Senate votes down broad Obamacare repeal

[Oreo]

WASHINGTON — The Senate voted narrowly on Tuesday to begin debate on a bill to repeal major provisions of the Affordable Care Act, but hours later, Republican leaders suffered a setback when their most comprehensive plan to replace President Barack Obama’s health law fell far short of the votes it needed.

The Tuesday night tally needed to reach 60 votes to overcome a parliamentary objection. Instead, it fell 43-57. The fact that the comprehensive replacement plan came up well short of even 50 votes was an ominous sign for Republican leaders still seeking a formula to pass final health care legislation this week.

For Republicans, the failure ended the day on a sour note, hours after a more triumphant scene on the Senate floor. Lawmakers from both parties had risen to their feet in the afternoon and applauded when Senator John McCain, Republican of Arizona, showed up in the chamber despite his diagnosis of brain cancer. He cast a crucial vote in favor of opening what promises to be a freewheeling, hard-fought debate over the future of the Affordable Care Act.

The 51-50 vote to start debate, with Vice President Mike Pence breaking a tie, came only a week after the Republican effort to dismantle a pillar of Mr. Obama’s legacy appeared all but doomed. It provided an initial win for President Trump, who pushed, cajoled and threatened senators in recent days to at least begin debating the repeal of the health care law.

But the victory could be fleeting: Senate Republicans still have no agreement on a repeal bill that they can ultimately pass to uproot the law that has provided health insurance to millions of Americans.

https://www.nytimes.com/2017/07/25/us/politics/senate-health-care.html

As John Boehner stated in February--all the repeal/replace rhetoric was nothing more than wildly optimitic happy talk for the campaign season. Citing that Republicans never agree on health care, and stating that eventually they'll work with Democrats to fix what needs to be fixed with Obamacare.
Report: John Boehner says Obamacare won't be repealed and replaced - CBS News

They can start with the cost of Prescription Drugs. There is no excuse that we are paying 4 to 6 times higher for the same pill as Europe and Canada are. This skyrockets premiums, puts huge deficits into Medicare and Medicade programs. And the only thing they have done to address it, is cut benefits. It's time to take on big PHARMA.
https://www.fool.com/investing/gene...-your-prescription-drug-prices-are-so-pa.aspx
6 reasons for expensive prescription drugs - Business Insider
Why Prescription Drugs Cost So Much - AARP

 

[Chomsky]

In order to score political points, they'll pass some piece of crap if the keep banging on it. But it will be ObamaCare Worse, having the worst of all it's qualities, and it sucks pretty bad now.

What a freakin' mess this all is!

 

[Helix]

Assuming that they eventually succeed in passing a repeal, senators and representatives should have to be covered by whatever the replacement plan is. They shouldn't be able to vote in ****ty, bare bones coverage and then still get to keep their cushy plans.

 

[OpportunityCost]

In order to score political points, they'll pass some piece of crap if the keep banging on it. But it will be ObamaCare Worse, having the worst of all it's qualities, and it sucks pretty bad now.

What a freakin' mess this all is!

Almost like it would have been better to expand Medicare slightly and pass minimal taxes to the healthcare industry to pay for it, eh? Not passing some bill that wreaked havoc on 15% plus of the economy...

 

[joG]

In order to score political points, they'll pass some piece of crap if the keep banging on it. But it will be ObamaCare Worse, having the worst of all it's qualities, and it sucks pretty bad now.

What a freakin' mess this all is!

The fool should have known that to shift a proportionately so large chunk of the economy and reorganize such a fundamental societal function as the supply of health care so drastically in one large and incomprehensible tomb of a law you cannot build on a partisan vote. Of course, the impression in the minds of liberals was that one does not need to take the high road, having gone the lower one on abortion or gay marriage, where one had survived the blow back until now. So the idiot hubris is in some pathetic way understandable. But excusable it is not.

 

[joG]

Almost like it would have been better to expand Medicare slightly and pass minimal taxes to the healthcare industry to pay for it, eh? Not passing some bill that wreaked havoc on 15% plus of the economy...

