health care

New CBO Report Says House-Passed Health Care Plan Would Leave 23 Million More Uninsured, Cut $119 Billion Off Federal Deficit

It would leave slightly fewer people without insurance coverage than under the original version of the bill, but would trim less from the federal deficit.

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JIM LO SCALZO/EPA/Newscom

The House-passed Republican health care plan would increase the number of Americans without health insurance by 23 million over 10 years, but would reduce premiums for those who maintain coverage, according to a new Congressional Budget Office analysis of the bill released Wednesday evening.

If the American Health Care Act were to become law this year, an estimated 14 million people would lose coverage by 2018, the CBO estimates, with that number increasing to 19 million by 2020 and 23 million by 2026. That's slightly less than the 24 million Americans that the CBO estimated would lose health care coverage under the original version of the bill, before it was amended in early May.

Replacing Obamacare with the AHCA would reduce the federal deficit by an estimated $119 billion over the next 10 years, the CBO estimates, which is less than the $150 billion savings included in the original version of the bill (and baked into the budget plan released by the White House this week). Almost all the budgetary savings—an estimated $834 billion, most of which is canceled out by other elements of the bill—come from changes to Medicaid, the joint federal-state program to provide health coverage for the poor, including a major provision of the AHCA that would allow states to handle more Medicaid decision-making.

Congressional Budget Office

While the numbers have changed a bit since the initial CBO score for the bill was released in March, the basic trade-offs within the AHCA remain largely the same. The bill would maintain many elements of Obamacare, but would repeal the individual mandate that requires Americans to purchase health insurance, while allowing insurance companies to offer plans that are considered sub-par by Obamacare's coverage mandates and to price plans differently based on an individual's health record, in some circumstances.

The result is that some people will choose not to purchase insurance, while others might not be able to afford to do so—though the bill provides tax credits to help make insurance more affordable. Those tax credits, the CBO says, would "lower average premiums enough to attract a sufficient number of relatively healthy people to stabilize the market."

The CBO estimates that premiums would be reduced under the rewritten version of the AHCA, but that would not be the case for everyone, as "premiums would vary significantly according to health status and the types of benefits provided, and less healthy people would face extremely high premiums, despite the funding that would be available." Many of those people would end up in state-run "high risk pools" created by the legislation.

Wednesday's release is the first CBO analysis of the AHCA since it was passed by the House with a 217-213 vote on May 4. Republicans faced criticism for rushing to a vote in the House before the CBO could finish scoring the rewritten bill, but so far the Senate has not touched the AHCA and further changes are likely to happen before the bill reaches President Donald Trump's desk (if it ever does).

Prior to the re-write, the CBO said the Republican health care plan would result in 14 million fewer people having insurance next year, with a decline of 24 million after 10 years. Premiums were estimated to rise by 15 to 20 percent through 2020, and would continue to rise during the 2020s but at a slower rate than what is projected under current law.

The new report is sure to be a major factor in the Senate's deliberations on the AHCA, which remains a flawed (and deeply unpopular) attempt at replacing Obamacare.

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  1. How about an analysis of how the CBO’s predictions for Obamacare turned out. Were they accurate? Hmm…

    1. NPR always describes them as the “Non-partisan Congressional Budget Office” what more assurances do you need or improprieties are you asserting?

      1. Well if you can’t believe top men…

    2. The CBO score is never perfect, but are you really expecting it to be? Predicting the effects of massive pieces of legislation is ridiculously hard. The CBO is what we’ve got. I see no reasonable alternative.

      1. Pulling whatever one needs to confirm one’s political preconceptions directly from one’s ass seems to be the standard around here.

        1. Well we’ve been hearing it from the White House for 8 years…

        2. Thanks for showing up and adding something worthwhile to the conversation. You are to Reason what Carl is to the meme world.

        3. Oddly enough, that is the criticism of the CBO and its bias towards statist policies.

      2. The CBO score is never perfect, but are you really expecting it to be? Predicting the effects of massive pieces of legislation is ridiculously hard. The CBO is what we’ve got. I see no reasonable alternative.

        There is indeed a reasonable alternative. Look back to your statement about massive and complex pieces of legislation with murky effects [written by economic illiterates], and then let’s start problem-solving there.

      3. The two biggest missed projections by CBO were per capita Medicaid spending (50% higher than projected) and enrollment.

        Given the missed cost projections the savings due to Medicaid reform under the proposed law are virtually guaranteed to be understated.

        And the biggest breathless concern over AHCA? You got it: enrollment. Start with a flawed assumption that all of the states, sorry States (not that the SCOTUS cares about words these days), that didn’t expand Medicaid rolls still will, then project how many would lose coverage based on that. Oh, and count the people who voluntarily chose to not get coverage as lost coverage as well. Seems like sound reasoning.

      4. This is the lose-your-wallet-in-the-dark, look-under-the-streetlamp theory of legislative evaluation.

        If it doesn’t work, then it doesn’t work.

        The CBO scored Obamacare’s Risk Corridors as “revenue neutral”. ‘Nuf said.

