obamacare fix

Night Thoughts on Trump and America

With Donald Trump away vacationing at one of his golf resorts, the rest of us may have a chance to relax. But in truth it’s more like a short break in a continuing nightmare. Just enough time to turn on the light, look at the clock and ponder where we are, before the nightmare envelopes us again.

What can we ponder that will make all of this a bit less frightening? For one thing, it could be far worse. Trump could have fulfilled his campaign promises to repeal Obamacare, lock Hillary up, build a wall, and throw out all immigrants without papers.

By now he might have confused so many Americans about the truth that most of us would believe the words coming out of his mouth. Hell, by now he could have incited another civil war.

Actually very little has happened. He’s huffed and puffed, threatened and fumed, yet almost none of it has found its way into concrete laws. And it may not: The typical “honeymoon” enjoyed by new presidents is over for him. His first hundred days came and left, almost without a trace.

Another thing is Trump’s “favorables,” as pollsters call them, continue to tumble into territory never before seen at this stage of a presidency. Only about a third of the country still supports him; the opinions of the rest range from bad to awful. And his credibility is shot. 

Even Republicans in congress are now more willing to buck him (some are even talking about fixing what needs fixing in Obamacare). Meanwhile, special counsel Robert Mueller has impaneled a grand jury with the power to subpoena Trump’s financial records. Didn’t Trump hint he’d fire Mueller if he did this? Wouldn’t firing Mueller be the beginning of the end?

Trump has also ignited a prairie fire of grassroots activism, almost all of it against him. Across the country, people who were never politically active are rolling up their sleeves and getting involved – attending congressional town meetings, writing letters to the editors of their local papers, organizing for the 2018 midterms. Some are even running themselves.

This outburst of political effort resisting Trump has no parallel in recent history. John F. Kennedy asked Americans to ponder what they might do for America; Donald Trump is getting them to actually do it.

In the middle of the night one’s thoughts also turn to where we are in life.  Trump was born in 1946, the same year Bill Clinton, George W. Bush, and, coincidentally, Clinton’s own special prosecutor, Ken Starr were born. And yours truly. We are all, shall we say, beyond our prime. There’s only so much damage a septuagenarian can do from here on.

To put it another way, a few weeks from now I’ll be returning to the classroom and a new crop of college freshmen. They were born in or around 1998. Chronologically, they’re as far removed from Trump and the rest of us early boomers as we were, when we went to college, from Americans born in 1894. Which is to say, a very long way.

So unless Trump brings on a nuclear war that ends life as we know it on the planet, he is unlikely to have much influence on the lives of my upcoming freshmen. His first (and perhaps only) term in office will be over when they’re just 22. Think of being 22 years old and having your whole life ahead of you, without Trump.

At the same time, Trump has been a boon to ethicists, moral philosophers, and the rest of us who tend to wake up in the night and think about big scary things. Trump has brought the nation back to first principles.

Most presidents spur debates over things like whether the economy needs a more stimulative fiscal policy, or whether America should support the expansion of NATO to the Baltic states. Trump has made us debate whether the U.S. economy can exist separate from the rest of the world, and whether we should even belong to NATO.

Some presidents get us talking about civil rights and civil liberties. Trump has got us talking about democracy versus tyranny.

I don’t mean to minimize the damage he’s already done. I don’t remember America so angry and divided – not even through the battles over civil rights and Vietnam. Trump has also demeaned the office of the presidency, licensed bigotry, appointed absurdly incompetent people to his Cabinet, violated every ethics and conflict-of-interest rule imaginable, reduced America’s influence and moral authority in the world, and may even have conspired with a foreign power to rig a presidential election.

That’s a lot in just under seven months. He deserves a vacation.

But taking the slightly longer view, the nation is still functioning. Our democratic institutions have so far stood the test and remain strong, just as the founding fathers intended. Presidential power is checked and balanced so the current occupant of the Oval Office is hemmed in. Plus, our friends and allies around the world understand that our condition is temporary. America will be back.

It has been an incredibly stressful time, but most of us are okay. In fact, I’d venture to say most Americans remain optimistic – especially my upcoming college freshmen, who have their whole lives ahead of them.

politico.com
Centrist lawmakers plot bipartisan health care stabilization bill

A coalition of roughly 40 House Republicans and Democrats plan to unveil a slate of Obamacare fixes Monday they hope will gain traction after the Senate’s effort to repeal the law imploded.

