Affordable are Act aka Obamacare: Chance of Repeal

[RubySlippers]

Okay the Supreme Court rules on this and its the law of the land, with the exception Medicaid has to be opted into by states not mandatory to participate with a clear strong majority vote.

So what are the odds this will be fully repealed before it kicks in in 2014?

As I see this if the Senate stays with a slight Democratic majority and/or Obama is returned to office its over and there will be no appeal.

If Romney gets in and the Senate shifts over to the Republicans then it gets interesting. Their options are pretty simple and neither are ideal to consider by the Republicans.

1. They can try for a full repeal of the entire law and hit the filibuster in the Senate stalling it.

2. They can repeal the financial parts by reconciliation and that leaves the king kong of the ACA the mandate insurers cannot turn anyone away with others intact and again face a Democratic filibuster.

Romney could grant waivers to anyone that asks but if a state opts in they must provide the funding so its not an assurance states would refuse all that funding if its there to do the Medicaid expansion and the exchanges in the end.

So how would you see a repeal happening if they try it or can they repeal it?

[Callie Del Noire]

I think this is a massive shitstorm started for the purely political purposes by the Republicans. They are going to play it for maximum political capital. This is a game to keep things focused on the President instead of issues. I honestly don't see a positive approach that will make things less polarized, which is what the GOP wants.

As long as they keep playing the repeal right..they will keep the rank and file, and a good portion of the libertarians, behind their candidate.

[Apple of Eris]

Reminded me of this:



Anyway, I doubt it will be repealed unless Repubs sweep congress and the WH, and honestly, unless the Prez does something completely crazy between now and the election, I doubt that will happen. This not being a mid-term election, you'll have a greater turnout, and a greater turnout generally favors those seen as moderates. To me it seems the Republicans are making it harder for themselves by continually edging further right. In a major election that just makes it harder on them to be appealing to a generally moderate populace.

Of course if the economy tanks or something, all cards are off the table.

[Callie Del Noire]

Apple you're forgetting the GOP has UNLIMITED Citizen United funds to fear monger and spin with. Lack of reporting of funds in the superpacs, accountability, or even a need to remain true to the facts mean the GOP will spin up their solid core into a frothing mass of voting maniacs, add in possible pulls from the libertarian crowds.

I think it will be much closer than most think. It's going to come down to 'pivot' states. Either that or one of them screws up by the numbers

[RubySlippers]

I must point out a repeal of the entire law at once requires the Senate to fall to the Rpublicans in November by 11 or more seats, anything else the Democrats can filibuster it since it has both budget and non-budget portions so cannot be done in reconciliation by a simple majority vote. If they go after what they can which I admit is alot of the ACA they still have the non-budget portions this includes the king kong the insurance mandate that insurance companies have to cover everyone that wants to regardless of medical condition that again can be filibustered as a seperate bill.

And Democrats can use that as a bargaining chip for reforms to the law over a repeal after all you need them in the end to play ball. So I see a repeal a hail mary sort of try that is not in the end likely over some bipartisan reforms maybe of some of the law the Democrats can agree to that are not critical to the core of the law.

So Romney is actually not a big issue neither is the Senate elections save it would be better if the Democrats hold the Senate and could take the White House it would stop a repeal cold. If the Senate is held by Democrats with its current number or more seats there still would be no repeal.

[Callie Del Noire]

Exactly..and in at LEAST 11 vulnerable states the GOP will use that issue as a club to leverage control if they can.

"They are trying to do bad things to your medical choices"
Doom/Gloom/Assisted Suicide Boards/Death Committees..ect.

This is all to manufacture issues that they don't have as bad a history as the real relevant issues of their 'gifts' to big money, the fact that they will NOT do what needs to be done to fix the mortgage issues and will work to make the current business as usual attitude in washington continues. Lobbyists ruling the decision process, the White House rubberstamping anything that the GOP pushes through without review.

[Sasquatch421]

Right now there is no chance of it being repealed since it needs to get past the senate and if by some small chance it did.... Obama would just veto it. Right now ti is a waste of time trying, but that could very well change in November.

[RubySlippers]

They must get the eleven seats a tall order, when was the last time that many seats fell to one party in the Senate in one election. I can't seem to find a case that happened in one election.

And I meant after November in my original post.

[Callie Del Noire]

Like I said..this wasn't ever intended to do anything more than stir the pot. The GOP is hoping by being soundly thrashed by the 'wicked Dems' in the Senate and the President that they can show the libertarians and small government moderates they are on the same side and they need to back the GOP this time around.

All it takes is a good long look at the last eleciton to know they lost because of the moderates they've been snubbing for the last 20 years.

[gaggedLouise]

I don't see the Republicans getting to (or even near) the sixty seats limit in the senate either, which will make it very hard to repeal the entire law. Actually I think Obama will get re-elected by a small margin. Romney is obviously having trouble raising the wider base of the GOP to the fight; for some he's not conservative enough, for some not a real Christian, and to many he's just not dramatic or credible enough as a political figure. This will dog him into the campaign I think, but I admit it's just an assessment from me.

