This should be required viewing. THIS is what the health insurance fight is about. Moral vs. immoral. Right vs. wrong.

This should be required viewing. THIS is what the health insurance fight is about. Moral vs. immoral. Right vs. wrong. https://t.co/5MBWWScAiY

— Victoria Helen Stone / Dahl (@VictoriaDahl) October 20, 2018

Senate GOP "Search and Destroy" Repeal Bill Dead. Why does "Trimming health care spending" make sense to Republicans?

Medicaid, Medicare and veteran health care covers 36 percent of the U.S. population. 32 percent in Wisconsin. That's a huge percentage of government health care. Why not go all the way with a national health care plan? And yet, Republicans continue to attack any government involvement. 

But there's a reason these major safety net programs were created; the marketplace did not provide or did not adequately cover any of these health care services. 

In order to destroy these public services, Republicans continue to push the fantasy that Democrats came up these safety net programs because they love big government, that "government is the answer to everything," and because Democrats love to spend, spend spend. 

Monumental Distraction: Consider the real reason, as explained by James Madison in the book "The Debate on the Constitution" ... "forgetting that the public good, the real welfare of the great body of the people is the supreme object to be pursued; and that no other form of government whatever, has any other value, than as it may be fitted for the attainment of this object."

Senate "Search and Destroy" Health Care Bill Dead: Only a few Republicans realized how bad their own legislation was, and backed away. But it never should have gotten that far.

The report from NPR below highlights the doctors side of the debate, just one of many professions never consulted by our all-knowing anti-government/but big government Republicans. Is "it's time to trim health care spending" a sane argument to begin with? Here's the audio:

"Where in this bill is the protection for children," asks Dr. Jonathan Davis, the chief of newborn medicine at Tufts Medical Center, as he stands in the hospital's NICU among babies who weigh as little as 1 pound. Roughly 60 percent of babies in the Tufts NICU are covered by Medicaid. it's unclear whether Tufts could provide this care for free if the baby or her mom didn't qualify for Medicaid. Davis says they also need good insurance after they leave the hospital.

"Because if those children don't go home to get great primary care, follow-up, early intervention and support, all those gains that could potentially have been made are going to be lost."

ACA "Death Spiral" thanks to GOP/Trump repeal/replace Fumbling.

It's not the ACA exploding, it's the Trump administrations shoot from the hip health care debacle that's spooking the insurance horses. Remember, Republicans were once real big on whining about how "uncertainty" would destroy the economy...correction; health care.  

Uncertainty about what the Trump administration is doing with health care has already led insurers to increase costsHealth insurance companies are saying that no matter what happens with the Republican health-care bill in the coming months, premiums will go up in 2018 just from the uncertainty of the situation. "The health plans I work with want to stay in, but the Trump administration is not making that easy," insurance industry consultant Robert Laszewski explained to Vox.In one example, CareFirst, a BlueCross BlueShield plan in Maryland, Virginia, and Washington, D.C., submitted 2018 premiums last week that reflect hikes averaging between 39 and 52 percent depending on the state."Uncertainty breeds higher costs," New Mexico Health Connections chief executive Martin Hickey told Vox. "We have to plan for the worst case scenario until it finally gets decided."

Yup, right from the insurance industries mouth...

“We were hoping for more stability this year,” says Chet Burrell, chief executive of Carefirst, a Blue Cross Blue Shield Plan in the D.C. metro area. “But these factors have lead to instability, and the beginning of a death spiral.”

Burrell says that his plans would have had hikes this year anyway, because it has lost money during its three years on the Obamacare marketplaces. But it tacked an extra 15 percent onto its premiums because it does not expect the Trump administration to enforce the individual mandate.

“The current approach at the federal level has been to say they’re not going to enforce it,” he says. “We think the effect of that is to encourage healthy people not to enroll.”

Can't blame Obama: And he wasn't the only insurer:

Iowa could be left in a similar situation: 94 of its 99 counties are served by just one health plan, Medica, which is not committed to sticking with the marketplace in 2018.

“Without swift action by the state or Congress to provide stability to Iowa’s individual insurance market, Medica will not be able to serve the citizens of Iowa in the manner and breadth that we do today,” the plan said in a statement to the Des Moines Register.

Two other insurance plans, Wellmark and Aetna, also quit the Iowa marketplace this year citing the law’s uncertain future.

Insurance Industry Insider Shreds GOP's RyanCare plan.

There is one shining spot for insurers in the GOP health care plan (remember, insurance has nothing to do with providing health care).

The Republican plan does allow insurance companies to offer coverage that pays for a lower share of a person's health care costs — just half of all costs rather than the 60 percent to 90 percent mandated under the ACA.

Funny thing though, according to a former insurance industry insider, Republicans don't know what the hell they're doing. I know I've said this same thing before, but now I've got backing. From NPR:

Scott Horsley, NPR News: There is some political irony here. The people and places most likely to be hard hit by the change - older, rural, lower income - are the same ones that helped to elect the president. That's why some Republican senators who represent those areas are now talking seriously about possible changes to the GOP bill.

But there are also many Republicans who want to prevent the government from helping anyone buy insurance. And they would try their grand experiment on the entire U.S. population…which should make you wonder if they’re not the most reckless irresponsible people ever elected into public office.

