Patterico's Pontifications

6/22/2017

Senate Health Care Bill Released

Filed under: General — Dana @ 10:44 am



[guest post by Dana]

During interview with Sen. Ted Cruz over at the Daily Wire this week, Ben Shapiro asked Cruz about the GOP’s health care bill:

SHAPIRO: If the Senate rubber stamped the House bill, would you support it, given that the House bill didn’t actually repeal Obamacare in many crucial ways?

CRUZ: The first version of the House bill was very problematic and there were many issues with it – first and foremost, that it didn’t do nearly enough to drive down premiums. I think the House Freedom Caucus improved the bill significantly. They focused quite rightly on the need to drive down premiums. The Senate needs to go much further than the House Bill. We need to improve it significantly more. I don’t know if the Senate will do so or not. It is what I have been working day and night, practically every waking hour for he last five months to do: bring senators together to get that done.

SHAPIRO: Are you worried that Republicans will pass a bill that doesn’t repeal Obamacare, declare victory, then watch as premiums skyrocket and the free market is blamed for what is essentially a continuation of a heavily government-regulated Obamacare system?

CRUZ: There are two bad outcomes that are possible. One bad outcome is that we fail to repeal Obamacare – we fail to pass any bill at all. For the past seven years we’ve campaigned promising the voter that we would repeal the disaster that is Obamacare, that has cost millions of Americans their jobs, thrown them into part-time jobs, cost them their doctors, caused premiums to skyrocket. If we fail to deliver after being given every branch of government, that’s profoundly harmful both as a substantive matter of policy but also as a political matter. The credibility of Republicans would be deeply, deeply undermined.

There’s a second outcome that’s even worse than that. We pass a bill titled “Obamacare Repeal,” but doesn’t in fact repeal Obamacare — in fact expands it. We hold a press conference patting ourselves on the back, claiming to have repealed it. And then next year, premiums continue to skyrocket and it’s demonstrated that what Republicans said isn’t true. I think that has even greater policy harms and political harms. So I’m trying to avoid both of those. I’m trying to get Republicans in the Senate and the House and the President and the Vice President to do what we said we would do. That’s what I’m urging all the players to do.

This morning, the GOP’s Senate repeal plan was released. You can read it here. You can also read Mitch McConnell’s discussion draft here.

As Allahpundit commented :

McConnell’s team put out a fact sheet this morning detailing their major changes to ObamaCare — or non-changes, I should say. Yeah, the mandate’s gone and there’s a massive (delayed) rollback of Medicaid, but the premium subsidies are still there, they’re still pegged to income, and there’s a bunch of new money ($25 billion) appropriated to stabilize ObamaCare’s rickety exchanges over the next four years. There’s also money set aside for two years of cost-sharing subsidies, which the House GOP has spent three years fighting in court on grounds that they never appropriated those funds in the first place. In other words, in at least one respect, the Senate bill is … an expansion of ObamaCare.

All in all, the bill’s a jumble of provisions designed to shore up the current law and, bizarrely, to make it less sustainable. With the mandate gone, many O-Care taxes repealed, and the cost-sharing subsidies marked for phase-out in 2019, much of the revenue needed to keep the exchanges buoyant is set to disappear over the next few years.

A vote on the bill is set for next Thursday. The CBO plans to release estimates for the Senate health care bill next week. And some senators are expressing concerns that there may not be enough time to fully process the bill before next week’s scheduled vote.

Here are a few quick reactions from conservatives to the bill’s release this morning:

SEN. RAND PAUL (Kentucky): “Conservatives have always been for repealing Obamacare, and my concern is that this doesn’t repeal Obamacare,” he said as he was walking back to his office through the Capitol tunnel.

“What I’m seeing so far is it keeps 10 out of 12 regulations, it continues the Obamacare subsidies, and I think ultimately will not bring down premiums,” he continued, “because instead of trying to fix the death spiral of Obamacare, it simply subsidizes it with taxpayer money to insurance companies.”

SEN. RON JOHNSON (Wisconsin): “The primary driver of premium increases is guaranteed issue,” he told reporters, referring to the ACA provision that bars insurers from rejecting customers. “Who would buy auto insurance if you could buy insurance after you’ve crashed your car?” Johnson said. “Well, that’s the exact same reason that guaranteed issue, when it’s been passed in states, is collapsing insurance markets, is collapsing the Obamacare market.” He would prefer that people with pre-existing conditions be taken care of through high-risk pools.

Further, here is an interesting look at the senators who have concerns about the bill, and some who may be considering voting “no”.

Happy reading.

(Cross-posted at The Jury Talks Back.)

–Dana

18 Responses to “Senate Health Care Bill Released”

  1. Good morning.

    Dana (023079)

  2. The Senate plan is really hostile to self-employed 50 and 60-year-olds, or those living on their 401(k)s in that it allows drastically increased premiums and claws back subsidies. There are many pre-Medicare seniors who will be spending half their income on insurance PREMIUMS, with the actual bills on top of that.

    This is a group that the Democrats will target, perhaps by promising Medicare entry at a lower age.

    Kevin M (752a26)

  3. Other than making life harder for some of their long-term voters, the GOP plan does NOTHING to dismantle the ACA. Rather it entrenches it and fixes some holes.

    Either House plan is FAR better than this hot mess.

    Then again the aim of the Senate plan seems to be capping Medicaid expenses, not repealing (or even reforming) the ACA. I think that McConnell will needs some Democrat votes to pass this, and telling them it entrenches the ACA may be his strategy.

    Kevin M (752a26)

  4. There’s an awful lot of lying going on on both sides about preexisting conditions.

    The real problem with the exclusion was not deadbeats trying to sign up now that they have cancer, but currently-insured people who need to change plans being refused due to an ongoing problem.

