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Trump Signs Executive Order on Obamacare

cpwill said:
It ended the mandate. I'd call that not-insignificant.
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Interesting read: https://fivethirtyeight.com/features/trumps-executive-order-on-obamacare-means-everything-and-does-nothing/

But there’s nothing preventing the HHS secretary from granting hardship exemptions to everyone who doesn’t have insurance, rendering the mandate meaningless. If he’s confirmed, Rep. Tom Price, Trump’s pick to lead HHS, could have granted blanket hardship exemptions before the executive order was issued, but in case there was any question, the folks at HHS now have their bosses’ itemized list of priorities..
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It follows with a brief explanation of the hazards of Price doing that, which I kinda listed out earlier in this thread.
 
Redress said:
Interesting read: https://fivethirtyeight.com/features/trumps-executive-order-on-obamacare-means-everything-and-does-nothing/

It follows with a brief explanation of the hazards of Price doing that, which I kinda listed out earlier in this thread.
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Yup - you and Cardinal. My point has been that A) the Mandate doesn't seem to have brought that many people into the exchanges, as the punishment wasn't heavy enough to make up for the costs of doing so (given that guaranteed issue and community rating had already ended the risk of not doing so), and so therefore B) losing the mandate wasn't likely to cause that many to fall off.

Far fewer people ended up on the exchanges, and they were older and sicker. We aren't likely to lose that many younger, healthier people, not least because we didn't have them to begin with.

I find it interesting that the article brings up the fact that all the required-add ins that could only be paid for via insurance premiums might be going away.... but doesn't mention the fact that this drove premiums up, and that its loss is likely therefore to exert downward pressure on prices.
 
cpwill said:
Maybe this will serve as a Teachable Moment for Democrats on the perils of granting broad authority to the Executive to shape, enforce, or get rid of law as the POTUS see's fit.
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Back to SUBSIDIZED EMERGENCY ROOM CARE for the poor. That's what we had before the Affordable Care Act. Either way we, the non-poor, pay with higher premiums. The hospitals have never absorbed these care expenses.
 
Deuce said:
Sure, lets not have a mandate but also force insurance companies to take people with pre-existing conditions. THIS WILL WORK OUT GREAT
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That's kind of what we have now. A mandate in name only. And no, it's not working out great.
 
Media_Truth said:
Back to SUBSIDIZED EMERGENCY ROOM CARE for the poor. That's what we had before the Affordable Care Act. Either way we, the non-poor, pay with higher premiums. The hospitals have never absorbed these care expenses.
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What do you mean "back to"? Obamacare had no effect on emergency room visits. Another failed promise.
 
cpwill said:
Maybe this will serve as a Teachable Moment for Democrats on the perils of granting broad authority to the Executive to shape, enforce, or get rid of law as the POTUS see's fit.
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Where's the outrage from the right now? I guess it's only bad if a Democrat does it. Like everything else.
 
Taylor said:
That's kind of what we have now. A mandate in name only. And no, it's not working out great.
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No, because the penalty was technically something. As was already stated, making the penalty less costly than the insurance itself was not a swift idea. So what they want to do is keep the pony, but eliminate the funds to pay for the pony. If anyone actually thinks that's going to do nothing to the cost of health care, people are even more ignorant about what made the ppaca work than anyone could have ever imagined.
 
Cardinal said:
No, because the penalty was technically something. As was already stated, making the penalty less costly than the insurance itself was not a swift idea. So what they want to do is keep the pony, but eliminate the funds to pay for the pony. If anyone actually thinks that's going to do nothing to the cost of health care, people are even more ignorant about what made the ppaca work than anyone could have ever imagined.
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That "something" doesn't rise to the level of what would come from a true mandate - not even close. That was the point. There are 30 million people uninsured in this country. Insurance is mandatory, but not really.
 
Taylor said:
That "something" doesn't rise to the level of what would come from a true mandate - not even close. That was the point. There are 30 million people uninsured in this country. Insurance is mandatory, but not really.
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That was already said repeatedly. What you're continuing to ignore is the most important part: what they want to do is keep the pony, but eliminate the funds to pay for the pony. If anyone actually thinks that's going to do nothing to the cost of health care, people are even more ignorant about what made the ppaca work than anyone could have ever imagined.
 
