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You are here: Home / Anderson On Health Insurance / Recapping the revised Senate bill

Recapping the revised Senate bill

by David Anderson|  July 13, 20179:55 pm| 87 Comments

This post is in: Anderson On Health Insurance, Fuck The Poor

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The Senate released their revised bill.

The biggest and only important news is that there is fundamentally nothing different with Medicaid. It is still being destroyed. It won’t be destroyed as quickly in Louisiana in this version as it would have in the previous versions, but Medicaid will see a 25% reduction in federal funding by 2025 and 35% reduction in annual federal funding by 2036.

Everything else is a detail. There is an Alaska pay-off for more state stabilization funds. There is a provision for Florida.

There is the Cruz amendment.

Regarding the Cruz amendment, I just can’t deal with it. It is not exasperation, it is an incomprehension as to how this amendment actually works on any level without a fractured market. Maybe that is the entire point of the amendment.

No way to have a single risk pool w/ entirely different rules, no risk adjustment. Also Senate bill allows states to waive req't entirely. https://t.co/GuCn6F7KFg

— Edwin Park (@EdwinCBPP) July 14, 2017

Fundamentally things were tweaked around the edges of a bill that will produce incredible suffering without altering that basic fact.

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Reader Interactions

87Comments

  1. 1.

    Salter Wobchak

    July 13, 2017 at 9:58 pm

    Somehow I think McTurtle still finds a way to pass it.

  2. 2.

    JMG

    July 13, 2017 at 10:00 pm

    They want to destroy all health insurance, public, private, you name it, except their own. I don’t advocate this, because murder is very bad and shooting Congresspeople only makes people feel sorry for them, but the probabilities are that if you take health insurance away from over 20 million Americans, more than one will rage out about it and also be a major firearms owner.

  3. 3.

    Ohio Mom

    July 13, 2017 at 10:01 pm

    I imagine that when I call Portman’s office tomorrow, I’ll be told he’s studying it.

  4. 4.

    Brachiator

    July 13, 2017 at 10:04 pm

    What’s the stuff about provisions that push for catastrophic plans as a means of reducing costs of premiums?

  5. 5.

    jl

    July 13, 2017 at 10:04 pm

    @Salter Wobchak: No reason to make it easy for them.

    Moderate GOPers in Senate punked again, and a cave to reactionaries (Cruz amendment) is being dishonestly sold as a comprise fix.
    No change in destruction of Medicaid, and this was the issue that the moderate Senate GOPer said was the fatal problem.
    Cruze sops to moderates are fraudulently funded.
    McConnell is trying to push a corrupt dishonest deal, telling moderates that the slashed Medicaid funding will be fixed somehow in the future to cover their votes. Who is McConnell bald face lying to, the moderates or the reactionaries?

    And moderate GOPers who will vote for this corrupt mess are spineless punks or dishonest weasels and they need to hear it.
    Everyone needs to contact a Congress critter tomorrow.

  6. 6.

    ? ?? Goku (aka The Hope of the Universe) ? ?

    July 13, 2017 at 10:05 pm

    @JMG: If tens of millions lose health insurance, including those who have employer-provided, I doubt there will be much sympathy for the GOP at that point. I hope McConnell is one of the ones killed. He’s a monster and would deserve it.

  7. 7.

    rikyrah

    July 13, 2017 at 10:05 pm

    Regarding the Cruz amendment, I just can’t deal with it. It is not exasperation, it is an incomprehension as to how this amendment actually works on any level without a fractured market. Maybe that is the entire point of the amendment.

    you rarely speak like this…I know now just how horrid it is.

  8. 8.

    jl

    July 13, 2017 at 10:06 pm

    @JMG: Whoever wrote the Cruz amendment is trying to do just that. Destroy meaningful health insurance for everyone except the very rich. It has provisions that damage both the individual, and small and medium employer market. And gives large and malicious employers an opening to screw their lower income employees. It’s poisonous.

  9. 9.

    Adam L Silverman

    July 13, 2017 at 10:08 pm

    @rikyrah: I had the same problem with Speaker Ryan’s Better Way write up on US foreign policy. It’s 14 pages long. I’ve read it at least a 1/2 dozen times since he released it last year. It makes no sense. It’s a bunch of talking points/bullet points stitched together. Some even contradict others. It’s why I never did a post about it/analyzing it.

