Repubocare - "You want to lose your majority? Because this is how you lose your majority" - Granite Grok

Repubocare – “You want to lose your majority? Because this is how you lose your majority”

If you REALLY wanted Government to get out from between you, your doctor, and your insurance plan, you’re gonna hate this. Once again, the Republicans are failing to get the job done; YOU LIE!

Alternative title: ‘What Good Is a Majority if You Aren’t Going to Use It?’

This is NOT either a Repeal or a Replacement – this is putting new sheet metal on a rusting 32 Ford – without fixing the powertrain or suspension.  End result is that it looks a bit prettier but doesn’t run much better.

Shiny ObjectLast night as I was going over the “Repeal and Replace” of Obamacare, I said that ” I am going to have to reference back to the original bill and see what the actual ramifications are” in terms of Medicaid Expansion by reading the original Obamacare bill.  Well, I guess I don’t have to as the Right side of the blogosphere is just chuck-a-block full of commentary and pointing what the Republicans (snark) did during the last 7 years while campaigning and screaming “WE’LL REPEAL IT” once we had a majority in the House, and then a majority in the Senate…..and then they needed the Oval Office.

And our reward for keeping the faith, putting their butts in those seats is THIS LOAD OF CRAPOLA??  They had SEVEN years to get it right – and now this is the equivalent of the dog catching the car bumper and these Smart Republicans of DC are going “crap, we gotta give them something, right?”  And the calls are ALREADY going out “YOU MUST SUPPORT THIS BILL“.   Yeah, well screw you because you all just screwed the rest of us.  Good decision, me leaving the Party – I don’t want to be associated with this stench no way and no how.

If had been done in the private sector, we’d be able to convict them all of a huge “bait and switch”.  This isn’t the Free Market solution we were promised.  This isn’t the killing of the massive amount of regulations.

This is a 

turd that they polished up and called it perfect.  If this is what we all struggled for, we’ve been hoodwinked, cheated, and GOP-lied to.  Oh, Oh, this is just phase 1 – just WAIT for 2 & 3?  Er, no – I don’t trust you after this.

The Republicans just showed us that they don’t have the courage, the guts, to do the right thing.  They are too worried about the votes against them by the squishy middle if they had really done what they promised.  They fear the votes against them for taking away something that the Dems gave them.

They DON’T fear their base, so it seems, and they haven’t a clue as to how MAD those of us that have to PAY for all that healthcare those subsidized people AND try to pay for our own.  I guess they believe, still, in “where else will they go but us?”.  Yeah, just ask Kelly Ayotte that, and Walt Haverstein, and Scott Brown.

So let me recap from last night AND add more from smart people who have had the time to dive into this morass.  Trust me, if you have any amount of Conservativism in your bones, you’ll hate it.  If you REALLY wanted Government to get out from between you, your doctor, and your insurance plan, you’re gonna hate this. Once again, the Republicans are failing to get the job done. You lie!

A recap – so, what is “the Good” – the Shiny Objects to make us think “hey, they listened”?

  • Gone – individual mandate (the IRS controlled fine) and the employer mandate (50+ employee mandated healthcare)
  • Taxes on prescription drugs, over the counter meds, health insurance plans, net investment income, tanning sessions, medical devices, the increase of the Medicare tax
  • Flexible / Health Savings Accounts – can contribute much more to them. Much more important, the increased tax on them rolled back (from 20% back to 15%).  Amount that can be contributed is raised from $2250
  • Abortion coverage not funded.  If you want it, get a covering plan but it is NOT mandated.
  • States will get more power in deciding how Medicaid monies will be used

  • Changes to how insurers can charge by age / income (widens what insurers can charge the young to the old from 3X to 5X – the table is in the bill). The Obama 3X distorts the rates charged to the young – one reason they didn’t sign up.
  • Medicaid turns from a fee-for-service to a per-capita grant (an incentive to get it right)
  • This can be both Bad and Good – ban on lifetime caps (provides “safety” but also helps to raise the cost – what everyone is complaining about)
  • Patient and State Stability Fund – trying to create, with $100 Billion, to establish “point solutions” in high risk pools at the State level instead of this everyone
  • No payments to insurers for cost-sharing reductions (the “risk corridors” that were back door subsidies to insurance companies)

Don’t get me wrong – I am glad to see all of those items things go.  Of all of them, the individual mandate (government taxing you for doing nothing) and the employer mandate.  Oh, rolling back of Obama redefining 30 hours as being full time employment?  Haven’t seen it yet, but it does seem that the 50 employee trigger (the mandate) is gone – THAT was a job crusher as it constituted a cliff diving marginal tax.

But with the exception of those two things, the rest of them, important as they may be, are superficial.  The “hey, look what we did for you!”

