The American Health Care Reform Act - H.R. 3121

[cpwill]

For the next time someone claims Republicans have no replacement.

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Things I like about this plan:

- Equalizing the tax treatment between individuals and businesses for buying health insurance. It is long since time we de-linked health insurance from our jobs, and made it easier for people not to lose health insurance at the same time that they lose their employment.

- Tax Benefit of $7.5K for individuals and $20K for families, which counts against both income and payroll taxes and is refundable. This will help counteract the regressive nature of the payroll tax, support universal access to coverage for those that want it, represent a tax cut for the majority of working families, and seriously help our lower-income families' finances.

- Expanding Access to HSA's. Which will probably be a major destination for most of our lower-income folks' tax refunds from the credit. This will allow insurance to function as insurance, and utilize market incentives to bring down the cost of health care, in addition to the cost of health insurance.

- Breaking State Barriers and Applying Anti-Trust Law to Health Insurance Agencies. As President Obama highlighted, one (count em: one) health insurance agency basically owns the entire market in my home state of Alabama - because that insurance agency has purchased the state legislature. Alabama's citizens therefore have no escape, just as Blue Cross / Blue Shield has no competition, and therefore does not need to be responsive to us. Subsidized and bloated monopolies are bad business, and bad for consumers. This will additionally place market pressure on the health insurance agencies, and force them to innovate in finding new ways to serve you, the customer, or die.

- Caps on Attorney's Fees and Punitive Damages, but not Economic Damages. In reality, Texas' Tort reform missed the mark on this one - economic damages for serious malpractice can go way above the cap. Those who can demonstrate actual economic damage deserve to be compensated. But punitive damages and a system that provides only incentives for Tort Lawyers to convince as many people as they can to sue as much as they can only encourages massive amounts of defensive medicine, creating huge waste of scarce resources within our system, and driving up the cost for everyone. Capping two of the cost-drivers while keeping unlimited economic damages for victims is good policy.



Things I Don't like about this plan:

- The Pro Life Provisions. Just because a child's father was a thug, a criminal , a sadist, or a cousin doesn't mean the child deserves the death penalty. While I'm in favor of taking half a loaf of bread in the abortion debate when I can, this is an unnecessary compromise of the Hyde Amendment

- The Caps on the High Risk Pools. 200% of the average price is too high, assuming they mean 200% of your equivalent family size. This needs to explicitly be 200% of all sold plans (including the cheaper, individual ones), or be put at 100% of the Tax Credit.

- Failure to incorporate Medicaid. If we are going to give every individual $7,500 and every family $20,000, we should include the Medicaid enrollees, and take the savings from that and pour it into subsidizing the pre-existing condition, high-risk pools so that they can afford to lower the cap, as I suggested.




Anywho, take it apart, put it back together, see what you think.

 

[joG]

For the next time someone claims Republicans have no replacement.

Home Page

Two Page Summary



Things I like about this plan:

- Equalizing the tax treatment between individuals and businesses for buying health insurance. It is long since time we de-linked health insurance from our jobs, and made it easier for people not to lose health insurance at the same time that they lose their employment.

- Tax Benefit of $7.5K for individuals and $20K for families, which counts against both income and payroll taxes and is refundable. This will help counteract the regressive nature of the payroll tax, support universal access to coverage for those that want it, represent a tax cut for the majority of working families, and seriously help our lower-income families' finances.

- Expanding Access to HSA's. Which will probably be a major destination for most of our lower-income folks' tax refunds from the credit. This will allow insurance to function as insurance, and utilize market incentives to bring down the cost of health care, in addition to the cost of health insurance.

- Breaking State Barriers and Applying Anti-Trust Law to Health Insurance Agencies. As President Obama highlighted, one (count em: one) health insurance agency basically owns the entire market in my home state of Alabama - because that insurance agency has purchased the state legislature. Alabama's citizens therefore have no escape, just as Blue Cross / Blue Shield has no competition, and therefore does not need to be responsive to us. Subsidized and bloated monopolies are bad business, and bad for consumers. This will additionally place market pressure on the health insurance agencies, and force them to innovate in finding new ways to serve you, the customer, or die.

