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You are here: Home / Politics / Republican Venality / It Begins, Again: Paul Ryan Drops His ‘Replacement ACA’ in the Punchbowl

It Begins, Again: Paul Ryan Drops His ‘Replacement ACA’ in the Punchbowl

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No matter how cynical you try to be…


Some of the GOP fellowship are smart enough to start edging towards the exits…

Reader Interactions

147Comments

  1. 1.

    Wag

    Senator Gardner from my home state is running scared. He has been run through the wringer over his lack of town hall meetings and his unresponsive staff, as well his office’s failure to return phone calls from constituents. My 80 year old parents participated in a several hour long protest in front of his downtown Denver office.

    He’s toast in the next cycle.

  2. 2.

    Raoul

    Reactions I’m seeing from policy types is that this is an unholy mess. Which is why I favor calling it Ryancare.

  4. 4.

    Yarrow

    I’ll be calling my Representatives first thing tomorrow morning. This thing is a mess and a disaster and absolutely cannot be allowed to pass.

  6. 6.

    cynthia ackerman

    Re: not clear what problem this solves, clearly the problem is not enough grannies starving.

    Surprise, surprise.

  8. 8.

    Corner Stone

    @Wag: I am glad you fixed that because I had no idea what “loacknif” was and was starting to get a complex.

  13. 13.

    Mike J

    I love the fact that 10% of the bill is dedicated to making sure high dollar lottery winners are kicked off medicare before the end of the year. I can’t see how this applies to more than 2600 people per year, ant not for more than 11 months. (Exercise for the reader. If 50 states have 52 lotteries per year, what is the maximum number of months of medicare eligibility saved by this bill?)

  14. 14.

    Jim, Foolish Literalist

    Ken Klippenstein‏Verified account @ kenklippenstein 4h4 hours ago
    34% of Americans have no savings at all, rendering House GOP’s proposed health savings accounts irrelevant to 1/3

  18. 18.

    dmsilev

    @Mike J: It’s like the GOP is a high-school student with an essay to write for homework and they’re having a lot of trouble reaching the 5 page minimum length so they dump in some filler, then stretch the margins and tweak the fonts….

  20. 20.

    Ruckus

    @Mike J:
    Even fewer than your quick math. Not every state has high dollar winners every week, depending of course on your def of high dollar winners.
    It’s like everything they do, it’s bullshit, being sold as a polished turd. And not even fresh bullshit at that. Or much of a polishing job. They are hoping that few will notice that they have the scholarly talents of rotting fruit.

  21. 21.

    chopper

    House is going to start having committee votes on Obamacare bill on Wednesday that they released to the public at 6 p.m. today. No CBO score

    it’s amazing that these same fuckbags that complained up and down about how ‘quick’ the ACA was passed even though it bounced around the hill for months are gonna ram this shit through in no time and totally get away with it with the beltway press.

  24. 24.

    Major Major Major Major

    Why all the weird secrecy, the hidden bill, the secret meeting room, Rand Paul with a printer stuff? It’s not like the contents are a surprise. Maybe they wanted the lotto thing under wraps.

  25. 25.

    efgoldman

    @satby:

    We should really look for a way to impeach Ryan first.

    Sometime before summer, the house kkkrazy kkkaukus will turf him the same as they did to Weeping Cheetoh.
    First of all, this mess will never go into law, and isn’t radical enough (repeal without replace) for the kkkrazies.
    Then sometime this month they have to tackle the debt limit… again.
    You know the kkkrazies will refuse to do so.

  27. 27.

    Villago Delenda Est

    Ryan drops a turd in the punchbowl, and he doesn’t expect anyone to notice?

  28. 28.

    efgoldman

    @NotMax:

    Lots of jobs to be created ferrying the indigent and elderly out to ice floes.

    Not so much. The climate change hoax means many fewer floes big enough to float a starved granny on.

  29. 29.

    Adam L Silverman

    @efgoldman: Actually Senator Coons threatened today to shut down the government over some of this stuff. So at least some Democrats are learning.

  31. 31.

    Villago Delenda Est

    @Mike J: Look, should I win the lottery, one of the things I’ll do is reimburse the VA for a lot of care I receive. Now, admittedly, not everyone sees this as a priority…they’re busy buying cars and boats with their winnings.

