What comes after the ACA?

[sol]

Great news analysis about how much bloat there is in health care spending

What jumps out at me is that the US spends 8% of health spending on the administration of it, versus 3% globally. Administration is the paperwork and medical coders and claims administrators.

Unfortunately, a 5% improvement is not going to make us competitive with other countries, on healthcare spending.  I mean every little bit helps, I suppose, but I would have thought this was a larger part of the problem.

[EnjoyIt]

Great news analysis about how much bloat there is in health care spending

What jumps out at me is that the US spends 8% of health spending on the administration of it, versus 3% globally. Administration is the paperwork and medical coders and claims administrators.

https://www.nytimes.com/2017/04/22/opinion/sunday/our-costly-addiction-to-health-care-jobs.html?action=click&pgtype=Homepage&clickSource=story-heading&module=opinion-c-col-top-region&region=opinion-c-col-top-region&WT.nav=opinion-c-col-top-region&_r=0

I cut of 5% would be welcome.  We spend about $10k per person per year.  On a population of 330 Million that comes to $3.3 Trillion/yr.  a 5% cut would decrease spending by $165 billion which would be some significant savings.  $165 Billion would be more than enough to help supply care for those who can't afford access.

I suspected administrative costs would be higher.  Interesting info and thanks for sharing.

For every doctor, there are 16 other health care workers. And half of those 16 are in administrative and other nonclinical roles, according to Bob Kocher, a former Obama administration official who worked on the Affordable Care Act and is now a partner in the venture capital firm Venrock.

Also, this does not include the inefficiency that regulation has created in the industry.  What used to takes 1 physician an hour to accomplish now takes much longer which requires more care givers to do the same job and that increases cost as well and not accounted for in the above 8% making the number much larger.

[jim555]

Trump's latest tweet:
"ObamaCare is in serious trouble. The Dems need big money to keep it going - otherwise it dies far sooner than anyone would have thought."

This statement is drenched in dishonesty.  He is threatening to cut off funding for the Silver CSRs due to the House Repubs lawsuit and then he blames the Dems for something he is doing.  Playing games with peoples lives entertains him.  Sorry Donnie get Mexico to pay for that big beautiful wall and stop holding the CSRs hostage for it.

[DavidAnnArbor]

Yes the cost sharing reduction is vital to making the insurance and health care affordable.

[Lagom]

This is fun. The latest plan includes an exemption for GOP politicians/staffers based in states that opt-out so that they can personally continue to keep the benefits of the ACA. But that doesn't matter because the ACA is still unequivocally a terrible idea amirite??

http://www.msn.com/en-us/news/politics/republicans-exempt-their-own-insurance-from-their-latest-health-care-proposal/ar-BBAnqI1?li=BBnb7Kz

[obstinate]

This is fun. The latest plan includes an exemption for GOP politicians/staffers based in states that opt-out so that they can personally continue to keep the benefits of the ACA. But that doesn't matter because the ACA is still unequivocally a terrible idea amirite??

http://www.msn.com/en-us/news/politics/republicans-exempt-their-own-insurance-from-their-latest-health-care-proposal/ar-BBAnqI1?li=BBnb7Kz

I love how each iteration is worse and more extreme than the last.

[nereo]

This is fun. The latest plan includes an exemption for GOP politicians/staffers based in states that opt-out so that they can personally continue to keep the benefits of the ACA. But that doesn't matter because the ACA is still unequivocally a terrible idea amirite??

http://www.msn.com/en-us/news/politics/republicans-exempt-their-own-insurance-from-their-latest-health-care-proposal/ar-BBAnqI1?li=BBnb7Kz

I love how each iteration is worse and more extreme than the last.

FWIW - the GOP is looking to undo this loophole after getting some egg on their faces.  Allegedly most didn't realize it was even in there (which seems plausible given how few actually read and understand the actual legislation anymore), and everyone's mum about who put it in there.

(link to article)

[Gin1984]

This is fun. The latest plan includes an exemption for GOP politicians/staffers based in states that opt-out so that they can personally continue to keep the benefits of the ACA. But that doesn't matter because the ACA is still unequivocally a terrible idea amirite??

http://www.msn.com/en-us/news/politics/republicans-exempt-their-own-insurance-from-their-latest-health-care-proposal/ar-BBAnqI1?li=BBnb7Kz

I love how each iteration is worse and more extreme than the last.