When ACA was passed, I read the tomb. It was quickly evident that the thing was unspeakable as a tool to change over 15% of the economy and a central function of society. Besides the loss in growth and jobs it would cost, it was obvious that those hurt by the shift would organize and work to revoke it and that revocation would again seem to hurt people. That was part of the package that Obama wrapped, when he disregarded bipartisanship and in spite of the difficulties of such a monumental law and stood it on one wobbly partisan leg. I could hardly believe the naive hubris.

 

[OpportunityCost]

Assuming that they eventually succeed in passing a repeal, senators and representatives should have to be covered by whatever the replacement plan is. They shouldn't be able to vote in ****ty, bare bones coverage and then still get to keep their cushy plans.

You mean like they AREN'T now?

 

[Mycroft]

The Congressional dog and pony show continues...and nothing gets done.

 

[JasperL]

Almost like it would have been better to expand Medicare slightly and pass minimal taxes to the healthcare industry to pay for it, eh? Not passing some bill that wreaked havoc on 15% plus of the economy...

If you mean Medicaid and not Medicare, that would be fine, but it wouldn't have solved most of the problems with healthcare, with the biggest problems if you'd been seriously ill, pre-ACA you couldn't get insurance, and lots of working people above the Medicaid limits still couldn't afford insurance.

The GOP can obviously repeal the ACA and then put in the kind of replacement you're talking about, and it sounds easy, but we've been pointing out for years now that "healthcare is complicated" and there just aren't any easy fixes that do a damn thing. The CBO tells us the effects of these 'simple' solutions, which would be generally 20 million+ fewer without health insurance, and in many cases much HIGHER premiums.

 

[fmw]

In order to score political points, they'll pass some piece of crap if the keep banging on it. But it will be ObamaCare Worse, having the worst of all it's qualities, and it sucks pretty bad now.

What a freakin' mess this all is!

Indeed. The fix is simple to understand but impossible to implement. The swamp wins again.

 

[JasperL]

When ACA was passed, I read the tomb. It was quickly evident that the thing was unspeakable as a tool to change over 15% of the economy and a central function of society. Besides the loss in growth and jobs it would cost, it was obvious that those hurt by the shift would organize and work to revoke it and that revocation would again seem to hurt people. That was part of the package that Obama wrapped, when he disregarded bipartisanship and in spite of the difficulties of such a monumental law and stood it on one wobbly partisan leg. I could hardly believe the naive hubris.

Got any evidence for your predictions, such as the loss of growth and jobs it would cost? Or how about the number helped versus hurt by the changes? Any change in the status quo will have winners and losers, but pointing out that there would be losers doesn't indicate an organizing force to get a law repealed.

And as to bipartisanship, in your view, what kind of changes to the ACA would have brought GOP members on board? What those of us in the reality based world at the time recall is the more moderate GOP members proposed lots of amendments and changes to ACA, but would never agree to a yes vote in exchange for those changes. And it's kind of hard to compromise with the GOP when they say, effectively, you can give me what I want and I'll still vote HELL NO.

 

[calamity]

When ACA was passed, I read the tomb. It was quickly evident that the thing was unspeakable as a tool to change over 15% of the economy and a central function of society. Besides the loss in growth and jobs it would cost, it was obvious that those hurt by the shift would organize and work to revoke it and that revocation would again seem to hurt people. That was part of the package that Obama wrapped, when he disregarded bipartisanship and in spite of the difficulties of such a monumental law and stood it on one wobbly partisan leg. I could hardly believe the naive hubris.

ACA actually spurred growth.

To match the increased spending, the healthcare sector's labor market has also been booming.

"Employment data also corroborates this: as shown in chart 3, the healthcare sector produced about 240,000 jobs per year between 2010 and mid-2014," said the note. "Since then, it has averaged at 354,000/year and the sector is currently producing about 500,000 jobs annualized."

Obamacare good for the economy - Business Insider

Where the hell do you get your misinformation? I want to be sure I avoid it.