    3. Yeah, predictions of how bad ObamaCare were way off. ObamaCare was a lot more expensive and didn’t even come close to CBO predictions.

      1. You’re full of shit. Obamacare came in under budget and reduced the deficit more than anticipated.

        Of course, one primary reason is because of all the red state governors who refused Medicaid expansion.

        1. As usual you are full of shit. The only “savings” over the original projections were due to more people opting out AND the states which did not expand Medicaid coverage. Per capita Medicaid spending was 50% higher than projected.

          But keep licking Barry’s ass.

          1. The estimated cost of President Obama’s signature health care law is continuing to fall.

            The Congressional Budget Office announced on Monday that the Affordable Care Act will cost $142 billion, or 11 percent, less over the next 10 years, compared to what the agency had projected in January.

            The nonpartisan agency said the Affordable Care Act will cost less for two essential reasons. The first, and most significant, is that health insurance premiums are rising more slowly, and thus requires less of a government subsidy.

            In addition, slightly fewer people are now expected to sign up for Medicaid and for subsidized insurance under the law’s marketplaces. That’s because the agency now says that more people than anticipated already had health insurance before the law took effect, and fewer companies than anticipated are canceling coverage. All in all, three million fewer people are expected to sign up for Affordable Care Act provisions by 2025.

            https://goo.gl/Cd0AJL

            1. Your own link says I’m right.

              In addition, slightly fewer people are now expected to sign up for Medicaid and for subsidized insurance under the law’s marketplaces.

              And what were you saying about premiums?

              The findings, assembled by the Health and Human Services Office of the Assistant Secretary for Planning and Evaluation, show that since 2013, one year before the Obamacare regulations were fully implemented, premiums have risen from an average of $2,784 in 2013 to $5,712 in 2017 on the federal exchange, healthcare.gov. This represents an increase of $2,928, or 105 percent.

              1. Your big complaint about Obamacare is that is does not work well enough.

                1. What? My complaint is that it is a massive expansion of the welfare state. It’s a failure in every meaningful measure to boot.

                  1. My complaint is that it is a massive expansion of the welfare state.

                    Why aren’t you complaining about Medicare then?

                    Dumbya just expanded Medicare $120 billion a year without paying for it! You TEAM RED! hacks only hate Dem Big Gov programs.

                    1. God you’re a fucking moron. I AM complaining about Medicare. AND SS.

              2. NotAnotherSkippy|5.24.17 @ 7:39PM|#
                “Your own link says I’m right.”

                Turd does this on a regular basis, and then swears (with the words right in front of his turdness), that they really don’t mean that!
                Funny as hell!

                1. He gets his ass handed to him every time we tangle and yet he still tries. It’s a good cool down for my brain at the end of the day.

  2. How many people did they say would gain/lost insurance under Obamacare and how far off were they? And I don’t mean how many people got more expensive insurance after their Obamacare made their previous insurance illegal. I mean what was the net gain they predicted and what were the actual numbers.

    1. It’s funny how those types of questions are rarely answered (i.e., actual facts), and certainly rarely publicized on the news. Meanwhile these projections (i.e., guesses) are reported everywhere and treated as actual facts.

      Also the “news” seems to treat people who don’t want insurance as people who are “losing” insurance.

      1. How dare you make explicit the implicit assumptions that undergird statist rhetoric!!!

        Must be some sort of racist hayter,,,

  3. Of course since much of the loss in coverage is due to Medicaid cuts, “more uninsured” means fewer on welfare.

    1. True, but that higher Medicaid cost was not paid via higher payroll taxes.

      Obamacare paid for Medicaid with a 2.8% surcharge on capital gains over $250,000.

      Now with the GOP plan workers will bear the burden of un-reimbursed mandatory ER/hospital fees – thank Reagan for EMTALA.

      1. Try again, asswipe. There were income tax increases as well.

        1. STFU, you lying TEAM RED! hack.

          1. Awesome fact-filled retort. *lick* *lick*

            1. Cite the PAYROLL tax hike, you idiot. CITE IT.

              Obamacare paid for Medicaid with a 2.8% surcharge on capital gains over $250,000.

              The above is a fact. The pay-for was a capital gains tax – not a payroll tax.

              1. You make this too easy, dumbfuck.

                Payroll Tax Hike: Obamacare imposes an additional 0.9 percent payroll tax on individuals making $200,000 or couples making more than $250,000. This tax increase costs Americans $123 billion over ten years.

                1. I admit I didn’t pay it. I make less than $250,000 payroll.

                  Cry me a fucking river.

                  1. So you lied. Nothing new.

                  2. Oh. I didn’t realize you were so poor.

                    Now I feel kind of guilty.

                    Here you go, poverty man.

                    * throws a dollar in Palin’s hat *

                  3. I admit I didn’t pay it.

                    Well, there’s a first!

  4. You’re assuming they will keep their coverage under Obamacare. There is sufficient evidence that they will be losing it regardless.

