Trump's Full Court Press on healthcare

[RunningMn9]

Was this in Obamacare - if you have a "seriously delinquent tax debt", you get no rebate. The definition of the term is in 7345(b) - I need Isgrimnur to look that up for me...

Well, Rip is fuct.

[Fireball]

Before passing the ACA, the House held 79 hearings, with 181 witnesses and accepted 121 amendments to the bill over the course of a year. The Senate held roughly 100 hearings and other public meetings over almost 18 months, and spent 25 *days* debating the bill on the floor. The GOP leadership wants to slam this terrible bill through the Congress in three weeks.

[El Guapo]

It's so stupid. For estate taxes, all I need to know is the fair market value of the deceased's assets at death to determine the tax. For income taxes, I have to know that information PLUS the tax basis (cost at purchase). It's more work.

It would help you make some extra bank, though, right?

[El Guapo]

A great summary of why the GOP health care bill is the hot mess that it is.

[Zarathud]

Well, that's about par for the course for these incompetent assholes.

Apparently the reference to inheritance is the Social Security Act, not the tax code. So it only covers probate assets. That means inheritances via irrevocable trust aren't covered. So no problem if you have a trust fund.

Rip is still screwed.

[El Guapo]

Before passing the ACA, the House held 79 hearings, with 181 witnesses and accepted 121 amendments to the bill over the course of a year. The Senate held roughly 100 hearings and other public meetings over almost 18 months, and spent 25 *days* debating the bill on the floor. The GOP leadership wants to slam this terrible bill through the Congress in three weeks.

Seems like the bill is starting to crater? The Heritage Foundation has come out against it, and I know the Freedom Caucus was making negative noises. With few to no democratic votes in play, they need the Freedom Caucus folks to support the bill just to make it through the House.

Question then becomes what happens if this bill fails to pass the House.

[Isgrimnur]

My Rep is hip-deep in it. He's Chair on the Subcommittee on Health.

https://twitter.com/michaelcburgess/sta ... 4313079808

[El Guapo]

Oh, man. You need to be calling that guy daily.

[El Guapo]

House GOP's Obamacare Replacement Will Make Coverage Unaffordable For Millions -- Otherwise, It's Great.

It's important to know that this is by Avik Roy, who is one of the most prominent right wing health care policy wonks.

[El Guapo]

Question: do you think Ryan called this the American Health Care Act (AHCA) specifically because that's very similar to the ACA, so that people will confuse the two, which would then make it easier for the Republicans to blame the ACA when millions lose health insurance and the health care markets implode?

[Isgrimnur]

I'm pretty sure he's a lost cause on this topic. However, he did actually have a town hall this past weekend.

"It's the sum total of my existence right now," said Burgess when asked about how much time he’s spending on a bill to repeal the ACA.

Burgess said much of the ACA will remain the same, including a rule that stops companies from setting yearly and lifetime limits on health insurance.

"What will change: mandates taxes, and money for community health centers," he said.

The town hall meeting comes a week after about 30 people stood outside his Lake Dallas office demanding more town halls.
...
Burgess said he will hold another town hall meeting soon.

[El Guapo]

I'm pretty sure he's a lost cause on this topic. However, he did actually have a town hall this past weekend.

"It's the sum total of my existence right now," said Burgess when asked about how much time he’s spending on a bill to repeal the ACA.

Burgess said much of the ACA will remain the same, including a rule that stops companies from setting yearly and lifetime limits on health insurance.

"What will change: mandates taxes, and money for community health centers," he said.

The town hall meeting comes a week after about 30 people stood outside his Lake Dallas office demanding more town halls.
...
Burgess said he will hold another town hall meeting soon.

I'm sure that he's a lost cause in terms of persuading him on the merits of health care policy. He may not be a lost cause in terms of "shit, people seem really pissed about this - could this be risky for me to sign onto?"

Bear in mind that representatives in conservative districts have the option, as David Frum argued in the article I posted on the previous page, of "denounce and preserve." I.e. of taking a super hard line of "every word of Obamacare has to be repealed", which as a practical matter would mean that nothing passes, in which case the ACA remains.

[El Guapo]

CATO and FreedomWorks also now officially against the bill.

