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(Politico)   Bipartisan House Problem Solvers caucus has a plan that would fix American healthcare, if anyone's interested   ( politico.com) divider line
    More: Spiffy, Democratic Party, House repeal packages, bipartisan working group, Problem Solvers caucus, poorest Obamacare customers, Senate's repeal, Rep. Kurt Schrader, GOP's repeal  
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2165 clicks; posted to Politics » on 31 Jul 2017 at 2:18 PM (11 weeks ago)   |   Favorite    |   share:  Share on Twitter share via Email Share on Facebook   more»



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2017-07-31 11:47:21 AM  
This could be interesting. A caucus, spread across party lines, with the stated goal to get federal policies and programs working via compromise and pragmatism? Could this be, at long last, an acknowledgement by Congress of the frustration of the common citizen?

Ok, you can all stop laughing now...
 
2017-07-31 11:54:14 AM  
Does it have tax cuts for the rich?  No?  Then screw you.
 
2017-07-31 11:55:02 AM  
And rainbows spewed from the herds of unicorns on the horizon.

Jack Johnson - The Horizon Has Been Defeated
Youtube TTCaZVIUNp0
 
2017-07-31 11:56:51 AM  
This doesn't "fix" healthcare in the US, it just helps Republicans and Democrats look like they're doing something.  Republicans would get a partial repeal and Democrats would get the win on keeping the ACA in place and functional.

It's still a completely broken system, all this would do is ensure that we keep the ACA in place instead of actually fixing healthcare in America.
 
2017-07-31 12:08:52 PM  
Funding cost-sharing subsidies? That should have been done years ago and hardly counts as a fix.

Increasing the employer mandate threshold from 50 to 500 FTE-equivalent employees? That exemption was designed to exclude small businesses from an excess regulatory burden. I can't plausibly argue a business with 499 employees is small; that's a company with an annual payroll of at least $10,000,000. How many small businesses do you know that collectively pay their employees $10,000,000 a year? No thanks to this idea.

Federal stability fund? Don't give states the flexibility to use this for "various purposes." I guarantee they'll use it for completely unrelated purposes because states have done this since the dawn of the federal government. Just create a fund expressly for lowering premiums and/or a fund expressly for covering catastrophic health expenses. Then you're set.

Modifying the state innovation waivers? No; the point of those waivers was to get out of the way of states who can do a better job than what Obamacare is doing. If a state is deliberately going to do less than what Obamacare does in some way, you don't qualify for the waiver.
 
2017-07-31 12:16:01 PM  
So, both members are agreed?
 
2017-07-31 12:22:43 PM  
These are Band-Aids that do nothing to fix the underlying issues with the ACA and some of them, like repealing the medical device tax or moving the employer mandate from 50 to 500 employees, might actually make things worse.
 
2017-07-31 12:25:35 PM  
Except the Hastert Rule. As a reminder, the Hastert rule does not involve former GOP Speaker paying hush money for his former sexual assault victims, sure he did that, but this is just an invidious aside. The Hastert rule, actuall first practiced by Gingrich but strongly asserted by Hastert until he ouster in disgrace was that the Majority party (especially a GOP majority) will not let a bill come to the floor unless the majority of the majority party support it. Thus we can't have just a few GOPers joining most of the Dems to pass policy.

And thus, any compromise must gain majority GOP support. That would require some serious face saving gyrations when their constituencies still want something to rub in the face of Democrats. Of course simply naming a bill to tweek the ACA to expand coverage and hold down premiums would be very popular as legislation goes but it would have to be named the 'Suck it Obama we hate you Better Stronger More American Heath Care Bill'
 
2017-07-31 01:03:06 PM  

J Noble Daggett: Except the Hastert Rule. As a reminder, the Hastert rule does not involve former GOP Speaker paying hush money for his former sexual assault victims, sure he did that, but this is just an invidious aside. The Hastert rule, actuall first practiced by Gingrich but strongly asserted by Hastert until he ouster in disgrace was that the Majority party (especially a GOP majority) will not let a bill come to the floor unless the majority of the majority party support it. Thus we can't have just a few GOPers joining most of the Dems to pass policy.