 

[calamity]

Got any evidence for your predictions, such as the loss of growth and jobs it would cost? Or how about the number helped versus hurt by the changes? Any change in the status quo will have winners and losers, but pointing out that there would be losers doesn't indicate an organizing force to get a law repealed.

And as to bipartisanship, in your view, what kind of changes to the ACA would have brought GOP members on board? What those of us in the reality based world at the time recall is the more moderate GOP members proposed lots of amendments and changes to ACA, but would never agree to a yes vote in exchange for those changes. And it's kind of hard to compromise with the GOP when they say, effectively, you can give me what I want and I'll still vote HELL NO.

Of course not. His argument is pure crap. As we see in my post 12 above. He is actually 180 degrees out of synch with reality. Not that this should surprise us.

 

[JasperL]

The fool should have known that to shift a proportionately so large chunk of the economy and reorganize such a fundamental societal function as the supply of health care so drastically in one large and incomprehensible tomb of a law you cannot build on a partisan vote. Of course, the impression in the minds of liberals was that one does not need to take the high road, having gone the lower one on abortion or gay marriage, where one had survived the blow back until now. So the idiot hubris is in some pathetic way understandable. But excusable it is not.

Most of health care was unaffected or only marginally affected by the ACA. The Medicare changes were not noticeable to the vast majority of seniors. The employer market was also largely unaffected, at least the large employer market which is where the vast majority get their coverage. The big changes were to the then non-functional individual market.

And the GOP is seeing right now that it's actually very hard to do little things to healthcare and accomplish anything worthwhile. The best of the GOP plans will increase the number of uninsured by 20 million+, and if you start dismantling the mandates and subsidies and the rest of the stuff ACA did in the individual market, premiums are predicted to go UP in that market, not down, and to leave millions who aren't covered at work without insurance.

So you talk about hubris, etc. but what all of us who support keeping the basic structure of ACA are waiting on is any viable alternative that does a damn thing. Appears to me all anyone opposed to ACA can do is to throw insults to Obama, and whine about how awful the ACA is, but that's the easy part - "You did it WRONG!!!" OK, and.... What's hard is figuring out something better, and on that score the whiners come up completely empty. Gets tiring after a while.

 

[OpportunityCost]

If you mean Medicaid and not Medicare, that would be fine, but it wouldn't have solved most of the problems with healthcare, with the biggest problems if you'd been seriously ill, pre-ACA you couldn't get insurance, and lots of working people above the Medicaid limits still couldn't afford insurance.

The GOP can obviously repeal the ACA and then put in the kind of replacement you're talking about, and it sounds easy, but we've been pointing out for years now that "healthcare is complicated" and there just aren't any easy fixes that do a damn thing. The CBO tells us the effects of these 'simple' solutions, which would be generally 20 million+ fewer without health insurance, and in many cases much HIGHER premiums.

That would be why you fix the problems piecemeal and not attempt to re-engineer the entire industry. The CBO also says nothing about those people getting insurance of some sort, merely that they would be uninsured. You seem to gloss over the fact that the ACA eliminated a lot of choices in the healthcare market as well. Restoring some of those may be a good thing.

 

[JasperL]

That would be why you fix the problems piecemeal and not attempt to re-engineer the entire industry.

You're just repeating YEARS of right wing talking points. You can't fix 'the problems' piecemeal in any satisfactory way. I gave you two big problems - affordability for working people without coverage at work. What "piecemeal" change solves that? How about pre-existing conditions? Please tell us how to address that in a stand alone piece of legislation. Etc.

And ACA didn't re-engineer the entire industry. It re-engineered the individual (non-employer) market, which is where about 7% of the population get their insurance.

The CBO also says nothing about those people getting insurance of some sort, merely that they would be uninsured. You seem to gloss over the fact that the ACA eliminated a lot of choices in the healthcare market as well. Restoring some of those may be a good thing.

Yes, the ACA eliminated a lot of choices, but it did so as part of an effort (mostly) to solve the problem of pre-existing conditions. This isn't the place to go into the details, but the problem the right wing never recognizes is the pieces have to fit, and they each have a purpose. The mandate is hated, but if you don't have a mandate and you don't have minimum coverage, then the pre-existing condition solutions don't work.