If anything, these past four years have shown how the political system is in a kind of death grip, both in the USA and in Europe. It's become near impossible to achieve viable reforms or "government for the people, by the people", instead we're getting an increasingly bought-up , self-entitled, impenetrable and shackled political scene.

[Serephino]

I very much doubt it will get repealed.  Callie is right, this is a purely political show.  They have to because last year most of them promised during their campaigns that the first thing they would do is repeal Obamacare.  I remember that, and I wonder how many others do.  But that wasn't the first thing they did.  The first thing they did was SOPA and all those crazy abortion laws.  Then when people got pissed off about those they decided to go after the budget like they promised.  They slashed the hell out of social programs.

I can pretty much guarantee that even if the GOP does win the election, they'll forget all about the health care law and go right back to what is really important to them.  Everything they tried to ram through these past 2 years that they couldn't because of the Senate will very quickly become law if they control both houses.  A woman's uterus is what's important to them.  Though, I suppose if insurance companies fork over enough cash that might get the Gop's attention.   

[RubySlippers]

A local hospital since the state likely will not expand Medicaid has a plan they will cover the premiums of poor patiants, provide the treatement then let the insurance lapse getting the money from the insurance company since the patiant cannot be refused once they get a months premium. And one did the math if they get a good policy paying 80% they will get noticeably more money than under medicaid for any care over a certain threshhold. And it would be legal without a repeal. I suspect the state insurers will beg for the Medicaid expansion is any hospital does this as a normal policy and well as the state to go into the Exchanges. I will note any private person could also do this which is the issue the bills King Kong that needs the rest of the law to fence it in.

[Chris Brady]

Correct me if I'm wrong (and please do, my facts are tenuous at best at the moment, memory and all that) but wasn't 'Obamacare' originally something of a Republican idea in the first place?

I THINK I remember reading or hearing something along those lines...

Again, though, I could be wrong.

[AndyZ]

Here's my prediction:

Not too much will happen before November.  Regardless of whether the tax cuts are kept in part or in total, or not kept at all, it won't affect too much growth.  All the growth that the Bush Tax Cuts had to give was used up when they were implemented.

In November, Republicans will keep the House, get the White House with Romney, and get more than 49 seats but less than 60.

During the first year, Republicans will work on trying to convert Democrats to getting rid of Obamacare.  They'll probably try throwing in deals similar to what Republicans called the Cornhusker Kickback and Louisiana Purchase.  If that works, they'll replace it with things like tort reform and allowing health insurance to be sold across state lines.  If that doesn't work, they'll just gut it with reconciliation.

Republicans will then continue to use the reconciliation process against any of their opponents who weren't willing to work on their behalf for getting rid of Obamacare.  There's all kinds of stuff they'll be able to remove from specific states when they take a machete to the budget.  There's a reason that people were calling reconciliation the nuclear option, and it's been invoked.

Although a number of public jobs will go down the drain, things will start picking up when the private sector is unleashed (unless the big business in their question has a Democrat in their pocket and has already gotten an exemption).  Unemployment will decrease rapidly during the first two years and even out to something reasonable (I'm guessing 5% but figure I'll be off by a point or two depending on other factors) by 2016.  Democrats will try to claim that it would have happened even faster if not for Republican obstructionism, but I don't think people who aren't Democrat will believe it.

We'll see if I'm correct.

[Oniya]

Correct me if I'm wrong (and please do, my facts are tenuous at best at the moment, memory and all that) but wasn't 'Obamacare' originally something of a Republican idea in the first place?

I THINK I remember reading or hearing something along those lines...

Again, though, I could be wrong.

You would be correct.  http://healthcarereform.procon.org/view.resource.php?resourceID=004182  The website linked shows 'Federal Health Care Bills Containing an Individual Health Insurance Mandate, 1993-2009' as well as 'Policy Origins of Individual Mandate, 1989-1994' - who introduced the bills, how many co-sponsors each had on all sides of the aisle, and a brief summation of each.  There are also links to the bills in question, for those who want to stare at legalese until their eyes cross.

[gaggedLouise]

Here's my prediction:

Not too much will happen before November.  Regardless of whether the tax cuts are kept in part or in total, or not kept at all, it won't affect too much growth.  All the growth that the Bush Tax Cuts had to give was used up when they were implemented.

In November, Republicans will keep the House, get the White House with Romney, and get more than 49 seats but less than 60.

During the first year, Republicans will work on trying to convert Democrats to getting rid of Obamacare.  They'll probably try throwing in deals similar to what Republicans called the Cornhusker Kickback and Louisiana Purchase.  If that works, they'll replace it with things like tort reform and allowing health insurance to be sold across state lines.  If that doesn't work, they'll just gut it with reconciliation.

Republicans will then continue to use the reconciliation process against any of their opponents who weren't willing to work on their behalf for getting rid of Obamacare.  There's all kinds of stuff they'll be able to remove from specific states when they take a machete to the budget.  There's a reason that people were calling reconciliation the nuclear option, and it's been invoked.

