Replacement would be the same thing that was available before. Employer provided healthcare, and if you don't have that, you can buy private insurance.

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"People think it must be fun to be a super genius, but they don't realize how hard it is to put up with all the idiots in the world."

Not an issue for me but the Donald has promised the "best affordable healthcare available". Let's wait and see. It seems a bit strange that the Republicans have spent the last eight years promising to repeal Obamacare but have no option to replace it with and are now scrambling.

Uh, no.

Repeal and do nothing is better than what we have now.

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Civilize the mind, but make savage the body.

- Chinese proverb

Nevertheless, spot raises a good point -- that too many people are relying on it to pull the rug out from underneath them, which is exactly what would happen if "replacement" meant simply going back to the same thing that was available before.

If you think that's a problem that justifies keeping Obamacare in place until a "replacement" for it is found, then why oppose Obamacare in the first place?

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"People think it must be fun to be a super genius, but they don't realize how hard it is to put up with all the idiots in the world."

I mean, people are talking here like there haven't been half a dozen serious 'repeal and replace' bills offered up by Republicans in the past few years. It's not like there haven't been 'replace' ideas, it's that they haven't been taken seriously because the 'repeal' would never happen while Obama was in office.

Let's see how things go in the next 12 months...these things take time, but I think in the next few months you'll start hearing about a few options being kicking around and by the summer a serious 'repeal and replace' bill will be put up by the House.

But I do totally agree with the premise that repeal without replace is a non-starter. Obamacare is bad, but the optics of scrapping it without a serious effort to improve on health care costs and insurance affordability in this country is a losing proposition.

As long as that is the goal, health care costs will continue to spiral out of control and the system is doomed.

We need to stop, stop, stop focusing on health insurance and focus on why health care costs are out of control.

Health insurance is the primary reason a single aspirin is billed at $20 during a hospital stay.

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If there are no dogs in Heaven, then when I die I want to go where they went. - Will Rogers

Emery's Third Coast Triathlon | Tri Wisconsin Triathlon Team | Push Endurance | GLWR

The truth is you can't repeal ACA and it be completely gone the next day. It will take several years to unwind all of the details.

If they repealed without a replacement, it is like setting deadlines with no real answer in place yet. Basically putting themselves in the hot seat for no good reason.

Price has a plan to replace it. So its not like they have nothing. IMO it is terrible, but to say they have nothing is false.

Did you ever try to buy private insurance? Before ACA? I think if you had you would not be proposing this as a viable alternative.

I'm not an ACA fan, but what we had before was a train wreck as well. There's no sense going back to it.

You do not provide a link to a source that adequately explains your position. Please provide a source as I would like to learn more.

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I have a personality disorder, I don't drink coffee...

If you take the view that health insurance is simply a reflection of the cost of health care (Ie you live in reality) then you have to recognize that your point is an absurd one.

Millions of people and business have made significant decisions and adjustments in reliance on the ACA that they never would have made otherwise. And they now find themselves in a place that they never would have been in/ You're naïve if you think that a simple repeal of the ACA is would only just unwind the clock.

Health insurance, as we have it now, does not reflect the true cost of healthcare.

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Civilize the mind, but make savage the body.

- Chinese proverb

Not at all...I have a $108-a-month HSA policy with my wife that has a $2.5K deductible and $8K OOP max. I find that to be very affordable, but it's not what's available in many markets.

Notice in my post I said 'health care costs' first...I think you and I agree on this, but you should be able to find cheap insurance that works more like the catastrophe coverage of the past, I consider that to be 'insurance affordability'. The main goal should be cost of care, though, which the ACA did nothing to improve and in some cases increased those costs.

There's not a lot that I agree with you on, but this is absolute truth. The articles I've linked below are pretty telling of how overburdened the system is with administrative work, which isn't helped by passing it all through insurance companies whose goal is to extract every cent of profit they can from the system, which probably drives up the cost as providers have to cover their administrative end, billing, and upcharge the cost of services to cover all of that, resulting in an endless, out of control loop.

http://www.forbes.com/sites/brucelee/2016/09/07/doctors-wasting-over-two-thirds-of-their-time-doing-paperwork/#6cd50fb86e5d


http://www.kevinmd.com/blog/2011/01/10-minute-office-visit-8-people-45-minutes-work.html

Yes and I paid 106 bucks a month for a high deductible GSA plan.

