Cruelty, Incompetence and Lies

Graham-Cassidy, the health bill the Senate may vote on next week, is stunningly cruel. It’s also incompetently drafted: The bill’s sponsors clearly had no idea what they were doing when they put it together. Furthermore, their efforts to sell the bill involve obvious, blatant lies.

Nonetheless, the bill could pass. And that says a lot about today’s Republican Party, none of it good.

The Affordable Care Act, which has reduced the percentage of Americans without health insurance to a record low, created a three-legged stool: regulations that prevent insurers from discriminating against people with pre-existing conditions, a requirement that individuals have adequate insurance (and thus pay into the system while healthy) and subsidies to make that insurance affordable. For the lowest-income families, insurance is provided directly by Medicaid.

Graham-Cassidy saws off all three legs of that stool. Like other Republican plans, it eliminates the individual mandate. It replaces direct aid to individuals with block grants to states, under a formula that sharply reduces funding relative to current law, and especially penalizes states that have done a good job of reducing the number of uninsured. And it effectively eliminates protection for Americans with pre-existing conditions.

Did Graham-Cassidy’s sponsors know what they were doing when putting this bill together? Almost surely not, or they wouldn’t have produced something that everyone, and I mean everyone, who knows anything about health care warns would cause chaos.

It’s not just progressives: The American Medical Association, the insurance industry and Blue Cross/Blue Shield have all warned that markets would be destabilized and millions would lose coverage.

How many people would lose insurance? Republicans are trying to ram the bill through before the Congressional Budget Office has time to analyze it — an attempt that is in itself a violation of all previous norms, and amounts to an admission that the bill can’t bear scrutiny. But C.B.O. has analyzed other bills containing some of Graham-Cassidy’s provisions, and these previous analyses suggest that it would add more than 30 million people to the ranks of the uninsured.

Lindsey Graham, Bill Cassidy, and the bill’s other sponsors have responded to these critiques the old-fashioned way — with lies.

Both Cassidy and Graham insist that their bill would continue to protect Americans with pre-existing conditions — a claim that will come as news to the A.M.A., Blue Cross and everyone else who has read the bill’s text.

Cassidy has also circulated a spreadsheet that purports to show most states actually getting increased funding under his bill. But the spreadsheet doesn’t compare funding with current law, which is the relevant question. Instead, it shows changes over time in dollar amounts.

That’s actually a well-known dodge, one that Republicans have been using since Newt Gingrich tried to gut Medicare in the 1990s. As everyone in Congress — even Cassidy — surely knows, such comparisons drastically understate the real size of cuts, since under current law spending is expected to rise with inflation and population growth.

Independent analyses find that most states would, in fact, experience serious cuts in federal aid — and everyone would face huge cuts after 2027.

So we’re looking at an incompetently drafted bill that would hurt millions of people, whose sponsors are trying to sell it with transparently false claims. How is it that this bill might nonetheless pass the Senate?

One answer is that Republicans are desperate to destroy President Barack Obama’s legacy in any way possible, no matter how many American lives they ruin in the process.

Another answer is that most Republican legislators neither know nor care about policy substance. This is especially true on health care, where they never tried to understand why Obamacare looks the way it does, or how to devise a nonvicious alternative. Vox asked a number of G.O.P. senators to explain what Graham-Cassidy does; the answers ranged from incoherence to belligerence to belligerent incoherence.

I’d add that the evasions and lies we’re seeing on this bill have been standard G.O.P. operating procedure for years. The trick of converting federal programs into block grants, then pretending that this wouldn’t mean savage cuts, was central to every one of Paul Ryan’s much-hyped budgets. The trick of comparing dollar numbers over time to conceal huge benefit cuts has, as I already noted, been around since the 1990s.

In other words, Graham-Cassidy isn’t an aberration; it’s more like the distilled essence of everything wrong with modern Republicans.

Will this awful bill become law? I have no idea. But even if the handful of Republican senators who retain some conscience block it — we’re looking at you, John McCain — the underlying sickness of the G.O.P. will remain.

