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

[Guinevere]

Three women ended up defeating the repeal only concept - Collins of Maine, Murkowski of Alaska, and Capito of West Virginia. A proper ending for legislation that didnt really consider women at all.

[BoSoxGal]

If we had to have a Republican, why couldn't we have had this guy?

Opinion

OP-ED CONTRIBUTOR
John Kasich: The Way Forward on Health Care
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Gov. John Kasich of Ohio, right, with Gov. John Hickenlooper of Colorado during a news conference about the Republican health care legislation last month.
CAROLYN KASTER / ASSOCIATED PRESS
By JOHN KASICH
JULY 18, 2017
Columbus — Washington’s approach to health care over the past decade is yet another example of our lawmakers’ increasing distance from the rest of America. First one party rams through a rigid, convoluted plan that drives up costs though unsustainable mechanisms that are now unraveling. Then the other party pursues fixes that go too far the other way — and again ignores ideas from the other side.

Neither extreme is cutting it, and the quick opposition that doomed the Senate plan reflects how unacceptable its ideas are to so many. The American people want and deserve reasonable, balanced, sustainable health care so that they can live without the fear of bankruptcy if they get sick, our most vulnerable neighbors are treated with compassion and those who seek to improve their lives can get healthy, confront addiction and get work.

Despite weeks of hard effort, the Senate plan was rejected by governors in both parties because of its unsustainable reductions to Medicaid. Cutting these funds without giving states the flexibility to innovate and manage those cuts is a serious blow to states’ fiscal health at a time when most — Ohio included — are feeling headwinds from a softening national economy. And, unlike the federal government, states must balance their budgets. Particularly problematic was the bill’s failure to adequately meet addiction and mental health needs — which often occur together. Diverting funds away from the comprehensive, integrated physical and mental health care that is proving effective is a step backward.

The Senate plan also failed to repair Obamacare’s damage to the insurance markets. Insufficient tax credits would make coverage unaffordable for many lower income Americans: Two of the subsidies in the bill would be temporary and a third would likely be unsustainably underfunded. Congress should avoid doing anything likely to cause further instability in the huge and complex private insurance market.


In the uncertainty created by the Senate plan’s collapse, Congress should guard against a hasty next step. Just taking up the fatally flawed House plan is not an answer, and this idea should be immediately rejected for the same reasons senators rejected the Senate’s own proposal. Also, simply repealing Obamacare without having a workable replacement is just as bad. Both would simply yank health coverage out from under millions of Americans who have no other alternative.


After two failed attempts at reform, the next step is clear: Congress should first focus on fixing the Obamacare exchanges before it takes on Medicaid. If we want to move Americans off Medicaid, there must be somewhere stable for them to go. For all its faults, at least Medicaid is currently a stable system for those who need it. The exchanges are anything but, and need immediate improvements.

One vital improvement would be to provide adequate tax credits, which would help keep health plans in the individual market and encourage — not undermine — robust competition. Companies should also be required to continue following reasonable guardrails like ensuring minimum coverage that is genuinely useful and covers pre-existing conditions. Once we see these repairs taking hold, Congress should then take up needed improvements to Medicaid as part of comprehensive entitlement reform.

States are willing to assume greater financial risk by transitioning to a block grant or per-capita cap, but will also need new flexibilities, such as tools to manage the rising cost of pharmaceuticals — the fastest growing component of Medicaid. And states cannot expect the federal government to continue paying 90 percent of Medicaid expansion costs given our nation’s historic debt; they must accept a gradual return to traditional cost-sharing levels.

Finally, we can never truly fix the rising cost of health care unless we start paying for value rather than volume. We are making this transition in Ohio by paying physicians for providing better care, not simply more care, in order to pursue better health outcomes.

In resetting health care reform in these ways — and I don’t rule out that other, balanced approaches bear consideration also — Congress can surmount the fatal flaws of both Obamacare and the current approaches: the reflection of a single partisan point of view. Health care policy is only partisan in the abstract. When you or your loved one is sick and needs care, ideology is irrelevant; getting well is all that matters. That same common sense must be reflected in the way we fix Obamacare. Another one-sided plan, driven hard by one party against the wishes of another, can never succeed because it will essentially maintain the status quo: partisan opposition and no real solutions.