  32. 32.

    Redshift

    @Major Major Major Major: It’s the difference between taking about what everyone knows they’re going to do, and taking about what they’re actually doing. The first has deniability (and accusations of bias, and…)

    It’s still stupid, but apparently they thought they could roll this out and force ask their members to vote on it before any ours or health care advocates had time to read it and figure out exactly how awful it is. Which in turn gives you an idea of how desperate they are – this is the best strategy for passing it they could come up with.

  33. 33.

    chopper

    @efgoldman:

    the kochs came out recently saying ‘okay, we’ve waited long enough, repeal this shit’, and the teabaggers know which side their bread is buttered on. i know goopers get in line and all, but i’m not sure ryan, the turtle and trump (lol) have the requisite skills to be able to ram this shit through. the baggers are already pissed at the idea of ryan’s ‘subsidies under another name’.

    please proceed, shitheads.

  34. 34.

    Jim, Foolish Literalist

    Sahil Kapur‏Verified account @ sahilkapur 13m13 minutes ago
    “This is a Republican welfare entitlement.” New memo by RSC (boasts 150 House members) attacks the ACA replacement.

    The Republican Study Committee, founded and I imagine funded by Paul Weyrich, claims 172 members, which does not include Paul Ryan.

  35. 35.

    Yarrow

    @Mike J:

    high dollar lottery winners are kicked off medicare before the end of the year.

    Medicare or Medicaid? Kicking grandma off Medicare is not going to go over well. Kicking poor people off Medicaid is another issue. Medicaid is tied to income anyway so it makes a little more sense, even though it’s terrible.

  37. 37.

    Villago Delenda Est

    Oh, I just love them taking care of the truly greedy, the poor oppressed heath insurance CEOs.

    Paul Ryan should be flayed alive for this shit.

  39. 39.

    Frankensteinbeck

    @Major Major Major Major:
    I see two obvious reasons for that. First, they’re terrified of the public blow back they’re getting. All this town hall stuff scares them so badly that Capitol Hill is awash in urine. I’m not sure why it scares them so much, but it does. Pushing this through as fast as possible reduces the amount of time they have to face their constituents about it. There are logical gaps here, but it’s the kind of reasoning scared people use.

    Second, this is all they’ve got. If it doesn’t pass, they need 60 senate votes to repeal Obamacare. Trying to keep as many legislators as possible from finding things to object to is crucial to anyone evil enough to actually want to pass this. So, Paul Ryan.

    Merely possible explanations:

    As a combination of the above, Paul Ryan wants to shorten the time he has to deal with the Freedom Caucus whining at him about this bill as much as possible.

    They didn’t have it finished until today. This is edging close to literally the scribbled-together last minute homework project. It’s what Ryan put together just to say something exists when he couldn’t get a real proposal made. Hiding it until now helped him fool people into thinking he ever had a plan.

  41. 41.

    Lizzy L

    @Mike J: I LOVE this. Thank you for the link, I am sending this to everyone I know.

    This bill — let’s call it Ryancare, that’s really catchy, no? — is indeed a hot mess. It really sucks. I can’t see how they get it through the Senate. I mean, they screw old people bigtime. It’s right there for everyone to see. Even as I type, the phone lines at the AARP are blazing like Macy’s Christmas lights. Defunding Planned Parenthood just because they can is going to piss off a lot of people, especially the younger ones — in their 20s, let’s say — who get or have gotten care through PP. It’s also going to piss off their mothers, at least the ones for whom abortion is not the only issue.

    Gotta push back. No pasaran. Call, email, visit offices. Make noise.

  46. 46.

    Kelly

    @efgoldman:

    Not so much. The climate change hoax means many fewer floes big enough to float a starved granny on.

    Fewer floes means longer trips to find floes means more jobs. Win/Win

  48. 48.

    GregB

    It’s just like Kellyann said…everyone is so cynical and critical of these earnest government folks.

    I mean, Paul Ryan and Dr. Mengele put a lot of time and effort into this and people are just being mean to them. Unfair.

  51. 51.

    catclub

    @efgoldman:

    Then sometime this month they have to tackle the debt limit… again.
    You know the kkkrazies will refuse to do so.

