Author Topic: What comes after the ACA?  (Read 384059 times)

Mr. Green

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Re: What comes after the ACA?
« Reply #3750 on: October 13, 2017, 05:18:26 PM »
I am still hopeful that it gets replaced with something better, as promised...  And I think Trump deserves the chance to do so.  He was elected by the American people on that promise.
This is humorous in the saddest way possible because a President doesn't make laws. They can talk all they want about changing things but if Congress doesn't want to do it, it doesn't matter what the President says.
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MDM

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Re: What comes after the ACA?
« Reply #3751 on: October 13, 2017, 05:26:25 PM »
...a President doesn't make laws. They can talk all they want about changing things but if Congress doesn't want to do it, it doesn't matter what the President says.
Obama and Trump have both used executive orders to do things that congress "is supposed to" do.  Whether one thinks that is good or bad seems to depend, in many cases, on whether one agrees with what Obama or Trump did.  Or one could be happy or unhappy that the executive branch is usurping the legislative branch's function, regardless of the specific case.

seattlecyclone

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Re: What comes after the ACA?
« Reply #3752 on: October 13, 2017, 06:08:22 PM »
...a President doesn't make laws. They can talk all they want about changing things but if Congress doesn't want to do it, it doesn't matter what the President says.
Obama and Trump have both used executive orders to do things that congress "is supposed to" do.  Whether one thinks that is good or bad seems to depend, in many cases, on whether one agrees with what Obama or Trump did.  Or one could be happy or unhappy that the executive branch is usurping the legislative branch's function, regardless of the specific case.

I've long been unhappy about the president's ever-increasing power. Even when it was a president taking actions I mostly agreed with, I was always aware that we could get someone who could abuse that power and that granting such a large amount of power to one man is just asking for trouble when you pick the wrong man.
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ixtap

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Re: What comes after the ACA?
« Reply #3753 on: October 13, 2017, 06:26:27 PM »
I am still hopeful that it gets replaced with something better, as promised...  And I think Trump deserves the chance to do so.  He was elected by the American people on that promise.

He said he had a plan. He has not put forward any plan.

sol

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Re: What comes after the ACA?
« Reply #3754 on: October 13, 2017, 07:38:56 PM »
I am still hopeful that it gets replaced with something better, as promised...  And I think Trump deserves the chance to do so.  He was elected by the American people on that promise.

He said he had a plan. He has not put forward any plan.

And while we're picking nits, he was elected by the electoral college (on that promise).  The American people mostly voted against him.

But I do agree that he deserves a chance to offer something better.  It's been 11 months, and I'm still waiting to see it.  Today's developments were a step in the wrong direction, though.

EscapeVelocity2020

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Re: What comes after the ACA?
« Reply #3755 on: October 14, 2017, 12:26:25 AM »
I am still hopeful that it gets replaced with something better, as promised...  And I think Trump deserves the chance to do so.  He was elected by the American people on that promise.

He said he had a plan. He has not put forward any plan.

And while we're picking nits, he was elected by the electoral college (on that promise).  The American people mostly voted against him.

But I do agree that he deserves a chance to offer something better.  It's been 11 months, and I'm still waiting to see it.  Today's developments were a step in the wrong direction, though.

Honestly - let's just be honest for a minute - Trump likes to make others do the impossible.  Maybe it worked for him in the past, pushing his brinkmanship to the edge and getting all the last crumbs he could even if he had to declare bankruptcy, but US government is not a pyramid like it was in his business world.  He puts up a ridiculous ultimatum and the Legislature looks at him like, WTF.  We wanted this to work, many of them even thought this would work and be amicable, but Trump unexpectedly throws friends under the bus and works with the opposition.  I don't see how this gets any better going forward; Trump has used all the plays in his limited playbook and he's not exactly at an age to learn new tricks.
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nereo

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Re: What comes after the ACA?
« Reply #3756 on: October 14, 2017, 06:30:37 AM »
Honestly - let's just be honest for a minute - Trump likes to make others do the impossible.  Maybe it worked for him in the past, pushing his brinkmanship to the edge and getting all the last crumbs he could even if he had to declare bankruptcy, but US government is not a pyramid like it was in his business world.  He puts up a ridiculous ultimatum and the Legislature looks at him like, WTF.  We wanted this to work, many of them even thought this would work and be amicable, but Trump unexpectedly throws friends under the bus and works with the opposition.  I don't see how this gets any better going forward; Trump has used all the plays in his limited playbook and he's not exactly at an age to learn new tricks.