Cardinal said:
That was already said repeatedly. What you're continuing to ignore is the most important part: what they want to do is keep the pony, but eliminate the funds to pay for the pony. If anyone actually thinks that's going to do nothing to the cost of health care, people are even more ignorant about what made the ppaca work than anyone could have ever imagined.
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Again, we may as well be offering free houses and cars, too. Sure, people want the pony so long as they don't have to pay for it.
 
cpwill said:
I think they can blanket waiver - just as Obama did.

Also, the mandate was pretty ineffective at getting people to the exchanges, indicating its loss will result in few getting off.

We have a long way to go yet, unraveling this abortion. Hopefully this also gets rid of the regulatory restrictions on plans, which would drive price down.

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That's not a fair description.
 
Cardinal said:
That was already said repeatedly. What you're continuing to ignore is the most important part: what they want to do is keep the pony, but eliminate the funds to pay for the pony. If anyone actually thinks that's going to do nothing to the cost of health care, people are even more ignorant about what made the ppaca work than anyone could have ever imagined.
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Every healthy person who drops their coverage as a result will apply upward pressure on premiums for everyone else.

I feel like many of these Obamacare critics never seemed to understand that the purpose of the individual mandate, pre-existing conditions, and the subsidies for low earners are to provide the foundation of the law.
 
Absentglare said:
That's not a fair description.
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Eh. I think it's apt. We told y'all at the time this fight was only beginning.

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Taylor said:
Again, we may as well be offering free houses and cars, too. Sure, people want the pony so long as they don't have to pay for it.
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Okay, but...MOVING FORWARD...their plan is to not pay for the perks.
 
Cardinal said:
Okay, but...MOVING FORWARD...their plan is to not pay for the perks.
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Oh, I think they're going to remove some of the perks as well. Regardless, I don't think anyone believes this is going to "fix" Obamacare, or that it's even possible to do so by executive order.
 
Redress said:
It really doesn't do anything, and I have no problem with the president having the power to issue such an order. Executive Orders are legal, elections have consequences. Just because I do not like what he did does not mean I am going to claim he should not be able to do it. What will be fun is all those who have bitched and moaned about executive orders now applauding one...
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I'm generally not a fan of utilizing executive orders to pick and choose which laws to enforce via directing "Focus" towards or away from a particular area, ala the DREAM related immigration executive orders.

However, there is a significant difference between this executive order by Trump and others by Obama, like the one I was referencing above. While this difference may not be directly noticeable, or even the basis for the complaint, of many of those that took an idiotic non-nuanced view of "executive orders = bad" or "executive orders = good", it is in line with something I've been pointing out here repeatedly on this forum for years.

The notion of "executive orders" is not blanketly "constitutional". It is absolutely possible for an executive order to be unconstitutional and outside the bounds of reasonableness. This was established in Youngstown Sheet & Tube Co v. Sawyer. This is the case that spoke of three levels of Presidential authority as it relates to executive action, ranging from a far reaching amount of power that includes delegated powers of Congress when the executive action is in line with the express or implied authorization from congress....to the Zone of Twilight when his power is slightly more restricted because congress has not expressed or implied anything regarding the matter...to the point where his power is extremely limited because the presidential act is imcompatible with the expressed or implied will of the congress.

In many of the cases of Obama's executive actions, it was done at a time when the expressed will of the majority of the bodies of congress where clearly opposite of those the acts were seeking to do. This, at the VERY least, meant those actions needed to be scrutinized with a far more discerning eye, and where the power of the executive was significantly limited. In this case, you just had an authorization by congress indicating pretty clearly that it's will is in line with this Presidential action. Therefore, while the action is perfectly reasonable to be complained about in terms of:

1. What it actually does
2. Whether you like presidents using it this way

There is far less ground to argue upon as it relates to whether or not this particular type of executive action is wrongful or out of bounds with regards to the power of the Presidency, comparative to many of the instances spoken about with President Obama since 2014 when Republicans had complete control of Congress.
 