What never gets enough attention are the dramatically reduced services in the GOP’s insurance policies. This is big, because it’s what made many Americans not even bother to get insurance before the ACA. It’s another big reason health care bankruptcies skyrocketed, destroying families along the way.

NPR: Republicans have said repeatedly that they want insurance companies to be able to offer cheap, stripped-down policies that don't cover as many services as those under the Affordable Care Act, also known as Obamacare. That way, consumers will have the choice to spend less on premiums if they don't want comprehensive coverage.

The problem is Republicans have a three-part strategy to reshape health care. The first is the American Health Care act, which essentially repeals Obamacare's individual mandate, taxes and subsidies, and replaces them with smaller tax credits to help people buy insurance.

Then they intend to make changes in regulations and pass additional legislation to reduce the benefits insurers have to offer and allow more competition between insurers. They say their ultimate goal is to reduce the cost of insurance so more people will buy coverage.

Stripped down coverage. Want to pay a monthly premium, that increases every year, for that? Just to be clear, if the plan below sounds good to you, well, maybe the GOP has a bridge you’d like to buy too:

The Republican plan does allow insurance companies to offer coverage that pays for a lower share of a person's health care costs — just half of all costs rather than the 60 percent to 90 percent mandated under the ACA. 

Republican explanation for Massive drop in the Insured rate repealing ACA? "Some people don't care enough" and just not responsible...lazy.

This recent comment pretty much explains how Republicans are going to frame the issue of dumping 20 million people from health care. They're lazy.

Check this irresponsible comment:

Republican Rep. Dennis Ross of Florida told Bloomberg: “Not everybody is going to have health care. Some people just don’t care enough about their own care,” he argued, saying Republicans can provide people access to affordable insurance plans, “but whether they take it or not is like trying to legislate responsibility.”

Get that? If you "don't care enough about your own care," or just aren't responsible, that's not our problem. They're lazy, just like the unemployed getting food stamps and Medicaid.

Once again, the uninsured will raise premiums on those who are responsible and buy insurance. It like they never understood why we had a health care crisis in this country in the first place.

The cost of health care is a huge business expense as well, write off or not. And that write off is also on the chopping block.

GOP Health Care Reform Plan a Mind Numbing, Convoluted, Confusing and Complex maze of Regulations. Can't wait to see the Insurer policies small print....

Besides being a great look at the Republican health insurance reform plan (still waiting for the CBO estimate), imagine trying to navigate this system below for you and every family member...every year, throughout the year. Don't forget to read through the insurers small print policy exceptions that don't require minimum coverage. Who's got this kind of time or expertise?

And Republicans hate regulation?

High risk pools are paid for twice by the public, once in tax dollars and again in premium increases for the insurer contribution. Beautiful. We would hate to have insurers find themselves stuck with sick people.

My plan beats this; every doctor is your doctor; every hospital is your hospital; no copays or deductibles. Yes, it's single payer/Medicare for all. But you be the judge...you can take my plan, or navigate the maze of regulations listed below, that will continually change over time:
___________________________________________________________________________________

What The Bill Does Not Do

First, it must be emphasized what the bill does not do. It does not repeal the ACA. Indeed, it only repeals particular sections of the ACA, such as its taxes, mandates, Medicaid expansion and subsidies. And some of these it only does after 2019. It does not appear to repeal most of the ACA’s insurance reforms, such as the requirements that health plans

• cover preexisting conditions;
• not health status underwrite; meet actuarial value requirements;
• cover adult children up to age 26;
• not discriminate on the basis of race, nationality, disability or sex;
• cap out-of-pocket expenditures; and
• not impose lifetime or annual limits.

It does not touch the ACA’s Medicare reforms or cuts. It is replace, but not repeal.

Medicaid

Much of the bill is focused on changes to the Medicaid program. It ends the ACA expansion for low-income adults and essential health benefit requirements as of the end of 2019, as well as the ACA’s presumptive Medicaid eligibility provisions and disproportionate share hospital payment reductions. The bill establishes a per-capita cap approach to funding state Medicaid programs beginning with fiscal year 2019. The per-capita cap provisions are lengthy and complicated and I will leave it to others more expert on Medicaid than myself to explain them.

Federal payments to the states through Medicaid or any other program for Planned Parenthood would be prohibited.

High-Risk Pools: The State Innovation Grant And Stability Program

The bill would establish a “State Innovation Grant and Stability Program,” beginning in 2018. States could use funding from this program for a variety of initiatives such as high risk pools, reinsurance programs, programs to subsidize providers for direct provision of care or to reduce cost sharing, or programs to promote access to preventive services. Beginning in 2020, states would have to apply for the funding, but an application would be deemed approved within 60 days of submission if not acted on and, once an application is approved, it would be deemed reapproved each year through 2026. It is not wholly clear how the funds would be distributed before 2020, but apparently no application is necessary.