Let's be clear for a moment - Trump has a long history of over-promising and under-delivering, and it has worked for him int he past.  Further, he has an incredibly long list of people he's chummed up to and then thrown under the bus when he decided it would give him an edge.  Bankruptcy wasn't a unintended consequence for the Trump brand, it was part of the intitial blueprints of his 'deals'; pay a premium using borrowed money with high interest rates, default, and then negotiate for pennies-on-the-dollar under the threat that otherwise the whole system would just crumble and - hey, wouldn't that be a shame?  He followed this playbook for his failed casinos.

This echos in his current dealings with the ACA.  He promised glitz and glamour ("great healthcare for everyone at a much lower cost!"), drummed up expectations at debates, rallies and on twitterverse, got a bunch of hapless sods (the GOP) to give him the political capitol he required, and then when it turned out that his initial promises turned out to be bat-shit-crazy-land-impossible he threw everyone under the bus (it;s "mean"!; "It's not surprising McConnel FAILED"; ), and now that its clear his promises will not bear fruit he's in full sabotage mode ("Let O-Care Fail!"; Trump signs EO undermining ACA; HHS cuts funding, time frame for ACA enrollment) which he explicitly admits is to force others to cut a deal. Then as now he's leveraging the pain and suffering of everyday people to get his way. Before it was the workers and economy of New Jersey; now it's the healthcare for millions. His expectation is that the other parties will eventually cut a deal because they have a moral compass and will (eventually) reach a point where the current state of affairs (with his sabotage) is simply ethically unpalatable.  One true danger here is he's playing this game with career politicians who are responsible for just a small constituancy and are - at times - unwilling to follow their own moral compasses in favor of survival (re-election).

70+ year olds rarely change their ways or suddenly develop a completely different outlook on life. What Trump was before he is now, and there will be no "Presidential Pivot" or Billionaire Fighting for the little guy.  He's out to "win" based on his own definition, and he tallies it as a win anytime he loses less than the other folks in the room.

...now that we're temporarily off-focus from the ACA and on to tax reform, watch how this is starting to play out.  Trump has made lofty (many would say "bat-shit crazy") promises of 6% growth, tax cuts for the middle class and huge gains for the upper quartile of society.  He's promised this won't add a penny to the deficit over 10 years which almost every credible economist has called ludicrous. Assuming he follows his playbook his next step will be to start throwing people under the bus when his crazy promises cannot be obtained (DEM obstructionists! Ryan can't get it done!...) and then, somehow inflict pain to extract leverage.  He'll veto spending bills and budgets while signing EOs to stall the economy or push it into a recession in the hopes that Congress will pass a "stimulus package" that, curiously, has tax cuts for the right, the end fo teh estate tax and a number of his other priorities which will help Trump Inc.
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protostache

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Re: What comes after the ACA?
« Reply #3757 on: October 14, 2017, 11:19:34 AM »
I don’t know if I’ve articulated it out loud, but since he announced I’ve had a sneaking suspicion that Trump’s ultimate goal, his best “win,” is to get the estate tax repealed and then die in office. I don’t know he can consciously think of such a thing but it definitely seems like a possible path for this train wreck of a presidency.

scottish

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Re: What comes after the ACA?
« Reply #3758 on: October 14, 2017, 01:33:25 PM »
On a lighter note, this was in the Onion today:

Quote
BEAVER DAM, WI—In an effort to justify the recent set of executive orders the president signed earlier this week to dismantle the Affordable Care Act, exhausted Trump supporter Phil Holt reportedly just decided Friday that massive cuts to healthcare subsidies were the reason he voted as he did. “Ultimately increasing the cost of healthcare for me, my family members, and others like me is why I voted for Trump the first place,” said the completely drained Holt, 56, who reportedly has spent the last nine months since Trump took office rationalizing every step the White House has made as his motivation for casting his ballot for the president. “When I went to the polls, I based my vote solely on the hope that insurance would be allowed to skirt around Obamacare policies that protect the elderly and those with pre-existing conditions from being discriminated against. Destabilizing the nation’s healthcare system is exactly what I wanted from Trump and exactly what I got. Yes, exactly.” At press time, a weary Holt had determined that getting a second job just to afford healthcare was always a part of making America great again.

nereo

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Re: What comes after the ACA?
« Reply #3759 on: October 14, 2017, 02:10:46 PM »
I don’t know if I’ve articulated it out loud, but since he announced I’ve had a sneaking suspicion that Trump’s ultimate goal, his best “win,” is to get the estate tax repealed and then die in office. I don’t know he can consciously think of such a thing but it definitely seems like a possible path for this train wreck of a presidency.