Although a number of public jobs will go down the drain, things will start picking up when the private sector is unleashed (unless the big business in their question has a Democrat in their pocket and has already gotten an exemption).  Unemployment will decrease rapidly during the first two years and even out to something reasonable (I'm guessing 5% but figure I'll be off by a point or two depending on other factors) by 2016.  Democrats will try to claim that it would have happened even faster if not for Republican obstructionism, but I don't think people who aren't Democrat will believe it.

We'll see if I'm correct.

(my italics)

It seems the question whether reconciliation could possibly be used to bury Obamacare is a whole debate topic unto itself. And then it's just whether it would be permitted, not whether such a move would be in line with the proper use of the reconciliation procedure. Seeing that the law package isn't mainly a budget issue and bears heavily on public health and - by extension - social security (sickness often works together with unemployment and social uprooting, so if the health care issues are not addressed, it's likely to balloon social security costs and continue to balloon on-the-spot hospital costs) it's hard to see how Obamacare could be pushed down into the grave with a reconciliation move. Especially when Romney enacted a similar package during his time as governor of Massachusetts.

Also, reconciliation vote can only be used once a year. Don't you think there are other issues Romney would want it for?

I think Callie is right, this is political theatre. I've seen similar things in other elections, an issue gets blown to the sky and dominates the campaign only to sink to the bottom of the sea once victory has been achieved. Romney's people already know that it will be very difficult and divisive to get rid of ACA, and that it could well become a millstone around their necks in 2016. There's a limit to how much recent legislation you can repeal without undermining the authority of your own office.

[Trieste]

I'm a little frustrated that health care reform has essentially passed and been upheld, and yet it continues to be one of the political drums to bang. Health care, abortion, and birth control are in the news a whole hell of a lot lately.

What about jobs? What about overseas wars that are draining what money we do have? What about focusing on things that affect ALL Americans instead of small percentages? The highest estimate of how many would pay tax penalties due to an individual mandate that I have read is like 5% of taxpayers - more common was like 2-3%. I don't know the percentages of women who seek abortions, but I'm willing to bet it isn't the majority of women. The largest population affected by the recent political crap would be those who make use of birth control - which is an issue about which I have yet to hear anyone demand something should be done. Unless you count Rush Limbaugh which I...don't. Conversely, there are few families that don't have a member off at war, or just back from war, etc. There are very.few families that haven't been affected by unemployment, underemployment, and foreclosures.

I'm sick, sick, sick of the energy being put into essentially denying the country healthcare while we have other crap to clean in this country.

[Callie Del Noire]

I agree Trieste, but give the Tea Party's continued refusal to hold their sponsors accountable for the economic woes, job losses and such the need a white whale to distract the average voter. Toss in that any TRUE corporate tax reform that could make in-sourcing jobs back into the country profitable would mean the end of the tax loop holes that allow companies lie GE and Big Oil to hide profits off shore for something that might not be as good as their good deal gigs on the books and they will avoid that like the plague.

Yup, the murdered of the Affordable Care Act will be front and center tillNov.

[Trieste]

Am I the only one who feels like the political process has gone significantly off the rails since Citizens United? Don't get me wrong, it wasn't perfect before that, but it seems like overnight there were SuperPACs everywhere and no political concern for constituents any longer.

Am I imagining things?

[Oniya]

Not the only one by far.  Various states are even trying to do things on the sub-federal level.  (I remember hearing Montana was trying to counter it, Bernie Sanders is speaking out against it in Vermont, and I think Sherrod Brown (Ohio) cosigned on something leading up to the Supreme Court hearing.)  Have you seen the picture of Boehner done up like a NASCAR driver with all his 'sponsors'?

[Trieste]

Nope. I think that needs rectifying. *makes puppy eyes at Oniya*

[Oniya]

Also, look up the DISCLOSE Act (Senate Bill 3369).



Link to big, easy to read version:  http://i.imgur.com/j5c2S.jpg  (2323 x 3000 px)

[gaggedLouise]

Hahaha, that pic is absolutely hilarious!  :D

[Callie Del Noire]

Yeah.. the lack of transparency in the SuperPacs is scary, the resistance to the FCC's mandate to put political advertising purchases online, and generally any manner of campaign finance reform is a 'bad thing' on the Hill.

Yeah, Citizen's United rolled back nearly a CENTURY of campaign finance reform. Bernie Sander's amendment looks promising but the lack of media attention is 'strangely' constant.

Me personally.. I want it restricted to 10k per person. No companies, unions, or organizations of ANY kind. Full reporting and transperency, making concealing funding a felony. But I've been in a 'Fuck the polis/lobbyists' mood of lately.

[Oniya]

Me personally.. I want it restricted to 10k per person. No companies, unions, or organizations of ANY kind. Full reporting and transperency, making concealing funding a felony. But I've been in a 'Fuck the polis/lobbyists' mood of lately.