It’s sort of a pre-existing condition, and it’s poisoning America.

https://www.nytimes.com/2017/09/22/opinion/graham-cassidy-lies-healthcare.html?smid=fb-share&_r=0

***********

Oh no... controls move from central govt to the states. That must really scare leftists.

Free ain't cheap comrade.

From Matt Gaetz, little low-life lying worm:

THE END OF OBAMACARE?

As you have probably heard, this week, the Senate has been working on a plan to repeal and replace Obamacare. As with all previous Republican-led proposals, the media coverage of it has been ferociously negative, relying on distorted and inaccurate numbers, and doing a grave disservice to anyone who wants to learn about the legislation without bias.

The Graham-Cassidy healthcare proposal has many great elements. It removes the individual mandate, which requires people to buy insurance or else face a hefty penalty. This mandate is dangerous and unconstitutional; the government should not have the right to force you to purchase something you do not want. Hundreds of constituents have contacted my office asking for the individual mandate to be repealed, and Graham-Cassidy finally does it. It also removes the employer mandate, which has thrown a wet blanket on our economy. Even though our economy is growing rapidly — the stock market continues to break records, unemployment is at a 16-year low, and our GDP is growing faster than most pundits thought possible — until the employer mandate is repealed, our economy will never grow as quickly as it should.

Graham-Cassidy gives states a great deal more flexibility, because resources will be allocated to them in the form of block grants. This is important for a number of reasons: first, it prevents certain states like Massachusetts from consuming an undue share of federal resources. Second, it reins in our out-of-control entitlement spending, which is the largest driver of our national debt. It is generational theft to borrow money from future Americans in order to pay for wasteful spending today, and Graham-Cassidy helps address this crucial issue. Finally, Graham-Cassidy allocates federal resources to the states in the form of block grants. This means that each state can experiment and modify their insurance programs so they work better for the people in that state. Florida has different needs than New York; allow individual states to develop their own programs gives America 50 different solutions to healthcare problems, rather than the “one-size-fits-none” and “if you don’t like it, too bad” approach that was forced on us with Obamacare.

Finally, the Graham-Cassidy plan has immense benefit for states (like Florida) that did not expand their Medicaid programs under Obamacare. Florida will end up with far more resources per person, which will result in lower premiums, greater access to providers, and better quality of care.

The end-of-the-world headlines about the proposal are misguided and inaccurate, and many are based on dubious assumptions. For instance, the Congressional Budget Office (CBO), who rarely “show their work” on their reports considers people with low-cost, limited-coverage policies to be “uninsured.” That’s flat-out wrong. (Clearly, if you have insurance, then you’re not uninsured). Similarly, in its analysis of earlier healthcare proposals, the CBO has claimed that ending the individual mandate would cause over ten million people to go without any insurance — even people with low-cost or free Medicaid coverage. That doesn’t make sense: if you face a penalty for not buying insurance, and that penalty is removed, why would that make you suddenly decide to leave a free insurance plan? Also, if you choose to go without health insurance, that shouldn’t be considered “losing coverage” — if I give someone my pen, then I haven’t “lost” it; getting rid of it was a voluntary choice. The CBO’s claims are as bogus as Virginia Gov. Terry McAuliffe’s claim that we lose 93 million Americans a day to gun violence.

The CBO does not have a great track record of success in its predictions. Medicaid expansion was nearly twice as expensive as they initially predicted. They predicted 23 million people would enroll in Obamacare by 2012, but only 10.3 million did. Obamacare was predicted to cost around 850 billion dollars over a decade, but those costs have now soared to over 2 trillion dollars. I voted to defund the CBO, but, sadly, the amendment did not pass. (We’ll try again next year!)

I will carefully consider Graham-Cassidy when (or if) it comes to the House. In the meantime, be on the lookout for fake news!

(Bold added).

