Here is the TLDR of the Senate AHCA draft.
Here is the difference between the Senate and House GOP repeal bills, helpfully summarized in two sentences:https://t.co/5eWQjmXEuM pic.twitter.com/cPuClgWg9W
— Greg Sargent (@ThePlumLineGS) June 22, 2017
There are a lot of details that matter (I even like Sec. 102-b-1-B-II) but that is the fundamental difference.
CPI-U comes into play for Medicaid funding in FY 2025.
Per Capita Caps are in play for Medicaid
Enrollment caps for block grants for Medicaid are in play.
Old people in Alaska will be paying 16% of their income in premiums before receiving subsidy assistance.
Taxes are being cut massively with no incentive effect intentions.
There are massive work disincentives embedded in multiple spots throughout the bill
Deductibles are going up
Silver and Gold plans will be hideously priced and hyper narrow networks to dodge sick people
Section 1332 waiver protections are gutted
Any federal dollar can not be in the same zip code as a dollar that is used for abortion
New York is getting hit hard on both the Buffalo Kickback and the Basic Health Plan as immigration status is tightly defined.
? ?? Goku (aka Junior G-Man) ? ?
This will cost them dearly. Electorally or some other way, I’m not certain
DO NOT believe any GOP Senators in the next 72 hours coming out with “concerns” or threatening not to support the bill.
It’s planned McConnell Theatre: GOP Senators voice “concerns,” meaningless amendments added, those GOP Senators come home. Even Trump had his role, saying this morning the bill “needs negotiating.” All part of McConnell’s tactics. DON’T FALL FOR IT.
CALL. CALL. CALL.
These fucking soulless scumbag motherfuckers. That they would even propose something like this shows just how subhuman they are.
Regarding 1332 waivers: Does the Senate bill permit states to eliminate the ACA’s standards for what a qualifying health insurance plan must cover? Preliminary reports suggested that was going to be part of the Senate plan.
If so, then how is that not as bad or worse than the House bill’s provision allowing insurers to charge more to people with pre-existing conditions? If insurers can design any kind of flimsy plan they want, then they can effectively exclude anybody with expensive health problems simply by not covering those conditions. Don’t want any diabetes sufferers? Don’t include diabetes treatment in the plan.
Villago Delenda Est
Fuck the 99.99%. ALL HAIL THE .01%!
Parasites rule, workers drool.
Major Major Major Major
The same zip code, are you fucking kidding me?
When in the course of human events it bec
As expected, a total disaster. Now can we break out the Jamison’s for our coffee?
David, am I reading section 126(b) (page 41 line 17) correctly, that EHBs are just totally wiped out Jan 1 2020, no state waivers needed? Does that also mean lifetime and annual caps, which are only banned for EHBs, are also gone, since if there are no EHBs there’s nothing that falls under the ban on limits? Or because only 42 U.S.C. 1396u–7(b)(5) is being amended to say that benchmark plans don’t require EHBs as of Jan 1 2020, but 42 U.S.C 18022 (b) still defined EHBs, that the ban on lifetime/annual limits would still be in effect even though they aren’t “essential” in the sense that benchmark plans don’t have to cover them?
@Trentrunner: McConnell knows exactly where the votes are. All the talk about him just wanting to get something to the floor even if it failed is bullshit. All these Senators are going to say they don’t see how they could vote Yes, and then magically, 50 or 51 votes will appear out of a unicorn’s ass when the vote is held.
@? ?? Goku (aka Junior G-Man) ? ?:
Which other way?
Every candidate apposed to this needs to be clear. They need to say: Healthcare is a right and I will work to repeal the AHCA and reinstate the ACA.
West of the Rockies (been a while)
I think maybe it’s a red wine kind of morning…
On this issue there is really only one question that needs to be asked: Do you believe health care is a right?
If the answer is Yes then we can find ways to get there. If the answer is an equivocation or No then stick them in the chest with a rusty pitchfork and push them over the side of a bridge.