The best next step is for members of both parties to ignore the fear of criticism that can come from reaching across the aisle and put pencil to pad on these and other ideas that repair health care in real, sustainable ways. America needs it, and I know that a bipartisan group of governors, including myself, stands ready to help in any way we can to provide an affordable, sustainable and responsible system of health care for the American people.

John Kasich is the Republican governor of Ohio.

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[Econoline]

It's becoming obvious that Trump's only possible option for fulfilling his promise to “repeal Obamacare and replace it with something terrific” is to abandon the GOP Congressional “leadership” and work with the Democrats and the few Republican moderates to enact a single-payer system. Not gonna happen...but if it did, he could go down in history as a President who actually accomplished something meaningful. *SIGH* Wouldn't it be nice if we had a President who had ever, ever, in his life, shown an interest in anything other than his own short-term personal gain?




ETA: Or maybe Mitch McConnell could be the one to change course—and give Trump no option but to go along?

I'm not holding my breath.

[BoSoxGal]

Just exactly how fucking tone deaf are the GOP?!?!

Charlie Gard is being given legal and permanent residence in the US by Congress in order to allow him to fly to America for treatment.

Jeff Fortenberry, Republican U.S. Representative for Nebraska, tweeted: 'We just passed amendment that grants permanent resident status to #CharlieGard and family so Charlie can get the medical treatment he needs.'

It is the latest move by US lawmakers who are determined to keep up the pressure on Great Ormond Street doctors in the on-going international political row over the 11-month-old's medical care.

They refuse to reform immigration to allow millions of productive residents to obtain legal status, they refuse to put forward ACA reform that benefits all Americans in obtaining adequate healthcare, but they'll extend permanent resident status to this family so their terminally ill severely brain damaged infant can obtain millions in medical care?!

Fucking twisted, that is!

[Lord Jim]

If we had to have a Republican, why couldn't we have had this guy?

Gee, if John Kasich had won, we'd actually have a President who thinks, and learns, and knows stuff....

What a concept...

[rubato]

The GOP voters would never have him. After more than a decade of being whipped into frenzied terror with lies about immigrants they would never accept someone who did not parrot that delusion.


Yrs,
Rubato

[Crackpot]

It he would have swept the moderates and independents and Wes who would have said he really supported him (Kasich) all along.

[Lord Jim]

If Kasich had won the nomination, he'd have beaten Hillary easily, probably would even have carried the popular vote...

If Kasich had been the nominee, Clinton would have lost all the nose-hold votes she got (like mine) and there were millions of them...

That would have more than made up for the inbred yokels staying home who crawled out of their backwoods holes to cast their first ever votes because they finally had the chance to vote for somebody as coarse, oafish and ignorant as they are...

[ex-khobar Andy]

Just exactly how fucking tone deaf are the GOP?!?!

Charlie Gard is being given legal and permanent residence in the US by Congress in order to allow him to fly to America for treatment.

Jeff Fortenberry, Republican U.S. Representative for Nebraska, tweeted: 'We just passed amendment that grants permanent resident status to #CharlieGard and family so Charlie can get the medical treatment he needs.'

It is the latest move by US lawmakers who are determined to keep up the pressure on Great Ormond Street doctors in the on-going international political row over the 11-month-old's medical care.

They refuse to reform immigration to allow millions of productive residents to obtain legal status, they refuse to put forward ACA reform that benefits all Americans in obtaining adequate healthcare, but they'll extend permanent resident status to this family so their terminally ill severely brain damaged infant can obtain millions in medical care?!

Fucking twisted, that is!

And of course I hope that Charlie can recover as some US doctors (?) have suggested. But again it is ironic that the healthcare argument has so long been about keeping government out of it, and letting the doctors make the choices. Here we have an obvious case where political intervention, if it works, will be applauded and if it does not will be forgotten. I hope for the sake of Charlie and his family that the doctors at GOSH are wrong. But I doubt it.

[BoSoxGal]

Even the US doctor who wants to use Charlie as a lab rat for his never tested experimental treatment doesn't suggest that his brain damage can be reversed - and the brain damage leaves him blind, deaf, uncomprehending, unable to breathe on his own, and suffering up to four epileptic seizures per day, seizures which are very painful. I'm quickly losing sympathy for his parents - thank heavens for the courts and doctors who believe in the oath.

