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GOP Senators Unveil Patient Freedom Act to Replace Obamacare

GOP Senators Unveil Patient Freedom Act to Replace Obamacare

The plan gives states the option to keep or opt out of Obamacare.

GOP Senators Bill Cassidy (LA) and Susan Collins (ME) unveiled one possible replacement for Obamacare called the Patient Freedom Act. This plan would leave the majority of the power to the states, letting each one decide “whether the want to keep ObamaCare.” Fox News reported:

“We recognize that our bill is not perfect,” said Maine Sen. Susan Collins, who introduced the 2017 Patient Freedom Act with Louisiana Sen. Bill Cassidy, a physician and fellow Republican.

“We need comprehensive legislation,” Collins continued. “It’s still a work in progress. … But if we don’t start putting specific legislation on the table that can be debated, refined, amended and enacted, then we will fail the American people.”

The states that want Obamacare can keep the entire with “its subsidies, mandates and protections for people with pre-existing conditions.”

Those that choose to opt out will have another plan to “provide a uniform tax credit linked to a health savings account to help people afford a basic, less comprehensive health insurance plan.”

Collins and Cassidy have not presented the legislation yet, which means they did not release a lot of details “like the size of the tax credit under the alternative to ObamaCare, were not immediately available.” Those that opt out could receive “95 percent of the federal money that they would get under ObamaCare, but to use for the alternative tax credit system instead.”

Cassidy pointed out the two senators kept the Obamacare option to persuade Senate Democrats to side with them. They need 60 votes to pass the legislation, which means at least eight Democrats must vote for it:

“At some point in this process, we’re going to need a bill that can get 60 votes,” Cassidy said at a press conference Monday. “We think that helps us get to 60.”

“California, New York: You love ObamaCare, you can keep it,” he added.

Yeah, the plan did not impress Senate Minority Leader Chuck Schumer:

“While I have a great deal of respect for Senators Collins and Cassidy, their proposal today illustrates the dilemma both they and Republicans are in,” Senate Minority Leader Charles Schumer (D-N.Y.) said in a statement.

“Ultimately, this proposal is an empty facade that would create chaos — not care — for millions of Americans. Republicans should drop their disruptive repeal plans and work with Democrats to improve, not gut, the Affordable Care Act and healthcare system for all Americans.”

Sen. Rand Paul (R-KY) said he will release his replacement plan sometime this week. Last week, though, he gave a small preview of his draft:

Paul suggested Sunday that the replacement plan will include more low-cost insurance plans

“One of the key reforms that we will do is, we’re going to legalize the sale of inexpensive insurance,” he told CNN’s “State of the Union.” “That means getting rid of the ObamaCare mandates on what you can buy.”

Paul wants to “include health saving accounts and tax credits to help customers save money.”


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buckeyeminuteman | January 24, 2017 at 8:37 am

What about the people stuck in a state which decides to keep Obamacare? If the federal gov is going to be creating rules on health insurance, it needs to apply nationwide. The entire thing was crap and needs to disappear.

    The “problem” is article 1, Section 8 and the 10th Amendment. Congress wasn’t granted the power to legislate insurance or medical care. As tempting as it is for the federal government to dictate these things, it is really up to the States. It would help if Congress would repeal the McCarran-Ferguson Act which forbids selling insurance over state lines and exempts insurance companies from anti-trust laws. Congress created this problem and they should fix it.

The democrats can’t stop the repeal of Obamacare, but they can obstruct any bills designed to lower insurance and medical costs. I guarantee they will do that just to create chaos and then blame the Republicans for it.


Burn it all, root and branch.

If a state wants ObamaDoggle, THEY can enact it themselves.

One thing I noted did not appear in The Hill piece is WHO pays for the ObamaDoggle that states get to keep if they want.

If they don’t eliminate the employer-based preference in the law, that’s a big mistake. It introduces all manner of distortions in insurance decisions.

Next, if they stick with Medical savings Accounts, they’re being unhelpful. MSAs require paperwork and they require you to put so much aside. People who can least afford their medical bills don’t put money aside – they come up with the money when they need it.

The paperwork for a small businessman is atrocious. No thanks.

Also, if they’re going to keep the Internal Revenue code, they should make — for EVERYONE – every dollar spent on medical care (except, ahem, elective plastic surgery) deductible. Every single dollar. Under obamacare, you have to spend at least 10% of your Adjusted Gross Income on medical care before it’s deductible, and that doesn’t include insurance costs, just actual medical care. Before it was 7.5%. It should be ZERO. We want people to pay for themselves, and not ask us. They’re less likely to ask if they can deduct it.

    Conservative0317 in reply to CloseTheFed. | January 24, 2017 at 11:55 am

    ” People who can least afford their medical bills don’t put money aside – they come up with the money when they need it.”

    “…they should make … every dollar spent on medical care … deductible. Every single dollar.”

    HSAs will still even work for both of these positions. By contributing to an HSA on a regular basis, or depositing the money they come up with when they need it, the total amount (up to their individual limit) is a pre-tax deduction from income. I do both of these. The regular deposits give me a fund to pay for medical expenses, but when I need more I pull that from some other reserve and deposit it in the HSA to pay for the treatment.