  5. So if there was a complete repeal of Obamacare and more free market incentives, would the CBO’s estimates of lost coverage be reported the same way and would the bill be labeled as deeply ‘flawed’ and ‘unpopular’? Right now it seems like you guys are defending the status quo more than critiquing the proposed bill.

    1. Reason’s hyperlinks are orange.

      1. From the first link:

        CBO and JCT estimate that, in 2018, 14 million more people would be uninsured under H.R. 1628 than under current law.

        CTRL+F “lose”

        1. Pick a damn argument. Want to complain about the choice of language? Go ahead. I almost came here to do that myself. (though I don’t think you can do that and say that most of the people are Medicaid moochers; in that case, it is correct to say they’re losing coverage)

          That’s not Waka’s complaint. He even granted that characterization by saying, “lost coverage.”

          1. Actually the pedantry is your shtick. The fact is that the intent here WAS to claim that ppl would lose coverage. The reality is that the CBO report is projecting 14mil fewer would have coverage in 2018 than would be the case under existing law. That does NOT necessarily mean that the majority of those 14 mil already HAVE coverage and even if they did it isn’t really a loss if you give it up voluntarily. XM actually posted the numbers at 6:34. Nor does that invalidate the fact that the majority of coverage expansion came as a result of Medicaid.

            1. OK. Waka was not talking about that, and so my response regarding hyperlinks was not about that. Stay on target.

    2. Are you disputing that the bill is neither deeply flawed or unpopular? The flawed part kinda depends on your goals, I guess. There’s no doubt that it’s extremely, indisputably unpopular.

      1. But what if we were talking about a different bill that didn’t have flaws? Reason would still call it flawed. smdh

      2. “There’s no doubt that it’s extremely, indisputably unpopular.”

        Yeah, not giving away free shit is often not popular. With imbeciles.

        1. Shockingly, liberals respond to insults as positively as conservatives do. Who thought.

          1. mortiscrum|5.24.17 @ 10:11PM|#
            “Shockingly, liberals respond to insults as positively as conservatives do. Who thought.”

            Shockingly, imbecilic liberals still hope for free shit, imbecilic liberal

            1. Don’t call them “liberal”. You know better

        2. So you agree with mortiscrum? Or are you incapable of leaving the goalposts where they were set?

    3. Yes.

    4. Right now it seems like you guys are defending the status quo

      They do that a lot here. Reason is a conservative outfit but not the least bit reactionary. I imagine if we had a right wing wave election in 2018 and Trump and whoever replaced Ryan and McConnell announced they were rolling back , not just the New Deal, but the whole Progressive Era Suderman and co. would be churning out “what do they intend to replace it with” pieces and praising the activist judiciary’s blocking attempts as ” constitutional separation of powers”

      1. Just remember that the only reason we have Obamacare is because the GOP didn’t have a national health policy.

        1. Still don’t.

  6. When they say ‘insurance’, do they mean Medicaid? That’s what they mean…isn’t it?

    If Medicaid is insurance, than Social Security is a bank account. Idiots.

    1. It’s referred to as “insurance” in one spot, and “coverage” in another. The words have become fairly interchangeable when it comes to healthcare. The loss is mostly among Medicaid.

      1. The words are only interchangeable if words don’t have meaning.

  7. The republicans were elected to repeal and replace Obamacare.
    This disaster of a proposed bill does not repeal Obamacare.
    End of story.

    1. When have Republicans ever told the truth?

      Don’t expect a border wall either. Or a balanced budget. And expect lots of Iraq style nation-building. Wait till Trump gets a war with Iran – 3x the size of Iraq. Bibi the Rat wants a war with Iran more than Fat Rush likes little boys.

      1. Palin’s Buttplug|5.24.17 @ 7:28PM|#
        “When have Republicans ever told the truth?”

        Just about as often as turd or the Ds do, turd.

  8. If it leaves just one person on government insurance, it hasn’t cut deep enough.

    1. Congratulations on finding the one true simplistic ideology!

      1. Medicare for all!

        1. “Medicare for all!”

          Yep, Tony’s simplistic, stupid and willing to have someone steal for him!

          1. Nah, Tony’s one of those supposed center-left people. Complexity is a virtue. We should write long and complicated bills for everything and appoint the smartest bureacrats to administer them. Markets are sorta ok in some places but not in others, and government should still step in to create lots of rules to reign them in. It’s all grounded in a sense of “pragmatism”

            1. It’s not that complexity is a virtue, it’s that the world happens to be complex.

              1. Man my spelling was awful there

                Anyway that complexity is one reason we’re libertarian: we don’t trust people to have vast amounts of authority in such a complex world because they will always lack crucial information. It’s why we prefer decentralization. Leonard Read’s essay I, Pencil is a great example of how a complex world can work without the need for any kind of central planning

      2. Healthcare is a right!

        1. We should always have the right to a good or service provided by others

  9. Unless something has changed, at least some of the 14 million “uninsured” people would be consumers who choose not to buy insurance after the individual mandate has been watered down. Here’s what the CBO said back in March

    “CBO and JCT estimate that, in 2018, 14 million more people would be uninsured under the legislation than under current law. Most of that increase would stem from repealing the penalties associated with the individual mandate. Some of those people would choose not to have insurance because they chose to be covered by insurance under current law only to avoid paying the penalties, and some people would forgo insurance in response to higher premiums.”

