Author Topic: What comes after the ACA?  (Read 773823 times)

nereo

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Re: What comes after the ACA?
« Reply #3550 on: September 28, 2017, 05:50:41 AM »
I saw some echoes of this somewhere else too - maybe the Washington Post article on Moore's win? - that several members are strongly considering retirement in these times. Unfortunate to some degree, I'd rather have a "normal" Republican rather than some Bannon-endorsed hard-right/alt-right looney.
I agree. Moore's win is nothing short of shocking to me, and it distresses me that someone with his views could ever rise to the role of US senator. I think many are voting for extreme candidates like him as a middle finger to the GOP, but what their longer-term impacts will be are less clear.
Like Cruz and Paul, I don't see Moore playing nicely with the more mainstream GOP.  Perhaps it will further prevent them from enacting any legislation at all.  Or conversely, he might actually get his way (or at least concessions), and pass legislation in his biblical view.

Moore has not risen to the role of US senator, the election isn't until december.

True.  Which is why I was careful to say "could rise to the role"...  I was expressing shock and dismay that this is the republican candidate in a deeply red state.
it could have been worded a bit more clearly though.

Quote
It will be interesting to see if the Democrats put any resources into the general election.  Seems like it might be worthwhile.  At least they could mount a "get out the vote" campaign among traditional Democratic constituencies.  Alabama's population is about 25% African-American; presumably pretty much all of those people would vote for Moore's opponent.  Perhaps many people who are still registered as Democrats but typically vote Republican in national elections might think twice before voting for Moore.
You'd better believe that this is going to become another multi-$ special election with national money pouring in on both sides. Even if its a longshot, the Dems will use this election to highlight all the things they think is wrong with this administration and this senate.  The fact that it's Moore, a fireband nut-job religious whacko who is anti-gay rights, anti-Muslim, anti-seperation of church and state plays right into their hands. They can use this election to frame the entire GOP as regressive, intolerant bigots.
Even if the Dems lose (and they probably will) the balance in the Senate will remain unchanged, yet the public image will be of the GOP stalwarts defending such a man. In contrast, all the Dems have to do present a candidate who seems a reasonable centrist and who doesn't get tripped up by scandals (and it's taking larger and larger scandals to 'move the needle' since DJT announced his candidacy).

GuitarStv

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Re: What comes after the ACA?
« Reply #3551 on: September 28, 2017, 07:56:47 AM »
I saw some echoes of this somewhere else too - maybe the Washington Post article on Moore's win? - that several members are strongly considering retirement in these times. Unfortunate to some degree, I'd rather have a "normal" Republican rather than some Bannon-endorsed hard-right/alt-right looney.
I agree. Moore's win is nothing short of shocking to me, and it distresses me that someone with his views could ever rise to the role of US senator. I think many are voting for extreme candidates like him as a middle finger to the GOP, but what their longer-term impacts will be are less clear.
Like Cruz and Paul, I don't see Moore playing nicely with the more mainstream GOP.  Perhaps it will further prevent them from enacting any legislation at all.  Or conversely, he might actually get his way (or at least concessions), and pass legislation in his biblical view.

I'm shocked that you're shocked that a racist, bible-thumping, tea party nutcase won a Republican primary in Alabama. ;)

It will be interesting to see if the Democrats put any resources into the general election.  Seems like it might be worthwhile.  At least they could mount a "get out the vote" campaign among traditional Democratic constituencies.  Alabama's population is about 25% African-American; presumably pretty much all of those people would vote for Moore's opponent.  Perhaps many people who are still registered as Democrats but typically vote Republican in national elections might think twice before voting for Moore.

https://thinkprogress.org/alabama-found-guilty-of-racial-gerrymandering-e42f48e19c40/

The GOP has a long standing solution for the black problem in Alabama.

sol

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Re: What comes after the ACA?
« Reply #3552 on: September 28, 2017, 08:39:27 AM »
the Dems will use this election to highlight all the things they think is wrong with this administration and this senate.  The fact that it's Moore, a fireband nut-job religious whacko who is anti-gay rights, anti-Muslim, anti-seperation of church and state plays right into their hands. They can use this election to frame the entire GOP as regressive, intolerant bigots.

It won't matter.  The congressional GOP is chock full of regressive intolerant bigots.  The regressive intolerant bigots won a 2010 wave election that put the tea party in power, and it's been all down hill from there.  I don't think they'll have any qualms at all about defending Moore.

nereo

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Re: What comes after the ACA?
« Reply #3553 on: September 28, 2017, 08:56:57 AM »
the Dems will use this election to highlight all the things they think is wrong with this administration and this senate.  The fact that it's Moore, a fireband nut-job religious whacko who is anti-gay rights, anti-Muslim, anti-seperation of church and state plays right into their hands. They can use this election to frame the entire GOP as regressive, intolerant bigots.

It won't matter.  The congressional GOP is chock full of regressive intolerant bigots.  The regressive intolerant bigots won a 2010 wave election that put the tea party in power, and it's been all down hill from there.  I don't think they'll have any qualms at all about defending Moore.