[BoSoxGal]

[Econoline]

Author Adam-Troy Castro absolutely nails it, on Facebook:

• Imagine a guy who would dangle a child over the edge of a cliff and promise to drop it, saying, "I can catch her in time. Chances are, I can catch her in time. I will drop her now and then worry about catching her, later. How do I know I'll be able to do it? I'll be motivated."
  
  Imagine that unbelievable piece of crap.
  
  Now consider Mitch McConnell, acting in accordance with our piece of crap of a President, saying that we can repeal Obamacare on a two-year delay and worry about concocting and voting in a replacement during that interval.
  
  People's lives are at risk.
  
  Children's lives are at risk.
  
  Don't worry. I can drop this kid now. I can always worry about moving real fast and catching her later.

[Guinevere]

This is so NOT a surprise, yet it is still horrifying:

https://www.vox.com/policy-and-politics ... alth-costs

“I know a lot about health care,” President Donald Trump declared in a Wednesday interview with the New York Times.

But Trump’s answers to other questions betrayed how little he knows about health policy. As Ezra Klein wrote yesterday, this has become a major stumbling block in Republican efforts to repeal and replace Obamacare. Trump can’t strike a deal on health care when he doesn’t understand health policy.

Trump cited numbers that don’t seem to come from any recent version of the health care debate.

“From the moment the insurance, you’re 21 years old, you start working and you’re paying $12 a year for insurance, and by the time you’re 70, you get a nice plan,” Trump told the Times.

Of course, anyone who has purchased health coverage, let alone studied the health insurance market, knows that a $12 annual premium is nonexistent — and that premiums are typically paid in months rather than years. The numbers Trump cites seem to come from the universe of life insurance rather than that of health insurance. Life insurance premiums are significantly lower and a completely different benefit program than health coverage.

This isn’t the first time Trump has so dramatically underestimated the costs of health insurance. In a May interview with the Economist, he estimated that health coverage ought to cost $15 per month.“Insurance is, you’re 20 years old, you just graduated from college, and you start paying $15 a month for the rest of your life and you really need it, you’re still paying the same amount and that’s really insurance,” Trump told the magazine.

The fact that Trump settles on $12 or $15 as the appropriate amount to pay for health insurance betrays a lack of familiarity with the actual cost of coverage. You do not have to be a health policy expert to get this — just someone who has ever purchased a health plan.

How exactly does this man represent the average joe, the blue collars, middle America?????

[Burning Petard]

I guess I am a flagrant elitist, because I believe that " average joe, the blue collars, middle America" totally agrees with POTUS, for they also are just ignorant and unable to connect a plausible result with a theoretical action, and see no value in remembering anything they might have said or supported yesterday.

snailgate.

[Sue U]

This is so NOT a surprise, yet it is still horrifying:

https://www.vox.com/policy-and-politics ... alth-costs

“I know a lot about health care,” President Donald Trump declared in a Wednesday interview with the New York Times.

But Trump’s answers to other questions betrayed how little he knows about health policy. As Ezra Klein wrote yesterday, this has become a major stumbling block in Republican efforts to repeal and replace Obamacare. Trump can’t strike a deal on health care when he doesn’t understand health policy.

Trump cited numbers that don’t seem to come from any recent version of the health care debate.

“From the moment the insurance, you’re 21 years old, you start working and you’re paying $12 a year for insurance, and by the time you’re 70, you get a nice plan,” Trump told the Times.

Of course, anyone who has purchased health coverage, let alone studied the health insurance market, knows that a $12 annual premium is nonexistent — and that premiums are typically paid in months rather than years. The numbers Trump cites seem to come from the universe of life insurance rather than that of health insurance. Life insurance premiums are significantly lower and a completely different benefit program than health coverage.

This isn’t the first time Trump has so dramatically underestimated the costs of health insurance. In a May interview with the Economist, he estimated that health coverage ought to cost $15 per month.“Insurance is, you’re 20 years old, you just graduated from college, and you start paying $15 a month for the rest of your life and you really need it, you’re still paying the same amount and that’s really insurance,” Trump told the magazine.

The fact that Trump settles on $12 or $15 as the appropriate amount to pay for health insurance betrays a lack of familiarity with the actual cost of coverage. You do not have to be a health policy expert to get this — just someone who has ever purchased a health plan.

How exactly does this man represent the average joe, the blue collars, middle America?????

[Lord Jim]

Somebody needs to find a stronger hammer and a bigger stake...

