What comes after the ACA?

[Gin1984]

Anyway, we could buy meds through our health insurance and resell.  Very low risk, cash agreed with people who paid much more on their own...

I don't get it... is this legal? How does it work?

No, it is not legal at all.

[JustGettingStarted1980]

Anyway, we could buy meds through our health insurance and resell.  Very low risk, cash agreed with people who paid much more on their own...

I don't get it... is this legal? How does it work?

No, it is not legal at all.


How is this not insurance fraud?

[EscapeVelocity2020]

Bizarre post sure, but that's how I roll, I just prefer to call it thinking outside the box :)  Like I prefaced, I've been on vacation for a while (and was catching up on bits and pieces of threads that I follow, so I kinda threw a bunch of thoughts together into this one post).  I've seen people calling it insurance fraud, but I'm interested exactly how this is the case... 

For a hypothetical example, we have neighbors with cheap insurance and pay $400/mo for a common medication.  I can get the exact thing for $50/mo and can also get a monthly perscription by asking for it (as I said, it is a common med and most dr's prescribe if you claim to need it - nothing 'abusable' like opioids, but say something like allergy, heart, or other 'maintainance' meds that are unreasonably expensive).  So out of the kindness of my heart, I buy it for myself and sell some of it to them for a very reasonable $100/mo.  I'm not doing this (just like I'm not piggybacking my credit or taking government subsidies that I don't need (see the RootofGood AMA on Reddit for that discussion)), but I also don't see how it is insurance fraud (and also don't see how I'd ever get caught, but that is beside the point).  Maybe it is on the borderline of being unethical, but that is a whole other discussion...

[protostache]

Bizarre post sure, but that's how I roll, I just prefer to call it thinking outside the box :)  Like I prefaced, I've been on vacation for a while (and was catching up on bits and pieces of threads that I follow, so I kinda threw a bunch of thoughts together into this one post).  I've seen people calling it insurance fraud, but I'm interested exactly how this is the case... 

For a hypothetical example, we have neighbors with cheap insurance and pay $400/mo for a common medication.  I can get the exact thing for $50/mo and can also get a monthly perscription by asking for it (as I said, it is a common med and most dr's prescribe if you claim to need it - nothing 'abusable' like opioids, but say something like allergy, heart, or other 'maintainance' meds that are unreasonably expensive).  So out of the kindness of my heart, I buy it for myself and sell some of it to them for a very reasonable $100/mo.  I'm not doing this (just like I'm not piggybacking my credit or taking government subsidies that I don't need (see the RootofGood AMA on Reddit for that discussion)), but I also don't see how it is insurance fraud (and also don't see how I'd ever get caught, but that is beside the point).  Maybe it is on the borderline of being unethical, but that is a whole other discussion...

It's the very definition of fraud. You don't need the medication but you lie to your doctor so they write you a scrip for it. Then you take that scrip and buy the medication using the insurance discount, thus defrauding the insurance company.

Prescription medication is always intended to be used by the person who's name is on the scrip and it's illegal to distribute prescription drugs without a license to do so, so you're actually committing at least two crimes with your scheme.

[GenXbiker]

It's the very definition of fraud. You don't need the medication but you lie to your doctor so they write you a scrip for it. Then you take that scrip and buy the medication using the insurance discount, thus defrauding the insurance company.

Prescription medication is always intended to be used by the person who's name is on the scrip and it's illegal to distribute prescription drugs without a license to do so, so you're actually committing at least two crimes with your scheme.

That's what I was thinking as well.  Craziness.

[protostache]

Bizarre post sure, but that's how I roll, I just prefer to call it thinking outside the box :)  Like I prefaced, I've been on vacation for a while (and was catching up on bits and pieces of threads that I follow, so I kinda threw a bunch of thoughts together into this one post).  I've seen people calling it insurance fraud, but I'm interested exactly how this is the case... 

For a hypothetical example, we have neighbors with cheap insurance and pay $400/mo for a common medication.  I can get the exact thing for $50/mo and can also get a monthly perscription by asking for it (as I said, it is a common med and most dr's prescribe if you claim to need it - nothing 'abusable' like opioids, but say something like allergy, heart, or other 'maintainance' meds that are unreasonably expensive).  So out of the kindness of my heart, I buy it for myself and sell some of it to them for a very reasonable $100/mo.  I'm not doing this (just like I'm not piggybacking my credit or taking government subsidies that I don't need (see the RootofGood AMA on Reddit for that discussion)), but I also don't see how it is insurance fraud (and also don't see how I'd ever get caught, but that is beside the point).  Maybe it is on the borderline of being unethical, but that is a whole other discussion...

