Version 2 of Senate GOP Trumpcare Out: Pre-Existing Condition Discrimination Is Back

[Deleted]

The funny part is after this clown show is look over Obama will look better then he was.

Well I admit, Obama wasn't that bad first term but the second, oh boy, he lied and pandered.. and lied, and sold out, he was far worse than Dubya and thats saying something. Trump on the other hand isn't that bad. He has to deal with a lot of opposition and hes still winning, so you have to cut him some slack.

[Deleted]

I know facts don't matter in Jesusland, so I wont even bother asking you to explain yourself. Enjoy Trump, you certainly earned him.

Why thank you, Trump is lovely!

[Belize]

I guess I don't get a response for using facts.

Sad. Very low energy. Not a whole lot of winning.

[Xeones]

Well I admit, Obama wasn't that bad first term but the second, oh boy, he lied and pandered.. and lied, and sold out, he was far worse than Dubya and thats saying something. Trump on the other hand isn't that bad. He has to deal with a lot of opposition and hes still winning, so you have to cut him some slack.

Sarcasm can be difficult to detect on the internet.

[Thepersona]

Less socialism is a huge win in my book.. and maybe Im a bit spiteful but destroying Obamas legacy is too.

but trumpy hasnt done anything to kill obamacare (apart from his 3 failures of a bill) like seriously... the republicans had 1 job, for 7 years... and they tank it

[Kujako]

but trumpy hasnt done anything to kill obamacare (apart from his 3 failures of a bill) like seriously... the republicans had 1 job, for 7 years... and they tank it

His constant shifting and twitter nonsense is doing plenty to kill Obamacare by causing mass uncertainty as to the future of the insurance market, causing insurance companies to increase prices as a hedge against Trump and Co actually doing any of the things they keep saying they'll do.

[Shadowferal]

And yet another setback for the GOP Repeal
The provisions that would likely be removed include polices important to conservatives, such as restrictions on tax credits being used for insurance plans that cover abortion.
Language in the bill defunding Planned Parenthood for a year also violates budget rules, according to the parliamentarian. That guidance is sure to anger anti-abortion groups who backed the bill specifically because of those provisions.
The parliamentarian has also not yet ruled on a controversial amendment from Sen. Ted Cruz (R-Texas) that would allow insurers to sell plans that do not meet ObamaCare regulations. If that provision were struck, conservative support for the bill would be in doubt.
In a blow to the insurance industry, the parliamentarian has advised that two key market stabilization provisions in the bill would be against the rules. First, the legislation can't appropriate the cost-sharing reduction subsidies insurers rely on to keep premiums and deductibles low; it can only repeal them.
Additionally, a "lockout" provision requiring consumers with a break in coverage to wait six months before buying insurance also violates the rules, according to the guidance.

[paralleluniverse]

NYT has an amazing article.

These Americans Hated the Health Law. Until the Idea of Repeal Sank In.

DOYLESTOWN, Pa. — Five years ago, the Affordable Care Act had yet to begin its expansion of health insurance to millions of Americans, but Jeff Brahin was already stewing about it.

“It’s going to cost a fortune,” he said in an interview at the time.

This week, as Republican efforts to repeal the law known as Obamacare appeared all but dead, Mr. Brahin, a 58-year-old lawyer and self-described fiscal hawk, said his feelings had evolved.

“As much as I was against it,” he said, “at this point I’m against the repeal.”

“Now that you’ve insured an additional 20 million people, you can’t just take the insurance away from these people,” he added. “It’s just not the right thing to do.”

As Mr. Brahin goes, so goes the nation.

When President Trump was elected, his party’s long-cherished goal of dismantling the Affordable Care Act seemed all but assured. But eight months later, Republicans seem to have done what the Democrats who passed the law never could: make it popular among a majority of Americans.

Support for the Affordable Care Act has risen since the election — in some polls, sharply — with more people now viewing the law favorably than unfavorably. Voters have besieged their representatives with emotional telephone calls and rallies, urging them not to repeal, one big reason Republicans have had surprising trouble in fulfilling their promise despite controlling both Congress and the White House.