The bill would appropriate $15 billion for the program for calendar years 2018 and 2019, and $10 billion a year for the following calendar years through 2026. The money would be allocated among the states using a formula that is based for 2018 and 2019 on relative marketplace participation and premium costs for each state, and thereafter based on the percentage of residents of states that are below some income threshold or uninsured. (The formula for 2018 and 2019 might favor states that did not expand Medicaid because individuals with incomes between 100 and 138 percent of the poverty level would be in the exchanges rather than on Medicaid). States would have to match the federal contributions at a rate initially set at 7 percent for 2020, increasing to 50 percent by 2026.

Continuous Coverage Requirement

A continuous coverage requirement in the individual and small group markets would begin with plan year 2019, or 2018 for special enrollments. Premiums would increase by 30 percent for twelve months for individuals who had a gap in creditable coverage of at least 63 continuous days during the preceding 12 months (or, for people leaving dependent coverage, who did not enroll during the first available open enrollment period). The legislation does not seem to allow preexisting conditions exclusions or health status underwriting, rather only imposing a premium penalty on people who do not maintain continuous coverage.

The bill would end the ACA’s essential health benefit definition as of the end of 2019 and allow states to define EHB beginning with plan year 2020. Premiums would be allowed to vary by a 5 to 1 ratio, rather than 3 to 1 as under the ACA. Verification of special enrollment period eligibility would be enhanced. The bill would extend indefinitely ACA non-compliant individual and small group plans that were allowed to continue under the 2013 transitional plan guidance, recently extended; it also apparently allows insurers to offer these plans to new enrollees and not just to renew them for current enrollees.

Cost-Sharing Reduction Payments And Tax Credits

The bill would end the ACA’s cost-sharing reduction payments at the end of 2019. It would extend the ACA’s premium tax credit provisions through the end of 2019 but modifying the tax credits to:

• Allow their use for ACA-compliant off-exchange plans after 2017. Credits for off-exchange coverage could only be claimed at tax filing time and not as advance tax credits.
• Allow their use for catastrophic plans for which individuals were otherwise eligible.
• Prohibit their use to cover premiums of plans that cover non-Hyde amendment abortions—abortions for which federal funding in other programs would be prohibited by the Hyde amendment—although insurers could sell separate abortion coverage).
• Change the formula for determining the percentage of income that individuals must spend on premiums before receiving tax credits to decrease the percentage for younger individuals and increase it for older individuals.

The bill would create a new age-adjusted, fixed-dollar tax credit beginning with 2020 amounting to

• $2,000 for individuals under 30;
• $2,500 for those ages 30 to 40;
• $3,000 for those ages 40 to 50;
• $3,500 for those ages 50 to 60; and
• $4,000 for those over 60.

The total tax credit for a tax family would be capped at $14,000 or the amount available for the five oldest individuals in the family. The tax credit would only be available for individual coverage (including, apparently, short-term coverage but not excepted benefits) or unsubsidized COBRA continuation coverage that does not cover non-Hyde amendment abortions. It would not be available to persons eligible for employer coverage (regardless of affordability or adequacy) or a government program. It also would only be available to U.S. citizens or nationals or a limited class of lawful aliens.

The tax credits would be adjusted for inflation. It would be advanceable, payable to health insurers on a monthly basis. Persons whose tax credit exceeded the cost of their coverage could have the excess deposited in their HSA. However, most older people, and even younger people in some parts of the country, would have to supplement the tax credits substantially out of their own pockets to afford coverage. Older enrollees could face premiums five times as high as younger enrollees, but only receive tax credits twice as high. Insurers would be required to report to the IRS and to covered individuals information on advance payments received.

Repeal Of Individual Mandate Penalty And ACA Tax Provisions

The bill would zero out the penalties for the individual and employer mandate. It would repeal the taxes imposed by the ACA, including:

• The Cadillac plan tax.
• The exclusion of coverage for over-the-counter medication from tax-subsidized accounts such as HSAs.
• Limitations on contributions to flexible spending accounts.
• The tax on prescription medications.
• The medical device tax.
• The health insurance tax.
• The tanning tax.
• The Medicare surcharge and Medicare tax on unearned income for high-income taxpayers. as

The bill would also allow deductibility of medical expenses above 7.5 percent of income instead of 10 percent as under the ACA. The penalty imposed on expenditure of HSA funds for non-medical purposes would be reduced from 20 to 10 percent.

The taxes are repealed as of the end of 2016, except for the medical device tax, which extends through 2017. In 2015, the CBO estimated that the repeal of these taxes would result in the loss of over a trillion dollars in revenue over ten years. The repeal of the Medicare taxes would provide $2.6 billion in tax cuts per year for the 400 highest income taxpayers, $7 million each.

Limit On The Employer-Sponsored Insurance Tax Exclusion

The bill would add to the taxable income of employees, beginning after 2019, the cost of employer group coverage that exceeds the “annual limitation.” For 2019, that amount would equal the 90^th percentile cost for premiums for self-only employer coverage; the amount would be adjusted for inflation thereafter based on consumer price index (CPI) increases plus 2 percentage points. (This means that the employer-sponsored coverage subject to tax could ratchet up quite quickly if health care cost inflation exceeds this amount) Employer contributions to HSAs, MSAs, long-term care, and oral or vision coverage would not be subject to the tax; neither would coverage for law-enforcement personnel, firefighters, or emergency responders. The deduction for coverage for self-employed persons would be subject to similar limits.