"As I have repeatedly stressed, health care reform legislation ought to be the product of regular order in the Senate. Committees of jurisdiction should mark up legislation with input from all committee members, and send their bill to the floor for debate and amendment. That is the only way we might achieve bipartisan consensus on lasting reform, without which a policy that affects one-fifth of our economy and every single American family will be subject to reversal with every change of administration and congressional majority.

I would consider supporting legislation similar to that offered by my friends Senators Graham and Cassidy were it the product of extensive hearings, debate and amendment. But that has not been the case. Instead, the specter of September 30th budget reconciliation deadline has hung over this entire process.

We should not be content to pass health care legislation on a party-line basis, as Democrats did when they rammed Obamacare through Congress in 2009. If we do so, our success could be as short-lived as theirs when the political winds shift, as they regularly do. The issue is too important, and too many lives are at risk, for us to leave the American people guessing from one election to the next whether and how they will acquire health insurance. A bill of this impact requires a bipartisan approach.

Senators Alexander and Murray have been negotiating in good faith to fix some of the problems with Obamacare. But I fear that the prospect of one last attempt at a strictly Republican bill has left the impression that their efforts cannot succeed. I hope they will resume their work should this last attempt at a partisan solution fail.

I cannot in good conscience vote for the Graham-Cassidy proposal. I believe we could do better working together, Republicans and Democrats, and have not yet really tried. Nor could I support it without knowing how much it will cost, how it will effect insurance premiums, and how many people will be helped or hurt by it. Without a full CBO score, which won't be available by the end of the month, we won't have reliable answers to any of those questions.

I take no pleasure in announcing my opposition. Far from it. The bill's authors are my dear friends, and I think the world of them. I know they are acting consistently with their beliefs and sense of what is best for the country. So am I.

I hope that in the months ahead, we can join with colleagues on both sides of the aisle to arrive at a compromise solution that is acceptable to most of us, and serves the interests of Americans as best we can."

TOM PRICE BILLED TAXPAYERS $300,000 FOR PRIVATE JETS BECAUSE HE DOESN’T LIKE BEING INCONVENIENCED

Flying around the country trying to cut health-care coverage for millions of people isn’t easy.

https://www.vanityfair.com/news/2017/09/tom-price-private-planes

You scared of Tom Price?

ALTLEFTCRIMINALS wrote:You scared of Tom Price?

I'm frightened by your lack of coherence.

Price and Mnuchin both now under investigation for misuse of taxpayer dollars:

https://www.dailykos.com/stories/2017/9/22/1700631/-Two-Trump-Cabinet-members-are-now-under-investigation-for-wasting-taxpayer-money-on-private-jets?detail=emaildkre

Floridatexan wrote:
Price and Mnuchin both now under investigation for misuse of taxpayer dollars:

https://www.dailykos.com/stories/2017/9/22/1700631/-Two-Trump-Cabinet-members-are-now-under-investigation-for-wasting-taxpayer-money-on-private-jets?detail=emaildkre

Hillary lost 6 BILLION dollars as SOS, where were your concerns then? Hmmmm. Hypocrite much?

Floridatexan wrote:
Price and Mnuchin both now under investigation for misuse of taxpayer dollars:

https://www.dailykos.com/stories/2017/9/22/1700631/-Two-Trump-Cabinet-members-are-now-under-investigation-for-wasting-taxpayer-money-on-private-jets?detail=emaildkre

Lock them up! Lock them up!

ALTLEFTCRIMINALS wrote:

Floridatexan wrote:
Price and Mnuchin both now under investigation for misuse of taxpayer dollars:

https://www.dailykos.com/stories/2017/9/22/1700631/-Two-Trump-Cabinet-members-are-now-under-investigation-for-wasting-taxpayer-money-on-private-jets?detail=emaildkre

Hillary lost 6 BILLION dollars as SOS, where were your concerns then? Hmmmm. Hypocrite much?