Does that mean government subsidy dollars or private insurance dollars or insurance purchased using a subsidy (which may be the same as the first)? That would cover just about every zip code in the country with the possible exception of Midway Island since that is mostly sand and goony birds.
Or, as I like to put it, because the multibillion-dollar fortune Alice Walton inherited was not nearly enough to satisfy her, poor people must die.
Good thing there’s no shortage of ice floes these days.
Without being hysterical or hyperbolic, isn’t the use of block grants for Medicaid essentially a death sentence for a not insignificant number of people in each state?
And then there is…THE MAVERICK!
I think the “zip code” thing is a joke. Right?
As a New York State resident, I’ve been following Froma Harrop, who points out that states like New York and California can still keep health coverage by passing single payer plans. She says that blue states can use tax cuts to their advantage.
I’m kinda leaning toward this myself. Instead of blue state tax money going to prop up Trump country, we could use it ourselves. And in some parts of the state we need it. I’m just thinking at this point the country can’t stay together and in the next ten years, serious talk of secession will come up. Which may be for the best in the long run. Red and blue America can’t live together and we can’t expect them to.
There’s something about seeing a horrid bill like this in writing that actually makes it more horrid than just imagining how horrible it will be.
and not to put to fine a point on it YES.
Block grants are the GOP way of killing a program w/o actually looking like they are killing it. They just starve it to death by reducing federal funding knowing full well that the states can’t pick up the slack. From what I’ve read, when they have done this before, they have include fine print which allows the state to transfer the money to other programs as needed. The result is their fellow Nazi’s at the sate level can transfer money meant for poor kids to the fund to develop an upscale marina. The GOP will argue that this is good because the marina will hire a few POC at minimum wage jobs w/o benefits.
@Trentrunner: Proving my own point:
This. Is. Kabuki. DO NOT FALL FOR IT.
CALL CALL CALL CALL CALL
I shouldn’t be, but I’m shocked that “essentially the same as the House bill” is the best the Senate GOP could do, even just in terms of disguising what they’re up to. It’s lazy.
TOTALLY OT but Der Fuhrer has finally kept a promise. He told us last week that he would reveal the big secret about the tapes this week, On Twitter he is saying there are no tapes and never were. Question for the legal eagles – whither the tapes exist or not doesn’t just the threat constitute criminal intimidation and would be part of an obstruction of justice charge.
“All politics is local.” Check out the ER admission stats from my metroplex, in time since ACA passed. Republicans want to make sure that “unsured” count trades places with the Medi-Cal one.
How many states will be able to pick up the slack on Medicaid expansion? Will any? I expect New York and California, if no one else, should be able to, but that’s if the feds don’t interfere further.
Tilda Swintons Bald Cap
1 McConnell knows everyone hates Congress already, so he has no fucks to give.
2 McConnell knows that the current President (but not the Party) will take the heat for this, so he has no fucks to give.
3 McConnell knows he can obstruct the next Democrat just like he did Obama, so he has no fucks to give.
4 McConnell back loaded the cuts so everyone will forget who is responsible, so he has no fucks to give.
5 McConnell knows the next Republican POTUS candidate in 2020 can run against the cuts, so he has no fucks to give.
This is the best description of the bill I’ve seen:
Wealth Care bill. #wealthcarebill
It’s catchy, descriptive and accurate. Maybe we can get it some attention.
Major Major Major Major
@Trentrunner: It’s not even good kabuki.
@Tilda Swintons Bald Cap: it’s almost like…like someone should rid us of this meddlesome Turtle…
@Tilda Swintons Bald Cap: I agree with all but #5, don’t see how that would work.
They want to steal healthcare..
So that millionaires and billionaires can get a tax cut.
THAT is the bottom line.
This is NOT a healthcare bill.
This is a TAX CUT BILL.
