Tag Archives: Affordable Care Act

Mo Brooks is the man

Mo Brooks (R, AL-95) has filed a bill to repeal the Affordable Care Act. The entirety of the bill reads as follows:

Effective as of Dec. 31, 2017, the Patient Protection and Affordable Care Act is repealed, and the provisions of law amended or repealed by such Act are restored or revived as if such Act had not been enacted,

MoBrooks
It’s clear to me that Mo Brooks is my kind of guy. Just a few weeks ago I suggested that a true repeal bill would read, “The ACA is hereby repealed.” See? Great minds really do think alike.

Unsurprisingly, Brooks is a member of the House Freedom Caucus.

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Dear Paul Ryan

Paul – can I call you Paul? – it’s a good thing you’re such a likeable guy; otherwise, I could really get to loathe you. For the past several years, you’ve been talking about repealing the Affordable Care Act. Silly me, I thought you had a plan. Instead, you introduced ACA-Lite and what a disappointment that turned out to be.

I feel like you were just stringing me along and then jilted me at the altar.

jilted-bride

Being in denial, and what jilted bride isn’t, I watched your infomercial. You know, the one with the whiteboard? I like the way you rolled up your sleeves, to show how you were really getting down to work.

paul ryan infomercial

Let’s just say I remain unconvinced. Maybe the Continuous Health Insurance Coverage Incentive sounds good to you, but it sure sounds an awful lot like the Individual Shared Responsibility Payment. Maybe tax credits really are better than subsidized premiums, but not being all policy-wonkish, I’m not seeing it. It all sounds like spreading the wealth around to me.

And what was that all about when you said, “This is the closest we will ever get to repealing and replacing Obamacare?” I’ve heard something like that before…let me think…Right, I’ve got it. It was at the used car dealership, when the smarmy sales guy told me that if I went to pee, the deal was off the table.

Here’s the thing, Paul. I want to believe that AHCA is an improvement over ACA, but I haven’t found anyone yet who can explain to me why it’s better. And, let me tell you, the CBO report didn’t help you out any, despite their dubious credibility.

smarmy car salesmanYour “Three Phase Plan” isn’t fooling anyone, either. “We have to pass the plan in order to find out…” Oh, wait. That was a different plan. It kind of has the same feel, though. “We have to pass this steaming pile of crap in order to get to the good stuff.” Okay, sure. I suppose Tom Price can be trusted to hold up his end of the deal, but tell me this: If you have to pass Phase 1 through reconciliation because you don’t have the votes, how do you propose to pass the legislation of Phase 3? I don’t see how that works.

So, Paul, to sell me – and probably millions of other conservatives like me – you either need to be able to explain the “benefits” of your plan in language that I can understand or you need to toss the whole thing in the trash and start over. At this point, I prefer the latter.

Love,

Me

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ACA-Lite

Update below.

There’s no graceful way to ease into this, so I’ll just dig right in.

  1. Paul Ryan

    That face you make when your eight-year plan is found wanting.

    The mandate and it’s odious and dubious ‘tax,’ have been renamed the “Continuous Health Insurance Coverage Incentive” and the payee changed from the federal government to insurance companies(!). It’s a misnomer to call it an incentive as it’s actually a disincentive for people to allow their coverage to lapse. Those who do so for a period of greater than 63 days are subject to a 30% premium penalty for the following year.* And it’s not an option for the insurance companies; they “shall” charge the penalty.

  2. The plan keeps the so-called Cadillac tax on premium insurance plans. Sure, you can have really excellent coverage, but in addition to higher premiums, you’re going to be paying the government for the privilege.
  3. Subsidies have been reinvented as refundable tax credits for low and middle income families. Leaving aside the obvious point that unless everyone receiving them is actually paying taxes (think Earned Income Credit), the need for this alone is an admission by the House GOP that under their plan, premiums are still going to be unaffordable, even for middle income families.
  4. The bill “dismantles” all of the ACA’s taxes including those on on prescription drugs, over-the-counter medications, health-insurance premiums (unless, of course, you want a plan that’s better than they think you really need), and medical devices. Here’s the “but”…it includes a 1.45% income tax increase to make up for them. This may seem like a net win to some people, but for healthy individuals whose employers pay their insurance premiums (and they are out there), this will be a tax increase.
  5. The plan does defund Planned Parenthood, but if they thought this bone would be enough to satisfy their traditional base, they are sadly mistaken. And here’s another thing: nothing under the plan would prevent insurance companies from offering abortion coverage, “…so long as premiums for such separate coverage or plan are not paid for with any amount attributable to the credit allowed under this section…” Paul Ryan has been telling us for years with regard to government funding of Planned Parenthood that money is fungible. Except for when it’s not, apparently.
  6. Under the plan, Health Savings Accounts come roaring back. Unfortunately, that’s the only nod to market-based solutions included. HSAs are great, but they aren’t for everyone and I’m left with the impression that the authors of the legislation offer them as the one-size-fits-all solution to all our problems.

Those are my specific concerns, but there are some undercurrents that I also find troubling, such as having to report my health insurance information to the IRS (disclaimer: I want the IRS abolished, not given more power over my life) and language that implies that the federal government will still be deciding what kinds of plans and coverage should or must be offered.

When the plan first became available yesterday afternoon, I was nearly apoplectic over it. Right or wrong, I expected more from House Republicans. I was especially disappointed to see my Congresswoman, Cathy McMorris Rodgers, defending this stinking pile like she was offering up filet mignon. It’s rather depressing that after eight years of talking about it, this is the best plan they could offer.

This isn’t a repeal in any meaningful sense of the word and I find it rather insulting that House Republicans would try to pass it off that way. We are not so stupid that we can’t see what’s right before our eyes and the GOP shouldn’t think for a second that the passion that inspired the Tea Party can’t be turned against them.

Update: Now we’re hearing about phases 2 and 3, which will supposedly remove state line restrictions and promote competition. You know what, GOP? I’m not buying it. You wasted your last bit of credibility with phase 1.


*I’m not an insurance expert and I’m sure as heck not a legal expert, so the language surrounding the duration of the premium penalty is confusing to me. That’s the long way of saying that I just guessed that the penalty was to be assessed for 12 months. Here’s the actual language so you can see for yourself. If you’re crazy enough to want to read it for yourself, it’s on page 62.

2017-03-07 (2)

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Filed under Health Care, Washington

When Will You Fight?

Still, if you will not fight for the right when you can easily win without bloodshed; 

If you will not fight when your victory will be sure and not too costly;

You may come to the moment when you will have to fight with all the odds against you and only a precarious chance of survival.

There may even be a worse case. You may have to fight when there is no hope of victory, because it is better to perish than live as slaves. 

~Winston Churchill

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Selling Obamacare

Not only are you paying for Obamacare in concrete and immediate ways with higher taxes, and skyrocketing insurance premiums (by the way, Jonathan Gruber is a lying SOB or too stupid to be associated with MIT), you’re also paying in ways for which the bill may not come due for decades, by killing medical innovation and decreasing the desirability of medicine as a profession.

But there’s one more way you’ll be paying that even the most pessimistic probably hadn’t anticipated: A $20 million PR campaign to sell the benefits of Obamacare to a recalcitrant public. The Obama Administration: Screwing the American taxpayer every day.

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