Liberalization Of Tax Benefits From HSA Contributions

The amount that taxpayers could shelter from taxes in annual HSA contributions would be increased to the amount of the HSA out-of-pocket limit, more than doubling the current limit. HSA requirements would also be loosened to allow both spouses to make catch-up contributions to the same health savings account and for HSA coverage for medical expenses incurred before the establishment of an HSA.

Other Provisions

The bill would end the Prevention and Public Health Fund as of 2018 and rescind all unobligated funds after that date. It would provide $285 million for FY 2018 for community health centers, far less than the ACA provided initially. The bill would also repeal the small business tax credit after 2019.

Further limits would be placed on funding of non-Hyde amendment abortions in certain benefits and programs.

Future Hurdles And The Funding Question

As stated at the outset, these provisions may very well change before we see a final bill; indeed, they may have changed already. It is also hard to see how some of these provisions, such as the changes in essential health benefits or age rating, would survive budget reconciliation limitations in the Senate. It is also likely that some provisions of the bill would be rejected by House conservatives or moderate Senate Republicans, and most of the bill would certainly be rejected by Democrats.

The biggest question posed by the draft is how Congress proposes funding it. The bill would give up all of the taxes that funded the ACA, yet would provide tax credits, albeit less generous than the ACA’s, to millions of additional individuals. The only real revenue in the bill is the tax on generous employer plans. It simply does not seem to add up, but the CBO will soon tell us whether it does or not.

Conservative Estimates say 165,000 Wisconsinites will Spend More and/or lose Health Insurance!

Repealing the Affordable Care Act (ObamaCare) is going to force tens of millions of Americans off their health care plans. 

Let's take a look at Wisconsin, district by district, and see who's constituents will suffer the consequences of a purely political decision:

Between 20 and 30 million people will lose their health insurance if Obamacare is repealed by Congressional Republicans with no replacement plan. Charles Gaba, a Michigan-based health care analyst and owner of acasignups.net, wants to remind people that “each one of those numbers is a real, live human being.” That’s why he decided to break down the number of people who could potentially lose insurance after a full repeal of Obamacare by congressional district, so people could get a sense of the impact a repeal would have in their own community.

Estimates are fairly conservative—does not account for the number of people under the age of 26 who could be thrown off their parents’ plans or the repeal’s affect on Medicare. The actual number of people who would lose insurance is likely greater (a recent estimate from the Urban Institute puts it at 32 million).

Paul Ryan to the Rescue? While Paul Ryan waits for the cost estimates for his repeal and replace health care plan from the Congressional Budget Office and the Joint Committee on Taxation, news outlets obtained the actual outlined repeal/replace Republican plan. 

I think "driving off a cliff" best describes what the Republicans have in mind. There is no global example where a country thought this was a good idea, or for that matter, worth trying.

With a "free market" health care plan corporate profiteering will kick into overdrive as time goes on, forcing "consumers" with cancer, heart conditions, and victims of accidents to pay a majority of the bills headed their way. It's not like anyone can afford to stick $2,000 to $12,000 away in a savings account.

Warnings have been issued from both political camps on the dangers of destroying the taxing sources needed to fund the Republican plan. Remember, Republicans have pledged never to raise taxes, so just keeping in place Obama's ACA's taxes would help the GOP keep that pledge and fund their plan:

Republicans want to change all of that. To lower the cost of healthcare, Republicans would provide relief from all the Obamacare tax increases, including: 

• The tax on health insurance premiums • The medicine cabinet tax • The tax on prescription drugs • The tax on medical devices • The increased expense threshold for deducting medical expenses. 

My very well off younger brother mentioned that he had one major pet peeve over ObamaCare; he thought it was unfair his higher earnings prevented him from getting subsidized help. Well, that's no longer a problem:

The credit is not based on income. This will help simplify the verification process and expand access for Americans who have been left behind by Obamacare.

The CBO has already panned every one of Ryan's previous versions of this cruel profit based plan for sick people that assumes medical treatment is a consumer product that we shop for. Not one of the following items lowers the cost of health care, unless you consider not having decent coverage a good idea:

1. Americans would no longer be required to purchase health insurance.

2. The plan also calls for ending the health insurance exchanges.

3. The federal income-based subsidies given to Americans will also go away.

4. The government would offer refundable tax credits based on age.

Taxpayers, Not Insurance Companies Pay For Sick: The most insulting part of Ryan's plan is his no nonsense admission that taxpayers will be footing the bill to treat sick people, instead of insurance companies, who are left with health premium paying Americans. Here's what Ryan said when asked who would pay for taking care of the sick:

PAUL RYAN: By having taxpayers, I think, step up and focus on, through risk pools, subsidizing the care for people with catastrophic illnesses. Those losses don't have to be covered by everybody else, and we stabilize their plans.

The House GOP plan also seeks to provide "State Innovation Grants" so states can establish insurance pools for high-risk consumers with preexisting conditions. The grants could be used to establish something similar to the Health Insurance Risk Sharing Plan (HIRSP) Wisconsin had in place prior to Obamacare taking effect. The goal is to reduce out-of-pocket costs like co-payments, premiums and deductibles for people who have more health coverage needs.