Did you ever try to buy private insurance? Before ACA? I think if you had you would not be proposing this as a viable alternative.


What is it that lawyers say? Never ask a question you don't know the answer to?

I sure did buy private insurance before the ACA. And as frustrating as that system could be, it was far, far preferable to buying insurance under Obamacare on every level. It was more affordable, I had more options, the plans were better, they had lower deductibles, and I had the freedom to determine for myself whether or not I needed to buy it, or what amount of coverage I found acceptable for my situation. My personal situation today would be improved in a real and meaningful way if I could go back to that.

Just because the situation with health insurance was flawed before does not mean that any solution is better, and it doesn't mean the ACA didn't make it worse. It did. It should be repealed. Period.

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"People think it must be fun to be a super genius, but they don't realize how hard it is to put up with all the idiots in the world."

Because I think that there were many in the middle ground that thought the US health care system needed reform, but that Obamacare wasn't it. I think one can say without being hypocritical that Obamacare did some good things, but is overall an abomination that needs to go. So, keep the good things and get rid of the all the crap that didn't need to be in there. I don't think that repeal without a mechanism to help folks get the health care they need is a good idea, and my guess is that repeal without replacement will be used by the mass media to club the Republicans fairly effectively as they repeatedly show folks suddenly without any health care options.

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Taco cat spelled backwards is....taco cat.

Is that individual or group?

I couldn't agree more. Let people choose the healthcare plan that meets their need rather than the Obamacare one size fits all. My friend owns a small business and his plan has gone up 200% and currently costs more than his mortgage.

In the first place, I don't really care that the media will use repeal as a club against the Republicans. They will, no matter what replacement is offered. Doesn't matter. I don't care a damn about the "optics" for the Republicans when it comes to the ACA. It's time to put up or shut up.

As for the good the ACA has done . . . What are those good things, in your view? How can they be separated from the rest of the ACA? Why don't all the original objections to the ACA still apply, especially now that most of the dire predictions are coming true? Is it the federal government's job to provide health insurance for citizens?

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"People think it must be fun to be a super genius, but they don't realize how hard it is to put up with all the idiots in the world."

Replacement would be the same thing that was available before. Employer provided healthcare, and if you don't have that, you can buy private insurance
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The problem is that there would be no incentive to return premiums for pre-ACA prices. Lots of people would lose their insurance. Others would maintain their coverage at inflated prices. Repealing without a replacement is lose-lose for all.

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Take a short break from ST and read my blog:
http://tri-banter.blogspot.com/

Well, my experience with private insurance (pre-ACA) was a bit different than yours. My wife and I were repeatedly turned down for "pre-existing conditions". When we addressed these and showed they weren't applicable, a new "pre-existing condition" would be dredged out of our medical history and used to deny coverage.

And all the major insurance companies share a common database - once one of them has turned you down you are flagged and all of them will turn you down. It's a rigged system.

All this despite the fact that my wife and I have been continuously covered by health insurance since birth. No gaps in coverage whatsoever.

The insurance companies repeatedly told us to apply to our state's high-risk pool. Ludicrous! My wife and I are perfectly healthy individuals who rarely visit the doctor and have no chronic conditions.

Fortunately I was in a position to extend coverage through COBRA, although it cost a pretty penny. Many people are not so fortunate.

The very idea that anyone would propose repealing ACA without implementing a replacement is absurd.

Group...certainly that's not something you'd find in the private marketplace but my point is that affordable insurance AND care is the goal. Affordable care is paramount, nothing comes close to mattering as much as focusing on health care costs in this country. But the insurance needs to be rethought as well, first and foremost do away with some of the mandates that ACA put upon plans that make them more costly.

The problem is that there would be no incentive to return premiums for pre-ACA prices.