Zyphlin said:
I'm generally not a fan of utilizing executive orders to pick and choose which laws to enforce via directing "Focus" towards or away from a particular area, ala the DREAM related immigration executive orders.

However, there is a significant difference between this executive order by Trump and others by Obama, like the one I was referencing above. While this difference may not be directly noticeable, or even the basis for the complaint, of many of those that took an idiotic non-nuanced view of "executive orders = bad" or "executive orders = good", it is in line with something I've been pointing out here repeatedly on this forum for years.

The notion of "executive orders" is not blanketly "constitutional". It is absolutely possible for an executive order to be unconstitutional and outside the bounds of reasonableness. This was established in Youngstown Sheet & Tube Co v. Sawyer. This is the case that spoke of three levels of Presidential authority as it relates to executive action, ranging from a far reaching amount of power that includes delegated powers of Congress when the executive action is in line with the express or implied authorization from congress....to the Zone of Twilight when his power is slightly more restricted because congress has not expressed or implied anything regarding the matter...to the point where his power is extremely limited because the presidential act is imcompatible with the expressed or implied will of the congress.

In many of the cases of Obama's executive actions, it was done at a time when the expressed will of the majority of the bodies of congress where clearly opposite of those the acts were seeking to do. This, at the VERY least, meant those actions needed to be scrutinized with a far more discerning eye, and where the power of the executive was significantly limited. In this case, you just had an authorization by congress indicating pretty clearly that it's will is in line with this Presidential action. Therefore, while the action is perfectly reasonable to be complained about in terms of:

1. What it actually does
2. Whether you like presidents using it this way

There is far less ground to argue upon as it relates to whether or not this particular type of executive action is wrongful or out of bounds with regards to the power of the Presidency, comparative to many of the instances spoken about with President Obama since 2014 when Republicans had complete control of Congress.
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I do not think any one is going to argue that an Executive Order cannot be unconstitutional. Clearly they can be. And we have a mechanism to determine legality of Executive Orders. As such, the merits of an Executive Order have to be examined individually(much like government regulations, where some argue that regulations are bad and costly, but when pressed admit they like their food to be handled safely). One of the things I get so frustrated at is that people want simple, blanket statements like EOs are bad, but don't really want to look at what each one does kinda thing. In the case of this one, it basically does nothing expect make some people think he did something, so I am pretty unconcerned about it. If he issues an EO I do not like, I will complain about the content, not that it is an EO.
 
ocean515 said:
Surely you realize there are many remedies being looked at to correct the flaws in Obamacare.
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Remedies that retain rating restrictions on insurers? Given that the entire point of the across-state-lines concept is to backdoor regulate the industry, I'm not sure how you square that circle.

cpwill said:
Far fewer people ended up on the exchanges, and they were older and sicker.
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That doesn't seem to be borne out by the 2017 premiums. From 2014-2016 exchange premiums were far below expectations (i.e. the premiums assumed by the CBO in developing cost projections); however, that led to something like a -5% margin across exchange business in 2014. As most people probably know, 2017 saw a correction to that underpricing.

Looking back at the CBO's projections from 2009, the benchmark premium in 2016 was expected to be $5,200 on average. If you assume a relatively modest 3% growth, that gets us to around $5,360 this year or just under $450/month this year.

We know from ASPE that the average benchmark premium for a 27-year-old in 2017 is $302/month. Under the ACA's age rating rules, if the CBO estimate was correct that translates into an average age of 47 in the exchanges. Now we don't know the age profile for enrollees in 2017 yet, but we know what it was in 2016--or at least the distribution within the age bands ASPE uses when reporting enrollment. If you use the midpoint of those age bands to get the average age last year you get 41, if you use the less charitable--and unrealistic--assumption that everyone enrolled is at the very top of their age band you get just under 46.