Where were these headlines Before the Election???

So this is what it takes to wake people up to the health care crisis, a sole creation of the politically motivated Republican Party's 8 year push to hate all things Obama. 

The headlines below seemed to have struck a nerve:

Ryan's ACA Replacement Plan isn't about Health Care, it's about the Health of the Insurance Industry: Part 2

A few thoughts on repealing ObamaCare, otherwise known as the ACA (so many people thought they were two totally different plans).

When I saw actual side-by-side "competition" between insurers force some off the exchanges, it was my epiphanic moment. Insurers not only don't like competition, it would actually kill them.

So the ridiculous idea that insurers would lower their premiums once they had to compete across state lines didn't make sense anymore:

1. They'd take a huge hit on Wall Street.

2. We already saw what would happen if insurer premiums simply grew too slowly, like they did on the exchanges; insurers gave up and left the exchanges.

3. If prices do decline or rise too slowly, small insurers won't survive, and only the strongest and largest insurers will be left. Again, this creates large closed noncompetitive monopolistic networks, the ones Paul Ryan claimed destroyed ObamaCare and raised premiums.

4. Insurer "competition" doesn't have anything to do with the actual prices charged by doctors and hospitals. The repeal/replace plan is all about the insurance industry. What part of this reigns in the rising cost of health care?

Then I saw this analysis. It confirmed what I was already thinking:



Republicans have sucked so much of the air out of the room, just debating repeal and replace, that what I've listed above is not getting any attention. It's even more difficult to deal with 2 or 3 years from now.

ObamaCare Repeal will be a Huge Tax Cut for the Top 1%.

Not only will Trump's tax reforms benefit the top income brackets most, but repealing the Affordable Care Act will be the obscene cherry on top. That's because the top 1% help fund ObamaCare through taxes.

Is Trump looking out for the little guy? Not so much. Many Americans will lose their health care, and many will see much higher premiums and deductibles once ObamaCare's funding source is slashed:

Why do Republicans want to repeal Obamacare so much? Because it would be a big tax cut for the rich. Obamacare was one of the biggest redistributive policies of the last 50 years. The Republican Party, after all, exists for what seems like the sole purpose of reversing redistribution. So undoing Obamacare would undo a lot of taxes at the top, and a lot of subsidies at the bottom. 

You can see that in the chart below from the nonpartisan Tax Policy Center. The bottom 40 percent are a good deal worse off, the middle 55 percent are mostly unaffected, and the top 1 percent would do pretty, pretty well. In fact, they'd get an average tax cut of around $32,820.

Although, as you can see below, it's even more lopsided than it sounds. The 44.8 percent of the total benefits that the 99 to 99.9 percent would get makes them seem like plebes compared to the 72.7 percent that the top 0.1 percent would.

Still, Trump voters are convinced the poor are getting a free ride on the exchanges, despite rising premiums and deductibles. How do they pay for the increases if they're poor? Details, details. Check out the following mind bending lunacy that to at least one person, makes sense:

Tess Scotishtess: "The only people who like it are those who get subsidiaries making it free or almost free, because the rest of us are having to pay for them. Well enough, I dont want to pay for people who are too lazy to get up and get a job, and for welfare, you know what we should be drug testing 100% of all welfare recipients, just like when you go and get a job. It is time for all Americans to be heard, not just those who are poor, and willingly poor and maintained by the government." 

Health Care CEO's worried Republicans will throw insurance markets into Chaos over Lawsuit and Repeal.

Like I've said over and over, Republican politicians don't have a clue about health care, or how it works in the real world. Want proof? Apparently, Republicans never thought there was a health care problem in the first place: 

“People have crappy insurance,” Rep. John Shimkus (R-Ill.) told Politico last week. “This fear that they’re going to lose something that they don’t think they have anyway is crazy.”

George W. Bush once said we already had a national health care system, emergency rooms.

But health care is about to get a whole lot worse if Trump and Paul Ryan have their way, and there's nothing to stop them...unless....

...let's see if corporate CEO's opposition to repealing ObamaCare carries as much weight as their support for Walker's changes to Wisconsin's business climate, which we're never allowed to forget:

Modern HealthCare: Healthcare CEOs are willing to consider Trump's healthcare reform ideas. But they have strong concerns about whether his plan would match the ACA's performance in expanding coverage and slashing the uninsured rate to less than 9%, according to Modern Healthcare's post-election Power Panel survey.

Beyond the ACA, the CEOs surveyed stressed the need for action to curb the growth of prescription drug prices, with 60% saying that should be a top priority for the new administration and Congress.

86% of the CEOs responding to the survey either strongly or somewhat agreed that repeal should not proceed without a replacement plan that provides affordable health insurance for all Americans who lack employer-based coverage.

GOP ObamaCare Lawsuit could Crash Insurance Market: Republicans are now worried their lawsuit to repeal the insurance company safety net payments in ObamaCare may just crash the industry:

House Republicans have asked a federal appellate court to delay (an) appeal in a case that could end some payments to health plans and throw the individual insurance market into chaos.