  10. 10.

    David Anderson

    July 13, 2017 at 10:10 pm

    @rikyrah: I usually allow myself the conceit that even if I have fundamental moral differences and place significantly different value weights on processes and outcomes of a given policy, I can understand the fundamental mechanics of a policy proposal. I was in a wonderful Twitter canoe and several other conversations with very smart people trying to figure out how the hell this thing could work over the past two days and the best answer that I have seen is “Magic”

    And that is coming from people who have spent their entire lives thinking these things through and in one case is ideologically friendly to Cruz and Lee. Magic is the best answer that I have see on implementation.

  11. 11.

    pamelabrown53

    July 13, 2017 at 10:14 pm

    @David Anderson:
    David, What’s in the Florida provision? Probably should know about that before attempting to call Rubio’s office tomorrow.

  12. 12.

    Miss Bianca

    July 13, 2017 at 10:17 pm

    @Adam L Silverman: Wow.

    ETA: What in the name of living fuckwadness has this country come to? Does government stink so much in the nostrils of the conservative electorate that basic *competence* at it is a sign of the beast? Or what? These fucking people like Cruz and Ryan – how DARE they put forward such contemptuously feeble horseshit? It’s like “none of this makes any sense and it doesn’t HAVE to, nyah, nyah, suck it, public, cause my corporate masters told me government of, by, and for the people will not only perish from this earth, but it’s my obligation to kill it. For them.”

  13. 13.

    Adam L Silverman

    July 13, 2017 at 10:18 pm

    @David Anderson: And that’s not counting Cruz’s amendment using money that the main bill allocates for other things. So with his amendment it, at least, double dips. I’ve seen some write ups indicating it may actually be triple or quadruple dipping.

    Math is hard…

  14. 14.

    Adam L Silverman

    July 13, 2017 at 10:19 pm

    @Miss Bianca: Just thinking about it makes my head hurt. I’d seen some of his other policy proposals. So I was prepared for it not really being a policy proposal. But hoo boy! And whoa Nelly!

  15. 15.

    Another Scott

    July 13, 2017 at 10:20 pm

    Reuters has a quick summary (warning – has one of those annoying move-around video boxes):

    Critics said despite some changes to coax wavering senators, the revised bill’s core remains unchanged: restructuring and cutting the critical Medicaid social safety-net program, taking away insurance from millions of Americans and driving up healthcare costs for millions of the most vulnerable Americans, especially older people and the sick.

    The revamped bill contains a provision that appears to be aimed at winning over Senator Lisa Murkowski of Alaska, a moderate who had opposed the original bill. It would funnel additional money to states that have higher insurance premiums – at least 75 percent above the national average. Alaska is the only state with premiums that high, Senate aides said.

    McConnell is evil, not stupid. He knows how to count. He must figure that this is enough to pass the bill.

    Though the tone in the Reuters piece is that the bill has many, many opponents, it’s going to be a battle to defeat this thing. We need to do what we can to prove McConnell wrong.

    Grrr.

    Keep fighting!

    Cheers,
    Scott.

  16. 16.

    Omnes Omnibus

    July 13, 2017 at 10:26 pm

    When I call Ron Johnson I harp on how damaging Medicaid will hurt rural WI. When I call Tammy Baldwin, I say keep on keeping on and thank the staffers for their efforts as well. Also too, Mark Pocan is a good egg. Oddly, 2/3 of my Congressional representation is gay – I just note it because I think it is probably quite uncommon.

  17. 17.

    Major Major Major Major

    July 13, 2017 at 10:30 pm

    @Omnes Omnibus: none of my representation is gay and I’m in San Francisco!

  18. 18.

    ? ?? Goku (aka The Hope of the Universe) ? ?

    July 13, 2017 at 10:31 pm

    @Another Scott:

    The revamped bill contains a provision that appears to be aimed at winning over Senator Lisa Murkowski of Alaska, a moderate who had opposed the original bill. It would funnel additional money to states that have higher insurance premiums – at least 75 percent above the national average. Alaska is the only state with premiums that high, Senate aides said.