Reminds me - I saw this the other day, thought of you, and ran it through Snopes just to make certain.

'Should any political party attempt to abolish social security, unemployment insurance, and eliminate labor laws and farm programs, you would not hear of that party again in our political history.  There is a tiny splinter group, of course, that believes you can do these things.  Among them are H. L. Hunt (you possibly know his background), a few other Texas oil millionaires, and an occasional politician or business man from other areas.  Their number is negligible and they are stupid.'

Dwight D. Eisenhower - http://www.snopes.com/politics/quotes/ike.asp

[Callie Del Noire]

Reminds me - I saw this the other day, thought of you, and ran it through Snopes just to make certain.

'Should any political party attempt to abolish social security, unemployment insurance, and eliminate labor laws and farm programs, you would not hear of that party again in our political history.  There is a tiny splinter group, of course, that believes you can do these things.  Among them are [ur=http://en.wikipedia.org/wiki/H._L._Huntl]H. L. Hunt[/url] (you possibly know his background), a few other Texas oil millionaires, and an occasional politician or business man from other areas.  Their number is negligible and they are stupid.'

Dwight D. Eisenhower - http://www.snopes.com/politics/quotes/ike.asp

Yeah.. Dwight was right THEN. Today, after forty years of planning and loading all three branches of the government with people towards a goal. There is a concerted effort to weight the courts, disrupt the balance of power between the branches, and to instill a unitary president that truly in charge with no counters. It's not ENTIRELY just the GOP doing this though they have done the lion's share.

Today.. I fear the man would be greatly mistaken. I am betting within two decades we'll see successful attacks on all those programs. Of course by then voter apathy will have ceded too much power to the parties.

[Sasquatch421]

I still think we need to get rid of the entire government and redo the whole thing. Get rid of the parties and make it so it's not only those who have the money can be president.

Do I like Obamacare? No... but there are parts that are good. I just don't think that the government should force people into buying healthcare. They should just change what we already have and make it more affordable. I mean it stays in what's next? Forcing everyone to buy a Prius to save on fuel?

[Trieste]

Well, first of all, it was ruled a tax. And second of all, it's a minuscule number of people who will be paying that tax. Thirdly, expanding current programs doesn't come without a price tag, which is what the tax penalty is going to help defray. And fourth, it isn't just bad housing loans that lead to massive numbers of bankruptcies - this country is drowning in bankruptcies due to medical bills. Medical care isn't something you can put off until you can better afford it - when a medical emergency happens, it happens. We NEED comprehensive preventative care, affordable emergency care, sane prescription coverage, and, yes, vision and dental coverage for -everyone- in this country. And if people don't want to pay into their own coverage, then they will pay the taxes because who will be picking up their coverage when - not if, but when - they need it? Other tax payers.

The difference between mandating a Prius and mandating health coverage is that a Prius is not a necessity or a right, and first-world medical coverage for our first-world country is both a necessity and a right.

[Callie Del Noire]

I am still out on the ACA but till the GOP offers something that helps more than there sponsors I won't be backing them. I mean come on, some are offering some insane ideas are drinking the denial koolaid.

[Oniya]

I was actually explaining it to my sister (the EMT) - who was initially saying that she didn't want her money going to enable the people that currently abuse the system (she told me this one story about a diabetic who would spike her blood sugar deliberately, call the ambulance, and while she was at the ER, she'd complain of pain to get pain meds).

I explained it this way:

Leave the abusers out of the picture for a minute - just put them over there for a little bit.  Let's talk about the responsible people who can't afford health care at the moment.  A responsible diabetic would much rather be able to get their insulin regularly.  They would much rather pay a small amount once a month to ensure that they don't accrue major bills for amputations, strokes, heart disease, etc.  By being on health insurance, that person is going to save the hospital money by not getting to the point where they need the ER.  And actually, there's probably a lot of these people out there.

[RubySlippers]

I am still out on the ACA but till the GOP offers something that helps more than there sponsors I won't be backing them. I mean come on, some are offering some insane ideas are drinking the denial koolaid.

The only issue I have with the GOP is the big one noone has a counter to the Medicaid expansion for the working poor, as in my group.

I purposefully work less than I could due to the fact I must qualify for charity law care if I go to the hospital and to access the free clinic and drug assistance programs for my prescriptions for diabetic supplies (I'm a Type 1 Diabetic). I work 32 hours a month. I could work three times that phsycially and make a fairly decent income still under the 133% of the Medicaid expansion but would be able to be more productive. Right now that is not an option but I have to do what I do for my health and I hate it. I love sidewalk performing and could work robust weekend hours and special events but then I lose my existing health care blanket.

But asking me to pay for insurance at market rates is crazy I would be working those hours to just pay for health care insurance if I could afford a policy at all.

[Callie Del Noire]

The only issue I have with the GOP is the big one noone has a counter to the Medicaid expansion for the working poor, as in my group.

