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A full repeal of Obamacare must get through the Senate,


Posted: Mar 9, 2017

Peter Nelson, my colleague at Center of the American Experiment, is one of the country’s leading experts on health care policy. On the Center’s web site, he urges conservatives to take a deep breath and understand the constraints that Congressional Republicans are working under. In particular, a full repeal of Obamacare must get through the Senate, which means it must get 60 votes. There are only 52 Republican senators. Therefore, the first bill that has been unveiled is intended to be passed under the reconciliation process, which requires only a bare majority. Only Obamacare provisions that have a budgetary impact can be repealed in the reconciliation bill. Other measures will have to follow afterward. Peter writes: Critics do have reason to complain and demand change, but the current response recklessly sets up the expectation of a full repeal among those in the conservative base, an expectation that Congress cannot meet. Upon failing to meet this expectation, the base may become needlessly demoralized and distrustful. Republicans can repeal a substantial portion of Obamacare with a simple majority through the budget reconciliation process, but this process only allows Republicans to repeal those portions with a budgetary impact. Repealing just items with a budgetary impact leaves in place the insurance regulations that are presently driving up health care costs and spinning many state insurance markets into death spirals. Specifically, the reconciliation process can’t repeal Obamacare’s essential health benefit requirements that force people to buy very generous and, therefore, very expensive health plans. Most troublesome, reconciliation cannot repeal insurance regulations that force insurers to sell coverage to everybody, regardless of whether they responsibly maintained coverage. This allows people to wait until they are sick before gaining coverage. A key problem is that repealing the individual mandate without repealing the requirement on insurers to guarantee coverage increases the incentive to wait to buy coverage until you need it. That’s why the House plan imposes a 30 percent penalty on people who buy coverage who failed to maintain continuous coverage. This penalty has been panned by critics, but anyone who studies health insurance markets will tell you something like this is necessary, so long as Obamacare regulations remain in place. The good news is that the reform process is beginning, not ending. GOP leaders say there are two more bills yet to come, and we have a Republican president whose administration can reverse those portions of the Obamacare disaster that came into being through regulations. Which is many of them. Another point too often lost in the debate is the role the Trump administration will play in complementing Congress’s work. Though certain regulations cannot be immediately repealed, the Trump administration can modify regulations through the rule-making process. For instance, the Department of Health and Human Services (DHHS) can authorize a much more affordable set of essential health benefits. DHHS has already proposed important changes to stabilize individual insurance markets. Peter thinks that the Medicaid provisions in the current bill represent a very important set of reforms, and will address that aspect of the legislation soon. In the meantime, conservatives shouldn’t be depressed over what we have seen so far: Much of the rest of the bill is open for reasonable debate among conservatives—such as those refundable tax credits to buy health insurance—and critics are certainly entitled to their strong opinions and encouraged to share them. But it’s dangerous if, to foment a public outcry to force changes to the bill, critics instill within the conservative base a sense that full repeal is possible if not for those weak-kneed Republicans elected to Congress. If conservative leaders set unattainable expectations, they will create a perception of failure in Congress that will deflate the conservative base. ;

"In particular, a full repeal of Obamacare must get through the - Senate, which means it must

[ In Reply To ..]
get 60 votes.” Which ain’t gonna happen.

So the thing has to be dismantled piecemeal. Which is what they’re doing.

Everyone relax.

The Democrats did not have 60 vote to pass it. - Use the same kind of underhanded

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skullduggery to repeal it.

Rand Paul's bill introduces an alternative. - The bill includes a staggered repeal

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of ObamaCare taxes, including a repeal of the Medical Device Tax in 2018 and the Cadillac Tax in 2020.

The legislation would also eliminate eligibility for ObamaCare's Medicaid expansion as of 2020 as well as the higher federal matching rate included in the Affordable Care Act.

The move would likely draw opposition from a group of moderate Senate Republicans who have threatened they would vote against any bill that doesn't protect the Medicaid funding expansion in their home states.