    That’s the problem with this bill. All the changes are just bribes to get something passed without regard to how good it really is

  19. 19.

    Major Major Major Major

    July 13, 2017 at 10:32 pm

    @? ?? Goku (aka The Hope of the Universe) ? ?: that’s the least of this bill’s problems.

  20. 20.

    David Anderson

    July 13, 2017 at 10:33 pm

    @pamelabrown53: A recalculation of the DSH payments so that is based on the total number of uninsured individuals instead of number of people covered by Medicaid. That tweak favors states that did not expand Medicaid.

  21. 21.

    pamelabrown53

    July 13, 2017 at 10:34 pm

    @Another Scott: @15.
    Agree that McConnell is evil, not stupid. It appears the “Florida provision” was included at Marco Rubio’s request. It includes exceptions to the spending caps for public health emergencies such as the mosquito born Zika virus. At least when the elderly are thrown out of nursing homes they can get some relief for their mosquito bites.

  22. 22.

    Omnes Omnibus

    July 13, 2017 at 10:34 pm

    @Major Major Major Major: That is kind of my point.

  23. 23.

    David Anderson

    July 13, 2017 at 10:34 pm

    @Adam L Silverman: Even better, as written, the Cruz Amendment allocates $70 billion per year — that will get cleaned up but just sloppy

  24. 24.

    Villago Delenda Est

    July 13, 2017 at 10:34 pm

    Two things:

    1. Cruz does not understand insurance

    2. Cruz does not understand Christianity

  25. 25.

    Major Major Major Major

    July 13, 2017 at 10:34 pm

    @Omnes Omnibus: just making conversation, dude.

    I guess my state senator is gay.

  26. 26.

    ?BillinGlendaleCA

    July 13, 2017 at 10:36 pm

    @jl:

    Whoever wrote the Cruz amendment

    Based upon the rest of your comment, sounds like ol’ Ted wrote it himself.

  27. 27.

    pamelabrown53

    July 13, 2017 at 10:36 pm

    @David Anderson:
    Thanks. I thought it was the exception (Zika) to the spending caps for public health emergencies.

  28. 28.

    Omnes Omnibus

    July 13, 2017 at 10:36 pm

    @Major Major Major Major: I didn’t mean to sound argumentative. Sorry.

  29. 29.

    efgoldman

    July 13, 2017 at 10:37 pm

    @Miss Bianca:

    “none of this makes any sense and it doesn’t HAVE to, nyah, nyah, suck it, public, cause my corporate masters told me….”

    @Adam L Silverman:

    So with his amendment it, at least, double dips. I’ve seen some write ups indicating it may actually be triple or quadruple dipping

    You may remember that Granny Starver’s first budget/tax plan, even before he was “speaker”, was full of mystery asterisks along the line of the old “and then a miracle happens” cartoon.
    This is more of the same bullshit.
    It’s like they think no-one ever finished fourth-grade arithmetic.

  30. 30.

    David Anderson

    July 13, 2017 at 10:39 pm

    @pamelabrown53: could be both

  31. 31.

    Omnes Omnibus

    July 13, 2017 at 10:40 pm

    @efgoldman: Underpants gnomes.

  32. 32.

    efgoldman

    July 13, 2017 at 10:41 pm

    @Omnes Omnibus:

    I wasn’t meaning to sound argumentative.

    Yes, you were!

    [Low-hanging fruit]

  33. 33.

    Alain the site fixer

    July 13, 2017 at 10:42 pm

    My stupid bad for temporarily showing tomorrow’s post. Night all…

  34. 34.

    randy khan

    July 13, 2017 at 10:44 pm

    I’m thinking a lot of things about this bill, but none of them the kind of thing I’d share in polite company.

  35. 35.

    Omnes Omnibus

    July 13, 2017 at 10:45 pm

    @efgoldman: SHUT YOUR FESTERING GOB, YOU TIT! YOUR TYPE MAKES ME PUKE! YOU VACUOUS TOFFEE-NOSED MALODOROUS PERVERT!!!

  36. 36.

    efgoldman

    July 13, 2017 at 10:45 pm

    @randy khan:

    none of them the kind of thing I’d share in polite company.

    This is the perfect place, then, isn’t it?

  37. 37.