- Caps on Attorney's Fees and Punitive Damages, but not Economic Damages. In reality, Texas' Tort reform missed the mark on this one - economic damages for serious malpractice can go way above the cap. Those who can demonstrate actual economic damage deserve to be compensated. But punitive damages and a system that provides only incentives for Tort Lawyers to convince as many people as they can to sue as much as they can only encourages massive amounts of defensive medicine, creating huge waste of scarce resources within our system, and driving up the cost for everyone. Capping two of the cost-drivers while keeping unlimited economic damages for victims is good policy.



Things I Don't like about this plan:

- The Pro Life Provisions. Just because a child's father was a thug, a criminal , a sadist, or a cousin doesn't mean the child deserves the death penalty. While I'm in favor of taking half a loaf of bread in the abortion debate when I can, this is an unnecessary compromise of the Hyde Amendment

- The Caps on the High Risk Pools. 200% of the average price is too high, assuming they mean 200% of your equivalent family size. This needs to explicitly be 200% of all sold plans (including the cheaper, individual ones), or be put at 100% of the Tax Credit.

- Failure to incorporate Medicaid. If we are going to give every individual $7,500 and every family $20,000, we should include the Medicaid enrollees, and take the savings from that and pour it into subsidizing the pre-existing condition, high-risk pools so that they can afford to lower the cap, as I suggested.




Anywho, take it apart, put it back together, see what you think.

Thank you for the run down. I have not looked at the plan in detail, as it is simply too long and I have my own insurance and all.

One point I find especially interesting or maybe troubling is the handling of the Hyde Amendment. It seems to me that the government might have overstepped there and is certainly stretching the constitution. On the other hand it would be a sales point for an insurer that sells insurance that does not cover abortion. Would that be allowed under ACA, do you think?

 

[PirateMk1]

For the next time someone claims Republicans have no replacement.

Home Page

Two Page Summary



Things I like about this plan:

- Equalizing the tax treatment between individuals and businesses for buying health insurance. It is long since time we de-linked health insurance from our jobs, and made it easier for people not to lose health insurance at the same time that they lose their employment.

- Tax Benefit of $7.5K for individuals and $20K for families, which counts against both income and payroll taxes and is refundable. This will help counteract the regressive nature of the payroll tax, support universal access to coverage for those that want it, represent a tax cut for the majority of working families, and seriously help our lower-income families' finances.

- Expanding Access to HSA's. Which will probably be a major destination for most of our lower-income folks' tax refunds from the credit. This will allow insurance to function as insurance, and utilize market incentives to bring down the cost of health care, in addition to the cost of health insurance.

- Breaking State Barriers and Applying Anti-Trust Law to Health Insurance Agencies. As President Obama highlighted, one (count em: one) health insurance agency basically owns the entire market in my home state of Alabama - because that insurance agency has purchased the state legislature. Alabama's citizens therefore have no escape, just as Blue Cross / Blue Shield has no competition, and therefore does not need to be responsive to us. Subsidized and bloated monopolies are bad business, and bad for consumers. This will additionally place market pressure on the health insurance agencies, and force them to innovate in finding new ways to serve you, the customer, or die.

- Caps on Attorney's Fees and Punitive Damages, but not Economic Damages. In reality, Texas' Tort reform missed the mark on this one - economic damages for serious malpractice can go way above the cap. Those who can demonstrate actual economic damage deserve to be compensated. But punitive damages and a system that provides only incentives for Tort Lawyers to convince as many people as they can to sue as much as they can only encourages massive amounts of defensive medicine, creating huge waste of scarce resources within our system, and driving up the cost for everyone. Capping two of the cost-drivers while keeping unlimited economic damages for victims is good policy.



