where is our replacement for the ACA?

[djAdvocate]

so, several posters hate it. 
that's great.
you might want to see what was promised, here:

1) universal coverage.  that's right.  not 10% uninsured.  universal.
2) keeping the exchanges.  he promised that this week.
3) "you can keep your doctor".  that's right.  can't remember where i heard that before.
4) "you can buy whatever insurance you want".  ditto
5) expanding medicaid.  good luck with that.  the GOP generally hates this idea.
6) ending the universal mandate.  that's nice, but where is the funding mechanism?  if there is no funding mechanism, we have a word for that: UNFUNDED MANDATE.

so, what i see here is a list of A rated, expensive proposals, and no means of funding it.

time for some John Oliver:



there are only two possible outcomes, imo:

1) a disaster that makes the ACA seem hilariously cheap by comparison
2) nothing, and the ACA goes rolling merrily along.

have at it, Mr. President.  i just bought a 50 lb sack of popcorn kernels. 

[Rukh O'Rorke]

I'll take mine lightly salted with a bit of chili powder

[Rob Base 2.0]

They don't have a clue. They screwed the pooch in this one. I am hoping they just repeal it.

[busymom]

No to the repeal.  That's a guaranteed way for 20 million people to lose their insurance.  (And, that's a LOT of votes.)


It's incredibly short-sighted to even consider getting rid of the ACA without having another plan up & running. 

[dondub]

Those 20 million that now have insurance are part and parcel why the conservatives think the ACA is a total failure so big deal when they don't and start dying again.

Pro life just ain't what it used to be.

[djAdvocate]

Mar 1, 2017 22:35:15 GMT -5 Rob Base 2.0 said:

They don't have a clue. They screwed the pooch in this one. I am hoping they just repeal it.

why?  so 20M people can lose their insurance?

[Opti]

Mar 1, 2017 23:06:25 GMT -5 djAdvocate said:

Mar 1, 2017 22:35:15 GMT -5 Rob Base 2.0 said:

They don't have a clue. They screwed the pooch in this one. I am hoping they just repeal it.

why?  so 20M people can lose their insurance?

Because some folks really believe they'll keep more of their income because less will be going to taxes ... after all its not like we are going to build a big expensive wall, try to fight ISIS ourselves(new war to be funded) or build up the world's largest military compared to capita .....

Are you sure you got enough popcorn?

[OldCoyote]

How successful has ACA been?? How about here in AZ where the premiums went up 116% and we are down to one insurer!
 

[djAdvocate]

Mar 1, 2017 23:31:02 GMT -5 OldCoyote said:

How successful has ACA been?? How about here in AZ where the premiums went up 116% and we are down to one insurer!
 

this question was not about the ACA, bro.  it was about it's replacement.  focus.

[Opti]

Mar 1, 2017 23:31:02 GMT -5 OldCoyote said:

How successful has ACA been?? How about here in AZ where the premiums went up 116% and we are down to one insurer!
 

I can't speak for anyone but myself. But I work a high stress PT job and have for years. I finally got to go see the dentist because of ACA. I had been without medical care for 10 years prior to ACA except for a small couple month stretch ... because of a FT gig from a company run by Mormons. We got paid healthcare whether we liked it or not.

Premiums have gone up in fits and starts during my entire lifetime. Unlike some, I will not fully blame ACA for that. I worked for a Pharma company before I started my downscale life in the below median income desert. I had to pay full retail for pharma drugs and then get reimbursed. It did not make me want to have America fund pharma drug research for the world nor did it make we want to join the company sponsored PAC. Again, I can't speak for anyone but myself, but I've been watching premiums and wanting healthcare for decades. Your belief is much different than my personal experience and different from the experience of other downscaled former professionals that I know. YMMV.

NJ has more than one insurer. Maybe the problem is conservative AZ.

[Deleted]

Mar 1, 2017 23:31:02 GMT -5 OldCoyote said:

How successful has ACA been?? How about here in AZ where the premiums went up 116% and we are down to one insurer!
 

Must be nice...

As of next year, Tennessee will be down to NO insurers (on the Healthcare.gov website) in some "regions" (including mine)... if nothing changes.

[Deleted]

I've said it before and I'll probably say it again. The can't JUST repeal it at this point. It would be a disaster... just of a different kind.

No. At this point it MUST BE replaced with something that actually works.

[Rob Base 2.0]

Dudes it's not worth a conversation because 80 % of you here are not interested in a conversation. You are interested in a monologue or talking to your echo chamber.

[OldCoyote]

ACA (aka) Obamacare...

Do you remember, this was shoved thru as a cure all for "ALL" ills,,,,

Now that has done exactly what the Repos said would happen,,, it is the Repos fault!

Now that all the pressure is being put on this administration to create the next thing that will most likely fail!

As long as there are no measures to control medical cost, nothing will work!

Open the borders to proscription drug sales, If you need surgery, allow your medical dollars to be spent in places like India.

Where you can stay in a hospital that resemble a five star hotel with American trained Dr.s!

When the American medical and drug sales gets some competition the prices will drop.