    Something has really changed with the crazies. Under Bush there was no battle at all (within the GOP) over the debt ceiling, but I agree that there will be now.

    Although we say that the GOP only cares about deficits under a Democratic president, I think they will NOT do an infrastructure bill – so they care to that extent.
    Raising the DOD budget and cutting taxes irresponsibly is still expected.

  52. 52.

    catclub

    @Yarrow:

    Kicking grandma off Medicare is not going to go over well. Kicking poor people off Medicaid is another issue.

    Not as different as you think. Medicaid is what pays for a LOT of senior care in nursing homes.

  53. 53.

    catclub

    @Lizzy L:

    This bill — let’s call it Ryancare, that’s really catchy, no? — is indeed a hot mess. It really sucks.

    Kevin Drum chose ‘bloodbath’. Dead people everywhere.

  55. 55.

    efgoldman

    @catclub:

    I think they will NOT do an infrastructure bill

    You’re right, but not for debt/deficit reasons. They just don’t think eebill gummint should be in that business.

  56. 56.

    Yarrow

    @catclub: No, I understand that. But Medicare is what means still-healthy grandma can go to the doctor and not have to pay much, as well as be covered if she has to go to the hospital. That’s the kind of person I’d expect would be up in arms should she lose her health coverage because she won the lottery.

    Impoverished grandma in the nursing home would be less likely to make a fuss, although her family might. Also, unless she still has a car or able to walk to the store, she’s less likely to have the lottery ticket in the first place.

  57. 57.

    aimai

    @Yarrow: Impoverished grandma in the nursing home still votes, usually reliably, until she drops dead or becomes demented. And her nursing home care is paid for on Medicare or Medicaid.

  59. 59.

    Jim, Foolish Literalist

    @catclub: also the handicapped and disabled, who have families and friends and advocates. I’m really bad at predictions, especially about Republicans, but I have a feeling that Ryan , to say nothing of some of his dumbest members, who probably believed all the talk radio hysterics themselves, have no idea what kind of hornets’ nest(s) they’ve stirred up

  60. 60.

    Another Scott

    @catclub: They can’t just raise the Pentagon budget under the Sequester rules. The Sequester rules cannot be changed unless the Democrats go along, and they’ll only go along if domestic spending can go up as much as the Pentagon budget goes up.

    Ryan has said there’s not going to be a Infrastructure bill this year.

    Donnie isn’t going to get to spend a bunch of money on his Army of ICE Agents and his Wall and his Giant Navy and all the rest because the budget is going to be stuck in Continuing Resolutions for the rest of this year and probably next (it seems to me, but I have no inside information) and maybe longer.

    It may save the ACA, also too, but we can’t take that for granted. We have to fight them every single day.

    Cheers,
    Scott.

  61. 61.

    Yarrow

    @Mart: The lotto thing will affect people on Medicaid. Qualifying for Medicaid is done by income anyway, so if you get a big windfall it would generally affect your eligibility for Medicaid, whether it’s a lottery win or some rich uncle died and left you a gazillion dollars.

    I don’t know anything about the specifics, but it doesn’t sound that different from how things are now, except it sounds like they want it enacted immediately.

  62. 62.

    chopper

    @GregB:

    Instead of a toaster or piggybank, you get a free colonoscopy with your health savings account.

    you wish. you’ll get a free picture of somebody else’s colonoscopy.

  63. 63.

    Lizzy L

    @catclub: This. A lot of old folks in and out of nursing homes have Medicare as their primary insurance and Medicaid as the secondary insurance — and those bills that Medicare doesn’t cover add up, believe me. Starving grannies is not actually all that popular, in the heartland or anywhere else.

  64. 64.

    lgerard

    @Raoul:

    Reactions I’m seeing from policy types is that this is an unholy mess. Which is why I favor calling it Ryancare.

    More like Ryandon’tcare

  66. 66.

    Felanius Kootea

    @Mike J: Thank you for that link to the district by district breakdown of those who will lose their health insurance if repeal goes through. Will come in very handy – I’ve already sent it to a bunch of people.

  67. 67.

    Yarrow

    @aimai: My point is that as far as selling this piece of shit bill, it’s easier to sell kicking poor people off Medicaid when they win the lottery than it is selling kicking middle class, still-healthy seniors off Medicare when they win the lottery. It’s always been easier to sell shitting on poor people than shitting on middle class people. This lottery thing is no different.