The change in public opinion may not denote newfound love of the Affordable Care Act so much as dread of what might replace it. The nonpartisan Congressional Budget Office estimates that both the House and Senate proposals to replace the law would result in over 20 million more uninsured Americans. The shift in mood also reflects a strong increase in support for Medicaid, the health insurance program for the poor that the law expanded to cover far more people, and which faces the deepest cuts in its 52-year history under the Republican plans.

Most profound, though, is this: After years of Tea Party demands for smaller government, Republicans are now pushing up against a growing consensus that the government should guarantee health insurance. A Pew survey in January found that 60 percent of Americans believe the federal government should be responsible for ensuring that all Americans have health coverage. That was up from 51 percent last year, and the highest in nearly a decade.

The belief held even among many Republicans: 52 percent of those making below $30,000 a year said the federal government has a responsibility to ensure health coverage, a huge jump from 31 percent last year. And 34 percent of Republicans who make between $30,000 and about $75,000 endorsed that view, up from 14 percent last year.

“The idea that you shouldn’t take coverage away really captured a large share of people who weren’t even helped by this bill,” said Robert Blendon, a health policy expert at Harvard who has closely followed public opinion of the Affordable Care Act.

In 2012, when The New York Times talked to Mr. Brahin and others here in Bucks County, Pa., a perennial swing district outside Philadelphia, their attitudes on the law tracked with national polls that showed most Americans viewed it unfavorably.

But now, too, sentiment here reflects the polls — and how they have shifted. Many people still have little understanding of how the law works. But Democrats and independents have rallied around it, and many of those who opposed it now accept the law, unwilling to see millions of Americans stripped of the coverage that it extended to them.

“I can’t even remember why I opposed it,” said Patrick Murphy [Wow, the stupidity!], who owns Bagel Barrel, on a quaint and bustling street near Mr. Brahin’s law office here in Doylestown.

He thought Democrats “jammed it down our throats,” and like Mr. Brahin, he worried about the growing deficit. But, he said, he has provided insurance for his own dozen or so employees since 1993.

“Everybody needs some sort of health insurance,” Mr. Murphy said. “They’re trying to repeal Obamacare but they don’t have anything in place.”

Five years ago, people here could barely turn on their televisions without seeing negative ads warning that the Affordable Care Act would lead to rationed care and bloated bureaucracy. The law’s supporters, meanwhile, including the president whose name is attached to it, were not making much of a case.

To win support, Democrats were emphasizing that little would change for people who already had coverage; President Barack Obama famously promised that you could keep your plan and your doctor, even as a few million people’s noncompliant plans that did not offer all the law’s required benefits were canceled as the law was rolled out.

“The best way to get something passed was to argue it was small change,” said Stanley Greenberg, a veteran Democratic pollster. “It was only when Republicans got control that people then on their own discovered that this is what the benefits are.”

Jennifer Bell, sitting outside Mr. Murphy’s bagel shop with a friend, was raised a Democrat and always supported the health care law. But it was only after she was injured in a serious car accident in 2013 that she thought to advocate for it. She used to get health insurance through her job as a teacher. Now disabled with extensive neurological damage, and working part-time in a record store, she qualifies for Medicaid, and without it, she said, could not afford her ongoing treatment.

“It’s very, very scary to think about not having health insurance,” she said.

“If the condition doesn’t kill you, the stress of having it does, in this country,” she added. “The fact that people do without health insurance is a sin, in my opinion.”

Ms. Bell, 35, joined about 2,000 others for a women’s march in Doylestown after the inauguration, and now makes calls to Representative Brian Fitzpatrick and Senator Patrick J. Toomey, both Republicans, urging them to protect the Affordable Care Act. She is working to elect a Democrat challenging Mr. Fitzpatrick, who voted against the House bill to replace the law, saying he worried about people losing coverage.

More vigorous support among the law’s natural constituents since Mr. Trump’s election has helped lift public opinion. The Kaiser Family Foundation polls tracking monthly support for the law have shown the greatest gains among Democrats and independents, with an increase of 10 to 12 points among each group over the last year, while Republicans’ opinion has remained as unfavorable as ever.

“When something is threatened to be taken away, people start to rally around it,” said Liz Hamel, the director of public opinion and survey research for Kaiser, a nonpartisan group.

There has been an increase in the percentage of Republicans and Democrats saying that Medicaid is important for them and their families; between February and July the percentage of Republicans saying so had increased 10 points, to 53 percent.