FWIW - the GOP is looking to undo this loophole after getting some egg on their faces.  Allegedly most didn't realize it was even in there (which seems plausible given how few actually read and understand the actual legislation anymore), and everyone's mum about who put it in there.

(link to article)

Except that an aide from the Rep who officially wrote it, confirmed THEY knew it was there.  So I'd go with they are lying again.

Sent from my SPH-L710 using Tapatalk

[DavidAnnArbor]

I don't see how this new version can pass the Senate, and maybe not even the House.

In the meantime the effort to possibly not fund the cost sharing may become the way Trump tries to blow up affordable healthcare act

[stoaX]

Single payer government funded/run healthcare in Cali for everyone including illegal immigrants:

https://www.google.com/amp/www.latimes.com/politics/la-pol-sac-single-payer-healthcare-20170426-story,amp.html?espv=1

Doubt it will get very far.

It includes vision and dental too.  That will be one hefty price tag.  The big unknown is how many people will come to the state to get their free healthcare if California doesn't have any rules about who is eligible.

[nereo]

Single payer government funded/run healthcare in Cali for everyone including illegal immigrants:

https://www.google.com/amp/www.latimes.com/politics/la-pol-sac-single-payer-healthcare-20170426-story,amp.html?espv=1

Doubt it will get very far.

It includes vision and dental too.  That will be one hefty price tag.  The big unknown is how many people will come to the state to get their free healthcare if California doesn't have any rules about who is eligible.

Finally!  A useful function for Bay Area traffic!

[EnjoyIt]

Single payer government funded/run healthcare in Cali for everyone including illegal immigrants:

https://www.google.com/amp/www.latimes.com/politics/la-pol-sac-single-payer-healthcare-20170426-story,amp.html?espv=1

Doubt it will get very far.

Considering that California is the ranked #44 in fiscal health based on revenue and obligations, I would first make sure I sold all municipal bonds that pertain to California, and I would then consider moving to avoid an even further increase in taxes.  This plan won't be cheap.

[Bucksandreds]

This is fun. The latest plan includes an exemption for GOP politicians/staffers based in states that opt-out so that they can personally continue to keep the benefits of the ACA. But that doesn't matter because the ACA is still unequivocally a terrible idea amirite??

http://www.msn.com/en-us/news/politics/republicans-exempt-their-own-insurance-from-their-latest-health-care-proposal/ar-BBAnqI1?li=BBnb7Kz

I love how each iteration is worse and more extreme than the last.

FWIW - the GOP is looking to undo this loophole after getting some egg on their faces.  Allegedly most didn't realize it was even in there (which seems plausible given how few actually read and understand the actual legislation anymore), and everyone's mum about who put it in there.

(link to article)

That's not egg that the Repubs have on their faces. That's billionaire semen. It's part of the whole trickle down economics thing. It trickles down their chins and is part of the payment for those big campaign contributions.

[Monkey Uncle]

I don't see how this new version can pass the Senate, and maybe not even the House.

In the meantime the effort to possibly not fund the cost sharing may become the way Trump tries to blow up affordable healthcare act

He backed off of that earlier this week (at least for now).

[Lagom]

Single payer government funded/run healthcare in Cali for everyone including illegal immigrants:

https://www.google.com/amp/www.latimes.com/politics/la-pol-sac-single-payer-healthcare-20170426-story,amp.html?espv=1

Doubt it will get very far.

It includes vision and dental too.  That will be one hefty price tag.  The big unknown is how many people will come to the state to get their free healthcare if California doesn't have any rules about who is eligible.

They'll probably due away with Prop 13 and start taxing homeowners on the REAL value of their houses (so.much.money.). State income tax and sales tax are already pretty high so not too many places to increase unless they place it on (the soon to be fleeing) business or the (soon to be fleeing) wealthy.

Edited: I just read the whole Bill and other then transferring fed money into a state reserve fund didn't see how they planned to fund it. Or how they planned to determine residency (legal or illegal).
http://leginfo.legislature.ca.gov/faces/billTextClient.xhtml?bill_id=201720180SB562

I don't think this bill is in danger or passing, but either way I seriously doubt the disaster that is Prop 13 will ever be repealed. It's one of those things that every generation will hate until they are finally the old farts paying 75% less in taxes than their young neighbors and then they will fight tooth and nail to keep it.

[jim555]

Looks like a House vote tomorrow Thursday, which means they think they have the votes.  Trumpcare 3.0 is an even worse version of the original turd.  Rich folks need their tax cuts!

