out? Medicare is not worth a crap unless you sign up for a supplemental or Advantage plan with a private insurer.

The ACA is quite affordable for people whose family income qualifies for subsidies. The number of people insured is way higher than it used to be. Medicaid should have been expanded in all states. Instead half the states refused to expand as a stunt even though their citizens still had to pay for the expansion through their Federal taxes.

It's affordable to a relatively few who qualify for those subsidies, however even then, most cannot afford the deductibles. As for exapnding Medicaid, why should states go along with a policy they and the majority of their citizens do not support? As the SCOTUS ruled, mandating them to was unconstitutional.

Much of the increased cost of health insurance is because of the Republican campaign against the ACA which was packed with false representations and hyperbole. Not enough people participated and Medicaid was not implemented as designed. The destruction of the Mandate without implementing an alternative, forced insurance companies to raise rates to continue covering pre-existing conditions. Health insurance is based on the risk pool it covers. If your family is the risk pool then you will never get affordable insurance if someone in the family has a chronic or expesive medical issue. You used to have to take a physical to get health insurance. Of course health insurance is less expensive if it only covers healthy people, has a maximum payout, benefits from denying claims, excludes coverage for expensive health problems, and includes trash policies like mini-med plans. The ACA ended all of that.

Now health insurance is not based on the health of anyone, it's guaranteed to all at the same rates. It's based on the overall cost of care in a geographical region, your age and whether or not you smoke. Plenty of people get health insurance through the exchanges and insurance companies now have more actuarial data regarding the cost of that risk group, so competition is beginning to kick in regarding consumer costs of insurance.

That is a load of half truths and utter nonsense. Blaming the increased rise in cost of health insurance on republican opposition is in itself partisan hyperbole. The ACA has failed to bring down healthcare due to it's two worst faults. One is it's insanely stupid one size fits all approach to health insurance. It mandates that everyone buy a given amount of coverage whether they need all of that coverage or not. It does not allow individual tailoring to individual need. Providers are not going to give away all that coverage. They are going to find one way or another to charge for it. The second worst fault is the individual mandate(fortunately now repealed) and the employer mandate. With such a captive customer base, and the government subsidizing the providers, what motive is there for competition?

Republicans have no alternative plan. Going back to pre-ACA conditions is already politically unpopular and will never happen. The only way forward is either to support the ACA with sensible modifications or go to single payer.

I'll give you partial credit on that one. The establishment republicans never were concerned about repealing the ACA. They campaigned on repealing it during the Obama Administration, and even voted on it once, knowing he would repeal it. They never thought they would gain the White House under a republican President any time soon with the will to repeal it. So when the time came and their bluff was called, you are right...they did not not have an alternative plan ready to go as they should have. They did however come up with and vote on a partial repeal, which was tanked by that turd Senator John McCain. Before the ACA, healthcare reform was in fact needed, however the so-called ACA is not the answer. It was sold as a bill to make health insurance affordable to all....not just those who qualified for expanded Medicaid. The ACA is tenfold worse then what we had before the ACA.

 

[AGENT J]

What clause? No such clause exists in the law.



No court has ruled about single payer and single payer is not in the ACA. The fact is, we already have single payer for everyone over 65 years of age.



The ACA is quite affordable for people whose family income qualifies for subsidies. The number of people insured is way higher than it used to be. Medicaid should have been expanded in all states. Instead half the states refused to expand as a stunt even though their citizens still had to pay for the expansion through their Federal taxes.



Much of the increased cost of health insurance is because of the Republican campaign against the ACA which was packed with false representations and hyperbole. Not enough people participated and Medicaid was not implemented as designed. The destruction of the Mandate without implementing an alternative, forced insurance companies to raise rates to continue covering pre-existing conditions. Health insurance is based on the risk pool it covers. If your family is the risk pool then you will never get affordable insurance if someone in the family has a chronic or expesive medical issue. You used to have to take a physical to get health insurance. Of course health insurance is less expensive if it only covers healthy people, has a maximum payout, benefits from denying claims, excludes coverage for expensive health problems, and includes trash policies like mini-med plans. The ACA ended all of that.

Now health insurance is not based on the health of anyone, it's guaranteed to all at the same rates. It's based on the overall cost of care in a geographical region, your age and whether or not you smoke. Plenty of people get health insurance through the exchanges and insurance companies now have more actuarial data regarding the cost of that risk group, so competition is beginning to kick in regarding consumer costs of insurance.