If those cost-sharing reduction payments were eliminated, as House Republicans have sought, insurers either would have to sharply raise premiums or exit the ACA exchange markets. 

But some Republicans and health policy experts fear that any hasty, drastic moves would crash the individual insurance markets. They warn that ending the cost-sharing reductions without any replacement system might panic insurers by causing them to lose lots of money.

CEO's warn:

CEOs participating in the new survey worried that Republicans will put even more reliance on high-deductible health plans, which they believe are discouraging patients from seeking needed care. They also were wary of GOP proposals to restructure Medicare and Medicaid.

Like Food Stamps, Republicans want you to Work for Health Care! Oh, and getting dropped for Preexisting Conditions returns.

I hope Republicans get their ObamaCare replacement plan together just in time for the elections.

The conservative Republican Study Committee (RSC) on Friday submitted its recommendations to shape a plan ...  The recommendations come from the RSC’s already-existing legislation, the American Health Care Reform Act, which would completely repeal ObamaCare and replace it with a new system. 

I promise, it will be ugly, and Americans aren't going to like it. Who's brilliant idea was it to bring back preexisting conditions? Republicans of course, as away to protect insurance company profits, by dumping sick people into the state high risk pools with even higher premiums. The Hill:

The law would undo ObamaCare’s provision that bars insurance companies from refusing to cover people with pre-existing conditions and instead set up a system of high-risk pools for them.

You'll also like their insulting suggestion only lazy people take advantage of health care subsidies. Republicans think you should work health care, pay out of pocket for all your premiums, and then wait a year to write them off as a tax deduction when you file. Not many can afford that. And tax deductions don't count as much as tax credits. Currently, the ACA deducts that subsidy off your monthly premium immediately, so you don't have to shell out money you don't have.

The proposal would replace ObamaCare’s refundable tax credits with a tax deduction, which tends to provide less help to low-income people by reducing the taxes people owe rather than allowing for the possibility of getting money back in a refund.

If you were ever faced with a hypothetical choice between a $100 tax deduction and a $100 tax credit, you would want the credit. Unlike a tax deduction, a $100 tax credit reduces your tax dollar-for-dollar($100). On the other hand, a tax deduction reduces your taxable income by $100. If you are in the 25% tax bracket, a $100 tax deduction reduces your taxes by $25.

Conservatives Lost Principles: Drug testing food stamp recipients and requiring them to work has been a Republican goal for years, now being realized in many red states, so why not health care? Their idea to block grant money to the states for Medicaid would result in the same draconian regulations and right wing social engineering we're seeing on choice and voting. We're talking about basic life saving health care. Think about it, what does working have to do with broken legs, contagious diseases, heart attacks and cancer?

The RSC argues this change would “encourage work while ensuring the federal government does not create another new entitlement program.”

Those in Poverty Dumped Again, Guess they can't Keep Their Doctors!!! Medicaid expansion would die, and so would people: 

By repealing ObamaCare, the measure would also undo the law’s expansion of Medicaid, which has provided much of the coverage gains that have led to an estimated 20 million people gaining insurance from ObamaCare. The RSC says Medicaid spending is climbing at an unsustainable rate and is too often providing care for able-bodied adults.

Yes, there's that term again, "able-bodied adults," like that somehow makes health care affordable?

House Energy and Commerce Committee Chairman Fred Upton, part of the task force put together by Speaker Paul Ryan (R-Wis.), said recently the group needs “another month or so” to come up with a plan.

Almost all of these free market proposals has already been a part of our health care system before the ACA, and it was a disaster. Republicans want to go back to that:
 

Walker ObamaCare tantrum: Will do nothing for 185,000 on Exchanges threatened by Supreme Court Decision to kill Tax Credits.

If Democrats were strong, they would never let Scott Walker off the hook for running away from the possible collapse of the government run ACA exchange in our state.

It seems unimaginable Walker could just stand by and watch 185,000 Wisconsinites lose their health insurance without lifting a finger.

It seems unimaginable that Walker would simply blame someone else for the problem, and do nothing.

It seems unimaginable that voters would not push back against this belligerent irresponsible behavior from someone supposedly elected to manage these kinds of problems. He says it's too much "pressure." 

Grownups don't behave like this. They don't let people get hurt.

And yet, Scott Walker expects us to accept this bullshit:

"We're going to push back. This president of the United States—they've got to come up with a solution....They're going to try to put the pressure on us but we need to put the pressure right back on them."

Republican repeal of Affordable Care Act would only increase premiums and the uninsured, while providing no coverage for the sick.

I was fascinated by the headline sent to me by my conservative friend in Milwaukee:

"This Newest Obamacare Blanket Exemption May Have You Considering a Move to Guam or Puerto Rico"

My friend would love to see the Affordable Care Act crash and burn, despite his recent difficulties he had getting health care. He’s now on Medicaid’s BadgerCare Plus due to his income level. Go figure.

The Department of Health and Human Services website announced that a vast number of Obamacare regulations will no longer apply to all U.S. territories. Two of the main components of the plan, the individual mandate and the premium subsidies, have never applied to the territories, however.

Every item U.S. territories are now exempt from, and wildly supported by my friend, are the very protections any normal human being would want to have.