[nereo]

Looks like a House vote tomorrow Thursday, which means they think they have the votes.  Trumpcare 3.0 is an even worse version of the original turd.  Rich folks need their tax cuts!

My personal read is that they are just pea-cocking around right now, saying "we'll vote tomorrow, asbolutely, we are confident, it'll be great!".  Then it'll go like last time, where it gets pulled at the 11th hour with little fanfare.

It's a bit telling when you've got a 23 set majority and you can't even get to 218.  Literally zero support from across the isle and a few dozen (or so) from your own party not even willing to toe the line.

[jim555]

Looks like a House vote tomorrow Thursday, which means they think they have the votes.  Trumpcare 3.0 is an even worse version of the original turd.  Rich folks need their tax cuts!

My personal read is that they are just pea-cocking around right now, saying "we'll vote tomorrow, asbolutely, we are confident, it'll be great!".  Then it'll go like last time, where it gets pulled at the 11th hour with little fanfare.

It's a bit telling when you've got a 23 set majority and you can't even get to 218.  Literally zero support from across the isle and a few dozen (or so) from your own party not even willing to toe the line.

I would like to think you are right.  But they need to do this now due to the way their schedule lays out.  I don't underestimate them, they are not even waiting for the CBO scoring of the bill.

[NESailor]

Looks like a House vote tomorrow Thursday, which means they think they have the votes.  Trumpcare 3.0 is an even worse version of the original turd.  Rich folks need their tax cuts!

My personal read is that they are just pea-cocking around right now, saying "we'll vote tomorrow, asbolutely, we are confident, it'll be great!".  Then it'll go like last time, where it gets pulled at the 11th hour with little fanfare.

It's a bit telling when you've got a 23 set majority and you can't even get to 218.  Literally zero support from across the isle and a few dozen (or so) from your own party not even willing to toe the line.

Right?  I love how we've redefined success when led by a guy who's major claim to fame (if we strip the hyperbole) is "I didn't lose my inheritance and managed to slowly grow it (maybe) despite multiple professional bankruptcies".   WINNING!

Anybody here read Kaiser Health News?  Usually a great synopsis of the current topics every morning.  My take on today's synopsis:  This thing is a shitshow and the major challenge is not really repealing it as much as trying to disown any and all consequences of any and all actions related to healthcare.  Some leaders we've elected...

[WhiteTrashCash]

The funny thing about this whole situation for me is that unlike many of Trump's voters I have employer-provided health insurance, yet I voted for Clinton to preserve his voters' healthcare because I am a nice person. Now Trump wants to take health insurance subsidies away from millions of his voters to give tax breaks to corporations which will result in stock values increasing. I have invested a bunch in Vanguard, so I'm going to get a piece of the profits across the board.

Put that all together and Trump's voters basically voted to take away the federal subsidies for their own health insurance and give the money to me instead. Well, okay then. Thanks, I guess.

[Luck12]

This week I called 15 congressional offices on this awful bill.   Might be too late but the House Rules Committee is accepting comments on this at 202-225-9191, I called in and let a curse word or two in along with several reasons it's a travesty. 

They're just pushing this through quickly so they can pass huge tax cuts for the wealthy faster. 

So I guess we are largely fucked if/when this gets passed by the Senate? 

Tom Perez was right:  Republicans don't give a shit about people. 

[EscapeVelocity2020]

This probably isn't the right place to be a philosophical asshole, but I can't help it anymore.  I really liked Obamacare, or at least the idea of universal healthcare for all American citizens, although I currently and probably always would pay in to the system and get nothing in return.  Overall, I was invigorated to see a somewhat universal healthcare suddenly become reality, complete with online applications and help centers to move this country forward into the 21st century (or at least give my fellow man what every other first world country has had for decades).  Sadly, it was too fragile; too beautiful for Republicans not to gut.  Like a pinata that can be beaten for years to come, I will now get a cut on my taxes (actually, I get to keep money that I didn't used to give to the government) and I have some protections just in case I do lose my coverage.  Well, I get a nice loophole that I can take bare-bones coverage and then lapse for a while without penalty, then re-apply.  Unfortunately, the whole Republican-ideology of exploiting tax loopholes and lowering taxation is exactly the wrong way to understand universal health care.  So this ultimately is a short fuse set to blow up American healthcare and return to private insurance (the prior inane status quo) as opposed to a thought-through plan to expand medicare and move forward with exchanges.