I purposefully work less than I could due to the fact I must qualify for charity law care if I go to the hospital and to access the free clinic and drug assistance programs for my prescriptions for diabetic supplies (I'm a Type 1 Diabetic). I work 32 hours a month. I could work three times that phsycially and make a fairly decent income still under the 133% of the Medicaid expansion but would be able to be more productive. Right now that is not an option but I have to do what I do for my health and I hate it. I love sidewalk performing and could work robust weekend hours and special events but then I lose my existing health care blanket.

But asking me to pay for insurance at market rates is crazy I would be working those hours to just pay for health care insurance if I could afford a policy at all.

That is why I'm worried about it. When the HMOs first appeared I had a friend whose mother was an exceptional needs person, which meant at the time he was having to get health coverage for her in addition to the tricare coverage. Suddenly he had to justify every little bit of coverage to the other provider because the manager assigned to his mother. It came to the point, right after the tools in California deregulated the power industry, where it was less effort to pay the additional care through the tricare system than to have him or his wife fight with the manager for every damn treatment she needed. Not to mention he was having to go on deployment.

In the last 25 years, health care has become more and more about profit and less and less about care. In the US anyway. The ACA was an effort to fix a lot of the problems. Thanks to a GOP House empowered by groups who are profiting on the current situation a LOT of the issues were not fixed. (not that the GOP were the only ones manipulated by special interests but they are the majority in the house)

I've felt the problem with insurance companies in the US over the last few decades as they are more about profit for stockholders than providing a service. Profit is all fine and good but when you shit on your clients.. like they did with my friend.. to sketch a few points of profit out of human suffering.. No. Then more regulation is the right thing. One of the first points I liked about the ACA was making Health Care Providers keep a certain amount of their income to TREATING their clients.

If the special interests hadn't had their hooks in the legislative branch, particularly all the incoming Tea Partiers...we might have gotten something good out of it. Had the GOP not decided back in 1995 that the 'gentlemen's' social attitude of congress had to go, or either party since then worked to restore it, we might have gotten something closer to what we were promised.

Romney gets elected.. kiss ACA goodbye and I promise the abortion that the special intersts get to replace it will be.. interesting.

[TheGlyphstone]

Romney gets elected.. kiss ACA goodbye and I promise the abortion that the special intersts get to replace it will be.. interesting.

Pun intended?

[RubySlippers]

Romney is not a dictator the repeal must go through Congress and the Senate is where the repeal will face its big challenge there are no real repeal options. The Democrats can block a flat out full repeal, the partial repeal is not much of an option as I noted. And that is only if Obama is not returned to office and/or they lose a few Senate Seats. If one or the other (or both) favor the Democrats its over. And a reconciliation can be done once if they use it early on Health Care making the ACA left alot worse then they lose if when the budget talks hit later in the year or if any other major spending bill needs to be done. And they must act in 2013 or the law kicks in.

Seems to me the ACA is likely staying, with changes but not without the Senate Democrats approval making those muted.

And I will note if Obama is returned to office he is going to not have to worry about being reelected and can play hardball over this he will have nothing to lose, I would not want to be a state facing him at that point and trying to opt out.

[Callie Del Noire]

Romney is not a dictator the repeal must go through Congress and the Senate is where the repeal will face its big challenge there are no real repeal options. The Democrats can block a flat out full repeal, the partial repeal is not much of an option as I noted. And that is only if Obama is not returned to office and/or they lose a few Senate Seats. If one or the other (or both) favor the Democrats its over. And a reconciliation can be done once if they use it early on Health Care making the ACA left alot worse then they lose if when the budget talks hit later in the year or if any other major spending bill needs to be done. And they must act in 2013 or the law kicks in.

Seems to me the ACA is likely staying, with changes but not without the Senate Democrats approval making those muted.

And I will note if Obama is returned to office he is going to not have to worry about being reelected and can play hardball over this he will have nothing to lose, I would not want to be a state facing him at that point and trying to opt out.

I think you aren't considering how much the system has been gamed by 25 years of the GOP changing the rules. The GOP has control of the legislature..and I give it even odds to continue if not grow it given the local level party antics I'm seeing. In the senate, yes they have to gain 11 seats to get a full on majority BUT they can work their leverage as a block if they make ANY gains. The GOP is much more in lockstep with each other when it comes to party loyalty and they can do a LOT of things to slip in or defuse ACA.

If Romney gets elected without the democrats gaining in BOTH houses, they will do what they can to defeat it. Odds are he'll continue the 'Unitary' attitude of the Bush II white house and push the limits of Presidential power in a way that he lets laws affect his power. Check into it.. 'Unitary President'. Scary things.

[RubySlippers]

Perhaps but can they stop the law in time, their only real chance would be in my view November 2014 when more Senate seats come up and they could take over. But by then alot of states will likely opt into the Medicaid expansion and likely set-up exchanges with the money out there and then would anyone want to take that away from millions of working poor and with exchanges the lower middle class even more people?