What does this have to do with the ACA healthcare debate?

Absolutely nothing, but there's nothing going on with the ACA healthcare debate so why not foam it up a bit? :)

[EscapeVelocity2020]

Yeah, sorry, I'll lay off my nonsequiters.  Thanks for the responses.

[DavidAnnArbor]

Does enrollment for the 2018 year start in November ?

[jim555]

Does enrollment for the 2018 year start in November ?

November 1 through December 15, 2017, they propose to narrow the window by half.

[Monkey Uncle]

Well, now there's something to talk about.  Seems the head freedummy is actually entertaining stabilizing the ACA.

http://www.msn.com/en-us/news/politics/conservative-chairman-in-talks-about-obamacare-stabilization-deal/ar-AApTbPM

[nereo]

They have to do something, I would love it if they tinker with obamacare enough that they can claim victory, while the reality is not much changes or it actually improves as they stop undermining it.

The GOP freedom caucus is rattling their sabers again, asking for a strait repeal vote.  Zombie bill still isn't dead.

The (perhaps only) way forward seems obvious now - tweak the ACA enough so that it's stable, declare victory (we fixed it!), deny it's still Obamacare (our's is much better... even though we kept most things the same) and go home (to less caustic town hall meetings).

[EnjoyIt]

They have to do something, I would love it if they tinker with obamacare enough that they can claim victory, while the reality is not much changes or it actually improves as they stop undermining it.

The GOP freedom caucus is rattling their sabers again, asking for a strait repeal vote.  Zombie bill still isn't dead.

The (perhaps only) way forward seems obvious now - tweak the ACA enough so that it's stable, declare victory (we fixed it!), deny it's still Obamacare (our's is much better... even though we kept most things the same) and go home (to less caustic town hall meetings).

How do you tinker with it?  What do you add? Only way to fix it is either add laws that somehow decrease cost or tax people more to fund it.  Neither will go through because republicans hate increasing taxes and lobbyist will not allow cutting costs.  Nothing will change unless republicans work with the democrats and ignore the lobbyists.

[nereo]

They have to do something, I would love it if they tinker with obamacare enough that they can claim victory, while the reality is not much changes or it actually improves as they stop undermining it.

The GOP freedom caucus is rattling their sabers again, asking for a strait repeal vote.  Zombie bill still isn't dead.

The (perhaps only) way forward seems obvious now - tweak the ACA enough so that it's stable, declare victory (we fixed it!), deny it's still Obamacare (our's is much better... even though we kept most things the same) and go home (to less caustic town hall meetings).

How do you tinker with it?  What do you add? Only way to fix it is either add laws that somehow decrease cost or tax people more to fund it.  Neither will go through because republicans hate increasing taxes and lobbyist will not allow cutting costs.  Nothing will change unless republicans work with the democrats and ignore the lobbyists.

seems the answer is in your question.  I think a few dozen Dems would definitely work with the GOP to maintain the ACA.  Ironically both could go back to their home districts and declare victory (Dems: "we saved it, even in the face of total GOP control" / GOP: "We fixed it!").
Republicans love to talk about deficit cutting and fiscal responsibility but have done the exact opposite for at least the last two decades.

[protostache]

CBO released their estimate of what would happen if the President decided to stop paying CSRs on January 1st 2018.

Summary:

• Gross premiums for Silver plans offered through the marketplace would increase 20%-25% but net premiums would stay the same because the only people buying those plans would be people eligible for cost sharing reductions. Others would either buy Bronze or Gold on-exchange with their increased premium subsidies or off-exchange Silver which CBO is projecting insurance commissioners will allow to have a different rate than on-exchange (i.e. the Silver Switcharoo).
• Federal deficits would increase by $6 billion in 2018, $21 billion in 2020, and $26 billion in 2026, for a total of $194 billion over the 2017–2026 period.
• The number of people uninsured would be slightly higher in 2018 but slightly lower starting in 2020.