Oh well, America almost made it into the 21st century.  It had everything going for it (hindsight), but fumbled on the 1 yard line.

[nereo]

 
So I guess we are largely fucked if/when this gets passed by the Senate? 

Well I think that's where it gets really interesting (from a armchair politics standpoint). IF it gets voted on and passes to the senate it'll be debated upon, tweaked etc.  There are several republican senators that are likely not to support the bill in its current form (Collins (ME) comes to mind).  So my bet is the senate will either modify it heavily or kill it outright.  Since the senate by design moves slower than the house (as it should be) the CBO will be able to 'score' the present bill, which I doubt will be good news for the GOP. If the senate restructures the bill to be more moderate with more generous subsides that will piss off the freedom caucus who are most concerned with shrinking the budget obligations than anything else.

Democrats right now if it passes in the house but gets killed (or restructured) in the senante.  Those attack ads for vulnerable house seats will practically write themselves.

My money is still on this being pulled sometime this afternoon and disavowed like some bastard child.

Personally, I'm miffed at this whole thing. There are some reasonable flaws with the ACA that could have been addressed either with modification or repeal/replace. Seven years - I had hoped the plan put forth would have been far more thought out.  Instead its being rushed through with last minute sweeteners ($5B... no $8B for the risk pools!) just to get enough votes from the main party. The legislative rush seems designed more to outrun analyses (by the CBO and moderate/liberal interest groups) than because of any national urgent need to change the system we have right this very second. Sigh.

[thenextguy]

The funny thing about this whole situation for me is that unlike many of Trump's voters I have employer-provided health insurance, yet I voted for Clinton to preserve his voters' healthcare because I am a nice person.

The Republican bill could impact your employer-provided insurance, too.

[Luck12]

The funny thing about this whole situation for me is that unlike many of Trump's voters I have employer-provided health insurance, yet I voted for Clinton to preserve his voters' healthcare because I am a nice person.

The Republican bill could impact your employer-provided insurance, too.

Yep.  I don't entirely blame people for not knowing the full ramifications of this since they're rushing this so quickly.  Lifetime and annual max benefits only apply to essential benefits.  Change the definition of essential benefits and you end up with neutred elimination of lifetime and annual max.  Means higher chance of bankruptcy even with employer coverage should you surive cancer, stroke, etc.   

Also, "selling across state lines" essentially means we'll have the "Delaware of health insurance", race to the bottom type of situation.   

[NESailor]

The funny thing about this whole situation for me is that unlike many of Trump's voters I have employer-provided health insurance, yet I voted for Clinton to preserve his voters' healthcare because I am a nice person.

The Republican bill could impact your employer-provided insurance, too.

Yep.  I don't entirely blame people for not knowing the full ramifications of this since they're rushing this so quickly.  Lifetime and annual max benefits only apply to essential benefits.  Change the definition of essential benefits and you end up with neutred elimination of lifetime and annual max.  Means higher chance of bankruptcy even with employer coverage should you surive cancer, stroke, etc.   

Also, "selling across state lines" essentially means we'll have the "Delaware of health insurance", race to the bottom type of situation.

Let's start a pool.  My vote is it'll be Kentucky - the new preferred health insurance domicile.

[JayhawkRacer]

The funny thing about this whole situation for me is that unlike many of Trump's voters I have employer-provided health insurance, yet I voted for Clinton to preserve his voters' healthcare because I am a nice person. Now Trump wants to take health insurance subsidies away from millions of his voters to give tax breaks to corporations which will result in stock values increasing. I have invested a bunch in Vanguard, so I'm going to get a piece of the profits across the board.

Put that all together and Trump's voters basically voted to take away the federal subsidies for their own health insurance and give the money to me instead. Well, okay then. Thanks, I guess.

This is exactly how I feel. Tons of people voted against their best interests. Myself included. I just voted to support those less fortunate than me, and Trump voters voted to support those more fortunate than themselves.

[Trudie]

Since Trump was elected I have called my Representative -- a member of the Freedom Caucus -- on health care no fewer than ten times.  This morning I actually got through to his Washington, D.C. office and also left a message at his local office.  A staffer called me back and what ensued was a ten-minute (albeit, civil) debate about health care reform.  I repeatedly pointed out that the tactics the Republicans were taking had a decidedly "back room" feel to it.  That by saying we are "reading and studying the bill," yet rushing it through without much debate nor -- most importantly -- scoring by the CBO it's a bad deal.  Not only for the people who will have to live under it, but for the Republicans politically who advanced it.  He wanted to argue that the passage of Obamacare was equally non-transparent, to which I encountered, "To the contrary, I remember over a year of public debate."  They do not care.

