• This is a political forum that is non-biased/non-partisan and treats every person's position on topics equally. This debate forum is not aligned to any political party. In today's politics, many ideas are split between and even within all the political parties. Often we find ourselves agreeing on one platform but some topics break our mold. We are here to discuss them in a civil political debate. If this is your first visit to our political forums, be sure to check out the RULES. Registering for debate politics is necessary before posting. Register today to participate - it's free!

The Dem plans for health care and the ACA

Congress was filled with a fair number of never-Trumper Republicans. Those idiots stalled much of Trump's agenda.

Why would Never Trumpers prevent Pro Trumpers from passing an alternative plan to PPACA?

It doesn’t add up.
 
We already know the House Dems' first vote in the new Congress will be to defend the ACA against the GOP lawsuit to end pre-existing condition protections. But what then?

The package of reforms with the most support in the Dem caucus in the current Congress (H.R.5155 - Undo Sabotage and Expand Affordability of Health Insurance Act of 2018) is the obvious starting point.

What are those reforms?

Premium relief through more generous premium subsidies

How it works now: The ACA provides subsidies to people under 400% of the federal poverty line for their premiums: once they've put a certain percentage of their income toward a benchmark silver plan, the subsidy pays the rest of the cost of the plan.

How it would change: The Dem reforms would make the premium subsidies more generous by (1) lowering the percentage of income an individual or family has to contribute, and (2) making premium subsidies available to people over 400% FPL, eliminating the "cliff" some have criticized.

To put this in concrete terms, let's imagine the example of a family of four (two 40-year-olds with two young kids) buying the national average 2018 benchmark plan.

If that family makes $30K, its monthly premium falls from $50 under the ACA to $25 under the proposed reforms.

If it makes $50K, its monthly premium falls from $263 to $167.

If it makes $75K, its monthly premium falls from $595 to $438.

And if it makes $105K, its monthly premium falls from $1,494 to $744.

Out-of-pocket spending relief through more generous cost-sharing reductions

How it works now: The ACA requires insurers to reduce out-of-pocket limits and spending (e.g., deductibles, copays, etc) for low-income people, effectively making their coverage more generous. This is referred to as cost-sharing reduction (CSR).

While silver plans normally have 70% actuarial values (actuarial value being a measure of plan generosity that indicates how much the insurer shells out vs. how much enrollees have to pay out of pocket when people get services), under the ACA people with lower incomes get silver plans of 73% actuarial values, 87%, or even 94%.

Capture.png


These reductions are the reason that, despite all the hoopla about high deductibles in the exchanges, the median deductible actually faced by consumers in the marketplaces in 2016 was $850.

How it would change: The Dems would make the CSRs both more generous and more widely available. The CSR94 plans are currently reserved for only the poorest segment of marketplace shoppers; the Dem bill would make them available to everyone currently eligible to buy a CSR plan (i.e., those at or below 250% FPL). And while shoppers above 250% FPL currently aren't eligible for CSR plans at all, the Dems would make CSR87 plans available to those above that income level but below 400% FPL.

Household incomePlan Generosity for CSR Plans (ACA)Plan Generosity for CSR Plans (H.R. 5155)
100%-150% FPL94%94%
150%-200% FPL87%94%
200%-250% FPL73%94%
250%-400% FPL-87%

Oh, and they permanently make appropriations available to reimburse insurers for those cost-sharing reductions. The GOP has refused to appropriate funds to fulfill the government's obligation to make insurers whole for the CSRs, which led to large premium hikes in 2018 to make up for the lost revenue.

According to widespread reports, the government's cost for affordable healthcare for all will be somewhere around $30 trillion over 10 years. That is a huge cost for free healthcare.
 
According to widespread reports, the government's cost for affordable healthcare for all will be somewhere around $30 trillion over 10 years. That is a huge cost for free healthcare.

That is not this topic. You're talking about the feds taking on all private health spending to become the sole buyer of health care services. That is not what is on the table here, nor is it what this thread is about.

This is about making more generous the financial support available to buy private insurance in the marketplace, so that families can more easily afford their premiums and deductibles. Feasible, relatively simple, incremental improvements to make the markets function better and to improve people's lives.
 
According to widespread reports, the government's cost for affordable healthcare for all will be somewhere around $30 trillion over 10 years. That is a huge cost for free healthcare.

Hmm... we (as in the US popualtion) are spending (at least) that much now.

U.S. health care spending increased 4.3 percent to reach $3.3 trillion, or $10,348 per person in 2016. Health care spending growth decelerated in 2016 after the initial impacts of ACA coverage expansions and strong retail prescription drug spending growth in 2014 and 2015. The overall share of gross domestic product (GDP) related to health care spending was 17.9 percent in 2016, up from 17.7 percent in 2015.

https://www.cms.gov/Research-Statis...onalHealthExpendData/downloads/highlights.pdf
 
Obamacare was a horrible horrible law that threw people off their plans, and made other people accept plans with features they did not want. Obama LIED when he said you could keep your doctor. Why anybody would want to save that foul law is beyond me.

People with pre existing conditions can have access to health care.
The working poor don't lose their insurance by going to work or getting a raise in pay.
College kids have until age 26 to get a job that provides health insurance.
People without health insurance who are nonetheless treated at the emergency room pay a fee to defray the cost to the rest of us.

That's why.
 
Hmm... we (as in the US popualtion) are spending (at least) that much now.



https://www.cms.gov/Research-Statis...onalHealthExpendData/downloads/highlights.pdf

LOL, of course - that's where they get the 30T number from.

The elephant in the room is the cost of health care in the U.S., and the reason that elephant will live on for quite a while is that millions of Americans ARE that elephant. Their livelihoods would be gone if we cut the unnecessary expenditures baked into the system.

