(12-08-2016 12:01 PM)MplsBison Wrote: (12-05-2016 05:25 PM)Hambone10 Wrote: unwillingness to address the question.
You asked me why and I told you what I think.
Why don't you lay your hand on the table instead of just sitting back and criticizing??
I've told people what i think about healthcare for years now... in unbelievable detail.
The expansion of Medicaid is not something the Federal government CAN do. They lack the power to do it. 10th amendment. What the government does instead is they offer subsidies or threaten loss of funds if states don't go along. Also a violation of the 10th in many, but not all cases. This WOULD have been a clear violation (lots of caselaw on the matter) if they had denied medicaid or even medicare funds to states that didn't go along.
So instead they offered to fund it for a few years. That's a way around the 10th and the caselaw. The feds can clearly decide to incentivize state actions, as opposed to punishing state actions.
What happens when those subsidies expire?
Democrats likely would have extended them past the next election, so that they could try and pull the same BS they did this time... problem is, the law wasn't as popular overall as they expected it to be.... so the threat didn't work.
So Republicans need to find some way to keep the benefit but not write new law or extend old law paying for it... otherwise THEY own the 'extension'.
Democrats EASILY could have instead voted to expand Medicare to cover the poor 'above what Mediciad did' or previously uninsurable... which wouldn't have violated the 10th Amendment. Problem for them with this is that they would have HAD to invoked new taxes to pay for it... and owned that tax increase and the increase in the size of the government forever. That's why they wanted the 'penalty' to be a penalty and not a tax.
Otherwise, seriously... why would they care?
By the time it hit the SCOTUS, many of the 'benefits' of the ACA had already been scaled in, but many of the 'costs' had not yet... so although Republicans cared, democrats didn't by then.... Plus it was months before the election.
If you think insurers lobbied, of course they did. If you think politicians didn't manipulate for their own benefit, of course they did. Republicans wanted the ACA 'penalty' struck down which would have eliminated the mandate. The only way to replace the mandate is with the mandate that ALREADY exists... and that is Payroll taxes for Medicare and Medicaid. Otherwise, it has to be funded out of the general fund.
The worst move Republicans could make is to FIX the problems that the ACA caused... to eliminate the lies that Democrats told... and then do things that likely put Democrats right back in charge of the mess they intentionally created by the timing of many of the provisions of the ACA.
The NEXT game would be that while states that declined the subsidies would be fine, states that didn't would now perhaps have to increase STATE taxes to cover the expiring subsidies... and many states couldn't do that... because unlike the feds, the states can't print money.... so NOW the solution to the problem the feds caused in the first place, is for the feds to take medicaid over anyway. It no longer violates the 10th because states like California would ASK the Feds to take it over. Single payer.
The 10th amendment and separation of medicare and medicaid is what keeps single payer from being an option... UNLESS you either ask the people for a vote, which they know they wouldn't win... OR you do this.
I can't explain it any simpler than that. You can argue with my opinions/conclusions... but while there certainly are MANY people better informed than I on these issues, you're going to have to actually be IN this industry (or very very close to it) to be one of those people.
Quote: (12-05-2016 05:25 PM)Hambone10 Wrote: complete distortion
Unless you can show me where he campaigned on shutting down ACA in three years, it's not a distortion at all.
Please pay attention to what i say.
Obama didn't campaign on putting the ACA in over multiple years, or that the 'cadillac tax' wouldn't be put in during his Presidency either. He merely campaigned on those being one of the first things he 'passed'... and he did. It took him almost a year with absolutely NO dissent from the other party, but he passed it.
Similarly, Trump didn't say that the ACA would be
completely gone as one of the first things (as you want to imply), merely that it would be one of the first things he passed to make it go away.
More importantly.... and again, you need to try and address this if you have the guts to....
As a supporter of the ACA, or of Hillary who would not have gotten rid of the ACA, Democrats like you don't want Trump to pass this AT ALL... whether it happens immediately or not... so if it takes 3 years to get rid of it, you're not MORE unhappy.
There may be SOME Republicans with poor understanding of the 'land-mines' that the Democrats have left who will be upset if it takes 3 years rather than 30 days... but they're STILL not as upset as if they would have been if Hillary had been elected, or if Trump never does it. I'm further convinced that once they understand the land mines, they will be even less upset.
People like me (and there are lots of us) who understand the land mines never expected it to be COMPLETED within the first year (especially in that 2017's elections for insurance have already been made, which means NOTHING AT ALL will change until at least 2018) are not upset at all.
There IS no complaint coming from group 3.
The complaints from group 2 are real, but can easily be mitigated through understanding and 'the lesser of evils'.
The complaints from group 1 are disingenuous.
Quote: (12-08-2016 06:41 AM)solohawks Wrote: Latest plans pre subsidy outta NC are around 1000 dollars for a high deductible plan. Don't qualify for a subsidy? Prepare for a 2nd mortgage
Or get a job that provides healthcare as a benefit. 
Which means they pay you less than they otherwise could. The cost doesn't come out of thin air.
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GOP mulls letting ObamaCare live three more years.