    Lose your job due to illness, or layoff, or your company going broke, eventually lose your insurance, can’t get a replacement due to the exclusion. Any plan that returns to THAT regime is a non-starter.

    (And if you bring up the HIPAA plans, with their timed jump through 20 hoops, I’m gonna get rude.)

    Kevin M (752a26)

  5. Ted Cruz:

    There’s a second outcome that’s even worse than that. We pass a bill titled “Obamacare Repeal,” but doesn’t in fact repeal Obamacare — in fact expands it.

    No, the second bad outcome is that they repeal it, but don’t replace it with something good.

    The thing that makes it a repeal, or not a repeal, is the elimination of the individual mandate, and the accompanying tax/penalty, and freedom from the exchanges. This bill also gets rid of the employer mandate.

    Basically, McConnell punted.

    Sammy Finkelman (f61675)

  6. Cruz ought to use this to get McConnell fired. The more I look at it, it’s terrible. It makes all the problems of Obamacare worse, repeals little anyone cares about, expands the problems to bigger problems, while stamping it with the GOP label.

    McWeasel is, as usual, running scared and trying to be as innocuous as possible. As a result, he’s got something that won’t get 40 votes.

    Kevin M (752a26)

  7. At the very least, if they really have to get something passed, just go after the Medicaid, call it Medicaid Reform and that will get the 50 GOP votes. Separate the ACA out and leave it unchanged, or at least make it a little less hostile to GOP voters (not more, as the Senate plan does). Then do a clean bill on the ACA itself. Mixing Medicaid in just gives it too many moving parts.

    Kevin M (752a26)

  8. There’s a book out about the problems with health care economics:

    https://www.amazon.com/American-Sickness-Healthcare-Became-Business/dp/1524756202 By Elizabeth Rosenthal

    Here’s a book review:

    https://www.nytimes.com/2017/04/04/books/review/an-american-sickness-elisabeth-rosenthal.html

    This bill doesn’t tackle that at all. The Democrats don’t want to tackle it, but just pretend the market is efficient. A few Republicans maybe want to, but many prefer to solve the difficulties with lies.

    Now anything that does tackle it will be leap in the dark, and will not be scored as saving money by the Congressional Budget Office. It will not be score-able in fact.

    In 1960, health care spending in the United States was only about 5% of GDP, lower than in any other industrialized country, and there weren’t that many people not getting the right kind of care.

    There’s no counterpressure on prices.

    We need pressure, but not at cost of any form of rationing, and that can only be done by the consumer or a sufficient percentage of them.

    Sammy Finkelman (f61675)

  9. 7. Kevin M (752a26) — 6/22/2017 @ 11:14 am

    At the very least, if they really have to get something passed, just go after the Medicaid, call it Medicaid Reform and that will get the 50 GOP votes. Separate the ACA out and leave it unchanged, or at least make it a little less hostile to GOP voters (not more, as the Senate plan does). Then do a clean bill on the ACA itself. Mixing Medicaid in just gives it too many moving parts.

    The key element that needs to be in the bill is the repeal of the individual mandate. The bill does that and makes as few otherer changes as possible, while saving some people from the consequences of the death spiral, by, for instance, not tying the tax credits to the exchanges.

    It has to add money, especially since it is also repealing the special Obamacare taxes, and Medicaid Reform is in there, not for itself, but in order to save money, so that CBO will score it as at least neutral on the budget so that it can pass with 51 votes without having to change the Senate rules.

    All in all, you get a plan that will not work, and some people get left out in the lurch. But you can stumble on for three or four years maybe.

    Sammy Finkelman (f61675)

  10. Senator Johnson is correct, they will never fix Health Insurance as long as there is guaranteed issue. Republican leadership has fallen into the trap of providing for pre-existing conditions through the current legislation.

    Dejectedhead (32153d)

  11. President Obama criticizes the bill as “a massive transfer of wealth”. Without batting an eye.

    https://mobile.twitter.com/ABC/status/877975859625435137/photo/2

    Dana (023079)

  12. those lowlife Hot Air bottom-feeders just want clicks, and it affects their analysis i think

    happyfeet (a037ad)

  13. Obama’s ACA was never about providing access to health care: outrageously high deductibles in addition to expensive co-pays combine to expose the ACA as a massive government mandated fraud.

    Americans are thus required to buy a ‘pig in a poke’ they can’t begin to afford. The provisions of ‘guaranteed issue’ and ‘pre-existing conditions’ force the doors wide open for political and economic exploitation of the most egregious sort.

    he ACA is a tax on ordinary taxpayers

    ropelight (7f7ed0)

  14. This is why twain said your property and money wasnt safe:
    https://www.conservativereview.com/articles/the-gops-obamacare-out-repeal-replace-in-copy-paste

    narciso (d1f714)

  15. The key element that needs to be in the bill is the repeal of the individual mandate.

    The individual mandate is a philosophical objection, sure, but hardly the most harmful provision in the law. Again, Sammy, you are talking about something you have no experience with.

    Kevin M (752a26)

  16. Some of the other coverage mandates, the unsustainable subsidy stream.

    narciso (d1f714)

  17. Here’s the thing- Trump wants a win. But if he sees his numbers melting away w/t base and broader public due to this legislation, he’ll weigh the value of a win by not signing this in it’s current form if it ever gets out of Congress. It’s all about him, not health care.

    DCSCA (797bc0)

  18. So Obama smelled weakness, and he went in for the kill. But how many people still believe the political swill that Obamacare is a good thing?

    As for grappling with opioid addiction, people (rehab center owners) will certainly suffer if we shut off the spigot of spectacular reimbursement rates.

    http://www.ocregister.com/2017/05/21/how-some-southern-california-drug-rehab-centers-exploit-addiction/

    Patricia (5fc097)


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