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Re: Why voters won't sit still for a repeal
Let's talk about that for a moment...
I watched the Supreme Court case on the PPACA/ObamaCare and there were two things I took away from it:
1) Most people get their health care coverage through their employer (i.e., big corporations, not small, independent business owners); and,
2) Unless people were heavily influenced to purchase health care coverage through a state or federal exchange portal, few people would seek to obtain health insurance or be able to afford it on the private market.
There were four key components to making ObamaCare work properly:
1) Mass enrollment of new, healthy applicants to pick up the tab on applicants with pre-existing health conditions (that the states did not incorporate into their pre-existing health care plan rolls);
2) Decreased unemployment or under-employment with more full-time employees by the start of the individual mandate (2015/2016...??);
3) Many new young enrollees (18-26 yrs old) under the CLASS Act (as opposed to parents keeping their children on their insurance plans until age 26);
4) States starting their own health insurance exchanges OR accepting the Medicaid Expansion option (which would have enrolled more low-wage applicants).
These initiatives combined would have brought down the cost of health care coverage through the federal health insurance exchange. So, what happened?
Once the Supreme Court ruled that the federal government (Dept. HHS) could not force states to accept Medicaid block-grant funds, that opened the door to opposition efforts: a) not to expand Medicaid primarily in GOP-controlled states, b) gain control of state governments as broadly as possible so as not to start state-sponsored HIEs, and (c) widespread congressional GOP efforts to defund the PPACA. But those efforts weren't the only ones to harm the effectiveness of healthcare reform initiatives.
Another major pitfall was the provision that allowed parents to retain their children on their insurance until age 26 (married or single). This provision of the PPACA competed with the CLASS Act, a component of the the PPACA which sought to enroll young adults under 26 into a healthcare program similar to Medicare. A portion of the young adult employee's income tax would still go toward Medicare with the caveat that applicants could tap into their Medicare benefits after 5-years as opposed to waiting until they retired. But when the Dept. HHS saw that few young adults were signing up for the CLASS Act (due in large part to high unemployment and low-wage jobs associated with the 18-26 age group) and more were remaining on their parent's insurance, the CLASS Act was scrapped.
Now, here's something else few people think about as being associated with the fall of the PPACA: state employees and state budgets.
It became clear to me in 2010 that Republican-held states were using state-employees as an excuse to balance their bloated budgets. Hiring freezes and mass layoffs were two ways inwhich states could reduce their employee rolls while also ensuring that healthcare costs would increase. This was significant because many states had a high number of state-employees. Take Alabama, Wisconsin and Indiana as three prime examples. These state Governors and their legislators were able to convince their residents that state-employee benefits were too high. As a result, three things began to happen:
1) More GOP-controlled states became "right-to-work" states;
2) More state-employees were laid-off or forced to retire;
3) States imposed hiring freezes.
These tactics worked to reduce the number of enrollees on private-sector, large group health care plans of which many states held contracts.
On the contrary! I think alot of people care about ObamaCare. What they don't like are the mechanics of it. But to be fair, many of the ideals that came to shape ObamaCare were provisions that were dusted off as old ideas first supported by Republicans during the fight over HillaryCare, including the individual mandate. But as has been stated here before, "they were for it before they were against it".
....continued...
Let's talk about that for a moment...
I watched the Supreme Court case on the PPACA/ObamaCare and there were two things I took away from it:
1) Most people get their health care coverage through their employer (i.e., big corporations, not small, independent business owners); and,
2) Unless people were heavily influenced to purchase health care coverage through a state or federal exchange portal, few people would seek to obtain health insurance or be able to afford it on the private market.
There were four key components to making ObamaCare work properly:
1) Mass enrollment of new, healthy applicants to pick up the tab on applicants with pre-existing health conditions (that the states did not incorporate into their pre-existing health care plan rolls);
2) Decreased unemployment or under-employment with more full-time employees by the start of the individual mandate (2015/2016...??);
3) Many new young enrollees (18-26 yrs old) under the CLASS Act (as opposed to parents keeping their children on their insurance plans until age 26);
4) States starting their own health insurance exchanges OR accepting the Medicaid Expansion option (which would have enrolled more low-wage applicants).
These initiatives combined would have brought down the cost of health care coverage through the federal health insurance exchange. So, what happened?
Once the Supreme Court ruled that the federal government (Dept. HHS) could not force states to accept Medicaid block-grant funds, that opened the door to opposition efforts: a) not to expand Medicaid primarily in GOP-controlled states, b) gain control of state governments as broadly as possible so as not to start state-sponsored HIEs, and (c) widespread congressional GOP efforts to defund the PPACA. But those efforts weren't the only ones to harm the effectiveness of healthcare reform initiatives.
Another major pitfall was the provision that allowed parents to retain their children on their insurance until age 26 (married or single). This provision of the PPACA competed with the CLASS Act, a component of the the PPACA which sought to enroll young adults under 26 into a healthcare program similar to Medicare. A portion of the young adult employee's income tax would still go toward Medicare with the caveat that applicants could tap into their Medicare benefits after 5-years as opposed to waiting until they retired. But when the Dept. HHS saw that few young adults were signing up for the CLASS Act (due in large part to high unemployment and low-wage jobs associated with the 18-26 age group) and more were remaining on their parent's insurance, the CLASS Act was scrapped.
Now, here's something else few people think about as being associated with the fall of the PPACA: state employees and state budgets.
It became clear to me in 2010 that Republican-held states were using state-employees as an excuse to balance their bloated budgets. Hiring freezes and mass layoffs were two ways inwhich states could reduce their employee rolls while also ensuring that healthcare costs would increase. This was significant because many states had a high number of state-employees. Take Alabama, Wisconsin and Indiana as three prime examples. These state Governors and their legislators were able to convince their residents that state-employee benefits were too high. As a result, three things began to happen:
1) More GOP-controlled states became "right-to-work" states;
2) More state-employees were laid-off or forced to retire;
3) States imposed hiring freezes.
These tactics worked to reduce the number of enrollees on private-sector, large group health care plans of which many states held contracts.
On the contrary! I think alot of people care about ObamaCare. What they don't like are the mechanics of it. But to be fair, many of the ideals that came to shape ObamaCare were provisions that were dusted off as old ideas first supported by Republicans during the fight over HillaryCare, including the individual mandate. But as has been stated here before, "they were for it before they were against it".
....continued...
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