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Thread: Health Care Reform Repeal Passes House

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    Re: Health Care Reform Repeal Passes House

    Quote Originally Posted by Kandahar View Post
    Do you understand why the individual mandate was included in the first place?
    of course private insurers favor forcing millions of inidividuals to buy their exorbitantly expensive product

    but the dependence of obamacare on the mandate more centrally stems from the need to force young invulnerables into the pool to balance all the rest of us

    Medical Progress Today

    the above link is posted not as an argument but rather as a descriptor of the lay of the land

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    Re: Health Care Reform Repeal Passes House


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    Re: Health Care Reform Repeal Passes House

    Quote Originally Posted by Kandahar View Post
    No, I'm talking about the politicians who should know better (or receive economic advice from people who know better), not voters who know little to nothing about the details of the health care reform bill, or how the parts of it interact with one another.
    the voters you disparage know what's in the bill, reported on fully for the better part of 2 years by almost every voice in the msm

    this is the party's problem

    half trillion in cuts to medicare, all the while obama simultaneously expands its already teetering enrollment by millions:

    Capitol Briefing - Senate votes to keep Medicare cuts

    er costs increase:

    ER visits, costs in Mass. climb - The Boston Globe

    doctors refuse new medicare patients:

    http://www.nytimes.com/2009/04/02/bu.../02health.html

    the doc fix passes, another quarter tril unaccounted for:

    Senate passes 1-year doc fix - The Hill's Healthwatch

    another quarter T double counted:

    Budget Office Rebuts Democratic Claims on Medicare (Update1) - Bloomberg

    our already broken backed states are burdened with 200 billion in the form of brand new medicaid enrollees

    Governors balk over what healthcare bill will cost states - The Boston Globe[/QUOTE]

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    Re: Health Care Reform Repeal Passes House

    Quote Originally Posted by Kandahar View Post
    That means that if the GOP wants to defund it, they're going to have to repeal it. Yes, there are a few peripheral items in the law that are discretionary spending...but they are minor and uncontroversial items.
    no, according to multiple msm sources, obamacare depends on funding for dozens if not hundreds of steps between where we are and where he expects to see full implementation

    for instance, 49 states have already received grants simply to explore how they are to set up their exchanges

    those markets, in addition, are to be funded in their development by congress

    hr2 passed boehner's house yesterday, hr3 calls for the defunding of any and all exchanges that include an insurer that funds abortion (naral is going ballistic)

    Abortion on deck in health care debate - On Congress - POLITICO.com

    ie, there's opportunity aplenty for republican mischief

    indeed, the very construction of obamacare leaves states tremendous leeway concerning how precisely they are to implement the multiple particular provisions

    the result can only be described as chaos

    One [health care concern] is the many federal deadlines creeping up on states — dates by which the law requires them to make key decisions related to implementing health care reform. The other is the overwhelming cost of Medicaid. The state-run health insurance program for low-income people is eating up a fast-growing portion of state budgets that are entering the fourth — and probably worst — year of fiscal crisis.

    The result is a messy situation chock full of contradictions. One of the federal law’s milestones for 2011 is for states to decide whether and how to launch their own health insurance exchanges. Every state but Alaska has begun planning to that end — even as 20 states continue fighting the federal law in court. Meanwhile, the budget crisis gives most states no choice but to try and squeeze cost savings out of Medicaid. Simultaneously, states will be deciding whether to deny costly services to Medicaid patients — as Arizona already has done with organ transplants — even as they plot a course toward universal coverage.

    Many governors want flexibility to cut their Medicaid rolls by limiting who is eligible. That’s a strategy that states have used to weather previous recessions, but provisions in the federal health care law, as well as the economic stimulus law, prevent them from doing it now.

    Last year, at a time when states made severe cuts in many programs, Medicaid spending grew by 8.2 percent. Medicaid has surpassed K-12 education as the largest portion of state budgets.

    On average, the federal government pays 54 percent of all Medicaid bills; for poor states the federal share can be as high as 84 percent. Although states complain about the strings attached to Medicaid, no other federal program pumps as much money into state economies. According to the National Association of State Budget Officers, Medicaid accounts for nearly 43 percent of all federal dollars flowing into states.

    The federal stimulus program added another $137 billion to state Medicaid coffers to help make up budget shortfalls in 2009 and 2010. Last fall, Congress extended a scaled down version of the subsidy worth $25 billion more, but that help gradually dissipates this year until it runs out entirely at the end of June.

    When it’s finally gone, states will have to find a way to replace about $60 billion for the coming budget year. That pressure comes at a time when the weak economy and high unemployment rate have driven Medicaid enrollment to a record high.

    Faced with this dire budget situation, states in 2011 are likely to turn to two places to cut Medicaid costs. Neither of them are particularly desirable.

    One is payments to doctors and hospitals. States already have substantially cut back on reimbursement rates over the past two years, however. If fees go much lower in some states, health care providers will stop seeing Medicaid patients. Many doctors and hospitals already have fled the program.