Hard to see how it isn't DOA already.

[Max Peck]

CNN has the full text of the proposal.

On page 14, it defines Qualified Lump Sum Income and it sure looks like it include inheritances. Am I reading that right?

Yes, I believe so.

Expectations have been that Trump will repeal the estate tax and treat inheritances as income. This confirms that thinking.

It's so stupid. For estate taxes, all I need to know is the fair market value of the deceased's assets at death to determine the tax. For income taxes, I have to know that information PLUS the tax basis (cost at purchase). It's more work.

But if you're smart like Trump and don't pay any income tax, it simplifies things, no?

[Grifman]

A great summary of why the GOP health care bill is the hot mess that it is.

Excellent article, it pretty much it what I felt would happen a while ago when Trump was elected. The Republicans, trapped by their own rhetoric and increasing far right philosophy, would be unable to make the square hole round. Obamacare, WAS, the conservative health care plan, if you really wanted to increase coverage and help people out. Any plan that the Republicans were going to come up with otherwise was bound to decrease coverage because everything they were floating just can't get the job done. The Republicans just committed intellectual suicide in their almost irrational opposition to Obamacare.

[raydude]

CNN has the full text of the proposal.

On page 14, it defines Qualified Lump Sum Income and it sure looks like it include inheritances. Am I reading that right?

Yes, I believe so.

Expectations have been that Trump will repeal the estate tax and treat inheritances as income. This confirms that thinking.

It's so stupid. For estate taxes, all I need to know is the fair market value of the deceased's assets at death to determine the tax. For income taxes, I have to know that information PLUS the tax basis (cost at purchase). It's more work.

Maybe I'm missing the obvious here, but given that the estate tax kicks in if assets are 5.45 million or more why do we feel sorry enough for rich people to repeal it?

[El Guapo]

CNN has the full text of the proposal.

On page 14, it defines Qualified Lump Sum Income and it sure looks like it include inheritances. Am I reading that right?

Yes, I believe so.

Expectations have been that Trump will repeal the estate tax and treat inheritances as income. This confirms that thinking.

It's so stupid. For estate taxes, all I need to know is the fair market value of the deceased's assets at death to determine the tax. For income taxes, I have to know that information PLUS the tax basis (cost at purchase). It's more work.

Maybe I'm missing the obvious here, but given that the estate tax kicks in if assets are 5.45 million or more why do we feel sorry enough for rich people to repeal it?

Basically, the Republican Party cares enough about it because its donor constituencies care a lot about it, and the Republican Party has convinced many voters to care about it via misleading branding (i.e. "death tax"), and by implying that regular people might earn enough for it to matter to them eventually.

[Rip]

Don't worry - they know how to make this work.

In case you can't see it -

GOP Rep. Chaffetz: Americans may need to choose between "new iphone... they just love" and investing in health care

You know who he sounds like?

“I guess what I would say is if you looked at that person’s budget and you looked at their cable bill, their telephone … cell phone bill, other things that they’re spending on, it may turn out that they just haven’t prioritized health care because right now everybody is healthy," he said.

“Nobody actually wants to spend money on health insurance until they get sick,” he added.

[Smoove_B]

If someone could get "Cadillac" health insurance that covers both preventative care and emergency treatment for $100 a month and they use that $100 a month to instead purchase an iPhone, then yes, that person is likely not making good decisions.

So let's not pretend that $1200 a year is in any way going to address medical care for Americans.

[El Guapo]

The fact that pretty much everyone hates this bill immediately, and Ryan / McConnell must not have consulted with them in advance, yet Ryan and McConnell are trying to ram this through ASAP, raises the question of whether it might have been intended to fail.

[Smoove_B]

The look on McConnell's face in that photo is easily the most punchable I've ever seen. LORD GIVE ME STRENGTH

[stessier]

Don't worry - they know how to make this work.

In case you can't see it -

GOP Rep. Chaffetz: Americans may need to choose between "new iphone... they just love" and investing in health care

You know who he sounds like?

“I guess what I would say is if you looked at that person’s budget and you looked at their cable bill, their telephone … cell phone bill, other things that they’re spending on, it may turn out that they just haven’t prioritized health care because right now everybody is healthy," he said.