Things I Don't like about this plan:

- The Pro Life Provisions. Just because a child's father was a thug, a criminal , a sadist, or a cousin doesn't mean the child deserves the death penalty. While I'm in favor of taking half a loaf of bread in the abortion debate when I can, this is an unnecessary compromise of the Hyde Amendment

- The Caps on the High Risk Pools. 200% of the average price is too high, assuming they mean 200% of your equivalent family size. This needs to explicitly be 200% of all sold plans (including the cheaper, individual ones), or be put at 100% of the Tax Credit.

- Failure to incorporate Medicaid. If we are going to give every individual $7,500 and every family $20,000, we should include the Medicaid enrollees, and take the savings from that and pour it into subsidizing the pre-existing condition, high-risk pools so that they can afford to lower the cap, as I suggested.




Anywho, take it apart, put it back together, see what you think.

1) Dump the pro life provisions.
2) Dump the cap on punitive damages and keep the cap on attorney's fee's, and make ALL civil trial proof standards the same as the criminal standard, beyond reasonable doubt.
3) Dump the tax deduction of heath insurance or care for business. Get business completely back out of the health insurance provider roll unless they really want to pay the tax for some reason.
4.) Have a set of typical model plans that people can use to compare insurance with, but are NOT required to utilize if they don't fit their situation.

Those are three mods I can think of.

 

[trfjr]

For the next time someone claims Republicans have no replacement.

Home Page

Two Page Summary



Things I like about this plan:

- Equalizing the tax treatment between individuals and businesses for buying health insurance. It is long since time we de-linked health insurance from our jobs, and made it easier for people not to lose health insurance at the same time that they lose their employment.

- Tax Benefit of $7.5K for individuals and $20K for families, which counts against both income and payroll taxes and is refundable. This will help counteract the regressive nature of the payroll tax, support universal access to coverage for those that want it, represent a tax cut for the majority of working families, and seriously help our lower-income families' finances.

- Expanding Access to HSA's. Which will probably be a major destination for most of our lower-income folks' tax refunds from the credit. This will allow insurance to function as insurance, and utilize market incentives to bring down the cost of health care, in addition to the cost of health insurance.

- Breaking State Barriers and Applying Anti-Trust Law to Health Insurance Agencies. As President Obama highlighted, one (count em: one) health insurance agency basically owns the entire market in my home state of Alabama - because that insurance agency has purchased the state legislature. Alabama's citizens therefore have no escape, just as Blue Cross / Blue Shield has no competition, and therefore does not need to be responsive to us. Subsidized and bloated monopolies are bad business, and bad for consumers. This will additionally place market pressure on the health insurance agencies, and force them to innovate in finding new ways to serve you, the customer, or die.

- Caps on Attorney's Fees and Punitive Damages, but not Economic Damages. In reality, Texas' Tort reform missed the mark on this one - economic damages for serious malpractice can go way above the cap. Those who can demonstrate actual economic damage deserve to be compensated. But punitive damages and a system that provides only incentives for Tort Lawyers to convince as many people as they can to sue as much as they can only encourages massive amounts of defensive medicine, creating huge waste of scarce resources within our system, and driving up the cost for everyone. Capping two of the cost-drivers while keeping unlimited economic damages for victims is good policy.



Things I Don't like about this plan:

- The Pro Life Provisions. Just because a child's father was a thug, a criminal , a sadist, or a cousin doesn't mean the child deserves the death penalty. While I'm in favor of taking half a loaf of bread in the abortion debate when I can, this is an unnecessary compromise of the Hyde Amendment

- The Caps on the High Risk Pools. 200% of the average price is too high, assuming they mean 200% of your equivalent family size. This needs to explicitly be 200% of all sold plans (including the cheaper, individual ones), or be put at 100% of the Tax Credit.

- Failure to incorporate Medicaid. If we are going to give every individual $7,500 and every family $20,000, we should include the Medicaid enrollees, and take the savings from that and pour it into subsidizing the pre-existing condition, high-risk pools so that they can afford to lower the cap, as I suggested.




Anywho, take it apart, put it back together, see what you think.

but but but MSNBC told me they had no plan so all that you posted must be a lie

 

[274ina]

all only for poeple that are part of the fantasy economy.........

HSA?
tax credit?
Tax treatment?

bla bla bla gobble gook?

