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Two Republican Senators trying to revive ACA repeal with worst bill yet


9 Nines

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It would scrap most to all federal regulation under ACA, and give block-grants to states (which means states could put the money in general funds then use it for other stuff) that wind down each year to no block grants by 2027.   So, depending on state, less to no subsidies/Medicare funding, no protections for preexisting conditions, no requirements on what is to be covered etc. 

 

http://www.businessinsider.com/graham-cassidy-health-care-bill-whats-in-it-details-2017-9

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Many Washington correspondents on twitter are reporting that McCain said he is a no today.   The Hill has confirmed it also.  If true bill is dead pretty much.   http://thehill.com

Starting in 2020, the Cassidy-Graham bill would entirely eliminate both the Affordable Care Act’s subsidies and the enhanced federal funding that underwrites the expansion of Medicaid in 31 states (plus the District of Columbia). The bill would then establish a “block grant,” handing money directly to the states for helping people to pay for health care. This would produce the best of all worlds, as Cassidy and Graham would say, because it would mean states could stop worrying about the complications of the Affordable Care Act and simply use that money in ways that will work best for them and their citizens.

 

It’s true the bill would give states new flexibility ― so much flexibility, in fact, that they wouldn’t have to direct the funding to the low- and middle-income Americans who need the help most. Nor would they have to keep regulations that prohibit insurers from charging higher premiums to people with pre-existing medical conditions, or include benefits like mental health and maternity that carriers frequently excluded in the old, pre-Obamacare days and would almost surely start excluding again if they had the chance.

 

 

 

http://www.huffingtonpost.com/entry/dont-look-now-but-full-obamacare-repeal-is-back-on-the-table_us_59bd9f2de4b086432b07a12a

 

Senate Majority Leader kicked CBO off other tasks, requesting it to put full attention on this new bill.  In other words, they are trying to cram it through at the last minute.  This would be the worst bill yet.  It completely scraps the federal system.  It sends block grants to states and asks states to use the money for healthcare systems but does not require the  use for healthcare - states can do what they want with very flexible waivers and the states that want to do the right thing building a system to insure more people would actually be penalized with less money (it actual rewards less action as an incentive to kill government assistance in healthcare.) 


 

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The bill, if enacted, would make 2018 policies not able to get the tax credits.  Basically the law would outlaw tax credits for 2018 and 2019 (they would not be allowed in 2020 and beyond) for plans that cover abortion but all plans cover abortion now, and those plans are to be submitted by insurance companies by a deadline of 9-27-17 but if this law is passed and signed, it would be after that.  Therefore it would outlaw tax credits for plans on the exchanges, the only plans that get the tax credit, in 2018 after those plans are already submitted. 

 

So is this bill passes and is signed, it will likely cause disruptions to 10s of millions of people starting in 2018 - an election year. 

 

http://acasignups.net/17/09/19/important-graham-cassidy-abortion-catch-22-especially-ca

 

However, the current ACA tax credit structure would stay in place for the next two years (2018-2019)...and this presents several problems:

 

For 2019, any insurance policy sold on the ACA exchange would have to have abortion coverage stripped out of it. They could still sell the policies including abortion coverage off-exchange, but not on the exchanges...which means no one would be able to receive APTC subsidies or CSR assistance.

 

For 2018, the same would apply...except that the deadline for signing 2018 individual market particpation contracts is in 8 days, while Graham-Cassidy likely wouldn't actually be signed into law for 9-10 days.

 

That means that Graham-Cassidy would immediately make thousands of insurance policies which legally qualified as QHPs illegal less than 48 hours later...for an enrollment period which starts just 32 days later.

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Based on this bill, Jimmy Kimmel calls out Sen Cassidy (call him a liar) and tell the senator to quit using his name in the senator's publicity stunts and then explains how the current proposals that the Senate is trying to rush to pass by next week guts life time caps, coverage for pre-existing conditions, allow much higher rates for older and sicker people, etc.

 

And he urges you to call your representative (he gives phone number also - generic number that routes you to your senators/representatives.) 

 

This dialog is informative:

 

 

 

 

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4 hours ago, Titans_Win_Again said:

Yea, they're trying to sneak this shit bill through before anyone notices. If McCain has an ounce of decency he'll vote this one down for the exact same reasons as the last one, despite his friend Graham authoring it.

We'll if the praise for McCain was worthy.

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8 hours ago, Titans_Win_Again said:

Needless to say (but I'll say it anyway, just for fun) Trump will shill this thing despite having absolutely no idea what's in it.

Even the author(s) of the bill have no idea because it pushes the entire situation to each state and the deadline is 2019 for each state to get something done (law goes into full effect January 2020.)