I find it bizarre that his calls to repeal the estate tax haven't triggered more widespread condemnation about self-dealing and hubris.  This could (depending on his actual net worth) save him and his estate half a billion dollars.  It's the ultimate windfall for his heirs, and a singularly compelling reason why they should continue to endure any level of media scrutiny if there's even a chance it will come to fruition. 

It's the height of hypocrisy to claim that "rich people like me won't benefit at all" and that his tax proposals "are no good for me." This could be the only reason left why he continues to want to be president.

tl/dr: If Trump gets the tax deal he wants, he and his heirs will receive >$500,000,000 in tax savings. That's one hell of a paycheck.
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radram

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Re: What comes after the ACA?
« Reply #3760 on: October 15, 2017, 07:14:05 AM »


tl/dr: If Trump gets the tax deal he wants, he and his heirs will receive >$500,000,000 in tax savings. That's one hell of a paycheck.

I think it is an interesting point to mention that Trump is correct that a full elimination of the estate tax would not benefit HIM. He, of course, would be dead (believe me).

iris lily

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Re: What comes after the ACA?
« Reply #3761 on: October 15, 2017, 07:57:05 AM »
...a President doesn't make laws. They can talk all they want about changing things but if Congress doesn't want to do it, it doesn't matter what the President says.
Obama and Trump have both used executive orders to do things that congress "is supposed to" do.  Whether one thinks that is good or bad seems to depend, in many cases, on whether one agrees with what Obama or Trump did.  Or one could be happy or unhappy that the executive branch is usurping the legislative branch's function, regardless of the specific case.

I've long been unhappy about the president's ever-increasing power. Even when it was a president taking actions I mostly agreed with, I was always aware that we could get someone who could abuse that power and that granting such a large amount of power to one man is just asking for trouble when you pick the wrong man.
Ahreed, I dont care who is subverting Congress' authority with regulatory action, but it is written ng. The creeping power of the executive office is worrisome.

sol

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Re: What comes after the ACA?
« Reply #3762 on: October 15, 2017, 08:56:07 AM »
Ahreed, I dont care who is subverting Congress' authority with regulatory action, but it is written ng. The creeping power of the executive office is worrisome.

The "creeping power of the executive" really started to take off under Dick Cheney.  If you're looking for a reason to lament the disintegration of moral boundaries between public and private interests, you need look no further than the CEO of a private government contracting firm becoming Vice President.  As it turns out, ignoring conflicts of interest in the pursuit of personal profit from public office didn't start with our current President.  Expanding the power of the executive branch by removing the normal checks and balances is all part of the "get rich quick from public office" playbook. 

Trump is just following chapter two.  Chapter five is "start international conflict that directly benefits your personal business model."

MDM

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Re: What comes after the ACA?
« Reply #3763 on: October 15, 2017, 09:39:01 AM »
Although, one could also make a reasonable case that Trump's CSR ruling actually returns power to the legislative branch, because Congress had not appropriated those funds in the first place.

sol

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Re: What comes after the ACA?
« Reply #3764 on: October 15, 2017, 09:43:43 AM »
Although, one could also make a reasonable case that Trump's CSR ruling actually returns power to the legislative branch, because Congress had not appropriated those funds in the first place.

I don't think it's executive overreach when the President directs executive branch agencies to implement the laws that Congress has passed.  In this case, Congress admitted it just forgot to allocate the funding for the law that it voted for by a supermajority.  The President kind of bailed them out on that one.

MDM

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Re: What comes after the ACA?
« Reply #3765 on: October 15, 2017, 10:23:53 AM »
...Congress admitted it just forgot....
Perhaps understandable in a 6 year old, but Congress could have just put on its big boy and girl pants and fixed it.  Or they could still do so.  Not that Congress has a stellar reputation, but "they forgot" is a particularly lame excuse for any executive order.

sol

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Re: What comes after the ACA?
« Reply #3766 on: October 15, 2017, 11:29:14 AM »
...Congress admitted it just forgot....
Perhaps understandable in a 6 year old, but Congress could have just put on its big boy and girl pants and fixed it.  Or they could still do so.  Not that Congress has a stellar reputation, but "they forgot" is a particularly lame excuse for any executive order.

In this case, "they forgot" is shorthand for "were distracted just long enough by an obstructionist minority who shut down the federal government in order to protest expanding healthcare access to more Americans."