The Problem Solvers caucus, led by Tom Reed (R-N.Y.) and Josh Gottheimer (D-N.J.), is fronting the effort to stabilize the ACA markets, according to multiple sources. But other centrist members, including Rep. Kurt Schrader (D-Ore.), and several other lawmakers from the New Democrat Coalition and the GOP’s moderate Tuesday Group are also involved.

Their plan focuses on immediately stabilizing the insurance market and then pushing for Obamacare changes that have received bipartisan backing in the past.

The most significant proposal is funding for Obamacare’s cost-sharing subsidies. Insurers rely on these payments – estimated to be $7 billion this year — to reduce out-of-pocket costs for their poorest Obamacare customers.

President Donald Trump has repeatedly threatened to cut off the payments, deriding them as a “bailout” for insurance companies. White House counselor Kelly Conway said on Sunday that Trump will decide “this week” whether to scrap the subsidies — which could make the markets implode.

Okay, sounds good so far. What else does the “Problem Solvers caucus” want to do?

[C]hange Obamacare’s employer mandate so that it applies only to companies with more than 500 workers. Currently companies with at least 50 workers can be hit with a tax penalty if they don’t provide coverage to their workers.

Oh heeeeeeeeeeeell no. That would deprive millions of people of health insurance and cause premiums to go up for those who get to keep their insurance.

The preferred free-market plan for health care policy should be no plan whatsoever. The idea that we need a federal top-down strategy to manage a huge chunk of the economy is at the very heart of the problem. We don’t need a federal plan for health care. Yet Republicans have allowed liberals to frame the entire health insurance debate in these anti-market terms.

So the American Health Care Act, or AHCA, is obviously weak tea, falling far short of a promised free-market solution, much less a full “repeal” of Obamacare. It’s a half-measure that endeavors to fix Obamacare with small doses of deregulation while failing to repeal its core. It’s almost as if Republicans were trying to mollify their constituents and save Obamacare at the same time.

—  David Harsanyl, Senior Editor of The Federalist

See my problem with Bernie Sanders is he trying to get single payer insurance where we r no where near having the votes. But we do have the votes to fix the things need to fix Obamacare. He is always selfish. Why not fix Obamacare and then work with the Dems to get the house and Senate back and then work on single payer healthcare insurance. But he was never for Obamacare n the first place so he doesn’t care

Eighteen million people could lose their insurance within a year and individual insurance premiums would shoot upward if Congress repealed major provisions of the Affordable Care Act while leaving other parts in place, the nonpartisan Congressional Budget Office said on Tuesday.

A report by the office sharply increases pressure on Republicans to come up with a comprehensive plan to replace the health care law. It is likely to doom the idea of voting to dismantle the 2010 health law almost immediately, with an effective date set sometime in the future while Congress works toward a replacement.

If nothing followed the gutting of President Obama’s signature domestic achievement, the budget office said, 32 million people could lose their health insurance by 2026, and premiums in the individual insurance market could double. Senator Susan Collins, Republican of Maine, showed the unease of some in her party when she said that repealing the health care law and delaying a replacement could send insurance markets into “a death spiral.”

She detected “a growing consensus among members of both the Senate and the House that we must fix Obamacare and provide reforms at nearly the same time that we repeal the law,” she said on the Senate floor on Tuesday.

The new budget office report, issued after a weekend of protests against repeal, will only add to the headaches that President-elect Donald J. Trump and congressional Republicans face in their rush to take apart Mr. Obama’s health law as they try to replace it with a health insurance law more to their liking.

— 

The New York Times“Health Law Repeal Could Cost 18 Million Their Insurance, Study Finds.”

I wonder how many of those 18 and 32 million people dumbassedly voted for Trump.

Emergency Room visits are increasing under Obamacare

I thought Obamacare was supposed to fix this…

from Wall Street Journal:

Emergency-room visits continued to climb in the second year of the Affordable Care Act, contradicting the law’s supporters who had predicted a decline in traffic as more people gained access to doctors and other health-care providers.

A survey of 2,098 emergency-room doctors conducted in March showed about three-quarters said visits had risen since January 2014. That was a significant uptick from a year earlier, when less than half of doctors surveyed reported an increase. The survey by the American College of Emergency Physicians is scheduled to be published Monday.

Medicaid recipients newly insured under the health law are struggling to get appointments or find doctors who will accept their coverage, and consequently wind up in the ER, ACEP said. Volume might also be increasing due to hospital and emergency-department closures—a long-standing trend.

