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Obamacare Replacement by GOP Login/Join 
Now in Florida
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quote:
Originally posted by Il Cattivo:

IOW, you may see Trump shifting to push for an outright repeal by the end of next week.



I don't see how that works. Does failure of the GOP bill magically create 60 votes for an outright repeal? It seems that they wouldn't even be able to find 50 votes for a full repeal.

I would love to see the GOP get a 60 seat majority in the 2018 midterms - it would be interesting to see if they would then pass a clean repeal. My guess is that they would not.
 
Posts: 4177 | Location: FL | Registered: March 09, 2009Reply With QuoteReport This Post
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I don't see how that works.

Memo to the Majority Leader: you have 52 votes and it's time to use them, as you did with Justice Gorsuch.
... or step aside.


"The United States government is the largest criminal enterprise on earth."
-rduckwor
 
Posts: 12163 | Location: St. Louis, MO | Registered: April 03, 2009Reply With QuoteReport This Post
Middle children
of history
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quote:
Originally posted by ChicagoSigMan:
quote:
Originally posted by Il Cattivo:

IOW, you may see Trump shifting to push for an outright repeal by the end of next week.



I don't see how that works. Does failure of the GOP bill magically create 60 votes for an outright repeal? It seems that they wouldn't even be able to find 50 votes for a full repeal.

I would love to see the GOP get a 60 seat majority in the 2018 midterms - it would be interesting to see if they would then pass a clean repeal. My guess is that they would not.




It doesn't take 60 votes. They did it before with 52 and then Obama vetoed it.



quote:
Originally posted by chellim1:
December, 2015: The Senate voted to repeal Obamacare with 52 votes:

The measure passed 52-47 after the Senate voted to significantly strengthen the bill originally passed by the House and brought straight to the floor by Majority Leader Mitch McConnell (R-Ky.).

The House will need to approve the amended legislation before it can be sent to the White House.

Thursday’s vote was a major event in the Senate, as Democrats never allowed a stand-alone vote on an ObamaCare repeal bill when they controlled the chamber.

Democrats were also unable to block the GOP measure, which was brought to the floor under budget reconciliation rules that prevented a filibuster.

“For too long, Democrats did everything to prevent Congress from passing the type of legislation necessary to help these Americans who are hurting,” McConnell said on the floor. “Today, that ends.”

The measure guts the law by repealing authority for the federal government to run healthcare exchanges, and scrapping subsidies to help people afford plans bought through those exchanges. It zeros out the penalties on individuals who do not buy insurance and employers who do not offer health insurance.

http://thehill.com/policy/heal...ng-much-of-obamacare

January, 2016:
Obama used his veto pen without fanfare on a legislative package rolling back his signature healthcare law and stripping federal funding from Planned Parenthood.

Speaker Paul Ryan (R-Wis.) on Friday pledged that Congress would vote to override Obama’s veto. The party lacks the two-thirds majority necessary to achieve that, however.

“It’s no surprise that someone named Obama vetoed a bill repealing Obamacare. But we will hold a vote to override this veto, taking this process all the way to the end under the Constitution,” Ryan said in a statement.

Ryan said the vote showed there is a “clear path” for Republicans to repeal the law.

“The idea that Obamacare is the law of the land for good is a myth. This law will collapse under its own weight, or it will be repealed,” he said. “We have now shown that there is a clear path to repealing Obamacare without 60 votes in the Senate. So, next year, if we’re sending this bill to a Republican president, it will get signed into law.”

http://thehill.com/homenews/ad...althcare-bill-repeal




I firmly believe that any man's finest hour, the greatest fulfillment of all that he holds dear, is that moment when he has worked his heart out in a good cause and lies exhausted on the field of battle - victorious.

-Vince Lombardi
 
Posts: 2120 | Location: Ohio | Registered: September 06, 2008Reply With QuoteReport This Post
Thank you
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"My rule of life prescribed as an absolutely sacred rite smoking cigars and also the drinking of alcohol before, after and if need be during all meals and in the intervals between them." Winston Churchill
 
Posts: 10714 | Location: Mouseville, FL | Registered: November 07, 2008Reply With QuoteReport This Post
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It seems that they wouldn't even be able to find 50 votes for a full repeal.



Unfortunately that may be true...
It's time to find out.


"The United States government is the largest criminal enterprise on earth."
-rduckwor
 
Posts: 12163 | Location: St. Louis, MO | Registered: April 03, 2009Reply With QuoteReport This Post
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Senate Republicans Reveal New "Obamacare-Lite" Healthcare Bill

In what could very well end up being just another exercise in futility, Senate Majority Leader Mitch McConnell has just released a new version of a healthcare plan which, among other things, incorporates demands from Senator Ted Cruz (R-TX) and Senator Mike Lee (R-UT) to allow insurers to sell low-cost, skimpier plans all in an effort to draw conservative support for the new bill.