MDM

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Re: What comes after the ACA?
« Reply #3767 on: October 15, 2017, 03:05:59 PM »
...Congress admitted it just forgot....
Perhaps understandable in a 6 year old, but Congress could have just put on its big boy and girl pants and fixed it.  Or they could still do so.  Not that Congress has a stellar reputation, but "they forgot" is a particularly lame excuse for any executive order.

In this case, "they forgot" is shorthand for "were distracted just long enough by an obstructionist minority who shut down the federal government in order to protest expanding healthcare access to more Americans."
Which brings us full circle back to "should the president do things constitutionally assigned to Congress, and does one's answer depend on whether one agrees with what the president does?" :)

obstinate

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Re: What comes after the ACA?
« Reply #3768 on: October 15, 2017, 08:44:21 PM »
Which brings us full circle back to "should the president do things constitutionally assigned to Congress, and does one's answer depend on whether one agrees with what the president does?" :)
#44 believed the CSRs were not constitutionally assigned to congress. The first federal judge the lawsuit was appealed to disagreed, but that does not mean #44 was wrong. It means one federal judge thought he was wrong.

Moreover, there are different definitions of "should," depending on what you're optimizing for. Morally? Whose moral framework? Practically? With a short, medium, or long view? Legally?

Finally, the constitution was written by a bunch of old farts who had no idea what this country would become, and viewing it as some sort of sacred cow is unhealthy. Most other countries have rewritten their constitution several times since ours was ratified, and it seems pretty clear that better ideas of good governance have emerged since the 18th century.

sol

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Re: What comes after the ACA?
« Reply #3769 on: October 15, 2017, 08:46:16 PM »
...Congress admitted it just forgot....
Perhaps understandable in a 6 year old, but Congress could have just put on its big boy and girl pants and fixed it.  Or they could still do so.  Not that Congress has a stellar reputation, but "they forgot" is a particularly lame excuse for any executive order.

In this case, "they forgot" is shorthand for "were distracted just long enough by an obstructionist minority who shut down the federal government in order to protest expanding healthcare access to more Americans."
Which brings us full circle back to "should the president do things constitutionally assigned to Congress, and does one's answer depend on whether one agrees with what the president does?" :)

I'm not convinced. A supermajority of Congress wanted to expand healthcare to more Americans. A minority of Congress did not, so they prevented the majority of Congress from doing what it wanted. 

If we're going to talk about the failures of our checks and balances, how about we start there?  That's like a basic democracy fail.  You're seriously complaining that the Executive restored the will of Congress over the opposition of the congressional minority?

MDM

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Re: What comes after the ACA?
« Reply #3770 on: October 15, 2017, 08:59:55 PM »
  You're seriously complaining that the Executive restored the will of Congress over the opposition of the congressional minority?
Yes.

It's akin to free speech.  Easy to defend when one agrees with what is being said.  Problematic when one disagrees.

SecondBreakfast

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Re: What comes after the ACA?
« Reply #3771 on: October 16, 2017, 03:13:24 AM »
I'm not sure if the American system of government really works for modern America. Or anywhere else, to be honest. Most countries that apply American-style constitutional democracy seem to collapse into endless bickering, gridlock and corruption pretty quickly. No, what you need is the swift, authoritative action of a parliamentary system, preferably under the oversight of a divinely-appointed monar- *is dragged off and dumped in Boston harbour*

former player

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Re: What comes after the ACA?
« Reply #3772 on: October 16, 2017, 04:08:12 AM »
I'm not sure if the American system of government really works for modern America. Or anywhere else, to be honest. Most countries that apply American-style constitutional democracy seem to collapse into endless bickering, gridlock and corruption pretty quickly. No, what you need is the swift, authoritative action of a parliamentary system, preferably under the oversight of a divinely-appointed monar- *is dragged off and dumped in Boston harbour*
Ha!

I suspect that any variety of democratic system would be OK as long as it can change as needed with changing times.  When you set a system in stone, gradual adaptation goes out of the window and it ossifies until the point of civil war or revolution.  The USA problem is not the constitution per se, it's that the constitution is not sufficiently amenable to change *joins SecondBreakfast in a harbour swim*.

(The only people who have got this right are us English, who with one or two minor interruptions have kept legal and constitutional continuity within a framework of human rights since 1066.)
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nereo

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Re: What comes after the ACA?
« Reply #3773 on: October 16, 2017, 04:57:28 AM »
I'm not sure if the American system of government really works for modern America. Or anywhere else, to be honest. Most countries that apply American-style constitutional democracy seem to collapse into endless bickering, gridlock and corruption pretty quickly. No, what you need is the swift, authoritative action of a parliamentary system, preferably under the oversight of a divinely-appointed monar- *is dragged off and dumped in Boston harbour*
Ha!

