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Healthcare/ACA 2017
#36
A[quote name="RCA" url="/community/t/156221/healthcare-aca-2017#post_4211375"]
I've always said(not so much here, but in real life) that education is the key to the positive future of our country.  It would take such a small amount of money compared to what we spend on our military to make a significant change, but there is no way in hell Republicans will ever back funding of education in a serious manner, mainly for what you stated above.

The less educated people are, the easier they are to control.
[/quote][quote name="VTRan" url="/community/t/156221/healthcare-aca-2017#post_4210962"]
I read something online that said something along the lines of the GOP replacement IS Obamacare seeing as it was a conservative/GOP plan to begin with.

The problem now is that they've disowned it because of that damn black President so they can't be seen 'drinking from that same fountain'.

Bottom line is that the GOP want people poor, sick and uneducated....all the better for the oligarchy and the fundamentalist preachers to take advantage of. 

There might be problems with a number of Democratic politicians but they certainly aren't the death cult that the GOP has transformed itself into.
[/quote]

I'm in a foul mood today as Trump's swearing looms...to the point that I think we should get wiped out by aliens.
I mean, even in the best scenario of alien contact, which entails benevolent aliens, can you see them not killing us all after taking one quick look at out history as a species, were greed, fanatism and racism have lorded over common sense, empathy and love?
If some idiot savant achieved warp drive tomorrow, the Vulcans would probably pretend they didn't saw it.*

*Did I use the reference right? Not really well versed in Trek Lore
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#37

Republican governors who didn't take the Medicaid expansion: "Hey, Congress, now that Republicans are in charge, I totally want some Medicaid funding.  I mean, yeah, I totally hurt the poor in my state the last few years, but who wants to give Democrats credit for anything?"



https://apnews.com/553476353876416f89e3701fac5ed267



Quote:

DES MOINES, Iowa (AP) — Republican governors who turned down billions in federal dollars from an expansion of Medicaid under President Barack Obama's health care law now have their hands out in hopes the GOP-controlled Congress comes up with a new formula to provide insurance for low-income Americans.
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#38

Republicans are hoping to avoid in-person town hall meetings, so they don't get recorded:



https://www.washingtonpost.com/powerpost...61d367ef34

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#39

May as well follow Trump's lead and stick to Twitter.

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#40
A[quote name="ryoken" url="/community/t/156221/healthcare-aca-2017#post_4211415"]I mean, even in the best scenario of alien contact, which entails benevolent aliens, can you see them not killing us all after taking one quick look at out history as a species, were greed, fanatism and racism have lorded over common sense, empathy and love?
If some idiot savant achieved warp drive tomorrow, the Vulcans would probably pretend they didn't saw it.*

*Did I use the reference right? Not really well versed in Trek Lore[/quote]

Given that the whole human history of warfare has come down to resource scarcity (either real or created artificially in the name of economics), my fantasy is that any alien species advanced enough to travel to meet us would usher in a post-scarcity economy, even if it's just an experiment to see whether our species is capable of having a real civilization before fumigating the globe.

And yes, it was the Vulcans.
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#41

South Dakota, not exactly Clinton country, is worried about the future of health care:



http://www.argusleader.com/story/news/po.../96783820/



Quote:

For at least 27,000 South Dakotans, the result of that conversation could mean the difference between having a health insurance policy or going without.



That's how many people in the state have purchased individual policies through the federal exchange. And nearly 89 percent of subsidy-qualified applicants, 22,005 in total, got tax rebates through the program.



Hundreds of thousands in the state have also benefited from the elimination of annual and lifetime limits, free preventative care and guaranteed coverage for those with pre-existing conditions.



Trump and Republicans in Congress including South Dakota's congressional delegation have said they plan to keep those popular pieces of the ACA, but what remains unclear is how they could continue funding those facets without the offset of a tax penalty for those who opt to go without health insurance.



And few answers have emerged about how proponents of the repeal could break down the health insurance law without sparking panic among providers, causing more to pull out of state exchanges and pushing premium rates through the ceiling.