In my opinion, where this really got screwed was back in the 40's when the gubment decided to give employers tax breaks for underwriting HC insurance for employees. From then on, most people became oblivious to how much the HC they were getting was actually costing. The 'market' became quite perverted.

Illustration : A nurse gives you a vitamin during your stay in a hospital. The bill is $25.00. That is insane.
 
That is not this topic. You're talking about the feds taking on all private health spending to become the sole buyer of health care services. That is not what is on the table here, nor is it what this thread is about.

This is about making more generous the financial support available to buy private insurance in the marketplace, so that families can more easily afford their premiums and deductibles. Feasible, relatively simple, incremental improvements to make the markets function better and to improve people's lives.
Democrats passed the ACA with glee thinking Americans would love it. They did not love it. They rejected it by the tens of millions. They hated its high costs and high deductibles. Not a single DC politician wanted it for themselves.
 
What ransom will the GOP demand for more affordable plans and lower deductibles?
Probably not going to happen. They're mutually exclusive.
 

President Trump Leads a Listening Session on Healthcare


 
Who's going to pay for this premium relief?

Yep. The taxpayers.

Don't care about that deficit anymore, do we?

Anyway, this won't get past the Senate...let alone the President.

Why are the Dems wasting their time?

arnt we paying are medical bills now any way
 
Democrats passed the ACA with glee thinking Americans would love it. They did not love it. They rejected it by the tens of millions. They hated its high costs and high deductibles. Not a single DC politician wanted it for themselves.

The politics of the ACA have shifted beneath your feet and you don't seem to have realized it. People don't want the ACA repealed, they want it preserved and improved. The policies in the OP are one way to begin that work.


President Trump Leads a Listening Session on Healthcare

 
They made such a stink over the tax rate cuts not being paid for - I just expected that some additional revenue would be proposed to fund this give away.

Both parties only care about the deficit when it's not them doing the spending. People are going to pretend that's not true if their party, but sadly it is.
 
arnt we paying are medical bills now any way

Come on. Focus, eh?

We aren't talking about "medical bills". We are talking about this plan from the Dems to subsidize medical insurance premiums.

But hey...if you want the government to pay people's medicals bills...on top of their premiums...you should just quit *****footing around. Cut to the chase and pass total government health coverage. Put hundreds of thousands of people out of work and blow up the deficit.

Hell, not even the Dems wanted to do that back in 2009.
 
Come on. Focus, eh?

We aren't talking about "medical bills". We are talking about this plan from the Dems to subsidize medical insurance premiums.

But hey...if you want the government to pay people's medicals bills...on top of their premiums...you should just quit *****footing around. Cut to the chase and pass total government health coverage. Put hundreds of thousands of people out of work and blow up the deficit.

Hell, not even the Dems wanted to do that back in 2009.

actually i would like total government health coverage

seems like a larger pool of people paying for healthcare on a regular basis would cut costs what with a smaller percentage of people needing it at any one time to paying for it
 
actually i would like total government health coverage

seems like a larger pool of people paying for healthcare on a regular basis would cut costs what with a smaller percentage of people needing it at any one time to paying for it

No. It won't cut costs. The costs will remain the same or increase. Now...the amount the government pays might be reduced. That won't cut costs. It'll only reduce supply. This is simple economics.
 
No. It won't cut costs. The costs will remain the same or increase. Now...the amount the government pays might be reduced. That won't cut costs. It'll only reduce supply. This is simple economics.

the costs each person will need to pay on a regular basis should be cut got a deeper pool to draw from
 
the costs each person will need to pay on a regular basis should be cut got a deeper pool to draw from

Ah. So you are talking about different costs than I am.

Anyway, you are wrong again. Oh...sure...you could reduce the taxes people pay. Do that enough and you'll eventually get into that "free stuff" territory. For some people. But bottom line, the government has two choices:

Raise taxes to pay for the costs of health care.

Deficit spending.

Which do you prefer?

I prefer neither.
 
Ah. So you are talking about different costs than I am.

Anyway, you are wrong again. Oh...sure...you could reduce the taxes people pay. Do that enough and you'll eventually get into that "free stuff" territory. For some people. But bottom line, the government has two choices:

Raise taxes to pay for the costs of health care.

Deficit spending.

Which do you prefer?

I prefer neither.

raise taxes to pay for healthcare but by a smaller amount then what we are currently handing over to are doctors when we don't have insurance or towards insurance companies should not be free all of us with jobs should pay into it for 1 anther and those who cant

would also be cutting out the cost of the insurance companies profits

and though it matters way less i guess there advertising costs as well
 
That is not this topic. You're talking about the feds taking on all private health spending to become the sole buyer of health care services. That is not what is on the table here, nor is it what this thread is about.

This is about making more generous the financial support available to buy private insurance in the marketplace, so that families can more easily afford their premiums and deductibles. Feasible, relatively simple, incremental improvements to make the markets function better and to improve people's lives.

"Making support available" simply means someone or lots of someones are going to be paying through the nose to provide generous healthcare to people who cannot afford to pay for their own care.
 
Who's going to pay for this premium relief?

Yep. The taxpayers.

Don't care about that deficit anymore, do we?

Anyway, this won't get past the Senate...let alone the President.

Why are the Dems wasting their time?

Votes in upcoming elections. They don't realize that means negative votes.

Dems think that having healthcare as the number one concern of Americans leaving midterm polls means Americans think ACA should be held intact.:lamo.
 
Last edited:
As I've mentioned on other threads, generous and cheap healthcare insurance (ACA, for example) does not equal good healthcare nor the good access to healthcare.
 
Back
Top Bottom