Trump's Full Court Press on healthcare

[Jeff V]

If you look under the hood of what they passed they dropped preexisting conditions and covering contraceptives. A disaster for Healthcare looms and the media is too preoccupied to call it out. These guys are pure pond scum. I can only hope it comes around to bite the but i doubt it.

When you have Duterte pushing free contraceptives in the Phillipines while American politicians are taking them away from poor women that need them most - that's when you know that the world has gone completely insane.

Duterte is pro-Death and US is pro-Life.

Are you suggesting that contraception is equivalent to killing a "life"? i.e. that by not allowing the sperm and egg to hook up, it's the same as aborting a fetus? That may be the most extreme viewpoint I've ever encountered.

Well, that's the Catholic Church position on contraception, and the Philippines are the most Catholic country in Asia.

[raydude]

I don't think the Catholic Church ever said it was equivalent to killing. They say it's a sin but that's like taking Jesus' name in vain is a sin. Saying 'Holy Jesus!' is not the same as killing someone.

[Unagi]

If you look under the hood of what they passed they dropped preexisting conditions and covering contraceptives. A disaster for Healthcare looms and the media is too preoccupied to call it out. These guys are pure pond scum. I can only hope it comes around to bite the but i doubt it.

When you have Duterte pushing free contraceptives in the Phillipines while American politicians are taking them away from poor women that need them most - that's when you know that the world has gone completely insane.

Duterte is pro-Death and US is pro-Life.

Are you suggesting that contraception is equivalent to killing a "life"? i.e. that by not allowing the sperm and egg to hook up, it's the same as aborting a fetus? That may be the most extreme viewpoint I've ever encountered.

Every sperm is sacred,
every sperm is great...
.. and if a sperm is wasted
- god gets quite irate.

[stessier]

I don't think the Catholic Church ever said it was equivalent to killing. They say it's a sin but that's like taking Jesus' name in vain is a sin. Saying 'Holy Jesus!' is not the same as killing someone.

The Church doesn't draw equivalencies that way. There are mortal sins and venal sins (you can think of them as major and minor). One of the requirements for something to be a mortal sin is that it is of "grave matter". Killing, contraception, and taking the name of the Lord in vain are all "grave matters" according to the Church. There are other requirements as to whether or not something is actually a sin, but on a first level of analysis, all three are setup to be of the same seriousness.

[Jeff V]

I don't think the Catholic Church ever said it was equivalent to killing. They say it's a sin but that's like taking Jesus' name in vain is a sin. Saying 'Holy Jesus!' is not the same as killing someone.

But the theological outcomes are equivalent? They don't seem to split hairs all that much: you sin, you go to hell. Kill someone, go to hell. Covet your neighbor's wife's sweet, sweet ass; you better believe you are going to hell, especially if you're yelling "fuck me Jesus!" while doing the deed. So spewing into some sort of cul-de-sac, that too would earn one the same outcome?

[Skinypupy]

From the Congressional Budget Office's report release today:

In brief, CBO and JCT estimate that enacting that legislation would affect insurance coverage and premiums primarily in these ways:

- The number of people who are uninsured would increase by 18 million in the first new plan year following enactment of the bill. Later, after the elimination of the ACA’s expansion of Medicaid eligibility and of subsidies for insurance purchased through the ACA marketplaces, that number would increase to 27 million, and then to 32 million in 2026.

- Premiums in the nongroup market (for individual policies purchased through the marketplaces or directly from insurers) would increase by 20 percent to 25 percent—relative to projections under current law—in the first new plan year following enactment. The increase would reach about 50 percent in the year following the elimination of the Medicaid expansion and the marketplace subsidies, and premiums would about double by 2026.

[El Guapo]

I'm glad that media outlets gave so much attention to these consequences during the election season.

[Ralph-Wiggum]

Who cares about millions going uninsured when we could talk about emails? And tweets! And tweets about emails!

[YellowKing]

You forget math is facts, and facts are lies!!!

[Skinypupy]

You forget math is facts, and facts are lies!!!

I've already had two people tell me this report was completely partisan and/or "fake news". Ugh.

[Chaz]

One thing Trump and the GOP are really good at is taking a term used by their opponents, and then applying it so broadly that it loses any and all meaning. It's a pretty amazing magic trick that just keeps working. That we're at the point where a CBO review is considered fake news is depressing.

[hepcat]

Yeah, I was thinking the same thing during that fiasco of a press conference last week.

[Zarathud]

Are we to the point where we can denounce Trump for lying about official business or is everything still the act of a private citizen until he takes the oath of office?

[El Guapo]

One thing Trump and the GOP are really good at is taking a term used by their opponents, and then applying it so broadly that it loses any and all meaning. It's a pretty amazing magic trick that just keeps working. That we're at the point where a CBO review is considered fake news is depressing.