Competition, the fact that people aren't compelled to buy expensive plans, the fact that the government isn't providing massive subsidies . . .

Lots of people would lose their insurance.

Some would. Others would be able to afford insurance again. Either way, the first group is going to eventually lose their insurance anyway, because the ACA is simply not sustainable. And it isn't the federal government's role to implement some massive, unsustainable, unconstitutional plan in order to maintain the pretense that it's providing health insurance for everyone- because it's not the role of the federal government to provide health insurance for everyone.

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"People think it must be fun to be a super genius, but they don't realize how hard it is to put up with all the idiots in the world."

Uh no there would be incentives because I don't need things like sex change coverage in my plan.

And what does your employer pay?

Like others I have bought private insurance before and after the ACA and while it was a bit more cumbersome to compare plans and make sure you were getting everything you wanted to I would go back to the pre ACA days in a heartbeat. My insurance premiums have gone up 280% and that is with a higher deductible and copays. There is nothing affordable about the ACA unless you get a subsidy.

Even with a subsidy, you have to pay 10% of your household income. Not exactly affordable for a lot of people.

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"People think it must be fun to be a super genius, but they don't realize how hard it is to put up with all the idiots in the world."

i'm not trying to be an ass here, trying to ask a serious question. Why is this option "ludicrous". It provided you with an option when most private insurance companies have said they would prefer to pass on coverage for you. Which, IMO they should have the option to do.

So you were provided with an option to be covered. Was it ludicrous because of the cost of it, or the benefits provided or ludicrous because of the name of it (because you don't feel you are high risk).

I know a lot of small business owners in my state who have chosen this option for their family, especially if they had small kids, once presented with either no option or a very high priced group option from a private carrier. Once they got past the "stigma" of being in the "high risk" pool they found a plan which met all their family needs at a price cheaper than they could get on the open market.

thanks

EDIT: BTW I would note this option was provided by your state, before the fed stepped in with a federal ACA program. Whatever state you are in, I don't think this is unique

assuming that isn't rhetorical my answer is "no"

I believe 50%. And I'd still consider my coverage to be sufficient and affordable at $210 a month.

I'm not trying to prove that my insurance is the end-all, be-all, my point is that affordable care helps ensure affordable insurance, but there are ways to reduce the cost of insurance as well. The end game should be to find ways to decrease the cost of care and to ALSO allow for the insurance marketplace to be competitive with few restrictions to provide consumers with many options, hopefully driving down insurance costs as well. That's my opinion at least.

Bingo!

It also creates ridiculous billing procedure whereby a healthcare provider must charge $100 for a $40 item, knowing insurance will cut the reimbursement to $40.

IMO, all healthcare providers should be not-for-profit. That may not be feasible, but I believe it is. From there, you have to ask whether all health insurance carriers should be not-for-profit.

When we are talking about controlling healthcare costs, we cannot allow into the equation an entity that does nothing but shuffle money from the patient to the provider in a manner that creates the most profit for said entity. How could that possibly work???

We don't use health insurance like we use auto insurance (for example). Auto insurance is, for the most part, a safeguard to protect against large loss. Most people in the pool will not use their auto insurance.

Not the case for health insurance. The vast majority of those buying health insurance will use said health insurance. Some on a regular basis. It is not solely a safety net to protect against catastrophic costs. It is the regular method of payment for health care.

To me, it is almost like saying - you are not going to pay direct for your gas. Instead, you will pay $X every month into a general fund. Then, when you go to the gas station, you just pump away and will get billed later for the portion you have to pay. Depending on how good your plan is, that may or may not leave you will a sizeable bill. But, the payment system is going to get a taste before paying the gas station.