I wasn't referring to the congressional GOP and their core base.  Trump once said he could shoot someone in Times Square and he wouldn't lose any voters - at the time it was seen as hyperbole but it seems his core base won't leave regardless.
I'm talking about the 'independent' voters that backed DJT over HRC by four points as well as the hoards of citizens just coming of age and forming their political identity. These people are going to be treated to months of commentary Moore's regressive and regressive stances on law, and top GOP figures will be hugging and shaking his hand.

Seriously, the Dems could not have asked for a better example of racial, gender and religious intolerance. All at a time when our country is steadily becoming less white, less evengelical and more accepting of non-heterosexual individuals.

I'm still appalled and slightly frightened at the prospect of such an extremest in the US Senate, but for the GOP: you reap what you sow.

Exflyboy

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Re: What comes after the ACA?
« Reply #3554 on: September 28, 2017, 09:10:59 AM »
So a repeal only bill comes back next year.. thats when they can go back to passing with just 50 votes.. Is that correct??

nereo

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Re: What comes after the ACA?
« Reply #3555 on: September 28, 2017, 09:37:20 AM »
So a repeal only bill comes back next year.. thats when they can go back to passing with just 50 votes.. Is that correct??
not quite.
under normal Senatorial procedures they need 60 votes (a "super majority") to end debate (the filibuster) and vote yes/no on the measure.  Up until Sept 30th they could have used the reconciliation process IF the bill does not add to the deficit because it would be viewed (bizarrely) as just a change outlays.  That option expires with the end of the fiscal year (Sept 30th)

In theory they could try to use reconciliation *again* if there is another continuing resolution after December for FY2018 and it meets all the aforementioned conditions under reconciliation (e.g. not adding to the deficit).   But that would face the same damn problems the last 3 bills have faced; freedom caucus members who won't vote for anything but a complete repeal on one end, 'moderate' GOPers who aren't willing to sell their state down the river and a united Dem front that ensures at least 48 "no"s.

...at least, that's how I understand it.  Someone please correct me if I've made a mistake somewhere.

sol

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Re: What comes after the ACA?
« Reply #3556 on: September 28, 2017, 09:38:44 AM »
So a repeal only bill comes back next year.. thats when they can go back to passing with just 50 votes.. Is that correct??

It could, but they want to use next year's budget reconciliation bill to shoehorn tax "reform" through congress without a majority.  That may be even more unpopular than was gutting healthcare, so the plan is to focus on a single topic at a time.

I don't think they'll have much appetite to add anchovies to their shit sandwich.  The ACA should remain law until after the midterms, though the president can continue to sabotage the implementation by cutting subsidies, refusing to help people enroll, and sowing uncertainty in the market by continuing to threaten insurers.

farmecologist

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Re: What comes after the ACA?
« Reply #3557 on: September 28, 2017, 10:04:48 AM »

Honestly..this thing will never be truly 'dead' until the democrats take the house, senate, or president.   Any one of those three will pretty much put an end to it.  And any seats the dems can pick up in the senate will be very important.

I also saw that trump is willing to sign an executive order regarding health care.   Seems like he is not willing to give up on it either.   Looks to me like they are in 'death by 1000 cuts' mode now.

nereo

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Re: What comes after the ACA?
« Reply #3558 on: September 28, 2017, 11:08:18 AM »

Honestly..this thing will never be truly 'dead' until the democrats take the house, senate, or president.   Any one of those three will pretty much put an end to it.  And any seats the dems can pick up in the senate will be very important.
Or if another half-dozen red states decide to throw in the towel and expand medicare.
but yeah... they'll keep rattling this ghost because they've built their reputations on repeal and replace.  Each time though I think their excuses ring a little more hollow, and more centrists see the cost of voting 'no' to be a bit less extreme.  I'm not sure Trump's threats carry the fear within the GOP they did just a few months ago.

I also saw that trump is willing to sign an executive order regarding health care.   Seems like he is not willing to give up on it either.   Looks to me like they are in 'death by 1000 cuts' mode now.
Yeah, this is what worries me the most.  Since they can't repeal/replace now, their strategy (which some have been very open about) is to sabbotage the law.  The calculus seems to be that the more it stumbles the lower public opinion of the ACA will go.  The risk is they hope/believe/prey that they can somehow escape all blame for actually causing the said collapse.

It will be curious to see whether the GOP continues to sabbotage more moderate members efforts at stabilizing and bolstering the ACA, as they did last week when they abruptly shelved one such effort.

RedmondStash

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Re: What comes after the ACA?
« Reply #3559 on: September 28, 2017, 11:45:57 AM »
I also saw that trump is willing to sign an executive order regarding health care.   Seems like he is not willing to give up on it either.   Looks to me like they are in 'death by 1000 cuts' mode now.
Yeah, this is what worries me the most.

I saw that too. But -- how much power does Trump have with presidential executive orders? What can he actually do? I know he thinks he can do anything, but legally, there have to be limits, or else it would be the president and not Congress creating legislation.

nereo

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Re: What comes after the ACA?
« Reply #3560 on: September 28, 2017, 12:38:09 PM »
I also saw that trump is willing to sign an executive order regarding health care.   Seems like he is not willing to give up on it either.   Looks to me like they are in 'death by 1000 cuts' mode now.
Yeah, this is what worries me the most.