    Omnes Omnibus

    July 13, 2017 at 10:46 pm

    @randy khan: So talk about it here.

  38. 38.

    ?BillinGlendaleCA

    July 13, 2017 at 10:47 pm

    @Omnes Omnibus: I came for an argument.

  39. 39.

    efgoldman

    July 13, 2017 at 10:48 pm

    @Omnes Omnibus:

    VACUOUS TOFFEE-NOSED MALODOROUS PERVERT!!!

    “Toffee-nosed”? Really?
    That from one of the random Shakespearean insult generators?

  40. 40.

    Major Major Major Major

    July 13, 2017 at 10:48 pm

    @Omnes Omnibus: it’s ok, I know you can’t help it.

  41. 41.

    efgoldman

    July 13, 2017 at 10:49 pm

    @?BillinGlendaleCA:

    I came for an argument.

    No you didn’t

  42. 42.

    Omnes Omnibus

    July 13, 2017 at 10:50 pm

    @?BillinGlendaleCA: Aha! No, you want room 12A, next door

    @efgoldman: Nope, a quote from the sketch.

  43. 43.

    ?BillinGlendaleCA

    July 13, 2017 at 10:51 pm

    @Omnes Omnibus: Oh, thank you good sir.

  44. 44.

    Another Scott

    July 13, 2017 at 10:52 pm

    Sen. Kaine has a good statement out today:

    Thursday, July 13, 2017

    WASHINGTON, D.C. – Today, U.S. Senator Tim Kaine, a member of the Senate Health, Education, Labor, and Pensions (HELP) Committee, released the following statement on the release of the latest version of the Senate Republican health care bill:

    “I’m hearing from Virginians what other Senators are hearing from their constituents across the country: drop this horrible bill and instead work together on bipartisan fixes to the health care system. None of the versions of TrumpCare meet the President’s promises that no one will lose health insurance or pay more for coverage, and that Medicaid will be protected. This newest version of the bill includes a provision that would allow insurers to sell skimpy health plans that will mean even higher premiums for Americans with pre-existing conditions and would destabilize the existing ACA marketplace. I’ve traveled across Virginia talking to parents, kids, teachers, doctors, and nurses about the health care system and what we should do to make it better. Just this week, mothers in Northern Virginia shared their concerns with me about what the Republican bill would mean for their kids with complex medical conditions who rely on Medicaid to get the care they need. We should be listening to them, abandoning TrumpCare, and working together on solutions – like the bills many of us have put forward – that would lower costs and improve health care for all Americans.”

    Kaine has been a leading voice calling on Republicans to work across the aisle with Democrats on proposals to improve the health care system that could get bipartisan support, including the reinsurance bill he introduced earlier this month to help stabilize the individual health care marketplace and lower premiums, which would help families in Virginia and across the country.

    Something like this line of argument might have some sway, especially among older people who are Donnie’s base, though personally I’m a bit more vocal and strident than he is on this. But he knows Virginia better than I do…

    I wrote to Warner and Kaine just now. (Warner’s web site is very, very slow. I wonder if he’s suffereing a DDOS for his statements against Donnie about Russia or something.)

    Keep fighting, everyone.

    Cheers,
    Scott.

  45. 45.

    Omnes Omnibus

    July 13, 2017 at 10:54 pm

    @Ben from Virginia: Whatever name you post under, you are dumber than a bag of hair.

  46. 46.

    Major Major Major Major

    July 13, 2017 at 10:55 pm

    @Ben from Virginia: Go away, you waste of spinal fluid.

  47. 47.

    Omnes Omnibus

    July 13, 2017 at 10:55 pm

    @?BillinGlendaleCA: Not at all! (under my breath) Stupid git.

  48. 48.

    Another Scott

    July 13, 2017 at 10:56 pm

    @Ben from Virginia: You must win the lottery all the time, what with you being able to predict the future and all.

    Cheers,
    Scott.

  49. 49.

    Adam L Silverman

    July 13, 2017 at 10:56 pm

    @Major Major Major Major: That’s not what I heard on Alex Jones!

  50. 50.

    Omnes Omnibus

    July 13, 2017 at 10:57 pm

    Is a bag of hair smarter than a box of rocks? Asking for a friend…

  51. 51.