    The CBO is apparently ignoring the fact that the individual mandate has been replaced by insurance premium surcharge, and they’re operating under the assumption that a bunch of states will stop taking in new medicaid (that’s insurance?) patients in response to the per capita block granting. Based on what, I don’t know.

    Notice that CBO will only consider you as “insured” only if you have comprehensive plan. If you have mini med or supplemental plans (they offer other examples) you’re not considered insured.

    So again – 14 million people will not be booted from their insurance by 2018. That’s NOT what’s happening here.

  10. How many of those who would “lose” their coverage are people who would have not elected for coverage had it not been government mandated?

  11. “The result is that some people will choose not to purchase insurance, while others might not be able to afford to do so?though the bill provides tax credits to help make insurance more affordable.”

    We should point out that ObamaCare as it is remains unsustainable.

    More and more insurance companies refusing to participate, even as premiums skyrocket, deductibles go higher, etc.

    The alternatives aren’t either 23 million more uninsured or the status quo.

    The alternatives are between the AHCA or the health industry continuing on its present course over the cliff.

    1. We should point out that ObamaCare as it is remains unsustainable

      Then let it die and quit trying to repeal it.

      But the truth is you TEAM RED! types are afraid it won’t die.

      DEATH SPIRAL!!!!!! BLOOP! DERP!! ITS DYING ON ITS OWN!!!

      1. Massive govt programs don’t die alone, they take the rest of the govt down with them. Likely the economy too.

      2. I guess it shouldn’t surprise me that a troll has no sense of compassion. You’re talking about letting millions of sick people suffer–for what reason?

        I guess some trolls just want to watch the world burn.

        1. I care about markets, you little Social Justice Warrior you.

          Obamacare is MUCH BETTER THAN MEDICARE.

          Medicare is the real problem with our OLD FOLKS GET EVERYTHING medical system.

          1. Obamacare is Medicaid and in no rational universe is Medicaid better than Medicare.

            1. That is precisely why I want a three tier system over Single-Payer.

              1- I want private insurance for ME AND MY FAMILY.
              2- Medicare is a sorry-ass retirement system I will need to supplement
              3- Medicaid is for the destitute and low-tier docs and my high-tier docs opt out of Medicaid.

              I like 3-tier for purely selfish reasons.

              1. You love Barrycare because Medicaid expansion finally gave able-bodied lazy asses like yourself coverage.

          2. Palin’s Buttplug|5.24.17 @ 7:53PM|#
            “I care about markets, you little Social Justice Warrior you.”

            You may “care” about markets, you steaming pile of shit, but you’re entirely too stupid to comment on them.
            Fuck off.

      3. Letting it die equates to “jacking up premiums on healthy young people, forever, to subsidize and put floaties on the sinking fatass we call Obamacare. Oh and more taxes on devices, payroll, income, and whatever else keeps this bastard breathing”

        I’ll pass. But since you and your friends like it so much, there’s a section on your federal income taxes where you can gift money to the government. You guys come up with the 200 billion to cover the next few years and we’ll all gladly go along.

        Otherwise eat my 145% premium increased shorts. If your old, choke on them and croak so I can stop subsidizing your healthcare as well.

        1. I see it like my argument about fiscal conservatism.

          Eventually, we will cut the budget. We’ll spend more than we can finance until the international credit markets will demand more than we can afford to pay in interest. At the point, the international credit markets will cut us off. Then we’ll be forced to cut everything whether we want to or not–just like happened to Greece. The big difference is that there isn’t anybody in the world big enough to bail us out. They’ll be nothing to do but cut.

          And that will come as a big shock with a lot of suffering. I don’t want to see people suffer. It’s much more compassionate to make the hard choices about what to cut now–rather than wait until we have no choices because we have no funds. Fiscal conservatism is compassionate. Waiting until we blow up before we cut anything is mean as hell.

          It’s the same thing with Medicaid. I don’t want to see ObamaCare blow up. That will entail a lot of needless suffering. There are no lessons to be learned from watching it blow up that we don’t already know. Might as well start with undoing what we can–like the ObamaCare Medicaid expansion. That’s compassionate.

          Wanting to watch it all burn means that Shrike is evil in addition to stoopid.

        2. Someone else complaining about a molehill called Obamacare instead of the mountain Medicare.

          I want ALL government programs repealed. And start with the worst – MEDICARE.

          I know what you GOPers think though IF WE REPEAL MEDICARE OLD FOLKS WON’T VOTE FER ME!

      4. Then let it die and quit trying to repeal it.

        But the truth is you TEAM RED! types are afraid it won’t die.