      To be honest, I’ve always believed that the better option would be to find the typical insurance costs, raise all of the tax brackets by that much, and then remove insurance from one of the things that was pre-tax.

      Health care is about more than just doctor’s visits and prescriptions. For example, I’m a mild asthmatic. However, I’ve discovered if I get my carpets professionally deep cleaned every four months or so, I don’t need the majority of my medication. A $60 carpet cleaning is quite a bit cheaper, in real dollars, than a Dulara prescription, but only one of these costs me money.

      It occurs to me, I’m actually overdue to get it done again, especially after the floor repair and all the concrete dust it kicked up in the process.

UnCivilServant | January 24, 2017 at 9:22 am

No! No! No! Burn the thing down. If the states stupid enough to do so enact their own programs later, thats their own problems, but there should be naught but a bad aroma left of the ACA.

I agree Medical Savings Accounts will not help the majority of people, they don’t make enough money , but that is the way the Trump Admin is going I think.
Thought is that if you have to pay a “fair share”, you won’t go to the Dr frivolously.

I was reading today that we have the hugest percentage of males out of work ever, even the obama Admin was worried about it, because of, get this, video games, it’s not as boring anymore, and of course opioids, not boring if your high, but alas, they are so disabled. Pretty sure they lawyered up and got disability. I saw it everyday at work in the hospital. They would come in with nefarious complaints to have documentation.

Health Savings Accounts are the most important aspect of any reform package. They are the only method to put pressure on pricing, since consumers will now care how much a procedure costs. You can even fund the account for the poor, if that is desired.

This really means that if a state wants to expand Medicaid/Medicare along with, they can do so and receive federal funds to support it.

No. The American people are the ones Who should be given the right to choose the right health plan for them and their family. We are not children whose parents make that choice for us. I understand their desire to provide choice – something Obamacare never did – but that choice should be with the people! Let Obamacare die from attrition – if you put the alternatives in a row, Obamacare will be the one that cost the most and delivers the least. Put them all out on the table, and let people choose. Obamacare – not individual citizens under Obamacare – will deservedly die a quick merciful death.

In other words, “If you like your 0bamacare you can keep your 0bamacare.” I love it.

You must sever the subsidy for the cost of uninsured pre-existing conditions from insurable risks. Using tax on income to cover this cost is more equitable than exploding the cost of “insurance” by deflecting the subsidy burden to insurance buyers.

If a state wants their own scheme they do not need to reference any federal scheme at all.

People are still confused by the difference between a doctor and an insurance policy…
One can save your life.
The other can bleed you to death.

There is no solution to medical costs and insurance costs.

The Federal Government caused all of this mess when they instituted Medicare. When the medical care profession was provided guaranteed payment for a large class of people, this immediately caused an increase in charges for the services. The increase in revenue spurred an expansion of the health care industry. The increased costs of medical care then caused those people not eligible for Medicare to have to purchase medical insurance. This bolstered the increase in medical costs, which then continued to drive up insurance costs. The practice of medical providers to accept significantly discounted payments for medical services, from insurers, drove up the billing for those without insurance, especially in those states which would not allow medical practitioners to accept the same reduced payments from those without insurance. Medicaid only made this worse. Excessive litigation for malpractice also drove up health care costs, though tort reform, in some states, has reduced that factor.

The whole point is that as long as the government provides guaranteed payment for a large class of people, those outside that class are going to end up paying more, either at the point of service or in insurance premiums. It has now reached the tipping point, where most people are going to have to have insurance to offset medical costs. Unless costs are rolled back or we go to a government sponsored single payer insurance system, some people are going to be without affordable health care.

    nordic_prince in reply to Mac45. | January 24, 2017 at 8:29 pm

    You’re right that the federal government caused the mess, only it didn’t start with Medicare – it started with FDR-era wage and price controls. Given that this is fundamentally a government-created problem, why on earth would you think that government (“government sponsored single payer insurance system”) is a solution?

    Hell no. Any viable, long-term solution has to get the federal government as far away as possible from anything even remotely related to “health care.”

Nope. Pass.

Abolish Obamacare entirely. The ONLY thing you have to do is legislate to ensure continuous coverage for people currently on an Exchange Plan or that took part in the Medicaid expansion. This would be a short term fix applicable to ONLY those people – once they move on to better coverage, that’s it.

Otherwise, use the Commerce Clause for its original purpose – federal legislation that prevents states from restricting us from buying insurance across state lines. The US was meant to be a free-trade zone.

Also, extend the tax credit that companies get for providing insurance to their employees to ALL Americans individually, as an option. We’d gradually shift away from employer provided to individually purchased plans – resulting in far more competition and choice, with resultant price reductions and creative product innovations. Insurers would compete for our business the way car insurers do.

Let the states do Tort reform.


Note the bogus premise for this “compromise” legislation.

The RINO’s pushing it are claiming they have to give the D’s much of what they want because they need to get to 60 votes for cloture.

Except that they don’t.

The Senate passed Obamacare through “reconciliation” rules – simple majority. R’s can repeal the same way – only need 50 Senators and VP tie-break to abolish the whole thing, and they’ve got 52 R Senators. So, they can afford a couple defections and still get everything they want without giving the Senate D’s anything at all. Only requirement is a CBO Score showing deficit reduction, which given Obamacare’s current financing should be a slam dunk.