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Congress to Send Obamacare Repeal to President

JasperL said:
I agree with you, but there was no chance to pass nationalized healthcare, so we got what we got. And I don't favor doing away with the ACA because the only thing worse than the ACA was the status quo that was leaving more and more uninsured every year, with no end to the trend in sight.

But, sure, an actual former VP for Wellpoint was the principal drafter of the the ACA under Baucus. But I'm not sure how we realistically compete with the money the insurers, hospitals and doctors orgs would have spent to kill any universal healthcare system, especially when there was no chance to get even ONE vote from the GOP for that.
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ACA is the status quo. It's the same exact system we had, only now government forces you to buy insurance. We'll still have uninsured people because there are many who cannot afford health insurance, even with these provisions to buy it. Furthermore, it changes incentives within companies so that they engineer the working hours of employees to avoid tripping the ACA wire.

Obamacare has done nothing but funnel money to the Insurance companies, and that's what it was designed to do.
 
Ikari said:
It's obvious that's what is going on though. People don't want to see it that way because it's easier not to. It helps keep up the partisan blinders by claiming something like healthcare for everyone vs. socialism. The D and the R can point fingers at each other, and in the end they both just shovel money into the corporations that fund them. Obamacare has no way to control gouging, the Insurance companies make up some excuse and cry because that also plays right into the system, then they jack up their costs because...people have to buy their product. They ain't hurting because of Obamacare, they were just guaranteed full consumership of their product.

I'm all for a single payer system, a true Universal Healthcare system funded by taxes and that everyone has. No "you have to buy insurance", it should be "you have insurance, go to the damned doctor already!" It will cost us all a lot less in the long run to do it this way.

But it won't benefit the Corporate State as much, so we won't do it. Thanks Bushama.
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Oh, man, you have been lied to rather horrifically. It makes no sense to have the people who funded the campaign of the president also set the law. And you are right, something I have fought for years, it is neither D or R, but the fear-based garbage.

But over and above the insurance companies, it's about the profits of the health provider companies. Yes, oh yes, the US can bag there is no waiting for an MRI [there is in some areas] but the cost of those machines idled until you need is criminal; so while claiming "the best" health care system" we are talking about a Cadillac system being paid for by those who can least afford it, the middle class.

Obama has done you no favors with this license to print money
 
JasperL said:
Any state, right now, can pass a simple law and allow any insurer anywhere in the country to come into their state and sell any insurance product. So Congress didn't "refuse to allow" anything - it's been allowed forever, it just takes state legislation to essentially end that state's power to regulate insurance sold in that state. If you're a fan of state powers, you should be happy. States are free to do exactly what they want in this area. If they want to continue to regulate insurance products sold in their state, they can. If not, a simple law allows anyone to sell any insurance product.

Georgia did it and no one came. Bottom line is this "sell insurance across state lines" stuff is just a mostly meaningless talking point on the right wing - a fake solution to any actual problem with our healthcare system, but it sounds good when you have no other ideas.
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What you just described does not correct the problem that exists. I'm not talking about insurance companies getting permission from the state to sell in that state, I'm talking about the lack of the right for any citizen of the US to buy insurance that may be offered for sale in a state other than the state in which they reside, interstate commerce, not intrastate commerce. Congress (Democrats) did in fact refuse to allow this as part of the PPACA.
 
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Ikari said:
ACA is the status quo. It's the same exact system we had, only now government forces you to buy insurance. We'll still have uninsured people because there are many who cannot afford health insurance, even with these provisions to buy it. Furthermore, it changes incentives within companies so that they engineer the working hours of employees to avoid tripping the ACA wire.

Obamacare has done nothing but funnel money to the Insurance companies, and that's what it was designed to do.
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Well, that's just not true. I do some work for a little charity and every one of the clients were uninsured unless they had a spouse with insurance, and nearly all the employees were uninsured because they were formerly drunks and homeless, and have preexisting conditions and the charity cannot afford the $15k or so per person insurance costs. The employees are nearly all now insured with something which is one helluva lot better deal than the nothing they had, and one of the first things we do with the clients, who come mostly from jail or the streets, is try to get them insurance through ACA. They all have to work - it's part of the deal - but you'd not be surprised that few jobs out of jail of off the streets come with benefits. They are part of that big drop in the uninsured that we can see in the data and it's a big f'ing deal to some of them, especially the older guys who have chronic problems.