What poor person can know or use these things?

UHC. 3 letters. everything else is banned and eliminated.

 

[The Man]

How about people 18 and over, if they're offered insurance through their employer or their spouse's employer, cannot stay on their parents' insurance?

 

[specklebang]

How about a government funded insurance company that handles all the high risk low income stuff and let the rest of it alone.

Why must everything be for the lowest denominator.

As 247Ina points out, poor people are stupid, so a single insurance company would be easiest for them. Employers should be able to offer insurance to show that they are a good place to work.

 

[cpwill]

all only for poeple that are part of the fantasy economy.........

HSA?
tax credit?
Tax treatment?

bla bla bla gobble gook?

What poor person can know or use these things?

The ones in Indiana did just fine. Their public employees loved it, too. But your paternalistic assumption that poor people are too stupid to figure out how to take money out of an account and spend it on a doctor is noted.

UHC. 3 letters. everything else is banned and eliminated.

Yeah, they tried that in Canada. It got overturned by the Supreme Court, when it turned out that (shockingly) government provision of goods led to massive shortages, and people were being de facto denied care and dying en masse on waiting lists. "Access to a Waiting List is not Access to Health Care", I believe, is what they wrote in the decision.

 

[cpwill]

How about a government funded insurance company that handles all the high risk low income stuff and let the rest of it alone.

Why must everything be for the lowest denominator.

As 247Ina points out, poor people are stupid, so a single insurance company would be easiest for them. Employers should be able to offer insurance to show that they are a good place to work.

As this plan keeps Medicaid, we have the low income covered, and as it establishes high risk pools, it has that covered as well.

And employers have no more business buying my health insurance for me than they do buying my car or my house insurance for me.

 

[ttwtt78640]

How about a government funded insurance company that handles all the high risk low income stuff and let the rest of it alone.

Why must everything be for the lowest denominator.

As 247Ina points out, poor people are stupid, so a single insurance company would be easiest for them. Employers should be able to offer insurance to show that they are a good place to work.

We already have that - it is called Medicaid.

 

[specklebang]

We already have that - it is called Medicaid.

My ex got a raise in her SS to $970 last year or so and they kicked her out of Medicaid. It's not easy to get Medicaid. Its only for the ultra-poor but it doesn't help a full time worker who makes $10 an hour which doesn't provide a lot of spare money for medical.

If they expand Medicaid to $25K, then my idea will be invalidated but not as it stands now.

 

[274ina]

The ones in Indiana did just fine. Their public employees loved it, too. But your paternalistic assumption that poor people are too stupid to figure out how to take money out of an account and spend it on a doctor is noted.



Yeah, they tried that in Canada. It got overturned by the Supreme Court, when it turned out that (shockingly) government provision of goods led to massive shortages, and people were being de facto denied care and dying en masse on waiting lists. "Access to a Waiting List is not Access to Health Care", I believe, is what they wrote in the decision.

UHC is not Gov central planning or rationing goods. it is eliminating the CEO from rationing and setting goods.

OK so when I get a $450,000 bill. How is a HSA going to save me??????? Its just more complicated BS that only benifits the rich.

UHC.
All people
Salarys only
no profits no yachts no wall street

Fixed costs.

Simple.

 

[cpwill]

UHC is not Gov central planning or rationing goods. it is eliminating the CEO from rationing and setting goods.

:doh I think that may be the most desperately disconnected thing I think I have ever read on this forum. I don't even know how to respond to this except to point out that it in no way correlates with reality, or the experience of any government that has ever instituted UHC, ever.

OK so when I get a $450,000 bill. How is a HSA going to save me??

It's tied to a high-cap catastrophic coverage plan. So you will pay out your $8 grand or whatever from the fund, and then the remaining $442,000 get's covered by the insurance company.

Its just more complicated BS that only benifits the rich

Actually if you'll bother to read the links provided, you will find out that when they are an option, and people get to observe how they function, people flock to them and they are overwhelmingly popular.

UHC.
All people
Salarys only
no profits no yachts no wall street

All people can have access to waiting lists.
Massive outflow of doctors.
Reduced Medical Results.