The law still faces hurdles even beyond the debate in Congress. Five years ago, Cindy McMahon, who works at the store on the vegetable farm her family has owned for nearly a century, was not intending to buy health insurance, despite the law’s requirement that people have it or pay a tax penalty. She remains uninsured (and the Trump administration has suggested it may not enforce the penalty).

“If I had to pay a penalty, it’s still less than I have to pay for having health care all year,” Ms. McMahon said. At 52, she has diabetes and says the strips to test her blood sugar are so expensive that sometimes she tests once a month rather than daily. She has not looked into whether she might qualify for the Medicaid expansion; she was not aware Pennsylvania had expanded the program.

Frank Newport, the editor in chief of Gallup, said that the area of biggest agreement in polls is that Americans want the law changed. In the most recent poll, 44 percent of Americans said Congress should keep the law but make “significant changes.” That compares with 23 percent who want to keep it as it is, and 30 percent who support the Republicans’ plan to repeal and replace it.

Mr. Greenberg said the growing belief that the government should make sure people have health coverage was less an outbreak of compassion than a matter of affordability. In focus groups he conducted, Trump voters said they wanted the president and Congress to lower their health insurance premiums; they did not want to lose the Affordable Care Act’s protections against insurers charging more to people with pre-existing conditions, or denying coverage of basic health benefits.

Mark Goracy, an insurance consultant in Langhorne, near Doylestown, calls the coverage he and his wife get through the individual market “a joke.” Their premium is $1,415 a month, with combined deductibles of more than $12,000.

Still, Mr. Goracy, 62, said he nonetheless wants the law’s mandate blocking insurers from charging people more because of pre-existing conditions to survive.

While he once wished for “root-and-branch” repeal of the Affordable Care Act, he is not disappointed about the Republican failure to repeal it.

“Unlike when Democrats passed A.C.A. with not one Republican vote, what the Republicans need to do is get together with 20 or 25 Democrats and pass some kind of reform,” he said. “That, to me, is how legislation is supposed to proceed.”

Source: https://www.nytimes.com/2017/07/20/h...nsylvania.html

[ati87]

NYT has an amazing article.

These Americans Hated the Health Law. Until the Idea of Repeal Sank In.

Because these people first assumed that the ACA was for ''black people'' till they discovered that even the aryan race get sick sometimes.

[Breccia]

These Americans Hated the Health Law. Until the Idea of Repeal Sank In.

People fear what they don't understand. Intelligent people try to learn about it. Stupid people do not.

[Breccia]

Early morning tweet. Because Trump.

Republicans have a last chance to do the right thing on Repeal & Replace after years of talking & campaigning on it.

First of all, you campaigned on it too.

Second of all, I'd love for it to be the "last chance" but if Trump said it it's over 50% likely to be False or Pants On Fire.

- - - Updated - - -

Hey kids, it's Rand Paul! His "no" vote is more and more certain.

[ati87]

Early morning tweet. Because Trump.

Republicans have a last chance to do the right thing on Repeal & Replace after years of talking & campaigning on it.

First of all, you campaigned on it too.

Second of all, I'd love for it to be the "last chance" but if Trump said it it's over 50% likely to be False or Pants On Fire.

- - - Updated - - -

Hey kids, it's Rand Paul! His "no" vote is more and more certain.

I'm seriously wondering if Trump actually believed the stupid right-wing talking points the GOP has been spouting for years. Sure the avg online troll probably believed the crap but I wonder at this point if nobody told the president that everything he heard on Fox News for the last 8 years was just bullshit.

He is the president, he should just hire somebody to collect every Daily show episode since Obama got into office to and learn was Bullshit Mountain is.

[Breccia]

I'm seriously wondering if Trump actually believed the stupid right-wing talking points the GOP has been spouting for years.

You're the first in a long time to say this. Most people are wondering the other way 'round.

[Wyrt]

Hey kids, it's Rand Paul! His "no" vote is more and more certain.

Oh Rand Paul, you complete nutter. At least your insanity is helping people this time, even if unintentionally.

[Edge-]

http://www.nydailynews.com/newswires...icle-1.3352020

THOSE DAMN WOMEN!

Bonus points for him literally bringing up pistol duels as a way to handle literally anything in the 21st century. At least he looks the part for a basement dwelling internet tough guy.