    The other thing states can cut is the types of services they cover. South Carolina, for example, plans to stop providing hospice care for the terminally ill. Massachusetts will no longer pay for dentures. North Carolina has stopped covering surgery for the clinically obese. In Texas and Nevada, lawmakers have toyed with the idea of dropping out of the Medicaid program altogether.

    The problem is, nearly every state has cut their Medicaid programs to the marrow over the past two years.

    Compared to their budget dilemmas, the decisions states must make about implementing health care reform seem relatively easy. The first agenda item is to decide whether or not to run a health insurance exchange — a virtual marketplace that would allow individuals and small businesses to compare public and private policies and premiums.

    The most controversial decision states will face in designing their exchanges will be whether to create an open, unfettered marketplace such as one already adopted in Utah. Another option is to negotiate prices and more tightly control the insurance industry, as Massachusetts has done under its three-year-old health care reform program.

    Other decisions, such as whether to run the exchange through a state agency, a nonprofit or an independent commission also will require some deliberation this year. In many states, the biggest challenge in designing an insurance exchange will be finding the staff to do it after two years of widespread state government layoffs and furloughs.

    The good news for states is that the federal government will pay the full cost of developing insurance exchanges. Once the exchange is up and running, however, states will be on their own.

    Then will come the usual challenges of putting together a brand new program. Small states will be challenged to pull together a large enough pool of providers to successfully bid for low premiums. Meanwhile, large states may find the enormity of the project and the short time frame daunting.

    Even as states implement the exchanges, however, the backlash against the federal law is bound to go on. The key flash point is the individual mandate. In addition to Arizona, six states — Georgia, Idaho, Louisiana, Missouri, Oklahoma and Virginia — already have approved laws or constitutional amendments making it illegal to require anyone to purchase an insurance policy.

    Opponents and supporters of the health care law agree that if the individual mandate were struck down, most other aspects of its approach to achieving near universal coverage also would unravel.
    Health care budgets in critical condition

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    Re: Health Care Reform Repeal Passes House

    End the individual mandate.

    Since they can’t defeat the whole thing, Republicans will chip away at the parts.

    Soon after the repeal vote, House Speaker John Boehner (R-Ohio) will need to decide when to push smaller bills, chief among them a measure to repeal a reporting requirement that could burden small businesses.

    Republicans also will want to make a direct run at the mandate on individuals to purchase insurance — an effort that they believe could attract bipartisan support, even in the Senate.

    That’s a key vote to watch, because the individual mandate is in some ways the foundation of the whole bill — guaranteeing insurance companies that they’ll have millions of new customers, the young and healthy alongside the old and sick. That’s one way to spread insurance costs over the whole population and keep things more affordable. Without it, insurers argue, the whole system could fall apart.

    “That is a good thing,” Upton said in an interview with the American Enterprise Institute.

    Cut off funding, short term.

    King sees a way to begin the fight to choke off funding much earlier than the normal appropriations process, which won’t start until the late spring.

    Congress must renew by March 4 a stopgap spending measure to keep the federal government operating. The House could insert language into the new continuing resolution prohibiting any money from being used to implement the law, King said.

    “That is a big and significant vehicle, and, if we defund Obamacare in that legislation, that will be awfully hard to put the toothpaste back in the tube,” King said.

    It’s unclear whether the House leadership will choose to go this route — and if they do, the measure will almost certainly stall in the Senate, setting up the potential for a government shutdown. Either way, Boehner would face pressure from his most conservative members not to pass up the opportunity.

    Cut off funding, long term.

    Republicans will use the appropriations process in the late spring to again go after the individual mandate.

    House Appropriations Committee Chairman Hal Rogers (R-Ky.) said he will try “as early as possible” to cancel funding for the Internal Revenue Service, the agency tasked with enforcing the individual mandate. It will need billions of dollars to begin ramping up.

    “We will spend the good part of the year, if not all the year, finding where we can defund or unfund Obamacare as it progresses,” Rogers said on “The Hugh Hewitt Show” earlier this month.

    Republicans will try to hold back funds needed by the Health and Human Services Department, which will require at least $5 billion to $10 billion over the next 10 years, according to the Congressional Budget Office.

    They could also take a more targeted approach. For example, they could try to codify into law an executive order prohibiting federal funds from being used to fund abortions. One way to do it would be by prohibiting any state plans that receive federal money from offering abortion services, a Republican Appropriations Committee aide said.
    Repeal vote is just Republicans' first step on health care - Carrie Budoff Brown - POLITICO.com

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    Re: Health Care Reform Repeal Passes House

    the rest of the politico piece is equally instructive

    Craft a GOP alternative.

    Republicans insist they’re interested in more than just repealing the law and reverting to the status quo.

    So on Wednesday, the House will also approve a resolution ordering four relevant committees to draw up alternative health care proposals.