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If there are no dogs in Heaven, then when I die I want to go where they went. - Will Rogers

Emery's Third Coast Triathlon | Tri Wisconsin Triathlon Team | Push Endurance | GLWR

That is almost too cheap to be true

I know for a fact that there's gamesmanship in the system of billing. Two examples: I get 30 chiropractic visits a year for general adjustments & those are supposed to be 100% covered, maybe 10-15 minute visits between the pre-chiro warm up and flex/stretch machine and the adjustment. The chiro bills the initial visit as 4 visits on 4 consecutive days because she doesn't like the rate she negotiated down to. Then I get a $100 bill later, not itemized, not after any more than 10 visits, no real explanation, only after I stopped going there because I wasn't comfortable with the weird billing. Not $97, not $108, an even $100. Total gamesmanship, which wouldn't be the case with more transparent billing.

The dentist I switched to locally "accepts" my insurance. But she doesn't really accept it. She charges 100% of the fee up front, sends insurance the reimbursement request on your behalf, and insurance sends you a check for their agreed-upon rate with her. The problem, she inflates her 100% to say $150, the insurance agreed-upon rate is $96, and that's what they reimburse, so you've paid $54 out of pocket in the end. Either way, she's getting her full $150 fee, still paying someone for the administrative paperwork to submit the reimbursement request, so it's costing everyone more in the end as opposed to her just not accepting insurance at all and billing the actual cost direct. I don't go to her anymore anyway because she tries to push invisalign braces on absolutely everybody at every visit, no matter how much she's told to pound sand.

Bonus example: My wife's chiro will code a massage as a medical necessity so insurance covers all but a co-pay. Maybe it's a medical necessity sometimes, but I'd guess that in 98% of cases it's not at all necessary and covering it would be akin to me asking for yoga classes to be paid for.

Somewhere we've got to get this kind of crap out of the system. That should really be the ground floor of this whole health care debate -- getting the base cost down, get a focus on preventative care where doctors have the time to spend to educate their customers about lifestyle improvements for health changes, and then a good long-term solution can be debated about what that looks like, be it a 100% private system, a mix of some sort, or single payer...but what we have is so fundamentally flawed that those debates are really baseless & everything is a band aid until we address the foundation.

It was ludicrous for several reasons: 1) as mentioned, my wife and I are perfectly healthy, with low medical bills and no chronic conditions, 2) the cost would've been exorbitant (about $4K/month).

So you're chiropractor is committing fraud and you dentist is a dick. Hmmm

1) as mentioned, my wife and I are perfectly healthy, with low medical bills and no chronic conditions

Except you have a pre-existing condition of some sort . . . Not trying to be difficult, but it seems relevant, even if you say you've "addressed it and showed they weren't applicable."

I obviously don't know you're medical history, but it seems like you either have a pre-existing condition or you don't. I don't see how an insurance company could dig into your medical history, come up with new pre-existing conditions, and deny coverage based on that.

Pre-existing conditions are obviously a problem. On the one hand, those who legitimately have a pre-existing condition have a real problem if they lose their insurance due to changing jobs, or whatever. I get that. On the other hand . . . It's insurance. Those who have pre-existing conditions and then apply for "insurance" at normal rates are basically asking the insurance company for charity. It doesn't make sense in an insurance model.

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"People think it must be fun to be a super genius, but they don't realize how hard it is to put up with all the idiots in the world."

ok. Still not sure how if 1) is correct that an insurance company out to make a profit would be going out of it's way to manufacture a pre-existing condition for you.

My son is on the autism spectrum (very high functioning) . He is otherwise healthy with low medical bills and no chronic conditions. I suspect if I shopped us around he may be uninsurable due to a pre-existing condition. I might not like this but I don't think it is "ludicrous" for an insurance company to conclude this.

but under 2) we can agree that you had an option provided by the state prior to enactment of ACA; it was simply that cost was a factor. I am not sure how ACA solves this for you. Doesn't it just transfer it from a state option to a fed option. Today that option may be cheaper but if your ACA policy doubles in the next few years are you back to the same ludicrous place?

EDIT: BTW I bet if you pushed the private insurance company far enough they would provide you with a policy option and a quote. I just bet the monthly premium would look a lot like the state option ($4k/month) and it is easier for an insurance company to say you are denied than have someone on the local news complaining about a $4k premium. But as Lloyd's of London will tell you; anything is insurable, it's just a matter of assessing the risk and getting an appropriate premium for it.