[Travis B]

At least he looks the part for a basement dwelling internet tough guy.

I disagree. I think he is an incredibly sexy man. Just look at this pic of him in his ducky pajamas and try to not get turned on:

[Breccia]

Bonus points for him literally bringing up pistol duels as a way to handle literally anything in the 21st century.

I like how he challenged some hypothetical dude in Texas. Yeah, I know he's from Texas, but still, that's some good hypothesizin' son.

[Crissi]

and he will probably still win re-election because Corpus Christi is a bit backwards.

Need @Vanyali for more information on the area.

[Glorious Leader]

I'm seriously wondering if Trump actually believed the stupid right-wing talking points the GOP has been spouting for years. Sure the avg online troll probably believed the crap but I wonder at this point if nobody told the president that everything he heard on Fox News for the last 8 years was just bullshit.

He is the president, he should just hire somebody to collect every Daily show episode since Obama got into office to and learn was Bullshit Mountain is.

Trump is your grandpa or older uncle who watches fox news and screams at his television. That guy got elected president.

- - - Updated - - -

http://www.nydailynews.com/newswires...icle-1.3352020

THOSE DAMN WOMEN!

Bonus points for him literally bringing up pistol duels as a way to handle literally anything in the 21st century. At least he looks the part for a basement dwelling internet tough guy.

Limbaaugh said similar shit as well recently. Mcconell is not in control but susan collins is apparently.

[Breccia]

Parliamentarian deals setback to GOP repeal

Ahead of a crucial vote Tuesday, Republicans are working to revise their ObamaCare repeal-and-replace bill after the Senate parliamentarian said some provisions would need 60 votes in order to be included in the measure.

These provisions include language that defunds Planned Parenthood for a year, a lockout provision aimed at ensuring people don’t just sign up for insurance plans when they’re sick and a ban on tax credits going toward plans that cover abortion.

Sen. John Thune (R-S.D.) said changes are being made to the bill to meet the requirements. “And that happened last time,” he said. “Some of it is just restructuring stuff, getting feedback and interacting with the parliamentarian to find out what’s the best way of doing it.”
He acknowledged the abortion language is particularly important.

The guidelines from Senate Parliamentarian Elizabeth MacDonough, a referee of sorts over Senate rules, mean senators need to tweak certain provisions of the bill in an effort to get them to comply with the strict rules of reconciliation, the fast-track budget maneuver Republicans are using to avoid a Democratic filibuster.

That’s because it’s almost certain Democrats will vote against allowing these measures to stay in the bill if they’re subject to a 60-vote threshold.

But without them, it could further complicate support from organizations, industry and some lawmakers.

It’s a complicated task because provisions passed under reconciliation must have a direct impact on the budget and cannot be primarily oriented toward making policy changes.

Republican leadership is barreling toward a vote to debate healthcare Tuesday. It’s unclear if enough senators will support a motion to proceed to the bill — and as of early Monday evening, Senate Majority Leader Mitch McConnell (R-Ky.) hadn’t announced if the first amendment will be a vote on a clean repeal of ObamaCare with a two-year delay or the repeal-and-replace bill that has lead to deep divisions in the Senate GOP conference.

One conservative aide wrote in an email that leaders will need to ensure the bill defunds Planned Parenthood or the bill won’t pass the upper chamber.

Anti-abortion groups, such as the Family Research Council and the Susan B. Anthony List, have also threatened to oppose the bill if it doesn’t defund Planned Parenthood and prohibit financial assistance from going toward plans covering abortions. Yet they seemed optimistic Republicans will find a workaround.

“The news from the parliamentarian was another dip in the roller coaster ride,” SBA List President Marjorie Dannenfelser told The Washington Post over the weekend. “We have been reassured the problem can be fixed, so are in a tentative support mode still.”

Senate GOP aides say tweaking the bill to comply with the parliamentarian’s guidance is part of the process and was done when Republicans hammered out the legislation repealing ObamaCare in 2015.

At that time, the parliamentarian initially said eliminating the individual and employer mandates needed 60 votes to be included in the bill, but the measure’s language was later modified to comply with reconciliation rules.

David Christensen, vice president for government affairs at the Family Research Council, said they’re hopeful Republicans can find a workaround to keep the abortion-related provisions in the bill.