This highlights the irrational outright hatred of the president’s program, him personally, the ideological mindlessness of smaller government, no desire to slow rising costs, and a willingness to waste lots of hard earned income on junk insurance policies that don’t cover even essential benefits.

They will be exempted from guaranteed coverage, community rating, single risk pools, rate review, the medical loss ratio, and “essential” benefits.

The article ends with a comment that proves how voting against your self-interest is considered a win, and any consequences suffered by the sick are their own damn fault.

How about allowing additional flexibility to actual U.S. citizens in recognition of our unique situations, hmm?

Of course, the suggested flexibility only increases premiums for those who do buy insurance, and segregates the sick into publically paid for risk pools. The insurers? They get to make a profit, without any risk. Nice.

Dissecting the Market Based Republican Health Care Plan. Big Government, Costly, Citizen Uncertainty, Fewer Covered, and Junk Policies.

Finally, a rabid conservative columnist who isn't afraid to gather up every bad Republican health care idea and present it as real reform. From Jennifer Rubin’s Washington Post column "Right Turn," the single most outrageous collection of “market based” health care ideas ever. Thank you, thank you, thank you….

You'll notice the biggest problem with a Republican market based health care plan is that it's even more convoluted and bureaucratic than ObamaCare. And it will cost big money:

She hasn't aged a day...

Conservative … market-based solutions aren't “free … It is likely that federal expenses would rise by approximately $30 to $40 billion per year, well below the $200 billion (and rising) annual expense of Obamacare when fully implemented.” This will not satisfy those who think there is no role for the federal government in health care

You got that right. Let’s take a point by point look the plans “Seven Pillars:”

Build a “defined contribution” approach to the public financing of health care. 

Translated, that means government dependence for everyone waiting for their next months insurance subsidy. Hypocrites?

Encourage personal responsibility and mandate continuous coverage protection.

No translation needed. It’s a big government “mandate”  again, Republican style.

Establish a genuine partnership with the states.

Translated, states become dependent on federal grant money and do whatever they want with it. Nothing more accountable than that?

Address the tax treatment of employer-sponsored plans.

Translated, good-bye to employer coverage and the business insurance deduction, which in turn abandons the Republican promise that we can all keep our current doctor. Ouch!

Overhaul Medicaid.

Translated, states will get small block grants, no federal minimum requirements, no strings attached, giving states the freedom to throw everybody off Medicaid. See, we're saving money.  

Initiate premium-support reform of Medicare.

Translated, fixed income seniors will have to pay more into health care….it’s a cost shift from our government to individuals who can’t afford it.

And finally, offset all new costs through spending cuts.

Translated, if you want health care at all, give up retirement security and every penny you've earned in your lifetime, enjoy a lower quality of life (we promised too much), cut spending on education, research, environment safeguards, oversight of our food supply, and guarantee tax freedom for corporations.

If successful, this new program could permanently change the national political conversation over health care policy.

Translated, true, we’ll live out our lives searching for gasoline in a world similar to the Mad Max world in “Road Warrior.”

The good news is that ObamaCare’s colossal failures (we haven’t even gotten to the implementation problems) have opened the door to conservative reform.  Do they want Obamacare or something that gives them a lot more value for taxpayers’ dollars?

Failures? You mean where businesses couldn't get their act together in time? Let's open the door. Nothing more comforting than health care on the cheap or junk insurance policies. Take that ObamaCare.

Republicans are doing everything they can to prevent Americans from having what they have. Health care.

It was no big deal when Republicans opposed health care for all, we kind of knew they would.

But the dynamic has changed…dramatically. And now everyone in the U.S. should be, I hope, fed up to here with their tantrums. The difference is a national health care plan. 

Simply put; Republicans are now doing everything they can politically, to kick families of Medicaid and keep Americans from getting subsidized health care for themselves and their families.

It’s under this new reality that we should all be “mad as hell.” Where are the conservatives who hate it when somebody else gets something they don't have? 

Republicans want to take our health care away in every way possible, day after day, vote after vote...while we pay for theirs? They're rubbing our faces in it. 

After all this, it's time to pull their taxpayer health care plans in the event we lose ours.

Here's Chris Hayes, who first got me thinking:



What fired me up was this article in Mother Jones:

Kevin Drum: The Republican Temper Tantrum Against Obamacare Continues.

Still, the absolute fury that it continues to generate even now, three years after passage, is remarkable. The fury is so deep that an expansion of healthcare to the poor and working classes has become a part of the culture wars every bit as bitter and divisive as guns, gays, and abortion. Jon Cohn revs himself up to write about this today:

"As you have read … the federal government is starting a public education campaign about Obamacare—not to promote the law, mind you, but simply to inform the public about the new insurance options that will be available once the law takes full effect. In 2005, the Bush Administration ran a similar campaign to let seniors know about the Medicare drug benefit. 

As word spread that the Obama Administration had approached professional sports leagues about forging a similar partnership, GOP leaders warned the leagues to stay away. “It is difficult for us to remember another occasion when [a] major sports league took public sides in such a highly polarized public debate,” (said Sen.’s) Mitch McConnell and John Cornyn."