Called the "Consumer Freedom Amendment," we highlighted the main points of the Cruz/Lee proposal last month:

The "Consumer Freedom Amendment" would leave existing ObamaCare plans on the individual market, while also allowing insurers to sell plans that don't comply with requirements of the Affordable Care Act.

"What that does — it leaves existing plans on the market but it gives new options so that people can purchase far more affordable health insurance. It will enable a lot more people to be able to afford buying health insurance," Cruz told The Hill on Thursday afternoon.



Cruz's amendment would allow insurers to continue offering plans that follow ObamaCare's "Title One" requirements, including essential health benefits, which mandates 10 services insurers must cover with no cost-sharing.



But insurers could also sell skimpier, cheaper plans that don't cover those 10 services or meet other ObamaCare requirements.

"If a health insurer offers a plan consistent with the Title One mandates, insurers can also sell in that same state any other plans that consumers desire," Cruz said.


Cruz Lee

Of course, with precious little votes to spare, McConnell's new bill has plenty of handouts for moderate Republicans as well. The rewritten package would add $70 billion to the $112 billion McConnell originally sought that states could use to help insurers curb the growth of premiums and consumers' other out-of-pocket costs. It also has $45 billion for states to combat the misuse of drugs like opioids. That's a big boost from the $2 billion in the initial bill and an addition demanded by Republicans from states in the Midwest and Northeast that have been ravaged by the drugs.

As The Hill points out, the revised bill largely keeps the Medicaid sections the same, meaning that deeper cuts to the program will still begin in 2025, and the funds for ObamaCare’s expansion of Medicaid will still end in 2024. The changes to Medicaid emerged as a top concern of moderates such as Senators Rob Portman (R-Ohio), Shelley Moore Capito (R-W.Va.) and Lisa Murkowski (R-Alaska).

The revised bill also restores some of the original Obamacare taxes on investment income and the payroll tax in an effort to help fund Medicare. Axios had more highlights:

An additional $70 billion to help states stabilize their markets and offset the costs of covering expensive patients — on top of more than $100 billion that was already there.

$45 billion to fight the opioid epidemic.

A provision allowing people to use tax-preferred health savings accounts to pay their premiums


Changes to the ACA that would let more consumers use tax subsidies to buy plans that only offer catastrophic coverage.

The bill would no longer repeal two of the ACA's tax increases on wealthy families, and it won't include a new tax break for health-care executives.

In other words, more provisions that simply make the bill look and feel an awful lot like Obamacare...a fact that Senator Rand Paul pointed out in an op-ed just yesterday in which he blasted McConnell's new bill as more or less a capitulation by Republicans to simply "keep Obamacare."

I miss the old days, when Republicans stood for repealing Obamacare. Republicans across the country and every member of my caucus campaigned on repeal – often declaring they would tear out Obamacare “root and branch!”

What happened?

The Senate Obamacare bill does not repeal Obamacare. I want to repeat that so everyone realizes why I’ll vote “no” as it stands now:

The Senate Obamacare bill does not repeal Obamacare. Not even close.

Seems that McConnell is trying to 'have his cake and eat it too' with efforts to appeal to both conservative and moderate elements of the Republican party.

Will he be successful? John Cornyn seems to think so:

US SENATOR CORNYN, NO. 2 REPUBLICAN, SAYS WILL HAVE ENOUGH SUPPORT TO PASS HEALTHCARE BILL BY THE TIME IT IS PUT TO A VOTE

Of course, it seems like we've heard that somewhere before...

http://www.zerohedge.com/news/...lite-healthcare-bill


"The United States government is the largest criminal enterprise on earth."
-rduckwor
 
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Now in Florida
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Originally posted by Brett B:
[
December, 2015: The Senate voted to repeal Obamacare with 52 votes:


That was not a full or "clean" repeal. That was done under reconciliation. It was stronger than what is now being proposed but still not a true repeal "root, stock and branch".
 
Posts: 4177 | Location: FL | Registered: March 09, 2009Reply With QuoteReport This Post
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That was not a full or "clean" repeal. That was done under reconciliation.

The Dems. pushed it through under reconciliation, after losing the Kennedy seat in MA, without 60 votes. The Republicans can repeal it under reconciliation, without 60 votes. There will not be 60 votes for anything.

Memo to the Majority Leader: you have 52 votes and it's time to use them, as you did with Justice Gorsuch.
... or step aside.


"The United States government is the largest criminal enterprise on earth."
-rduckwor
 
Posts: 12163 | Location: St. Louis, MO | Registered: April 03, 2009Reply With QuoteReport This Post
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Senator Ted Cruz (R-TX) and Senator Mike Lee have a tough decision to make. The amendment is an improvement... but this bill is a Christmas tree, with ornaments and gifts for everyone. It will be a budget buster, expanding deficit spending. If they take the bait, it would make Republicans responsible for all of the taxes and subsidies of Obamacare. The insurance companies would require massive subsidies to avoid the "death spiral" because this doesn't eliminate the requirement of offering an "essential benefits" package.

We know where Sen. Paul stands. Cruz and Lee will hold the key and can either go along with McConnell or push for full repeal with Sen. Paul.


