So, I’ve just read a delightful little piece from Vox’s Ezra Klein regarding the potential future of a single payer system. Basically it amounts to this: if the Republicans push through the AHCA they may very well pave the way for a medicare for all program.
Why would that happen? Well firstly because the AHCA, based off what we know from the house, will cause millions of people to lose healthcare, healthcare costs to skyrocket, and inevitably massive electoral changes because of that. Secondly, Obamacare, for all it’s successes was also fairly flawed (fixable but flawed), and due to the way it passed and what it attempted to achieve many members of the democratic congress may will prefer to go for the simpler system that people are now openly advocating for.
Let me explain: when Obama and his congress were trying to pass the Affordable Care Act they did two things, and had to deal with a third (you may have noticed, I like lists):
- Worked with insurers to create a system they could support in a public private marketplace. The insurers then undercut the Obama administration by screwing up the pricing and participation, and then failing to stand up to republicans as we speak (primarily so they can regain control over costs and types of insurance they provide, and therefore make more money)
- The Dems worked with the Republicans to try and create a bipartisan bill, mostly to be polite. They didn’t have too, but instead they brought them in, allowed a number of amendments to be added and removed and did their level best to involve and respect the Republican view of healthcare. In turn the Republicans turned their backs on the arrangement and opposed the bill as best they could then.
- Past that, the Republican party then opposed and demonized the ACA for the next seven years, and used it to sweep themselves into office, rather than work to make it an effective bill for their constituents. Because Obama, or something.
So, basically despite their best attempts, the Dems were opposed an obstructed from making an incrementalist healthcare program work because the Republicans were basically being a bunch of dicks. So this time they might not even bother, nor might they need to, consult them in anyway and just pass single payer health care. If they can sweep the house, get the senate, which might well be possible, on a healthcare platform there is every chance they could pass such a bill. And since it would fundamentally be ‘better medicare’ people would be more open and accepting and most importantly understanding of the bill, Insurers wouldn’t be able to get in the way and Republicans would have a much harder time attacking the program.
Best of all the Democrats are openly and actively talking about this, not just the hopefuls but the moderates. They’ve seen incrementalism fail despite their best efforts, and now they have momentum. This could actually work.
So hey, silver lining for American healthcare. Maybe.
Vox: Republicans are About to Make Medicaid for All Much More Likely
Well, with 216 votes the Obamacare repeal bill has passed! Yep, the AHCA bill is through and will most likely cost the US billions (if not trillions) of dollars, strip millions of their healthcare and maybe even collapse the insurance industry!
Sigh, it’s like their not even trying anymore.
Though admittedly, it’s the Republicans, it’s not like anyone can expect them to actually make effective legislature.
Still given the nature of the senate, the concerns with a statewide election and the general, more moderate tone of the six year term members of that particular body it is likely that the bill will either be substantially changed (and therefore very unlikely to be passed again in the house, cause Freedom Caucus) or will just fail entirely. They might have been elected on getting rid of Obamacare, but no one wants be they one the state blames for costing millions their healthcare.
Well maybe Cruz and Cotton, and Paul but eh, I don’t know.
Still, I wasn’t sure it was gonna pass the house in the first place so certainly there’s no guarantee the bill won’t make it to Trumps desk. Also as I recall it has to be deficit neutral to pass reconciliation, right? Maybe it is dead in the water then.
Politico: Obamacare repeal sqeuks past
Paul Ryan’s healthcare bill is still in danger of failing, not only are a number of house conservatives still opposing the replacement bill for the ACA, even though some are willing to change their votes with concessions from Trump, but Senate conservatives are openly calling the bill dead on arrival (DOA). Its openly acknowledged that the republican senate only needs to lose two of its members for the bill to fail, especially with the Democrats united in opposition to the bill. The problems of course lead back to the issue of repealing Obamacare, and actually providing healthcare, or Medicaid benefits for their constituents. Ideological conservatives loathe Obamacare, because market place logic for a basic human right is apparently sensible…somewhere. And the more moderate members of the Senate and house are more concerned with their people losing both cover (24 million will lose their cover if the bill passes) and not being voted back in for being the guy who did that to them.
Naturally Ryan remains focused on passing this bill, even if the policy is detrimental to the majority of America, businesses and the economy (because the sheer level of money used on healthcare is enormous, and could be better applied if they moved away from a capitalist system. But that’s neither here nor there), which could be lead back the issue of the border adjustment tax, which having seemingly failed now seems to have resulted in an $800 billion decrease in Medicaid spending. All for tax cuts for the wealthy, because reasons.
At this stage, even if it does pass the house, it will probably fail in the senate, which may lead to the fall back plan of waiting for Obamacare to implode from its own destructive path.
Which, you know, it isn’t.