LIAR

http://www.politifact.com/truth-o-meter/statements/2016/oct/20/donald-trump/trump-wrongly-says-6-billion-went-missing-state-de/

When Hillary Clinton "ran the State Department, $6 billion was missing. How do you miss $6 billion? You ran the State Department, $6 billion was either stolen — they don't know."
— Donald Trump on Wednesday, October 19th, 2016 in the third presidential debate

NAMD (National Assoc. of Medicaid Directors) Statement on Graham-Cassidy:



http://medicaiddirectors.org/wp-content/uploads/2017/09/NAMD-Statement-on-Graham-Cassidy9_22_17.pdf

Republicans Reeling After Study Finds 32 Million Will Lose Insurance Under Graham-Cassidy

By Jason Easley on Fri, Sep 22nd, 2017 at 12:59 pm

The Republican efforts to repeal Obamacare were dealt a blow on Friday as the non-partisan Brookings Institute found that at least 21 million would lose their health insurance, 15 million immediately, and as many as 32 million by 2026 under Graham-Cassidy.

According to Brookings:

Based on this analysis, we estimate that the Graham-Cassidy legislation would reduce the number of people with insurance coverage by around 21 million each year during the 2020 through 2026 period. This estimate likely understates the reductions in insurance coverage that would actually occur under the Graham-Cassidy legislation, particularly toward the beginning and end of the seven-year period, because it does not account for the challenges states will face in setting up new programs on the bill’s proposed timeline, the possibility that uncertainty about the program’s future will cause market turmoil toward the end of the seven-year period, or the bill’s Medicaid per capita cap and other non-expansion-related Medicaid provisions.

….

The Graham-Cassidy legislation’s adverse effects on insurance coverage are likely to increase after its block grant funding expires at the end of 2026. After that time, the legislation is similar to the “repeal and delay” proposal that the Senate considered in July, which CBO estimated would reduce the number of people with insurance coverage by 32 million people in the long run. Reductions in insurance coverage would likely be somewhat larger under the Graham-Cassidy proposal because of the legislation’s non-expansion related Medicaid provisions, which would further reduce insurance coverage.

http://www.politicususa.com/2017/09/22/republicans-reeling-study-finds-32-million-lose-insurance-graham-cassidy.html

Graham-Cassidy will not go to the floor for a vote...it's officially dead. The reconciliation window closes on Sept. 30th.



https://www.dailykos.com/stories/2017/9/26/1701808/-McConnell-fails-again-Trumpcare-dead-Again?detail=emaildkbn

http://www.chicagotribune.com/news/opinion/editorials/ct-obamacare-fail-health-care-insurance-medicine-0911-jm-20160909-story.html

Come November, the grim trudge across the increasingly barren Obamacare landscape begins anew. Illinois consumers likely face staggering price hikes for individual insurance policies. Some types of plans could cost an average of 43 percent to 55 percent more. Ditto across the country: A first tranche of states approved 2017 rates with similarly cardiac-arrest-inducing premium increases.

Many Illinois consumers will find fewer choices because major carriers fled this market. UnitedHealthcare bolted. So did Aetna. Land of Lincoln Health collapsed mid-year, leaving policy holders to scramble for coverage that could cost them plenty. In many places across Illinois and the nation, people will find drastically fewer choices of plans than they did last year.

Those insurers fled because they didn't want to lose more money on a government-run market that is so far out of whack — a market they think likely will never be profitable for them. That isn't surprising, as we enumerate below.

But by diagnosing Obamacare, all of us can see the mistakes that any repair or replacement can avoid. So let's look at the failings and how they can drive solutions:

Obamacare failed because it flunked Economics 101 and Human Nature 101. It straitjacketed insurers into providing overly expensive, soup-to-nuts policies. It wasn't flexible enough so that people could buy as much coverage as they wanted and could afford — not what the government dictated. Many healthy people primarily want catastrophic coverage. Obamacare couldn't lure them in, couldn't persuade them to buy on the chance they'd get sick.

Obamacare failed because the penalties for going uncovered are too low when stacked against its skyrocketing premium costs. Next year, the penalty for staying uninsured is $695 per adult, or perhaps 2.5 percent of a family's taxable household income. That's far less than many Americans would pay for coverage. Financial incentive: Skip Obamacare.