  70. 70.

    hovercraft

    @efgoldman:
    They were supposed to be the “true conservatives” of the republican party, until Obama made them lose their minds and elect true crazies in 2010, who thought they were sellouts. There is a great deal of overlap, but the Freedom Caucus is a more concentrated form of crazy, these people are like president Bannon, they don’t actually believe in government.

  71. 71.

    Lizzy L

    Christopher Jacobs, at The Federalist:

    Based on my conversations with multiple sources close to the effort, the Congressional Budget Office (CBO) had indicated to congressional staff that the prior House framework could see at least 10 million, and potentially up to 20 million, individuals losing employer-sponsored health insurance. Further, CBO stated that that House framework, even after including a refundable tax credit for health insurance, would not cover many more people than repealing Obamacare outright.

    By comparison, Obamacare led to about 7 million plan cancellation notices in the fall of 2013. While those cancellations caused a major political firestorm, the framework the House released prior to the recess could cause a loss of employer coverage of several times that number. What’s more, that framework as described looks for all intents and purposes like a legislative orphan appealing to no one—neither moderates nor conservatives—within the Republican party:

    A significant erosion of up to 10-20 million individuals with employer-provided health coverage;
    A new entitlement—the refundable tax credits—that by and large wouldn’t expand coverage, but instead cause individuals currently in employer plans to switch to the credits;
    More federal spending via the refundable tax credits;
    A tax increase—a cap on the current exclusion for employer-provided health coverage—to pay for the new spending on the credits; and
    An increase in the uninsured (compared to Obamacare) of at least 15 million—nearly as much as repealing the law outright.

    POS.

  73. 73.

    Timurid

    So they think they have a bombproof plan for rigging 2018 and 2020? Otherwise none of this makes sense.

  74. 74.

    Another Scott

    House Dems on Ways and Means:

    Pallone & Neal Denounce Republican ACA Repeal Bill

    Mar 6, 2017 Press Release

    WASHINGTON, DC – Energy and Commerce Committee Ranking Member Frank Pallone, Jr. (D-NJ) and Ways and Means Committee Ranking Member Richard Neal (D-MA) released the following joint statement tonight after Congressional Republicans proposed their bill to repeal the Affordable Care Act (ACA) and noticed the two committees will mark up the bill beginning Wednesday morning:

    “The Republican repeal bill would rip health care away from millions of Americans, ration care for working families and seniors, and put insurance companies back in charge of health care decisions – contrary to everything President Trump has said he would do with his health care plan.

    “The American people want health care that is affordable and available when they need it, but the Republican repeal bill would charge them more money for less care. It would dramatically drive up health care costs for seniors. And repeal would ration care for more than 70 million Americans, including seniors in nursing homes, pregnant women and children living with disabilities by arbitrarily cutting and capping Medicaid. The Republican repeal bill would not protect patients, save money, or help working families; it is nothing but a drastic and devastating step backward.

    “The Republican repeal bill was drafted in secret, and introduced less than two days before our committees are scheduled to mark it up. This action makes a mockery of Speaker Ryan’s claims that ‘we’re not hatching some bill in the backroom and plopping it on the American people’s front door.’ It also stands in stark contrast to the transparent and deliberate process Democrats followed when the Affordable Care Act was introduced and moved through our committees. It’s disgraceful that there was no transparency in this process, and that the American people are not being given time to read and comment on a bill that significantly affects their health security.”

    ###

    A good opening salvo. More of this, please.

    (via HouseDemocrats on Twitter)

    Cheers,
    Scott.

  75. 75.

    Yarrow

    @Timurid: State of emergency and call off elections? Wouldn’t be the first country to do that. Otherwise, make voting requirements so stringent that only retired white people are eligible and able to vote. And maybe rig some voting machines while they’re at it.

  76. 76.

    Timurid

    @Yarrow: Considering that national elections continued during the Civil War, the Great Depression and World War II… what kind of emergency would they have in mind?

  77. 77.

    Felanius Kootea

    @Mike J: Unfortunately (or fortunately), I live in California and not near any red districts. I could troll Darrell Issa though.