And thus, any compromise must gain majority GOP support. That would require some serious face saving gyrations when their constituencies still want something to rub in the face of Democrats. Of course simply naming a bill to tweek the ACA to expand coverage and hold down premiums would be very popular as legislation goes but it would have to be named the 'Suck it Obama we hate you Better Stronger More American Heath Care Bill'


I thought the Hassert rule was if you didn't give 100%, you had to stay behind after wrestling practice an let the coach watch you shower.
 
2017-07-31 01:09:40 PM  
The group also wants to create a federal stability fund - dollar amount unspecified -- that states can tap to reduce premiums and other costs for people with extremely expensive medical needs. Both the Senate and House repeal packages contained similar pots of money.

Uh...why would a "repeal" be adding $$$ to the program?  Not that I'm against that, but...
 
2017-07-31 01:12:05 PM  

Serious Black: Federal stability fund? Don't give states the flexibility to use this for "various purposes." I guarantee they'll use it for completely unrelated purposes because states have done this since the dawn of the federal government.


Ah.  I see.  So, it's less of a patch to the ACA and more "hey, we're just throwing money to the wind and hoping for the best!"
 
2017-07-31 02:18:59 PM  
This looks like a straightforward way to soften and Trump-proof the ACA.  I could get behind that.

But the bill should be funded.  As is, it appears to add cost (through the stability pools) and remove revenue (by reducing the number of business that have to pay penalties and removing the medical device taxes).
 
2017-07-31 02:20:48 PM  
Is Paul Ryan in support of the proposal? No? Then it will never, ever see the light of day.
 
2017-07-31 02:21:02 PM  
The name could use some work.
 
2017-07-31 02:24:00 PM  
A coalition of roughly 40 House Republicans and Democrats plan to unveil a slate of Obamacare fixes Monday they hope will gain traction after the Senate's effort to repeal the law imploded.
The Problem Solvers caucus, led by Tom Reed (R-N.Y.) and Josh Gottheimer (D-N.J.), is fronting the effort to stabilize the ACA markets, according to multiple sources. But other centrist members, including Rep. Kurt Schrader (D-Ore.), and several other lawmakers from the New Democrat Coalition and the GOP's moderate Tuesday Group are also involved.
Their plan focuses on immediately stabilizing the insurance market and then pushing for Obamacare changes that have received bipartisan backing in the past.


CTRL+F "single payer"
0 matches found
 
2017-07-31 02:24:04 PM  
The GOP ought to change strategy. Do their level best to make Obamacare work. Dare the Dems to oppose good fixes, then take credit as heroes of the people who fixed the "broken and horrible" Obamacare, and turned it into something Americans could be proud of.

In otherwords, the GOP couldn't block it's passage, they couldn't sabotage it, and they couldn't repeal it. But they could improve it and take the credit all the way to the next election.
 
2017-07-31 02:25:50 PM  
Let me know when they have an actual bill brought to the floor with actual specifics to be judged. Until something specific hits the floor, it's not worth debating hypothetical proposals for something this complicated. Yes, that same admonition applies for the vaguely defined "single payer" or "socialized" healthcare propositions.
 
2017-07-31 02:26:07 PM  
i.imgur.com
 
2017-07-31 02:29:54 PM  

AdmirableSnackbar: This doesn't "fix" healthcare in the US, it just helps Republicans and Democrats look like they're doing something.  Republicans would get a partial repeal and Democrats would get the win on keeping the ACA in place and functional.

It's still a completely broken system, all this would do is ensure that we keep the ACA in place instead of actually fixing healthcare in America.


The ACA was better than the situation we had before. This sounds like it would improve the current situation. Incremental steps at fixing the "completely broken system" sounds better than a) doing nothing and b) making it worse.
 