Fixed costs.

Leads to reduced resources, the same as any other time government attempts to impose price controls.

Simple.

Universally the least simple, most complicated, and most expensive thing government does.

 

[274ina]

:doh I think that may be the most desperately disconnected thing I think I have ever read on this forum. I don't even know how to respond to this except to point out that it in no way correlates with reality, or the experience of any government that has ever instituted UHC, ever.



It's tied to a high-cap catastrophic coverage plan. So you will pay out your $8 grand or whatever from the fund, and then the remaining $442,000 get's covered by the insurance company.



Actually if you'll bother to read the links provided, you will find out that when they are an option, and people get to observe how they function, people flock to them and they are overwhelmingly popular.



All people can have access to waiting lists.
Massive outflow of doctors.
Reduced Medical Results.



Leads to reduced resources, the same as any other time government attempts to impose price controls.



Universally the least simple, most complicated, and most expensive thing government does.

you dont know how UHC works then. Leave USA, go live it for a while. They make decisions on MEDICAL NEED. Not "costs" that are imposed and artificial.

WOW! so whats the difference between a $8k We all cant pay and $450,000 we cant pay? OPPS, as I said. it only benefits the rich.

Whats wrong with waiting for things that are not medicly needed right now. (I know the rich cant stand waiting, but to bad- its just your ego, its not medical need.)

How is there reduced resoures with UHC and fixed salarys? See, you still cant grasp the concept of UHC. If the $150k Dr treats 1,000 year or 3,000 makes no difference to the
extra 500 in need. He just sees more people. And when his schedule is full, you hire another $150k Dr. Now you have even MORE capacity for only $150k in spending.
See in UHC there is no "price", so all your market jargon does not apply.

If its so bad then why does EVERY OTHER WESTERN NATION HAVE IT??????????????????

 

[cpwill]

you dont know how UHC works then. Leave USA, go live it for a while. They make decisions on MEDICAL NEED. Not "costs" that are imposed and artificial

Fail. I lived in Japan for three years. And cost absolutely comes into it, with every single UHC program out there - that's why each UHC also comes equipped with a rationing body.

WOW! so whats the difference between a $8k We all cant pay and $450,000 we cant pay? OPPS, as I said. it only benefits the rich.

That's the point of the HSA in the first place - it covers the $8K and then insurance covers the rest. Do you suffer from low reading comprehension, or was that really not clear to you?

Whats wrong with waiting for things that are not medicly needed right now.

What, like seeing a specialist or hip replacement surgery or chemotherapy? Nothing so long as you don't care about your quality or length of life.

How is there reduced resoures with UHC and fixed salarys

Because not only do you now get reduced numbers of providers, you have them less efficiently allocated.

See in UHC there is no "price", so all your market jargon does not apply.

Nothing is ever free, least of all when government is buying it.

 

[Threegoofs]

This isnt a real plan.

Its a plan to give every family 20k back in tax credits to apply to health care. Gee. I wonder what happens to the deficit when that happens? Isnt the whole concept of the GOP complaining about debt and deficits? Oh, thats right. They;ll just implement the Ryan budget and we will be eating melamine tainted dogfood in the future.

Selling insurance across state lines (thats what that 'antitrust' provision really means) means more crappy insurance sold that covers little but makes insurance companies lots of dough. Dont know how you are going to convince the states rights crowd that they are giving up their insurance regulation on the state level.

The high risk pool thing is also a bit silly, because a whole lot of really sick people end up losing their income, and then they still have to pay really high premiums. Then they cant do that, and either go bankrupt or get sicker from lack of care. Thats kinda the old system we used to have.

For a good critique from one of the better healthcare economists and doctors out there, go to:

The Republican Study Committee has a “replace” plan. | The Incidental Economist

 

[274ina]

Fail.


That's the point of the HSA in the first place - it covers the $8K and then insurance covers the rest. Do you suffer from low reading comprehension, or was that really not clear to you?



.

same old GOP talking points. Nothing about reality.

