Obamacare...(new title): GOP DEATH PLAN: Don-Ryan's Express

[visionary]

 

[visionary]

 

 

 

[The Sisko]

19 hours ago, tshile said:

I apologize if this has been mentioned, I haven't seen discussion about it...

 

This comes from a few conversations I've had with people in the Healthcare industry (not insurance, care.)

 

One of the GOP talking points being pushed, which is getting mentioned by their surrogates but not expounded on, that I think poses a serious threat... but doesn't get talked about because it's not sexy like "x million will lose coverage" or "pick your doctor pick your plan" (which is itself laughable because it means you don't understand ACA) or "x million saved"...

 

The "remove restrictions around creating new Healthcare facilities"...

 

Just something to think about when you hear that bullet point from the GOP talking points circulating around get dropped on your favorite news show.

 

I haven't had a chance to read their crap proposal yet, but I'm not surprised by this. However I think the risk/outcomes are a bit different than perhaps you described. Getting rid of certificate of need (CON) laws would potentially be catastrophic for facilities everywhere, not just in poor neighborhoods. Hospitals, even in affluent areas, typically use a limited number of profitable cost centers to subsidize stuff that doesn't make money so they're able to remain financially viable and hence offer the full range of services. Without CON, what would invariably happen is that specialized facilities would pop up to siphon off only the most profitable patients for key procedures. The result of ditching CON is that those with great health insurance and a good prognosis (to avoid costly and embarrassing bad outcomes for the cherry picking facility) would be able to go to these facilities. If you don't have great health insurance, have a poor prognosis, or just don't have a condition that will potentially make someone money, you're likely to be out in the cold, i.e. there won't be ANY hospital available. In short, the old saying that there's no mission without margin is total truth. Ditching CON takes away the margins that keep general hospitals open.

 

A great example of this is Cancer Treatment Centers of America. I hate them with the heat of a thousand suns. They pushed their way into our state by agreeing to a limited scope of practice and then immediately started complaining and lobbying to get their practice expanded so as to offer more "choice" to patients. If you're not aware, they're a total sham and are a poster child for the problem with getting rid of CON.

Edited March 9, 2017 by The Sisko

[tshile]

Yeah, I may have misunderstood. It was a conversation that was over my head in many ways. 

[The Sisko]

54 minutes ago, tshile said:

Yeah, I may have misunderstood. It was a conversation that was over my head in many ways. 

There may be just as much or more truth to the way you explained it. As I said, I haven't read their proposal yet and I work at the periphery of policy so it's not my specialty. However I am quite certain that the issues I presented with loss of CON are absolutely a problem for most, if not all hospitals.

[visionary]

 

 

 

 

 

 

 

 

 

Edited March 9, 2017 by visionary

[The Sisko]

I figured it would end up working out this way. The already draconian establishment GOP proposal will get pulled even further right by the nutjob wing of the party. Excellent. I love it. Screw Meemaw even harder. Those midterms are looking better all the time. ?

[Sacks 'n' Stuff]

3 hours ago, visionary said:

 

Hmmm... his name is Andrey Ostrovsky. Sounds a little suspicious to me. Also, why is there a sickle & hammer emoji available to us on this site all of a sudden?

 

☭  ☭  ☭  ☭  ☭  ☭  ☭  ☭  ☭  ☭  ☭  ☭  ☭  ☭  ☭  ☭

 

If the Capitals win the cup this year, I'll KNOW something is up.

[visionary]

 

[Larry]

I note the language "freeze enrollment in Medicaid". I'm wondering exactly how that works. "Well, yeah, you're poor, and you need health care. But we can't let you in until somebody else drops out"?

[LadySkinsFan]

You mean dies Larry.

 

1. Don't get sick

2. If you get sick, die quickly.

 

It's pretty clear that the Republicans are serving as the death panels.

[visionary]

 

[Jumbo]

think this fits here...