2017-07-31 02:30:05 PM  
Maybe we could, I don't know, work up a Healthcare bill instead of a Redistribution of Taxes bill and see what happens.

'Cause it seems that even with Fake News, hiding a Tax bill is like hiding a Black man in a White House.
 
2017-07-31 02:30:18 PM  
I could fix healthcare with a plan that fits on the back of a postcard.

Republicans would hate my plan because it covers poor people. Democrats would hate it because it still allows insurance companies to participate in healthcare. Both sides would hate it because it takes away all kinds of opportunities to carve out special exemptions for friends and family, payments to specific states or districts, or other pork.

On the off-chance anybody cares, here's the plan:

-- Everybody gets a voucher for basic healthcare, not transferable, not refundable

-- Insurance companies can accept the vouchers in full or partial payment for any plans they choose to offer, with only one rule: If a plan accepts vouchers at all, it must accept everybody's vouchers and charge everybody the same amount, regardless of existing conditions, age, gender, or anything else. The insurance company turns in the vouchers to the government to get paid on them

-- Anybody can use their voucher to opt in to Medicare, as a backstop

-- Individuals can pay as much of their own money in addition to the value of vouchers as they want to, if they want better-than-Medicare service
 
2017-07-31 02:31:26 PM  

Lost Thought 00: Yes, that same admonition applies for the vaguely defined "single payer" or "socialized" healthcare propositions.


Literally the details defining the single payer Medicare for All policy stance from Bernie Sanders

The Medicare for All Bill introduced by Sanders in every session since 2003

This isn't hard
 
2017-07-31 02:31:38 PM  
Stabilizing the ACA markets is better than nothing, that's for sure.  Continuing to fund cost-sharing subsidies would be much better than letting Trump cut off payments.  It's not Medicare for all (which I still think would be easier to implement than these Rube Goldberg market contraptions), but the good news here is that at least some Republicans are talking about "fixing" instead of "repealing" Obamacare, which is a step in the right direction.

If Republicans start to acknowledge that the ACA is here to stay, then it guarantees that people won't be kicked off insurance in a hard repeal scenario.  It also gives much better cover for more Dems to move toward single-payer, since they won't be playing defense for the ACA anymore.
 
2017-07-31 02:32:24 PM  

xanadian: The group also wants to create a federal stability fund - dollar amount unspecified -- that states can tap to reduce premiums and other costs for people with extremely expensive medical needs. Both the Senate and House repeal packages contained similar pots of money.

Uh...why would a "repeal" be adding $$$ to the program?  Not that I'm against that, but...


NPR covered it a few days in a row during the first round of the repealamania. Block grants mean "here is a flaming pile of money. It's labeled "for healthcare" but no obligation to spend it on anything. It's basically slushfund filler paying for what will eventually be roads for 75% of the states."
 
2017-07-31 02:32:36 PM  

Epoch_Zero: Lost Thought 00: Yes, that same admonition applies for the vaguely defined "single payer" or "socialized" healthcare propositions.

Literally the details defining the single payer Medicare for All policy stance from Bernie Sanders

The Medicare for All Bill introduced by Sanders in every session since 2003

This isn't hard


None of which have made it to the floor for debate
 
2017-07-31 02:32:40 PM  
If this really does keep Trump from being able to kill off the ACA by defunding it then perhaps it is a good first step towards the kind of healthcare plan that every civilized nation needs.
 
2017-07-31 02:34:34 PM  
Y'know, sometimes I get to thinking "Okay, Republicans, go ahead and end the ACA. Do it!" Just to shut them up and reap the consequences.

But then I get to thinking, I can see them spinning the situation and accepting no responsibilty for what they did.
 
2017-07-31 02:34:53 PM  

Lost Thought 00: Epoch_Zero: Lost Thought 00: Yes, that same admonition applies for the vaguely defined "single payer" or "socialized" healthcare propositions.