 

 How are states going to be able to do that in two years.  The federal exchanges, with federal funding, took many years and still had problems.  Experts and consultants that did that work opine that states cannot possibly do it in that short of time span.  Also, some states have part-time legislators and therefore would only have one year to do it.  For example, Texas legislators only meet every other year - they met this year; so they will not convene until 2019.

 

Also, the bill was put together so hastily that it is bound to have problems itself.  For an example, see the article I posted above:  outlawing tax credits for plans that cover abortion but the plans that must be submitted for 2018 will cover that, therefore as the bill is written, no plans on exchanges in 2018 will get the tax credits that they have been getting.  How many more snafus like that are in something put together basically over-night.  ( By the way: a few senators, not large committees with expert consulting and advice, put this together in their spare time over 3 months for something directly affecting a big a part of the economy and something that will indirectly or directly touch almost every American.)

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Also of note: The CBO was instructed to drop everything to score this  The CBO is doing that but qualified that with the time frame given (by early-mid next week), it will only be able to give a partial score - no score on impact to deficits (I do not understand how it gets through the Bryd Rule without that) nor a score on loss of coverage.   That might allow valid reconciliation point of contention challenges to kill the bill or major parts of it but if the Senate is is so gung-ho to pass this, it might fire the parliamentarian during this to put someone into the spot who will rule it is okay (the Senate Majority Leader held up a Supreme Court seat for a year so I would not be surprised if he did that.) 

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I just hope enough people become aware of this by early next week so that millions will put pressure on the Senate not to do this and they can get 3 Republicans to say "no."

 

It seems like it is getting attention but I am afraid that the media and people will be complacent thinking it will fail like the others and not give it much attention, but the Senate is taking the same pattern as the House.  The House failed its first attempts but then right around the time of a soft deadline to get the House bill to the Senate in time for the Senate to be able to act on it, it was passed by the House.  The Senate is following that same deadline script. 

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4 minutes ago, Rolltide said:

http://www.heritage.org/index/ranking

 

Interesting that most of the freest economies on earth according to the Heritage foundation are countries with universal health care. What kind of super moron thinks we should have a society where people just die because they can't afford proper medical treatment?

 

If France, Canada and the UK can have universal healthcare for all of their citizens then so the fuck can we. 

 

And i'm sick and tired of lame pubs like Tuxedo parroting libertarians and opposing things like this based on some principle of small government. They love big intrusive government!!! They love military spending and wars and the government forcing religion on your kids in public school. But using government as a means to help people with their groceries or healthcare is immoral to these assholes. 

 

According to these public assholes the people who need healthcare the most are the ones who should not get it. 

While about half America is pleased and the other half is not pleased with the ACA, a large majority does not want a bill like the Senate is trying to do, but they are trying to do it anyway.  Why?  If you recall from June, a group of large donors, including the Koch brothers, publicly warned that their donations are closed until the ACA is repealed and tax work gets done.  I do not know if that is the reason but with polling showing ~75% of people do not want a drastic repeal like this, then what else is the motivation? 

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10 hours ago, Rolltide said:

 

 

If the pub idiots had their way we would not have medicare or medicaid.

 

It is not just an ACA repeal.  This bill would pretty much wipe out Medicaid as a federal program.  

 

Right now Medicaid, which by the way covers either a majority or near a majority of seniors in retirement/nursing homes, is heavily funded by the federal government on a per enrollee basis.  This bill would stop that funding, replacing it with block grants that are fixed in size.  So if a state experienced bad luck with its enrollees' health, and its expenses went up, it would have to manage those with a fixed block grant, which means it would have to cut healthcare to enrollees (pressure toward bureaucratic so-called death panels.)   Also, as I noted, Medicaid is heavily used for seniors in nursing homes.  As the large Baby Boomer generation ages, those occupants will also rise, yet these block grants actually fall in size each year (that is correct - the block grants go down in dollars each year, and per this bill, in 2027 that go to zero - so if not re-financed by then, they stop.)  As everyone knows, healthcare cost go up every year but these block grants fall in size every year. So something would have to give and it will be healthcare to many people (even more pressure for death panels.)  

 

Also it will stress states' budgets very much.  Right now, with more funding from the federal government, the average state's budget still has about 1/3 of its budget spent on Medicaid.  Even with the status quo law, that percentage would likely go up as Baby Boomers age because of the nursing home angle.  This law will amplifies that by cutting federal dollars as those state costs go up.  How many states will go bankrupt over this (Moody's opines many might face bankruptcy pressure if this law passes and Moody's stated that it might downgrade some states' credit ratings over it which would cause those states' interest payment costs to go up adding even more costs to those states.) It seems to me it will be a situation of either bankrupt states or cutting healthcare/elderly pushed out of nursing homes. 

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