    Major Major Major Major

    July 13, 2017 at 10:58 pm

    @Omnes Omnibus: Do computers count as rocks?

  52. 52.

    Adam L Silverman

    July 13, 2017 at 10:58 pm

    @David Anderson: That was what I was referring to. Or at least that’s what I thought I was referring to.

  53. 53.

    Manyakitty

    July 13, 2017 at 10:58 pm

    @efgoldman: Monty Python

  54. 54.

    Adam L Silverman

    July 13, 2017 at 11:00 pm

    @efgoldman: Not many people know that…

  55. 55.

    Omnes Omnibus

    July 13, 2017 at 11:01 pm

    @Major Major Major Major: Should they?

  56. 56.

    efgoldman

    July 13, 2017 at 11:03 pm

    @Manyakitty:

    Monty Python

    The whole goddamned country is now an extended, overdone, no longer funny Python sketch.

  57. 57.

    Yarrow

    July 13, 2017 at 11:03 pm

    Is it possible that the Cruz amendment is being allowed to be made public so that McConnell can hang its awfulness around Cruz’s neck? No one likes Cruz and McConnell would probably be glad to take him down a peg with a failure that has his name on it.

  58. 58.

    frosty

    July 13, 2017 at 11:03 pm

    @Omnes Omnibus: Ahem. “Twit”. And no, I’m not allowed to argue about it.

    ETA: Unless you’ve paid.

  59. 59.

    Omnes Omnibus

    July 13, 2017 at 11:03 pm

    @Ben from Virginia: Do you have a point or are you just here to spread doom and gloom?

  60. 60.

    Another Scott

    July 13, 2017 at 11:04 pm

    @Ben from Virginia: You’re trolling, and not doing a very good job at it.

    ‘night.

    Cheers,
    Scott.

  61. 61.

    Villago Delenda Est

    July 13, 2017 at 11:04 pm

    @Ben from Virginia: McConnell is a sack of shit. As you are.

    This will not end well for him.

  62. 62.

    Major Major Major Major

    July 13, 2017 at 11:05 pm

    @Omnes Omnibus: I mean, they’re more or less made of highly refined rocks, the important parts at least.

  63. 63.

    Adam L Silverman

    July 13, 2017 at 11:05 pm

    @Ben from Virginia: Back in your box!

  64. 64.

    Adam L Silverman

    July 13, 2017 at 11:06 pm

    @Omnes Omnibus: Same guy I ban every two months or so. Give or take a week. He’s back in his box.

  65. 65.

    Omnes Omnibus

    July 13, 2017 at 11:06 pm

    @frosty: Copy/paste thing.

  66. 66.

    Gian

    July 13, 2017 at 11:07 pm

    sorry to be off topic, but I saw tonight that Maddow referenced part of the Russian election interference plan involved exacerbating the Sanders-Clinton conflict, at least in part by posting anti-Clinton stories on pro-Sanders sites.

    no I don’t think this will cure the schism, but, to me at least, it’s food for thought.

  67. 67.

    Major Major Major Major

    July 13, 2017 at 11:08 pm

    Remember when Ben from Virginia, aka that Stein-voting, fedora-wearing Becnel asshole, told Cole that it was OK if he was an idiot because sobriety is hard?

    Fuck him.

  68. 68.

    frosty

    July 13, 2017 at 11:09 pm

    @Omnes Omnibus: Oh, okay, that’s very different. Never mind.

    (Are we allowed to combine Python and Emily Litella in one thread?)

  69. 69.

    Adam L Silverman

    July 13, 2017 at 11:10 pm

    @Gian: Yep. I wrote about it here in one of the maskirovka posts.

  70. 70.

    divF

    July 13, 2017 at 11:11 pm

    @Major Major Major Major: And I am happily missing all of this, since I pied the guy the first time he showed up using the new, built-in pie feature ! Thank you, sir.

  71. 71.

    Brachiator

    July 13, 2017 at 11:11 pm

    @?BillinGlendaleCA: OT. The current LA Weekly has an article about an exhibit of photos by Dennis Hopper at a gallery in Hollywood. You might be interested in this.

  72. 72.

    Millard Filmore

    July 13, 2017 at 11:11 pm

    @Another Scott:

    (warning – has one of those annoying move-around video boxes)

    I’m waiting for the day when the close button on advertising boxes gets negative gravity.