[AdrianC]

As expected:

Obamacare plans in Ohio to cost 34 percent more on average in 2018
http://www.journal-news.com/news/local/obamacare-plans-ohio-cost-percent-more-average-2018/TRrCVV3lswotkXCMBOEXiK/

About 11 percent of the increase is because the Ohio Department of Insurance required insurance companies to assume that the payments, called cost sharing reduction payments, will end. The Trump administration is now deciding on a month-to-month basis whether to make the payments and so far has continued to make them.

Christopher Brock, spokesman for the Ohio department, said the reason his office made insurers assume the federal subsidies will end is because if the payments were to suddenly stop, and insurance companies no longer had that money to help offer lower prices on deductibles and co-payments, then the insurance companies would either have to take a loss or suddenly drop out.

“That’s not good for the consumer and it’s certainly not good for the market as well,” he said.

Interesting that the Department of Insurance is requiring the companies to assume CSRs will end.

[NoStacheOhio]

As expected:

Obamacare plans in Ohio to cost 34 percent more on average in 2018
http://www.journal-news.com/news/local/obamacare-plans-ohio-cost-percent-more-average-2018/TRrCVV3lswotkXCMBOEXiK/

About 11 percent of the increase is because the Ohio Department of Insurance required insurance companies to assume that the payments, called cost sharing reduction payments, will end. The Trump administration is now deciding on a month-to-month basis whether to make the payments and so far has continued to make them.

Christopher Brock, spokesman for the Ohio department, said the reason his office made insurers assume the federal subsidies will end is because if the payments were to suddenly stop, and insurance companies no longer had that money to help offer lower prices on deductibles and co-payments, then the insurance companies would either have to take a loss or suddenly drop out.

“That’s not good for the consumer and it’s certainly not good for the market as well,” he said.

Interesting that the Department of Insurance is requiring the companies to assume CSRs will end.

If the CSRs don't end, don't consumers get a refund at the end of the year?

[DavidAnnArbor]

Wow that's a big jump, and if you don't get subsidies it really is a screwover.

[sol]

An alternative headline for that story could be "Ohio Department of Insurance raises taxes on Ohioans".  First paragraph:  In an attempt to curry political favor in Washington DC, The Ohio Department of Insurance has asked hard working Ohioans to pay additional taxes this year.  The increased tax burden will likely be refunded at the end of the year unless the President decides to make the tax increase permanent by ending the Affordable Care Act's cost-sharing provisions.

As expected:

Obamacare plans in Ohio to cost 34 percent more on average in 2018
http://www.journal-news.com/news/local/obamacare-plans-ohio-cost-percent-more-average-2018/TRrCVV3lswotkXCMBOEXiK/

About 11 percent of the increase is because the Ohio Department of Insurance required insurance companies to assume that the payments, called cost sharing reduction payments, will end. The Trump administration is now deciding on a month-to-month basis whether to make the payments and so far has continued to make them.

Christopher Brock, spokesman for the Ohio department, said the reason his office made insurers assume the federal subsidies will end is because if the payments were to suddenly stop, and insurance companies no longer had that money to help offer lower prices on deductibles and co-payments, then the insurance companies would either have to take a loss or suddenly drop out.

“That’s not good for the consumer and it’s certainly not good for the market as well,” he said.

Interesting that the Department of Insurance is requiring the companies to assume CSRs will end.

[NoStacheOhio]

An alternative headline for that story could be "Ohio Department of Insurance raises taxes on Ohioans".  First paragraph:  In an attempt to curry political favor in Washington DC, The Ohio Department of Insurance has asked hard working Ohioans to pay additional taxes this year.  The increased tax burden will likely be refunded at the end of the year unless the President decides to make the tax increase permanent by ending the Affordable Care Act's cost-sharing provisions.

I'm going to defend the Dept. of Insurance here a little bit, because I don't see it as an attempt to influence Washington one way or the other. Their stated reasoning is sound. A midyear change like this would be catastrophic to the system as a whole, and healthcare is huge in Ohio (Cleveland, Columbus and Cincinnati all have major national hospitals, at least one of which is one of the five largest employers in the state).

Yes, raising premiums on individuals/families because of political bullshit sucks hard. If that's the (refundable?) cost for avoiding a meltdown then so be it. This is a symptom of the larger problem, and the public is collateral damage.