 

http://www.msn.com/en-us/news/politics/‘is-that-not-correct’-male-gop-lawmaker-asks-why-men-should-pay-for-prenatal-coverage/ar-AAo5g2W?li=BBnb7Kz

 

‘Is that not correct?’: Male GOP lawmaker asks why men should pay for prenatal coverage

Quote

 

In the 27 hours the House Energy and Commerce Committee spent debating Republicans’ Obamacare revision plan, a handful of moments stand out.

 

This is one of them.

 

At the start, Democratic Rep. Mike Doyle (Pa.) was talking with Republican Rep. John Shimkus (Ill.) about Shimkus’s objections to the Affordable Care Act’s requirements for health-insurance plans. As a reminder, former president Barack Obama’s signature 2010 health-care law ordered that all health plans cover certain essential health benefits, such as doctor visits, hospital care and prescription drugs.

 

The law also required plans to cover pregnancy and childbirth. That’s where the fireworks started in the Energy and Commerce Committee.

 

“What mandate in the Obamacare bill does he take issue with?” Doyle asked Shimkus, using the formal parlance of congressional committees.

“What about men having to purchase prenatal care?” Shimkus said. At that point, one could hear the room start to stir.  “I’m just . . . is that not correct?” Shimkus said. “And should they?” 

 

The moment is starting to circulate on social media, along with criticism of Shimkus. NARAL Pro-Choice America, a group that advocates for abortion rights, called attention to it on Twitter and included the video: (at link) 

 

Shimkus was raising a question common among opponents of the ACA.

 

In 2013, during another famous exchange in the Energy and Commerce Committee, former Rep. Renee L. Ellmers (R-N.C.) brought up the same thing with former health and human services secretary Kathleen Sebelius.

 

“Do men not have to buy maternity coverage?” Ellmers said, referring to the health-care law’s essential health benefits. “To the best of your knowledge, has a man ever delivered a baby?”

 

Here’s how insurance expert and columnist Nancy Metcalf answered a similar question from a Consumer Reports reader that year:

 

Health insurance, like all insurance, works by pooling risks. The healthy subsidize the sick, who could be somebody else this year and you next year. Those risks include any kind of health care a person might need from birth to death—prenatal care through hospice. No individual is likely to need all of it, but we will all need some of it eventually.

 

So, as a middle-aged childless man you resent having to pay for maternity care or kids’ dental care. Shouldn’t turnabout be fair play? Shouldn’t pregnant women and kids be able to say, “Fine, but in that case why should we have to pay for your Viagra, or prostate cancer tests, or the heart attack and high blood pressure you are many times more likely to suffer from than we are?”

 

Once you start down that road, it’s hard to know where to stop. If you slice and dice risks, eventually you don’t have a risk pool at all, and the whole idea of insurance falls apart . . .

 

Before the new health law took effect, insurers can and did exclude maternity coverage from individual plans. In fact, in half of states you can’t purchase maternity coverage on the individual market for any price. In most of the rest, you can buy a maternity rider on your policy. In many cases it costs more than the main policy itself, and you can’t use it for at least a year after you buy it, and it often has a separate deductible of up to $5,000.

 

Why so expensive? Because the only people who buy it are, naturally, people planning to have a baby. Insurers know this and price accordingly.

 

Requests for additional comment from Shimkus and Doyle were not returned.

 

 

[Riggo-toni]

So apparently midwives are the "forgotten people" whose jobs Trump will bring back?

[Hersh]

2 hours ago, Jumbo said:

think this fits here...

 

http://www.msn.com/en-us/news/politics/‘is-that-not-correct’-male-gop-lawmaker-asks-why-men-should-pay-for-prenatal-coverage/ar-AAo5g2W?li=BBnb7Kz

 

‘Is that not correct?’: Male GOP lawmaker asks why men should pay for prenatal coverage

 

 

Just watched another congressman attempt to explain this on msnbc. Essentially the GOP wants almost an a la carte approach and if you don't have prenatal care (if you are a woman) you'd just pay a surcharge to get the prenatal coverage after getting pregnant. However, he went on to say that two people, a male and female in the same general health and the same age, will pay the same rate for insurance. 

 

I wish they would just admit that people with more money will be able to get the best coverage and if you don't have as much money, don't get sick. If the GOP sticks with this approach, they are going to get destroyed at the polls when this takes effect. 

