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

[Bang]

Plan?
Here's your ****ing plan

Now **** off

 

~GOP For the People

[Larry]

2 hours ago, twa said:

Block grants were the demand here and remain so....and it does expand Medicaid.

 

Please feel free to explain to us what you think are the differences between block grants, and Medicaid expansion, and why you think one is superior.  

 

With specific examples.  Not vague slogans about how local control is better (if the local control is Republican).  

 

Me, I confess, I'm pretty convinced that the difference between the two is that the block grant sends money to the state, but then allows the state greater options on where to divert the money.  (For example, the Republican Governor who I heard announcing why he wanted the Feds to send him federal money, but let him decide what to do with it, is that the latter option allows him to withhold the money from citizens who don;t meet the unspecified work requirements that he wants to impose, thus diverting Medicaid money from people who, you know, can't afford medical care, to "people who deserve it more")  

 

Because near as I can tell, the only possible reason for wanting "block grants" is "because it sends buckets of money to the state, and then allows the state to divert said money away from <what the Feds used to mandate it be spent on>, and send it <somewhere else, instead>."  So please, tell us what diversion you (or said states, in your opinion) have in mind.  

[Fergasun]

#FakePoliticians

Does anyone question why health care is 1/6th of our economy?  I heard that number back in 2009 --- it should be 1/12th or 1/9th. 

 

"Health care" should not be a for profit business "part of our economy".  Yet I hear people talk about this all the time.

 

The real question, if I were a #RealPolitician would be to work on getting health care costs down, period. 

 

My son hurt his foot, I have PPO and went to doctor.  I know out of pocket its $20... but he had an xray which I have no idea how much it cost, or if I could save money going to the "Walmart of Xrays".  What am I going to say as they usher him to the xray machine "I demand to know that your xray service is part of my PPO!". 

 

He was fitted for a boot I paid out of pocket for, again, I really had no idea if I could go to the "Medical boot store" down the street and save money.  

 

Its a big scam!  I dont't want to accept this system.  Just because I like the Dr. doesnt mean I should give up cost shopping my xray or walking boot.  

[twa]

1 hour ago, Larry said:

 

Please feel free to explain to us what you think are the differences between block grants, and Medicaid expansion, and why you think one is superior.  

 

 

Block grants cap federal costs and encourage better utilization of healthcare funds vs the unlimited Medicaid cost system in place now.

 

Where do you think grant funds would be diverted to?

[Larry]

56 minutes ago, twa said:

 

Block grants cap federal costs and encourage better utilization of healthcare funds vs the unlimited Medicaid cost system in place now.

 

 

I guess you missed the part of my post where I asked for specifics, as opposed to vague slogans.  

 

but yes, I'm well aware that one of the reasons Republicans like "block grants" is because it allows the federal government to cut programs while claiming that they aren't cutting them.  I'll illustrate via an example, using completely made up numbers.  

 

Hypothetical:  Let's say that, right now, there's a program (maybe a retirement program, maybe unemployment benefits, or some other "entitlement" program.)  Statistics for the program are:  

 

1)  This year it pays $10,000, to 1,000 people.  Net federal spending, this year, $10M.  

2)  Next year, inflation is expected to be 5%, and the number of people receiving the benefits will climb to 1,100 people.  

 

Under the current system, next year, the number of people who fit the already-existing criteris will go to 1,100.  And the already-existing benefit will go to $10,500.  Federal spending will go to $11.5M.  (Unless Congress passes a change to the law, reducing the benefit, or reducing the eligability requirement, or both.  If Congress does not take the active step of changing the rules, then spending will go up by 11.55%  

 

Under the block grant system, for one thing, if Congress does nothing, then the program doesn't even exist, next year.  Congress actually has to pass something, just to keep it going.  

 

In addition, the block grant system also allows Congress to, say, decide that next year, Congress will spend $10M.  The same amount they spent this year.  

