Whither Obamacare?

[11B4V]

What I do in the privacy of a bathroom stall on my iProduct is my business.

Besides, it's Friday--all the GS monkeys are "working from home."

[jimmy olsen]

As I said, the Freedom Caucus won't go along with this.

http://www.slate.com/blogs/moneybox/2017/02/27/conservatives_are_already_threatening_the_house_gop_s_health_care_plan.html

Conservative Hardliners Are Already Threatening the House GOP's Health Care Plan

By Jordan Weissmann
Jordan Weissmann is Slate's senior business and economics correspondent.

Late last week, a draft version of the House GOP's evolving Obamacare replacement leaked to the media, offering the most detailed peek yet at what Republicans might have in mind for health reform. But those still young, painstakingly laid plans already look like they might be in trouble, as North Carolina Rep. Mark Meadows, who chairs the powerful and hardline House Freedom Caucus, has told CNN that he'd vote against the legislation were it to hit the floor of Congress tomorrow.

Meadows says he is concerned about the refundable tax credits the bill would offer to help Americans pay for insurance on the individual market. Unlike Obamacare's tax credits, which are only available to Americans who earn less than 400 percent of the poverty line and are more generous for lower-income families, the GOP's subsidies would be available to all Americans who lack employer-based coverage and would rise with age. Those under 30 would be eligible for $2,000 of assistance while those 60 and older would be eligible for $4,000. Meadows considers this system a nonstarter; ditto the taxes needed to pay for it.

"What is conservative about a new entitlement program and a new tax increase? And should that be the first thing that the president signs of significance, that we sent to the new president?" Meadows told CNN. "A new Republican president signs a new entitlement and a new tax increase as his first major piece of legislation? I don't know how you support that—do you?"

Interestingly, Meadows echoes some progressive complaints about the GOP's draft bill—namely, that it would benefit rich, older Americans more than the needy.

"So the headline is that the GOP is reducing subsidies to needy individuals when in fact, the growth of the taxpayer-subsidized reimbursements will actually increase. The total dollars that we spend on subsidies will be far greater," he said. "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."

Meadows isn't the only Freedom Caucus member to express skepticism about the bill that's now circulating—Ohio Rep. Jim Jordan also has qualms, according to CNN, while Florida's Ted Yoho previously objected to some of its features. A primary concern seems to be that the tax credits are refundable, meaning that if they're worth more than an American owes in taxes, that person gets the difference back in cash (or, in this specific case, in payments toward their health insurance premiums). In the eyes of the Freedom Caucus, that makes them an entitlement rather than a tax break—and they're not really wrong. Refundability is really just a not-so-subtle way to hide government benefits in the tax code. The fact that far-right conservatives are wising up to that bodes poorly for the legislation's chances, given the Freedom Caucus' sway in the House.

All of this once again raises the question of whether any health reform proposal could placate enough Republicans to pass Congress. A plan lacking refundable tax credits would be of minimal help to lower-income families, who would be especially in danger of losing their insurance once Obamacare's Medicaid expansion was rolled back. With relatively moderate Republicans in the Senate (emphasis on relatively) already squeamish about the possibility of throwing millions of Americans from their coverage, it's hard to see how such a bare-bones plan like what the Freedom Caucus has in mind could get traction there—much less attract the Democratic votes necessary to overcome a filibuster and fully replace the ACA.

The Republican plan is still in its early stages, so perhaps there's still quietly room for some kind of compromise. And in the end, Senate Majority Leader Mitch McConnell and House Speaker Paul Ryan are reportedly betting that hardliners and moderates alike won't risk their necks by blocking a repeal-and-replace bill that the majority of their GOP colleagues support. But it seems equally plausible at this point that we'll discover that Republican health-care reform is just the oxymoron that so many suspect.

[Admiral Yi]

Best Slate article evah

[Phillip V]

Trump Concedes Health Law Overhaul Is 'Unbelievably Complex'

https://www.nytimes.com/2017/02/27/us/politics/trump-concedes-health-law-overhaul-is-unbelievably-complex.html

[CountDeMoney]

But he said it would be so easy.

[jimmy olsen]

Freedom Caucus in the House on one side, these guys in the Senate on the other. I just don't see how a GOP reform or repeal can pass?

http://www.motherjones.com/politics/2017/03/republican-senators-obamacare-medicaid-expansion-portman-capito-gardner-murkowski

Republican Senators Just Rebelled Against the House Plan to Repeal Obamacare

They are fighting to protect Medicaid expansion.