        Not without considerable pain from people who would suffer from it at no fault of their own. And the media will spin this as a humanitarian catastrophe.

        “Let it die” will then lead to you whining “Why won’t they do anything to fix this mess?”

  12. “Almost all the budgetary savings?an estimated $834 billion, most of which is canceled out by other elements of the bill?come from changes to Medicaid”

    It should be pointed out that hospitals aren’t operating at a loss because of Medicaid doesn’t reimburse providers for the full cost of care. The providers are simply gouging private insurers to make up for the difference.

    Get your head around this chart, or you have no idea what you’re talking about:

    http://tinyurl.com/lcayz2f

    What it means is that there is no way to bring the cost of care down for private insurance patients that doesn’t involve cutting Medicare and/or Medicaid.

    Cutting Medicare is politically impossible, and, hell, I wasn’t sure I’d live to see the day when Congress had the guts to cut Medicaid. We libertarians should be tickled to see the House plan do that. We should only hope and pray that Senate will do likewise.

    For those who can’t see the obvious, the fewer people there are on Medicaid, the less providers will need to gouge private insurance to make up for their losses. Look at the chart. Feel it. Know it. Live it.

    1. The logic doesn’t follow. If a patient has no insurance the hospital has to make up the costs incurred due to EMTALA anyway. You need to add the fact that Medicaid is inefficient and broken and creates additional deadweight loss above and beyond defaulted payments. As a nation we’re spending over $500BB on a program that makes people feel a little better and slightly lowers their financial risk. Obviously money well spent…

      1. “If a patient has no insurance the hospital has to make up the costs incurred due to EMTALA anyway.”

        Take a look at these numbers:

        http://tinyurl.com/mgh9udk

        The percentage of national costs eaten by hospitals by treating people with no insurance has remained the same since 1980–for 35 years it’s been around 6%. Those bills typically go to collection agencies.

        The percentage of total national costs used by Medicaid patients has doubled over that time. That’s particularly devastating because Medicaid pays less than Medicare even–so the distortion is even greater.

        Meanwhile, Medicaid covers things that people do have some control over–like pregnancy. You want to talk about moral hazard? How much you wanna bet people are more careful when they think they might have to pay the bill?

        1. Game it out. Assume everything else is equal (a big assumption, granted)

          A world with no Medicaid but with EMTALA: 100 Patients still show up and are treated but there’s no reimbursement.

          A world with Medicaid and EMTALA: 100 Patients show up and are treated and there’s partial reimbursement.

          In both cases the hospitals have to cover their losses, but the losses are lower with a population that has partial coverage (Medicaid), and the only way to do that is by spreading those costs onto the remaining privately insured customers.

          I’m not defending Medicaid, but you need more to your argument.

          1. Uninsured patients are a much smaller group than Medicaid.

            Leaving people die in the street because they don’t have insurance is political suicide.

            Medicaid is something more discretionary–we can kill it in the name of reforming ObamaCare; hell, they actually passed it in the House.

            Medicaid causes hospitals to fail in neighborhoods with large Medicaid populations. Remember, the poor aren’t distributed evenly in your city, much less the country. In some areas, 90%+ of the hospital census is Medicaid patients. If they can’t find enough private pay patients to cover the difference–they close.

            Read this:

            http://tinyurl.com/medhjus

            16 hospitals have closed in recent years–just in New York City–for that very reason, because Medicaid doesn’t pay enough to reimburse costs, and they couldn’t find enough private pay patients in those neighborhoods. Yeah, they may have some uninsured people, too–although they may have a lower rate than hospitals in middle class areas because everyone in that neighborhood qualifies for Medicaid.

            Medicaid is a much worse–and growing–problem. 60% medicaid/medicare does not mean every hospital has 60% of those. Some of them have huge Medicaid numbers–and they gouge particularly hard. That’s why your PPO wants you to pay a huge out of network fee to go to one of those hospitals.

            1. And if they didn’t have Medicaid, then what would happen? Medicaid patients would BECOME uninsured. It’s really not a long or difficult logical thread…

              1. Or they would buy private insurance. Or they would get a job. They would do what they did before ObamaCare.

                Take a look at these stats:

                “Mayo reported a sharp increase in the amount of unreimbursed costs related to Medicaid patients, from $321 million in 2012 to $548 million in 2016. The figures include its campuses in Arizona and Florida. Mayo nonetheless remained profitable in 2016, with income of $475 million.”

                “Mayo to give preference to privately insured patients over Medicaid patients”
                —-Star Tribune

                http://tinyurl.com/kekwamp

                Even the Mayo Clinic is saying they can’t afford to keep taking Medicaid patients over privately insured. They’re making up for losses by gouging privately insured patients, too–and the Mayo Clinic can draw patients from all over the country and the world. What chance does your average community hospital have of making up for those Medicaid losses?

                1. Some portion, like anal obstruction, would pick up private coverage. The majority wouldn’t, certainly not immediately. That means the hospitals would have an even larger hole to fill.