Obamacare failed because insurance is based on risk pools — that is, the lucky subsidize the unlucky. The unlucky who have big health problems (and big medical bills) reap much greater benefits than those who remain healthy and out of the doctors' office. But Obamacare's rules hamstring insurers. They can't exclude people for pre-existing conditions, and can't charge older customers more than three times as much as the young. Those are good goals, but they skew the market in ways Obamacare didn't figure out how to offset. Result: Young and healthy consumers pay far more in premiums than their claims (probably) would justify in order to subsidize the unexpectedly large influx of older, sicker customers who require expensive care. Too many unlucky people, too few lucky people: That will collapse any insurance scheme.

Obamacare failed because it allowed Americans to sign up after they got sick and needed help paying all those medical bills. Insurance should be structured so that, although you don't know if you'll need it, you pay for it anyway, just in case; your alternative is financial doom. But if you can game the system and, for example, buy auto coverage after you crash into your garage, then you have no incentive to buy insurance beforehand.

Obamacare failed because it hasn't tamed U.S. medical costs. Health care is about supply and demand: People who get coverage use it, especially if the law mandates free preventive care. Iron law of economics: Nothing is free; someone pays. To pretend otherwise was folly. Those forces combined to spike the costs of care, and thus insurance costs.

Obamacare failed because too many carriers simply can't cover expenses, let alone turn a profit, in this rigidly controlled system. Take Blue Cross and Blue Shield of Illinois, the state's dominant Obamacare insurer. Last year, for every dollar the carrier collected, it spent $1.32 buying care and providing services for customers, according to BCBS President Maurice Smith. No wonder BCBS is proposing rate increases from 23 percent to 45 percent for its individual plans.

A question looms: Is Obamacare plunging in a so-called insurance death spiral? Is the market so unstable that plans are doomed to get more and more expensive, driving more Americans and more insurers out of the market until ... Obamacare thuds to the pavement?

We won't predict that, but neither do we see a mathematical alternative. What's clear is that the solutions to Obamacare are implicit in its failures. A repaired or replaced system has to be more flexible, letting insurers offer a wider range of plans so that consumers, not lawmakers or bureaucrats, dictate what's best for them. That system should protect those who carry continuous coverage, not coddle those who duck in and out of plans when their health needs change.

A new system also should scrap the job-killing Obamacare mandates that discourage companies from hiring and discourage workers from adding hours. Instead of gearing subsidies to incomes, let Americans not covered via an employer reap tax credits to help finance their insurance purchases on the open market. And tell us again: Why can't insurers sell policies across state lines? Imagine the pricing competition that would unleash.

We can deny the current system's failings, or we can parlay our evolving knowledge into something much better.

Put another way: The next president and Congress either reckon with Obamacare's failures or ... wait for the thud.

PkrBum wrote:http://www.chicagotribune.com/news/opinion/editorials/ct-obamacare-fail-health-care-insurance-medicine-0911-jm-20160909-story.html

Come November, the grim trudge across the increasingly barren Obamacare landscape begins anew. Illinois consumers likely face staggering price hikes for individual insurance policies. Some types of plans could cost an average of 43 percent to 55 percent more. Ditto across the country: A first tranche of states approved 2017 rates with similarly cardiac-arrest-inducing premium increases.

Many Illinois consumers will find fewer choices because major carriers fled this market. UnitedHealthcare bolted. So did Aetna. Land of Lincoln Health collapsed mid-year, leaving policy holders to scramble for coverage that could cost them plenty. In many places across Illinois and the nation, people will find drastically fewer choices of plans than they did last year.

Those insurers fled because they didn't want to lose more money on a government-run market that is so far out of whack — a market they think likely will never be profitable for them. That isn't surprising, as we enumerate below.