“The obvious concern is the health care of the people of South Dakota. We’ve picked up 27,000 people under the ACA in South Dakota, people in South Dakota that didn’t have insurance before,” State Rep. Spence Hawley, D-Brookings, said Friday. "That’s a huge number for our small population."



An individual story:



Quote:

Gina Hale, 53, has been anxiously following congressional proposals to repeal, replace or reform the health care law.



Hale's daughter Emma Van Liere,16, was diagnosed with Rett Syndrome, a rare genetic condition that affects brain development, at 18 months. Hale and her husband Wayne Van Liere were able to cover Emma's health care through health insurance policies they got through their employers.



But when Van Liere's job was cut after the economic recession and Hale's work was trimmed to part-time, the bills, especially medical bills got harder to pay. And then Hale was diagnosed with Parkinson's Disease, a severe nervous system disorder, and had to quit her job.



Hale and Van Liere bought an insurance policy through a federal program that let them continue group health benefits after they lost their jobs.



The $2,500 monthly bills quickly ate through their savings and retirement funds, Hale said. And they didn't cover her emergency services or those Emma needed when she'd start to seize and shake as a result of her condition.



“It brought us to our knees financially," Hale said.



That became a little more manageable as the Affordable Care Act took effect. The monthly payments dropped to $700 when Van Liere bought an individual plan through the federal exchange.



“It basically meant we weren’t homeless, we could keep or mortgage," Hale said.



But it wasn't a perfect answer for the pair, who were still working part-time or on contracts when they could. Hale said she burned through both retirement funds and their kids' college funds paying for the insurance policy and additional medical bills. There were some weeks she was barely able to put food on the table.



In 2016, Van Liere found a new job out-of-state, but Hale still worries that the family's bad luck could return.



“We could be back in that situation again," Hale said. "It's scary, but we just don't know."



And that's why Hale wants Congress to consider maintaining the Affordable Care Act or at least leaving untouched the pieces that have benefited her family and many others.



That fits right in with the majority of Americans who would like to see the law improved, not repealed.

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#42

43,956 people could die annually from an ACA repeal:



https://www.washingtonpost.com/postevery...f88b0a42c9



Quote:

The story is in the data: The biggest and most definitive study of what happens to death rates when Medicaid coverage is expanded, published in the New England Journal of Medicine, found that for every 455 people who gained coverage across several states, one life was saved per year. Applying that figure to even a conservative estimate of 20 million losing coverage in the event of an ACA repeal yields an estimate of 43,956 deaths annually.

With Republicans’ efforts to destroy the ACA now underway, several commentators have expressed something akin to cautious optimism about the effect of a potential repeal. The Washington Post’s Glenn Kessler awarded Sen. Bernie Sanders (I-Vt.) four Pinocchios for claiming that 36,000 people a year will die if the ACA is repealed; Brookings Institution fellow Henry Aaron, meanwhile, predicted that Republicans probably will salvage much of the ACA’s gains, and conservative writer Grover Norquist argued that the tax cuts associated with repeal would be a massive boon for the middle class.



But such optimism is overblown.



The first problem is that Republicans don’t have a clear replacement plan. Kessler, for instance, chides Sanders for assuming that repeal would leave many millions uninsured, because Kessler presumes that the Republicans would replace the ACA with reforms that preserve coverage. But while repeal seems highly likely (indeed, it’s already underway using a legislative vehicle that requires only 50 Senate votes), replacement (which would require 60 votes) is much less certain.



Moreover, even if a Republican replacement plan comes together, it’s likely to take a big backward step from the gains made by the ACA, covering fewer people with much skimpier plans.



And:



Quote:

The frightening fact is that Sanders’s estimate that about 36,000 people will die if the ACA is repealed is consistent with well-respected studies. The Urban Institute’s estimate, for instance, predicts that 29.8 million (not just 20 million) will lose coverage if Republicans repeal the law using the budget reconciliation process. And that’s exactly what they’ve already begun to do, with no replacement plan in sight.