                  I agree that Medicaid is a disaster. I’m just saying that the argument that if we simply repealed eliminated Medicaid instantly private rates would immediately fall is flawed.

                  And Mayo has its own problems. Much of their “great” care follows what I call the MIT model: throw lots of money at a problem and claim you’re brilliant. Mayo basically orders every test possible and gets their own special Medicare reimbursement rates to pay for much of it. It plays the same games with private payers.

                  1. Point is that if even the Mayo Clinic–Even. The. Mayo. Clinic.–can’t sustain itself on the present number of Medicaid patients, then what hope does your average provider have?

                    No wonder insurance rates are so high.

                    And the best thing about cutting Medicaid is that it is the most politically feasible option that actually addresses the cause of the problem (or part of it anyway).

                    Increasing the size of Medicaid and forcing young healthy people to buy insurance to try to make up for the new round of gouging certainly didn’t do the trick. We’re not going to undo the damage of increasing Medicaid eligibility with out undoing the increase in Medicaid eligibility.

                    Cutting Medicare won’t make it through the House at this point. We barely got a cut to Medicaid through.

                    And no one’s going to turn dying uninsured people away, women giving birth away, etc. That’s just not politically feasible at this point in time.

                    This doesn’t need to be the end of the argument, of course. We can push for cutting those other programs–it’s just a question of whether the plan on the table makes things better by addressing part of the cause of the problem. And it’s one of those rare situations in which it does make things better!

                    1. You’re still not getting it. Most of that Medicaid population will still get treated and the hospitals will still have to eat the cost. Insurance rates would still be high because of EMTALA more than Medicaid and you admit that we’re not going to get rid of EMTALA.

                      So the real argument isn’t that cutting Medicaid will reduce private premiums. The real argument is that Medicaid drives additional stupid spending and causes other deadweight losses in addition to not actually enabling useful care.

                      That is and has been my only point.

                    2. “Most of that Medicaid population will still get treated and the hospitals will still have to eat the cost.”

                      No they won’t.

                      People do without healthcare. Those people will go back to doing whatever it was before they had Medicaid.

                      Sometimes heart conditions are too expensive to treat. Sometimes they can go without an EKG. Maybe they can’t afford angioplasty. Maybe they just go with medication instead.

                      When eligibility first expanded for Medicaid, after ObamaCare passed, there was a huge surge in new patients suddenly needing expensive procedures they were doing without before. People survived for millions of years without stents and hip replacements, and prenatal care.

                      Think of it this way: Are you saying that people will demand the same treatment even if they have to pay for it? Those are working people who won’t qualify for Medicaid–and they’re either going into collections or declaring bankruptcy. Not paying your hospital bill is not without consequences.

                      Some people who used to have insurance will go into the ER when they’re having a heart attack even though they don’t have insurance, but look at those figures from that link I gave you above. Uncompensated care was 5.1% of total hospital costs in 1980 and 6.0% in 2000. In 2014, after ObamaCare, uncompensated costs were 5.3%. There just isn’t that much difference before and after Medicaid expanded.

                    3. So if there isn’t much difference in uncompensated costs before and after medicaid expansion, then medicaid expansion didn’t cause any more provlems for hospitals. QED That’s completely counter to your argument.

                      Now it’s true that ER usage went up with barrycare and medicaid expansion, so you could make the case that more ppl are likely to abuse the system as a result. But in a world with EMTALA there is nothing to prevent thise same ppl from going to those same hospitals and getting those same procedures as uninsured. In fact the law requires that they get treatment.

                    4. At times I’ve been on Medicaid, I’ve gone to the doctor for things I would not have gone to the ER for had that been my only option. Cutting Medicaid will cut overall expenditure, you’re just arguing about how much. Some, but not all, will be made up for in the ER.

      2. The massive money-sucking leviathan that is our healthcare system, wastes its money by covering WAY MORE garbage than could ever be forced on emergency rooms. From ADHD meds to nicotine patches to cataract surgeries. Reason was recently claiming the ER is only two percent of healthcare costs.

        And state govts are working hard to find new things to force on the required coverage list every day to garner themselves more campaign contributions and buy more votes. The idea that we can throw money at people with a blank medicaid check and break even via the ER, much less save money, is really a pipe dream.

        1. Reimbursement rates are generally set by looking at utilization, but politically sensitive things definitely get more funding.

    2. Cutting Medicare is politically impossible

      YES, that is the problem.

      Why worry about a little $95 Obamacare mandate tax? I pay a 3% payroll Medicare mandate!

      Give me the little Obamacare $95 opt out “fine” over mandatory Medicare taxes anytime.

      1. The penaltax is 2.5% AGI/$695 for 1 adult. Fuck, you can’t even get THAT right.

        1. The penalty for failing to have coverage last year was the greater of $95 per adult or 1 percent of adjusted gross household income. That fine rises to the higher of $325 per adult or 2 percent of household income this year, and increases in future years.