The problem is that insurance companies can call anything they want to a "pre-existing condition".

Was initially turned down because I had been to a chiropractor's office for a few massages several years prior. Bingo - pre-existing back problem, no insurance for you.

I protested, they allowed that was unreasonable, had another look at my medical history. Oh - this guy had a visit to a podiatrist five years ago - diagnosed with a neuropathy. Bingo - pre-existing condition, no insurance for you. Never mind that the neuropathy responded to conservative treatment and I never saw the podiatrist again.

On the next go-round they found something in my wife's history. She too had been to a podiatrist and got orthotics prescribed. Bingo - pre-existing condition, no insurance for you.

After that, we were quite disgusted with that particular insurance company, so we tried others. But once one company turns you down, they all turn you down, because they all share a database that now documents your supposed pre-existing conditions.

TLDR: if you have ever been to a doctor with any sort of complaint, you have a pre-existing condition!

And that's why, at the time, I went back to COBRA at about 1800 bucks a month. Such a deal!

TLDR: if you have ever been to a doctor with any sort of complaint, you have a pre-existing condition!

Respectfully, though, that simply isn't true. Everyone's been to the doctor with various complaints- we don't all get classified with pre-existing conditions. Could it be that the types of problems you've been to the doctor for in the past are likely to be chronic, for most people even if not for you?

I honestly don't know, and I'm the last person to defend a health insurance company, or to argue that they're benevolent or incapable of idiocy. At the same time, they're in business to make money by providing insurance. It's not like they're looking for reasons to turn people down without any cause at all.

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"People think it must be fun to be a super genius, but they don't realize how hard it is to put up with all the idiots in the world."

That would be a HIIPA violation, and illegal.

See my long reply to vitus for the pre-existing story.

To be clear, I never said that ACA solved things for me. My point was simply that the system was completely effed up before ACA.

I am still unclear about "everyones" problem with pre-existing conditions.
From what I understand you aren't flat out denied coverage because of a pre-existing condition, it's just that the insurance company won't pay for care for that condition for a waiting period (6-12 months I think). Also the waiting period is waived if you have had "creditable coverage" for an appropriate time beforehand (again 6-12 months).
So, generally, speaking, if you are diabetic and getting treatment, and have insurance through your company, if you change jobs, and your new companies insurance kicks in on day 1, you are covered. If you new insurance doesn't kick in for 30 days, you might get stuck paying COBRA for that month so that you have continuous coverage.
It was one of the few cost controls in the "old" system, and works well in most cases. I have no idea what happened to eb, but that is not my experience with insurance, having changed jobs numerous times.

Let me restate - the database documents that you applied for heath insurance, and were turned down.

I don't think it includes any medical history - just insurance history. So technically not a HIPAA violation.

As you describe it, that sounds like a mostly reasonable system. I'm sure people fall through the cracks, but such is life.

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"People think it must be fun to be a super genius, but they don't realize how hard it is to put up with all the idiots in the world."

Ding ding ding.

Prices won't go down. What they might do is offer better prices with really shitty coverage.

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How does Danny Hart sit down with balls that big?

What they might do is offer better prices with really shitty coverage.

That's what I want. Where do I sign up?

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"People think it must be fun to be a super genius, but they don't realize how hard it is to put up with all the idiots in the world."

So what is your proposal for the many people (I'm not sure...millions?) who find themselves with such conditions? What if you find yourself with a pre-existing condition?

If you say - pay up because you had cancer...what happens if you can't pay? If you can't get insured and you can't afford the treatment...what exactly are we going to do with that as a society? Would these be something like built in passive market driven death panels? As in - you have access to care, we know you can't pay so you either choose to die quietly or you get the treatment and declare bankruptcy later?

I just don't get the logic - I understand that sick people are going to cost more to treat and conversely more to insure. But if we all say - fuck you I don't want to pay for your problems - well, we're all going to have to put ourselves into our own little individual risk pools and essentially only the healthy folks will end up being able to pay.