Literally the details defining the single payer Medicare for All policy stance from Bernie Sanders

The Medicare for All Bill introduced by Sanders in every session since 2003

This isn't hard

None of which have made it to the floor for debate


Well, shiat, I guess it's corporations bankrupting families forever then!
 
2017-07-31 02:35:44 PM  
There's some nice ideas in there (along with some bad ones - companies with 499 employees count as 'small'?), and I wish you all the success in the world.

But realistically?  Up against whoever got control of whatever committee is going to shiatcan your ideas, and then Ryan & McConnell to get the thing actually put up for a vote, and then Trump to sign it?  Okay, maybe not Trump - he could be bought off by getting all your aides and interns together to crowdsource a title that abbreviates to "The B.A.R.R.Y. S.O.T.E.R.O I.S. A. P.O.O.P.Y.H.E.A.D ACT OF 2017".

But the rest of them?  And the wing of the Republican party that kept voting against their own ideas because they didn't hurt enough people?

img.fark.net
 
2017-07-31 02:40:04 PM  

xanadian: The group also wants to create a federal stability fund - dollar amount unspecified -- that states can tap to reduce premiums and other costs for people with extremely expensive medical needs. Both the Senate and House repeal packages contained similar pots of money.

Uh...why would a "repeal" be adding $$$ to the program?  Not that I'm against that, but...


It goes something like this:
Medicaid expansion gives a state $10 billion for the health care of new enrollees.
Obamacare repeal cuts that funding, but replaces it with $5 million to cover the worst off.
Republican legislator gets to claim that he cut medicaid AND made sure there was money there to see that no one got hurt.

It's similar to how states start lotteries and say the money will go to fund schools, while at the same time cutting an equal (or usually greater) amount of money from the school budget than they expect the lottery to provide.
 
2017-07-31 02:42:50 PM  
None of that seems actively evil or awful, so there isn't a chance it passes either side.
 
2017-07-31 02:45:23 PM  
Off topic, but Trump just proved that thete is no chaos in tge White House.

He fired Mooch.

Seriously .
 
2017-07-31 02:45:38 PM  

Karac: There's some nice ideas in there (along with some bad ones - companies with 499 employees count as 'small'?), and I wish you all the success in the world.

But realistically?  Up against whoever got control of whatever committee is going to shiatcan your ideas, and then Ryan & McConnell to get the thing actually put up for a vote, and then Trump to sign it?  Okay, maybe not Trump - he could be bought off by getting all your aides and interns together to crowdsource a title that abbreviates to "The B.A.R.R.Y. S.O.T.E.R.O I.S. A. P.O.O.P.Y.H.E.A.D ACT OF 2017".

But the rest of them?  And the wing of the Republican party that kept voting against their own ideas because they didn't hurt enough people?

[img.fark.net image 245x130]


Think they have a chance?
 
2017-07-31 02:46:43 PM  

Archidude: Off topic, but Trump just proved that thete is no chaos in tge White House.

He fired Mooch.

Seriously .


Really? BWAHAHAHAHAHA!

So he fired the guy that a week ago his hiring caused someone else to quit?

BWAHAHAHAHAHAHAHAHA!
 
2017-07-31 02:46:48 PM  

Archidude: Off topic, but Trump just proved that thete is no chaos in tge White House.

He fired Mooch.

Seriously .


+1 to you. I thought you were joking, but isn't anything about Trump funny.
 
2017-07-31 02:49:03 PM  

Archidude: Off topic, but Trump just proved that thete is no chaos in tge White House.

He fired Mooch.

Seriously .


This administration loses characters faster than Game of Thrones.
 
2017-07-31 02:49:59 PM  
CNN is reporting Scaramucci is out.  Not that I don't celebrate that guy losing his job, but what an absolutely shiatshow.
 
2017-07-31 02:51:10 PM  

Archidude: Off topic, but Trump just proved that thete is no chaos in tge White House.

He fired Mooch.

Seriously .


WE HAVE A NEW RECORD HOLDER EVERYONE!
 