Politico: Healthcare bill DOA in Senate
The Republican Healthcare bill colloquially called Ryancare or Trumpcare, depending on who you ask and who they want to blame, is currently being worked on, allegedly incorporating changes to the bill to support the elderly and the poor says Reuters. Along with these are changes to federal block grants for states, and a requirement for able-bodied applicants of Medicaid to work. Presumably these changes are to encourage the support of both moderate Republicans, who would prefer more coverage for their constituents, and for the hardliners like the Freedom Caucus and Ted Cruz who want changes to Medicaid in an attempt to control the debt.
Whether these work is up to debate, however as Trump has seemingly gotten the Freedom Caucuses vote regarding the health bill there is all the more chance for this bill to pass the house. From there comes the Senate, and with it one of the more dangerous opponents of the bill: Sen. Tom Cotton of Arkansas. The Senator has been a biting opponent of the bill maintaining that it will cause premiums to remain high and has a host of other concerns regarding the bill and support within the senate.
Still, Trump is openly supporting the bill now. Might be enough.
Reuters: Republicans revamp Healthcare bill
Well, the CPO came out with their scorecard for Trumps healthcare plan. It’s about as bad as you would expect for actual people, though the deficit gets better so republicans will tout that.
Broadly the plan details how 14 Million people would lose their health care by 2018, with that number rising to 24 million people by 2026, with 7 million more losing their employers health insurance over a decade. Medicaid will bear the cost of the bill, with and $880 billion-dollar cut starting around 2019 when the Obama Medicaid expansion is pulled back. The heaviest taxpayer cost would go to those earning less than $26,500, many which are older Americans would foot the bill at $14,600 per year whereas those in the top 1% would be looking at a $75,000 tax cut. Compare that to Obamacare, where those only earning $26,500 would only have to pay $1600. The Deficit will go down by about $337 billion over a decade so there’s that. Finally, for whatever reason it seems that the individual insurance marketplace isn’t in a death spiral, and won’t be even if this bill passes. Huh.
This is all an estimate mind, and when the CPO came out with their estimate for the Affordable Care Act, they estimated that 28 million would lose their health care, rather than the 24 million who gained theirs, so there’s no guarantee this is correct, though it should also be pointed out that the CPO does have a good reputation for a reason. They’re not just non-partisan (by requirement) they do make a sincere effort to be correct and predictive whenever possible regarding these bills.
Regardless, congress is most likely gonna vote by party lines regardless so I don’t know how much this matters.
Politico: 5 Takeaways from the CBO’s Report
Ryan’s healthcare plan is out, and every republican under the sun is challenging it! Well, not every republican, just the Freedom Caucus, the Libertarians, the Pro-Planned Parenthood senators (there’s two) multiple representatives, and uh…huh.
Well, Ryan’s in trouble. Oh and Price and Trump too.
The main point here is that a number of opponents are challenging this ill because of the clauses the 146-page document has regarding Medicaid expansion, entitlements and allowances, and planned parenthood, with the die hard conservatives opposing due to the lack of sufficient reduction in entitlements and taxes, the Libertarians (mainly Rand Paul) due to the sheer level of federal government control and so on.
Four Senators even wrote a letter to Mitch McConnell, regarding the lack of protection for Medicaid the plan lacks. Never a good sign.
So the plan may be dead in the water, and if this doesn’t pass republicans may need to either outright just repeal Obamacare to keep their promises (which would result in the insurance single-payer market collapsing and god knows how many that would hurt, at least 20 million, and what that would do to the economy) or keep Obamacare and break their promise to their constituents.
The latter won’t happen, and the former terrifies anyone who can grasp the consequences and many, myself included, who don’t.
Time: Grand Old Problems
Trump has suddenly realized that being president is hard. Who knew?
Well everybody actually that’s rather the point
Still the point he was referring to was healthcare, and how the house and senate still haven’t come up with a replacement or can even agree on a basic idea. Some don’t want to spend a lot of money, some don’t want to interfere with the market, some are generally clueless, and it’s all basically a mess. And Trump is just realizing that yes, it is in fact a hard thing, a difficult thing, to be president and deal with healthcare. Kind of why Obamacare is actually a really good thing that people (suddenly, of course) have decided is actually pretty great.
So what’s the plan now? Repeal-and-delay, better known as ‘Republicans have no plan because they bitched for too long, and now they’re gonna avoid the question entirely’. For about three months.
The senate bill in question probably won’t pass, but if it does it’ll give some breathing room for the house and congress to come up with some sort of plan and not a [placeholder]. It’ll also piss of their base, 20 million people suddenly without healthcare, pretty much every liberal period, and galvanize the Democrats. So it also might not pass. Which will still piss of their base and leave Republicans back at square one.
Isn’t Politics fun?
Mother Jones: Republicans Give Up, Admit Healthcare is Hard
Mother Jones: Oh Sh*t