“There was a grand theory the law would reduce ER visits,” said Dr. Howard Mell, a spokesman for ACEP. “Well, guess what, it hasn’t happened. Visits are going up despite the ACA, and in a lot of cases because of it.”

read the rest

When you try to fix any problem with more big government, you can’t possibly be surprised when things get worse. 

anonymous asked:

I'm not American, could you explain why is Obama Care so controversial?

This is going to be pretty long; I just want to create a detailed list of all of Obamacare’s drawbacks for reference. (I bolded the important parts for tl;dr in case you don’t want to read all of this)

  • Premiums increasing (which really hurts unsubsidized families/individuals):

Premium costs of silver marketplace/healthcare plans (which allow the payer to pay a moderate amount compared to Gold and Platinum plans, but more than Bronze plans) from 2015 to 2016:

The average percent increase is 10% for a 40 year old who makes $30,000; before tax credits.

After tax credits for that single person making 30k it’s -0.2%; if they were to make above the cutoff (mentioned below) then the amount they pay is a significant 10% increase.

And to qualify for those subsidies, your income has to be between 100% and 400% of the federal poverty level, depending on your household size. (Ex: a family of 8 that makes 40k per year is eligible for several types of subsidies, while a family of 8 that has an annual income of 163k is only eligible for the premium tax credit).

Those costs are projected to increase in 2017 as well. Taking averages of people aged 30-60, the premium cost of Bronze plans are to increase 21% from 2016, 17% for silver plans, 22% for gold plans, and 15% for platinum plans.

While the above accounts for pure averages, it doesn’t look at the exponential increase that you pay for those premiums as you age. There’s a cut off at an individual who makes $48,000 annually; you’d have to earn $47,520 or less to be eligible for any subsidy. The average silver premium someone aged 30 (with a $48,000 income) pays 364.91 in 2017; that’s 9% of their monthly income. Someone aged 60 would pay $872.01; 22% of their monthly income. So that’s considerable strain on older people who make above that $47,520 cutoff.

  • People losing their plans, which Obama lied about because he initially said that ‘if you like your plan, you can keep it’. 

He also emphasized that there would be more competition and more choices, but that wasn’t the case. This happened because those original plans weren’t compatible with Obamacare’s guidelines. Because of that there’s fewer choices with healthcare plans in 2016 then there were in 2015.

The health insurance marketplace offers 6% less in exchanges in 2016 than they did in 2015. (keep in mind that’s only one year; there’s a lot to take into account if you think about the time that’s passed since Obamacare’s exchange program was passed into law).  

With state-level competition (from the Heritage Foundation); the 2016 exchanges have 27% less insurers than they did in 2013 when they were counted as individual market insurers. 2/3 of all the individual states have fewer insurers than they did in 2013. If we’re talking about counties (consumers are only able to purchase their health coverage on an exchange within their counties), a total 63% of them have 3 or fewer insurers available to choose from that specific exchange they have which makes for limited choices and less competition.

One of the biggest healthcare providers (United Healthcare group) is considering opting out of the exchange program because of the market not demonstrating to be cost-effective at all for them. Them opting out would have a huge impact because they offer exchange coverage to 34 states.

  • Higher deductibles (the amount of money you have to pay before your health insurance covers you):

Many people have expressed that they can’t afford to pay those deductibles which makes it harder for them to take advantage of the insurance they have. Democrats, not just republicans have discussed concerns about this too.

With the lowest-priced Obamacare health plans, deductibles (for individuals) alongside that are estimated to be $6,000 this year. For families they’re around $12,000. So while some people are insured, they can’t afford to use their own insurance because of those deductibles. These are without subsidies, so if you make above the threshold income/s, you have to pay those net amounts (according to which plan you have).

  • If you’re “able” to afford health insurance and you don’t have it, you have to pay a fee which is 2.5% of your income. 

For each individual person you pay what’s called a “maximum”. If you qualify for a health coverage exemption you don’t have to. Imo it’s pretty unreasonable that you have to be “punished” in the form a fee for choosing not to have healthcare. This doesn’t even apply for all forms of insurance; your coverage must be one that includes a ‘minimum of 10 health benefits’. Depending on how much your premium is under the ACA, the potentially high costs from limited healthcare options, deductibles, and income, some people have to opt out of being insured (and hope they don’t get sick) and pay that fee because it’s cheaper.

Although there are many problems that come with the ACA; repealing it completely without any substitute isn’t the way to go. We need to fix Obamacare from the inside out and keep the beneficial sides to it. Either that or offer a better alternative with the upsides to Obamacare implemented into it, in a way that doesn’t cause the deficit to increase.