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Republicans Plan To “Fix” ObamaCare

Republicans Plan To “Fix” ObamaCare

But only until 2017 . . .

There has been a lot of speculation, including by me, about what the Republican-controlled Congress will do should the Supreme Court rule against Obama in King v. Burwell.  Should the Court strike down federal subsidies, Republicans will need to have a plan in place to address this decision as it impacts those who are currently receiving subsidies for ObamaCare from the federal exchange because their state did not set up a state exchange.

Republicans are still talking about a “fix” but are now stressing that it is to be “transitional” rather than permanent.  According to Bloomberg:

[Representative Dennis Ross of Florida] added, “There’s a strong consensus in that room” that the subsidies must be continued in some form “until Republicans can substantively change the law.”

Participants at Wednesday’s closed-door meeting said key aspects of a transition plan were presented to lawmakers by Ryan, Energy and Commerce Committee Chairman Fred Upton, Budget Committee Chairman Tom Price of Georgia and Education and Workforce Committee Chairman John Kline of Minnesota.

Along with immediate repeal of the law’s individual and employer mandates, the plan would give states the option to build their own insurance exchanges and offer subsidies, using federal money.

Alternatively, people in states affected by the ruling would receive a subsidy to purchase an insurance plan either from healthcare.gov or on the open market.

The plan was “very well thought out” and satisfied conservatives, said Representative Bill Flores, a Texas Republican who is chairman of the Republican Study Committee, a caucus of about 170 conservatives.

The House plan, according to The National Journal, would:

  • Continue the Affordable Care Act’s subsidies through the end of 2015, absent a Court stay of its decision that did the same.
  • Immediately repeal the individual and employer mandates.
  • Starting in 2016, states would be allowed to opt out of the law and its other various regulations. States would receive a block grant, the same amount as the subsidies that their residents would receive, to implement their own health care plans.
  • In states that don’t opt out, individuals would continue to receive subsidies but could use them to purchase plans on and off of the ACA exchanges.
  • The plan would sunset in 2017, compelling a new Congress and president to come up with a comprehensive Obamacare replacement.

House Democrats reject the repeal of the individual and employer mandates, and the White House is opposed to anything more than a “one sentence bill that authorizes the subsidies in every state.”

According to Politico, the Senate does not yet have a single plan:

GOP senators have discussed several proposals behind closed doors but are nowhere near consensus. After vowing for years to scrap the law and replace it, the party is rife with tension over what it would do if the onus was suddenly on it to come up with an alternative. Even if Republicans could settle on a legislative response, President Barack Obama would almost certainly veto it.

With a ruling expected this month, McConnell has signaled his preference by signing on to Johnson’s plan. McConnell also has signaled an interest in a separate approach by freshman Sen. Ben Sasse, a conservative from Nebraska who has proposed offering financial assistance through tax credits over 18 months but reducing them gradually over that time period.

Presidential hopefuls Rand Paul and Ted Cruz oppose fixes, however temporary.  Politico continues:

“I would like to legalize inexpensive insurance policies, give more choice, let people choose their doctor, expand health savings accounts, help people save for their insurance,” Paul said. Asked if his plan would involve extending the subsidies, the Kentucky Republican replied: “A better way would be to try to legalize inexpensive insurance policies. … The president has made it illegal to buy inexpensive insurance in our country.”In a separate interview last week, Cruz said a victory for his side in the court case would be a “real opportunity for Congress to lead.”

He added: “In a perfect world, we would take that opportunity to repeal Obamacare. At a minimum, we should allow states to opt out.”

Cruz has his own Plan B: Scuttle the entire health care law, though he would allow for a six-month transition period in order to let the markets and states adjust to a full-scale repeal.

The Supreme Court decision is expected in the coming weeks, and it looks like Republicans plan to adopt a fix that will stand until Obama leaves office.   What comes after that will depend on who wins the White House in 2016.

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Comments

“Cruz has his own Plan B: Scuttle the entire health care law, though he would allow for a six-month transition period in order to let the markets and states adjust to a full-scale repeal.”

Yep. Just kill the whole damned, illegal boondoggle. Kill it dead.

    Exiliado in reply to Ragspierre. | June 20, 2015 at 8:49 pm

    And once dead, kill it again, just in case.

    That’s the ONLY fix.

    Estragon in reply to Ragspierre. | June 21, 2015 at 10:36 pm

    Great idea! NOW – show me the 290 votes in the House and 67 in the Senate to override the veto – ASSUMING you can get 60 in the Senate to vote at all.