@Corner Stone: @D58826:
It’s part of the long term strategy, rail about out of control spending by government until you get just about every state to pass a balanced budget amendment to their constitution, then you block grant social programs, and then reduced the federal contribution forcing the states to cut the number of people helped. All the GOPers have signed the pledge to nevah, evah raise taxes, so they wont and any democrat who tries to will be painted as stealing your money to give to the undeserving. Wait a few years and ipso facto the program is dead.
Tilda Swintons Bald Cap
@SenyorDave: You don’t think Trump would run against a bill he signed by lying about it like he does everything else? I think he or any other R POTUS candidate would. I mean, he promised not to touch any of this stuff, and yet …
READ THIS: it’s amazing. Medicaid could get decimated using waiver process. With incentives to.
You should be in shock. And then action. pic.twitter.com/ckn8yqNB3L
— Andy Slavitt (@ASlavitt) June 22, 2017
I talked to a GOP member of Congress about what they think of angry constituent calls. Their answer was revealing. https://t.co/DEU58Z4vlM pic.twitter.com/Iu1b7Ym7Pu
— Sarah Kliff (@sarahkliff) June 22, 2017
By the way, it is not just the Republicans and the .1% who get their jollies over this bill. The elite Village Media, who are mostly 1% themselves and all with rich employer provided health insurance just love to throw the numbers around about Medicare reduction. There is no reporting on the context (a large, aging baby boomer cohort will, as disabilities arise from Alzheimer and other forms of dementia, Parkinsons, strokes and heart attacks, and Type II diabetes complications will be hitting the Medicaid program just as funds are being cut.) Its going to a freaking disaster.
Trump’s approval ratings would soar (well, get over 40% again) if he were to veto this monstrosity or even threaten to do so.
@Corner Stone: yes. Block grants to the states will never be enough. States will limit enrollees, have caps, wait lists such as the mrmib in CA prior to ACA, impossibly complex reenrollment and a million little ways to ensure early, avoidable suffering and death.
And, the obligation to balance a state budget will require massive tax increases to meet the needs of the sick, disabled and elderly. Which states will be willing or able to increase taxes for health care?
But rich fuckers will be fine.
So there’s that.
Tilda Swintons Bald Cap
@rikyrah: There ya go !
By hellfire and damnation to eternal suffering.
@SP: IANAL, so I am looking into this with other people right now regarding EHB
So basically it comes down to Purging for profit. Literal blood money straight to billionaires. Its no worse than I was expecting, because I was expecting the worst.
And it will pass. Mark my word on it. The Rs have the votes or this bill never would have seen thr light of day.
@Tilda Swintons Bald Cap:
Sadly he also knows that even though Kentucky was one of the biggest Obamacare success stories, they voted first for an idiot from Connecticut who campaigned on taking away their insurance coverage, but then turned around and re-elected him by one his biggest margins ever. He won’t pay for this personally because he’s going to protect coal jobs. Stop laughing, he is, he said so.
Hey David, what provisions are in this steaming pile of shit for the victims, I mean the beneficiaries of clean coal? Black Lung Disease is not a bad payoff for having a livelihood is it?
One hidden consequence of the AHCA is that differing outcomes between states will accelerate the already ongoing sorting process of vulnerable people in red and swing states moving to blue states. The map will be even more unbalanced in 2020 and after, potentially allowing future Republican Presidential candidates to eke out Electoral College victories with even larger popular vote deficits than Trump’s in 2016.
The cost in California is staggering even given that there’s political will to do something like that. For a truly scary number, there’s also Dem interest in single payer but I don’t see that going anywhere. Like our affordable housing situation there are very tall barriers to a fix.
“But on further consideration, tax cuts for the ultra-rich are far more important. Fuck the poor!”
Medicaid subsidizes public schools:
School superintendents went to DC but they’ll be ignored. It’s a particularly cruel cut for them because these services are mandated by another federal law and the federal government has never covered the cost to the extent that they promised. This takes that open wound and pours salt in it.