Oh, health care is a good one for this stuff. You'll see the GOP promising "universal access" in health care, which sounds like universal coverage, but means that everyone has access *if they can afford to pay for it*, which is de facto the opposite of universal access. Or they'll say the plan covers pre-existing conditions, by which they mean it does if you maintained continuous coverage before the condition arose, which is to say that it doesn't cover preexisting conditions.

[malchior]

Listening to Tom Price's hearing. Price acknowledged that ACA drove better coverage but that people didn't have access to actual doctors. Ok that sounds like a problem that we can actually solve but nope because instantly they pivoted to the same old shit from the Republicans. That defensive healthcare costs and malpractice costs are driving the rise in prices. Except repeatedly it has been found to be about 3-4% of the pie. Something to be considered but hardly the main cost driver.

Edit: Franken is really going after him about his stock dealings. He brought up a bio med stock that was only offered privately to 20 people including another Rep and Price's chief of staff and a lobbyist. It was his largest single purchase in the last 3 years and he made $50k to $100k on it. Sounds totally legit. Oh - this came to light because he was nominated - otherwise the circumstances would have been totally obfuscated (not the fact he made the purchase). No corruption at all in Congress, right?

[Pyperkub]

I found this article really interesting, and I'm hoping Fireball swings by to comment:

One lesson I’ve learned from working on public policy in and out of government is that in a complex legislative debate, success and failure often feel exactly the same while they are happening. They both feel pretty much like pandemonium. During the lengthy period when some basic questions of strategy and substance are still open, everything seems up for grabs and the entire edifice always looks on the edge of collapsing. So it is not easy to judge the prospects for success by orderliness or discipline along the way. A better yardstick is whether there is a plausible strategy being championed by a critical mass of people on both sides of Pennsylvania Avenue. By that measure, the effort to replace Obamacare is in some trouble. On its face, the legislative strategy lawmakers are now pursuing is not a good fit for the substantive policy objectives it is expected to achieve, and Republicans have yet to come to terms with the mismatch.

The article goes on to describe some of the thought-processes and logic behind some of the moves, which was quite fascinating. I'm still not one to think that I'd ever want a 21st Century GOP defining my health care, and I do think their approach is (like just about everything else) rooted in the 1950's and 60's and ignorant of what the country will need for the next 50 years, not 50 years ago, but it is interesting to see the minutia.

[Isgrimnur]

Executive Order - Minimizing The Economic Burden Of The Patient Protection And Affordable Care Act Pending Repeal

Sec. 4. To the maximum extent permitted by law, the head of each department or agency with responsibilities relating to healthcare or health insurance shall encourage the development of a free and open market in interstate commerce for the offering of healthcare services and health insurance, with the goal of achieving and preserving maximum options for patients and consumers.

[Skinypupy]

First "official" outline of ACA replacement:

In its draft form, the Cassidy-Collins bill would give states three options:

• Keep the Affordable Care Act, with individuals and small businesses able to purchase insurance on state exchanges and low-income residents eligible for federal subsidies to cover the cost of that coverage. States that expanded Medicaid, a state-federal health program for the poor, would be able to maintain that.

• Give states the federal funding promised under Obamacare, the subsidies and Medicaid expansion money, to create tax-free Health Savings Accounts for low-income residents. Those individuals could then use the money in their HSAs to purchase insurance and pay for their health care.

• Reject any federal assistance, risking a spike in the uninsured rates and uncertainty in their insurance markets.

I lol'd at this part.

Collins suggested that Trump did not help matters with his executive order.

“The executive order is very confusing, and we really don’t know yet what the impact would be,” she said. “We need legislation.”

[stessier]

Am I reading it right - the first pass fix is to finish implementing it as originally planned? Not that I'm complaining, if true.

[El Guapo]

Am I reading it right - the first pass fix is to finish implementing it as originally planned? Not that I'm complaining, if true.

The point is, going from that summary, that states could choose. Blue states can keep the ACA essentially as is, red states get more freedom to screw the poor.

[Isgrimnur]

WaPo

The Post’s Mike DeBonis has obtained leaked audio of Republicans at a closed-door session airing serious anxieties about the GOP’s strategy to repeal and replace Obamacare. What’s remarkable is how decisively their specific comments in private undercut the party’s public, carefully-crafted talking points about the battle to come.