  73. 73.

    Gian

    July 13, 2017 at 11:14 pm

    @Adam L Silverman:

    But isn’t setting local factions against each other a British Colonial thing? Who do the Russians think they are?

  74. 74.

    efgoldman

    July 13, 2017 at 11:15 pm

    @Major Major Major Major: Thx, Mx4, again, for the super-easy pie filter. Ben was the first klown I pied. The feeling is almost serene.

  75. 75.

    frosty

    July 13, 2017 at 11:18 pm

    Thanks from me too. And like efg, Ben was my first too. I’m up to 3 now thanks to that More Progressive Than Thou asshole on one of the other threads tonight.

  76. 76.

    Major Major Major Major

    July 13, 2017 at 11:19 pm

    @efgoldman: I was at most project manager for integrating it, thank cleek.

  77. 77.

    sukabi

    July 13, 2017 at 11:21 pm

    @Adam L Silverman: well you could have posted a link to his piece and analyzed it like this “Speaker Ryan’s proposal is a bunch of contradictory talking points and buzz words that don’t mean Jack shit. It’s not a policy proposal, it’s a steaming pile of elephant shit.”

    But that is probably more attention than it deserved.☺

  78. 78.

    randy khan

    July 13, 2017 at 11:22 pm

    @efgoldman:
    @Omnes Omnibus:

    But then I’ll lose my veneer of respectability, and I’ve worked so hard to maintain it.

  79. 79.

    Adam L Silverman

    July 13, 2017 at 11:24 pm

    @Gian: Russian.

  80. 80.

    Omnes Omnibus

    July 13, 2017 at 11:27 pm

    @randy khan: Sorry. You ain’t got none more than the rest of us.

  81. 81.

    Lizzy L

    July 13, 2017 at 11:33 pm

    From Vox:

    Senate Republicans included a provision that exempts members of Congress and their staff from part of their latest health care plan. This exemption could have the effect of ensuring that members of Congress have coverage for a wider array of benefits than other Americans who purchase their own coverage. A Senate Republican aide confirmed that the exemption existed but was unable to comment as to the specific effect it would have. The aide said it was included to ensure that the bill hewed to the chamber’s strict reconciliation rules that limit the policies this health bill can include. The exemption is similar to the one that existed in the House health bill. After Vox reported on its existence, the House voted to close the loophole — and the Senate aide expected their chamber to follow the same path.

    Isn’t that special…

  82. 82.

    Major Major Major Major

    July 13, 2017 at 11:48 pm

    @Lizzy L: Man, didn’t the Republicans try to make the Dems adopt an amendment (one the Dems cannily did adopt) doing the exact opposite for the ACA?

  83. 83.

    Another Scott

    July 13, 2017 at 11:53 pm

    RollCall:

    House Speaker Paul D. Ryan said Thursday that if the Senate delivers a health care bill before the summer is over, he’d be open to joining Senate Majority Leader Mitch McConnell in keeping his chamber in during at least part of the August recess.

    The Wisconsin Republican said that if the Senate produced the legislation at the same time members prepare to fly home for a month, “we’re going to stay and finish health care.”

    They think they can win this BCRAP vote and ram it through the House, too. We have to keep fighting.

    Cheers,
    Scott.

  84. 84.

    ? ?? Goku (aka The Hope of the Universe) ? ?

    July 14, 2017 at 12:07 am

    @Lizzy L: Excepting themselves really says confidence in their own legislation

  85. 85.

    jl

    July 14, 2017 at 1:11 am

    exempt themselves, huh?
    Everyone needs to contact the Senators, whether Dem or GOP and express outrage and disgust at what is going on.
    At this point whether we win or lose shouldn’t make any difference. They need to hear their constituents’ outrage and disgust.
    And after McConnell’s disgraceful dishonesty and cynicism, time to ask the GOPers who they can stay with a party run by crooks.

  86. 86.

    schrodingers_cat

    July 14, 2017 at 9:34 am

    So what did Protocols of Zion* (Ben from Virginia) say now to get banned again?

    *He had said in one of his brilliant comments that’s what the preoccupation with all things Russia was like.

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