  78. 78.

    efgoldman

    @Yarrow:

    I don’t know anything about the specifics, but it doesn’t sound that different from how things are now

    Then why the fuck did they even bother, unless one of their christofascist members hates lotteries that much.
    Or maybe they dropped it in on purpose as something that can be negotiated away, so they can show how “flexible” they are.
    Yoga Gumby they’re not.

  80. 80.

    Steeplejack (tablet)

    @Mart:

    This makes me feel better about my $1 or $2 habit whenever I gas up the car or when the service counter is not busy at the grocery.

  81. 81.

    lgerard

    @Yarrow:

    What the ryandon’tcare plan addresses is lump sum lottery wins. They are not ongoing income, so the bill assigns a time period that they count as income for, increasing the time period with the dollar amount of the payment…100k counts for 3 months, 110k for 4 months , etc..

    The reason for this is simple. There was a case a while back where a lottery winner was technically eligible for some type of public assistance and it got all the wingnuts outraged.

  82. 82.

    Yarrow

    @Timurid: A made up one, of course. Some kind of terrorism happens here just before the election. Perhaps something they make happen but blame on Muslims or others. Maybe more than one city on the same day. President declares state of emergency, says too risky to have election. Postpones. Then postponed again. Or something.

    @efgoldman: Like I said, I’m not sure of the specifics. I just know that Medicaid eligibility is determined not only by income but by overall wealth. So someone becoming wealthy overnight, for whatever reason, would render them ineligible for Medicaid. However, the change could be that it applies immediately rather than a transition period of something.

    It seems bizarrely specific to lottery winners, so it does seem like someone has something against the lottery. Is that a big thing evangelicals rail against or something?

  83. 83.

    Ruckus

    @Felanius Kootea:
    It might be good to troll all of the CA republican house members. I’m sure they will ignore anyone who lives outside their district, but many of them are going to be in fights for their political lives. Couldn’t hurt to let them know about it. Also get that chart or link on any social media that you are active on. Let everyone know exactly how many people in republican districts will lose health care. I’d bet there can’t be more that a couple of dem house members who would be stupid enough to vote for this piece of shit. I can’t actually imagine any that would if they expect to get any rhythm from Chucky in the future.

  85. 85.

    Peale

    @efgoldman: or they just want to bait the press into focusing on that. It is irrelevant. And easy to mock. They are probably counting on Rachel Maddox to spend three segments on it tomorrow.

  86. 86.

    jl

    @Timurid:

    ” what kind of emergency would they have in mind? ”

    A few days of really really scary stuff from Fox and Friends?

  87. 87.

    Eric U.

    I think medicaid basically means you are destitute. With my brother, he can’t have more than $2000. We sold my mom’s house and when he got his share, $20000, it ended up costing him $32000 in benefits. It turns out to be a pretty severe tax on poor people and their relatives, because their parents have to spend everything to continue living in the nursing home.

  89. 89.

    Yarrow

    @lgerard: Thanks for the update. It doesn’t sound like that big of a change. But the reason is just comical. Of course it’s because wingnuts got completely bent out of shape by something completely stupid.

  92. 92.

    GregB

    @jl:

    I am pretty sure this cabal of nitwits, racists and gurning shitheels would have had tanks in the streets if they had the ebola scare that Obama dealt with so calmly.

  93. 93.

    TriassicSands

    It’s hard to tell what my favorite part of this bill is.

    The penalty for not maintaining continuous coverage is in the running.

    Let’s see, you lose your job and can’t afford health insurance while you’re unemployed. When you get a new job you now have a 30% surcharge on insurance, which makes it unaffordable.

    One of the principles behind this POS is that we have too many insured people and we have to get that number down. I have a feeling that when the numbers finally come out on POSCare it’s not going to look very good when compared to either Obamacare or the promises that the GOP and Trump have made. Remember, it’s going to cover more people, for less money with better coverage. And wasn’t there a pony in there somewhere?