"The United States government is the largest criminal enterprise on earth."
-rduckwor
 
Posts: 12163 | Location: St. Louis, MO | Registered: April 03, 2009Reply With QuoteReport This Post
Gracie Allen is my
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posted Hide Post
quote:
Originally posted by ChicagoSigMan:
quote:
Originally posted by Il Cattivo:

IOW, you may see Trump shifting to push for an outright repeal by the end of next week.



I don't see how that works. Does failure of the GOP bill magically create 60 votes for an outright repeal? It seems that they wouldn't even be able to find 50 votes for a full repeal.

Apparently there are eight or more votes that McConnell can't pick up for the "Save OCare" legislation because it doesn't go far enough to eliminate OCare. Shift eight votes in a 100 person body, and that's a big enough change to alter the momentum of building support behind the bill to fully repeal OCare. McConnell can then make all the BS promises he wants to that the Senate will discuss the return of any aspect of OCare that has the votes to pass - after the entirety of OCare is fully repealed.

The Reps would also be in a perfectly credible position to argue that they might just be willing to go nuclear on this issue by voting away the requirement for a 60-vote majority in favor of a simple 51-vote majority. Remember, the 60 vote thing is a product of Senate rules, not the Constitution, statutes or caselaw, and as such can be changed at any time by a simple 51 or more votes in favor of the change. Right now the Dems desperately need that 60-vote majority rule, if only to get a modicum of wriggle room and breathing space here and there between now and the next elections. Without it, the Dems would have to be absolutely swamped with legislation they hate but cannot possibly kill before it becomes law. I thing that if McConnell wanted to scare the Dems into not insisting on a 60-vote majority, all he'd really have to do is show them Cruz' Christmas wish list and ask them how often they think Cruz, with McConnell's help, can put together 51 votes.

What happens then will probably be up to inertia. No one has managed to gin up a successful public campaign to make any particular aspect of OCare untouchable yet - which is why the chickens in the Senate are perfectly comfortable with whittling away at it bit by bit.
 
Posts: 20135 | Location: Deep in the heart of the brush country, and closing on that #&*%!?! roadrunner. Really. | Registered: February 05, 2008Reply With QuoteReport This Post
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Obamacare 4.0: Swampcare fixes zero & WILL lead to single-payer:

Daniel Horowitz

GOP health care bill keeps the worst of Obamacare.

There is nothing new about the revised Senate health care bill. It takes all the bad aspects of the original bill and makes them worse, albeit with a phony amendment designed to attract conservatives – an amendment that is nothing more than a talking point.

The core problem with the GOP bill is that it keeps every essential element of Obamacare. The core problem of Obamacare is that after the government already took over half of health care, the ACA made the remainder of the private market so heavily regulated, subsidized, and distorted that nobody could afford either health care itself or medical insurance without government assistance.

Rather than straight up single-payer for the other half of the country (half of health care is already single-payer), Obamacare created a monopoly for a handful of insurers to use the regulations to box out competitors but subsist themselves on guaranteed subsidies and bailouts secured by their lobbyists.

Rather than competing for organic consumer demand, the consumer is completely cut out of the equation; they compete instead for lobbyist-driven subsidies that create a death spiral of monopolies and price inflation.

As we demonstrated at the time, the GOP bill keeps all of these elements. Just look at this chart from page six, which shows Stalinist price fixing for how much everyone under a certain income level should pay for government-sponsored and -regulated insurance. The rest of us are left out to dry.

swampcare subsidies

In that respect, Obamacare and Swampcare are even worse than single-payer because those over the subsidy level are not covered and cannot afford health care; they are out of options to purchase affordable insurance as well. This in itself creates a devastating tax cliff, which disincentivizes upward mobility and destroys the economy.

Part of why we never wanted official single-payer is because it’s impossible to then grow the economy beyond 2 percent. Well, the tax cliff from de facto single-payer that leaves out middle class families has created the same economic albatross.

Obamacare and Swampcare are the worst mix of government control and a zombie private market propped up by subsidies but secured as a monopoly through competition-crushing regulations. It has the “greed” of the private sector but lacks the inherent check from the free market of consumer demand because they are sponsored by the endless guarantees from government.

Venture socialism and crony capitalism are worse than straight-up socialism. We get the worst aspects of government control and human nature of the natural market.

Details of the revised Obamacare 4.0 bill

Keeps tax increases to pay for the entitlement: The revised bill maintains the two largest Obamacare tax increases: the increased Medicare payroll tax and the 3.8 percent surcharge on investment income. That was the only aspect of Obamacare that Republicans universally opposed until now.
Endless bailouts: In addition, it adds another $70 billion to the existing $112 billion bailout fund for insurers to further inflate the price of insurance and self-perpetuates the need for endless bailouts, which will lead to single-payer.
More Medicaid spending: The revised bill also throws more money at Medicaid than the previous version (not that any of the baseline rate reductions were going to take place anyway). As I explained before, once you fail to heal the private market, we will all be forced onto Medicaid and there will be no way to reduce the program. Mitch McConnell reportedly admitted that our allegation was correct when he allegedly told a group of liberal Republicans not to worry about the Medicaid cuts because they would never go into effect.