His one question, "Are you on Obamacare now?"  My answer, "No.  But we hoped to be in the next five years."  As if there aren't enough other poison pills in the bill that affect everyone else, including those on employer-provided insurance.

I provided my own personal story, about my husband who has a form of rheumatoid arthritis.  According to recent actuarial estimates we wpuld pay an additional $32K per year in additional premiums under the AHCA.  That's not affordable health care.

The staffer countered with, "Well, with high risk pools you'll never have to pay that."  My response:  "Yes - these high risk pools which, theoretically might be a workable idea if they were actually funded, if we have a CBO score, if we knew we wouldn't have a waiting list, and if we knew our state wouldn't gut protections leaving us out in the cold anyway."

There are just too many unanswered questions and they have moved in a very impulsive fashion.  It never ceases to amaze me how much they are willing to risk the health and well-being of a significant portion of our citizens to score political points.  I admit that Obamacare needs reform -- but this is political hackery.

[PathtoFIRE]

Since gutting the ACA is needed in order to later provide the level of permanent tax cuts that are being sought, based on Senate rules regarding reconciliation and filibuster, this provides a good argument for encouraging the Senate Republicans to go ahead and ditch the legislative filibuster as well. In that situation, I do wonder if the appetite for health care re-reform would disappear for all but the true ideologues.

[nereo]

Thanks for sharing, and for calling your rep in the first place.
My rep ran as an unopposed democrat, so there's not much that will change by me calling him.

I totally agree about this ridiculous rush to a vote. They're hoping that most won't remember the lengthy process to get the ACA passed (and to some extent they're probably right - memories are short and easily maleable).  Regardless, it jsut makes no damn sense to push forward now vs waiting another 7-10 days.  Even from a GOP perspective I wouldn't want my vote recorded before the CBO and several high profile (AARP, AMA, etc) have had a chance to weigh in.

There's a saying in law; never ask a question you don't know the answer to. 
Right now the GOP is being asked to vote when they don't know the CBO's answer (but they already suspect it will be very bad for them).

It seems their best hope is that the bill will be so modified by the Senate that it won't even resemble what they are sending out.  Of course, if I were a GOP Senator I'd be effin' pissed to have something so rank thrown up on my doorstep. 
Here's a turd, now turn it into a chocolate cake that we can all eat! ... and do it fast!

[NESailor]

It seems their best hope is that the bill will be so modified by the Senate that it won't even resemble what they are sending out.  Of course, if I were a GOP Senator I'd be effin' pissed to have something so rank thrown up on my doorstep. 
Here's a turd, now turn it into a chocolate cake that we can all eat! ... and do it fast!

I think it's everyone's best hope honestly.  The main reason being is that large swaths of the population have swallowed such immense amounts of anti-Obamacare Kool Aid that we cannot have an adult conversation about the topic anymore.

[Lagom]

Btw, the exemption for reps and their staff is still in this bill. But don't worry, they'll get to it later...

http://thehill.com/homenews/senate/331867-republicans-can-exempt-themselves-from-obamacare-rollbacks-in-new-legislation?rnd=1493866040

I really struggle to see the strategy here. I can't believe they actually hope that this bill goes the distance. Is there any way that doesn't lead to a total massacre at the midterms?

My best guess is they hope the Senate changes it to the point that it's relatively not terrible (at least not obviously) and then they can go into the midterms claiming some kind of YUGE victory in the healthcare debate.

[nereo]

The more time passes, the more brilliant John Boehner's calculated decision to exit at that particular time seems to me.
"...there's a blue bird on my shoulder..."

[nereo]

...and the vote is on! (so I'm already wrong there...)

[bacchi]

Looks like it'll be on party lines. <-- the vote on exempting Congress, that is. I'm sure the R&R bill will be the same.

Who decides what is a pre-existing condition? Is asthma?

[protostache]

Looks like it'll be on party lines. <-- the vote on exempting Congress, that is. I'm sure the R&R bill will be the same.

Who decides what is a pre-existing condition? Is asthma?

The insurance companies, of course.