  94. 94.

    lgerard

    You know what is missing from this bill…the all-important solution that was endlessly promoted by every wingnut

    Buying insurance across state lines

  97. 97.

    jl

    @TriassicSands: Maybe they are hoping that eliminating minimum standards for policies will patch things up with the lesser people back home. Everyone can afford a super cheap policy that covers almost nothing and has low lifetime caps and that will satisfy them. If you get hit by a bus, but can be patched up quickly with no long term consequences, and collect from Joe’s North by Northwest Health Insurance and Bailbonds Inc. last registered and known address in Nowhere SD, everything is good.

    Maybe they figure that they can bribe/scare the (at the moment) healthy majority with settling for this best last offer, and they will outvote the not rich sick (aka losers and parasite) who can suck it up and die.

  98. 98.

    Villago Delenda Est

    @lgerard: States Rights, except when it gets in the way of stealing from the poor to further enrich the rich.

  100. 100.

    TriassicSands

    Rand Paul: “Still have not seen an official version of the House Obamacare replacement bill, but from media reports this sure looks like Obamacare Lite!”

    More like Obamacare Lite Lite Lite Lite Lite. You can always count on Republicans to lie about or distort just about everything. This bill, if enacted into law, will leave millions of people worse off. Obamacare improved the lives of millions of people. Those don’t sound related at all.

  101. 101.

    jl

    @lgerard: I think that is snuck in by eliminating minimum standards for policies. Will make setting up operations in new state much cheaper. Not in every state, probably not in CA. But in many states, will have store front operations that are just shuffling paperwork between state where policy is bought and headquarters across the country.

  102. 102.

    TriassicSands

    @lgerard:

    Buying insurance across state lines

    That outdated idea has been replaced. Now, you can buy coverage from Russia.

  103. 103.

    NotMax

    @efgoldman

    Even more jobs. A bonanza manufacturing U.S.-made artificial ice floes (Faux Floe®) and towing ’em far enough offshore!

  104. 104.

    Ruckus

    @lgerard:
    That’s what they trade for losing the lottery provision.
    The entire thing is bullshit wrapped in layers of horseshit, with whale shit sprinkled on top to impress idiots. Like the ones that scrapped this together over coffee yesterday.

  105. 105.

    Yarrow

    @TriassicSands: I have a question about that 30% surcharge. In your example, say you’re lucky enough to get a job that offers health insurance benefits. Do you have to pay 30% more to your employer for your health insurance or something? Or would that only apply to people who buy it on the exchange?

  107. 107.

    Ruckus

    @Yarrow:
    You are asking specific questions? About a bill that was put together in 15 minutes by people who think they are geniuses because they got one question right on a 1000 question multiple choice test on what does lettuce taste like? Where every question, what does lettuce taste like, had the same 3 answers. A. Lettuce. B. Fresh stuff. C. Green stuff.

  108. 108.

    Mike J

    @NotMax:

    A bonanza manufacturing U.S.-made artificial ice floes (Faux Floe®) and towing ’em far enough offshore!

    And no efficiency standards. The Low Flow Faux Floe was a disaster.

  109. 109.

    lgerard

    @Ruckus:

    I’m not seeing anything about prohibiting states from setting insurance standards for policies sold in their states….so no selling across state lines.
    Then again, there is so much mumbo jumbo about lottery winners and abortion that I may be missing it.

  110. 110.

    lgerard

    @Yarrow:

    here’s your answer….good luck

    ‘‘(a) PENALTY APPLIED.—
    ‘‘(1) IN GENERAL.—Notwithstanding section
    2701, subject to the succeeding provisions of this
    section, a health insurance issuer offering health in
    surance coverage in the individual or small group
    market shall, in the case of an individual who is an
    applicable policyholder of such coverage with respect
    to an enforcement period applicable to enrollments
    for a plan year beginning with plan year 2019 (or,
    in the case of enrollments during a special enroll
    ment period, beginning with plan year 2018), in
    crease the monthly premium rate otherwise applica
    ble to such individual for such coverage during each
    month of such period, by an amount determined
    under paragraph (2).

    I think the answers are no and yes, respectively

  111. 111.

    danielx

    Fuckin’ Republicans….most especially including Rick Santorum, god take that swine to an early grave. The daughter unit is on Medicaid, though also still covered under the spousal unit’s insurance. The way it’s worked in our fair state up until now is that it’s difficult to qualify for Medicaid*, but once you do the coverage is pretty good. However….I can predict the outcome now if this passes. Vouchers, well hell, there are so many unmet needs** here in our fair state, and do those disabled and poor people really need such things as prenatal care, case workers, vision care, all that stuff that only poor people need? Clearly not, especially since they haven’t had the foresight to hire well-paid lobbyists to plead their case and do favors for legislators.