          I don’t care. I am not trying to freeload like you are.

          http://www.cnbc.com/2015/07/20…..ected.html

          1. Did you look at the fucking date, moron? That was for 2015. Geezus, you don’t even know what YEAR it is.

            1. I have private insurance you retard. I don’t pay a penalty tax.

              1. So you lied again.

                Are you typing this on your Obamaphone?

        2. And the big problem is Medicare, you dumbass.

          Why are you not campaigning to repeal it?

          1. You’re the one that thinks welfare is fine as long as we raise taxes to go along with it. And I have ALWAYS stated I want to eliminate both SS and Medicare.

        3. You’re an “I got mine so fuck you” type, aren’t you?

          A Medicare parasite – I should have guessed it earlier.

          1. Again, dumbass, *I’m* the one paying for *you*. I paid my portion of the national debt last year, did you?

            1. You’re not paying for a goddamn thing of mine, you jackass.

              My employer pays for a portion of my medical insurance and I pay the rest (I pay it in reality – except for their deduction).

              1. How many times do we have to go over this? You’re TANF check is not employment.

                1. You’re TANF check is not employment

                  You’re a Loser reduced to false insults.

                  Go eat the curdled cheese formed in Trump’s ass-cheeks, you GOP hack.

                  1. Palin’s Buttplug|5.24.17 @ 9:45PM|#
                    “You’re a Loser reduced to false insults.”

                    There are no false insults regarding your slimy ass.

                  2. And now you’re resorting to stealing insults from Trump. SAD!

  13. Let me know when Republicans disavow the Christian moral tenet of altruism. Until they do, we are all our brothers’ keepers.

    1. My tough-love approach is totally altruistic. People need incentives to better themselves. Also it will be better for the billions in the rest of the world also without health insurance, if we find market-based solutions to healthcare affordability rather than a parasitic safety-net system.

      Anyway welfare programs are based on threats of imprisonment and ruin to force other people to pay for things, not altruism. If you wanted to give your own money to other people you can just use your checkbook.

      1. What is the welfare state if not forced altruism?

        1. forced redistribution.

          1. Based on the principle that we are our brothers’ keepers.

            1. Based on the principle that we are our brothers’ keepers.

              That is not a USA principle.

              It MAY be a Christian principle but the USA is not a Christian nation.

              1. Christian politicians made altruism the law. How else to explain the welfare state? It didn’t just appear, overnight, without debate. The Social Security Act of 1935 was altruism for the aged. The Social Security Amendments of 1965 (Medicare and Medicaid) were altruism for the sick and aged. All Democrat (and Republican) social programs are based on altruism. The fact that Republicans are attempting to “repeal and replace” ObamaCare without repealing the Christian moral keystone of altruism is comical. It can’t be done. Obama (and 2000 years of Christian dogma) have won. It’s over.

                1. The Social Security Act of 1935 was altruism for the aged.

                  It’s adorable you think that.

                  FDR wanted to do what he could to insure the old voted Democrat. So he did this. It was a coldly political act. Altruism had zero to do with it.

                  The Social Security Amendments of 1965 (Medicare and Medicaid) were altruism for the sick and aged. All Democrat (and Republican) social programs are based on altruism.

                  The closest it comes to altruism is that they kept unemployable Democrats in Congress, so they had jobs.

            2. Whereas I prefer the tough-love approach based on the principle that we are our brothers’ keepers. Shall we repeat our points a third time?

            3. I thought you progs fucking loved science. Why do you have such a problem with natural selection?

            4. Dano:

              Based on the principle that we are our brothers’ keepers.

              The “principle that we are our brothers’ keepers”?
              Genesis 4:8-9

              Now Cain said to his brother Abel, “Let’s go out to the field.” While they were in the field, Cain attacked his brother Abel and killed him. Then the Lord said to Cain, “Where is your brother Abel?” “I don’t know,” he replied. “Am I my brother’s keeper?”

              So, Obamacare is based on the principle of having a lame answer while guilty?

              If you’re going to be a smug progressive, and try to use other people’s religion as a basis for value, your first step should be to know what you’re talking about.

              Your next step should be to start slapping yourself out of the sheer idiocy of it all. Because the only thing worse than a religious wacko is a hypocritical, smug progressive who’s too stupid to use religion as a weapon effectively.

              1. zzzzzzzzzzz

      2. You are entirely correct.

        The weak should die already (I am a Darwinist first and foremost).

        Let us start with Medicare weaklings then – they are the most expensive to maintain. I am sure you agree but humor me with a confirming reply please. You might just be a Medicare shill otherwise…

        You must admit that a dollar to save a child’s life is better spent than the dollar to prolong some old geezers live a few weeks…..? Hopefully you are rational like that?

        1. I propose making the funding of all govt programs voluntary as a transition. They can be “privatized” (“private-charity-ized”) next.

          1. So if SS/Medicare becomes voluntary then all paid benefits would soon cease to exist as the Medicare fund is exhausted.

            That is called Cold Turkey withdrawal. The political party responsible would face 70% voter backlash.

            You’re first!