 

Thus forcing the states to decide what to do.  They can allow the payment to inflation-adjust to $10,500, but tighten up the eligibility rules so that, while 11,000 people would have qualified for the program, now only 952 people qualify.  (147 people who would have qualified, under the existing rules, don't.)  Or they can cut the payment amount, so that 1,100 people now receive $9,090 each.  (Or they can do some combination of the two.  Maybe reduce the amount of the check by 5%, while also reducing the number of people who qualify by a lesser amount.)  

 

It allows such lovely scenarios as thousands of people demanding to know why their check went from $10,000, to $9,090, while Washington acts surprised and says "Gee, we didn't cut anything.  We spent the same amount as last year."  

 

(This is the technique that Paul Ryan used to produce at least one of his magically-balancing budgets.  He pretended that every year, the federal government will spend the same number of nominal dollars on Social Security, that it spent the previous year.  Never mind that the only way to achieve that result would be to cut the amount of every SS check by 8%, per year, for the next 30 years.  "Gee, we spent the same number of dollars, therefore it's not a cut.")  

 

In short, yes, I'm well aware that one reason why Republicans love the idea of "block grants" is because it makes it politically easier for Republicans in Washington to cut things, and then try to dodge responsibility for doing so.  

 

 

---

 

Having said all that, though, is that you're answer?  That you think the reason these Governors all claim they want block grants, is because it makes it easier for Washington to cut funding and then point fingers at the states?  Somehow, I doubt that all of these Republican states are really refusing to accept federal dollars for their constituents, simply because they want to make it easier for Washington, down the road,  to screw said constituents, and point the angry people who've been screwed towards the state, instead.  

 

And again, I'll point out:  The one Republican Governor I heard interviewed, who was saying that he wanted a block grant, specified that the reason he wanted it was so his state could make Medicaid work-related, so that he could "spend the money on people who actually deserve it".  

[twa]

43 minutes ago, Larry said:

 

 

I guess you missed the part of my post where I asked for specifics, as opposed to vague slogans.  

 

 

Hard to get more specific than a set limit vs no limit.

Is that what you consider a slogan?

Grants can carry conditions though obviously far less than the circus Medicaid has now.

 

Do you want a pony as well?

 

[Springfield]

No gonna lie.

 

I'm loving the fact that republicans have walked themselves to the edge of the cliff on this.  They have nothing.  Absolutely nothing.

 

Of course, the usual republican taint ticklers will be tickling the republican's taints once they finally come up with some more bull**** to **** over poor people.

Edited March 4, 2017 by Springfield

[Sacks 'n' Stuff]

11 minutes ago, Springfield said:

I'm loving the fact that republicans have walked themselves to the edge of the cliff on this.  They have nothing.  Absolutely nothing.

What chu talkin bout Willis? They have a MASTER plan 

A master plan for healthcare, a master plan to defeat ISIS, a master plan to make Mexico pay for the wall, a master plan to legally ban Musl..... er..... uhh.... (quick Sacks... what's a more politically correct and presidential thing to say???)

Oh, I know! KEEP THE BAD HOMBRES OUT!!

It's obvious to anyone. All this time they spent screaming about everything Obama tried to do, it's not just because they have declared war on the left in an attempt to seize control of the government. No, no. It was clearly because they had sooooo many better ideas in the works to help the citizens of our country.

Edited March 4, 2017 by Sacks 'n' Stuff

[Jumbo]

http://money.cnn.com/2017/03/03/news/economy/republican-repeal-obamacare-tax-credits/index.html

 

Republicans divided over how to help people buy health insurance. What's the latest hold-up in the Republicans' plan to repeal and replace Obamacare?

 

 

How to help people pay for their health insurance.

 

Republicans are fractured over whether to replace Obamacare subsidies with refundable tax credits that would be based on a person's age rather than their income. A faction of conservative lawmakers don't like that these credits would be paid out to everyone buying coverage in the individual market. They are calling it an entitlement program that would potentially be open to millions of Americans who are currently uninsured or receiving assistance through Obamacare.

 

These tax credits have long been the basis of the GOP plan, appearing in both House Speaker Paul Ryan's A Better Way blueprint from 2016 and the Empowering Patients First bill authored by Health Secretary Tom Price in 2015 when he was in the House.