 

[jaeger19]

Most of health care was unaffected or only marginally affected by the ACA. The Medicare changes were not noticeable to the vast majority of seniors. The employer market was also largely unaffected, at least the large employer market which is where the vast majority get their coverage. The big changes were to the then non-functional individual market.

And the GOP is seeing right now that it's actually very hard to do little things to healthcare and accomplish anything worthwhile. The best of the GOP plans will increase the number of uninsured by 20 million+, and if you start dismantling the mandates and subsidies and the rest of the stuff ACA did in the individual market, premiums are predicted to go UP in that market, not down, and to leave millions who aren't covered at work without insurance.

So you talk about hubris, etc. but what all of us who support keeping the basic structure of ACA are waiting on is any viable alternative that does a damn thing. Appears to me all anyone opposed to ACA can do is to throw insults to Obama, and whine about how awful the ACA is, but that's the easy part - "You did it WRONG!!!" OK, and.... What's hard is figuring out something better, and on that score the whiners come up completely empty. Gets tiring after a while.

Yeah... you might want to rethink the "most of healthcare was unaffected by the ACA"... it has a large and sweeping effect on healthcare.. from reimbursement, to medicare, Medicaid, to physician recruitment etc.

 

[JasperL]

Yeah... you might want to rethink the "most of healthcare was unaffected by the ACA"... it has a large and sweeping effect on healthcare.. from reimbursement, to medicare, Medicaid, to physician recruitment etc.

I don't want to get into an argument about the details - I'll concede that "unaffected" was way too strong a word, I'm aware that the changes were significant, but one problem or virtue of the ACA was it left the big pieces mostly intact - the employer market, Medicare, and Medicaid. The individual market was completely upended but that's 7% of the insured.

 

[faithful_servant]

Assuming that they eventually succeed in passing a repeal, senators and representatives should have to be covered by whatever the replacement plan is. They shouldn't be able to vote in ****ty, bare bones coverage and then still get to keep their cushy plans.

Every time I hear this stuff, I just shake my head... Doing so would cause ZERO change in their healthcare, since Congresscritters get paid enough to buy top level insurance or just pay for their medical expenses out of pocket. Doing as you suggest wouldn't force Congresscritters into bare bones coverage, it would only force them to pay out a little extra money that they can easily afford.

 

[<alt>doxygen]

https://www.nytimes.com/2017/07/25/us/politics/senate-health-care.html

As John Boehner stated in February--all the repeal/replace rhetoric was nothing more than wildly optimitic happy talk for the campaign season. Citing that Republicans never agree on health care, and stating that eventually they'll work with Democrats to fix what needs to be fixed with Obamacare.
Report: John Boehner says Obamacare won't be repealed and replaced - CBS News

They can start with the cost of Prescription Drugs. There is no excuse that we are paying 4 to 6 times higher for the same pill as Europe and Canada are. This skyrockets premiums, puts huge deficits into Medicare and Medicade programs. And the only thing they have done to address it, is cut benefits. It's time to take on big PHARMA.
https://www.fool.com/investing/gene...-your-prescription-drug-prices-are-so-pa.aspx
6 reasons for expensive prescription drugs - Business Insider
Why Prescription Drugs Cost So Much - AARP

Accurate, except the part where you wrote that the GOP will work with the dems to make things better.

IMO, they want to go back to the prior status quo, just with a lot less regulation. They think healthcare is a product, and people with means can negotiate prices with the holders of products. If you have no means or no product, they're (not really) sorry.:2wave:

 

[JasperL]

Every time I hear this stuff, I just shake my head... Doing so would cause ZERO change in their healthcare, since Congresscritters get paid enough to buy top level insurance or just pay for their medical expenses out of pocket. Doing as you suggest wouldn't force Congresscritters into bare bones coverage, it would only force them to pay out a little extra money that they can easily afford.