I saw that too. But -- how much power does Trump have with presidential executive orders? What can he actually do? I know he thinks he can do anything, but legally, there have to be limits, or else it would be the president and not Congress creating legislation.
Not just Trump, but the death by 1,000 cuts.

AS for what Trump can accomplish by EO - The ACA is largely implemented and overseen by the Depertment of Health and Human services (HHS). As a cabinet-level executive branch Trump nominated its secretary, Tom Price.  He can essentially direct HSS to reduce its staff and support for the marketplaces and all other aspects of the ACA.  Not unlike how the EPA can stop or reduce its enforcement of environmental infractions under Scott Pruit.
Individual state governors can further muck up the process.  It's like owning a restaurant you want to fail.  Sure you may be required to keep it open, but if the service and reliability suck enough people will get pretty pissed off.  Question is - will the GOP get blamed or Obama?  Given the sarcastic refrain of "Thanks Obama!" for literally everything I worry this may drop the popularity of the ACA more than it drops the already low favorability of the GOP

sol

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Re: What comes after the ACA?
« Reply #3561 on: September 28, 2017, 12:51:05 PM »
I worry this may drop the popularity of the ACA more than it drops the already low favorability of the GOP

That may well be the long term game plan.  Make government suck so much that they fulfill their own prophesy about how much government sucks.  Drag down public support for all forms of government, since their party reputation is already garbage and they gain relative position by dragging down everyone else.

Is anyone else surprised that our ruling party appears to be actively undermining the government they control?

nereo

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Re: What comes after the ACA?
« Reply #3562 on: September 28, 2017, 03:42:51 PM »

Is anyone else surprised that our ruling party appears to be actively undermining the government they control?

Reminds me of a bad joke about a right-wing anti-federalist running for the US Senate
"yes sir, congress is a bunch of corrupt, no good, ineffective bureaucrats, and if you elect me to the US Senate I will show you just how corrupt, ineffective and just plain bad they can be!"

DarkandStormy

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Re: What comes after the ACA?
« Reply #3563 on: September 29, 2017, 07:08:00 AM »
GOP yesterday: We just cannot afford to ensure every American has health care.

GOP today: Here's a $2 trillion tax cut for rich people.

nereo

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Re: What comes after the ACA?
« Reply #3564 on: September 29, 2017, 07:27:28 AM »
GOP yesterday: We just cannot afford to ensure every American has health care.

GOP today: Here's a $2 trillion tax cut for rich people.

A + B = C ?

DavidAnnArbor

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Re: What comes after the ACA?
« Reply #3565 on: September 29, 2017, 07:38:36 AM »
We're not a democracy any longer.  The US has become a weird corrupt Republic where secretive donations to political candidates, gerrymandering of districts, discouraging certain voters through Voter ID laws, making voting difficult in urban areas, and destroying the opposition through lies and false media reports help to maintain single political party control. In such an environment a lunatic becomes president and legislation is pushed as a panacea for working people when in reality it's a tax cut for richest 1/10 of 1%. Not sure where this leads us.

nereo

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Re: What comes after the ACA?
« Reply #3566 on: September 29, 2017, 07:57:36 AM »
We're not a democracy any longer.  The US has become a weird corrupt Republic where secretive donations to political candidates, gerrymandering of districts, discouraging certain voters through Voter ID laws, making voting difficult in urban areas, and destroying the opposition through lies and false media reports help to maintain single political party control. In such an environment a lunatic becomes president and legislation is pushed as a panacea for working people when in reality it's a tax cut for richest 1/10 of 1%. Not sure where this leads us.

For context, refer to history.  Sure we have major political problems to a functional democratic republic such a gerrymandering and voter supression efforts, but this country has seen - and survived - far worse. Voter intimidation frequently entailed physical violence and death threats (sometimes carried out) half a century ago. Citizens United may have opened the floodgates for super PACs and unaccountable money in politics, but at the turn of the 19th century a few monopolies and hyper-rich white men literally controlled both politicians and all media outlets available in many markets. Hired thugs broke up union strikes (violently) and for over half of our 240+ year history women, blacks, gays  and others have had far fewer rights and opportunities than they do now. American citizens of Japanese dissent were detained for years for teh simple reason that their ancestors were from Japan.

Present assaults on democracy demand outraged responses, but so far our country has held.

DavidAnnArbor

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Re: What comes after the ACA?
« Reply #3567 on: September 29, 2017, 08:39:51 AM »
Good counterpoint

sol

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Re: What comes after the ACA?
« Reply #3568 on: September 29, 2017, 09:03:13 AM »
The difference between this particular assault on democracy and our previous ones is the current President.  For the very first time in our history, we have elected a President with absolutely no history of holding elected office.  He has zero relevant political experience.  And he ran on a platform of deliberately undermining the Constitution.

The party he adopted and now owns has transformed under his leadership into one that actively seeks to undermine American values, and an electoral college majority's worth of people support that goal.

American history is littered with sins, but throughout this history we held strong to the notion of helping America succeed in the world.  We didn't always go about it in the right way, but our leaders at least tried to do what they thought was best for the country.  They wanted the country to grow in size and influence and prosperity.  Donald Trump doesn't care what happens to America, he only cares what happens to Donald Trump. 