The Bad“:

  • The “Cadillac tax” is still present until 2025.
  • Medicaid Expansion goes zombie until after 2020 (yeah, a Presidential election – how’s that gonna play out?)
  • (with grandFATHERING for current enrollees)
  • Changes to how insurers can charge by age / income (widens what insurers can charge the young to the old from 3X to 5X – the table is in the bill). The Obama 3X distorts the rates charged to the young – one reason they didn’t sign up.  Yeah, depending on your view, this can be both Good or Bad (or both).
  • Is this the Individual Mandate, sideways?  But pre-existing conditions still apply
  • For those States that already have Medicaid Expansion, people can enroll under these conditions
  • The Exchanges don’t die
  • This can be both Bad and Good – ban on lifetime caps (provides “safety” but also helps to raise the cost – what everyone is complaining about)
  • Lots of regs were put onto docs, clinics, and hospitals in Obamacare and raising their costs and we’ve seen what it has done – almost killed off individual practices and causing a MASSIVE consolidation in the industry.  Entrepreneurial ?  Not so much.  This does nothing to help that.
  • No tort reform (re: malpractice)

The Ugly“:

  • We don’t yet have an idea of how much this will cost – no CBO scoring yet.
  • Instead of the IRS tax of the individual mandate to “prod” people to sign up, you have to keep continual coverage or get dinged the next time you pick up a policy a surcharge of 30% for a year for a lapse of 2 or more months.  For being “free marketers”, WHY are the Republicans doing this Obama-lite “tax” (e.g., pay the insurers by govt fiat vs the individual mandate of just paying the govt)?
  • Community Rating, pre-existing conditions – still present. While seemingly a “nice thing”, these two are part of the huge problem of why insurance costs so much.  Jeanne Shaheen, with her SB711 bill here in NH, killed off the market as it became too expensive except for the largest of companies.
  • The continued infantilization of American youth continue – you are still considered a “child” at 26 years old by government fiat.  What, parents can’t pick up a rider on their own and have Junior pay for it?
  • The Exchange subsidy entitlement morphs into refundable tax credit subsidies at the individual level (meaning you can get a check back from Uncle Sam)
  • NO regulations are loped off at the neck, one of the things that we’ve been railing against these past few years.
  • NO BUYING INSURANCE ACROSS STATE LINES
  • NO EQUALIZING TAX advantages to individuals that employers now enjoy (e.g., no movement to making insurance portable instead the current practice of being tied to your employer).
  • Extra Federal monies for Medicaid Expansion cease after 2020.  So what’s NH going to do to fill that hole?  Heck, I am going to ENJOY watching California pay for all those poor and illegal aliens, given they’ve been signing up everyone under the sun.  How much higher will taxes go there???
  • The rollback of all the mandates that made up the “acceptable” level of insurance the Dems put in there (platinum, gold, silver) not rolled back until 2020 – yeah, that’s gonna help prices short term, eh?
  • DOES NOT PREVENT illegal aliens from being able to sign up (doesn’t check for identity fraud)
  • Doesn’t get rid of the mandate for docs / hospitals to provide transgender sex reassignment therapies (hormones, surgery) even if it goes against their conscience or philosophy.

Bottom line for me?  This sucks given that the Republicans didn’t keep their promises and TOTALLY GUT all those things that made Obamacare so vile.  They punted, prevaricated, and hoped we wouldn’t notice.  This was more than nibbling around the edges – but not a whole lot more. It still is a “healthcare payment system” instead of restoring the healthcare insurance marketplace accounting for risk.

Once again, screw you all.  Either fix this (and fix it right) or you’ll be out on your asses.

Already, the House Freedom Caucus has said “no” – that’s 40-50 House members right there.  The Republican Study Committee (conservative but not AS conservative as the Freedo Caucus) of about 150 have “grave reservations”.

Eight Republican Senators (Rand Paul, Ted Cruz, Mike Lee, Susan Collins, Rob Portman, Shelly Moore Capito, Lisa Murkowski, Cory Gardner ) have already said no (for differing reasons).

From the Washington Examiner comes this painful touch:

In releasing their healthcare plan on Monday, House Republican leaders sent a signal loud and clear: liberalism has already won.

Barring radical changes, Republicans will not be passing a bill that ushers in a new era of market-based healthcare. In reality, the GOP will either be passing legislation that rests on the same philosophical premise as Obamacare, or will pass nothing at all, and thus keep Obamacare itself in place.

Republicans – siddling up to the Progressive status quo.  Letting the Democrats move that Overton Window to the Left and leaving it there.

Glenn Reynolds: What we have here is the GOP negotiating with itself over the terms of its surrender.

Thus far, unacceptable. While one could say that Obamacare is SO far Statist that anything is better, it doesn’t match up with the promises the Rs gave us these last 7 years. Instead of LEADING, they’ve devolved to the stereotype: we really won’t make government smaller – we’ll just manage it better.

Still waiting to see that “manage it better” actually happen.  Somewhere.  Anywhere?

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