So unless the exchanges got a little older this year (and given that enrollment seems to be running ahead of last year, the opposite is more likely to be the case), the age and risk profile this year seems to be running a little better than the CBO expected when calculating the cost of the law seven years ago. Assuming that after collecting three years of claims data insurers know how to accurately price their products (which may have even been more the case last year than publicly acknowledged, despite the PR game).

So I'm not convinced by the argument that exchanges right now are older and sicker than anticipated. Premiums today (admittedly following the upward correction this open enrollment period) appear to be close to--even a bit lower than--the bean counters predicted back in 2009/10. In other words, the CBO predicting the risk profile in the exchanges seven years ago seems to have been on pretty much the same page as the actuaries of exchange-participating insurance companies in 2016/17.
 
Taylor said:
Oh, I think they're going to remove some of the perks as well. Regardless, I don't think anyone believes this is going to "fix" Obamacare, or that it's even possible to do so by executive order.
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Trump specifically wants to keep the main perks that nearly everybody approves of. He said that.
 
Cardinal said:
Trump specifically wants to keep the main perks that nearly everybody approves of. He said that.
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Yes, I think it's more likely he'll loosen requirements like "minimal essential coverage" (as Obama did early on) while also loosening the main requirement that nearly everybody disapproves of (the individual mandate).
 
Taylor said:
Yes, I think it's more likely he'll loosen requirements like "minimal essential coverage" (as Obama did early on) while also loosening the main requirement that nearly everybody disapproves of (the individual mandate).
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The main perks he wants to keep that are most noteworthy are pre-existing conditions and not dropping someone for getting sick. It's not possible to keep those and not pay for them. That was the point of the mandates.
 
Cardinal said:
The main perks he wants to keep that are most noteworthy are pre-existing conditions and not dropping someone for getting sick. It's not possible to keep those and not pay for them. That was the point of the mandates.
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If we polled people on whether or not they favored airline tickets that are fully refundable, most would say yes. Yet, when given the opportunity, it's something almost nobody goes for. People like the perk, but don't want to pay for it. Last I heard, the vast majority of people know about the individual mandate whereas only 50% are even aware of the guaranteed coverage component. That just goes to say what weighs more heavily on the mind.
 
cpwill said:
Maybe this will serve as a Teachable Moment for Democrats on the perils of granting broad authority to the Executive to shape, enforce, or get rid of law as the POTUS see's fit.
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Why? The order does nothing. And Obama's use of the EO wasn't new, or in any way extraordinary in number or kind. As you recall, the Bush administration aggressively attempted to expand the power of the Executive Branch, Cheney has long been a big fan of it, before and after he got to the WH. Remember "unitary executive"? The argument, advanced by the Bush administration, is the POTUS is the CEO of the executive branch and can run it as he sees fit, basically.

I think the teachable moment should apply to people across the board - be careful what you wish for. Exercising unilateral power to do stuff you like might come around and bite you in the ass when the other guy gets into office.
 
JasperL said:
Why? The order does nothing. And Obama's use of the EO wasn't new, or in any way extraordinary in number or kind. As you recall, the Bush administration aggressively attempted to expand the power of the Executive Branch, Cheney has long been a big fan of it, before and after he got to the WH. Remember "unitary executive"? The argument, advanced by the Bush administration, is the POTUS is the CEO of the executive branch and can run it as he sees fit, basically.

I think the teachable moment should apply to people across the board - be careful what you wish for. Exercising unilateral power to do stuff you like might come around and bite you in the ass when the other guy gets into office.
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The EO effectively ends the Mandate. With the exception of that and especially WRT your last paragraph - right on. If the wrong person getting the Presidency is as disastrous as folks seem to think it is, maybe the Presidency has too much power.

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Taylor said:
If we polled people on whether or not they favored airline tickets that are fully refundable, most would say yes. Yet, when given the opportunity, it's something almost nobody goes for. People like the perk, but don't want to pay for it. Last I heard, the vast majority of people know about the individual mandate whereas only 50% are even aware of the guaranteed coverage component. That just goes to say what weighs more heavily on the mind.
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I have no idea what your post is trying to communicate here.
 
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