I'm not as optimistic as nereo.  This isn't just more of the same America making mistakes, this is America actively trying to self destruct.  Dismantling the American healthcare system is but one symptom of this overarching objective.

MDM

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Re: What comes after the ACA?
« Reply #3569 on: September 29, 2017, 10:12:35 AM »
For the very first time in our history, we have elected a President with absolutely no history of holding elected office.
Except for the other U.S. Presidents With No Political Experience.

Quote
The party he adopted and now owns has transformed under his leadership into one that actively seeks to undermine American values, and an electoral college majority's worth of people support that goal.

American history is littered with sins, but throughout this history we held strong to the notion of helping America succeed in the world.  We didn't always go about it in the right way, but our leaders at least tried to do what they thought was best for the country.  They wanted the country to grow in size and influence and prosperity.  Donald Trump doesn't care what happens to America, he only cares what happens to Donald Trump.

I'm not as optimistic as nereo.  This isn't just more of the same America making mistakes, this is America actively trying to self destruct.  Dismantling the American healthcare system is but one symptom of this overarching objective.
Perhaps, but practically this same line of reasoning was used by conservatives maligning Barack Obama.  The more things change, the more they stay the same.

tyort1

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Re: What comes after the ACA?
« Reply #3570 on: September 29, 2017, 10:27:18 AM »
For the very first time in our history, we have elected a President with absolutely no history of holding elected office.
Except for the other U.S. Presidents With No Political Experience.

Quote
The party he adopted and now owns has transformed under his leadership into one that actively seeks to undermine American values, and an electoral college majority's worth of people support that goal.

American history is littered with sins, but throughout this history we held strong to the notion of helping America succeed in the world.  We didn't always go about it in the right way, but our leaders at least tried to do what they thought was best for the country.  They wanted the country to grow in size and influence and prosperity.  Donald Trump doesn't care what happens to America, he only cares what happens to Donald Trump.

I'm not as optimistic as nereo.  This isn't just more of the same America making mistakes, this is America actively trying to self destruct.  Dismantling the American healthcare system is but one symptom of this overarching objective.
Perhaps, but practically this same line of reasoning was used by conservatives maligning Barack Obama.  The more things change, the more they stay the same.

Agreed!  The history of this country (from a social progress perspective), has always been the progressives pushing for change, getting a bit, and then the reactionaries (conservatives) pushing back against that change.  The bigger or faster the change, the harder the pushback.  In fact, if one were to look at the amount and rate of change since the 1960's to today, we've actually had a huge amount of change at a very fast pace (vs the historical rate of change).  That's why you're seeing this level of craziness from the right - they are being honest when they say they "want their country back".  But it's not going back, and they secretly know that, and that's what gives the edge of bitterness and the "burn it all down" mentality. 

Here's the other thing adding fuel to the fire - the flight of young people away from small/medium sized towns, towards the cities.  Not only are Millennials by far the most progressive group in American history, but they are also leaving small town America at an accelerated rate, which (along with automation and the raping of small towns by companies like Walmart) leaves those small towns in pretty dire straits, economically.  What do you do, when your future moves to the city and ain't never comin' back?  If you're a small town conservative, you get angry and rage against the machine.  And elect Donald Trump, so that he can vent your rage and make everyone suffer as you have. 

nereo

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Re: What comes after the ACA?
« Reply #3571 on: September 29, 2017, 12:44:59 PM »
Sol's got me thinking about whether I"m an optimist as it comes to the future of US democracy.  Perhaps I am. More specifically though, I'm pretty pessimistic about the near-term (say the next 1-4 years) but far more bullish a decade out.  Similar to what tyort1 said, I think there's a 'tick-tock' that goes on; social issues get advanced, then there's a sharp reactionary pullback from those that are duped into thinking they somehow got 'left behind'.  Generally these people aren't left behind at all, but succumb to the argument that things would be even better if not for all that leftest evil goin' on.  Anyway, I digress...
Yes, I think its going to be a constant battle to keep health care and basic rights for large swaths of americans.  Wacko idealogues like Moore will join other 'burn-it-down' extremests like Cruz and they might actually carry through on some of their promises.  BUT - I don't think its sustainable.  The GOP faced a choice after their 2012 defeat (the famous "autopsy") about whether to be a more inclusive, mainstream party (the committee's recommendation) or to continue down their plight-of-the-white-man rabbit hole. Obviously with Trump they chose the latter.  But demographics is going to bite them in the ass in the long-term. Older white Americans are going to slowly die away, which overwhelmingly voted for Trupm and have supported this latest version of the GOP.  Millennials are filling their ranks.  While they still don't vote in the percentages that boomers do, by 2020 they will cast more total votes as the ranks of the boomers start to shrink (the oldest are already in their 70s). The Millennials are overwhelmingly in favor of gay marriage and by a strong majority support universal health care, but don't care as much about SS benefits. At the same time the country is becoming more diverse overall, with white voters making up a smaller and smaller portion.
Now I'm watching the GOP as it has doubled-down on its rich white base. Every time they've supported (or failed to condemn) racists tweets will make it that much harder to woo those voters in the future. It's simply demographics - over the next few election cycles their base is going to shrink relative to the broader population. By NOT being more inclusive and by directly attacking and scapegoating minorities they're going to make it much harder to flip these voters in the future.  There's a lot of work that demonstrates that we develop our political ideologies in our 20s and once established they are very hard to shift.  Right now we've got an historically unpopular president and congress among this vital future demographic. I doubt anything the GOP does after this president will make them look favorably on the GOP.