[thyme4change]

Don't worry - HSA's and opening the exchange across state lines will solve everything.  Even though there is no fucking way just about anyone can save enough in an HSA to receive major care - and most people won't even be able to save enough to have one simple operation.  And, there are states who have opened to using any plans that want to come on in and zero plans hopped in.  Even conservative think tanks are saying that although it won't hurt anything, it won't resolve the problems.

[Deleted]

Single payer, High Deductible Health Plans for all with HSA limits up to the deductible. Medicaid still exists for those that can't pay to the deductible.

I think people that can afford it should have to pay something but I also think someone shouldn't be bankrupted for medical issues.

We also as a society have to have a discussion about end of life care:

"One out of every four Medicare dollars, more than $125 billion, is spent on services for the 5% of beneficiaries in their last year of life. Yet even with Medicare or private insurance, you're likely to face a big bill: A recent Mount Sinai School of Medicine study found that out-of-pocket expenses for Medicare recipients during the five years before their death averaged about $39,000 for individuals, $51,000 for couples, and up to $66,000 for people with long-term illnesses like Alzheimer's."


time.com/money/2793643/cutting-the-high-cost-of-end-of-life-care/

[thyme4change]

Just replicate the very messed up VA and anyone can walk in and get care at no cost. Transition all Medicare and Medicaid people to that plan and us rich people can still buy insurance and go to private doctors and hospitals. Big companies will still offer insurance to attract workers.

I'm pretty sure that will make just about everyone unhappy, that is the only equitable solution.

[busymom]

The ACA was embraced by my state, and a lot of people signed on here.   And yes, the costs have gone up, but the cost of health insurance has risen quickly here even before the ACA.  IMHO, it's the insurance companies who profit on the policies that are the problem, not the ACA.  I suspect we might have single payer insurance in my lifetime.  

But in the meantime, for all of the people the ACA has helped, lets not "throw out the baby with the bath water". Ideally, we should keep the good parts of the program, and focus on reducing the cost.

[swamp]

Mar 2, 2017 8:34:32 GMT -5 OldCoyote said:

ACA (aka) Obamacare...

Do you remember, this was shoved thru as a cure all for "ALL" ills,,,,

Now that has done exactly what the Repos said would happen,,, it is the Repos fault!

Now that all the pressure is being put on this administration to create the next thing that will most likely fail!

As long as there are no measures to control medical cost, nothing will work!

Open the borders to proscription drug sales, If you need surgery, allow your medical dollars to be spent in places like India.

Where you can stay in a hospital that resemble a five star hotel with American trained Dr.s!

When the American medical and drug sales gets some competition the prices will drop.

thank you for  your rant.

now what alternative are you suggesting?

[Rukh O'Rorke]

Mar 1, 2017 23:31:02 GMT -5 OldCoyote said:

How successful has ACA been?? How about here in AZ where the premiums went up 116% and we are down to one insurer!
 

That seems unfortunate. Why did the other insurers pull out?

and can you explain why no insurers is better than one? (no ACA)

Is that one insurer only for ACA? If someone is buying private insurance - are there more options? And what kind of employer plans are still available?

[Rukh O'Rorke]

Mar 2, 2017 9:42:23 GMT -5 thyme4change said:

Just replicate the very messed up VA and anyone can walk in and get care at no cost. Transition all Medicare and Medicaid people to that plan and us rich people can still buy insurance and go to private doctors and hospitals. Big companies will still offer insurance to attract workers.

I'm pretty sure that will make just about everyone unhappy, that is the only equitable solution.

given issues with the care some received under the VA - I'm not sure that is a good answer.

aj seemed to have a reasonable outline there, a place to start perhaps.

What was in John McCain's health care plan? I know it was portable, and I thought it was good at the time. I wasn't sure if it would work as I felt we had gone too far down one avenue already with sprialling costs, and such, but I was willing to give it a try. But I think we are headed for single payer eventually, and now - I think that may be not only inevitable, but for the best.

We need to work in a manner that is going to maintain the standards for patient care, and medical innovation. And that may be the tough part.

[djAdvocate]

Mar 2, 2017 8:00:04 GMT -5 Rob Base 2.0 said:

Dudes it's not worth a conversation because 80 % of you here are not interested in a conversation. You are interested in a monologue or talking to your echo chamber.

i started this thread, and i am interested in a conversation.  but i doubt i will get one.

make all the excuses you like, tho.    we all realize that you are talking about yourself.

[djAdvocate]

Mar 2, 2017 8:53:19 GMT -5 thyme4change said:

Don't worry - HSA's and opening the exchange across state lines will solve everything.  Even though there is no fucking way just about anyone can save enough in an HSA to receive major care - and most people won't even be able to save enough to have one simple operation.  And, there are states who have opened to using any plans that want to come on in and zero plans hopped in.  Even conservative think tanks are saying that although it won't hurt anything, it won't resolve the problems.

when Ryan talks, he talks from the perspective of someone who has no problems getting insured.

that's precisely the problem, tho, isn't it?  one needs to adopt the perspective of someone who can't afford insurance to have even the faintest idea of how to fix this.