[Classical_Liberal]

I'm going to defend the Dept. of Insurance here a little bit, because I don't see it as an attempt to influence Washington one way or the other. Their stated reasoning is sound. A midyear change like this would be catastrophic to the system as a whole, and healthcare is huge in Ohio (Cleveland, Columbus and Cincinnati all have major national hospitals, at least one of which is one of the five largest employers in the state).

I agree, this is responsible governance. Too often there is a pass the buck mentality within our government, ignoring glaring problems that have a high likelihood of occurring. Rather than ending up with a budget crisis, raise the cost now, make the people understand that this increase is a direct result of Washington politics.  Citizens (or consumers as we are now called) are "shielded" from political shenanigans until years or decades later when we have to pay the piper for bad decisions now.  Better to do it upfront, directly, know exactly who and what policies are responsible for the added costs. Then let those responsible bite the bullet in the next election cycle, or change their plans when the polls reflect the consequences of their actions.

[sol]

I don't see it responsible governance. States should be able to make financial decisions based current law, and in this case they are instead making decisions because they fear the law will change in the future.

You could just as easily that Ohioans should pay 50% sales tax just in case the state legislature later decides that would be a good idea.  No.  You pay what the law says you should pay, today, and not a penny more.  You can't submit a state budget based on fears of future political shenanigans, you have to base it on what the law actually says.

[protostache]

I don't see it responsible governance. States should be able to make financial decisions based current law, and in this case they are instead making decisions because they fear the law will change in the future.

You could just as easily that Ohioans should pay 50% sales tax just in case the state legislature later decides that would be a good idea.  No.  You pay what the law says you should pay, today, and not a penny more.  You can't submit a state budget based on fears of future political shenanigans, you have to base it on what the law actually says.

This isn't a state budget, though. This is regulated private companies submitting rate change requests. These companies are completely free to drop out of the market if they don't like the situation. Most states had them submit two rate change requests, one with CSRs and one without, and then on Sept 20th they'll sign a contract based on what has happened in the intervening time. Ohio just asked them to plan on CSRs not getting paid, which is shitty, but at the time the rate change rules were put in place there was real fear that they wouldn't be paid at all.

[sol]

at the time the rate change rules were put in place there was real fear that they wouldn't be paid at all.

Right, fear.  Fear that the law would change in the future from what it says right now.  That's no way to run a business, and the state government shouldn't be forcing regulated businesses to operate that way. 

If the state decided to collect an extra 11% B&O tax this year, just because they felt like it, businesses world be outraged.  Why?  Based on what authority?  Because you have a feeling the law might change, and you want to penalize businesses because of your feeling?

[NoStacheOhio]

at the time the rate change rules were put in place there was real fear that they wouldn't be paid at all.

Right, fear.  Fear that the law would change in the future from what it says right now.  That's no way to run a business, and the state government shouldn't be forcing regulated businesses to operate that way. 

If the state decided to collect an extra 11% B&O tax this year, just because they felt like it, businesses world be outraged.  Why?  Based on what authority?  Because you have a feeling the law might change, and you want to penalize businesses because of your feeling?

I think the disconnect is between the "just because they felt like it" and "to avert a catastrophic meltdown of a sector structurally important to the state economy."

[brooklynguy]

Fear that the law would change in the future from what it says right now.

With respect to the cost-sharing reduction payments, it wasn't fear that existing law would change but uncertainty about existing law's actual status.  A federal district court had already held that the CSR payments are unconstitutional (because Congress never passed legislation specifically appropriating the funds to make those payments) and ordered that the payments be stopped, but it stayed the effectiveness of this injunction pending resolution of the case on appeal.  The appeal remains pending, so until the issue is determined in a final, non-appealable court decision (or, alternatively, Congress renders the issue moot by appropriating funds to make the payments), we're stuck in legal limbo.

[protostache]

It's not dead yet.

Cassidy and Graham are whipping really hard right now, but there are quite a few steps left for this and not very much time. The Parliamentarian decided that the budget authorization that would allow repeal to go through reconciliation dies on September 30th at the end of the Federal fiscal year. In addition, the House is on recess until the 25th. I'm not 100% sure but I think the deadline is for the president's signature, not just passage in both houses, so what passes in the Senate is basically what would pass in the House.

It's really bad for every state that expanded Medicaid, so if you have a Republican rep in an expansion state and you don't want this to pass, it's time to lean on them hard.