But what about gerrymandering? Right now we've got so many house seats that are so safe it supports tea-party candidates and other extremists. But gerrymandering works both ways.  Its a wall to keep out the rising tide, but should the tide ever overtop the wall it becomes a bathtub where the water can't drain away, swamping those inside.  The 2020 census should be eye-opening for the GOP (perhaps that's why they are currently underfunding it). As tyort1 mentioned, the biggest demographic shift has been from rural to urban areas. These wonky regions that are currently safe GOP moats are going to ahve to be re-drawn after the census in several states, and its going to take a lot more square miles of rural area for each district, diluting their power. The GOP lost the popular vote in hte last election, it could be much worse in the next.

Finally, should they ever get legislative momentum going they could be destroyed by their own actions. Right now they still blame all social ills on the last President ("thanks Obama!") but that goat can only be flogged so many times. Imagine they actually pass this tax reform are repeal the ACA. Even greater income disparity and millions of uninsured will almost certainly be the result, and they'll own that. Sooner or later a recession is going to hit and with each passing month its going to be harder to believably pin it on decisions by the previous administration.

in sum: the GOP has all the power right now and things will almost certainly get worse before they get better for progressively minded individuals. But the harder the GOP works to push their agenda the worse they'll do 7+ years from now. This could be a generational game-changer for republicans, but they are so focused on the 'now' they aren't (or won't) even consider the future.

GuitarStv

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Re: What comes after the ACA?
« Reply #3572 on: September 29, 2017, 01:47:23 PM »
Sol's got me thinking about whether I"m an optimist as it comes to the future of US democracy.  Perhaps I am. More specifically though, I'm pretty pessimistic about the near-term (say the next 1-4 years) but far more bullish a decade out.  Similar to what tyort1 said, I think there's a 'tick-tock' that goes on; social issues get advanced, then there's a sharp reactionary pullback from those that are duped into thinking they somehow got 'left behind'.  Generally these people aren't left behind at all, but succumb to the argument that things would be even better if not for all that leftest evil goin' on.  Anyway, I digress...
Yes, I think its going to be a constant battle to keep health care and basic rights for large swaths of americans.  Wacko idealogues like Moore will join other 'burn-it-down' extremests like Cruz and they might actually carry through on some of their promises.  BUT - I don't think its sustainable.  The GOP faced a choice after their 2012 defeat (the famous "autopsy") about whether to be a more inclusive, mainstream party (the committee's recommendation) or to continue down their plight-of-the-white-man rabbit hole. Obviously with Trump they chose the latter.  But demographics is going to bite them in the ass in the long-term. Older white Americans are going to slowly die away, which overwhelmingly voted for Trupm and have supported this latest version of the GOP.  Millennials are filling their ranks.  While they still don't vote in the percentages that boomers do, by 2020 they will cast more total votes as the ranks of the boomers start to shrink (the oldest are already in their 70s). The Millennials are overwhelmingly in favor of gay marriage and by a strong majority support universal health care, but don't care as much about SS benefits. At the same time the country is becoming more diverse overall, with white voters making up a smaller and smaller portion.
Now I'm watching the GOP as it has doubled-down on its rich white base. Every time they've supported (or failed to condemn) racists tweets will make it that much harder to woo those voters in the future. It's simply demographics - over the next few election cycles their base is going to shrink relative to the broader population. By NOT being more inclusive and by directly attacking and scapegoating minorities they're going to make it much harder to flip these voters in the future.  There's a lot of work that demonstrates that we develop our political ideologies in our 20s and once established they are very hard to shift.  Right now we've got an historically unpopular president and congress among this vital future demographic. I doubt anything the GOP does after this president will make them look favorably on the GOP.

But what about gerrymandering? Right now we've got so many house seats that are so safe it supports tea-party candidates and other extremists. But gerrymandering works both ways.  Its a wall to keep out the rising tide, but should the tide ever overtop the wall it becomes a bathtub where the water can't drain away, swamping those inside.  The 2020 census should be eye-opening for the GOP (perhaps that's why they are currently underfunding it). As tyort1 mentioned, the biggest demographic shift has been from rural to urban areas. These wonky regions that are currently safe GOP moats are going to ahve to be re-drawn after the census in several states, and its going to take a lot more square miles of rural area for each district, diluting their power. The GOP lost the popular vote in hte last election, it could be much worse in the next.

Finally, should they ever get legislative momentum going they could be destroyed by their own actions. Right now they still blame all social ills on the last President ("thanks Obama!") but that goat can only be flogged so many times. Imagine they actually pass this tax reform are repeal the ACA. Even greater income disparity and millions of uninsured will almost certainly be the result, and they'll own that. Sooner or later a recession is going to hit and with each passing month its going to be harder to believably pin it on decisions by the previous administration.

in sum: the GOP has all the power right now and things will almost certainly get worse before they get better for progressively minded individuals. But the harder the GOP works to push their agenda the worse they'll do 7+ years from now. This could be a generational game-changer for republicans, but they are so focused on the 'now' they aren't (or won't) even consider the future.