    This is the problem with these great ideas of Senator Cruz – it riles up the base fine, but has no practical chance in hell of happening. But so many of his supporters are of the sort who believed signing his internet petition against Obamacare (never even presented to anyone, btw, all a scam to collect emails for fundraising from suckers) might do something, they will probably blame GOP leaders instead.

    Because stupid and irrational.

Elected officials are not going to vote to give back power that they’ve taken from the people. Obamacare will not be repealed by the legislative process.

Any repeal, modification, or the merest change of a comma to a semi-colon presumes the Republican Party has the intestinal fortitude to stand up for their Employers (We the People). John Pelosi is a joke as the Speaker and his caucus is a circular firing squad.

Killing the subsidies isn’t enough. The entire law needs to be repealed. No more mandates, no more required coverage for services you don’t want or need.

    siguiriya in reply to Sanddog. | June 20, 2015 at 8:12 pm

    Help me out here. What exactly are the services that people don’t want or need? I mean real people, not theoretical people. I don’t exactly see people going to the barricades because their health insurance covers knee replacements and angiograms. I don’t see people clamoring for insurance with a $20K maximum annual payout.

    In one sense people already don’t pay for services they are unlikely to use. Premiums are based on age and gender. A forty year old woman will pay around half of what a sixty-two year old man pays for insurance — around $300 vs. $600 monthly where I live.

      Hi Siguiruiya, I can’t speak for Sanddog, but generally speaking, when people mention that they don’t want to be forced to buy coverage for services they don’t need, they mean things like the requirement that everyone have maternity coverage. This is deemed “minimum essential” coverage under ObamaCare and applies to everyone in America who has health insurance: single men, women past child-bearing age (including those with hysterectomies), etc.

      The idea is that everyone pays for everyone else; however, many people think this is unfair and onerous because it makes insurance more costly (either up front or via deductibles and out of pocket minimums).

      Whether or not the “minimum essential” coverage is acceptable to Americans is a key subject of debate. Should the government force people to buy coverage they don’t want and don’t need (and cannot ever possibly need)? Should it be up to the government to determine what is “minimum essential” for every American in every circumstance?

      One-size-fits-all government-mandated coverage is a problem for a lot of people (including myself).

      Ragspierre in reply to siguiriya. | June 21, 2015 at 3:34 pm

      “What exactly are the services that people don’t want or need?”

      Well, in my case, ALLLLLLLLLLLLLL of them. I’ve spent a life-time of paying for my own health care, choosing what I need and want, AND paying for it. I raised a large family on the same principles, and NEVER had a stitch of medical insurance at any point in my life, outside of a catastrophic plan.

      I’m not the Lone Ranger, but you won’t find us at any barricades. We’re busy with other things.

        siguiriya in reply to Ragspierre. | June 21, 2015 at 9:02 pm

        As far as the various services that one might not need — as I mentioned before some of that is taken care of in the calculation of the premium. As far as other services, well, health insurance isn’t a restaurant menu. I suppose there are countless services that one might never use. A blind woman isn’t going to need diabetic eye exams. A legless man won’t need the services of a podiatrist. A non-smoker won’t need a stop-smoking program. A person without a gall bladder won’t need a cholecystectomy. A permanently comatose person won’t need psychiatric care. Frankly, the cost of calculating a custom premium cost based on the fine detail of what everyone doesn’t need or thinks or hopes he doesn’t need would be prohibitive.

        As far as “catastrophic care” what counts as a catastrophe? An outpatient procedure — arthroscopy, kidney stones, cholecystectomy, etc. — can run $15k to $20k or more all in, between the hospital charge, surgeon and anesthesiologist professional fees, and the pre- and post-surgical labs, imaging, drugs, and clinic visits. Those are all relatively routine procedures, but for many people they would be catastrophic.

        I suppose it sounds like a nice idea to let people opt out of insurance altogether. But what happens when one of those people needs medical care? If we’re not going to let people suffer or die in the street, someone will have to pay for that care — either the government, or other patients through cost-shifting by the hospitals. People without health insurance tend to delay care as long as possible. When that happens a simple and relatively cheap blood pressure problem turns into an expensive stroke, diabetes turns into an expensive amputation, and a cholesterol problem turns into an expensive coronary bypass.

        Ragspierre in reply to Ragspierre. | June 21, 2015 at 10:28 pm

        “But what happens when one of those people needs medical care?”