[nereo]

Meanwhile, B. Sanders is whipping everyone into a frenzy with his "Health Care for All" singlepayer push.

[Monkey Uncle]

Here's an interesting, thoughtful, and non-hysterical examination of the Bernie bill:

http://www.msn.com/en-us/news/opinion/yes-bernie-sanders%e2%80%99s-plan-moves-america-closer-to-single-payer/ar-AArYj4t

Obviously Sanders' bill stands no chance of passing, and we probably should be glad it doesn't, but he's doing a good job of shifting the debate.  What the author doesn't really point out is that republican bumbling on "repeal and replace" is what really changed the conversation.  Nothing like a good over-reach to force things back in the right direction.

[protostache]

Here's an interesting, thoughtful, and non-hysterical examination of the Bernie bill:

http://www.msn.com/en-us/news/opinion/yes-bernie-sanders%e2%80%99s-plan-moves-america-closer-to-single-payer/ar-AArYj4t

Obviously Sanders' bill stands no chance of passing, and we probably should be glad it doesn't, but he's doing a good job of shifting the debate.  What the author doesn't really point out is that republican bumbling on "repeal and replace" is what really changed the conversation.  Nothing like a good over-reach to force things back in the right direction.

I'm actually very interested in the "fallback" plan embedded in the Bernie bill. It contains a full fledged public option that kicks in before Medicare For All is supposed to start. It would let everyone in the whole country younger than 65 buy into Medicare for the average price of care in the under-65 cohort. This would count as a Silver plan so cost sharing reductions and subsidies would apply as well. The existing Medicare network would have to be expanded somewhat because I don't think there are many pediatricians or obstetricians in it now, but that's not a huge problem.

[DavidAnnArbor]

Yes the public option should never have been taken out of the original bill.

[Monkey Uncle]

Yes, I have never forgiven Obama, Pelosi, and Reid for giving up on the public option without a fight.  Whenever someone finally manages to get that in place, I believe it will be the slippery slope that gradually converts the U.S. to public-funded universal care.

[DavidAnnArbor]

Yes, I have never forgiven Obama, Pelosi, and Reid for giving up on the public option without a fight.  Whenever someone finally manages to get that in place, I believe it will be the slippery slope that gradually converts the U.S. to public-funded universal care.

Are you kidding me?  They did fight, but there were 2-3 independents/conservative Dem Senators that hold all the cards. And the Republican Senators were all against the ACA

[jim555]

Looks like they will try one more time to kill the ACA.  They have till Sept 30th. 

[Monkey Uncle]

Yes, I have never forgiven Obama, Pelosi, and Reid for giving up on the public option without a fight.  Whenever someone finally manages to get that in place, I believe it will be the slippery slope that gradually converts the U.S. to public-funded universal care.

Are you kidding me?  They did fight, but there were 2-3 independents/conservative Dem Senators that hold all the cards. And the Republican Senators were all against the ACA

Hmmm, maybe my recollection is hazy, but I don't remember any real debate about the public option.

[DavidAnnArbor]

Yes, I have never forgiven Obama, Pelosi, and Reid for giving up on the public option without a fight.  Whenever someone finally manages to get that in place, I believe it will be the slippery slope that gradually converts the U.S. to public-funded universal care.

Are you kidding me?  They did fight, but there were 2-3 independents/conservative Dem Senators that hold all the cards. And the Republican Senators were all against the ACA

Hmmm, maybe my recollection is hazy, but I don't remember any real debate about the public option.

I remember because I was so angry at Lieberman and one or two others.

[protostache]

Yes, I have never forgiven Obama, Pelosi, and Reid for giving up on the public option without a fight.  Whenever someone finally manages to get that in place, I believe it will be the slippery slope that gradually converts the U.S. to public-funded universal care.

Are you kidding me?  They did fight, but there were 2-3 independents/conservative Dem Senators that hold all the cards. And the Republican Senators were all against the ACA

Hmmm, maybe my recollection is hazy, but I don't remember any real debate about the public option.

I remember because I was so angry at Lieberman and one or two others.

It was complicated and sad (involved Ted Kennedy dying before he could vote for it) but we've litigated already in this thread at least once.