I suspect that any variety of democratic system would be OK as long as it can change as needed with changing times.  When you set a system in stone, gradual adaptation goes out of the window and it ossifies until the point of civil war or revolution.  The USA problem is not the constitution per se, it's that the constitution is not sufficiently amenable to change *joins SecondBreakfast in a harbour swim*.

(The only people who have got this right are us English, who with one or two minor interruptions have kept legal and constitutional continuity within a framework of human rights since 1066.)

There are some interesting threads on different forms of governance throughout the world, along with how US perceptions differ sharply from other western developed nations.
Let's keep this thread focused on "what comes after the ACA" and not have it devolve into nation-bashing.
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DavidAnnArbor

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Re: What comes after the ACA?
« Reply #3774 on: October 16, 2017, 05:33:54 AM »
  You're seriously complaining that the Executive restored the will of Congress over the opposition of the congressional minority?
Yes.

It's akin to free speech.  Easy to defend when one agrees with what is being said.  Problematic when one disagrees.

These cost-sharing subsidies are in the ACA law. The Congress can choose to not fund it, but then the government will be sued in federal court, and lose, and have to pay them with interest. Paying interest on a lost case is not a way to keep the federal budget in control. 

DavidAnnArbor

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Re: What comes after the ACA?
« Reply #3775 on: October 16, 2017, 05:46:43 AM »
Some people think these short term health plans will be a great way to keep health insurance costs cheaper, but these short-term plans lack the ACA protections against insurance company chicanery.

Magellan on Bogleheads has a great post about this:
https://www.bogleheads.org/forum/viewtopic.php?f=2&t=229476&p=3574790#p3573723

"Here are 3 common tricks, often spelled out only in the plan's fine print, that insurers use on these policies to trip people up:
1) Deny claims if anything was incorrect or omitted on the application, even if the error is not intentional or material.
2) Limit max payout per year, or exclude certain types of coverage (eg hospital, outpatient, drugs)
3) Exclude coverage of some outpatient procedures or some prescription drugs.

The last one is particularly pernicious because you have to basically be a medical expert and read the policy's fine print and drug formulary to learn what's covered. Some plans cover some prescription drugs, but exclude all or most chemotherapy drugs. This can leave a 6 figure hole in your coverage even if everything else checks out."



former player

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Re: What comes after the ACA?
« Reply #3776 on: October 16, 2017, 06:04:45 AM »
There are some interesting threads on different forms of governance throughout the world, along with how US perceptions differ sharply from other western developed nations.
Let's keep this thread focused on "what comes after the ACA" and not have it devolve into nation-bashing.
Constitution-bashing is different from nation-bashing, right?

One of the fundamental problems with "what comes after the ACA" is the dysfunctional legislative system that created it in its current illogical form and then prevents it from being amended or replaced in any logical fashion, whether those changes are from a republican or democrat point of view.   And that dysfunctional legislative system derives from a poorly functioning constitution as well as from political problems in making changes to the legislative system which the current constitution would allow.

And, honestly, part of the problem with legislative failures on the ACA, taxes, infrastructure and spending is that they have driven the President to look for "wins" in foreign policy instead, which is now becoming a problem for the whole fucking world, given North Korea and Iran.  Maybe if a solution could be found for the ACA he would settle down and back off on the international front.
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nereo

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Re: What comes after the ACA?
« Reply #3777 on: October 16, 2017, 06:46:29 AM »
There are some interesting threads on different forms of governance throughout the world, along with how US perceptions differ sharply from other western developed nations.
Let's keep this thread focused on "what comes after the ACA" and not have it devolve into nation-bashing.
Constitution-bashing is different from nation-bashing, right?

Well for countries that are fundamentally based on a constitution, it's hard to make a distinction

One of the fundamental problems with "what comes after the ACA" is the dysfunctional legislative system that created it in its current illogical form and then prevents it from being amended or replaced in any logical fashion, whether those changes are from a republican or democrat point of view.   And that dysfunctional legislative system derives from a poorly functioning constitution as well as from political problems in making changes to the legislative system which the current constitution would allow.
That is all fine and well and good topics to discuss.  But the jump from the legislative processes which formed the ACA to the apparent superiority of other nations is where the train runs off the rails.  IMO there's no reason to bring other governmental systems into the discussion while explicitly saying 'this system is different than the one that created or could modify the ACA'.
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boarder42

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Re: What comes after the ACA?
« Reply #3778 on: October 16, 2017, 06:57:30 AM »
Some people think these short term health plans will be a great way to keep health insurance costs cheaper, but these short-term plans lack the ACA protections against insurance company chicanery.