    But the leadership isn’t giving them a deadline. The open-ended process suggests Republicans won’t be rushing to push their own vision of health care through the House anytime soon.

    Repeal redux.

    Look for a rerun of the repeal vote this summer.

    “If we keep it as an issue, which I am convinced that it will be, maybe we will have another vote to repeal it in the summer,” Upton said. “And maybe as members of Congress hear a little bit more from their constituents, maybe that vote will grow a little more. Ultimately, I think we do have a decent chance of getting this bill repealed.”
    Repeal vote is just Republicans' first step on health care - Carrie Budoff Brown - POLITICO.com

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    Re: Health Care Reform Repeal Passes House

    Quote Originally Posted by CaptainCourtesy View Post
    This is one of those many times that I wish the idiots in Washington could put their stupid partisanship aside and work together. There are good things in healthcare plans from BOTH sides. If they would sit down. take the best points from each, and craft something sensible, we might actually have healthcare reform that not only makes sense and gives everyone an opportunity to have coverage, but also allows choice. Heck, if they work hard enough, it might actually be as good as the plan I developed.


    I agree. This would serve the country best. I wish more called for this type of response from our leaders.

    AUSTAN GOOLSBEE: I think the world vests too much power, certainly in the president, probably in Washington in general for its influence on the economy, because most all of the economy has nothing to do with the government.

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    Re: Health Care Reform Repeal Passes House

    Quote Originally Posted by apdst View Post
    That's why they voted the Dems out and the Reps in? Because the Reps were going to go farther with the healthcare bill?
    The vote was based on dissatifaction and not what they actually thought anyone would do. That's why politicians pay more attention to exit polls than some do here. They understand, or should understand that what seems simple to someone not listening, is much more complicated to those who are paying attention. I once showed one exit poll showing 1/3 wanted less refomr, 1/3 wanted more, and 1/3 liked the reform as it was. If your a leader, you see that while 2/3's were unhappy with the reform, there was no clear mandate as to how to make a majority happy.

    It's the same type of problem as the fact that a solid majority like doing away with preexisting conditions and havong more people covered, in essence, liking the goals of the bill, but dislike the any method of paying for it. This disconnect is all too comon among the voting public. It crosses pary lines and contributes to an incoherent message to our leaders. And part of, only part, of the reason we get such crap for for final bills.

    AUSTAN GOOLSBEE: I think the world vests too much power, certainly in the president, probably in Washington in general for its influence on the economy, because most all of the economy has nothing to do with the government.

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    Re: Health Care Reform Repeal Passes House

    Quote Originally Posted by CaptainCourtesy View Post
    This is one of those many times that I wish the idiots in Washington could put their stupid partisanship aside and work together. There are good things in healthcare plans from BOTH sides. If they would sit down. take the best points from each, and craft something sensible, we might actually have healthcare reform that not only makes sense and gives everyone an opportunity to have coverage, but also allows choice. Heck, if they work hard enough, it might actually be as good as the plan I developed.
    Great point.

    But do you believe the GOPs weren't given a chance to contribute ideas the first time around. The entire foundation of the bill, the mandate, was developed by the Heritage Foundation.

    In the televised meeting/discussion with GOP leaders, Dems, and POTUS-- the GOP came off as talking point partisans, while Obama was able to articulate the concepts behind different aspects of the bill. Obama also explained why allowing purchasing across state lines wouldn't work, and why limiting liability was not going to lower costs as much as the GOP was claiming. Several fact-checks backed up Obama's explanation and the CBO has consistently come out with numbers that suggest a long term upside for the bill.

    But the downside for the insurance companies is that they would have to pay out more claims while taking on clients they would normally reject, and therefore see less growth over the long haul. Their stock will not go up. They will be forced to come up with more cost efficient ways of doing business. Employees whose job was to reject all claims will be laid off. Boo-hoo.

    Insurance companies produce nothing. They develop no new technology. They preform no medical procedures and administer no care. They are middle men. They are the death panels, deciding who lives and who dies.

    Health insurance is a backwards business model. The customer pays for a service, then is later denied the service based on vague and trivial conditions. It would be like going into a buffet restaurant, paying full-price at the door for your entire family, then after waiting in a long line, being asked to fill out more papers explaining why your son needs to eat. Then being refused service for your son because you didn't tell them how hungry he was.

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    Re: Health Care Reform Repeal Passes House

    Quote Originally Posted by hazlnut View Post
    Great point.But the downside for the insurance companies is that they would have to pay out more claims while taking on clients they would normally reject, and therefore see less growth over the long haul. Their stock will not go up. They will be forced to come up with more cost efficient ways of doing business. Employees whose job was to reject all claims will be laid off. Boo-hoo.
    You do realize, that being forced to take more sick people will not really hurt insurance companies growth, right? Insurance companies will just increase premiums on everyone to make up for the increased claims experience they face. The only thing it will actualyl hurt is the individuals and companies that end up having to pay premiums that are at higher levels then they otherwise would have been.

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