No one knows with any certainty what the Republicans will do, or how many will die as a result. But Sanders’s suggestion that 36,000 would die is certainly well within the ballpark of scientific consensus on the likely impact of repeal of the ACA, and the notion of certain replacement — and the hope that a GOP replacement would be a serviceable remedy — are each far from certain, and looking worse every day.

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#43

Quote:


 

Originally Posted by Iron Maiden View Post
 

43,956 people could die annually from an ACA repeal:



I can already see the counter arguments now.



"A hundred million people in Africa will die of starvation if we don't feed them all, should we pass that into law as well!"



"This is what happens when you create an enormous entitlement program!  People become dependent on health care and living, and it becomes extremely difficult to simply stop providing those things!"

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#44

A U.S. judge finds that Aetna mislead the public on its reasoning for leaving the ACA:



http://www.latimes.com/business/hiltzik/...story.html



The company wasn't allowed to merge with Humana, so the move was political retribution.



Even top executives were perplexed as to why the company was leaving Florida.

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#45

The issue with block grants:



http://wfpl.org/medicaid-block-grants-co...t-pleases/



Quote:

Under a block grant program, states could do almost anything with Medicaid. Kentucky could put in place those copays, for instance, as well as monthly payments, deductibles and a volunteer/GED education eligibility requirement.



And under a common scenario, those block grants would be based on the previous year’s spending. That doesn’t allow for much wiggle room.



Health care experts say this is a bad idea.



“They don’t account for unanticipated increases that can occur if there’s a recession, if there’s an epidemic like Zika, if there’s a new blockbuster drug,” said Judith Solomon, vice president of health policy at the Center on Budget and Policy Priorities.



A major employer shuts down and more people need to get on Medicaid? The state wouldn’t get any more money to make up for those new enrollees. The money pot stays the same. Which, according to Solomon, could lead to either cuts in services or cuts to other sectors, like teacher pay.



There is an alternative scenario in which block grants would be provided to states based on their beneficiaries, to help account for economic fluctuations or other factors that could increase the number of enrollees.

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#46

Leaked audio shows the GOP has no unified plan to deal with the ACA repeal:



http://www.vox.com/policy-and-politics/2...-tape-leak



Quote:

Republican House members representing blue states appear to be particularly worried. Rep. Tom MacArthur of New Jersey worried about pulling “the rug out from under” people covered by Obamacare, Rep. Tom McClintock of California warned that the GOP would own “the market we’ve created ... lock, stock and barrel,” and Rep. John Faso of New York said defunding Planned Parenthood in a repeal bill would mean “walking into a gigantic political trap” that could end up with “millions of people on social media” protesting repeal.
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#47

Around 50 health care workers are protesting at Orrin Hatch's office:



https://twitter.com/mmontano81/status/82...7122705409

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#48

Is there anyone in all of CHUD who believes that a single payer system (supplemented by various private insurance providers) isn't a logical inevitability and the best solution?  Is there anyone in this thread that believes core/basic healthcare should be a for-profit industry?



While the endless threads full of histrionic scree is amusing, I would actually like to hear some rational positions from someone ... anyone ... who believes that a predominantly private healthcare system is the way to go.

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#49

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#50
AYes, I certainly agree, and yes, that would be extremely difficult to get through, what with decades of opposition smear campaigning.

Which worked like gangbusters.
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#51
Quote:
Originally Posted by neil spurn View Post

Yes, I certainly agree, and yes, that would be extremely difficult to get through, what with decades of opposition smear campaigning.

Which worked like gangbusters.


So why isn't the narrative that the ACA is basically lipstick on a toxic fucking pig?  Because that's what it is.  It makes a terrible system slightly more palatable.  Why do I never, ever hear anyone say this?



I really have a hard time mustering any enthusiasm for the ACA.  I'm basically like "eh, better than the alternative."

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#52
Quote:
Originally Posted by Overlord View Post
 


So why isn't the narrative that the ACA is basically lipstick on a toxic fucking pig?  Because that's what it is.  It makes a terrible system slightly more palatable.  Why do I never, ever hear anyone say this?



I really have a hard time mustering any enthusiasm for the ACA.  I'm basically like "eh, better than the alternative."