They do have one year not exactly alot of time once sworn in to pass a full repeal through and a partial repeal will have problems far worse than the ACA alone. I suspect they will do a bipartisan law to change parts of the ACA to avoid a fight in the Senate since many agree some work is needed regardless of makeup.

It will be decided in November of this year if Obama is returned to office or the Senate is held by the Democrats the fight will be legislatively dead for two years or longer.

[Callie Del Noire]

Yeah.. but then they were too busy with 'more important' things like invading our privacy from all angles and looking to roll up our freedoms to 'protect' us.

[AndyZ]

(my italics)

It seems the question whether reconciliation could possibly be used to bury Obamacare is a whole debate topic unto itself. And then it's just whether it would be permitted, not whether such a move would be in line with the proper use of the reconciliation procedure. Seeing that the law package isn't mainly a budget issue and bears heavily on public health and - by extension - social security (sickness often works together with unemployment and social uprooting, so if the health care issues are not addressed, it's likely to balloon social security costs and continue to balloon on-the-spot hospital costs) it's hard to see how Obamacare could be pushed down into the grave with a reconciliation move. Especially when Romney enacted a similar package during his time as governor of Massachusetts.

Also, reconciliation vote can only be used once a year. Don't you think there are other issues Romney would want it for?

I think Callie is right, this is political theatre. I've seen similar things in other elections, an issue gets blown to the sky and dominates the campaign only to sink to the bottom of the sea once victory has been achieved. Romney's people already know that it will be very difficult and divisive to get rid of ACA, and that it could well become a millstone around their necks in 2016. There's a limit to how much recent legislation you can repeal without undermining the authority of your own office.

I'd rather not get back into the issue of whether it's a good law.  I'm out of ways on how to convince people that raising demand doesn't lower the price, but then, I still don't understand why people think that big insurance companies wouldn't want a bill which forces you to buy their product or get taxed.

If they can only use reconciliation once a year, is there anything keeping them from grouping together all kinds of stuff into that single use?  Since the CBO currently has the law at $2.6 Trillion instead of the $900 billion that was originally promised, there'd be all kinds of stuff for that money to get allocated into.

Maybe I just don't fully understand how reconciliation works.

[Serephino]

All the fear surrounding death panels really pisses me off.  I saw someone with a picture of a grave site on his facebook that had the caption; Obamacare, welcome to healthcare rationing.  Yeah, because it's so much better when a suit in an office does it....  I have a permanent disfigurement because of an HMO.  I had one through my mom's work when I was like 14.  I broke my arm in gym class. 

Now, to be fair, the attitude of my mother didn't help.  It wasn't swollen, and I could move it a little, so the gym teacher didn't think it was broken.  That, and I wasn't crying, so it couldn't have hurt that bad *sighs*  So, of course my mother didn't think a sprain was worth ducking out of work early.  I had to ride the bus home.  When my mom got home an hour after I did I pointed out that a person's forearm isn't supposed to be curved...

To get the HMO to pay for a trip to the ER we had to get permission from my listed family physician to go.  The really fun part was that the doctor I was going to moved, and the paperwork hadn't been processed by the insurance company yet.  We had to track him down.  I sat in my living room with broken arm waiting for the doctor's office to find the old one, get a hold of him, and for him to call us back.

Because treatment was delayed for so long I have a bone spur in my forearm.  It won't rotate more than 20 degrees.  I can't type with it.  I've learned to type one-handed, but I would never be able to get a job that involved typing, because I doubt most employers would look kindly on how I type, even though I can do it faster than the average person.  I wasn't allowed to do it one handed in typing class in school.  I had to wear a brace and elevate the keyboard with several books so my arm didn't have to rotate.

And let's not forget the day I had a 104F fever.  Yeah, my mom had to call for permission for that too.  The doctor's office told her to try Advil, and my temp did go down, and didn't get that high again.  I'm lucky.  Had it been more life threatening than that I would have died because we couldn't afford to not have an ER visit covered, and the damn HMO didn't want to pay out any more than they absolutely had to.     

[RubySlippers]

I'd rather not get back into the issue of whether it's a good law.  I'm out of ways on how to convince people that raising demand doesn't lower the price, but then, I still don't understand why people think that big insurance companies wouldn't want a bill which forces you to buy their product or get taxed.

If they can only use reconciliation once a year, is there anything keeping them from grouping together all kinds of stuff into that single use?  Since the CBO currently has the law at $2.6 Trillion instead of the $900 billion that was originally promised, there'd be all kinds of stuff for that money to get allocated into.

Maybe I just don't fully understand how reconciliation works.

That is over ten years so its really $260 billion year more for covering everyoneones health care as far as possible, education for health care delivery jobs, reforming medical records, setting up exchanges and lots of little things. A good deal of money but seeing the size of the health care pie is huge ($1.2 trillion a year) its not exactly earth shattering. And noone can say if its going to not have a good impact over a bad one we are talking a big economic boost, eliminating much of the need, shoring up hospitals that take the uninsured and eat the losses passing those on to everyone else, preventing the real risk of a plague being detected early over later (in Florida they had a bad TB outbreak among the homeless and poor) and state have to add to the law to make it work better. You could divert some discretionary funds from highways, enviornmental projects not impacting humans health, the military and others to easily dig up that money to expand health care.