What? the HSA magicly gets $8k in it? or must you have a living wage job to save that amount first? DUUUU

GOP math in action! $8k or $450k makes no difference. only if you are rich enough to save $8 does it work!

 

[cpwill]

same old GOP talking points. Nothing about reality.

What? the HSA magicly gets $8k in it? or must you have a living wage job to save that amount first? DUUUU

:lol: do you even read what you are responding to?

The bill comes with a $20,000 refundable tax credit for families, or a $7,500 for individuals. Furthermore, HSA's are usually donated to (often matched) by employers (or, rather, were before we decided to start screwing over individuals in the health insurance market), and grow pre-tax and tax-free .

GOP math in action! $8k or $450k makes no difference. only if you are rich enough to save $8 does it work!

:shrug: I had a $10K emergency fund when my family rated food stamps. I have yet to see anyone successfully describe to me how that was impossible.

Seriously, if you find you cannot save more than $8, pm me. I help people with basic budgeting and whatnot on the side - that's serious, important, real life stuff. Even if I think you are mildly psychotic when it comes to health care policy, I would be more than happy to sit down and go over your numbers with you.

 

[Greenbeard]

For the next time someone claims Republicans have no replacement.

Home Page

Two Page Summary.

The first thing I'd note is that this isn't a replacement. Not in the sense that you could throw out the ACA, institute this, and address the same issues. The ACA is comprehensive health care reform--it does private insurance, yes, but it's also Medicare reform, Medicaid reform, reform of health care delivery to improve quality, it's public health and prevention, it's workforce development, and so on. There's a reason it's long: it simultaneously tackles a lot of the challenges our system is facing. This GOP bill appears to be purely insurance reform and fairly weak at that.

Some reactions:

Eliminating the tax preference for employer-sponsored insurance (and thus unraveling the employer-based system) is very good in principle. But the bill neglects to take the one absolutely essential step needed if that's going to work: create a functioning individual insurance market. That means an exchange. That means consumer protections and comprehensible, meaningful choice architecture that allows for easy comparison shopping. I don't know if the state "transparency portals" are meant to be code for stripped-down exchanges but I get the sense they don't have the functionality they would need. This is critical: you can't start nudging people out of the employer-based system until you give them a place to go.

High-risk pools are obviously not a new idea, states have had them under HIPAA, they've had them under the ACA. And they're simply not a good long-term solution. They're better than nothing but they're limited in how much they can achieve.

The wheels really come off the wagon when they go back to the old standby about "across state lines" insurance sales. First of all, this is a pretty transparent effort to strip consumer protections and use the power of the federal government to deregulate the states (I've always wondered why the Tenth Amendment crowd never seems to take umbrage with this). More importantly, it's just a mess of an idea that either 1) does nothing at all, 2) generates chaos in the marketplace with an incoherent and disastrous perversion of the idea of competition, or 3) ends up in the unfortunate "race to the bottom" that leaves the consumer out in the cold. As structured, it's just bad policy.

The medical liability stuff is another standby and it's an area that needs to be looked at, but there's plenty of reason to believe that their particular blunt approach (caps to noneconomic damages) won't do much to reduce the defensive medicine they're worried about. Some more innovative state-level experimentation is probably in line here. Particularly since, unlike with the across-state-lines stuff, federalizing tort law has run afoul of the states' righters and has led to rifts within the GOP.

Anyway, it's good that they're at least thinking about these issues but bills like this ignore huge pieces of the puzzle when it comes to fixing the deficiencies of the health care system and most of the solutions they offer aren't particularly likely to work as proposed. Points for effort.

 

[Greenbeard]

We already have that - it is called Medicaid.

Being low-income has historically been a necessary but not a sufficient condition to qualify for Medicaid. That will change next year in the Medicaid expansion states but in the pre-ACA world (and in the states that have declined to expand) there are plenty of poor people who aren't eligible for the program.

 

[ttwtt78640]

Being low-income has historically been a necessary but not a sufficient condition to qualify for Medicaid. That will change next year in the Medicaid expansion states but in the pre-ACA world (and in the states that have declined to expand) there are plenty of poor people who aren't eligible for the program.