For millions of people the alternative is NO healthcare so yeah, maybe it is better than the alternative.



IMO, it was a first step and it may have led to single payer but the odds of seeing this happen has dropped to slim and none with the GOP fascists in charge.

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#53
AObama's thinking was, "I'll never get Republicans on board with single-payer. So, I'll use a Republican health care plan and get Republican support because Republicans..."

WHOOPS!
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#54
Quote:

Originally Posted by VTRan View Post
 


For millions of people the alternative is NO healthcare so yeah, maybe it is better than the alternative.



IMO, it was a first step and it may have led to single payer but the odds of seeing this happen has dropped to slim and none with the GOP fascists in charge.



Well, it starts with actually talking about the real problem.  Which, for some reason, I almost never see anyone do.



I think a big issue is that the people who stand to gain the least from singlepayer (large corporations, people employed by large corporations, etc.) are also the ones who tend to dominate media and sociopolitical narrative.

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#55
Quote:

Originally Posted by Overlord View Post
 

Well, it starts with actually talking about the real problem.  Which, for some reason, I almost never see anyone do.



I think a big issue is that the people who stand to gain the least from singlepayer (large corporations, people employed by large corporations, etc.) are also the ones who tend to dominate media and sociopolitical narrative.



The one real problem with the health insurance industry is just that....it's an 'industry'. An industry whose one main goal is to make as much $$$ as possible.



If denying care to someone will help raise the profits, so be it....."that person shouldn't have gotten sick in the first place"



So, talking about the 'real problems' with healthcare is all well and good if everyone can agree what the problem is. For the healthcare industry this unrelenting pursuit of profit isn't a 'bug' in the system to be 'fixed', it's  a 'feature' that needs to be exploited.  To them, nothing needs to be 'fixed'.



The healthcare industry, left to their own devices...just like much of Wall Street...will continue to fuck over the American public any chance they get.



Do I like that the gov. got into bed with the healthcare insurance industry to pass the ACA....no, but maybe now that we have millions of people's feet wedged into that door that wouldn't have otherwise....maybe this will wake people up and get some real and substantive single payer options in this country.



But all the above is moot now that we have neo-fascists running the country.


 

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#56
A[quote name="Bradito" url="/community/t/156221/healthcare-aca-2017/30#post_4224569"]Obama's thinking was, "I'll never get Republicans on board with single-payer. So, I'll use a Republican health care plan and get Republican support because Republicans..."

WHOOPS![/quote]

Fucking bingo right there
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#57

I've been meaning to share this.  Washington had almost this exact experience in the early 90s.  Democrats passed a health law, the people got scared and voted in Republicans, the new politicians decided to keep the things people liked about the law, a death spiral happened without the things people didn't like:



http://www.seattletimes.com/seattle-news...re-repeal/



Quote:

As congressional Republicans look to repeal the Affordable Care Act (aka Obamacare), Washington’s experience with health-care reform in the 1990s offers an illustrative example of the possible consequences of repealing only the unpopular parts of a law designed with many interlocking pieces.



What began as the most ambitious health-care overhaul in the nation was hacked away to the point where it became impossible to buy individual health insurance anywhere in the state.



Here’s what happened:



The Legislature passed a comprehensive health-care law in 1993, after several years of study and debate.



More than 15 years in advance, it looked a lot like the ACA.



It required most employers to provide health insurance to employees. It required individuals to get health insurance or pay a penalty. It required insurance companies to sell policies to anybody — whether they had pre-existing medical conditions or not. It required those policies to cover a set of basic benefits — things like prescription drugs and maternity care. It expanded Medicaid to give insurance to those who couldn’t afford it.



Like the passage of the ACA, the 1993 law led to huge Republican victories in the next election.



In 1994, Washington Republicans won their biggest victory in nearly 50 years, winning back the state House and coming within one seat in the state Senate.



They campaigned on ditching the unpopular parts of the health-care law, most specifically the mandates.



And they followed through.



And:



Quote:

The 1993 law, unlike Obamacare, never went into full effect.