My issue again doing nothing is not an option and I don't see a repeal on the table as an option unless the Senate falls hard to the Republicans in November and they take the White House.

[MasterMischief]

I just don't think that the government should force people into buying healthcare.

Wasn't it the Healthcare industry that insisted on the mandate?  They did not want their precious profits touched to ensure everyone had coverage.

[gaggedLouise]

Wasn't it the Healthcare industry that insisted on the mandate?  They did not want their precious profits touched to ensure everyone had coverage.

Washington had to get them on board too. But frankly I think Serephino's story touches on a key point. On many occasions, being able to act fast and not getting lost in the paperwork shuttled between various employers, bureaucrats and insurance people who want ever new documents and signatures to get off their butts for a minute saves a huge amount of money and future labour capacity, both to the family concerned and to society. If your eyes get infected and you have to put off seeing the doctor because you don't have fifty bucks to spare or your dad doesn't think it's important, it might result in serious impairment iof vision or even blindness. Most developed countries have long recognized that being able to toss up the bucks in that situation is not always 100% the responsibility of the individual.

[Trieste]

I think it's been long recognized that preventative care is the most cost-effective way to go about medical care. Emergency care, on the other hand, is the most expensive. It only make sense to cut costs by making preventative care accessible to everyone.

[OldSchoolGamer]

The GOP (if it gets the White House) will repeal all of the consumer protections but keep the individual mandate.  More money for their corporate masters that way.

[Trieste]

I sincerely think that they have a very narrow window of opportunity. I think that once Americans get a taste of what it's like to have the kind of modern medical coverage that we deserve nationwide - and the corresponding drop in wait times at the ER, etc - there will be very little national talk of 'repeal and replace'.

[Callie Del Noire]

I sincerely think that they have a very narrow window of opportunity. I think that once Americans get a taste of what it's like to have the kind of modern medical coverage that we deserve nationwide - and the corresponding drop in wait times at the ER, etc - there will be very little national talk of 'repeal and replace'.

Like the guys in charage of the GOP will care. They don't answer to their voters.. they answer to their corporate sponsors.

[Trieste]

I'm disheartened by the political climate we're seeing, too, but I do try to remind myself that these people DO need to be voted in, and for that they DO still need at least some support from, ah, Joe the Plumber. ::)

[Callie Del Noire]

I'm disheartened by the political climate we're seeing, too, but I do try to remind myself that these people DO need to be voted in, and for that they DO still need at least some support from, ah, Joe the Plumber. ::)

I know.. but with the truly epic amounts of money, lack of resposibility/oversight the SuperPacs can operate with very little of the truth is being used. They can, and do, use the cut and paste approach to slime their rivals and lie and lie and lie..

And too few of the people I talk to down here bother to do a little due dillagence to find out what is true and what isn't.. and the media is doing everything they can to hide it.

[Serephino]

That bugs the hell out of me too.  People twist words and whatnot so much it's hard to know which way is up.  Also, if you see/hear the same ad over and over again it tends to stick in your mind.  They don't even have to tell us who paid for the ad anymore, so who the hell knows where the money is coming from, and who the politicians will owe favors to.  So many people just sit in front of the TV and believe what they're told.  Five minutes on Facebook will prove that.  I saw this one thing; you know you are a Liberal if...  It was beyond offensive.  Apparently I'm pro- job killing, pro-death panel, and pro-murder.  Whoever posted that garbage believes it.

[Trieste]

There is some research to indicate that it doesn't matter whether they list who paid for it or not. The old adage of "if you hear something often enough, you start to believe it" applies to advertising as well. *shrug*

I don't really discuss politics on Facebook. I have made the conscious decision that my relationships with the people on my friends list mean more to me than internet debating, so I simply don't do it. If a friend makes a post asking for opinions on a topic, I'll state my opinion and then leave it at that. I don't debate on Facebook, at all. Ever.

[Oniya]

Heh.  About half the people on my friends list, I met through political debate online.  Another third are fiber-arts people.  The other sixth (give or take - there's some overlap) is made up of people I've actually met.

[Trieste]

I suspect that if that were the case for me, I'd probably debate more. But almost everyone on my friends list is family or family friends, or contacts made via student senate, or via my theatre troupe, etc. I'd say that there are probably only a handful I don't know in real life on my friends list, and the vast majority of people I keep touch with on FB are people with whom I really prefer to debate in person anyway.

[gaggedLouise]

That bugs the hell out of me too.  People twist words and whatnot so much it's hard to know which way is up.  Also, if you see/hear the same ad over and over again it tends to stick in your mind.  They don't even have to tell us who paid for the ad anymore, so who the hell knows where the money is coming from, and who the politicians will owe favors to.  So many people just sit in front of the TV and believe what they're told.  Five minutes on Facebook will prove that.  I saw this one thing; you know you are a Liberal if...  It was beyond offensive.  Apparently I'm pro- job killing, pro-death panel, and pro-murder.  Whoever posted that garbage believes it.