So to summarize . . . Trump is going to make America great again!

MDM

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Re: What comes after the ACA?
« Reply #3573 on: September 29, 2017, 01:58:10 PM »
So to summarize . . . Trump is going to make America great again!
Yup.  Y'all come down and visit now, y'hear?

talltexan

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Re: What comes after the ACA?
« Reply #3574 on: September 29, 2017, 02:07:21 PM »
@ Sol...

"But at least is NOT Socialism"....:)

Actually, Sanders appearing on the scene with his single payer bill was an incredible gift to Graham-Cassidy, who basically said the alternative to their bill was "Socialism". I.e. the Sanders plan.

jim555

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Re: What comes after the ACA?
« Reply #3575 on: September 29, 2017, 02:54:54 PM »
Price just resigned.  Guess he got tired of trying to sabotage the ACA.

Inaya

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Re: What comes after the ACA?
« Reply #3576 on: September 29, 2017, 03:06:49 PM »
So will Trump put somebody worse there, or simply not put anyone there?

sol

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Re: What comes after the ACA?
« Reply #3577 on: September 29, 2017, 03:13:33 PM »
So will Trump put somebody worse there, or simply not put anyone there?

Who could be worse than the fiercest critic the ACA in Congress?  Maybe Trump's personal doctor?


Mr. Green

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Re: What comes after the ACA?
« Reply #3578 on: September 29, 2017, 03:22:54 PM »
Agreed!  The history of this country (from a social progress perspective), has always been the progressives pushing for change, getting a bit, and then the reactionaries (conservatives) pushing back against that change.  The bigger or faster the change, the harder the pushback.  In fact, if one were to look at the amount and rate of change since the 1960's to today, we've actually had a huge amount of change at a very fast pace (vs the historical rate of change).  That's why you're seeing this level of craziness from the right - they are being honest when they say they "want their country back".  But it's not going back, and they secretly know that, and that's what gives the edge of bitterness and the "burn it all down" mentality. 

Here's the other thing adding fuel to the fire - the flight of young people away from small/medium sized towns, towards the cities.  Not only are Millennials by far the most progressive group in American history, but they are also leaving small town America at an accelerated rate, which (along with automation and the raping of small towns by companies like Walmart) leaves those small towns in pretty dire straits, economically.  What do you do, when your future moves to the city and ain't never comin' back?  If you're a small town conservative, you get angry and rage against the machine.  And elect Donald Trump, so that he can vent your rage and make everyone suffer as you have.
I believe we are witnessing the last gasps of the "old guard." When you suffocate someone they always fight the hardest right before they die. That's what is happening.

Exflyboy

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Re: What comes after the ACA?
« Reply #3579 on: September 29, 2017, 03:31:24 PM »
Now there is a picture of health...NOT!

The way I look at it.. I'm FIRED, fuck it.. We can live anywhere in the World and leave our money in US stock ETFs and the Healthcare Cartel will continue to pay 15% of my annual dividends. While I buy HC much cheaper somewhere else.


Bateaux

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Re: What comes after the ACA?
« Reply #3580 on: September 29, 2017, 03:40:48 PM »
Now there is a picture of health...NOT!

The way I look at it.. I'm FIRED, fuck it.. We can live anywhere in the World and leave our money in US stock ETFs and the Healthcare Cartel will continue to pay 15% of my annual dividends. While I buy HC much cheaper somewhere else.

Give me a heads up when it's time to bug-out. 

dividendman

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Re: What comes after the ACA?
« Reply #3581 on: September 29, 2017, 06:11:57 PM »
So will Trump put somebody worse there, or simply not put anyone there?

Who could be worse than the fiercest critic the ACA in Congress?

I fear Trump is going to answer your question very soon.

nereo

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Re: What comes after the ACA?
« Reply #3582 on: September 30, 2017, 10:23:50 AM »

I believe we are witnessing the last gasps of the "old guard." When you suffocate someone they always fight the hardest right before they die. That's what is happening.
uhh...... you're scaring me Mr Green. Let's keep our distances, ok?

FIREchiefsr

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Re: What comes after the ACA?
« Reply #3583 on: September 30, 2017, 02:50:17 PM »
Question about the ACA exchanges:

Consider somebody very poor and currently getting free insurance through an exchange.  As I understand it, a major concern right now is that with insurance companies pulling out of the exchanges there is less competition and the remaining company (in some cases) is hiking rates to ensure profitability.  The result is that the subsidies for the plans go up, thus costing the fed more money.  The "cure" is that the fed gives money to the insurance companies so that they won't lose money and will offer lower premiums in the exchanges.  Isn't the fed paying either way?  How does the fed save money by not guaranteeing the payments to the insurance companies?   I must be missing something here.  Thanks.
« Last Edit: September 30, 2017, 03:34:59 PM by FIREchiefsr »

jim555

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Re: What comes after the ACA?
« Reply #3584 on: September 30, 2017, 03:04:54 PM »
Trump keeps talking about ending the CSRs (Cost Sharing Reductions) for the Silver plans.  As a result the rates are rising since the insurance companies are obligated to give cost sharing whether or not Trump pays them.  When all is said and done it will cost the Feds more to end the CSRs since the subsidies go up when the prices go up.  The big losers are those making >400% FPL.