In the first place, I acknowledged that it's a real problem. I don't think forcing a health insurance company to pay for it at lower premiums is a realistic or viable solution. Do you?

But if the system works largely as efernand described, I think it's not much of a problem.

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"People think it must be fun to be a super genius, but they don't realize how hard it is to put up with all the idiots in the world."

That is not much different than I pay buying plans on the exchange in Washington. I think I am paying $250 a month for my 44 year old wife for a silver plan. I don't remember the exact details, but I believe it has a $3000ish deductible, co-pays for primary and specialists that apply prior to the deductible being met. For my adolescent son, we pay about $200, but for a much better plan, lower deductible and lower out of pocket max. And no, we are not receiving subsidy on either of these.

A pre-existing such as diabetes will lock you out of reasonably priced insurance.

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I have a personality disorder, I don't drink coffee...

That's fucking ridiculous.... the People's Republic of Illinois is significantly higher

you will likely get much worse coverage than you had before Obamacare at about the same price as before Obamacare. And this is what you want? Sounds like a win.

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How does Danny Hart sit down with balls that big?

you will likely get much worse coverage than you had before Obamacare at about the same price as before Obamacare.

Why is that?

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"People think it must be fun to be a super genius, but they don't realize how hard it is to put up with all the idiots in the world."

Personal experience.

Our provincial government mandated lower auto insurance. Heres what happened...

The insurance companies obliged. They offered 'low cost' insurance, low cost meant really shitty coverage. But if you wanted to keep the plan you currently had it was now 'premium coverage' and guess what? Your rates went up. It was a fucking joke. And that's exactly what we asked for.

Just be careful what you wish for. The insurance companies will always find a way to screw you.

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How does Danny Hart sit down with balls that big?

The insurance companies will always find a way to screw you.


I hate to be cynical, but so far in life this ^^^ has proved to be true.

...Which goes back to JSA's point ~ they do this by paying the doctors/providers, etc less than they collect from whoever's paying for it (whether employer, gubment, or out-of-pocket). In other words, it's nothing but additional admin BS tacked on above and beyond whatever it costs to treat the patients. How on earth could such a model NOT make things more fucking expensive than they should be?

Collecting premiums and then denying coverage is only the most lopsided case, but at some level it's baked into any for-profit system. That's fine for discretionary purchases like selling smart phones or pizzas which you could simply elect not to buy, but not for health care.

I'll admit there's a bit of hyperbole there, but my experience demonstrates that it's largely true. I know, N=1 and all, but the entire experience was quite shocking. Particularly the issue with the neuroma - it turned out that was due to my hockey skates, and once I got those punched out a bit the problem went away entirely over the course of a year. Total cost about $200 for a single 20-minute office visit and a follow-up phone call or two.

And it's not doctors or medically trained personnel that were making these determinations of pre-existing conditions; it was poorly trained admin staff who'd been trained to look for the flimsiest of excuses to deny coverage.

they do this by paying the doctors/providers, etc less than they collect from whoever's paying for it (whether employer, gubment, or out-of-pocket). In other words, it's nothing but additional admin BS tacked on above and beyond whatever it costs to treat the patients.

That's exactly right, which is why we ought to gut the health "insurance" industry as we know it and return to a system in which they actually provide health insurance, not health coverage. I've said that for years and years.

Every dollar that gets paid to a health insurance company in the present system is a dollar that gets skimmed right of the bat for the insurer's profit. They're a middle man, that's all- they take a cut, but don't actually provide anything inherently useful. If we had a model where individuals paid for their own health care for the vast majority of care, and just had insurance companies to insure against major health costs, we'd have a far saner system.

But you know how it is, you have all these infantilized citizens ought there who can't be trusted not to spend all their money on hookers and blow, and if we don't provide free health coverage, they'll die, and so will all their poor children. Think of the children.

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"People think it must be fun to be a super genius, but they don't realize how hard it is to put up with all the idiots in the world."

Wait til rural hhospitals dry up and blow away....

