The GOP Health Plan -or-If You're Not Wealthy You're Screwed

[Long Run]

It is only the group plans that were forced by the ACA to accept these high-claim individuals without any period of exclusion, which meant, of course, that all of the responsible people pay more to make up the difference for the irresponsible.

True, but then that is the way group coverage has existed for a very long time through employer group policies, isn't it? People who were laid off and without insurance for a long time could get coverage day one when they got a new job.

Actually, most employers required 2-6 months to qualify for health coverage (ACA allows 60 days), and then pre-existing conditions were excluded for 6 months. While eventually the group picks up the added cost of the high-claim person, there is a lengthy period where the person is paying a high price for not being insured. This is, of course, why COBRA and HIPAA portability were implemented to cover the common situation of a break in coverage due to layoff or hour reductions.

[Big RR]

Usually I saw a 30 delay (or immediate coverage) with no exclusion of preexisting conditions for most of my employers. But a delay in preexisting condition coverage hardly helps the plan, as the costs of treating chronic conditions like diabetes and hypertension are eventually picked up with no surcharge, and in many cases costly surgeries can also be delayed for that period.

And FWIW, even with COBRA, few people can afford the cost of coverage on their own, which is why many go without (and then develop complications which are far more costly to treat.

[rubato]

"... that all of the responsible people pay more to make up the difference for the irresponsible. ..."

Really? We are making up facts now?

"... that all of the fortunate people pay more to make up the difference for the unfortunate. "

Better.

yrs,
rubato

[rubato]

http://www.msnbc.com/rachel-maddow-show ... -need-move

GOP lawmaker: those with pre-existing conditions may need to move

Fascinating especially since RED states have all of the ten highest rates of smoking, obesity and the none highest rate for heart disease. Conservative states promote "irresponsibility"??


yrs,
rubato

[Long Run]

And FWIW, even with COBRA, few people can afford the cost of coverage on their own, which is why many go without (and then develop complications which are far more costly to treat.

Exactly, and this is why COBRA experience is super high -- the only ones who take advantage of it are the ones with expensive conditions. For them, it is a great deal since they pay general rates for a comprehensive plan, and even though it seems expensive, it is the same cost that their employer has been paying for them; and it allows them to stay in the same group they had been in until they find new coverage. So COBRA solved a significant problem -- keeping unhealthy people insured between eligibility for group coverage. Healthy people pass on COBRA and either buy a lower cost policy or go without insurance and take their chances.

[Big RR]

the only ones who take advantage of it are the ones with expensive conditions

No, the only ones taking advantage of it are the ones who can afford it; the conditions don't matter. Rational people who can afford health insurance will pay for it rather than take their chances (regardless of their health) and those who cannot afford it will not accept it, regardless of their health. And as these people are unemployed, few can afford it.

And FWIW, COBRA has a higher premium than the employer previously paid, and can include tacked on administrative and other fees.

As for lower priced policies, again, except for the very young they were not available before the ACA.

[Long Run]

No, the only ones taking advantage of it are the ones who can afford it; the conditions don't matter. Rational people who can afford health insurance will pay for it rather than take their chances (regardless of their health) and those who cannot afford it will not accept it, regardless of their health. And as these people are unemployed, few can afford it.

While those who are healthy and can afford it may go with COBRA, most find less expensive options. As for those who are less well off and have high claims, they find a way to elect COBRA since the cost of premium/versus the benefit makes this possible. For example, we regularly see medical providers pay the COBRA bill since a $500-$1,000 per month premium to receive $10,000+ in medical claims is a good deal.

And FWIW, COBRA has a higher premium than the employer previously paid, and can include tacked on administrative and other fees.

As for lower priced policies, again, except for the very young they were not available before the ACA.

By law, the cost of COBRA cannot exceed the employer cost plus no more than 2% in administrative fee. With many layoff situations, the employer picks up the COBRA cost for 2-6 months.