I'm OK with bashing the ACA, but I don't find the critiques all that persuasive unless they reasonably evaluate alternatives that are POSSIBLE in this reality. Sure, I'd love to have universal healthcare like the entire rest of the industrialized world but that simply had zero chance of passing in 2009. Given that, what is the next best option? If you say the status quo, then you need to tell the folks who now can get insurance why they're worse off now than when even the simplest medical problem could bankrupt them and their family doc was the ER.

And as to employers, they've been playing around with that kind of thing forever. The biggest growth for employers in my state are the temp agencies who can take what are now permanent employees like cleaning staff off the payroll for other firms, with the big benefit coming from if you fire the employee and rehire him through the temp, he's no longer part of your workforce and eligible for benefits. Has nothing to do with ACA and had been going on long before the ACA and would continue if it's repealed. As you know THAT problem is
 
countryboy said:
First time ever to make it to the prezzy's desk. ;)
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I am not convinced that matters all that much, a veto from Obama on this effort is no different than the rhetoric from Obama over the last 50+ times this was tried but failed somewhere in the Senate.

There is no way this was going to go past Obama's desk, and honestly just because we have a bill where Obama actually has to veto does not mean some new plateau was reached. To convince me that the GOP really accomplished something means Ryan organizing enough votes to override Obama's veto. Doubtful he can pull that off.
 
Beaudreaux said:
What you just described does not correct the problem that exists. I'm not talking about insurance companies getting permission from the state to sell in that state, I'm talking about the lack of the right for any citizen of the US to buy insurance that may be offered for sale in a state other than the state in which they reside interstate commerce, not intrastate commerce. Congress (Democrats) did in fact refuse to allow this as part of the PPACA.
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You're in NC I see. NC can, this week, pass a law that says any insurer anywhere can sell any health insurance policy in the state of NC. If you want interstate commerce in health insurance or any other type of insurance, all it takes is your state making it happen. Congress did NOT prohibit that. IF you don't have a "right" to buy some policy from an insurer in Wyoming, that's your state restricting your "rights" not the Feds. And your state can restore your rights, tomorrow, with no action by the Feds.

The reason they don't is YOUR STATE wants to continue to regulate insurance. What you're demanding really, is the feds telling NC - NO, guys, you cannot regulate insurance, we know better and will FORCE you to allow ANY insurance policy offered anywhere to be sold to your residents. It is in fact a massive intrusion into the regulatory powers of the states. Congress would be telling the 50 states that they no longer have any ability to regulate insurance in any way.

And the bottom line is the measure is a big nothing anyway. Some Wyoming insurer cannot realistically come into NC and sell a few policies. They have to enter the state in a serious way to develop the healthcare networks - the hospitals, doctors, etc. - and negotiate prices with them all, which is time consuming and costly and without a big bunch of customers as their bargaining chip, they cannot underprice the big boys anyway, who can tell a hospital - "Give me good prices or I'll not allow our customers who are half your client base to use your hospital on our approved list. We will send our 100,000 clients to your competitors. " Some little insurer from Wyoming can't do that - they would have to essentially pay on the hospital's term, with very little leverage to negotiate a better deal. It is those factors, and not that NC has different regs than Wyoming, that keeps interstate competition down.
 
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JasperL said:
You're in NC I see. NC can, this week, pass a law that says any insurer anywhere can sell any health insurance policy in the state of NC. If you want interstate commerce in health insurance or any other type of insurance, all it takes is your state making it happen. Congress did NOT prohibit that. IF you don't have a "right" to buy some policy from an insurer in Wyoming, that's your state restricting your "rights" not the Feds. And your state can restore your rights, tomorrow, with no action by the Feds.

The reason they don't is YOUR STATE wants to continue to regulate insurance. What you're demanding really, is the feds telling NC - NO, guys, you cannot regulate insurance, we know better and will FORCE you to allow ANY insurance policy offered anywhere to be sold to your residents. It is in fact a massive intrusion into the regulatory powers of the states. Congress would be telling the 50 states that they no longer have any ability to regulate insurance in any way.

And the bottom line is the measure is a big nothing anyway. Some Wyoming insurer cannot realistically come into NC and sell a few policies. They have to enter the state in a serious way to develop the healthcare networks - the hospitals, doctors, etc. - and negotiate prices with them all, which is time consuming and costly and without a big bunch of customers as their bargaining chip, they cannot underprice the big boys anyway, who can tell a hospital - "Give me good prices or I'll not allow our customers who are half your client base to use your hospital on our approved list." It is those factors, and not that NC has different regs than Wyoming, that keeps interstate competition down.
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You still don't get it.
 