So conservatives will spend more to make a point about a former president they don't like.

The insurance companies will sue and probably win and the Feds will have to pay them anyway.

FIREchiefsr

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Re: What comes after the ACA?
« Reply #3585 on: September 30, 2017, 03:34:16 PM »
Thanks jim555.  My understanding was that some of the companies leaving the exchanges are still selling individual policies in the same state (I assume because they have determined that the individual policy market outside of the exchanges provides a more desirable/profitable risk pool).

Other than the exchanges, are there any other parts of the ACA that are "failing?"  It seems that all of the consumer protection rules are functioning as designed, and somebody who doesn't qualify for subsidies is able to buy a policy in a competitive market.

DavidAnnArbor

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Re: What comes after the ACA?
« Reply #3586 on: September 30, 2017, 05:00:53 PM »
Malevolence tempered by incompetence.

Mr. Green

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Re: What comes after the ACA?
« Reply #3587 on: September 30, 2017, 10:59:54 PM »
I believe we are witnessing the last gasps of the "old guard." When you suffocate someone they always fight the hardest right before they die. That's what is happening.
uhh...... you're scaring me Mr Green. Let's keep our distances, ok?
I meant that is the body's physiological response to suffocation, not that I suffocate people. Lol

tyort1

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Re: What comes after the ACA?
« Reply #3588 on: September 30, 2017, 11:16:36 PM »
I believe we are witnessing the last gasps of the "old guard." When you suffocate someone they always fight the hardest right before they die. That's what is happening.
uhh...... you're scaring me Mr Green. Let's keep our distances, ok?
I meant that is the body's physiological response to suffocation, not that I suffocate people. Lol

It was Mr. Green in the library with the rope!

Monkey Uncle

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Re: What comes after the ACA?
« Reply #3589 on: October 01, 2017, 04:29:30 AM »
Other than the exchanges, are there any other parts of the ACA that are "failing?"  It seems that all of the consumer protection rules are functioning as designed, and somebody who doesn't qualify for subsidies is able to buy a policy in a competitive market.

I'd say that so far it is not succeeding in controlling costs.  But that has been discussed ad nauseum up-thread.

Bucksandreds

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Re: What comes after the ACA?
« Reply #3590 on: October 01, 2017, 06:12:37 AM »
Other than the exchanges, are there any other parts of the ACA that are "failing?"  It seems that all of the consumer protection rules are functioning as designed, and somebody who doesn't qualify for subsidies is able to buy a policy in a competitive market.

I'd say that so far it is not succeeding in controlling costs.  But that has been discussed ad nauseum up-thread.

Penalties for not buying insurance should have been equal to the cost of insurance. We'd have millions more healthy people on the exchanges and thus lower prices.  Subsidies should have been extended to higher incomes. ACA should have included more price setting/negotiation to control things like drug costs. When Democrats get back control (hopefully 2020) they'll have the choice to do this or push for full single payer. I think the former is more likely in the short term.

maizeman

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Re: What comes after the ACA?
« Reply #3591 on: October 01, 2017, 11:29:33 AM »
The way they wrote the law ACA penalty for not having health insurance actually is the same as the nationwide average cost for a bronze health insurance plan. The reason so many people pay less than that is that there was another provision which capped the penalty owed as a percent of income, so only a subset of people earn enough money to pay the full penalty.

Paul der Krake

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Re: What comes after the ACA?
« Reply #3592 on: October 01, 2017, 11:40:23 AM »
Massive increases here in Washington for 2018. Shame, it was one of the few states with quite reasonable rates (compared to the rest of the country).

https://www.seattletimes.com/seattle-news/health/states-health-exchange-rates-to-jump-24/


EnjoyIt

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Re: What comes after the ACA?
« Reply #3593 on: October 01, 2017, 11:45:30 AM »
In the US we pay ~$10,500 per person per year on healthcare.
The US population is $320.1 million in 2016.
Simple math tells us we spend $3,361 trillion on healthcare
The US government expects $3,654 trillion in revenue in 2018 (this includes income tax, social security and medicare, corporate tax, unemployment tax and import tariffs)

I think we have a significant math problem if we expect the government to cover everyone's healthcare as we currently have it.  We will need significant cost reductions and massive tax hikes. I would love to see everyone in the US have their healthcare covered. I just don't see it possible in our current environment.
« Last Edit: October 01, 2017, 11:49:24 AM by EnjoyIt »

madgeylou

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Re: What comes after the ACA?
« Reply #3594 on: October 01, 2017, 12:53:33 PM »
In the US we pay ~$10,500 per person per year on healthcare.
The US population is $320.1 million in 2016.
Simple math tells us we spend $3,361 trillion on healthcare
The US government expects $3,654 trillion in revenue in 2018 (this includes income tax, social security and medicare, corporate tax, unemployment tax and import tariffs)

I think we have a significant math problem if we expect the government to cover everyone's healthcare as we currently have it.  We will need significant cost reductions and massive tax hikes. I would love to see everyone in the US have their healthcare covered. I just don't see it possible in our current environment.