They just dumped it on schools. Again. There’s real anger at them dodging their responsibilities because the parents of these kids don’t blame their Senator or the President- they blame the principal. Universal education is expensive. We can go back to the bad old days when we didn’t have it and disabled kids were excluded from K-12 education access or we can pay for it. What we can’t do is dump it on schools and say “you figure it out”. They don’t have the funds.
Tilda Swintons Bald Cap
@Timurid: I thought we were just waiting for the demographic wave that would wipe away Republican electoral victories once and for all.
@? ?? Goku (aka Junior G-Man) ? ?: We’re all going to pay for this abortion of a bill if/when it passes.
You’re not paranoid when they really are out to kill you.
@Tilda Swintons Bald Cap:
I think he’s wrong about that one. He’s just shown how to bypass the filibuster and the Byrd rule with healthcare legislation; I fully expect the Democrats to do the same thing the next time they get a chance- assuming they don’t nuke the filibuster completely.
@Jeffro: But that’s shrill!
BTW for David et al in case it’s of interest, CalPERS has released its 2018 healthcare premium rates. It’s relevant because CalPERS represents an enormous client pool and has lots of clout.
Others have described the Kabuki we’re about to witness from those “moderate” Republicans who will object to the AHCA over a key issue or two (Planned Parenthood funding, opiate treatment), only to fall in line and vote for it after some minor tweaks addressing those concerns. So let me put it this way:
Imagine some criminals break into your house, announcing that they intend to kill the men, rape the women, kidnap the children as slaves, poison the pets, and, oh yes, steal the silverware to boot. Now imagine that the police show up, and through heroic efforts, drive the criminals away without the silverware. Unfortunately, the rest still comes to pass. . . .
Your moderate Republicans are those police. And the media is going to be focused on their heroic efforts to save the silverware, while basically ignoring the rest of the carnage.
This next week is going to suck so bad.
@Yarrow: I would also go after the tax cuts. “If you cared about the deficit and debt, you would not cut taxes”. Of course, their priority is the tax cuts but they really can’t say that or defend it.
Well-off states under Democratic control, so probably those plus MD, RI, OR, DE, CT, and of course MA (which basically did it on its own before). WA eventually when the Democrats get the legislature back (which could well be 2018). After that – IL can’t afford it, VT rejected single-payer because it couldn’t face the tax increases. Probably NJ when it can get a Dem trifecta. After that it get hard – VA isn’t going to have a Dem legislature for a while; CO and MN are only slightly above average income and will have a hard time paying for it. After that I think all the other states either have chronic budget problems or entrenched Republican politics, and usually both, since that’s what Republicans do.
@japa21: If he vetoes this after all the effort Ryan and McConnell have gone through to service their rich patrons, he’d be shivved immediately. Impeachment within a couple of weeks, followed by the exact same bill being presented to a compliant President Pence for signing.
People are noticing this bill will kill the disabled and the elderly by the thousands by butchering Medicare, but the numbers on ACA enrollment will be horrible too when they’re calculated. If the working poor have to pay 16% of income for insurance with no mandate the exchanges are going to collapse. At those rates they really have no choice but to go bare and rely on getting in after they have a health problem, and it’s the heavily subsidized poor who are currently holding up the exchanges. Rates are going to explode.
The Senate Republicans’ Health Care Act is like the secret from a spy movie: now that you’ve seen it, they have to kill you. Ingeniously, they do it by taking away your health care.
Well, God hasn’t done a good old-fashioned public smiting in a while.
You forgot about HI, as most people do. We’re blue, threw the last R out of our state Senate in November, and have a small number of Rs in the state House. We paved the way over 45 years ago for employer-provided health care with our the Prepaid Health Care program which is actually working fairly well. The big hit will come from the wipeout of Medicaid funds and how that will be made up here is one of the biggest questions about the trumpcare abomination.