The 1995 Legislature repealed most of it, including the individual mandate to carry health insurance. But they kept the ban on denying insurance for pre-existing conditions, known in insurance-speak as “guaranteed issue” — you’re guaranteed to be offered insurance, regardless of your health.



“Republicans came in, and they decided to gut the bill, not dissimilar to right now,” said Dr. Bob Crittenden, an aide to Gov. Jay Inslee, who, working for then-Gov. Booth Gardner, wrote the original version of the health-care bill. “They took out the mandate and left the guaranteed issue. The market went into a tailspin one-and-a-half years later.”



The defanged health-care law cratered the market for individual insurance policies (as opposed to employer-provided insurance or government-provided insurance, like Medicare and Medicaid, which was largely unaffected).



By 1998, three years after the changes to the law went through, 17 of the 19 insurers selling individual policies in Washington had left the state, according to a study by an insurance-industry group.



By 1999, it was impossible to buy an individual policy in Washington. Every insurer had pulled out.



Premera Blue Cross said it lost more than $120 million in Washington before it stopped selling individual policies.



With no requirement to buy insurance — and the guarantee that people could buy insurance if they got sick — healthy people could hold off, only signing up if they needed medical care.



A sicker population of people buying insurance pushed premiums up. Which, in turn, led more healthy people to hold off. Which pushed premiums up.



“They call it a death spiral,” Crittenden said.

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#58

A death spiral is what we're in the early sign of now.  If you get out and talk to small business owners and independent contractors, they'll tell you.  It is becoming harder and harder to financially justify not just paying the penalty and figuring you can buy insurance during open enrollment if you you get ill.  What's my premium going to be next year?  Can my coverage possibly get worse?



The penalties in the ACA are WAAAY too miniscule and toothless to mean anything to the sorts of people that insurance companies need (young, healthy, and typically either not making much or in a cash business).

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#59
AStronger penalties and subsidies for higher income brackets would have gone a long way. Had Clinton won, good midterm gains for the Democrats could have made those reforms possible.

The ACA was compromised from the begining. I think it's done a lot of good - covering more people and costing less than initial CBO projections - but Republicans couldn't get on board with a fairly moderate proposal because the sitting president was a Democrat.
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#60

Rep. Peter Roskam nixed an Obamacare town hall because a reporter was present:



http://talkingpointsmemo.com/livewire/pe...ign=buffer

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#61

500,000 less people signed up this year because of the Trump downplay:



https://twitter.com/ASlavitt/status/827628099617579008

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#62

happening now...



CNN to Host Debate Night with Bernie Sanders and Ted Cruz



https://www.youtube.com/watch?v=SNovtcAyv6g

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#63
Quote:

Originally Posted by VTRan View Post
 

happening now...



CNN to Host Debate Night with Bernie Sanders and Ted Cruz



https://www.youtube.com/watch?v=SNovtcAyv6g



Bernie, I'm going to need you to start an honest discussion of the fact that a private insurance system is fundamentally a broken concept, the ACA included.  You're my only hope.

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#64

A hell of a question about the possibility of bringing back high-risk pools from a concerned constituent at a Tennessee town hall:



https://twitter.com/mj_lee/status/829884141046996998

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#65

It's a cliche term but..."voting against their best interests..." comes to mind.



-FreshAir/NPR



Republicans Want To Get Rid Of Obamacare. But Then What?



For some perspective on what's happening in Washington and how it might affect our health care, we turn to Sarah Kliff, a senior policy correspondent at vox.com. Before joining Vox, Kliff covered health policy for The Washington Post and for POLITICO and Newsweek. She co-hosts a policy-oriented podcast for Vox called "The Weeds." Kliff and co-host Ezra Klein recently interviewed President Obama about the debate over health care and the possible repeal of the Affordable Care Act. I spoke with Sarah Kliff Tuesday.



Quote:


DAVIES: You spoke to a woman who owns a furniture store who has an interesting story because she's somebody with a pre-existing health condition. Tell us about her.