And on your last point, there obviously were many lower cost policies before the ACA for healthy people which is why there has been such a hue and cry that most of them disappeared with the ACA mandated benefits plus adding high-cost members to the pool driving up costs.

Which brings us back to the point that the pre-ACA law already covered the vast majority of situations to allow people with medical conditions to continue with insurance, leaving the pre-existing condition to mostly those who chose to not have insurance and took their chances. The ACA tried to address this by: 1) mandating everyone get insurance (and this extremely unpopular mandate had so many holes that more people escape the mandate than pay the tax); 2) expanded Medicaid (which worked, except the funding mechanism to pay for this was bogus); and 3) provided the Exchanges and subsidies (and many of these are hitting the death spiral point). The ACA is a classic example of poorly implemented policy, where we could have 95% of the benefit with 5% of the regulation, but they just had to get that last 5% of benefit, which left us with the complicated mess. Simpler solutions were and are available.

[Lord Jim]

Well tie me up and call me Loretta...*

Upton, Long reverse themselves and back Obamacare repeal bill

Two prominent Republican opponents of the House GOP’s Obamacare repeal bill reversed course and backed the measure Wednesday morning, after negotiating a last-minute amendment with President Donald Trump at the White House.

Reps. Fred Upton of Michigan and Billy Long of Missouri, whose defections this week rattled rank-and-file Republicans, emerged from their session with the president and said an amendment to add $8 billion to help cover people with pre-existing conditions would return them to the "yes" column on the bill.

Though there were concerns the revised measure might repel conservatives already reluctant to back the GOP plan, early signals suggested most would remain on board.

"I believe they will find broad support among [House Freedom Caucus] members for their amendment," said caucus Chairman Rep. Mark Meadows (R-N.C.) in a statement to POLITICO.

Some White House officials want a vote on the bill quickly, and House Republican leaders are warning Democrats that the bill might come up for a vote as early as Thursday. Two senior White House officials said they feared members leaving for recess without voting could doom eventual passage, but many in Congress have grown frustrated with the White House's timetables.

http://www.politico.com/story/2017/05/0 ... are-237910

So maybe they will get this through the House, though the current NYT Whip count has it at:

18
No

33
Undecided or unclear

https://www.nytimes.com/interactive/201 ... count.html






*A line spoken by FBI agent Tobias Fornell in one of my favorite NCIS episodes....

[Scooter]

So the fig leaf that means less than nothing in practice did its job.

Well played.

[Lord Jim]

Ryan apparently believes that he now has the votes:

House will vote on GOP Obamacare replacement bill on Thursday

The U.S. House of Representatives will vote Thursday on a controversial Republican bill that would repeal and replace key parts of Obamacare, the GOP's majority leader said.

"We're going tomorrow, yes we are," said Majority Leader Kevin McCarthy, R-Calif.

Asked he if had the votes to win passage of the bill, McCarthy told NBC News, "Yes we do."

"We will pass this bill," McCarthy said. "I feel great about the [vote] count."

House Speaker Paul Ryan, R-Wisc., said several days ago that he would not hold the vote without having those winning votes in hand. Thursday's scheduled vote will take place without the House having received an official projection of the costs of the revised bill, as well as estimates about how it will affect insurance premiums and the numbers of people with health coverage.

The expected vote will come a day after two leading Republicans, Reps. Billy Long and Fred Upton, agreed to switch their expected "no" votes on the bill to "yes" votes.

Long and Upton earlier this week had come out publicly against the bill because of a change made to it last week that would, in their view and in those of many others', weaken price protections for private individual plan insurance customers with pre-existing health conditions.

http://www.cnbc.com/2017/05/03/house-se ... -news.html

[Scooter]

Republicans just told 24 million people that they are useless parasites who should hurry up and die.

[Lord Jim]

I admit, I didn't think they'd pull it off...

They got 217 votes (exactly what they needed now that the new congress critter from Kansas has been seated) three chicken shits didn't vote (20 Republicans voted against)...

Now they're all trooping down to the White House to film a campaign clip for 2018 Democratic congressional candidates all over the country to use in their commercials...