[djAdvocate]

Mar 2, 2017 10:16:28 GMT -5 Rukh O'Rorke said:

Mar 1, 2017 23:31:02 GMT -5 OldCoyote said:

How successful has ACA been?? How about here in AZ where the premiums went up 116% and we are down to one insurer!
 

That seems unfortunate. Why did the other insurers pull out?

and can you explain why no insurers is better than one? (no ACA)

Is that one insurer only for ACA? If someone is buying private insurance - are there more options? And what kind of employer plans are still available?

no.  AZ had very low participation rates, and therefore no insurers wanted to step in under the ACA.  private insurance is robust, and costs have risen less dramatically than at any decade in (recorded) history.  but none of these facts matter to those that have no interest in fixing the system or supporting modest reform.

[busymom]

I think the quickest way to get any good health care plan up & running is for our politicians to lose their "golden" health care plans.  Once they see what the rest of us go through to get adequate coverage, health care would suddenly become their top priority.  

[djAdvocate]

Mar 2, 2017 10:44:23 GMT -5 busymom said:

I think the quickest way to get any good health care plan up & running is for our politicians to lose their "golden" health care plans.  Once they see what the rest of us go through to get adequate coverage, health care would suddenly become their top priority.  

i don't think even that would do it.  if they were forced to join the ACA, it would work no better than the private market.  they don't care about the cost, because they are members of the elite, and they have no issues with the cost of healthcare itself, let alone insurance.

maybe they should be forced to spend a year abroad in someplace like Italy, where things are vastly better.

[dezailoooooo]

Mar 1, 2017 22:35:15 GMT -5 Rob Base 2.0 said:

They don't have a clue. They screwed the pooch in this one. I am hoping they just repeal it.

and replace it or just forget it and those who lose the coverege for themselves , loved ones...just go suck lemons?  just asking...

[buystoys]

Mar 2, 2017 10:16:28 GMT -5 Rukh O'Rorke said:

Mar 1, 2017 23:31:02 GMT -5 OldCoyote said:

How successful has ACA been?? How about here in AZ where the premiums went up 116% and we are down to one insurer!
 

That seems unfortunate. Why did the other insurers pull out?

and can you explain why no insurers is better than one? (no ACA)

Is that one insurer only for ACA? If someone is buying private insurance - are there more options? And what kind of employer plans are still available?

I can't definitively answer why other insurers pulled out, but my suspicion is that the mandate "guaranteed" a profit that wasn't possible in many counties.  ACA insurance is set up to be purchased based on the county you live in, not the state you live in.  So, if 51% of the counties only had a 5% profit and the "guarantee" was 6%, the insurer had grounds to pull out of that state all together in the offering of individual policies.

Arizona was a signal to everyone who is stuck with purchasing individual policies.  There WERE no insurers for several counties (17, I think?) until two weeks before enrollment opened.  So, even with ACA all those people would have had no plan available.  The one insurer only became available because the state approved their huge premium increase of 116%.

I can't buy insurance from anyone who isn't on Healthcare.gov in my Texas county.  I looked.  There is only one insurer providing coverage in my county and they will only offer an HMO plan.  Since there is no competition, I have no choice but to pay whatever they choose to charge if I want coverage.  Large employers were never part of Healthcare.gov, so I'm not clear on what you are asking in your final question.

I'm glossing over details here as there are just too many to include and make a response legible. 

[NastyWoman]

Mar 1, 2017 23:12:19 GMT -5 Opti said:

Mar 1, 2017 23:06:25 GMT -5 djAdvocate said:

why?  so 20M people can lose their insurance?

Because some folks really believe they'll keep more of their income because less will be going to taxes ... after all its not like we are going to build a big expensive wall, try to fight ISIS ourselves(new war to be funded) or build up the world's largest military compared to capita .....

Are you sure you got enough popcorn?

ISIS? Isn't that a thing of the past yet? Didn't dt promise to rid the world of ISIS within his first 30 days on the job? We should have plenty of money now, so of course cancelling 20M people's healthcare insurance will mean that I can keep a big chunk of money that previously went to taxes. Alternative math tells me so 

[dezailoooooo]

Mar 1, 2017 23:31:02 GMT -5 OldCoyote said:

How successful has ACA been?? How about here in AZ where the premiums went up 116% and we are down to one insurer!
 

old...no one said there are no problems...there are...not all States are like Az....the program needs fixing but as some experts have said...overall program is good but repairs some changes need to be made...health insurence is always going to be expensive up there with a monthly rent or mortgage payment, car payment.....especially if working and no employer contribution.....it will never go back to what I was use to when workinhg..employer contributions very good...basically a 80/20  deal..ins paid 80%...individual responsible for 20% of the cost....that deal is long gone...never to come back.

Pubs problem is for eight years they have been screaming against Obama  Care with no thought really of coming up with replacement coverage ...now stuck where they are....take away coverage for 20 million...they really think all those folks are Democrats..??...Sure they are....all those miners with lung diseases....all those out in the midlands who were out of work...collecting food stamps ..unemployment benefits....If u believe that there is that bridge in Brooklyn u might be interested in purchasing...let me show u around.