Now, to be clear, these private comments reveal Republicans actually wrestling with the policy challenges that repeal (and replace) will create, which is a good thing as far as it goes. However, in so doing, they basically admit in various ways that Republicans will be responsible for the mess that repealing the law — which would probably be done on a delay while Republicans come up with a replacement — is expected to make.
...
“We’d better be sure that we’re prepared to live with the market we’ve created” with repeal, said Rep. Tom McClintock (R-Calif.). “That’s going to be called Trumpcare. Republicans will own that lock, stock and barrel, and we’ll be judged in the election less than two years away.”
...
Sen. Rob Portman (R-Ohio) warned his colleagues that the estimated budget savings from passing the Obamacare repeal bill — which could approach a half-trillion dollars — are needed to fund the costs of setting up a replacement. “This is going to be what we’ll need to be able to move to that transition,” he said.
...
Rep. Tom MacArthur (R-N.J.) also worried that the plans under GOP consideration could eviscerate coverage for the roughly 20 million Americans now covered through state and federal marketplaces, as well as those covered under Medicaid expansion: “We’re telling those people that we’re not going to pull the rug out from under them, and if we do this too fast, we are in fact going to pull the rug out from under them.”

Republicans have worked very hard to obscure whether their eventual replacement will cause those who have coverage now under Obamacare to lose it. They have done this by suggesting that no one will lose coverage during the transition, without saying whether they will lose it under the eventual GOP replacement. Trump himself has said that “everybody” will be covered under the GOP plan that replaces the ACA, and in early January, top adviser Kellyanne Conway also flatly stated this to be the case. But then Conway subsequently fudged that promise, saying instead that everyone would have coverage “during the transition time,” which doesn’t mean under the GOP replacement. Yet here you have Rep. MacArthur flatly admitting that an outcome which involves widespread loss of coverage is very possible.

[Default]

Easier to bitch about shit than to govern.

[Smoove_B]

Remember when he said he was going to be stiggin it to the prescription drug industry? I would have loved to be at this meeting:

Today, after a meeting with pharmaceutical industry lobbyists and executives, he abandoned that pledge

...

“Pharma has a lot of lobbies, a lot of lobbyists and a lot of power. And there’s very little bidding on drugs,” he said at a press conference at Trump Tower in Manhattan. “We’re the largest buyer of drugs in the world, and yet we don’t bid properly.”

...

So what I want, we have to get lower prices, we have to get even better innovation and I want you to move your companies back into the United States. And I want you to manufacture in the United States. We're going to be lowering taxes, we're going to be getting rid of regulations that are unnecessary.

I imagine him yelling at first, the pharmaceutical executives telling him to STFU and instead demanding he make it easier for them to all get rich. Absolutely amazing. He's a successful business man and he'll be able to negotiate much better deals when he's elected President, they said. It really would be funny if it wasn't so sad.

[El Guapo]

Trump's word is completely worthless. Him saying that he would allow Medicare to negotiate is meaningless.

[LordMortis]

Didn't I just read that I'm just mad because he's doing what said he would do?

[El Guapo]

Didn't I just read that I'm just mad because he's doing what said he would do?

There is that. On the one hand, specific promises on a given issue (e.g., Medicare negotiations, appointing a special prosecutor to go after Clinton, etc.) are pretty worthless. On the other, most of Trump's campaign statements / commitments / etc. do paint a pretty clear intention - he will punish minorities in general and Muslims in particular, he'll be extremely harsh on immigration, he will claim as much power as he can, he'll do "opposite of Obama" things, etc.

[Max Peck]

Maybe a little reverse psychology can shake things up.

Former House Speaker John Boehner predicted on Thursday that a full repeal and replacement of "Obamacare" is "not going to happen."

The Ohio Republican, who was forced out by conservatives in 2015, said he started laughing when he heard President Donald Trump and Republicans promise swift action on undoing and replacing the health law.

"Republicans never ever agree on health care," Boehner said.

Congressional Republicans are "going to fix Obamacare - I shouldn't call it repeal-and-replace, because it's not going to happen," he said. "Most of the framework of the Affordable Care Act ... that's going to be there."

Boehner spoke at a health care conference in Orlando, Florida. His remarks were reported by Politico.

As speaker, Boehner promised numerous times to repeal and replace Obamacare in full, and even presided over a 2013 government shutdown aimed at taking money away from the law.

Boehner spokesman Dave Schnittger confirmed the accuracy of the remarks reported by Politico but said they omitted some context. He said Boehner is confident Republicans "will right the many wrongs of Obamacare, whether your preference is to call it a repair, a replacement, or something else."

"His point was that the process of doing it from start to finish will not be an instantaneous one, and I think that's already been borne out by recent developments," Schnittger said.

However, Boehner's comments seemed to strengthen the resolve of the House Freedom Caucus, the group of conservatives who caused him endless trouble when he was speaker. The group responded to Boehner over Twitter, saying: "We made a promise to the American people. The Freedom Caucus remains 100% committed to full repeal & replace."

House Republicans aim to roll out legislation in coming weeks to replace major elements of the Affordable Care Act with a new system involving tax credits, health savings accounts and high risk pools, but crucial details remain unknown.