Beaudreaux said:
You still don't get it.
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What don't I get? What part do you disagree with?

Here's a few articles: https://www.washingtonpost.com/news...nsurers-even-want-to-sell-across-state-lines/

They looked at the three states - Maine, Georgia and Wyoming - that have passed laws allowing insurers from other states to participate in their markets. All have done so within the past two years.

So far, none of the three have seen out-of-state carriers come into their market or express interest in doing so. It seems to have nothing to do with state benefit mandates, and everything to do with the big challenge of setting up a network of providers that new subscribers could see.

"The number one barrier is really building that provider network that's attractive enough to get patients to sign up," said lead study author Sabrina Corlette. "To do that, you have to offer providers attractive reimbursement rates, which makes it difficult to get them in network."
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From Avik Roy, who supports Federal preemption in this area - requiring NY to sell policies under Wyoming guidelines: Forbes Welcome

Most importantly, it’s the biggest insurers in a state, with the most market power, who are in the best position to negotiate favorable rates with powerful hospitals. New entrants wouldn’t have that luxury. In other words, an Alabaman insurer might be able to offer a plan that’s 30 percent cheaper, because of fewer insurance mandates, but be forced to pay Georgian hospitals 30 percent more, because the Alabaman insurer didn’t have a large enough footprint in Georgia to negotiate better prices.
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Roy does conclude that they are worth doing and that eventually we'd have national markets develop - could be true. It's also likely that if mandate heavy NY is forced by Congress to allow bare bones plans to be sold in NY that prices would drop, but what you're talking about IS the Feds preempting the power of the state of NY to regulate insurance sold to its residents. It is a federal takeover of the NY insurance market. That's fine, but that's all it is, and you need to recognize it.
 
JasperL said:
What don't I get? What part do you disagree with? ...
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You are arguing that because I bring food to my house and my kids can eat that food and only the food I bring into my house and because of that, that they can just eat here at my house because I can bring any food I want into my house, therefore, they shouldn't have the right to go eat at a restaurant but be restricted to the food I allow in my house.

Congress used the Commerce Clause as being one of their authorities to enact the PPACA, yet they refused to allow interstate commerce, which is what the Commerce Clause restricts Congress' power regarding commerce.
 
Beaudreaux said:
You are arguing that because I bring food to my house and my kids can eat that food and only the food I bring into my house and because of that, that they can just eat here at my house because I can bring any food I want into my house, therefore, they shouldn't have the right to go eat at a restaurant but be restricted to the food I allow in my house.

Congress used the Commerce Clause as being one of their authorities to enact the PPACA, yet they refused to allow interstate commerce, which is what the Commerce Clause restricts Congress' power regarding commerce.
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I'm telling you that Congress did not "refuse" to "allow interstate commerce." What they did not do is preempt every single state insurance regulatory agency in the country (effectively disband them and strip them of all power) and mandate that states had to allow any and all health insurance policies to be sold in their state.

Any restrictions on your right to buy a policy from Wyoming or Georgia or Tennessee are imposed by the STATE OF NORTH CAROLINA and which can eliminate those restrictions with a simple act of the state legislature and the signature of your governor. It's just a fact.
 
JasperL said:
I'm telling you that Congress did not "refuse" to "allow interstate commerce." What they did not do is preempt every single state insurance regulatory agency in the country (effectively disband them and strip them of all power) and mandate that states had to allow any and all health insurance policies to be sold in their state.

Any restrictions on your right to buy a policy from Wyoming or Georgia or Tennessee are imposed by the STATE OF NORTH CAROLINA and which can eliminate those restrictions with a simple act of the state legislature and the signature of your governor. It's just a fact.
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I'm not arguing that. You can type it in any font size you like, it doesn't change what I have said, that Congress refused to put in the PPACA the right to buy insurance across state lines, and that was the Democrats for whatever that's worth.
 
Beaudreaux said:
I'm not arguing that. You can type it in any font size you like, it doesn't change what I have said, that Congress refused to put in the PPACA the right to buy insurance across state lines, and that was the Democrats for whatever that's worth.
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But that is not a restriction on interstate commerce. Those restrictions are imposed by the states, including NC, who have had the power to regulate insurance sold in their state for many, many decades. That power of NC to regulate insurance sold in NC is what you're calling a restriction on interstate commerce.