Yep. I am one of them. Too poor for the PPACA exchange, yet not disabled or a "head of household" to qualify for Medicaid in Texas. Not to worry that will soon be outlawed - states will be forced to "play nice" or lose matching federal funds. The SCOTUS stopped the last attempt (included in PPACA), but that mandate (universal Medicaid) will happen soon. The rule of thumb, replacing the constitution, is that if something is "important" (popular?), like education, it is a federal power.

 

[Greenbeard]

Yep. I am one of them. Too poor for the PPACA exchange, yet not disabled or a "head of household" to qualify for Medicaid in Texas. Not to worry that will soon be outlawed - states will be forced to "play nice" or lose matching federal funds. The SCOTUS stopped the last attempt (included in PPACA), but that mandate (universal Medicaid) will happen soon. The rule of thumb, replacing the constitution, is that if something is "important" (popular?), like education, it is a federal power.

I agree most states will eventually expand but I don't think it'll be due to any kind of new coercion (SCOTUS pretty effectively slammed the door on that kind of mandatory expansion of what at its core is a voluntary program for states). The financial deal is just that good and it's that important for safety net providers and hospitals, not to mention poor people, that the pressure is there and it's not going to go away.

Not to mention that the administration has signaled that it's open to allowing GOP governors to use a combination of the Medicaid expansion and the new private insurance exchanges to privatize Medicaid even more than it already is (the so called "private option" for Medicaid expansion). It'll be interesting to watch it play out over the next few years.

 

[ttwtt78640]

I agree most states will eventually expand but I don't think it'll be due to any kind of new coercion (SCOTUS pretty effectively slammed the door on that kind of mandatory expansion of what at its core is a voluntary program for states). The financial deal is just that good and it's that important for safety net providers and hospitals, not to mention poor people, that the pressure is there and it's not going to go away.

Not to mention that the administration has signaled that it's open to allowing GOP governors to use a combination of the Medicaid expansion and the new private insurance exchanges to privatize Medicaid even more than it already is (the so called "private option" for Medicaid expansion). It'll be interesting to watch it play out over the next few years.

It is more efficient to simply let care providers continue to write off the expense of care provided to the poor than to fill out massive amounts of paperwork to get partial reimbursement from the gov't.

 

[cpwill]

This isnt a real plan.

Its a plan to give every family 20k back in tax credits to apply to health care. Gee. I wonder what happens to the deficit when that happens?

Equalizing the tax treatment between individuals and businesses to allow people to compete on an even field and not get stuck at crappy jobs because it comes with benefits covers this gap.

Selling insurance across state lines (thats what that 'antitrust' provision really means) means more crappy insurance sold that covers little but makes insurance companies lots of dough.

:lol: as opposed to the current structure, which involves selling crappy insurance at high prices ensuring that insurance companies make lots of dough.....?

The breaking down of the state border is what forces competition, breaking up the monopolies or near-monopolies that currently exist due to state government intervention on behalf of favored corporations.

Dont know how you are going to convince the states rights crowd that they are giving up their insurance regulation on the state level.

Appeal to their preference for capitalism over corporatism.

The high risk pool thing is also a bit silly, because a whole lot of really sick people end up losing their income, and then they still have to pay really high premiums.

If you lose your income, you qualify for a program called "Medicaid".

For a good critique from one of the better healthcare economists and doctors out there, go to:

The Republican Study Committee has a “replace” plan. | The Incidental Economist

Yeah, most of this critique has been raised and dealt with already in-thread.

 

[Greenbeard]

The breaking down of the state border is what forces competition, breaking up the monopolies or near-monopolies that currently exist due to state government intervention on behalf of favored corporations.

There's been no evidence of that in the states that have toyed with this approach.

But more importantly, how can you have competition when you have different "competitors" in a single marketplace operating under different sets of rules? There's nothing level about that playing field.

If you lose your income, you qualify for a program called "Medicaid".

No, not necessarily. See above in this thread.