Tuesday, March 28, 2017

 

My Thoughts On Failing to Repeal Obamacare

Lately, there's been a lot of breaking the 11th Amendment, which isn't necessarily bad, but is pretty bad right now. Here's what I think.

I thought the whole idea regarding repealing Obamacare was to get the Government out of health care and health care insurance (two distinct things) as much as possible. I thought the idea was to allow choice of what sort of coverage people could buy (a cafeteria style option rather than one size fits all) and remove anything impeding the selling of such insurance so that competition would start to reduce the extreme uptick in the cost of most plans.

To do that, merely repealing the only-supported-by-Democrats legislation, and reducing statutory and regulatory impediments to competition, was all that was needed.

But the brainiacs decided to keep government involved and not fully remove the ACA and impediments to competition. Worse, they decided to keep what they thought were "popular" parts of Obamacare; namely, keeping 26 year old children on their parents healthcare plan and preventing health care insurance plans from refusing to cover medical treatment for conditions that pre-existed the purchase of the plan.

I could live with the 26 year old children, but not allowing pre-existing condition exclusions is the death knell for private health insurance. People will get the minimum catastrophic coverage or no coverage at all and then upgrade to plans offering greater coverage if they get sick or hurt.

The Freedom Caucus saw all this and said, we can't let our party pass what amounts to Obamacare lite which will suffer the same fate as real Obamacare.

They are getting a lot of abuse, but I see them as principled and smart people who properly opposed a terrible decision by the Republican leadership. I also think history will be ever kinder to them than the likes of Prager and Hewitt are being now. And I say that knowing those two people are much smarter than I am. They are human, though, and capable of making a mistake. They're mistaken here.

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Comments:
It is soooo hard to take away previously-bestowed benefits. And the hyperbolic discourse doesn't help anyone get a good read on what is really being discussed.

Unlike the Dems in Congress, the Republicans don't march in lockstep. They have diverse proposals for addressing the situation, some of which are radical, others more moderate. this discussion and debate is, as I see it, a good thing. Much, much better that some diktat presented by a handful of pols as an all or nothing burger.

As I understand it, this first bill proposed to take on just the elements that are repealable under the lesser vote required under reconciliation (Senate: 50+1 votes), because without Dem participation, the Republicans don't have the votes in either the House (I could be wrong on the House, tho) or Senate for full & total repeal.
Thus, Ryan's plan to repeal what he could now, with the promise to get rid of the rest at a later date. Yeah, right. We've heard those promises before. If this had passed now, and given the likely FUBAR with just a partial repeal, the Republicans would have ownership of the result that everyone, but everyone, would hate.
I'm ok with this. The Dems still own OC, and also own their refusal to address its weaknesses.
I think Trump is right to move on to his other agenda items. ...following the First Rule of Holes.
 
A straight appeal might have passed the House. I'm not sure you couldn't repeal it in the Senate through reconciliation. We may never know. I have never been convinced that we needed to replace it with federal law. I'm reasonably sure they'll get around to trying again in a few months.
 
Yah. It should be purely a state matter. Except that the feds are so tightly tied into health insurance/care via Medicaid, Medicare, SSI, EMTALA, tax law, etc.

Plus, the human moral imperative that we'll not let anyone simply bleed out on the sidewalk, but will treat all who need treatment, notwithstanding ability to pay for services.

I'm in favor of returning to the status quo ante 2008, and maybe just trying to address the [purported] original issue of a few million people for whom we might justify subsidizing care.
 
Lately the status quo ante is nearly always preferred vis a vis the federal government.
 
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