GBO on the health plan

[Lurker]

You are correct. It's merely the whole underpinning for the support of the exchange system, critical for the functioning of Obamacare. Without the mandate, exhanges are almost impossible to maintain. Without exchanges, there is no bargaining power with the insurance industry, which will result in higher insurance costs for everyone. Did I get that right?

Can you explain how the mandate is the "whole underpinning for the support of the exchange system" and why "without the mandate, exchanges are almost impossible to maintain"?

I'm fairly certain you are wrong and that I answered that ten months ago, but want to give you the opportunity to support your statement.

[Ddrak]

I'm not at all surprised, and would expect the SC to rule the same way. It was a bit of a silly half-assed idea anyway.

The best way to get around a mandate is do what they actually should have done - get the government to provide insurance to all legal residents for essential care. Set payment prices for procedures and allow people to pay the difference if their chosen hospital charges more. Raise taxes across the board to pay for it. No need for a mandate because everyone already HAS health care and it should be cheaper if you set it up properly and efficiently.

It also solves the serious issues hospitals have with people that can't afford emergency treatment.

Dd

[Embar Angylwrath]

You are correct. It's merely the whole underpinning for the support of the exchange system, critical for the functioning of Obamacare. Without the mandate, exhanges are almost impossible to maintain. Without exchanges, there is no bargaining power with the insurance industry, which will result in higher insurance costs for everyone. Did I get that right?

Can you explain how the mandate is the "whole underpinning for the support of the exchange system" and why "without the mandate, exchanges are almost impossible to maintain"?

I'm fairly certain you are wrong and that I answered that ten months ago, but want to give you the opportunity to support your statement.

I should have been more clear.

The mandate is essential for the exchanges to work as planned. Without the mandate, the economics of the exchanges are shifted. Insurance rates will likely go up for everyone, and really sky rocket for those that have pre-existing conditions. The whole purpose of the exchnages were to drive down costs through collective bargaining power. So while the exchanges may still be put inplace, they won't accomplish what they were touted to be able to accomplish without the mandate.

[Harlowe]

I'm not at all surprised, and would expect the SC to rule the same way. It was a bit of a silly half-assed idea anyway.

The best way to get around a mandate is do what they actually should have done - get the government to provide insurance to all legal residents for essential care. Set payment prices for procedures and allow people to pay the difference if their chosen hospital charges more. Raise taxes across the board to pay for it. No need for a mandate because everyone already HAS health care and it should be cheaper if you set it up properly and efficiently.

It also solves the serious issues hospitals have with people that can't afford emergency treatment.

Dd

I really think something like this is the only sensible way to make it work.

[Embar Angylwrath]

http://www.politico.com/news/stories/08 ... Page2.html

Good piece from Politico on the removal of the mandate. The author postulates removal of the mandate would not only affect exchanges, but would impact many other areas of the law too. Although he doesn't say this, the SC will consider that when it takes up the case. They may find that removal of the mandate changes the law's scope in such a large way that it can't fulfill the intent of Congress. The SC can review the Appeals Court ruling about leaving the rest of ACA intact. It may decide, if it finds the mandate unconstitutional, the law is unworkable, and overturn ACA completely.

[Harlowe]

Oh no is it actually working or is it the recession? I'm trying to figure out if this is really a good thing or not.


http://www.washingtonmonthly.com/ten-mi ... 31600.php#

[Embar Angylwrath]

Too many moving parts in that analysis and too little data over time to make any kind of factual statement yet.

[Kulaf]

Oh no is it actually working or is it the recession? I'm trying to figure out if this is really a good thing or not.


http://www.washingtonmonthly.com/ten-mi ... 31600.php#

I don't think there is any doubt it is going to bend the cost curve down. The question we tackled when this was all being debated was whether it is going to bend it enough, and should Medicare reform have been tackled separately and before Healthcare Reform.

Personally I think it should have been dealt with separately and focused on to a greater extent.

[Lurker]

Personally I think [Medicare] should have been dealt with separately and focused on to a greater extent.

Medicare is being dealt with separately and with greater focus by IPAB.

[Kulaf]

How?

In fact, according to Congressional Budget Office projections, Medicare spending won’t hit the targets that would cause IPAB’s recommendations to take effect in the next decade.

[Embar Angylwrath]

That's a great observation. If IPAB isn't even supposed to be needed for 10 years (as it relates to Medicare), how in the hell are they dealing with it now? They aren't even relevant at this point.

[Embar Angylwrath]

http://thehill.com/blogs/healthwatch/le ... reform-law

ACA seems to be headed to the Supreme Court. If they take it up, and most legal experts expect they will, they will most likely release their opinion in June of next year, right during the high season of the campaign. I expect it to come down to a 4-5 split, just don't know which way the split will fall.

Smart move on the part of the NFIB to obtain cert before the DOJ. Sort of puts them in the driver seat ahead of the Admin. Going to be interesting...