So what is the plan to get conservatives to support what is de facto single-payer? What about the Cruz amendment? Doesn’t it get rid of some of the regulations and will lead to lower premiums?

Not a chance.

In a tried and trusted subterfuge, McConnell took a conservative idea and bastardized it in order to place people like Ted Cruz in a tough position. Yes, technically consumers will be allowed to buy slimmed-down or higher-deductible plans, and (the few remaining) insurers will be allowed to offer them. But they still must offer the regulated plans tailor made through the Obamacare exchanges and subsidized both on the consumer end, on the state end, and on the insurer end.

Thus, the price inflation from the regulations and subsidies will keep premiums high and box out competition from those that lack the economies of scale. Even if they could also provide plans that aren’t “compliant,” they will not be that much cheaper because insurers will have to recoup the losses through healthier people.

In other words, this scheme maintains the original sin of Obamacare: placing everyone in the same pool and forcing the healthy to subsidize the sick, thereby making everyone pay the rate of the sick.

The original plan proposed by conservatives was to have two separate pools whereby sicker consumers would be offloaded into defined contribution subsidies and the rest of the market would be free of regulations AND subsidies in a separate pool. Telling insurers you must keep the insolvent regulations but that they can also have solvent plans is like saying you can carry a bottle of water in one hand if we blow torch your other hand.

Moreover, by keeping the endless subsidies and adding to the bailout fund, this bill ensures that there is no market and organic consumer demand to offer the cheap plans we had before Obamacare.

Everyone else, including healthy families earning under $85,000 or so will still be subsidized and the bailouts will still flow in order to sugarcoat any rate increase, leaving insurers with no deterrent against raising rates. Government will always kick in the rest. The subsidies apply even to those who purchase slimmed-down plans, which will distort their prices.

Here’s an example: At present, I’m paying $1,280 a month for a $13,100 deductible. Before Obamacare, I paid $425 a month for a $5,000 deductible, which, on net, covered more of my basic needs (prior to meeting the deductible) than the Obamacare plan. At the time, we all considered $5,000 to be a high deductible, but it was worth it in exchange for the lower premium.

Obamacare, which is fully kept in place by the GOP bill, has increased deductibles to $13k for a mega premium. Given that the market crisis will not be healed by this amendment, at best they will offer slim plans with a $13,000 deductible for slightly cheaper than the current rate (which is slated to skyrocket further), but well above the pre-Obamacare market.

Is it really worth it for conservatives to have this bill labeled as “the Cruz bill” and incur all the other political liabilities when it won’t fundamentally address the problem with medical insurance or health care?

As I noted before, the compromise solution is to go in the exact opposite direction. Keep the Medicaid expansion (McConnell admitted they are keeping it anyway), fund a separate high risk pool, and leave the rest of us the hell alone. Why are we blowing up the rest of the private market for such a small number of people when 84 percent of those who obtained coverage under Obamacare were thrown onto Medicaid — not private insurance. (Private coverage among those over the age of 26 actually decreased under Obamacare.)

Some might point to the provision Cruz secured in the bill to allow HSAs to cover premium payments as a bright spot. Expanded HSAs is certainly part of the solution after we repeal Obamacare to partially address the overutilization of health insurance and the problems with fourth-party payments so that consumers are directly responsible for their care and will bend the cost of health care itself.

The problem is that until we actually repeal the market distorting and destroying regulations and subsidies, expanded HSAs are tantamount to throwing a diamond on a landfill. We can get a tax exemption to purchase … what?

People are willing to pay more out of pocket to directly pay health care providers assuming they just pay a few hundred a month on catastrophic insurance to cover the a calculated risk. Such an outcome would actually solve the original sin of health care. But this bill will not solve the problem, because even catastrophic insurance will cost too much, rendering HSAs moot.

Passing “something” is not better than nothing. Passing bills is not progress. Doing the right thing is progress.

https://www.conservativereview...lead-to-single-payer


"The United States government is the largest criminal enterprise on earth."
-rduckwor
 
Posts: 12163 | Location: St. Louis, MO | Registered: April 03, 2009Reply With QuoteReport This Post
I believe in the
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quote:
Originally posted by chellim1:
quote:
That was not a full or "clean" repeal. That was done under reconciliation.

The Dems. pushed it through under reconciliation, after losing the Kennedy seat in MA, without 60 votes. The Republicans can repeal it under reconciliation, without 60 votes. There will not be 60 votes for anything.

Memo to the Majority Leader: you have 52 votes and it's time to use them, as you did with Justice Gorsuch.
... or step aside.


Not true.

quote:
The amendment bill, The Health Care and Education Reconciliation Act, cleared the House on March 21; the Senate passed it by reconciliation on March 25,....


The original bill was passed with 60 votes in the Senate in Decenber while Kenndy's replacement was still in office. The amendment reconciliation bill saved rheir ass.