There is a huge amount of waste in what we pay now -- and we have worse health outcomes than many countries who spend less. Our system could be streamlined to keep costs in line and provide better outcomes.

Also I don't think anyone is proposing to pay for healthcare out of current revenue. Some portion of what we are spending now would be diverted to single payer or public options.

protostache

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Re: What comes after the ACA?
« Reply #3595 on: October 01, 2017, 12:56:23 PM »
In the US we pay ~$10,500 per person per year on healthcare.
The US population is $320.1 million in 2016.
Simple math tells us we spend $3,361 trillion on healthcare
The US government expects $3,654 trillion in revenue in 2018 (this includes income tax, social security and medicare, corporate tax, unemployment tax and import tariffs)

I think we have a significant math problem if we expect the government to cover everyone's healthcare as we currently have it.  We will need significant cost reductions and massive tax hikes. I would love to see everyone in the US have their healthcare covered. I just don't see it possible in our current environment.

The math is not that simple. Getting every last person into the insurance pool would bring costs down all by itself, for one thing. Second, single payer is just one of a huge variety of options for universal coverage, many of which don't increase government outlays much. A handful of small changes would get us significantly closer to universal coverage with no major changes to the health care system as a whole:

  • Make the individual mandate significantly stronger stronger. I'm talking wage garnishment and auto enrollment.
  • Get rid of the health insurance tax deduction and the business mandate, discouraging businesses from offering it as a benefit. This would bring in an additional $310 billion per year.
  • Use the $310 billion per year additional tax revenue to extend premium subsidies to a max of 10% of income for any income level, as well as strengthening cost sharing reductions.

These changes and more are detailed in this post on acasignups.net from earlier this year.

sol

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Re: What comes after the ACA?
« Reply #3596 on: October 01, 2017, 01:49:34 PM »
I think we have a significant math problem if we expect the government to cover everyone's healthcare as we currently have it.  We will need significant cost reductions and massive tax hikes.

You've totally missed the point.  The "massive tax hikes" required to pay for all of that health insurance are already being paid by you and me and everyone else.  We just pay it to for-profit health insurance companies instead.  The taxes would only go up by the same amount that our health insurance costs would go down.  Without a profit motive involved, we'd arguably SAVE money in the process by paying less in increased taxes than we currently pay for health insurance.

It's not like taxes would go up to cover the cost of healthcare and we'd have to find that much more money.  We're already paying for it.  Single payer shouldn't cost one penny more than our current health care system costs. 

So don't fall for that conservative line about how it will cost the government trillions.  They only say that because under the current system, we pay for health insurance with a regressive fixed tax (everybody pays the same regardless of income) and rich people LOVE regressive fixed taxes.  If we went to federal single payer health insurance, total healthcare cost would stay the same (or go down) but rich people would probably pay more than poor people.  That's the real Republican argument against single payer.  Not that it will cost more, but that it will cost the country the same while costing rich people more and poor people less. 

Exflyboy

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Re: What comes after the ACA?
« Reply #3597 on: October 01, 2017, 01:49:59 PM »
In the US we pay ~$10,500 per person per year on healthcare.
The US population is $320.1 million in 2016.
Simple math tells us we spend $3,361 trillion on healthcare
The US government expects $3,654 trillion in revenue in 2018 (this includes income tax, social security and medicare, corporate tax, unemployment tax and import tariffs)

I think we have a significant math problem if we expect the government to cover everyone's healthcare as we currently have it.  We will need significant cost reductions and massive tax hikes. I would love to see everyone in the US have their healthcare covered. I just don't see it possible in our current environment.

The math is not that simple. Getting every last person into the insurance pool would bring costs down all by itself, for one thing. Second, single payer is just one of a huge variety of options for universal coverage, many of which don't increase government outlays much. A handful of small changes would get us significantly closer to universal coverage with no major changes to the health care system as a whole:

  • Make the individual mandate significantly stronger stronger. I'm talking wage garnishment and auto enrollment.
  • Get rid of the health insurance tax deduction and the business mandate, discouraging businesses from offering it as a benefit. This would bring in an additional $310 billion per year.
  • Use the $310 billion per year additional tax revenue to extend premium subsidies to a max of 10% of income for any income level, as well as strengthening cost sharing reductions.

These changes and more are detailed in this post on acasignups.net from earlier this year.

Waaay less.. In the UK they spend about $3500/person/year. But thats Sociliasm and therefore evil.. They have "death panels" over there don't ya know?

DavidAnnArbor

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Re: What comes after the ACA?
« Reply #3598 on: October 01, 2017, 02:54:24 PM »

Jump in 2018 insurance rates on the exchange largely a reflection of Trump/GOP sabotage

http://acasignups.net/2018-rate-hikes

jim555

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Re: What comes after the ACA?
« Reply #3599 on: October 01, 2017, 05:21:30 PM »
We made it to Oct. 1st!  The zombie is temporarily dead. 

I just wanted to add the CSR funding issue makes the Silver plans more expensive.  But the subsidies are hinged to the second lowest cost Silver plan, so it may actually make to non-Silver plans cheaper after the subsidy is applied.  This is why it will cost them more not to fund the CSRs.