This has always been at the core of many of my more socialist-sounding arguments. People are stupid. We can pretend that it's not a problem, or that it's their problem, or that somehow simply providing access to choices addresses it. But the level of stupidity out there is such that people truly left to their own devices will find a way to screw up YOUR life if we don't all decide to help 'em out. I'm exaggerating but I've grown more and more disillusioned with humanity as I grow older. I'm a CPA. Our entire society is based on evaluating pretty much everything in a common currency - money. Guess what my experience is with people's understanding of money? This, amazingly, includes almost everyone right up until junior financial professionals. That's why when I see those clickbait articles on Yahoo! ("75% of Americans have nothing saved for retirement!" or "2 out of 3 can't handle an emergency of just $400") I just nod in agreement.

Most people can't properly evaluate different options for their cellphone provider. Why do we think they can shop for "healthcare (coverage/insurance)"? Unless your a medical professional you can't really evaluate different options for treatment. Similarly, unless you have a significantly above average understanding of financial matters and insurance specifically, you have no fucking clue what you're looking at in terms of coverage.

Well, your candor is refreshing.

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"People think it must be fun to be a super genius, but they don't realize how hard it is to put up with all the idiots in the world."

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Civilize the mind, but make savage the body.

- Chinese proverb

I guess I could explain to you what I mean by that sentence but I suspect you'd actually understand it anyway if you read it. So my conclusion is that you're just trying to be a dick. Happy Friday!

The truth is you can't repeal ACA and it be completely gone the next day. It will take several years to unwind all of the details.


But "repeal & replace", sounds really good in a sound-bite and when Trump was blustering and blundering his way around the press conference this week.

He makes everything sound like the sky is falling! Obamacare is "Terrible" and the "Worst ever" and so on speaking in extreme, extremes as Trump is wont to do.

But the hard, complicated and messy part is what Trump doesn't talk about - what do they have to replace it. What is the plan?

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Steve Fleck @stevefleck | Blog

Exact same 'plan' they had the last time the GOP controlled the presidency and both chambers of congress ~ i.e., not a damn thing. If you have the $$, you're free to choose whatever flavor of insurance coverage you like; if you can't afford it, tough shit. We've seen this movie before...

If I recall, we had to pass the ACA before we could read it, why the double standard now? Can't the R's pass a new ACA and then we can find out what the replacement is?

Sure. They will just have to live with the consequences of that action like the democrats did from theirs.

Does that sound like a good plan to you?

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Kevin

http://kevinmetcalfe.dreamhosters.com
My Strava

What a funny thread, full of angst over something that is almost completely unknown. We do know a couple of things; the pubs have had several plans put forth over the last few years, and I have not read that any one of them did not cover pre-existing conditions. It's been widely reported that a couple of the most popular things from ACA will be kept.
I'd imagine pubs are in what are now "real" discussions, with a back and forth as to what will actually be in "the plan". Not much out so far, but one thing I did not like hearing floated is a tax on employer provided plans to help generate revenue. I'd expect pubs to end up with a better plan than ACA, hopefully much better, partially because they've had ACA to learn from (as well as break down walls that had limited govt in some areas).

I'm confused :( So if you and your wife are "perfectly healthy" what was your preexisting condition?

I gave more detail in a subsequent post - search on "neuroma".

Initial drafts of ACA were going to remove the tax-exempt status of employer-provided plans. That foundered largely due to labor unions, who argued that many of their contracts are negotiated for several years, and that suddenly taxing negotiated benefits would be unfair.

From a purely selfish standpoint, I'm worried about this too, since I have a very expensive employer-provided plan.

I do think it would be a good idea (in the long run) to make employer-provided health benefits taxable. But it's got to be done gradually and predictably so that employers and the labor market can adjust in a predictable tax environment.

It's funny because one part of Trump's health care reform proposal is to make employee contributions tax deductible. Not sure if he means deductible via Schedule A or elsewhere but either way, it wouldn't help people who can't afford health care since their tax is already very low or zero. It would be weird, to say the least, if they taxed employer contributions but gave a deduction for employee contributions.

Making employer contributions taxable would really shake things up and probably make HSA's combined with a high deductible policy a lot more popular.