“Nobody actually wants to spend money on health insurance until they get sick,” he added.

Right - but the difference in plans is this -

The Kaiser Family Foundation calculates the changes to customers in two sample markets: Reno, which is a cheap market, and Mobile, which is expensive. A 60-year-old in Mobile who earns $20,000 a year currently qualifies for a tax credit of $13,235 to buy insurance. Under Trumpcare, that tax credit would be reduced to $4,000 a year. On the other hand, people who earn $75,000 a year, who currently get nothing to help them buy insurance, would get a $4,000 credit from the Republican plan.

So Obama was telling a guy making 20k and getting a 13k credit to budget better if he still couldn't make ends meet. Your guy is telling the same guy he's only getting 4k and to budget better. But you'll never address this.

[Smoove_B]

Actually, I think they're telling the guy in Mobile, AL making $20,000 a year that he needs to tell his accountant what tax credits to use to offset capital gains. Because then this all totally makes sense.

Really, I can't believe this is their master plan. All this time, all the hearings and votes and cries to get rid of the ACA and this is what they've been holding in reserve. It's bananas.

[Grifman]

Yeah, it's an absolutely horrible plan. They've had 6 years and this is what they come up with. An emasculated version of Obamacare that does nothing to fix any of the real problems (and there are some) with Obamacare, or fix the problems with health care in this country.

[El Guapo]

Yeah, it's an absolutely horrible plan. They've had 6 years and this is what they come up with. An emasculated version of Obamacare that does nothing to fix any of the real problems (and there are some) with Obamacare, or fix the problems with health care in this country.

It doesn't really matter how much time they had, because as discussed the basic structure of the ACA is the conservative approach to mass health insurance coverage. So you can't repeal and replace it with something different that also ensures that substantially everybody has coverage. The GOP's options are essentially to repeal it entirely or almost entirely, and accept that tens of millions will lose health coverage, or to tinker with the ACA and label that a "replacement" plan. The House bill tries to take an element of each, but predictably leaves no one happy.

But no amount of additional time would have yielded a plan that's a free market based plan, better than the ACA, and substantially different from the ACA, because such a thing is fundamentally impossible given how health care markets work (and given the GOP's religious objection to any new taxes).

[Kraken]

Either go with no federal health care or single payer.

Anything in between is just a half assed solution that is destined to fail.

Single-payer is the obvious endgame...but not for this administration or Congress. Their own attempt has to crash and burn first.

[Holman]

[Zarathud]

Oh, the precious. The deplorable Trump follower meets the intellectually bankrupt conservative elite. I needed that laugh.

[Carpet_pissr]

That made my night. Delicious.

[Skinypupy]

Don't worry - they know how to make this work.

In case you can't see it -

GOP Rep. Chaffetz: Americans may need to choose between "new iphone... they just love" and investing in health care

The best response I saw: "6 days in the ICU cost my family 317 iPhones".

[El Guapo]

The AARP is now against the bill as well.

[Kraken]

As Fireball pointed out, it took the Democrats years to arrive at a consensus for the ACA, and they were using a state blueprint (Romneycare) designed by the opposition party. The Republicans have had years, too, but they could only agree on NOT THAT. Thinking that they can dash something off in a few months that will satisfy their party's factions, the insurance companies, hospitals, and employers...without sinking the economy or pissing off a critical mass of voters...yeah, not going to happen. They can't blow up the deficit for healthcare because they're already planning to do that with tax policy.

If only other advanced nations had successful healthcare systems that could serve as an example...but all of those are heresies. When your ideology and reality don't mesh, it isn't reality's fault.

[Smoove_B]

I wish I knew who created the label "Don T. Care" for this nightmare, but I'd like to buy that person a beer because it's perfect. Though in truth, it should probably be referred to as RepbubliCare because it's something the party needs to own. I will never get tired of reading articles about people that voted for this either thinking he would make it cheaper (this woman was paying $260 a month) or that their own personal healthcare wouldn't be impacted.

Martha Brawley of Monroe, N.C., said she voted for President Trump in the hope he could make insurance more affordable.