But by diagnosing Obamacare, all of us can see the mistakes that any repair or replacement can avoid. So let's look at the failings and how they can drive solutions:

Obamacare failed because it flunked Economics 101 and Human Nature 101. It straitjacketed insurers into providing overly expensive, soup-to-nuts policies. It wasn't flexible enough so that people could buy as much coverage as they wanted and could afford — not what the government dictated. Many healthy people primarily want catastrophic coverage. Obamacare couldn't lure them in, couldn't persuade them to buy on the chance they'd get sick.

Obamacare failed because the penalties for going uncovered are too low when stacked against its skyrocketing premium costs. Next year, the penalty for staying uninsured is $695 per adult, or perhaps 2.5 percent of a family's taxable household income. That's far less than many Americans would pay for coverage. Financial incentive: Skip Obamacare.

Obamacare failed because insurance is based on risk pools — that is, the lucky subsidize the unlucky. The unlucky who have big health problems (and big medical bills) reap much greater benefits than those who remain healthy and out of the doctors' office. But Obamacare's rules hamstring insurers. They can't exclude people for pre-existing conditions, and can't charge older customers more than three times as much as the young. Those are good goals, but they skew the market in ways Obamacare didn't figure out how to offset. Result: Young and healthy consumers pay far more in premiums than their claims (probably) would justify in order to subsidize the unexpectedly large influx of older, sicker customers who require expensive care. Too many unlucky people, too few lucky people: That will collapse any insurance scheme.

Obamacare failed because it allowed Americans to sign up after they got sick and needed help paying all those medical bills. Insurance should be structured so that, although you don't know if you'll need it, you pay for it anyway, just in case; your alternative is financial doom. But if you can game the system and, for example, buy auto coverage after you crash into your garage, then you have no incentive to buy insurance beforehand.

Obamacare failed because it hasn't tamed U.S. medical costs. Health care is about supply and demand: People who get coverage use it, especially if the law mandates free preventive care. Iron law of economics: Nothing is free; someone pays. To pretend otherwise was folly. Those forces combined to spike the costs of care, and thus insurance costs.

Obamacare failed because too many carriers simply can't cover expenses, let alone turn a profit, in this rigidly controlled system. Take Blue Cross and Blue Shield of Illinois, the state's dominant Obamacare insurer. Last year, for every dollar the carrier collected, it spent $1.32 buying care and providing services for customers, according to BCBS President Maurice Smith. No wonder BCBS is proposing rate increases from 23 percent to 45 percent for its individual plans.

A question looms: Is Obamacare plunging in a so-called insurance death spiral? Is the market so unstable that plans are doomed to get more and more expensive, driving more Americans and more insurers out of the market until ... Obamacare thuds to the pavement?

We won't predict that, but neither do we see a mathematical alternative. What's clear is that the solutions to Obamacare are implicit in its failures. A repaired or replaced system has to be more flexible, letting insurers offer a wider range of plans so that consumers, not lawmakers or bureaucrats, dictate what's best for them. That system should protect those who carry continuous coverage, not coddle those who duck in and out of plans when their health needs change.

A new system also should scrap the job-killing Obamacare mandates that discourage companies from hiring and discourage workers from adding hours. Instead of gearing subsidies to incomes, let Americans not covered via an employer reap tax credits to help finance their insurance purchases on the open market. And tell us again: Why can't insurers sell policies across state lines? Imagine the pricing competition that would unleash.

We can deny the current system's failings, or we can parlay our evolving knowledge into something much better.

Put another way: The next president and Congress either reckon with Obamacare's failures or ... wait for the thud.

This is from a year ago...the title of your thread should read "Why Trumpcare Failed". I have posted evidence here that Marco Rubio sponsored legislation that defunded the risk pool in 2013. That action alone was enough, but the real failure is from the states that refused to get on board and the repeated attempts to destroy it in Congress and in the courts. This article is uninformed or intentionally dismissive of pertinent facts. And you're still a jackass.

It was and is dead on. Everything is true and now proven. Obamacaid was designed to fail.

Free ain't cheap comrade.