Magellan on Bogleheads has a great post about this:
https://www.bogleheads.org/forum/viewtopic.php?f=2&t=229476&p=3574790#p3573723

"Here are 3 common tricks, often spelled out only in the plan's fine print, that insurers use on these policies to trip people up:
1) Deny claims if anything was incorrect or omitted on the application, even if the error is not intentional or material.
2) Limit max payout per year, or exclude certain types of coverage (eg hospital, outpatient, drugs)
3) Exclude coverage of some outpatient procedures or some prescription drugs.

The last one is particularly pernicious because you have to basically be a medical expert and read the policy's fine print and drug formulary to learn what's covered. Some plans cover some prescription drugs, but exclude all or most chemotherapy drugs. This can leave a 6 figure hole in your coverage even if everything else checks out."

i find the post halfway down about how if you're in a state thats beefing up the cost of silver plans to account for it - you're gonna see a 20% savings.  I just did a hypothetical around our FIRE date and assuming our kids dont have any major medical issues that require constat treatment and the ACA plans are still very affordable in our state.
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iris lily

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Re: What comes after the ACA?
« Reply #3779 on: October 16, 2017, 07:54:40 AM »
I'm not sure if the American system of government really works for modern America. Or anywhere else, to be honest. Most countries that apply American-style constitutional democracy seem to collapse into endless bickering, gridlock and corruption pretty quickly. No, what you need is the swift, authoritative action of a parliamentary system, preferably under the oversight of a divinely-appointed monar- *is dragged off and dumped in Boston harbour*


And good riddance to you, sir! Haha.

Shush dont tell anyone but I am a bit of a monarchist myself. Bring back the Stuarts!

Virescit Vulnere Virtus!
« Last Edit: October 16, 2017, 09:09:21 AM by iris lily »

Wexler

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Re: What comes after the ACA?
« Reply #3780 on: October 16, 2017, 09:25:01 AM »
EnjoyIt:

https://www.vox.com/policy-and-politics/2017/10/16/16357790/health-care-prices-problem

Check it out!  I think this is a good article. I don't totally agree that the ACA has no price control measures (bundling, for example, is a price control measure), but I do agree that bringing prices down was not a goal of the ACA and is a crucial fundamental next step.

My blood was absolutely boiling reading about that 25k MRI.  The hospital response was 100% nonsense.  Plus, the hospital had to know that its price was out of whack with the vast majority of reimbursement rates, and they did not inform the patient ahead of time.  I'd love to see a database of procedure average prices at each hospital.  If Stanford wants to charge 25k for an MRI, they can probably fill all their slots with rich foreign patients, but at least US patients can be warned. 

MDM

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Re: What comes after the ACA?
« Reply #3781 on: October 16, 2017, 11:03:28 AM »
These cost-sharing subsidies are in the ACA law. The Congress can choose to not fund it, but then the government will be sued in federal court, and lose, and have to pay them with interest. Paying interest on a lost case is not a way to keep the federal budget in control.
Perhaps.  One can also say that money for the CSRs was not appropriated, the president chose to fund them, but then the president was sued in federal court and lost.

protostache

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Re: What comes after the ACA?
« Reply #3782 on: October 16, 2017, 11:23:52 AM »
These cost-sharing subsidies are in the ACA law. The Congress can choose to not fund it, but then the government will be sued in federal court, and lose, and have to pay them with interest. Paying interest on a lost case is not a way to keep the federal budget in control.
Perhaps.  One can also say that money for the CSRs was not appropriated, the president chose to fund them, but then the president was sued in federal court and lost.

The executive didn't lose the case. One judge found that the House had standing (which surprised everyone, including the House) and accepted their interpretation of the facts. That judge stayed their ruling pending appeal, which the Obama administration was actively pursing until now.

One interpretation of this that that I read today paints this as a huge loss for the Executive and a huge gain for Congress as institutions. That lawsuit was the first of it's kind. Normally Congress and the Executive fight things out with the political process defined in the Constitution, but now with a bare majority they can pass a resolution and file a lawsuit in DC district court anytime they don't like what the Executive is doing. That's one of the primary reason why the Obama administration was fighting it.

jim555

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Re: What comes after the ACA?
« Reply #3783 on: October 16, 2017, 11:36:18 AM »
Side note for NYers:
New York's open enrollment period for 2018 is the full 90 days, not the shortened 45 days everywhere else.  Since NY runs its own exchange it has the ability to set to OE period.  As usual, the Essential plan and Medicaid plans are open all year.