The Moar You Know
@Gravenstone: This, and more so, the undeniable fact that fucking working people over is what gets Trump off.
@The Moar You Know:
Anyone and everyone who do not have the resources to fight back.
YOU ARE NOT BEING HYSTERICAL.
You realize the truth.
@Fair Economist: Or as has been noted numerous times before on a variety of issues – it is the blue/liberal states that keep bailing out the red/conservative states. And it is the red state voter who yells the loudest about tax and spend and the terrible liberals even though he is living on the taxes raised from those terrible liberals. So lets just rearrange the deck chairs a bit and blue state tax money stays in blue states where it will pay for some nice things and red states – well they can just STFU and live within their means.
@The Moar You Know: The only saving grace is that Der Fuhrer is so incompetent that he is preventing the GOP from doing even more damage. A competent lower key Pence would actually get the bill passed and do more damage to the safety net over the next couple of years.
Sad that we have come to the point that incompetence and criminal behavior is a plus
Unfortunately, this. I actually don’t mind that my tax dollars go to help my fellow citizens in red states, but it bothers me that they insist that they get to spit in my face and whine about the dirty, dirty money that I give them that they totally deserve more than I do.
@Timurid: Guilty. I spent part of the day trying to figure out how my family could move to NY or California, or some other bluer place. But I don’t think that is a realistic option, for many different reasons. I think we are pretty much stuck in southwest Ohio for the foreseeable future.
@Kay: I have seen this coming. One of my small upcoming pleasures will be rubbing this particular outcome in the faces of a few Republican special educators I know. “They would never do anything to OUR kids,” I was told. Assholes.
FSM not only do we have Trump and terrorists to worry about but now THIS
Oh the humanity
Of fuckin’ course…
Disabled protesters were dragged out of their wheelchairs and down the hallway to stop them from protesting the AHCA outside Mitch McConnell’s Senate office. I called Mitch McConnell’s Senate office number, and got through to a staffer.
She asked if I had a message for the Senator.
I said that I thought he should tell the Capitol Police that they were behaving in an unconstitutional manner by abridging the right of the people to peaceably assemble.
202-224-2541 CALL CALL CALL.
I just heard that Cruz, Lee and Paul are 3 R’s who won’t vote for it. Their reason is because it is “Obamacare-lite” and does not satisfy their libertoonian blood lust.
President Obama weighs in:
@StringOnAStick: I think I’ve read that some of those “no” Senators are saying they won’t vote for it as it is currently written. For example here’s a tweet on what changes Cruz is pushing for in order to get his support.
Somewhere in the continuum between heart-felt opposition and cynical public posturing lies the truth, but I suspect most of these folks are much closer to the latter end of that continuum; I think they wanna vote “yes”.
mai naem mobile
@LurkerNoLonger: Too many words..Donny Douchebag along with his Trumpkins needs pictures and graphs along with emoticons.
Sadly, we know the answer to this. The Republicans believe that healthcare is just another service that people with jobs and enough money buy in the free market.
And on top of this is the sickening sideshow of building more abortion restrictions into this bill.
Oh, yeah, and making sure that they pull out the tax increases on the wealthy that paid for a good chunk of the ACA.
@? ?? Goku (aka Junior G-Man) ? ?:
not for the Senate, not for some time. the way that body gets elected – where only 1/3 of the seats are open per two years – it won’t allow angry voters to get enough Republicans voted out. This 2018 actually has more vulnerable Democratic seats than Republican – it was 2016’s where a lot of Republicans were vulnerable, and damn our voters for not doing more – so would require 28 (!) seats flipping Blue(D) for the Republican Senate to lose majority. All Republicans have to do is win seven seats in 2018 (for a 50-50 tie) and they’ll remain in control. It’s horrifying.
A direct challenge to Trump, who at least had the brains at one time to say that the GOP bill was too mean.
Interesting point. These restrictions on Medicaid are the foreshadowing on a coming assault on Social Security.