        I know you’re not stupid, but you’re doing a damn good impression.

        THEY PAY FOR IT. Don’t you read?

        What do you think people did BEFORE health insurance became a common perk of employment?

        DAMN…!!!

          siguiriya in reply to Ragspierre. | June 22, 2015 at 2:02 am

          Many, probably most people can’t pay, because the costs are so great.

          In my almost 22 years at a large hospital I saw that all the time. An uninsured woman collapses at home and is rushed to the hospital. She undergoes surgery and gets a new heart valve. Total bill is $250,000. Woman and husband have a modest business that they run out of their apartment. They have an old car. They have a little money in the bank. But there’s no way they can pay the bill. No one would lend them that amount. No hospital is going to keep a receivable on the books for decades. The bill is either written off (passing the cost to other patients), or the State declares the woman medically indigent and pays the bill. In this case, the latter happened.

          A long hospitalization can run into the hundreds of thousands. A joint replacement can run over $100k. Yes, people can pay a few hundred or a few thousand, but a janitor making nine dollars an hour can’t pay off a bill equaling two or three times his annual salary, and it doesn’t take very much medical care to get into that range.

          Sugiria: ‘Many, probably most people can’t pay, because the costs are so great.’

          Then doctors and hospitals will either have to lower their prices or go broke. I’ve always paid my own way, but then I remember when doctors made house calls too.

The moral axiom of intrinsic value implies a need for universal health care.

That said, this is why the motives of the pro-choice Party are questionable. They reject intrinsic value on principle. Their only consensus is a desire for environmental stability, and reduced personal liability, hence promotion of the social safety net. Obamacare preserves the status quo, which includes progressive costs (e.g. taxes), inadequate conditions (e.g. environment, resources), redistributes funds (e.g. Medicare), and delegates reform (e.g. Medicaid).

Subotai Bahadur | June 20, 2015 at 2:12 pm

1)

Republicans are still talking about a “fix” but are now stressing that it is to be “transitional” rather than permanent.

Name one thing that is more permanent than a “temporary” government subsidy.

2) The Democrats and Obama will oppose repealing the mandates to their last breath. Name one time in the last 5+ years where the Republicans have not gone into a corner and [insert canine metaphor here] when opposed by even a minority of Democrats.

3) The Republicans have consistently broken every promise made during the campaign [the same campaign that gave them a record breaking landslide] to oppose Obama, the Democrats, and what they have done to this country. Instead, from the day after the election the Republicans have functionally merged with the Democrats in opposition to the Liberty Caucus and their own [probably former] voters. This looks to be yet another suicidal effort to lie to their voters again while saving what the Democrats want. They do not have, nor do they believe that they need, credibility with their own voters.

If they end up ratifying, saving, and endorsing Obamacare, which it appears they will do, in any putative 2016 elections they will discover what happened to the Whigs.

idiocy like this is why i am no longer a “Republican”…

the GOPe is just a subsidiary of the Demonrat party.

    redc1c4 in reply to redc1c4. | June 20, 2015 at 2:19 pm

    not that i have any great faith that the Roberts court will rule the subsidies unconstitutional…

    after all, they are the same ones who claimed a tax was not a tax.

      Estragon in reply to redc1c4. | June 21, 2015 at 10:40 pm

      Actually, Roberts ruled the mandate IS a tax – just Republicans had argued for years and Obama had denied. That was what made the bill pass constitutional muster, though.

Henry Hawkins | June 20, 2015 at 6:51 pm

“The Republicans are going to…..”

The Republicans aren’t going to do squat. New election coming, so new lies from the Republican leadership.

Along with immediate repeal of the law’s individual and employer mandates, the plan would give states the option to build their own insurance exchanges and offer subsidies, using federal money.

If a state chooses not to tax its citizens to pay for healthcare, why should we allow the federal government to tax those same citizens for healthcare?

This scam merely facilitates citizen enrollment into state plans that will eventually mandate expanded coverage primarily at the state’s expense but under federal control.

The Republican party is in a coma, nearing its end.

When Sheldon Adelson dies, the Republican party will die with him.

The ONLY fix that can possibly pass and survive a veto threat would be some form of temporary extension of the subsidies until real reform can be instituted.

Remember, THE STATUS QUO ANTE IS GONE FOREVER. The system we had was effectively destroyed by Obamacare. It can be rebuilt with reforms to work better than before, but not overnight – and not without the cooperation of the President. That won’t happen until Obama is gone.

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