Republicans have no alternative plan. Going back to pre-ACA conditions is already politically unpopular and will never happen. The only way forward is either to support the ACA with sensible modifications or go to single payer.

This nails it pretty perfectly

Fact is things are substantially BETTER overall with ACA but healthcare still needs fixed and improved. Its actually amazing the success it has had with the opposition it received at many turns and the ability of insurance companies to find loops holes etc because of that opposition. Its actually sad that SOME people think its bad and opposed it at the expense of the american people.

Also you are correct the only way forward is more improvement and fix broken parts. Going back to a worse system is a given loss. ACA is saving my moms life currently and benefited many other people i know. It damn sure aint perfect but its definitely better and we need to keep moving forward with improvements.

 

[manofknowledge]

I did not say such a clause exists in the law now. It was included in the original framework of the bill.

A public option was debated as the law was developed in lieu of a minimum coverage requirement but ultimatley rejected. It's not relevant to the law on the books.

And how is that single payer Medicare working out? Medicare is not worth a crap unless you sign up for a supplemental or Advantage plan with a private insurer.

People love Medicare. It covers 72% of all claims. That is equivalent to a Silver plan on the exchanges. Supplemental plans are popular because they are a good deal. Medicare covers all of the high dollar claims and so they are reasonably priced. It only shows insurance companies will still have plenty of business if Medicare were expanded to all ages.

It's affordable to a relatively few who qualify for those subsidies, however even then, most cannot afford the deductibles. As for exapnding Medicaid, why should states go along with a policy they and the majority of their citizens do not support? As the SCOTUS ruled, mandating them to was unconstitutional.

2.9 million non-elderly citizens do not qualify for health insurance subsidies due to income. 7.8 million qualify for tax credits. There is always a trade off between deductibles and premium costs. Preventive care is not applied to deductibles. So people who are healthy can get check ups and basic primary care at very low cost and should opt for a low premium high deductible plan. People who are on maintenance medication or have chronic conditions should opt to pay higher premiums to avoid the high deductile. All plans have a maximum out of pocket of about $12,000 for a family, $6000 for an individual. That is far better than paying full price at a hospital for an emergency stay due to accident or injury.

https://www.kff.org/uninsured/issue...for-aca-coverage-among-the-uninsured-in-2016/

The ACA has failed to bring down healthcare due to it's two worst faults. It mandates that everyone buy a given amount of coverage whether they need all of that coverage or not. It does not allow individual tailoring to individual need. The second worst fault is the individual mandate(fortunately now repealed) and the employer mandate. With such a captive customer base, and the government subsidizing the providers, what motive is there for competition?.

ACA health insurance is not one size fits all. There are four standard coverage levels. Among the levels premiums, deductibles, copays, coinsurance varies from plan to plan. All of them cover the same services so it is easy to compare prices. You just go online and look up the plans that interest you and choose one. Acceptance is guaranteed. Before the ACA individual and family plans were based on the health of the individuals covered. Coverage was not guaranteed but contingent on good health. If you want everyone to have access to insurance it must be a group plan where low cost participants offset the cost of people who need a lot of services. If the risk pool is large, the health of the group is not even significant. That is why employer group plans for large companies have always covered pre-existing conditions at no extra charge. There has never been more competion for health insurers than on an exchange. Their prices are published right online for everyone to see. The minimum coverage requirement is necessary for guaranteed issue. There are other ways to get there such as a public option. If the price of insurance is to come down some way to address guaranteed issue will be needed unless it turns out that so many people sign up it becomes a non-issue.

So when the time came and their bluff was called, you are right...they did not not have an alternative plan ready to go as they should have. Before the ACA, healthcare reform was in fact needed, however the so-called ACA is not the answer. It was sold as a bill to make health insurance affordable to all....not just those who qualified for expanded Medicaid. The ACA is tenfold worse then what we had before the ACA.

States that did not expand Medicaid did so out of ideology not practicality. The cost to the state is minimal. They failed to tell their constituents that they will still pay for it through there Federal taxes whether they get the benefit or not and meanwhile thousands of citizens are denied health insurance they should have qualified for at no cost to them. The fact that the Republicans don't have viable alternative plan only shows it is a difficult issue politically and the only real way forward is to improve what is already started.