These days you basically have to do your own fact-checking for much of what the media offers (and never mind consistency!). It used to be the job of the reporters and editing rooms I believe. Well, it makes it more interesting in a way - but more frustrating, too. I've totally lost count of factoids that should have been easy to spot for the media henchmen.

[Pumpkin Seeds]

The interesting thing to me is how many people do not realize they are paying for uninsured healthcare even now.  People do not seem to understand that a hospital must care for all sorts of problems from a population of patients unable to pay or unable to fully pay for their hospital stay.  Many of these problems, which become emergencies and so must be handled by a hospital, could have been caught early and prevented if the patient was allowed to see a clinical physician or nurse practitioner.  Funny how people are denied cheap healthcare in the form of doctor’s appointments, but mandated to have expensive medical care in the form of emergency room visits and hospital stays.

When a hospital has a patient that cannot afford their bill, the cost does not go down and is not absorbed into a magical fund.  The hospital has to pay for the services.  Nurses and doctors have to get paid, medications have to be bought and equipment paid for by the hospital budget.  None of these get cheaper if a patient cannot pay.  Often times the government subsidizes hospitals from their budget through taxes.  Such money could easily go to pay for schools, road improvements, criminal justice, etc.  Since people do not want to pay for “freeloaders,” the tax money meant for other projects is diverted.  Cities cannot function without emergency services and so cannot function without hospitals, so a hospital has to keep its doors open and so the city has to pay.

The other way people pay for this population is through their own insurance company.  A hospital does not get all the funds needed from the government and getting those funds is often a fight.  Insurance companies end up paying the full amount they will cover when that full amount is not required.  Essentially the insurance companies says “We will cover this much” and the hospital says, “What a coincidence that is how much it costs.”  So the insurance company loses money paying the maximum amount for a broken toe and so raises premiums.  Then every month insurance payers have to shell out more money.  Costs go up, premiums go up and the cycle continues.  The middle class, which opponents of the bill say will be crushed by Obamacare, are already crushed because their premiums are high and their coverage is low. 

People are already paying for the uninsured and underinsured.  They just don’t know it and the government is setup to pay in the least cost-effective manner possible.

[Serephino]

I don't debate on facebook either.  With the exception of like three people, I met them all through games.  I add them for the sole purpose of getting free game stuff.  Still, when they post stuff to their walls, I see it.  It makes me not have much faith in humanity.

People don't usually like to bother checking facts.  It was said in the internet or TV, so it must be true.  That's the scary part.  What Pumpkin said is true; everyone is already paying for this.  I have Medicare, which not every doctor accepts.  In fact, the list of doctors who take it is supposedly getting smaller.  The reason for this is their system.  How much they'll pay is set by the government.  There is no negotiation.  They will pay a set amount, and they are allowed to charge the patient a set amount.  I see this on my bills.  It has the amount the doctor/hospital wanted to charge.  Then it has what Medicare paid.  Under that is a deduction called Medicare allowance.  On the very bottom is what they are allowed to charge me.  Sometimes the difference is pretty significant.

I believe someone said somewhere that private insurance companies do the same thing, they just tend to pay a little more.  And of course, since the private company's main goal is profit, they have to charge enough in premiums to make as much profit as possible.  Trying to find a private insurance policy was a nightmare.  Some had limits on many times a year you could go to the doctor.  Some had yearly limits, most had lifetime limits.  Of course, they wouldn't take me anyway.  One honest salesman told us that their system shows I have Medicare Part A, which is mandatory, which means there's something wrong with me.  They don't feel they'd be able to profit off me, so they won't take me, even though I was trying to find better coverage than Medicrap. 

[MasterMischief]

The popularity of Fox News scares the crap out of me.  Those millions of viewers either believe it or want to believe it.  I can not believe that a large enough percentage just watch for amusement.

[Callie Del Noire]

The popularity of Fox News scares the crap out of me.  Those millions of viewers either believe it or want to believe it.  I can not believe that a large enough percentage just watch for amusement.

I realized Fox News was moral conservative cool aide a long time ago.

[Quiksilver]

health insurance just like almost all other insurances is a product usually provided by a private company.  like any product it should be our right weather we chose to buy or not buy. with obama care we get penalized if we say no.  thats 500 dollars that alot of people dont have. 

[Oniya]

If you are below a certain income level, your cost to buy health insurance under ACA is either waived or put on a sliding scale.  Having health insurance can and does make the difference between people getting treatable conditions treated in a timely manner or waiting until they become even more devastating - either in monetary costs or in paying the ultimate price. 

Are you telling me you would rather pay for an amputation instead of insurance that would cover prescription insulin doses?  Or pay for an angioplasty instead of insurance that covers prescription blood pressure/cholesterol medications?