KLIFF: Yeah. So this was a woman named Debbie, who - her husband actually got sick a few years with non-alcoholic cirrhosis of the liver. And they are a couple who generally have been pretty happy with Obamacare. They used to buy their own insurance before the health care law passed. And it got too expensive, so they went a few years without coverage. And when I talked to Debbie in Kentucky, she talked about how they were really grateful for the coverage because her husband got unexpectedly sick. He now needs a liver transplant, and that they can rely on this health insurance to cover it. And they were generally OK with the size of their premiums.



So we spent a while talking about that, and then I asked her who she voted for. And she told me she voted for Trump. And again, I was just kind of floored that someone who not only, you know, understood this was Obamacare - was happy with their coverage, voted for Trump. And again, she kind of heard this - she gave this explanation that I'd heard before that she, you know, has seen some jobs disappear in the area. This is an area that used to rely a lot on coal mining. And they see revenue in their furniture store go down when there's fewer coal miners buying things there. And she felt like Trump was the candidate who's going to bring back the coal industry, who was going to bring back jobs. And she watched the debates. She heard the talk about Obamacare, but she just didn't think that someone would take away her health insurance because why would someone possibly do that?



And that was, you know, one of the harder interviews I did during that story because I started talking about, well, they plan to repeal it, and we don't really know what they're going to replace it with. And it seemed to kind of dawn on her in the interview that their health insurance was at risk. And she was someone who seemed more nervous after we talked about what their future might look like.

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#66

Representative Jim Jordan, a Republican from Ohio, would like Ohioans to know that getting rid of Medicaid won't be so bad because de-funding Planned Parenthood will free up money to help cover rural hospitals:



https://twitter.com/daveweigel/status/83...6950278146



Later on, he admitted that other things would need to be cut too:



https://twitter.com/daveweigel/status/83...8747539460



So, um, just spitballing here without the actual numbers at my disposal, but Planned Parenthood funding is somewhere around $500 million per year (maybe even less).  Medicaid spending is, well, considerably more, like around $500 billion more.  So, yeah, Jordan's going to have to plan to cut other things.  Math is hard.



EDIT: For clarification, I just saw that the Medicaid expansion, itself, from the ACA costs around $70 billion.

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#67

What repealing the ACA would to various income brackets, according to the Tax Policy Center:



https://twitter.com/ASlavitt/status/815992966816952320



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#68
A[quote name="Iron Maiden" url="/community/t/156221/healthcare-aca-2017/60#post_4236349"]What repealing the ACA would to various income brackets, according to the Tax Policy Center:

https://twitter.com/ASlavitt/status/815992966816952320



[/quote]

Seems like the chart is narrowly focuses on taxes and does not take into account 1.)premiums almost certainly dropping when companies can exclude pre-existing conditions and 2.)folks deciding to go without insurance and pocketing the extra 3 to 7k a year per person.
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#69
Quote:

Originally Posted by VTRan View Post

The GOP response to the above story would be something along the lines of "...well, you could just go to the emergency room" or some other piece of linguistic bullshit.

I'm thinking that a good slogan for the Dems to use regarding this whole ACA repeal bullshit -

HEY AMERICAN PUBLIC...THE GOP HATES YOU AND THEY WANT YOU TO DIE BECAUSE THEY ARE GREEDY COMPASSIONLESS FUCKS.
IT REALLY IS THAT SIMPLE

​Having been an ER doc, I think anyone who says you can just go to the ER should be punched in the face as hard as possible and then made to queue up in an ER waiting room to see how well that works out for them.

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#70
Quote:

Originally Posted by Overlord View Post


Seems like the chart is narrowly focuses on taxes and does not take into account 1.)premiums almost certainly dropping when companies can exclude pre-existing conditions and 2.)folks deciding to go without insurance and pocketing the extra 3 to 7k a year per person.

This seems extraordinarily naive. People are already paying for the premiums where they're at. What motivation is there for the insurance companies to drop them? Especially when, as you say in point 2, they're actually going to lose a ton of customers when the 25-30 age group cancels their plans because they don't think they need them.



Two of the bigger provisions of the ACA were designed (albeit poorly) to limit how much premiums can increase. Because premiums never go down.

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