The one who really ought to be celebrating right now is Nancy Pelosi...

Regardless of what happens in the Senate, her chances of returning to the Speakership just got a boost...

[rubato]

Republicans just told 24 million people that they are useless parasites who should hurry up and die.

Now if only the democrats have the wits to turn them all into voters.

yrs,
rubato

[rubato]

The senate is another matter. A lot of representatives are in nice safe gerrymandered districts. Senators are exposed to the entire electorate of their states and will be less likely to accept the consequences.


yrs,
rubato

[RayThom]

Yes, let's hope better heads prevail in the Senate.

In the meantime we will have to put up with Lord Dampnut and his court jesters gloating about this series of unfortunate events for the next few weeks. The smirk on Drumpf's face while POTU2 was at the podium announcing this partisan victory was priceless.

Resist.

[rubato]

Democrats chant 'hey, hey, hey, goodbye' at House Republicans after they pass healthcare bill

if only it works out that way.


yrs,
rubato

[Lord Jim]

Not sure what the House GOP has to be celebrating about; this poll was taken last week, and I doubt that 8 billion additional dollars for the high risk pools will do anything to dramatically change the numbers:

Only 37 percent say Trump should repeal and replace Obamacare

As President Donald Trump and Republicans in Congress gear up for another attempt at repealing and replacing Obamacare, an ABC News/Washington Post poll finds broad public preference for keeping and improving it — including high levels of support for some of its key components.

See PDF with full results here.

Just 37 percent of Americans in the national survey say the Affordable Care Act should be repealed and replaced; 61 percent say it should be kept and fixed instead. Even more broadly, the public, by 79 to 13 percent, says Trump should seek to make the current law work as well as possible, not to make it fail as soon as possible, a strategy he has suggested.

These lopsidedly pro-Obamacare views are far different from the results of an ABC/Post poll in mid-January asking if Americans supported or opposed repealing the ACA: 46 and 47 percent, respectively. That question did not offer “keeping and improving” it as an alternative, and it was asked before the contours of the first, failed effort to repeal the law were known.

Obamacare’s rising fortunes are reflected in support for two key provisions of the law that Republicans have proposed changing in recent months. Surveyed Americans, by 70 to 26 percent, say coverage for existing conditions should be mandatory nationwide rather than left up to the states. Similarly, 62 percent prefer nationwide minimum insurance coverage standards (such as for preventive services, maternity and pediatric care, hospitalization and prescription drugs); just 33 percent would leave such standards up to the states.

Even among Republicans and conservatives polled, majorities support a nationwide standard for coverage of existing conditions (54 and 55 percent, respectively). A narrow majority of conservatives (53 percent) and a substantial share of Republicans (46 percent) also support a national standard for minimum coverage in this poll, produced for ABC by Langer Research Associates.

Further, just 20 percent of conservatives, a quarter of Republicans and 28 percent of Trump voters surveyed say he should try to encourage failure of the existing law.

In an additional expression of support for the law, polled Americans, by 43 to 26 percent, say they’d rather see Trump work with Democrats than with conservative Republicans in Congress to change it. Twenty-four percent prefer that he work with both.

These results reflect nearly universal sentiment among Democrats in favor of the law, majority preference among independents and moderates to keep and improve it and, as noted, divisions within the GOP and related groups.

http://abcnews.go.com/Politics/appetite ... d=46989828

I'm sure that the vast majority of the Senate Republicans would have much preferred not to have been handed this tar baby...

[Burning Petard]

The devil is always in the details. "Failing Obamacare" is to be phased out over 5 years, with the really bad stuff at the end, after the next presidential election cycle.

snailgate

[Guinevere]

And they played the Rocky theme while they came in to vote. So incredibly disgusting. I can't say fuck enough times today.

[Big RR]

And they played the Rocky theme while they came in to vote. So incredibly disgusting. I can't say fuck enough times today.

Just one more reason to hate that song. Idiots!