    Kind of like some of the deals I witnessed in retirement housing acquisitions in one of my previous lives – shit, we gotta pay for this money we were loaned by sharks some way or other or they’ll skin us, and nobody at xyz retirement community is really gonna notice if we slice a quarter a day from the raw food budget….and so forth. Note.

    Except that eventually people do notice, at which point they start asking well, we’re not getting what we paid for, what gives? And the powers that be say, this is a publicly-held, for-profit entity. If you don’t like it, git the fuck out***.

    Which is kind of where this whole deal is about. Medicaid is about providing care for those who cannot obtain care for themselves any other way, for any of a number of reasons. And, and…making sure that those receiving care provided by Medicaid receive care meeting some minimal standards. That being the case, it follows that Republican insistence on voucher programs, as enhancing “flexibility” and so forth****….

    Well, fuck that idea and the various horses it rode in on. Going to be on my legislators on this issue like orange on the shitheel currently adorning the Oval Office.

    *Like a seven year waiting list for various programs available under regulations, which is a whole ‘nother (ETA) shameful topic.

    **Such as, oh, a subsidy on financing for the arena where the Colts play, a bailout to Duke Energy to help cover their bad decisions….this could go on a while.

    ***Yes, this is pretty much the way it works.

    ****When you hear Republicans talking about “flexibility” regarding funding for social welfare programs, that means “massive funding cut”. This is always true – period, fini, end of story.

    Note: There is a (sub) moral to this rant, that being that if you are contemplating finding a retirement community for one or both parents or looking at one for yourself, look to nonprofit locals first if you can. Their bottom line is taking care of the people, whereas with for-profit entities, the bottom line…is the bottom line.

  112. 112.

    Yarrow

    @lgerard: LOL. Thanks. That clears everything up.

    @Ruckus: Well, they were pretty specific about the lottery stuff, which is so small as to be insignificant, so who knows what else they did.

  113. 113.

    Ruckus

    @lgerard:
    What I’m saying is that the lottery thing is quite possibly a throwaway. In there to trade for something that somebody cares about. It’s also possible that the dipshit geniuses forgot to put it in. See my comment #106. As has been pointed out, to get medicaid benefits you have to have nothing. No income, less than $2000 in the bank (and that one can be a lot easier than one might imagine, ask me how I know), no property that can be sold, like your house. Medicaid is for the fabulously poor and pays just enough to be better than absolutely nothing.

  114. 114.

    Fair Economist

    @Yarrow: The intention, I’m sure, is that it only applies to exchange insurance. Given how slapped-together this obviously is, I’m not sure that’s how the actual law reads. igerard’s cite refers to “individual or small group market” which would suggest it would not apply to large employers but would apply to small employers. That would produce some really whacko incentives, with smaller employers being heavily bribed to discriminate against older and unhealthy individuals who had let their coverage lapse.

  115. 115.

    Steeplejack (tablet)

    @chopper:

    This is great! We’re getting down into the detailed give-and-take of “how a bill becomes a law.” Democracy in action! Or maybe democracy inaction.

  116. 116.

    Ruckus

    @danielx:
    My understanding is that Medicaid is only as good as the state which runs their own program. So some states getting coverage is almost impossible, when you do get in the program is crap. Almost like they tried to make it as tough and useless as possible.

  118. 118.

    lgerard

    @Ruckus:

    your principle residence is excluded in counting assets for medicaid eligibility. Of course, after you die it is no longer your principle residence

  119. 119.

    efgoldman

    @Steeplejack (tablet):

    This is great! We’re getting down into the detailed give-and-take of “how a bill becomes a law.” Democracy in action!

    It’s getting awfuly hard to place these assholes on the stupid[—–]evil axis.
    And of course they all think of themselves as good christians…
    Almost makes me wish I believed in an afterlife, because every single one of these bastards would burn forever.