“We think that the news on the ruling raises some concerns, but I think we’re hopeful that pro-life senators are working through ways to ensure that funds don’t continue to be used in the mandatory programs for abortion providers like Planned Parenthood … and trying to think through ways to ensure that tax subsidies are not going to be subsidizing abortion coverage,” he said.

Christensen said there might be a way to redirect funding for the ObamaCare subsidies through programs that already restrict abortion services, like Medicaid or the Children’s Health Insurance Program.

While the parliamentarian OK’d the Planned Parenthood language in the 2015 repeal bill, it didn’t pass the test this time, even though the language is identical. An aide to Sen. Bernie Sanders (I-Vt.), ranking member of the Budget Committee, said his understanding is that Republicans haven’t been able to show that Planned Parenthood isn’t being singled out in the legislation.

“It passed last time because there was at least a question that other entities could be affected by the language,” the aide told The Hill.

“In the interim, Republicans have not been able to show that any entity other than Planned Parenthood is affected, and the new CBO score confirms that.”

The current language blocks Medicaid reimbursements for a year for entities that had expenditures that exceeded $350 million in fiscal 2014, but a CBO analysis from earlier this year concluded that would only apply to Planned Parenthood and its affiliates and clinics.

If Republicans can rewrite that language so it includes more abortion providers and generates more budget savings, as is required under reconciliation rules, that might be an adequate workaround, sources say.

Tim Head, executive director of the Faith & Freedom Coalition, said he is in regular contact with GOP leaders over the matter and is optimistic the abortion language will stay in.

“The workaround is in play. That’s the reason we’re optimistic that we can get the bill passed and still include this language that will make sure the pro-life community is satisfied,” he said.

Another item of concern is the bill’s continuous coverage provision, which requires consumers who had at least a 63-day break in healthcare coverage to wait six months before buying insurance. The parliamentarian advised this provision, as written, doesn’t fit within reconciliation’s parameters.

Leadership initially didn’t include the lockout provision in its first version of the Better Care Reconciliation Act, though aides quickly said they were working behind the scenes to add it and make sure it complied with the rules. Experts warned that, with the repeal of the individual mandate and without an incentive to keep insurance coverage, only the sickest would sign up for plans, leading to very high premiums.

America’s Health Insurance Plans, the industry’s main trade group, has told Congress of the need for a continuous coverage provision.

“If the tax penalties associated with the individual requirement are eliminated, any new legislation must include alternatives to incentivize continuous coverage,” the group wrote in a May 23 letter to Senate Finance Committee Chairman Orrin Hatch (R-Utah).

Additionally, the parliamentarian advised the legislation can’t fund critical payments to insurers compensating them for lowering the out-of-pocket costs for certain enrollees. The industry has been pleading for certainty they’ll continue to receive this money, which totals about $7 billion for fiscal 2017.

A document released by Sanders detailing the parliamentarian’s ruling also mentions provisions that can be included in the bill because they’re subject to a simple majority and others that are “still under review.”

The parliamentarian reviewed the June 26 bill, which doesn’t include a controversial measure from Sen. Ted Cruz (R-Texas) that lets insurers opt out of ObamaCare regulations as long as they sell an ObamaCare-compliant plan.

The inclusion of this amendment is crucial to Cruz’s support for the repeal-and-replace bill, but there’s been uncertainty on whether or not it meets reconciliation’s guidelines. The parliamentarian has not ruled either way.

It seems highly unlikely that the bolded parts can simply be dropped. There is slight, but nonzero, GOP support for PP, but a lot for ditching it. Banning some providers from tax credits is also not 100%. But the real issue is the lockout. As we've discussed ad medicum, the pillars of the ACA are
1) You have to have insurance
2) Insurance can't turn you down.

Removing 1 but not 2 means that people will wait until they get sick, then buy insurance, and nobody can stop them. So the rates will skyrocket. The CBO was very clear on the subject. The lockout is an attempt to slow that down (not stop it), but apparently, it's on shaky ground.

The red text is also noteworthy. I don't believe the CBO has ruled on Cruz, either, apologies if I missed it. But the vote is tomorrow. Voting on something that hasn't been researched is suspect, and why the GOP had issues before.