Patrick CaldwellMar. 6, 2017 6:31 PM

After a week of keeping their bill under guard by Capitol Police, House Republicans introduced their plan to repeal Obamacare late Monday afternoon. But a band of four Republican senators had already begun revolting in public—even before the language of the new measure had seen the light of day. They sent a letter to their caucus leader Monday afternoon saying that they couldn't support the latest leaked version of the House plans because it doesn't protect people who gained Medicaid under Obamacare.

One of the Affordable Care Act's most effective ways of lowering the number of people who lack health insurance has been a provision that allows those who earn 138 percent or less of the federal poverty level to enroll in Medicaid. The Supreme Court added a level of uncertainty to this implementation by allowing states to decide whether or not they want to opt into that program, but 31 states have accepted Medicaid expansion to date, granting government-covered insurance to about 11 million additional people.

Republican Sens. Rob Portman (Ohio), Shelley Moore Capito (West Virginia), Cory Gardner (Colorado), and Lisa Murkowski (Alaska) sent a letter to Senate Majority Leader Mitch McConnell on Monday voicing their concerns. "While we support efforts to repeal and replace the Affordable Care Act and make structural reforms to the Medicaid program," the letter says, "we are concerned that the February 10th draft proposal from the House of Representatives does not provide stability and certainty for individuals and families in Medicaid expansion programs or the necessary flexibility for states."

The four senators all hail from states that have accepted Medicaid expansion, and they made that necessary prerequisite for any plan they'd be willing to consider. "We will not support a plan that does not include stability for Medicaid expansion populations or flexibility for states," the letter explains.

This early warning spells serious trouble for Republican hopes of repealing Obamacare. Republicans plan to pass their repeal bill through a budget reconciliation process in which only a simple majority is necessary, so they don't have to worry about a Democratic filibuster. But with just 52 Republican senators (and few possible Democratic defections), Republicans probably can't pass a bill without these four senators. At the same time, the GOP leadership is having to fend off the Freedom Caucus in the House, as this group of tea-party-supported legislators threaten to withhold support because the bill doesn't go far enough in ditching policies—such as the government offsetting the cost for low-income individuals to buy health insurance—implemented by the ACA. While the four renegade senators sent their letter to McConnell, Sen. Rand Paul was complaining on Twitter that the House proposal wasn't conservative enough.

Senator Rand Paul
✔  ‎@RandPaul 

Still have not seen an official version of the House Obamacare replacement bill, but from media reports this sure looks like Obamacare Lite!

[CountDeMoney]

Chaffetz: Americans should forgo new iPhone to afford healthcare



Haven't heard the Welfare Queen card played for a while.  Bravo, Jason!

[derspiess]

Chaffetz: Americans should forgo new iPhone to afford healthcare



Haven't heard the Welfare Queen card played for a while.  Bravo, Jason!

I have a few more, if you'd like to hear them.

[CountDeMoney]

I just bet you do, King Cotton

[Phillip V]

Replacement is a disastrous proposal.

Cut funding for premiums to poor people at max $4k a year (if they are age 60) while cutting the 3.8% tax on people making $200K+ a year?  Hilarious.

Meanwhile, the government is still giving away money to the individual in some form, so "true conservatives" will still be super pissed.

Healthcare industry will be pissed about losing a crapload of money because the spigot of limitless federal premiums subsidies is turned off.

[FunkMonk]

Everybody hates this bill 

Which can mean only one thing in Trump's America: It will pass 

[celedhring]

Chaffetz: Americans should forgo new iPhone to afford healthcare



Haven't heard the Welfare Queen card played for a while.  Bravo, Jason!

The American poor should pool their money and buy up some GOP politicians. Seems the most efficient usage of money these days.

Replacement looks like a total disaster, btw.

[CountDeMoney]

I'm trying to figure out how, if I am forced to buy on the open marketplace--which I couldn't afford prior to ACA--how am I expected to afford it and then apply tax credits when I do my taxes tge following year?

Oh, I forgot--it's about having "access" to healthcare.

[celedhring]

I'm trying to figure out how, if I am forced to buy on the open marketplace--which I couldn't afford prior to ACA--how am I expected to afford it and then apply tax credits when I do my taxes tge following year?

Oh, I forgot--it's about having "access" to healthcare.

It's about giving choices to the American public. You can either end bankrupted by home bills or by healthcare bills.

[The Minsky Moment]

The GOP is chasing their tail on this.  The two redlines they've adopted are that the mandate must go, but that the pre-existing condition coverage guarantee must stay.  You can't make that work unless you throw tons of money at the insurance companies to compensate in some form or another, or you give up the charade and go single payer.  GOP can't assemble a majority behind that.

In way Trump is wrong - its' not THAT complicated, it's just that there are a limited number of viable options.