Edited March 10, 2017 by Hersh

[visionary]

 

[visionary]

 

[FanboyOf91]

[LadySkinsFan]

So more can die quickly.

[LD0506]

Now, now, they don't want everyone dead, just enough to reduce the rest to their place in the natural order of things, you know, peasants

[Hersh]

2 hours ago, visionary said:

Kasich

 

You think he is trying to position himself to run 3rd party in 2020? Sure seems like. 

Edited March 11, 2017 by Hersh

[Jumbo]

just more grist for the mill

 

http://www.msn.com/en-us/news/politics/wealthy-would-get-billions-in-tax-cuts-under-obamacare-repeal-plan/ar-AAo7P3r?li=BBnbcA1

 

 

Quote

 

Two of the biggest tax cuts in Republican proposals to repeal the Affordable Care Act would deliver roughly $157 billion over the coming decade to those with incomes of $1 million or more, according to a congressional analysis.

 

The assessment was made by the Joint Committee on Taxation, a nonpartisan panel that provides research on tax issues.

 

It is not unusual for tax cuts to benefit mostly the wealthiest, but still save some money for a majority of Americans. But the benefits of these reductions would be aimed squarely at the top.

 

The provisions would repeal two tax increases on high earners enacted in 2010 to help pay for the Affordable Care Act: an increase in capital gains taxes and other investment-related income, and a surcharge on Medicare taxes.

 

People making $200,000 to $999,999 a year would also get sizable tax cuts. In total, the two provisions would cut taxes by about $274 billion during the coming decade, virtually all of it for people making at least $200,000, according to a separate assessment by the committee.

“Repeal-and-replace is a gigantic transfer of wealth from the lowest-income Americans to the highest-income Americas,” said Edward D. Kleinbard, a professor at the University of Southern California law school and former chief of staff for the Joint Committee on Taxation.

 

Tax economists point out that even tax cuts for the wealthy can have indirect benefits for others. For example, the additional cash can prompt extra spending and extra hiring.

 

That said, “most of the benefit of getting rid of those two taxes would go to wealthy people,” said Joel Slemrod, a professor at the University of Michigan Ross School of Business and former senior staff economist for President Ronald Reagan’s Council of Economic Advisers. “It’s not significant for me to add a caveat.”

 

One of the taxes targeted in the repeal bill is a 3.8 percent tax on investment income, like capital gains. The other is a 0.9 percent surcharge on the Medicare taxes imposed on high-income earners — individuals making more than $200,000 a year and married couples filing joint returns who earn more than $250,000 a year. That brings the Medicare tax levied on that income up to 3.8 percent as well.

 

The tax repeal would solely benefit wealthy Americans because the taxes were imposed only on the wealthiest. The increases were passed in 2010, when capital gains rates were near historical lows. During the George W. Bush administration, Congress cut the rates to 15 percent from 20 percent. With the 3.8 percent tax imposed by the Affordable Care Act, the top capital gains rate stands at 23.8 percent for the wealthiest Americans. That still makes the rate lower it was for most of the 1970s, 1980s and 1990s.

 

The panel’s analysis was provided to members of the House Ways and Means Committee on Wednesday but has not been published on the committee’s website. A copy was reviewed by The New York Times.

 

The analysis found that by 2020, the repeal of the two tax provisions would save about $15.9 billion a year for those with incomes of $1 million or more. By 2026, the final year of the analysis, they would combine to save that group a little more than $20 billion a year.

For all the taxpayers who would benefit, the tax cuts would save nearly $37 billion in a single year by 2026.

 

On Monday, the Congressional Budget Office is expected to issue its analysis of the total cost of the Republican plan to replace the Affordable Care Act, including how much, if anything, it would add to the federal deficit in the coming decade.

 

 

more at link

[Sacks 'n' Stuff]

17 hours ago, Hersh said:

 

You think he is trying to position himself to run 3rd party in 2020? Sure seems like. 

Actual Republican is now 3rd party... Sad.

[visionary]

 

[visionary]

 

 

 

 

 

 

 

 

 

 

Edited March 12, 2017 by visionary