For Congress to 'put into the PPACA the right to buy insurance across state lines" they'd have had to effectively preempt every single state level regulation on health insurance products and require every state to sell any insurance product without regard to whether it complied with state laws on insurance. You're demanding that state regulatory powers over insurance products be effectively nullified by an act of the U.S. Congress. Every law on the books of NC about health insurance would be effectively repealed by the U.S. Congress. I don't care that you're demanding that, but you need to accept what you ARE demanding.
 
OrphanSlug said:
I am not convinced that matters all that much, a veto from Obama on this effort is no different than the rhetoric from Obama over the last 50+ times this was tried but failed somewhere in the Senate.

There is no way this was going to go past Obama's desk, and honestly just because we have a bill where Obama actually has to veto does not mean some new plateau was reached. To convince me that the GOP really accomplished something means Ryan organizing enough votes to override Obama's veto. Doubtful he can pull that off.
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Valid point, but I still think this is significant.
 
shrubnose said:
You have a poor memory. They passed the Affordable Care Act which the GOP would like to get rid of but will have to live with.

:lol:
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Why get rid of it ?

It's led to significant GOP victories on not only a national level but on a local and State level.

Texas is REDDER and the GOP took over the Senate and gained seats in the House thanks to that abortion of a law.

The ACA is so bad the Democrats have to continue to pretend it doesn't exist.
 
JasperL said:
But that is not a restriction on interstate commerce. Those restrictions are imposed by the states, including NC, who have had the power to regulate insurance sold in their state for many, many decades. That power of NC to regulate insurance sold in NC is what you're calling a restriction on interstate commerce.

For Congress to 'put into the PPACA the right to buy insurance across state lines" they'd have had to effectively preempt every single state level regulation on health insurance products and require every state to sell any insurance product without regard to whether it complied with state laws on insurance. You're demanding that state regulatory powers over insurance products be effectively nullified by an act of the U.S. Congress. Every law on the books of NC about health insurance would be effectively repealed by the U.S. Congress. I don't care that you're demanding that, but you need to accept what you ARE demanding.
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You still don't understand my point... I didn't say Congress restricted anything, I said they didn't make it legal to do something under their power in the Commerce Clause.
 
Beaudreaux said:
You still don't understand my point... I didn't say Congress restricted anything, I said they didn't make it legal to do something under their power in the Commerce Clause.
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From the perspective of the Feds, it's legal today for NC to allow any insurance product to be sold in that state. It was legal last year, legal in 1990, legal in 2000. So, correct, Congress did not vote to nullify every state level law or regulation on health insurance in the country nor did they vote to preempt and therefore neuter the power of every state insurance regulatory body over products sold in that state.

I'd think if you respected the power of states to govern their own affairs, you'd cheer this non-action on the part of the democrats in Congress.

Bottom line is if you want to buy a policy from Wyoming, write your STATE legislator. That's who can get it done. No need to look to Obama or democrats to do that job.
 
JasperL said:
From the perspective of the Feds, it's legal today for NC to allow any insurance product to be sold in that state. It was legal last year, legal in 1990, legal in 2000. So, correct, Congress did not vote to nullify every state level law or regulation on health insurance in the country nor did they vote to preempt and therefore neuter the power of every state insurance regulatory body over products sold in that state.

I'd think if you respected the power of states to govern their own affairs, you'd cheer this non-action on the part of the democrats in Congress.

Bottom line is if you want to buy a policy from Wyoming, write your STATE legislator. That's who can get it done. No need to look to Obama or democrats to do that job.
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You keep saying the same thing, just using different words.
 
Beaudreaux said:
You keep saying the same thing, just using different words.
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Sorry. You keep blaming a state-level problem on the democrats and Congress. You're barking up the wrong tree, as they might say in the mountains of western Carolina.
 
JasperL said:
Sorry. You keep blaming a state-level problem on the democrats and Congress. You're barking up the wrong tree, as they might say in the mountains of western Carolina.
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Geeze Louise. You still don't understand. Have a good evening, and I appreciate you being civil even though we just can't get in the same library much less on the same page of the same book.
 
Beaudreaux said:
Politicians keeping their campaign promise?
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What happened to "repeal and replace"? Voting to undo the progress that's been made with zero vision of what comes next is irresponsible at best. And having no alternative six years after promising a replacement is indefensible.

