Friday, February 24, 2017

What's really involved in repealing and replacing the "A"CA

I'm well aware of the growing frustration on the Right concerning the fact that there's no real action yet in Congress regarding repeal-and-replace. While I understand the challenges - only Medicaid expansion, subsidies and the law's taxation component and be dealt with via reconciliation, while the matter of who gets what kind of coverage will require 60 votes in the Senate - they are not insurmountable and the majority of the public that loathes the "A"CA knows that.

Are vulnerable centrist Democrat Senators from red states being targeted with appropriately strong persuasion? Is requisite leverage being brought to bear on Lisa Murkowski, the Alaska "Republican" who says she'll give a thumbs down to any plan that does not keep Medicaid expansion and funding for Planned Parenthood?

More basically, do Republicans on Capitol Hill understand that this is probably the best issue on which to assert itself as a co-equal branch of government? The Trump administration is well aware of how much it can do via executive order and is poised to seize the initiative if Congress doesn't act soon.

In short, where's the sense of being fired up?

This is probably the peak moment of goodwill and unity on the Right. It's not a very big window of opportunity, and the mood can quickly devolve into cynicism and bitterness. This has been item number one on the conservative wish list since 2009, and excuses at a time of majorities in both houses and a Republican administration will rightly be seen as illegitimate and cowardly.

UPDATE: This is encouraging:

A leaked draft of a House bill to repeal and replace Obamacare fills in important new details of how Republicans would remake the healthcare law.
The discussion draft envisions phasing out big parts of the Affordable Care Act by 2020, including rolling back its Medicaid expansion and switching its insurance subsidies from income-based to age-based.
It also seeks to ease regulations on insurers, eliminating the federal list of essential health benefits they must cover and directing states to write the rules instead. It allows insurers to charge older people up to five times what they charge younger people, instead of just three times. And while it gets rid of the law's mandates to buy coverage, it says insurers may charge consumers 30 percent more in premiums if they don't maintain continuous coverage.
Republicans already had outlined many of the draft's main provisions, including its expansion of tax-free health savings accounts, restrictions on subsidies for plans covering abortion services and repeal of the healthcare law's taxes.
Now, get out there and sell it.


  1. We'll see, we're back to 2009, all the same arguments will again be debated. And then voted on. What plan were all the Party of No holding out for back then?

  2. And you are pretty smug about opposition to Obamacare. Here's what the Jax Times Union (one of only 2 papers in the country, along with the Las Vegas paper to endorse Trump said went down last nite in a packed townhall in south Georga with the Republican congressman. I realize your ilk is attempting to demonize attendees at these gatherings nationwide as hired guns, but my cousin who was a City Judge in Brooklyn said she went to hers and they did have donuts. I realize your ilk also demonizes judges when they don't rule your way too so she's a liberal and a likely piece of dung to your ilk:

    Carter was just a couple of minutes into his question-and-answer session when the angry shouting began.

    The Affordable Care Act again was a top issue and Carter led off with it, promising Congress would replace it with a plan that was affordable and patient centered. When he mentioned that premiums had skyrocketed, a man shouted, “Mine came down thousands of dollars.”

    When a statement was made that Obamacare was in a death spiral, another man shouted, “You let it go there by letting the insurance companies opt out.”

    In an attempt to restore some order, Carter paused and said, “We’re going to have to respect each other.” That drew a loud response of, “You’re not respecting us.”


  3. "Letting the insurance companies opt out?" This is the horrifying mindset that must be addressed in this country- the idea that it is okay for government to "let" private entities do things and mandate that they do things. Government has no business doing either. The number of people in this country who are okay with tyranny is hair-raising.

  4. Like Rush said about Obama, I hope you fail.

  5. Universal, the most exceptional universal plan in the most exceptional nation ever, so far, on God's green earth!

  6. There are many here among us who detest the corporate dogs even more than the government.

  7. Nevertheless, the Affordable Care Act was a top issue in the Town Hall meeting in Tia sleepy little seaside town in South Georgia. People are caring, even if your mandate wipes the sleep out from its eyes with their plan.

  8. Universal health care is predicated on the falsehood that health care is a right.

  9. To urge calm, some Republicans have already made promises that patients won't lose coverage during a transition period away from Obamacare, while Trump himself has promised "insurance for everybody."

  10. And health insurance is already a right here in these free states. What happens with the catastrophically sick risks who are not covered in the casino or who run out of coverage because their liabilities are so monstrous? Yep, the gummit pays, i.e., we all pay anyway, but the esteemed executives get to keep theirs safe and plan for an even richer future, as do the stockholders their malignantly engineered profits trickle down to. It's called crony capitalism. And it ain't insurance.

  11. No, it's not. Nothing "becomes" a right. Rights are immutable and not subject to circumstances.

    And I am not defending crony capitalism. I am against anything that sullies an actual free market.

  12. It is already a right. If you show up in dire straits in the ER they have to take you. They'll actually worry about who pays the bill later. Hint: in the absence of insurance, the gummit pays.

  13. Well, the Donald who promises health insurance for everybody, he had him an advisor out for blood who disputes that. Read more at

  14. Of course he's too reasonable a gentleman for you, we know. Let's roll with the debate, and yes, there will indeed be a debate. I don't think too many people are aware of what you want to serve up but total free market health care, dream on, dream on. How about letting more students into med school, stopping the competitive freak show that begins in high school, for one. More doctors, less pay for the elite, of course, damn, I suppose that hurts, huh? Yep, medical care, if not a right, is an obligation. Free market, my ass, keeping the number of doctors down. But plenty of them are out golfing in the clubs with the Pubs this sunny Saturday.

    "I think there are some very conservative Republicans in the House who are going to say 'just get rid of the whole thing,'” Kasich said during the interview. “And that's not acceptable when you have 20 million people” who gained insurance under the Affordable Care Act.One of those arch conservatives – Ohio Rep. Jim Jordan, founder of the House Freedom Caucus –responded to the Ohio governor's remarks during his own TV appearance on Sunday. Jordan said Re publicans promised full repeal of the law, not tweaks or fixes as some are now advocating.

    "Well, we didn't tell the American people we're going to repeal it except we're going to keep the Medicaid expansion," Jordan said on ABC's. "We didn't tell the American people we're going to repeal it, except we're going to keep some of the tax increases that some are talking about. We told them we were going to repeal it and replace it with a market-centered, patient-centered plan that actually brings back affordable health insurance."

  15. And of course, kill all the lawyers. How do we rise up against them? Being in the hospital you feel like you are a risk being managed. Everybody is a potential Plaintiff and asses have to be covered first, all but the one poking out of your hospital gown.