Conservatives remain so spittle-flecked angry about it that they can't even abide the thought of a sports league helping to run a public education campaign that reduces confusion about who's entitled to what. Even now, they desperately want it to fail. And they're going to do everything they can to help it fail, even if that means screwing over their own constituents. It's a temper tantrum possibly unequalled in American political history. And it's revolting.

What Kind of Americans Cheer Repeal of Deal to Help the Functionally disabled?

The conservatives at the Drudge Report mirror their voting counterparts is their bloodthirsty desire to inflict as much pain on the needy as possible. 

Check out this Republican style "victory," and then tell me they're not sick bastards.

The Community Living Assistance Services and Supports program was a priority of the late Sen. Edward M. Kennedy, Massachusetts Democrat, and was designed to create a program for long-term care for the functionally disabled.

Mr. Obama halted the program, saying he couldn't find a way to make it cost-effective. But he had objected when Republicans tried to repeal it outright, saying he wanted to keep it on the books and try to amend it rather than kill it. But he did an about-face this week, accepting repeal in exchange for raising tax rates on the wealthiest.

GOP Style Free Market Health Care Deadly

Need another example of health care freedom and liberty?

YoungTurks: Wells Fargo allegedly fired an employee because his dying daughter needed expensive cancer treatment, according to a lawsuit filed in Palm Beach County Court on Thursday.

Wells Fargo fired mortgage consultant Yovany Gonzalez three days before his daughter Mackenzie was scheduled to get cancer surgery in August of 2010, the lawsuit states.

According to the suit, the hospital canceled the surgery because Mackenzie no longer was covered by health insurance.

Republicans Convinced Americans their Health, Wages, Benefits and Safety Nets the real Problem in U.S., not the Banks and Wall Street Excess.

I don't even know where to start describing how horrified I am at the point mad in the following story: 

NY Times: The state with the country’s worst health care record just happens to have a governor who has been the loudest voice against national efforts to improve it. A quarter of the residents of Texas, 6.3 million people, are uninsured, by far the highest percentage in the country. (That number includes more than a million children.) Texas ranks last in prenatal care and finished last on a new federal assessment of overall health quality that examined factors like disease prevention, deaths from illnesses, and cancer treatment.

That’s a nasty statistic if we’re supposed to be the greatest and wealthiest country in the world. But let's face it, there are these little things like humanity and compassion that just keep getting in the way. 

Yet Gov. Rick Perry recently told the Obama administration that he would proudly refuse a huge infusion of Medicaid money that would significantly reduce those shameful statistics and cover 1.7 million more people. The same indifference to suffering that pushed Texas to the bottom is now threatening to keep it there.

Despite the large number of people dying due to a preventable diseases, or who are left to suffer a lifetime of pain due to a chronic illness, conservatives aren't moved.  

At least five other Republican governors have made a similar choice … Their refusal illuminates a growing divide over the nature of a state government’s role. Around the country, a new study shows, states continue to face a fiscal crisis because of rising costs and Republican-driven cuts in federal aid.

That’s a “fiscal crisis” caused by, and brought on by their own irresponsible ideological actions.

Some governors and lawmakers are … using the downturn as an excuse to end a long tradition of states being the final backstop for society’s neediest. Over the last year, for example, eight states have cut or eliminated cash welfare payments to their poorest residents.

It happened last week in Pennsylvania, where 61,000 residents — almost all of whom are disabled and poor — were told that they would abruptly lose their $200 monthly general assistance payments, all to save $150 million a year. Our hands are tied by a tightening budget, welfare officials told astonished recipients, though Gov. Tom Corbett’s hands didn’t seem restrained when he handed out $300 million in business tax cuts earlier this month. In Maine, Gov. Paul LePage — who compared the health care reform law to the Holocaust — signed a budget bill in May that will reduce or eliminate existing Medicaid coverage for 21,000 people.

And from all indications, Americans appear supportive of Mitt Romney, who will institute nationally what we’re seeing in the above mentioned states. The race is even.

Is there anything the Republicans can't sell the American public? 

Employers Dumping Employee Health Insurance.

The Affordable Care Act is coming at just the right time. While Republicans claim they're tying to keep your current doctor and health plan, their policies have encouraged business to dump employees to save money. From the Economic Policy Institute: 

The expansion of insurance is particularly important now as a growing share of Americans are without health coverage. Historically, Americans under age 65 have received insurance through the workplace, but since 2000, that valuable source of coverage hasdeclined every year for 11 years running, a total decline of over 10 percentage points, as shown below.

So the mandate makes reform more efficient. This means it must be opposed by conservatives, because they have all along been determined to make any health reform as inefficient as possible. Remember the 2006 Medicare Part D legislation that cost way too much because it barred the government from bargaining with pharmaceutical companies over drug prices? And which subsidized private HMOs to cover Medicare beneficiaries? Remember the public option, which would’ve saved the public money but was taken out of the ACA in the early stages? Remember the voucherization of Medicare called for in the Ryan budget, which would insure that Americans spend far more to cover health costs in the future?

This was no grand constitutional issue, this was just conservatives doing what they reflexively do when it comes to health reform: trying to make sure it’s as inefficient as possible.