            1. That’s strange, the future prediction that I magically pulled out of my own ass says different.

              Anyway democratic backlash over reductions in govt largess are precisely why property rights must be protected from the mob.

              1. Your ass must be sore from all that pushing and pulling.

            2. Palin’s Buttplug|5.24.17 @ 9:34PM|#
              “That is called Cold Turkey withdrawal. The political party responsible would face 70% voter backlash.”

              Oh, look! Turd defends free shit!

            3. So if SS/Medicare becomes voluntary then all paid benefits would soon cease to exist as the Medicare fund is exhausted.

              It’s going to be exhausted regardless. Or the workers will have to pay so much in taxes to support it that working becomes a joke.

            4. There is no Medicare fund. It’s an accounting construct only.

    2. I do love it when progressives claim to be the true heirs to Judeochristian values.

      My my. How progressive.

      1. I am no progressive – I hate them. I hate conservatives more. Even MORE – I hate religion (which is why I hate Christians and Muslims more than any other group).

        I am a true classic liberal.

        1. I wasn’t talking to you, poverty man.

        2. Who loves welfare and taxes. So you’re amsoc.

        3. Palin’s Buttplug|5.24.17 @ 9:37PM|#
          “I am a true classic liberal.”

          Imagine the degree of self delusion required to post that!

          1. Sevo, you are really Newt Gingrich for sure. We all know that.

            If we all pitch in to gang-bang Callista will you finally be happy?

            1. “We”?

              Is there a gerbil up your ass?

            2. I will not be participating in the Callista gang-bang. But you know who might be interested? SIV. She has a certain look to her, if you know what I mean.

            3. Palin’s Buttplug|5.24.17 @ 9:57PM|#
              “Sevo, you are really Newt Gingrich for sure.”

              Imagine the degree of self delusion required to post that!

  14. Let me know when Republicans relinquish, on principle, control of American medicine. Until they do, they are no better than Democrats.*

    *Here’s where H&R’s Republicans say, “Oh yeah? The Democrats started it!”

    1. Yes, the H&R GOP was all RAH RAH RAH! over Dubya’s Medicare Welfare Drug Benefit Part D.

      They LOVE Big Government as long as the GOP is the Big Government!

      1. Palin’s Buttplug|5.24.17 @ 9:55PM|#
        “They LOVE Big Government as long as the GOP is the Big Government!”

        Gee, turd, care to cite who LOVES big government other than you and the other pathetic lefty trolls who show up here?
        Oh, and fuck off.

        1. Hillary broke my brain!
          Fuck, Daddy, Turd!

        2. Might makes right!

    2. Who is this “H&R”?

  15. More details about the 20 plus mil future “uninsured” folks, from the CBO –

    “A few million people among the uninsured would use tax credits to purchase policies that would not cover major medical risks, CBO and JCT estimate. Those policies would be priced to closely match the size of the credits. Although such policies would provide some benefits, they would not provide enough financial protection in the event of a erious and costly illness to be considered insurance.”

    In states that waive both mandates (highly unlikely) –

    “The existence of tax credits in the nongroup market would encourage a second market to emerge to sell policies priced to closely match the size of the credits. Although such plans would provide some benefits, the policies would not provide enough financial protection in the event of a serious and costly illness to be considered insurance.”

    So about the 24 million who might join the ranks of uninsured in less than 20 years – most of those people (1) voluntarily dropped coverage or declined to purchase insurace (2) used tax credits to purchase plans that do not meet CBO’s definition of private insurance. They are therefore “uninsured”.

    Of course, the media is reporting the story as if millions will be booted from their healthcare and people will be left with no options. The CBO preemptively counts millions of future victims of states that waive all the mandates, but will almost never happen.

    1. “The CBO preemptively counts millions of future victims of states that waive all the mandates, but will almost never happen”

      Thank you for some honest data.

  16. The House-passed Republican health care plan would increase the number of Americans without health insurance by 23 million over 10 years, but would reduce premiums for those who maintain coverage, according to a new Congressional Budget Office analysis of the bill released Wednesday evening.

    And the problem is …

  17. So, it doesn’t force millions to get insurance they don’t want, and it lowers premiums for those who have it and/or want it?

    Sounds good to me.

  18. Doesn’t matter. Senate Republicans are writing their own bill. In the end we’ll get ObamaCare Lite?, General Cheeto will declare victory (again) and government will retain control of medicine. B-b-b-b-but not Hillary!

  19. Instead of saying “will lose access to health care”, they should say “will lose the ability to make other people pay for their health care.” It may not change the outcome but at least it would be a more honest conversation.

  20. would those people no longer on the ACHA be not allowed to buy insurance and/or will they be to poor to buy insurance ?

    1. No, having purchased insurance under AHCA will neither bar you from purchasing insurance subsequently nor ensure that you are too poor to buy insurance. Are you sure this is the question you meant to ask? Or were you trying to imply something that wasn’t even a question?

      Fail.

  21. This looks all good to me. N.B. the reason it doesn’t cut the deficit more is because it reduces taxes. So fuck us, this is cutting spending.

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