[John122]

Just got a letter from HAP insurance in Michigan (my provider) that they will no longer be offering my insurance next year 2018 for ACA.. they said "We don't believe that raising rates by 52% is fair to any of our members...looks like my rates will be much higher in Michigan next year...
Sucks big time

[DavidAnnArbor]

Just got a letter from HAP insurance in Michigan (my provider) that they will no longer be offering my insurance next year 2018 for ACA.. they said "We don't believe that raising rates by 52% is fair to any of our members...looks like my rates will be much higher in Michigan next year...
Sucks big time

Sorry to hear that. I have Blue Care Network of Michigan and haven't received any letter like that. I know also I'm protected by the subsidies formula.

[brooklynguy]

It's not dead yet.

Cassidy and Graham are whipping really hard right now, but there are quite a few steps left for this and not very much time. The Parliamentarian decided that the budget authorization that would allow repeal to go through reconciliation dies on September 30th at the end of the Federal fiscal year. In addition, the House is on recess until the 25th. I'm not 100% sure but I think the deadline is for the president's signature, not just passage in both houses, so what passes in the Senate is basically what would pass in the House.

It's really bad for every state that expanded Medicaid, so if you have a Republican rep in an expansion state and you don't want this to pass, it's time to lean on them hard.

This threat seems to be growing more serious by the hour.  Arizona's governor just endorsed the bill, which makes it substantially more likely that McCain will vote in its favor.  The CBO also just announced that it will produce a budgetary score by early next week (in time to allow the bill to proceed for a vote before the end-of-month reconciliation deadline) but not provide a deeper qualitative analysis of the effects of the legislation--including its impact on health insurance coverage levels, which is sure to be detrimental--for "at least several weeks" (when it will be too late to impact voting decisions).

[OurTown]

If they pass it, maybe it will be so shitty that a future Congress will have no choice but to fix it and we will get a public option or single payer. 

[geekette]

Meanwhile, the sick get sicker and people go bankrupt.

McCain already backed it, from what I can see.

[thenextguy]

Meanwhile, the sick get sicker and people go bankrupt.

McCain already backed it, from what I can see.

That article is a bit dated. McCain is now pretending to be undecided, but he'll probably back it in the end.

[talltexan]

Here's an interesting, thoughtful, and non-hysterical examination of the Bernie bill:

http://www.msn.com/en-us/news/opinion/yes-bernie-sanders%e2%80%99s-plan-moves-america-closer-to-single-payer/ar-AArYj4t

Obviously Sanders' bill stands no chance of passing, and we probably should be glad it doesn't, but he's doing a good job of shifting the debate.  What the author doesn't really point out is that republican bumbling on "repeal and replace" is what really changed the conversation.  Nothing like a good over-reach to force things back in the right direction.

It's not a good job of shifting debate if it discredits moderates to the point that Graham-Cassidy passes.

[protostache]

Here's an interesting, thoughtful, and non-hysterical examination of the Bernie bill:

http://www.msn.com/en-us/news/opinion/yes-bernie-sanders%e2%80%99s-plan-moves-america-closer-to-single-payer/ar-AArYj4t

Obviously Sanders' bill stands no chance of passing, and we probably should be glad it doesn't, but he's doing a good job of shifting the debate.  What the author doesn't really point out is that republican bumbling on "repeal and replace" is what really changed the conversation.  Nothing like a good over-reach to force things back in the right direction.

It's not a good job of shifting debate if it discredits moderates to the point that Graham-Cassidy passes.

At this point it seems like Sanders' choice to release M4A last week instead of on October 1st was a strategic blunder. Time will tell, though. The math on the Republican votes is basically the same as it was for skinny repeal, except there won't be conference with the House, nor will the House have the opportunity to amend it. If Cassidy-Graham passes the Senate the House is going to put it up for a vote as is.

The math is actually pretty interesting in the House. There are an awful lot of Republican representatives in states that would lose billions of funding. The margin on AHCA was only four votes and there's scuttlebutt that GOP reps have already decided to flip if it comes up.

[nereo]

At this point it seems like Sanders' choice to release M4A last week instead of on October 1st was a strategic blunder. Time will tell, though. The math on the Republican votes is basically the same as it was for skinny repeal, except there won't be conference with the House, nor will the House have the opportunity to amend it. If Cassidy-Graham passes the Senate the House is going to put it up for a vote as is.

The math is actually pretty interesting in the House. There are an awful lot of Republican representatives in states that would lose billions of funding. The margin on AHCA was only four votes and there's scuttlebutt that GOP reps have already decided to flip if it comes up.