  120. 120.

    lgerard

    @Fair Economist:

    It only applies to exchange programs…it would be a nightmare otherwise

    On the other hand, if it did apply to employer group insurance it would piss off enough people who don’t really care about this subject enough because they feel it does not apply to them. At that point congress would have to come up with a real plan that actually worked or else

  123. 123.

    TriassicSands

    @Yarrow:

    I don’t know the answer to that. Since employer-based insurance is offered without the limitations of individual plans, I would assume it would apply only to people buying an individual policy. Good question.

  127. 127.

    pattonbt

    Ignoring the total crap the bill is, how does this even come close to being able to get enough R votes in any chamber? Its too nice for the tea-tards and too punitive for those scared for their jobs (or those with 5% of their soul left).

    And it should be called Trumpcare period. It will fit in with every other disaster he creates with his touch.

  128. 128.

    Ruckus

    @lgerard:
    Is that somewhat recent? I’ve know people who had to sell their parents home to someone for what was owed on it so they could be covered.
    It has been a number of years since I actually had any knowledge of people applying for or being on pure medicaid so I could be full of shit. And it wouldn’t be the first time.

  129. 129.

    jl

    @TriassicSands: Thanks. I thought I read there was less regulation on life time caps. I’ll remember to look for that when I read more detailed summaries tomorrow. Also, I’ll be on the look out for gimmicks that will make it easier to sell crummy policies across state lines, if that is an amendment waiting in the wings.

  130. 130.

    lgerard

    Agreed This ‘plan” is a total loser.
    I will bust out laughing if trump endorses this. I think he will back away rapidly claiming that this “isn’t the way he would do it” which will bring us right back to the point of waiting for his tremendous solution that is coming any day now.

  131. 131.

    lgerard

    @Ruckus:

    No

    The parent did not have to sell the home to get coverage. After they died and no longer occupied the home, Medicaid can recover from the estate. How this is done varies by state and by circumstance.

  133. 133.

    lgerard

    @jl:

    i see nothing about the state line thing at all in my reading of the legislation….I think that is out,
    Of course, I am dizzy from all the lottery language

  137. 137.

    Fair Economist

    @jl: This is a reconciliation bill, and it’s not supposed to be able to change laws without budgetary impacts. So nothing on making everybody in the country buy insurance under the lousiest state laws, aka buying across state boundaries.

    (I know in reality the companies don’t even offer the policies when allowed so it’s really a nothingburger. But if they did…)

  138. 138.

    Fake Irishman

    @Eric U.: only for long-term disability/nursing care, which is a special program (and varies by state quite a bit). General Medicaid for low-income people has only an income and no assets test anymore, for now.

  140. 140.

    jl

    @Fair Economist: OK, thanks. I’ll keep that in mind.
    True that the few existing state compacts that allow cross border sales have no takers, but lot of this bill is PR. And I think useful to watch for various changes that are designed to make that market more active, in case they decide to move from PR to actually making big changes.

    As far as I can tell, this bill is moderate tweaks to provide an underfunded much lower quality PPACA, with some exceptions (block grant Medicaid).

  141. 141.

    lgerard

    Removing the mandate is not a tweak though, it ensures that the program will fail. All that will be left are older people with pre-existing conditions, The policy costs will be astronomical.

    All the exchange bushwa is just a diversion to provide cover for the real goal here….killing Medicaid

  142. 142.

    Ohio Mom

    @Eric U.: Yikes. Was hiring an Elder Law attorney and setting up a trust not an option? That is what we special needs families do for our loved ones on Medicaid.

  143. 143.

    Eric U.

    @Ohio Mom: my sister went to the wrong attorney. And a malevolent medicaid administrator coupled with bad timing is impossible to fight even if they misapply the law. Which they did in this case.

  146. 146.

    Fred

    @Villago Delenda Est: The VA healthcare is yours. You earned it and the bill is paid in full.
    If you should win the lottery you should do any damned thing with it that makes you happy!
    There are few things in life I feel sure of but both of those things fall into that rare category.

  147. 147.

    Nora

    @TriassicSands: Exactly what I was thinking. They’re framing it as people “choosing” not to have health insurance, but I don’t see anything in the language that excludes people who lose their employer-provided health insurance for reasons beyond their control. Nice work! Fire people, make them lose their health insurance, and then punish them for having been fired when and if they get jobs again. Perfect Republican plan.

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