“I’m scared, I’ll tell you that right now, to think about not having insurance at my age,” said Ms. Brawley, who underwent a liver biopsy on Monday after her doctor found that she has an autoimmune liver disease. “If I didn’t have insurance, these doctors wouldn’t see me.”

So lets cast a vote for the guy that indicated his intentions to dismantle the care you were enjoying. Really, other than thinking the insurance companies were going to kick out all the lazy dark poor people and then somehow magically offer a super low white person rate, what the hell are they thinking? I really think there's a core group of people that doesn't understand how insurance pools work.

Dr. Molina, the Molina Healthcare chief executive, said insurers are likely to increase their premiums significantly because they will worry about enrolling more high-cost patients as healthier people opt to go without coverage.

“Insurance companies are going to jack up the rates,” predicted Dr. Molina, who said premiums might increase even more than they did last year when some companies raised the rates by 25 percent or more.

I mean, maybe the goal is to complete have the insurance industry implode, because that's apparently where we're heading if any of this happens.

[malchior]

That Times story points out something important in the subtext - these people *FELT* that he would make it better. An uninformed and incurious populace didn't bother to actually look at what was on the table - all of which was pretty much out in the open. Hopefully they'll pay attention next time.

Another thought I just had was it is also not shocking that the main features of their plans - selling across state lines is not there. They kept promising it despite knowing they couldn't pass anything with new regulations. In effect, they blatantly lied about that. But I've noticed not many articles are pointing out that they were selling this plan knowing that. Like everything else - it is a fraud and a sham to give rich people a tax cut. Anyone who thinks this is about healthcare or good governance or principles other than keeping rich people rich at the expense of the middle class is out of their minds. It amazes me daily that their isn't blood in the streets (figuratively) considering the constant fleecing of the populace. Instead they've literally embraced the people fleecing them. It is like national stockholm syndrome at this point.

[Chaz]

Well, according to yesterday's tweets, all the other stuff, ie: the stuff he promised that his voters thought they were getting, is apparently coming in a parts 2 and 3 of this health care plan.

Never mind that he's never mentioned anything other than "we'll be repealing and replacing immediately, with something better", or that it's unlikely that these magical parts 2 and 3 either appear, are what he's promising, or get passed. So basically, he's trying to sell the crappy part up front with the promise of the good stuff to come later. Let's see how that works out.

And I don't think it's crazy to say that most people don't understand how insurance pools work. Insurance and medical costs are both crazy complicated, and most of the mechanisms are completely hidden from consumers. I'm probably better informed than the average, and I only have a vague grasp of how things fit together. It's not at all shocking that a lot of voters believed he could deliver on the pipe dreams he was selling, because understanding why it was always crap is a hard, and you can't fit it in a sound byte.

[hepcat]

You know you've been had by a really good used car salesman when you don't notice the missing tire until after you've driven off the lot.

[El Guapo]

So lets cast a vote for the guy that indicated his intentions to dismantle the care you were enjoying. Really, other than thinking the insurance companies were going to kick out all the lazy dark poor people and then somehow magically offer a super low white person rate, what the hell are they thinking?

I think this was a big part of what they were thinking. They're suffering because Obama and previous institutional politicians were working for "them" - some mix of minorities, foreigners, the "global elite" (also a handy fill in for the Jews), big corporations, etc. Trump was going to reverse that and work for "us" - mainly white working class Christian Americans. So, it shouldn't be hard to bring health care costs down, because all it would take is taking that pot of money going to the undeserving and reallocating it to "us".

[Grifman]

There will be more analysis coming, I'm sure, but here is a good start in summarizing the flaws in Trumpcare:

http://www.cnn.com/2017/03/07/opinions/ ... index.html

[Grifman]

[malchior]

Well, according to yesterday's tweets, all the other stuff, ie: the stuff he promised that his voters thought they were getting, is apparently coming in a parts 2 and 3 of this health care plan.

And I'll give him credit that he didn't know that passing the major features was pretty much impossible because he is an idiot. However the Republicans knew this reality. Boehner spoke openly that the compromises necessary made it impossible and it looks like he was right. The bill is a Frankenstein's monster of mismatched parts. The whole thing is bizarre because it really feels DOA. If it gets through then we know something is really, really wrong because pretty much everyone hates the plan.