 

A draft replacement proposal that was leaked last month calls for providing credits of up to $4,000 to lower the premiums of those who don't get coverage through their employers or the government.

 

But in recent weeks, conservative Republicans in both the House and the Senate have come out against the GOP leadership plan. They say its tax credits are too similar to Obamacare's subsidies, which are also refundable tax credits but are based on an individual's income and the cost of coverage in their area.

 

Quote

 

Senator Rand Paul ✔@RandPaul

@RandPaul Renaming and keeping parts of Obamacare, new entitlements and extending medicaid expansion are not the #FullRepeal we promised

7:27 AM - 2 Mar 2017

 

 

Some are also concerned that GOP leaders want to pay for their plan by reducing the tax benefits of employer-sponsored plans. This controversial measure could ultimately drive even more people to the individual market, said Representative Mark Meadows, who heads the conservative Freedom Caucus.

 

Here are the two main beefs:

 

First, the tax credits are refundable. This lets everyone get the full benefit of the credit even if they pay little or no taxes, which is the case for many lower-income Americans. It's key to allowing these folks to be able to afford health insurance.

 

To Meadows, this would create a Medicaid-type program that has not proven effective in controlling health care costs. "We are sending federal assistance in a newly created method that somehow we think will work better than what we've had [in Obamacare]," said Meadows, who noted that he met with Senator Rand Paul to discuss the GOP leadership's proposals. "We are not ignoring the real needs of the working poor. [But] the fundamental question is how to do it in a way that's sustainable and drives down health care costs."

 

Second, the tax credits are based on age. This would solve one of Obamacare's big problems --that it is too costly for many middle class Americans who make too much to qualify for the subsidy. But it also means that anyone buying individual insurance will get government assistance, even if they are rich.

 

"So you can be a millionaire and not have employer-based health care and you're going to get a check from the federal government -- I've got a problem with that," said Meadows.

 

Republican leaders are now looking at limiting the ability of the wealthy to claim the credit. Regardless, only a few better-off Americans would qualify for it because most have health insurance through their jobs.

 

This tinkering is not what conservative Republicans were thinking of when they promised to repeal Obamacare. To them, the GOP leadership plan creates another entitlement program, meaning that it provides an open-ended government benefit to anyone who meets the criteria. In this case, it's buying coverage on the individual market.

 

"You are just swapping one financing structure for another financing structure," said Edmund Haislmaier, senior research fellow in Health Policy Studies at the Heritage Foundation. Instead, the Freedom Caucus has endorsed a plan authored by Paul and Representative Mark Sanford that would provide a tax credit of up to $5,000 for contributions to Health Savings Accounts. It would also allow people to pay their premiums with HSA funds.

 

HSAs disproportionately benefit higher-income Americans because only they have enough disposable income to fund them. Acknowledging this, Meadows said some lawmakers are looking at seeding the accounts of the working poor with federal funds to help them to pay for coverage.

 

[LadySkinsFan]

In other words, how can they easily cut any benefits for the poor and middle class down the road.

 

I hate Republicans because of their inhumanity.

Edited March 5, 2017 by LadySkinsFan

[The Sisko]

On March 3, 2017 at 0:26 PM, twa said:

 

Block grants cap federal costs and encourage better utilization of healthcare funds vs the unlimited Medicaid cost system in place now.

 

Where do you think grant funds would be diverted to?

 

Theoretically. Looking at welfare reform block grants it hasn't worked out that way. Most often it's simply been a mechanism to divert funds from the poor to other state budget "priorities". I posted about this earlier in this thread (IIRC) but Louisiana is a prime example of this.

 

Quote

 

20 Years Since Welfare's Overhaul, Results Are Mixed

...Walters says one problem is that over the years, welfare spending in the state has been slashed. The law Clinton signed allowed states to use federal TANF funds for things other than welfare. And when state budgets were stressed after the Great Recession, that's exactly what many of them did.