That could be true, but the big issue is the coverage that Congress gets is also generally what their staff get, and lots of them work for very little. And if they or their spouse or family have a pre-existing condition, if they don't use the federal coverage, they're likely as SOL as the rest of us - can't get insurance at all, or at a price that's affordable even on their pay.

 

[joG]

Got any evidence for your predictions, such as the loss of growth and jobs it would cost? Or how about the number helped versus hurt by the changes? Any change in the status quo will have winners and losers, but pointing out that there would be losers doesn't indicate an organizing force to get a law repealed.

And as to bipartisanship, in your view, what kind of changes to the ACA would have brought GOP members on board? What those of us in the reality based world at the time recall is the more moderate GOP members proposed lots of amendments and changes to ACA, but would never agree to a yes vote in exchange for those changes. And it's kind of hard to compromise with the GOP when they say, effectively, you can give me what I want and I'll still vote HELL NO.

I read a lot of economic and financial stuff professionally and it is the general opinion. As it corresponds to what the theory says you should expect in the first years, I didn't double check it. But, if you have a empirical research study on the effect on GDP I would be interested. It would be extremely surprising if a change of such great size and incalculability did not have an initially negative impact. It is more surprising that we didn't go into recession than anything else. The positive impact would not be expected for many years.

A

 

[joG]

ACA actually spurred growth.




Where the hell do you get your misinformation? I want to be sure I avoid it.

Well, I wouldn't make the mistake of taking a sektoral set of numbers and mistaken them for the impact from such a massive change in the economy.

 

[joG]

Most of health care was unaffected or only marginally affected by the ACA. The Medicare changes were not noticeable to the vast majority of seniors. The employer market was also largely unaffected, at least the large employer market which is where the vast majority get their coverage. The big changes were to the then non-functional individual market.

And the GOP is seeing right now that it's actually very hard to do little things to healthcare and accomplish anything worthwhile. The best of the GOP plans will increase the number of uninsured by 20 million+, and if you start dismantling the mandates and subsidies and the rest of the stuff ACA did in the individual market, premiums are predicted to go UP in that market, not down, and to leave millions who aren't covered at work without insurance.

So you talk about hubris, etc. but what all of us who support keeping the basic structure of ACA are waiting on is any viable alternative that does a damn thing. Appears to me all anyone opposed to ACA can do is to throw insults to Obama, and whine about how awful the ACA is, but that's the easy part - "You did it WRONG!!!" OK, and.... What's hard is figuring out something better, and on that score the whiners come up completely empty. Gets tiring after a while.

Well, he obviously did it wrong by not putting it on bipartisan legs. Also the package was much too large and complicated. When you read it, you knew it was doomed to cause havoc. What is surprising is that we avoided a recession. But, of course, we have been running quite a double deficit, so that impact might just be delayed.

 

[JasperL]

I read a lot of economic and financial stuff professionally and it is the general opinion. As it corresponds to what the theory says you should expect in the first years, I didn't double check it. But, if you have a empirical research study on the effect on GDP I would be interested. It would be extremely surprising if a change of such great size and incalculability did not have an initially negative impact. It is more surprising that we didn't go into recession than anything else. The positive impact would not be expected for many years.

A simple "No, I have no evidence" would have been sufficient, and I'm not going to do the research to prove or disprove your assertion - that's your job if you are going to make a statement that the effect is so obvious that any fool would recognize it.

I don't believe the significant negative impact was that obvious, or that the effect, to the extent there was an impact, on growth or GDP is an appropriate measure, by itself, to judge the law. Medicare no doubt is a drag on GDP growth because it sucks up a lot of resources to care for unproductive old people. It's possible that letting them die early and saving the money would improve GDP growth, but that wouldn't make it good policy.

Just in general, taxes have a negative economic impact, so we weigh the negative with the positive, such as with Medicare and SS and disability and so on. ACA is no different - you can't claim "Jobs!!! Growth!!!" and end the analysis there. And you acknowledge that moving to UHC does have positive impacts. Reduces job lock for example. Allows people to retire early. If fully implemented, could encourage small business formation if they don't have to worry about their own or their employees' healthcare as a big item. Etc.