This vampire just won't stay in its coffin:

With John McCain out, McConnell still plans a Senate health care vote next week

WASHINGTON — Senate Majority Leader Mitch McConnell, R-Ky., is still expected to hold a vote to proceed on some form of legislation to repeal Obamacare next week, despite the fact that Sen. John McCain likely won’t be back in Washington to cast his vote.

The Arizona Republican senator's absence, in addition to the GOP members who have announced their opposition to the bill, makes it even harder for McConnell to round up the votes to pass a bill.

McConnell’s spokesman David Popp told USA TODAY on Thursday that the vote is still on despite the news Wednesday night that McCain has been diagnosed with brain cancer. McCain is currently reviewing his treatment options back in Arizona, and it is not clear when he will return to Washington. Senate rules require that a lawmaker be at the U.S. Capitol in order to cast a vote.

Despite frustration about the closed-door process GOP leadership took in drafting the health care legislation, McCain was not expected to be one of the lawmakers blocking a bill. Republicans hold such a narrow majority, 52-48, that even with McCain’s vote they can only lose the votes of two senators and still pass a bill.

So far, four GOP lawmakers have said they will vote against the Senate bill to repeal and replace Obamacare, also known as the Better Care Reconciliation Act.

Three senators have also announced opposition to an alternate plan that would repeal Obamacare without a replacement, designed to force Democrats to the table to negotiate a replacement down the road.

As of Thursday afternoon, it was still not clear which of the bills would be brought up for a vote. [Well, that's perfectly understandable, since simple math shows that just based on the publicly announced positions, both bills will fail... ]

Asked by reporters whether there is an agreement on what version of the health care bill will be voted on next week, Sen. Bill Cassidy, R-La., replied, “Simple answer — no." At least a dozen other senators at the Capitol on Thursday were also unclear about what the final legislation would look like.

https://www.usatoday.com/story/news/pol ... 495683001/

[Guinevere]

1. It's a political stunt, so that those outspoken opponents of the ACA can at least claim they "voted to get rid of it" or make some similar assertion.

2. They think they can catch the Dems and the "no" vote Repubs unaware/on vacation and will try to finagle a pass somehow.

3. A little bit of both.

[Big RR]

Guin--with any members missing, would it be possible to get something to pass with less than 50 votes; I didn't think so, but I'm not certain.

[Bicycle Bill]

Were I a Democratic senator, I would install a futon in my office and sleep there to avoid being caught away from DC should the Repugnicants try to railroad something like this through Congress.  I'm sure my constituents would understand.

-"BB"-

[Lord Jim]

Guin--with any members missing, would it be possible to get something to pass with less than 50 votes; I didn't think so, but I'm not certain.

Well, I'm not Guin, (and I don't even play her on TV) but I believe I can handle this one...(note to rube: you may want to scroll past this post...lots of math ahead)

You need a majority of those "present and voting" (with the VP able to create a majority in the event of tie vote of the Senate members)

So...

In the current situation, with the GOP having a 52-48 majority (46 Democrats and two Independents who caucus with the Democrats...Bernie Sanders and Angus King)

That means with all 100 Senators present and voting, McConnell can afford to lose two GOP votes (which would create a 50-50 tie, and the VP would cast the tie breaking vote, creating a 51-50 majority)

Now, if there's one GOP member not available to vote, you have 99 rather than 100 total Senator votes available, and the GOP have a 51-48 advantage...

In this situation they would still need 50 votes, (because 50 is still the lowest number you can have and still have a majority; 50-49) so McConnell could only afford to lose one vote (and the VP doesn't vote, because obviously with an odd number of total votes there can be no tie to break...)

Now let's say for some reason one more GOP Senator was unavailable for the vote, so now the GOP margin is 50-48...

Well now the total number of available votes is 98, but the GOP can still afford to lose one vote and have only 49 Senators voting because the then the VP breaks the 49-49 tie and it passes 50-49....

But theoretically there's nothing magic about the number 50; if you have more Senators not available to vote, the number needed to pass this bill (or any bill requiring only a simple majority vote) would drop accordingly...(with or without the VP breaking a tie)

There's an absolute floor on how low this can go, because Senate rules requires 51 members present to constitute a quorum, without which the Senate cannot conduct a vote.

BTW, it's different with a bill that's subject to filibuster and therefore requires 60 votes...

Current Senate rules say it requires 60 votes to cut off debate on a bill subject to filibuster, no matter how many or how few Senators are voting.