Flip in which direction?  GOPers who voted for AHCA flipping against it, or vice versa?

Seems pretty high-stakes to me, particularly for the House. Members from California and NY stand to lose tens of billions in Medicaid funding over the next decade.  15 other states would also see a net loss in funding.  It would be pretty damning to vote for a bill that cuts your state's funding ~6 months before your re-election campaign gets into full swing.

If I were in the House, I'd be pissed at the Senate GOP for throwing this cherry bomb through my window.  Come to think of it, that's not unlike what the House did to teh Senate with the AHCA.  Karma?

Either way the political costs could be enormous.  Members who vote for the bill but are in states who will see their benefits cut risk pissing off their election campaign and possibly blowing a hole in their state's budget. And GOPers who vote "no" will have to explain how 8 years of "repeal and repalce" couldn't be accomplished despite controlling all arms of the government.  Again. 

[protostache]

At this point it seems like Sanders' choice to release M4A last week instead of on October 1st was a strategic blunder. Time will tell, though. The math on the Republican votes is basically the same as it was for skinny repeal, except there won't be conference with the House, nor will the House have the opportunity to amend it. If Cassidy-Graham passes the Senate the House is going to put it up for a vote as is.

The math is actually pretty interesting in the House. There are an awful lot of Republican representatives in states that would lose billions of funding. The margin on AHCA was only four votes and there's scuttlebutt that GOP reps have already decided to flip if it comes up.

Flip in which direction?  GOPers who voted for AHCA flipping against it, or vice versa?

Sorry I should have been more specific. Flip against.

[OurTown]

If that's true I hope they don't fuck it up at the last minute and pass it.

"I thought you were voting no."

"Wait, I though you were voting no."

"O fuck . . ."

[nereo]

If that's true I hope they don't fuck it up at the last minute and pass it.

"I thought you were voting no."

"Wait, I though you were voting no."

"O fuck . . ."

https://www.youtube.com/watch?v=Mn7OBOvJ2kI
Bart Simpson runs for class president, but almost everyone (including himself) forgets to actually vote.
"I demand a recount!"

[Threshkin]

Following

[teen persuasion]

At this point it seems like Sanders' choice to release M4A last week instead of on October 1st was a strategic blunder. Time will tell, though. The math on the Republican votes is basically the same as it was for skinny repeal, except there won't be conference with the House, nor will the House have the opportunity to amend it. If Cassidy-Graham passes the Senate the House is going to put it up for a vote as is.

The math is actually pretty interesting in the House. There are an awful lot of Republican representatives in states that would lose billions of funding. The margin on AHCA was only four votes and there's scuttlebutt that GOP reps have already decided to flip if it comes up.

Flip in which direction?  GOPers who voted for AHCA flipping against it, or vice versa?

Seems pretty high-stakes to me, particularly for the House. Members from California and NY stand to lose tens of billions in Medicaid funding over the next decade.  15 other states would also see a net loss in funding.  It would be pretty damning to vote for a bill that cuts your state's funding ~6 months before your re-election campaign gets into full swing.

If I were in the House, I'd be pissed at the Senate GOP for throwing this cherry bomb through my window.  Come to think of it, that's not unlike what the House did to teh Senate with the AHCA.  Karma?

Either way the political costs could be enormous.  Members who vote for the bill but are in states who will see their benefits cut risk pissing off their election campaign and possibly blowing a hole in their state's budget. And GOPers who vote "no" will have to explain how 8 years of "repeal and repalce" couldn't be accomplished despite controlling all arms of the government.  Again.

You'd be amazed at how our reps put ideology over self-interest.  My rep sponsored a bill that would make the state ineligible for million in Medicaid funding, all because of a feud over county funding of it (the bitter unfunded mandates).

"I have never seen representatives in Washington fighting to take funding away from their home state, but that’s exactly what Faso, Collins and their colleagues have done. This shocking action from officials elected to help their constituents comes at a high price for New Yorkers: every resident of this state will be forced to pay the 'Faso-Collins federal tax' to make up the difference," Cuomo said in a statement.   

  http://www.lockportjournal.com/news/collins-amendment-included-in-senate-health-care-bill/article_a36173bf-ec16-5a3e-89f6-e6409cc89db0.html