[Embar Angylwrath]

CLASS Act is shelved. Sebilius can't find a way to make the thing pay for itself. In fact, if its implemented, it would require massive infusions of cash to keep it afloat. There goes 40% (approx $86 billion) of the so-called defict reduction that was used to sell ACA to the American public. We've now gone from a supposed $210 billion in deficit reduction by CBO to $124 billion in deficit reduction.

And in the process of of all this, they really mismanged the communication. The admin stated that rumors of the CLASS Act shutting down were false. Then they announced it was shutting down. Pissed a lot of lefties off....

http://thehill.com/homenews/administrat ... w-implodes

[Lurker]

Obama should have just done what a Republican Administration would do; fudge the numbers and implement your preferred policy regardless of the facts.

[Embar Angylwrath]

Obama should have just done what a Republican Administration would do; fudge the numbers and implement your preferred policy regardless of the facts.

That's actually pretty close to what he did. He fudged the numbers to implement the policy. His own acturial advisors were telling the admin it was financially unsound and wouldn't work. I love the left saying that this was just a minor program, nothing to see here, please move along. This single part of ACA accounted for 40% of the supposed deficit reduction. One wonders what they would consider a major portion of the ACA.

Ex Dem Rep Artur Davis hits it on the head...

Yes, the CLASS program is a narrow feature of Obamacare that most Americans knew nothing about. But scrapping the program validates some of the central critiques of health care reform - that it is overly complex, is unsustainable financially, and is too experimental and bureaucratic. And none this is hindsight - it is exactly what critics of the law argued would happen if the White House insisted on a systems overhaul of health are rather than a targeted attack on pre-existing illness exclusions and a federally-funded expansion of Medicaid.

The travails of the CLASS program also illustrate the degree to which congressional Democrats and private sector interests inserted a backlog of frustrated policy goals into the fine print of "Obamacare." Hill staffers who were distrustful of the efficacy of the private insurance market fixated on CLASS as an eventual wedge into a "public option", and in private meetings made no bones about their thinking. At the same time, faced with the prospect of covering larger numbers of un-healthy customers who will pay out much less than they receive in benefits, the insurance industry tacked on its own bells and whistles - including an expansion of the prescription drug benefit and consumer and business mandates aimed at pulling larger numbers of high premium beneficiaries into the coverage pool.

The result was a safety net plan that got swollen into an unwieldy "wish list". Frankly, the administration was too thrilled with building a broad coalition, and claiming credit for a landmark, transformative law, to stop the floodgates.

I would disagree that an ACA element that moves $86 billion dollars is a "narrow feature", but other than that, he makes some good points.

[Ddrak]

Not having the public option is really killing the whole plan. When you rely on private insurers, Americans are going to die from lack of health care.

Dd

[Embar Angylwrath]

The ACA is much like the Thing. A bunch of parts stuck together in such a way that the whole thing is unworkable in the end.

Next to go is the mandate. Once that goes, there isn't much left that can work. Obama just saw 40% of the deficit savings evaporate overnight. So much for bending the cost curve. Ironically, if the mandate goes, and all that's left is a shell, he'll have spent his presidency on a failed policy initiative that grid-locked Congress, polarized the parties, and proved much of what the Republicans were saying.

Failulre on healthcare reform. Failure on economy. Failure on jobs. Not a good position to be in moving into an election.

I will give him this.. he did get Bin Laden, and he did it with a gutsy call that could have gone very bad. Props to him for that.

[Lurker]

Failulre on healthcare reform. Failure on economy. Failure on jobs. Not a good position to be in moving into an election.

Wow. So dramatic. Seems it's been long enough since you dodged acknowledging reality that you can start posting about Obama failing on jobs and the economy again, as if we've all forgotten which party deliberately sabotaged the recovery for political gain. Have I mentioned you are boring and predictable. (OMG AD hom!)

Health reform didn't polarize the parties. Polarization began when Clinton was in office and the Republican propaganda network really started gearing up. Rush, Fox News, etc. When Obama took office the Republicans announced their strategy early on and they stuck to it. They opposed everything, even ideas they had proposed and bills that Republicans had sponsored.

Yes, CLASS was part of the revenue stream that made up 40% of the deficit reduction in the first decade. But it's a small percentage of the projected deficit reduction in the years after that. I give the Obama Administration a lot of credit for not fudging the numbers on this. HHS was bound by the law to implement this provision only if it could show the program would remain solvent for 75 years. They couldn't and they scrapped the provision. In an election year.

Contrast that with past administrations that stuck with policy that didn't work because they value ideology over reality.

[Embar Angylwrath]

No drama. Just simple facts.

I find it odd that you're pointing outhow great and noble it was for HHS to actually follow the law. Like it was something extraordinary for them.

[Lurker]

No drama. Just simple facts.

Facts. Heh. That's amusing.

You parrot talking points like a typical rube ("Obama tripled the deficit in a few months! Obama failed on the economy and jobs!"), you absolutely refuse to respond to corrections of fact or to acknowledge that your party has blocked much of Obama's economic agenda because electoral advantage is more important to them than the good of the country, and then when enough time goes by after your non-response you post the same talking point again. and again. and again.

Did I mention you are boring and predictable?