Luckily, I have enough willpower to control the driving ambition that rages within me.

When you had the votes, we did things your way. Now, we have the votes and you will be doing things our way. This lesson in political reality from Lyndon B. Johnson

"Some things are apparent. Where government moves in, community retreats, civil society disintegrates and our ability to control our own destiny atrophies. The result is: families under siege; war in the streets; unapologetic expropriation of property; the precipitous decline of the rule of law; the rapid rise of corruption; the loss of civility and the triumph of deceit. The result is a debased, debauched culture which finds moral depravity entertaining and virtue contemptible." - Justice Janice Rogers Brown
 
Posts: 41528 | Location: Texas hill country | Registered: July 04, 2005Reply With QuoteReport This Post
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Well in that case... as bad as this bill appears to be... let them try to get 60 votes!
They seem to be angling for 50. Senators Paul and Collins are no votes. I think they are counting on Pence to break the tie.


"The United States government is the largest criminal enterprise on earth."
-rduckwor
 
Posts: 12163 | Location: St. Louis, MO | Registered: April 03, 2009Reply With QuoteReport This Post
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No law that enshrines the "pre-existing condition" policy can possibly fix the problem. Smart people will just wait until they get sick and then buy a policy. The whole idea of "insurance" is that large numbers of folks pay premiums against the probability that they will need care. When the probability becomes 1.0 (a certainty), then "insurance" fails.

I've said it before: "pre-existing conditions" that develop within some designated period prior to buying the policy should be priced with higher premiums. (I recommend at least 5 years, and would have to be certified by a doctor in writing.) It is essential to encourage purchase of insurance while one is still healthy.

Keeping "children" in the parents' policy until age 26 is dumb, too. Anyone over 18 is considered a legal adult in our Society, and unless a student living at home (or being supported by their parents) they should buy their own insurance. A 26-year old is not a "child".

flashguy




Texan by choice, not accident of birth

When they ask me, "Paper or plastic?" I just say, "Doesn't matter to me. I am bi-sacksual."
 
Posts: 18473 | Location: Dallas, TX | Registered: May 08, 2006Reply With QuoteReport This Post
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quote:
Smart people will just wait until they get sick and then buy a policy. The whole idea of "insurance" is that large numbers of folks pay premiums against the probability that they will need care. When the probability becomes 1.0 (a certainty), then "insurance" fails.

Right.
This bill preserves the 'death spiral' and stretches it out with your tax dollars going to bigger subsidies for the few remaining monopolist 'insurance' companies. When it fails, the only alternative will be 'single payer'.

The only thing this bill does is repeal Democrats' sole ownership of Obamacare. Republicans pass this, they now own the single piece of legislation that has haunted Democrats since 2010...
I hope Sen. Lee remains a strong vote for actual repeal.

But it actually may be the RINOs who kill it rather than the conservatives:

Senate Obamacare repeal bill on knife's edge of defeat

The latest whip count on the Senate health insurance reform bill is out and it doesn't look good for Majority Leader Mitch McConnell and the Republicans.

The Hill nose count shows that, in addition to all 47 Democrats in opposition, 2 Republican Senators are unalterably opposed - Rand Paul and Susan Collins. That means that McConnell must round up every single remaining Republican Senator to reach 50 votes and count on Vice President Pence to break the tie.

There are 23 fence sitting Republicans who could go either way ...

Here are some of them:

Sen. Shelley Moore Capito (W.Va.) — Capito said she does not know if she’ll vote to advance the new bill. “We have another meeting this afternoon on the Medicaid cuts,” she said Thursday. “I need to really look at it, look at the score, I still have concerns.” She has expressed concerns the first bill did not do enough to combat opioid abuse and cut Medicaid too deeply. Capito told Politico during the July Fourth recess that she will kill the repeal bill if it comes down to her. “If I have to be that one person, I will be it.”

Sen. Bill Cassidy (La.) — Cassidy won headlines when he talked about how the bill needed to pass a "Jimmy Kimmel test" on whether it would prevent children with pre-existing conditions from getting coverage. Cassidy on Thursday said he was not sure if he would vote to advance the revised bill. Cassidy has worked with Collins on alternate legislation.Sen. Shelley Moore Capito (W.Va.) — Capito said she does not know if she’ll vote to advance the new bill. “We have another meeting this afternoon on the Medicaid cuts,” she said Thursday. “I need to really look at it, look at the score, I still have concerns.” She has expressed concerns the first bill did not do enough to combat opioid abuse and cut Medicaid too deeply. Capito told Politico during the July Fourth recess that she will kill the repeal bill if it comes down to her. “If I have to be that one person, I will be it.”
Sen. Bob Corker (Tenn.) — Corker was undecided on the first bill.

Sen. Steve Daines (Mont.) — “I look forward to hearing directly from Montanans on this legislation,” Daines said about the first bill.

Sen. Joni Ernst (Iowa) -- Ernst did not take a position on Senate Republicans’ first ObamaCare repeal and replace plan, and said she was polling her constituents to gauge their feelings on the bill.