MDM

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Re: What comes after the ACA?
« Reply #3784 on: October 16, 2017, 12:32:12 PM »
One interpretation of this that that I read today paints this as a huge loss for the Executive and a huge gain for Congress as institutions.
That's good if one is concerned about a president going rogue; bad if one is concerned about a large group ever being able to take decisive action.

nereo

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Re: What comes after the ACA?
« Reply #3785 on: October 16, 2017, 03:06:50 PM »
One interpretation of this that that I read today paints this as a huge loss for the Executive and a huge gain for Congress as institutions.
That's good if one is concerned about a president going rogue; bad if one is concerned about a large group ever being able to take decisive action.

It's also worth pondering whether this method of congress regaining its powers is a good thing or not.  I've been advocating since 2001 for congress to step up and reassert its constitutional power of the purse and legislative check on the executive office, but here we've got the WH punting because its a political turd.  Literally no one in congress is happy that they're now responsible.
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protostache

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Re: What comes after the ACA?
« Reply #3786 on: October 16, 2017, 04:34:38 PM »
One interpretation of this that that I read today paints this as a huge loss for the Executive and a huge gain for Congress as institutions.
That's good if one is concerned about a president going rogue; bad if one is concerned about a large group ever being able to take decisive action.

If congress wants to regain power it needs to get together and pass some laws with a veto proof majority that restrict the executive’s power. That’s how this is supposed to work. The judiciary is not supposed to mediate between them like this.

DavidAnnArbor

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Re: What comes after the ACA?
« Reply #3787 on: October 16, 2017, 07:14:16 PM »
The congress passed the ACA in the first place. No law is ever perfect 100% and it is expected that congress may have to refine laws that are passed.
But when the Republicans took over the Congress rather than compromise over solutions to the ACA, they tried to sabotage the law.
Ultimately the Republicans were unable to come up with their own plan in 2017.
Not funding the CSR's is not a solution, and the government will be forced to fund them because that's the way the ACA law is written.
You can say the Congress has the power of the purse, but when it uses that power to go against the law, then the power is meaningless.
The government will be forced by the courts to fund the CSR.

MDM

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Re: What comes after the ACA?
« Reply #3788 on: October 16, 2017, 07:50:13 PM »
One interpretation of this that that I read today paints this as a huge loss for the Executive and a huge gain for Congress as institutions.
That's good if one is concerned about a president going rogue; bad if one is concerned about a large group ever being able to take decisive action.

If congress wants to regain power it needs to get together and pass some laws with a veto proof majority that restrict the executive’s power. That’s how this is supposed to work. The judiciary is not supposed to mediate between them like this.
If congress tried to so do, the executive could simply say "that's unconstitutional" and back to the judiciary they go to settle the playground spat.

MDM

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Re: What comes after the ACA?
« Reply #3789 on: October 16, 2017, 07:51:42 PM »
It's also worth pondering whether this method of congress regaining its powers is a good thing or not.
Agreed.

Quote
I've been advocating since 2001 for congress to step up and reassert its constitutional power of the purse and legislative check on the executive office, but here we've got the WH punting because its a political turd.  Literally no one in congress is happy that they're now responsible.
Yes, ducking responsibility is a trait of many politicians.

MDM

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Re: What comes after the ACA?
« Reply #3790 on: October 16, 2017, 07:54:04 PM »
The congress passed the ACA in the first place. No law is ever perfect 100% and it is expected that congress may have to refine laws that are passed.
But when the Republicans took over the Congress rather than compromise over solutions to the ACA, they tried to sabotage the law.
Ultimately the Republicans were unable to come up with their own plan in 2017.
Yup.  That was a major failure, considering all the posturing they had been doing for 7 years.

Quote
Not funding the CSR's is not a solution, and the government will be forced to fund them because that's the way the ACA law is written.
You can say the Congress has the power of the purse, but when it uses that power to go against the law, then the power is meaningless.
The government will be forced by the courts to fund the CSR.
Time will tell.

ZiziPB

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Re: What comes after the ACA?
« Reply #3791 on: October 17, 2017, 12:42:18 PM »
Looks like it didn't take long for something to be done with CSR funding:  http://www.cnn.com/2017/10/17/politics/health-care-csr-payments-deal-reached/index.html



Exflyboy

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Re: What comes after the ACA?
« Reply #3792 on: October 17, 2017, 03:55:54 PM »
Looks like it didn't take long for something to be done with CSR funding:  http://www.cnn.com/2017/10/17/politics/health-care-csr-payments-deal-reached/index.html

And Trump still spinning it like its a success.. which it is.. because HE failed.. again!
« Last Edit: October 17, 2017, 07:12:53 PM by Exflyboy »

Slate-WA

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Re: What comes after the ACA?
« Reply #3793 on: October 17, 2017, 04:52:12 PM »
Sorry if this has already been asked/answered: what is the plan for everyone's healthcare at this point- for those under 62. 