"So we now use TANF money to pay for things that are not traditional TANF expenditures," she says — such as early childhood education and other programs that used to be funded by the state. She says her administration is concerned about the state's poor and wants to replenish some of those welfare funds.

But Jan Moller of the Louisiana Budget Project is not optimistic the state will be able to find the money. He says welfare became something of a slush fund. The result is that today Louisiana uses only 8 percent of its welfare money on cash benefits for the poor and only 1 percent on programs to help them find jobs. It's one reason benefits are so low.

 

 

When it comes to human behavior, past performance is the best predictor of the future. They'll take the Medicaid block grant, make coverage available to a token few and then use the funds to offset other areas of the budget so they can cut taxes on the wealthy. Exactly what you'd expect of the Bible Belt because that's what Jesus would do. ?

[twa]

I like lower taxes 

[The Sisko]

5 minutes ago, twa said:

I like lower taxes 

 

Like most of the Muricun public, you want government services, you're just not willing to pay for them.

[twa]

13 minutes ago, The Sisko said:

 

Like most of the Muricun public, you want government services, you're just not willing to pay for them.

 

I do expect value.

[Kilmer17]

1 hour ago, The Sisko said:

 

Like most of the Muricun public, you want government services, you're just not willing to pay for them.

I'm willing to pay my share.  It's when others determine that my share is more than others that I start having issues. 

[The Sisko]

1 hour ago, Kilmer17 said:

I'm willing to pay my share.  It's when others determine that my share is more than others that I start having issues. 

 

I assume this is what you mean?

[Springfield]

1 hour ago, The Sisko said:

 

I assume this is what you mean?

 

Yeah, but a company isn't a person.

 

[visionary]

 

[Kosher Ham]

oh, man been a while since i have read any of this thread. 

 

Taxes are fine...paying for other folks to have children and they get my tax money...not fine. Paying for them to eat...not fine. 

I certainly give my fair share. I refuse to ENABLE. That is what we are going through right now. 

 

Stop encouraging by all of these programs to help the less fortunate and Start to encourage and educate. 

That is where the money should be spent. Single mother's and dead beat dad's would be a rarity instead of the expectation.

 

Those with mental issues or drug problems...well...I am not going to go there now. 

[Larry]

Right.  If we'd just stop giving food to people who can't afford to buy it, then they wouldn't choose to be poor.  

 

[TradeTheBeal!]

Starving the poor is definitely a recipe for American greatness.

[bearrock]

Anyone care to define fair share of taxes?  Should we just go back to pure capitalism without social safety nets?  Maybe pick and choose which government program to fund and benefit from?  Because I'm sure it's not going to cause a problem like some idiot deciding their share of funding the police or fire department is too expensive and then crying about how they can't get service when they need it.  Why have medicare and social security?  You should plan for your retirement and if you get wiped out in a stock crash caused by unregulated banking industry, that's life.  You are born into poverty and your parents, for myriads of possible reasons, can't keep food on the table, so what?  Why should you get free food and medicaid.  I mean surely left to individual decisions, people are going to be responsible and society will say if you didn't pay or plan for it, or sometimes life just happens, too bad for you.  I mean look how that turned out for health insurance.

 

I mean why have government at all amiright? 

Edited March 6, 2017 by bearrock

[Sacks 'n' Stuff]

20 hours ago, twa said:

I like lower taxes 

Too bad you're not a billionaire then, eh?

[Larry]

Oh, I haven't seen anybody proposing to just eliminate ALL taxes. (Although I will note that there have been a whole bunch of Republucans who have openly advocated for the elimination of pretty much all taxes on, say, Mitt Romney). 

 

And I also assume that everybody agrees that it's possible for taxes to be too high. Even on "the rich". 

 

But I'll note the latest IRS data shows that people (of all income levels) are paying much lower tax rates than they were in, say, 1980. (The first year for which data is available). Or compared to 2000. (Clinton's last year.)  so I think there's certainly historical data that says those tax levels didn't exactly cripple the economy. 

[bearrock]

Yeah, but when we start talking food for the needy, how much smaller is the government going to get?