Sen. Jeff Flake (Ariz.) — Flake is up for reelection in 2018. He said he would "thoroughly read and review it" after the first bill's release.

Sen. Cory Gardner (Colo.) — “If we can have opportunities to make the bill better, then by all means let’s take every chance and (all the) time we can,” he said of the first bill, according to the Denver Post.

http://www.americanthinker.com..._edge_of_defeat.html


"The United States government is the largest criminal enterprise on earth."
-rduckwor
 
Posts: 12163 | Location: St. Louis, MO | Registered: April 03, 2009Reply With QuoteReport This Post
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The swamp is still full of RINOs wanting to be fed.


Here Are 5 Backroom Deals Inside The Latest Senate Health-Care Bill

Another health-care bill, another pack of senators holding the nation hostage until they get special treatment.

July 14, 2017

Buried within the pages of the revised Senate health-care bill are numerous formula tweaks meant to advantage certain states. Call them backroom deals, call them earmarks, call them whatever you like: several provisions were inserted into the bill over the past two weeks with the intent of appealing to certain constituents.

It appears that at least three of these provisions apply to Alaska—home of wavering Sen. Lisa Murkowski (R-AK)—and another applies to Louisiana, home of undecided Sen. Bill Cassidy (R-LA). Below please find a summary (not necessarily exhaustive) of these targeted provisions.
The Buy Off Lisa Murkowski Again Fund

Section 106 of the bill includes new language—page 13, lines 4 through 13, and page 18, line 12 through page 19, line 4—dedicating one percent of the new Stability Fund dollars to “each state where the cost of insurance premiums are at least 75 percent higher than the national average.” As a Bloomberg story noted, this provision currently applies only to Alaska, and could result in $1.32 billion in Stability Fund dollars automatically being directed to Alaska.
The Alaskan Pipeline

The revised Section 126 of the bill includes modified language—page 44, lines 9 through 17—changing certain Medicaid payments to hospitals based on a state’s overall uninsured population, not its Medicaid enrollment. As Bloomberg noted, this provision would also benefit Alaska, because Alaska recently expanded its Medicaid program, and therefore would qualify for fewer dollars under the formula in the original base bill.
The Moral Hazard Expansion

The underlying bill determined Medicaid per capita caps based on eight consecutive fiscal quarters—i.e., two years—of Medicaid spending. However, the revised bill includes language beginning on line 6 of page 59 that would allow “late expanding Medicaid states”—defined as those who expanded between and July 1, 2015 and September 30, 2016—to base their spending on only four consecutive quarters. Relevant states who qualify under this definition include Alaska (expanded effective September 1, 2015), Montana (expanded effective January 1, 2016), and Louisiana (expanded effective July 1, 2016).

The most recent actuarial report on Medicaid noted that, while the actuary originally predicted that adults in the expansion population would cost less than existing populations, in reality each newly eligible enrollee cost 13.6 percent more than existing populations in 2016. Some states have used the 100 percent federal match for their expansion populations—i.e., “free money from Washington”—to raise provider reimbursement levels. Therefore, allowing these three states to use only the quarters under which they had expanded Medicaid as their “base period” will likely allow them to draw down higher payments from Washington in perpetuity.
The South Dakota Purchase

The revised bill includes a new Section 138, which makes services provided by a state to Indian Health Service enrollees subject to a 100 percent federal Medicaid match. Under current law, only services “received through an Indian Health Service facility whether operated by the Indian Health Service or by an Indian tribe or tribal organization” are subject to a 100 percent match. South Dakota Gov. Dennis Daugaard has pushed this provision for over a year, saying he would expand Medicaid under Obamacare—but only if the federal government would agree to provide a 100 percent reimbursement for all Medicaid services provided to Indian Health Service enrollees.
The Buffalo Bribe

This provision, originally included in the House-passed bill, remains in the Senate version, beginning at line 12 of page 69. Originally dubbed the “Buffalo Bribe,” and inserted at the behest of congressmen from upstate New York, the provision would essentially penalize that state if it continues to require counties to contribute to the Medicaid program’s costs.
More to Come?

While the current bill contains at least half a dozen targeted provisions, many more could be on the way. By removing repeal of the net investment tax and Medicare “high-income” tax, the bill retains over $230 billion in revenue. Yet the revised bill spends far less than that—$70 billion more for the Stability Fund, $43 billion more in opioid funding, and a new $8 billion demonstration project for home and community-based services in Medicaid.

Even after the added revenue loss from additional health savings account incentives, Senate leadership could have roughly $100 billion more to spend in their revised bill draft—which of course they will. Recall too that the original Senate bill allowed for nearly $200 billion in “candy” to distribute to persuade wayward lawmakers. In both number and dollar amount, the number of “deals” to date may dwarf what’s to come.