Beaudreaux said:
There are a number of other aspects that were left out by the Democrats, one of which I have no idea why they did so, and that is the ability to buy insurance across state lines.
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It did contain that (although in a way that respected state autonomy, which doesn't seem to be what you wanted).

But as Jasper laid out pretty clearly, the across-state-lines concept is a fairly useless concept; usually it's intended only as a Trojan horse for denying people coverage. At best it's based on a misunderstanding of how contemporary insurance (and health care provider) markets work. Which is why every state that's tried or contemplated trying it has found no interest from the industry. Realistically, what do you think this would achieve?
 
Beaudreaux said:
Geeze Louise. You still don't understand. Have a good evening, and I appreciate you being civil even though we just can't get in the same library much less on the same page of the same book.
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FWIW, here's an article today about 'selling across state lines' that sums up the regulatory issues. The author is an insurance company executive of some sort so gives an insider's view of the ACA and related stuff on a regular basis:

https://www.balloon-juice.com/2016/01/07/health-insurance-across-state-lines-coercion-or-consent/

The little-known provision, found in section 1333 of the roughly 1,000-page Affordable Care Act, allows for states to create “health care choice compacts” permitting insurers to sell policies to consumers in any state participating in the compact, as long as they follow specific rules. Five states – Georgia, Kentucky, Maine, Rhode Island and Wyoming – already have enacted interstate compact statutes,according to the National Conference of State Legislatures.

There could be several potential compacts. Massachusetts may decide that they are happy with the regulatory approaches of Rhode Island, New York, California and New Mexico and those states could form a compact. On the other hand, Texas could join with Oklahoma and Louisiana for a de minimis compact. The key aspect is that each particular state could choose what the minimal regulatory level would be appropriate for the home state. It is a compact of consent.

This is markedly different than the Republican idea of selling insurance across state lines. In that idea, the federal government would proclaim that a license in a single state is a license for all states. The insurance industry would become an isomorph of the credit card industry. The state with the weakest and most easily bought regulatory structure would have 98% of the viable insurance companies headquartered there within nine months of the law being passed.
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And, again, NC and all the other red states can choose the GOP option today, just disband their insurance regulatory regime and declare that any product licensed in any state is approved for sale in NC. For some reason, you think it's a good idea for Congress to impose that choice on all 50 states.
 
shrubnose said:
Congress is set to send President Obama a bill this week repealing the Affordable Care Act for the first time since the law's enactment in 2010 - effectively repealing the mandates and taxes at the heart of the law.

Read the article here: Congress to Send Obamacare Repeal to President - NBC News

This bill will not survive Obama's veto. This is yet another example of how our partisan, do-nothing congress gets nothing done with the G-nO-P in charge.

Some voters will notice this.
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I agree they were a do nothing Congress and hit Cons on that fact hard. That said, the Congress has finally passed a Budget, a short one but none the less a Budget, and they are finally getting the wheels moving forward again. My guess is that when it comes to this Bill they know it will be vetoed, that is not the point, what their goal is to show who supports the Act and who does not and after the elections it is my guess that they will send the Bill to the next President that they are counting on signing off on it and that will be that. Yes there is no assurance that a Repub will win the WH but if they raise enough attention that no matter who is office they will have to face the fact that a large numbers of Americans do not like what they got. I was, and still am, one of those that felt our healthcare system need some major changes, the main one being that Affordable healthcare be available for all Americans, unfortunately that is Not what we got. Most of the policies are worthless unless one has a major health issue and if one is working the premiums for a good policy one could get were no less than one could get on the open market. What it did do is force people to pay for insurance, often not the insurance they wanted and if they could not afford it they were "fined", brilliant, fine someone that already cannot afford to pay more. The sooner the Act dies the better, there has to be a better alternative. I still have a sneaky suspicion that it was meant to fail and to fix it the only alternative, for some, was a single payer plan, which if done properly is not totally out of the question but the key words are if properly done and we know what the chances of that are.
 
JasperL said:
FWIW, here's an article today about 'selling across state lines' that sums up the regulatory issues. The author is an insurance company executive of some sort so gives an insider's view of the ACA and related stuff on a regular basis:

https://www.balloon-juice.com/2016/01/07/health-insurance-across-state-lines-coercion-or-consent/



And, again, NC and all the other red states can choose the GOP option today, just disband their insurance regulatory regime and declare that any product licensed in any state is approved for sale in NC. For some reason, you think it's a good idea for Congress to impose that choice on all 50 states.
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Umm isn't that exactly what the Federal government did, force something on all the States.
 
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