It looks like insuring our family will cost 1800/mo 20k a year - is that was Mr Money Mustache is paying or is he self insuring?  This is the highest deductible plan available for a family of 4 that I can see.

v8rx7guy

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Re: What comes after the ACA?
« Reply #3794 on: October 17, 2017, 04:56:23 PM »
Sorry if this has already been asked/answered: what is the plan for everyone's healthcare at this point- for those under 62. 

It looks like insuring our family will cost 1800/mo 20k a year - is that was Mr Money Mustache is paying or is he self insuring?  This is the highest deductible plan available for a family of 4 that I can see.

If you're religious, look into health sharing ministry, $500/mo -ish.  Hopefully the law will change soon and we can start a new heath sharing ministry for those who subscribe to the MMM philosophy!

https://forum.mrmoneymustache.com/ask-a-mustachian/let%27s-talk-about-health-share/
« Last Edit: October 17, 2017, 05:01:46 PM by v8rx7guy »

DavidAnnArbor

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Re: What comes after the ACA?
« Reply #3795 on: October 17, 2017, 06:44:20 PM »
Sorry if this has already been asked/answered: what is the plan for everyone's healthcare at this point- for those under 62. 

It looks like insuring our family will cost 1800/mo 20k a year - is that was Mr Money Mustache is paying or is he self insuring?  This is the highest deductible plan available for a family of 4 that I can see.

Many will try to live within an income in the subsidies range

jim555

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Re: What comes after the ACA?
« Reply #3796 on: October 17, 2017, 07:09:45 PM »
Sorry if this has already been asked/answered: what is the plan for everyone's healthcare at this point- for those under 62. 

It looks like insuring our family will cost 1800/mo 20k a year - is that was Mr Money Mustache is paying or is he self insuring?  This is the highest deductible plan available for a family of 4 that I can see.

If you're religious, look into health sharing ministry, $500/mo -ish.  Hopefully the law will change soon and we can start a new heath sharing ministry for those who subscribe to the MMM philosophy!

https://forum.mrmoneymustache.com/ask-a-mustachian/let%27s-talk-about-health-share/
The big downside to this is the health sharing ministry has no legal obligation to pay your bills.  To me this kinda defeats the purpose of being insured. 

frugalecon

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Re: What comes after the ACA?
« Reply #3797 on: October 18, 2017, 03:26:30 AM »
Looks like it didn't take long for something to be done with CSR funding:  http://www.cnn.com/2017/10/17/politics/health-care-csr-payments-deal-reached/index.html

Sorry to burst your bubble, but nothing has been passed. I wouldn’t count on it just yet.

boarder42

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Re: What comes after the ACA?
« Reply #3798 on: October 18, 2017, 04:06:37 AM »
Sorry if this has already been asked/answered: what is the plan for everyone's healthcare at this point- for those under 62. 

It looks like insuring our family will cost 1800/mo 20k a year - is that was Mr Money Mustache is paying or is he self insuring?  This is the highest deductible plan available for a family of 4 that I can see.

If you're religious, look into health sharing ministry, $500/mo -ish.  Hopefully the law will change soon and we can start a new heath sharing ministry for those who subscribe to the MMM philosophy!

https://forum.mrmoneymustache.com/ask-a-mustachian/let%27s-talk-about-health-share/

Healthshare seems like a great solution.  Though I did just rerun the calc on the gov site for my state and it said 1800 a year for a family of 4 with an agi at the top of the 15% bracket. So what are you doing to reach 1800 a month. 

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Monkey Uncle

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Re: What comes after the ACA?
« Reply #3799 on: October 18, 2017, 04:45:26 AM »
Looks like it didn't take long for something to be done with CSR funding:  http://www.cnn.com/2017/10/17/politics/health-care-csr-payments-deal-reached/index.html

Sorry to burst your bubble, but nothing has been passed. I wouldn’t count on it just yet.

News this morning is that the deal is getting a chilly reception from Republican leadership in the Senate, and the crazies in the House are downright hostile.  All the support from Democrats and moderate Republicans won't matter if it never comes up for a vote.
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