I like this bill much better than Ryan's. I don't like the (sm) - trust us, we'll do it in so and so # of years

[ In Reply To ..]
I trust none of them.

Me either. The simple truth is that medical care cost so - must it has to be subsidizes, something is wrong.

[ In Reply To ..]
Just like education. The more something is subsidized, the higher the costs go up because they can charge whatever they want, it will be paid.

Someone further down is in favor of having single payer. We already essentially have had socialist medicine since the 1960s.

Both parties like power and control. They are not willing to give it up.
I'm the someone down below and no we don't have - socialist medicine
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nm
Medicare and Medicaid are social medicine, so - mired in debt it will take future
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generations to pay for it.
You will end up paying for it one way or another. Remember - the magazines that used to have
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different prices on them - USA $5.99, Canada $9.99 (that was for social programs).
We would end up paying higher taxes and - have our medical care free
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LOL That was due to the difference in currency exchanges.
That was just an example. The point is, you end up paying - for "free" anything through higher
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costs one way or another.
I don't believe I said free, I said single payer/ - national healthcare
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Taxes are higher but medical paid for.

That wasn't an example of anything to do with what we were talking about, that is currency exchange differences.
"Taxes are higher but medical paid for." Exactly - my point. Someone is paying for it
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somehow in the form or taxes or higher goods. "Free" or subsidized is paid for by someone.
You would be paying for it just like you are now, but... - sm
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the middle men (read CEOs) who are sucking us dry with their multimillion dollar salaries and stock benefits would be eliminated.
And the safety net is stretched so far its about to break. - nm
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x
What bothers me is when that is not enough, they keep - raising taxes and the costs of things,
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everything just keeps going up and up. It's never enough.

All you have to do is look at the Medicaid and Medicare programs. Trillions of dollars later since their inception and they still want more.
As a Medicare recipient, I can assure you that it is not...sm - VTMT
[ In Reply To ..]
free and is not a handout. I have worked all my life, paid into SS and Medicare, and now pay premiums of almost $300 a month for my coverage. I am not complaining at all. I love my Medicare, have total flexibility in which doctor I see and which hospital I go to with no referrals. My copay per year is $168. I believe in Medicare for all. Contrary to right wing belief, neither SS nor Medicare are going broke.
Already then. Sounds like everything is wonderful. - I'll just ignore the Medicare tax
[ In Reply To ..]
on my paycheck. I'm sure my grandkids will not have to pay an 80% tax rate to pay for my SS/Medicare.

Oh yeah, Obama grew the economy, too.
You paid for Medicare but technically you were paying for your - parent's Medicare. You are talking
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about gap insurance for the 20% that Medicare does not pay.

In order to keep both Medicare and Social Security afloat, we need people working. To keep people working, we need jobs. So no, it's not a right wing belief that govt programs are going broke. It's simply cause and effect.
No, I am also talking about my premium for...sm - VTMT
[ In Reply To ..]
Medicare part B, my gap policy for the 20% not covered by Medicare, and part D for drug coverage. Only Medicare part A is covered by payroll deductions during your work lifetime. I feel that I have the best medical coverage that is available anywhere in the US.
Medicare and other accounts were raided by Obama to - pay for and feed illegals.
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Department of Health and Human Services is raiding several of its accounts, including money for Medicare, the Ryan White AIDS/HIV program and those for cancer and flu research to cover a shortfall in housing illegal youths pouring over the border at a rate of 255 a day.

Washington Examiner
You will see hidden taxes like on sugar consumption. Sugar is the new - tobacco. A few years ago
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the tobacco industry was sued and they paid billions. It was supposed to be used for children's healthcare, but in order to keep the program going you have to keep people smoking. Then there's the whole secondhand smoke argument.

Is there such as thing as secondhand sugar? What if they fart and I'm downwind?

I know this sounds ridiculous, but that whole smoking thing was too. The lawyers are the ones who got most of the money.

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