They've had to defend their plans at raucous town hall meetings around the country this week, and a new poll out Thursday showed support for the law at a record high, with 54 percent approving and 43 percent disapproving. The poll was conducted by Pew Research Center Feb. 7-12 and has a margin of error of 2.9 percentage points. After years where more people disliked the law than liked it, it's been creeping gradually upward in popularity amid GOP attempts to dismantle it.

[Smoove_B]

Let's not forget that Mike Pence is also a horrible person:

"Despite the best efforts of liberal activists at town halls across the country, the American people know better," the vice president told the fired-up crowd. "Obamacare has failed and Obamacare must go."

...

Pence echoed campaign trail promises from then-candidate Donald Trump that the replacement to Obamacare would allow Americans to buy healthcare over state lines. Congressional Republicans released a broad outline of a new health care plan last week, but it was thin on details.

The vice president also pushed for a states' rights approach to health care that allows local governments "to take care of the least fortunate in the best way that will work in their state and their community."

And my favorite:

Contrasting himself with the president, Pence quipped that Trump was "known for his bigger than life personality, charm, and charisma. And I'm, like, not."

You are known for being the reason the largest HIV outbreak in the history of Indiana continued. But I guess since that "worked in your state and community" it was a great decision.

[RunningMn9]

Every time I hear Republicans pushing for States Rights I laugh. Your goddamn party was formed to thwart that ideology, not be a slave to it.

[Smoove_B]

Politico reporting they have seen leaked repeal package and it's a shitshow:

In place of the Obamacare subsidies, the House bill starting in 2020 would give tax credits — based on age instead of income. For a person under age 30, the credit would be $2,000. That amount would double for beneficiaries over the age of 60, according to the proposal. A related document notes that HHS Secretary Tom Price wants the subsidies to be slightly less generous for most age groups.

...

Another key piece of the Republican proposal: $100 billion in “state innovation grants” to help subsidize extremely expensive enrollees. That aims to address at least a portion of the “pre-existing condition” population, though without the same broad protections as in the Affordable Care Act.

It also would eliminate Planned Parenthood funding, which could be an obstacle if the bill gets to the Senate. And it leaves decisions about mandatory or essential benefits to the states.

How are we paying for all this:

According to the document, there’s only one single revenue generator to pay for the new tax credits and grants. Republicans are proposing to cap the tax exemption for employer sponsored insurance at the 90th percentile of current premiums. That means benefits above that level would be taxed.

6+ years and this is what they could come up with. They're all a bunch of chucklefucks.

[Isgrimnur]

$4k wouldn't cover the cost of a bronze plan for me. And I'm two decades off of 60.

[Rip]

$4k wouldn't cover the cost of a bronze plan for me. And I'm two decades off of 60.

You are eighty already?

[Isgrimnur]

$4k wouldn't cover the cost of a bronze plan for me. And I'm two decades off of 60.

You are eighty already?

Get off my lawn.

[Fitzy]

$4k wouldn't cover the cost of a bronze plan for me. And I'm two decades off of 60.

Are you taking into consideration the HUGE drop in price Trumpcare will bring?

[geezer]

Every time I hear Republicans pushing for States Rights I laugh. Your goddamn party was formed to thwart that ideology, not be a slave to it.

Well played if intentional. Credit due even if not. Let's get Atwater's opinion...

[Rip]

Trumpcare is going to be great.

Patient: I'm having problems, by back hurts all the time.

Trumpcare Doctor: No it doesn't.

Patient: I'm telling you it hurts.

Trumpcare Doctor: That is FakePain. Next.

[RunningMn9]

Every time I hear Republicans pushing for States Rights I laugh. Your goddamn party was formed to thwart that ideology, not be a slave to it.

Well played if intentional. Credit due even if not. Let's get Atwater's opinion...

Unintentional, but I did notice it right away.

[LawBeefaroni]

Nobody knew health care could be so complicated

On why he's failing on his promise to blow up the ACA and give everyone better, cheaper coverage.


I have at least several million colleagues that would disagree. I'm sure anyone who worked on it even read the ACA would disagree. Any patient who has had to sort through their bills would disagree.

Trump is such a fraud.

[El Guapo]

FDR on Obamacare repeal-and-replace.

[El Guapo]

Only true believers are permitted to see the glory of the Emperor's secret health care plan!

Yesterday, House Speaker Paul Ryan boasted that his party would follow a deliberate, transparent process to repeal and replace Obamacare. “This is how the legislative process is supposed to be designed,” he told the Today show, “We’re not hatching some bill in a backroom and plopping it on the American people’s front door.” Today House Republicans made it known that they will release their plan tomorrow and that it will only be made available to House Republicans. Representative Chris Collins tells the Washington Examiner the plan “would be made available Thursday morning to Republicans in a basement room of an office building that adjoins the Capitol.”