Jacobs is founder and CEO of Juniper Research Group,
http://thefederalist.com/2017/...-bill/#disqus_thread


"The United States government is the largest criminal enterprise on earth."
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Posts: 12163 | Location: St. Louis, MO | Registered: April 03, 2009Reply With QuoteReport This Post
#DrainTheSwamp
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Will premiums and deductibles come down? If not, then why is Trump saying he's waiting with pen in hand, ready to sign?


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Posts: 740 | Location: Glen Allen, Virginia | Registered: January 05, 2003Reply With QuoteReport This Post
Lawyers, Guns
and Money
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July 15, 2017
Why did we elect a Republican Congress?
By J. Marsolo

Obama and the Democrats passed Obamacare without any Republican votes on a slick parliamentary move by Harry Reid. Republicans vowed to repeal Obamacare. Next, Obamacare was saved by the vote of Justice Roberts when he decided that it is constitutional as a tax even though Obama and the Dems did not pass it as a tax. Republicans again vowed to repeal Obamacare.

Republicans said Obamacare is designed to fail so we end up with a single-payer system. The passage of Obamacare energized the Republican base, leading to a Tea Party, and a revival of conservative politics. We won the House in 2010 and have retained it since. We won the Senate in 2012 and have retained it since.

Republicans ran on the promise to repeal Obamacare, which resulted in a Republican Congress. During the Obama administration, the Republicans passed numerous bills to repeal Obamacare. They did not become law because Obama was president, who had veto power.

Donald Trump won in 2016. He ran on a platform to sign a bill to repeal Obamacare. Now we have a Republican House and Senate and a Republican president. All that is necessary is a simple bill to repeal Obamacare, which President Trump would sign. Send the same bill that was passed and sent to Obama.

Instead, we became bogged into a "repeal and replace" to craft a bill to replace Obamacare. The House had difficulty in passing a bill. Now the Senate is having difficulty in passing a bill. The Republican leadership has had since Trump's election but is still fumbling around to put together a bill acceptable to 52 Republican senators.

The problem is that any bill will be a version of Obamacare because the Republicans are trying to legislate a comprehensive health care bill to satisfy all interests , from Rand Paul, who wants a repeal, to Susan Collins, who wants Obamacare Lite. Some are pushing to expand Medicare so that it becomes the default for the uninsured.

Democrats will oppose any Republican bill. The bottom line is that many Republicans want to pass a more efficient and fair Obamacare plan rather than simply repeal Obamacare.

We do not need a comprehensive health care bill, same as we did not need a "Comprehensive Immigration Bill" that McCain, Graham, and Bush tried to sell in in 2007.

The Republicans should pass a simple repeal of Obamacare. If they have to get rid of cloture, then do it, just as Harry Reid used his moves.

Then Republicans should pass specific bills to deal with specific issues, such as waiting periods for pre-existing conditions, portability of insurance from employer to employer, using HSA to pay for premiums, increasing the amount for HSA, allowing consumers to choose coverage, selling policies across state lines, allowing income tax deduction for all medical bills from gross income, using VA hospitals to treat the uninsured and those with pre-existing conditions that have not yet met the time limits, and other issues.

There should be debate on each of these where Democrats are forced to vote on specific bills, instead of just allowing the Dems to vote no on one bill so they can say they are trying to save health care for all.

The repeal of Obamacare highlights the weakness and ineffectiveness of Congress. We still have reduction of income tax rates and simplification of the tax code, confirmation of federal judges and another Supreme Court justice, and funding for the wall. The only achievement so far by Congress is Neal Gorsuch on the Supreme Court.

Worse, the congressional Republicans do not support Trump by defending him against the daily onslaught by the Opposition Party, consisting of the Democrats and the Destroy Trump Media. It seems that Never-Trump senators, such as McCain, Collins, Graham, Sasse, Lee, Toomey, and others are willing to see Trump destroyed.

But if Obamacare is not repealed, and there is no tax cut, no funding of the wall, and Trump is not supported, the Democrats will take the House in 2018.

Republicans had better wake up and remember why they were elected.

http://www.americanthinker.com...blican_congress.html


"The United States government is the largest criminal enterprise on earth."
-rduckwor
 
Posts: 12163 | Location: St. Louis, MO | Registered: April 03, 2009Reply With QuoteReport This Post
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July 16, 2017
A simplified solution to the healthcare reform debate
By Howard J. Warner

Next week, the Senate is expected to vote on its revised bill to repeal and replace ObamaCare. As of this moment, there are at least two Republican senators doubtful that they can support the proposal. This would doom the bill; since reconciliation can be used once during a session this may preclude any meaningful repeal of the failing Affordable Care Act. After seven years of the promise by Republicans to undo the healthcare funding and regulatory legislation passed in 2010 under reconciliation they have exhibited inability to govern in the most “deliberative” body in the world. Since no Democrat will help in this process (putting the lie to the principle of compromise) a totally different approach is necessary.