Another reason the GOP wants to cut Medicaid.
A good chunk of Republicans do not believe in universal education. At best, they will throw you a few tax credits so that you can send your kids to a Christian Academy.
Can someone explain how eliminating EHBs is permissible under reconciliation rules?
@Lizzy L: Last week the Capital police were heroes. Thais week they act like the SS. I guess the individual cop really has no choice its the nazi like Yutrl and the ZEGS who give the orders.
Still (slowly) digesting the bill (patch; I doubt many Senators who vote for it will have a clue what it contains). But it (trusting DA’s summary) looks like a textbook example of a class warfare attack by the rich against the poor and middle class.
Still thinking about tactics and strategies, both short and long.
@altofront: Simple Yurtle will go thru parliamentarians until he gets one to agree and whatever rule changes to make it ok.
@LurkerNoLonger: I read this and I feel like puking with the actual nausea brought on by the realization that we, the American people, decided to replace *that* POTUS with the current one. If we wouldn’t all be so well and truly fucked by the passage of this bill, I’m tempted to say we deserve it because of the level of BUT HER EMAILZZZ BS we allowed ourselves to fall for.
I realize that in going out to dinner I must have missed something this so maybe someone can explain.
Among other things we are faced with:
1. A POTUS who has turned the WH into his own Mafia profit center.
2. A POTUS who is a lapdog for Putin.
3. A POTUS who denies the evidence that the Russians tried to hack our elections.
4. The Russians hacked into the 20126 election and will do so in 2018 unless something is done top stop them.
5. The GOP is implementing polices/rule changes/etc to roll back 120 years of hard won progressive gains.
6. Congress is in the process of rolling back Dodd-Frank so that the too-big to fail banks that crashed the economy in 2008 and do it again and still make money from doing it.
7. Congress is on the cusp of gutting Obamacare with the result that anywhere from 40-100 k people will needless die each ear.
And what are the House democrats doing. They are plotting to replace Nancy as minority leader. What is her sin (other than the biological one of being born a girl). She failed to wave her magic voodoo stick and win four special house elections in deep red districts that haven’t sent a D to Congress in living memory. Never mind that she helped get the legislation passed that saved the economy in 2009, that she was key to getting both Obamacare and Dodd-Frank passed and she has kept the caucus united in opposition to Der Fuhrer.
And who are these plotters – seems like the same progressive purity pony types whose constituents stayed home in such conspicuous numbers in 2010 and 2014 that the GOP took control of the Congress and just about every state government from the Atlantic to the Pacific. I think the only one they missed was Midway island and that only because the goon birds are notorious progressives.
Or did we just drop thru a worm hole and are now in G quadrant?
Even Will Rodgers and his joke about not belonging to an organized political party would be shaking his head.
@Brachiator: For once I agree with Trump on something: it is mean. They are mean.
and if further proof is needed that we have gone thru the worm hole (we went down the rabbit hole long time ago) there is this:
Now I guess there is a certain perverse logic to this. After all if you want to talk about how to rob a bank then Bonnie and Clyde are your best sources bank, Ted Bundy could teach a course on mass murder and AL Capone knows all there is to know about tax fraud. Maybe he could turn it into a PHD course at some university – Trump U perhaps.
I’m sure they won’t mind being sentenced to death. The ones who love them won’t mind either.
Tax cuts for the affluent. Any loyal American would freely accept dying unnecessarily for this principle. Any loyal American would freely accept a loved one’s unnecessary death for this principle.
sheila in nc
Did anybody see this piece:
Key quotes regarding the philosophy and objectives of both James McGill Buchanan and Charles Koch:
But clearly he, and Koch, and others of their ilk know that they would never get majority votes for such positions, hence, voter suppression, etc.
So it’s not just about very, very wealthy people trying to keep more of their money. It’s that they think all government social support is illegitimate.
Bundy was a serial killer/rapist, not a mass murderer. He killed them one at a time.