And yes of course asthma is a pre-existing condition. If you've ever made any claim to any insurance plan ever outside of a yearly checkup and a flu shot, that's going to be a pre-existing condition. (hyperbole, but not much)

[nereo]

Looks like it'll be on party lines. <-- the vote on exempting Congress, that is. I'm sure the R&R bill will be the same.

Who decides what is a pre-existing condition? Is asthma?

The insurer with whatever restrictions the bill (written by congress) dictates. 
The Kaiser foundation wrote a white paper about the differences between the ACA and the current version of the AHCA.
By their estimate 52MM people (roughly 27%) of the US can be labeled as having a 'pre-existing condition".

The potentially medically eligible population in high-risk pool states was likely much larger.  A Kaiser Family Foundation study found that 27% of adults under the age of 65 have health conditions that, prior to the ACA,  would have rendered them uninsurable if they had sought coverage in the non-group market.

http://kff.org/health-reform/issue-brief/high-risk-pools-for-uninsurable-individuals/

[bacchi]

And many of those states with the highest pre-existing conditions voted for Trump.

It is a nail biter! Some Repubs have voted nay.

[bacchi]

Whoa...it's gonna fail. Wow, unexpected. Nm. Fuuuuck.

[Lagom]

Whoa...it's gonna fail. Wow, unexpected.

Looks to me like it passed?

[NESailor]

And the Chief tweets...

"Insurance companies are fleeing ObamaCare - it is dead. Our healthcare plan will lower premiums & deductibles - and be great healthcare!"  (emphasis mine).

Totally baffling.  Any self-respecting reporter should keep asking him to explain this stuff:  Question:.... Nonsensical Answer.... Same question...nonsensical answer...same question.   Every. Single. One.   Until he either gets the message or people (slowly) realize he does not have all his marbles.

[OurTown]

How many of us will be working to age 65 now?

[bacchi]

Whoa...it's gonna fail. Wow, unexpected.

Looks to me like it passed?

It did, it did. I was hoping that one more Repub would flip.

The good news is that Senate-House negotiation will be very tricky.

[nereo]

How many of us will be working to age 65 now?

Let's not get ahead of ourselves.
It goes on to the Senate now, where it will have an ever tougher challenge and will almost certainly be altered.  what it will look like when they are done is anyone's guess.
Then (assuming the Senate can modify it enough to pass it) it has to go through reconciliation with the House before it gets to DJT. 

During that time period the CBO score will come out, as will a lot more analyses by everyone from the AARP to the AMA. 
There's no telling whether members like the Freedom Caucus will support the Senate's version of the bill or not.

Vote 217 up, 213 down.  Zero democrats supporting.

[NESailor]

I'm sure this will get butchered in the Senate so I'm not that worried about it yet.

Nevertheless - how goddamn audacious is this considering version 1.0 had approval ratings of what...17%?  They made the bill worse, and somehow got a majority to vote for it because...why exactly?  Stunning.

[jim555]

I think it gets through the Senate and eventually approved.  Repubs always tow the party line no matter how much noise they make before the vote.  The only upside is the end of uncertainty so contingency plans can be put into action.  I have been basically frozen waiting to see what happens with this issue.

[Lagom]

Apparently some of the republicans were chanting "na na na hey hey goodbye" on the floor? Really disgusting. But man will that make an easy campaign add for the dems.

[OurTown]

I'm about six years away from FIRE assuming I can cover health insurance.  Maybe I can get a p/t gig that has insurance.

[lbmustache]

I think it gets through the Senate and eventually approved.  Repubs always tow the party line no matter how much noise they make before the vote.  The only upside is the end of uncertainty so contingency plans can be put into action.  I have been basically frozen waiting to see what happens with this issue.

I feel the same way, as disheartening as this vote is. I can only hope the Senate makes this more palatable.

[Lagom]

I think it gets through the Senate and eventually approved.  Repubs always tow the party line no matter how much noise they make before the vote.  The only upside is the end of uncertainty so contingency plans can be put into action.  I have been basically frozen waiting to see what happens with this issue.

I feel the same way, as disheartening as this vote is. I can only hope the Senate makes this more palatable.

I'm sure they'll sprinkle some glitter on this turd of a bill and then start gaslighting the hell out of everyone with assurances that regardless of what independent think tanks say, this is what's best for America. Right now, polls suggest that's is a pretty damn risky gambit, but it's worked for them many times before, so we'll see.