In the House, a compromise was reached between the conservatives and moderates within the Republican party utilizing the repeal of various sections of ObamaCare and maintenance of others favorable to some. However, in the Senate this approach has not secured enough votes among Republicans. Sweeteners such as funds for opioid addiction treatment (the usual Washington method to gain votes) has not changed the calculus. Further, the revised bill keeps some taxes that were imposed by ObamaCare on the wealthier (increased payroll taxes) to deflect liberal criticism. This also fails to unite moderate republicans.

Recently, Texas Sen. Ted Cruz (among the most conservative Republicans) proposed an option for insurance companies to offer both Obama-styled policies and reduced ones that would be less expensive at the individuals' choice (which was incorporated into this bill). Maine's Sen. Susan Collins (among the most moderate republicans and opposed to this bill) and Louisiana's Sen. Bill Cassidy (a physician) previously proposed allowing each state to decide for themselves whether they wished to continue ObamaCare. This principle of choice could be the basis of all reforms. If we combine this with the Mitt Romney ideal put forth during the 2012 election, that each state is a “laboratory of innovation” in the nation, then perhaps this impasse could be solved.

As a disclaimer, I must state that I prefer a clean repeal and then a replacement plan (if it is market-based) much as Kentucky's Sen. Rand Paul (also a physician and opposed to this latest bill) has proposed. It appears that this is unlikely at this time. So, I realize that the dysfunctional Republican caucus needs more flexibility. This could be done by allowing choice in all aspects. This might be radical for Washington where politicians have large egos and disregard for the Tenth Amendment to the Constitution.

Simply put, the first change to the bill would allow each state the option to leave the Affordable Care Act. This would eliminate all provisions within that state and allow them to innovate any approach to healthcare they prefer. Further those states could be given the freedom to accept Medicaid funds through block grants. They would then be able to create a system that works for their population. Free from almost all the regulations imposed from Washington, they could create an efficient Medicaid system that could substitute greater at-home care for nursing home payments. They could allow poorer citizens to buy into Medicaid through a sliding scale premium base upon income. These states would have to manage their finances and could more easily be held accountable by voters.

Second, all citizens could be allowed the freedom to purchase medical policies that suit their needs even if their state continues ObamaCare. This will allow lower cost premiums for private purchases. This year my family premium will be $12,000 with a $13,000 deductible for in-service care, and an additional $13,000 for out of network care. This is hardly affordable for most Americans. Some of the ten required services in ObamaCare are worthless for my family. Republican senators might not be able to argue against those in their states being given this choice.

Coverage for pre-existing conditions must carry some penalty for lapses in coverage, whether it be reduced coverage for some period or higher premiums. Insurance requires some assessment for risk. Higher costs for coverage for older citizens is understood as handling this risk. This could be limited to a reasonable amount. Such policies could be more flexible when purchased as Medicare deductible coverage, reducing this cost to seniors.

The taxes imposed upon citizens would be removed and replaced by a user fee imposed upon those participating in the older (Obama) system that would then be used to subsidize premiums for poorer persons. This would be limited in scope so there would be reduced incentive to continue the failing system.

States that accepted enhanced Medicaid funding under ObamaCare fear the loss of these additional dollars. This includes some Republican governor-led states, putting pressure upon senators. To encourage block-granting in these states, the initial funding could be pegged at a higher level with their ability to alter regulatory complexities. Again, the aim is flexibility and choice.

Further, the idea of large group healthcare purchases should be expanded, including purchases across state lines. These principles further market forces which allows for cost controls. Liberals have argued that the efficiency of government regulations can limit unnecessary costs, but this has not worked. Few argue that transparency at the grocery store (where prices are clearly visible) is bad. This could be done through publishing statistics on cost and outcome at larger institutions. Further, in future legislation malpractice liability could be reformed; this would be opposed by trial lawyers.

Failure to remove the onerous aspects of Obmacare and its regulatory burdens dooms our healthcare system. We have the best medical care in the world. The argument is about how to finance it. Liberals seek a single payer system while conservatives wish to return to market forces. The present system is unsustainable and weary Republicans must replace it or suffer at the polls.

http://www.americanthinker.com...e_reform_debate.html


"The United States government is the largest criminal enterprise on earth."
-rduckwor
 
Posts: 12163 | Location: St. Louis, MO | Registered: April 03, 2009Reply With QuoteReport This Post
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The problem with the entire idea of "repeal and replace" is that you're trying to hit a moving target. OZeroCAIR was (falsely) advertised as a solution to the 'problem' of a few million uninsured. But it was actually an ideologically driven wolf dressed up in the sheep's clothing of fixing the health insurance markets. But it did no such thing. It was never intended to. And OZeroCAIR created its own problems. So we need a full repeal to go back to pre-OZeroCAIR market. Then take a look at the actual problems and try to solve those. Do that rather than leave bits and pieces of it in place (that come with their own problems). I have always been in favor of 'repeal'. When the GOP leadership (sic) started adding in "and replace" I knew they had no intention of ridding us of this monstrosity.


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“The only power any government has is the power to crack down on criminals. Well, when there aren't enough criminals, one makes them. One declares so many things to be a crime that it becomes impossible for men to live without breaking laws.” Ayn Rand

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