2017-07-31 02:51:21 PM  
The elephant in the room is the Budget. DJT is doing everything in his power to delay the process. He knows it's gonna be a real bloodbath this go around, and he's also keenly aware now that Congress isn't going to cater to his agenda.
As a matter of fact, he knows he may get nothing out of it.
As a matter of course, Congress needs to have that bloodbath just to keep things going. The longer they delay, the weaker the Fed govt will look under Republican control.
And they try to blame "obstructionist Dems," though they hold clear majorities, which makes them look worse.
DJT's grandstanding about the ACA is yet another distraction, and it threatens to undermine the ability of Congress to do its basic job. If it reaches a certain point, some could characterize it as tgreatening national security even, and disqualify him on that basis.
 
2017-07-31 02:56:44 PM  
1. They don't have a plan yet
2. It won't fix American healthcare

Other than that, completely accurate!
 
2017-07-31 03:03:50 PM  
Delusional idiots.

Nothing in their proposal is anything more than a band aid and will do nothing to control costs or insure more people.

These people are why we can't have nice things.
 
2017-07-31 03:27:11 PM  

Unhip1: The elephant in the room is the Budget. DJT is doing everything in his power to delay the process. He knows it's gonna be a real bloodbath this go around, and he's also keenly aware now that Congress isn't going to cater to his agenda.


You are giving waaaaay too much credit to the thinking ability of DJT.  He's a guy who seriously thought solving health care and defeating ISIS would be easy.  He thinks everything is easy, and everyone else is stupid.  He doesn't think it will be a bloodbath.  He thinks that the budget is an easy fix just like bringing back coal jobs.

The only joy I get out of this presidency is the thought of how frustrated every single thing that he can't do must make him, but then I realize that he considers everything he does a beautiful success regardless of how many people get hurt.
 
2017-07-31 03:33:09 PM  
Is the plan to have the GOP stop sabotaging the ACA in purposely difficult to explain ways, like for instance by screwing with the risk corridors and other nuts and bolts of the system? Because that could work.
 
2017-07-31 03:37:54 PM  
So after years of asking for ACA fixes, they are finally ready to implement some. I always say it's gotta get worse before anyone gets off their ass to do anything.
Finally, good job people. A little late tho after all the political bullshiat.
 
2017-07-31 04:41:43 PM  
This all looks good.

Putting Cost sharing subsidies on more stable ground will prevent Trump from sabotaging the insurance market.

Fully funding the stabilization fund is something Obamacare originally had, but it got removed by Republicans in 2014 to sabotage the insurance market.  It's notable that every version of repeal that the GOP put forward this year had them funded again.

Scaling back the employer mandate isn't bad, it was a poorly written and counterproductive.  If you go back to the coverage of the ACA debate in 2009-2010 you'll see a ton of liberal wonks wondering what the hell Baucus was thinking putting it in there in the first place.  The much more liberal version of the ACA that came out of the House didn't have it in there for instance.

The medical device tax is better on policy grounds but it's a tough sell politically, even very liberal Senators like Warren and Franken have lobbied against it.  It's policy effect is fairly modest though and if we have to sacrifice it to get the rest of the good stuff passed it wont be a huge loss.

All-in-all this would be a good bill and I hope the Representatives involved can get a discharge petition to move it to the floor.
 
2017-07-31 04:50:26 PM  
 
2017-07-31 05:14:24 PM  

Karac: xanadian: The group also wants to create a federal stability fund - dollar amount unspecified -- that states can tap to reduce premiums and other costs for people with extremely expensive medical needs. Both the Senate and House repeal packages contained similar pots of money.

Uh...why would a "repeal" be adding $$$ to the program?  Not that I'm against that, but...

It goes something like this:
Medicaid expansion gives a state $10 billion for the health care of new enrollees.
Obamacare repeal cuts that funding, but replaces it with $5 million to cover the worst off.
Republican legislator gets to claim that he cut medicaid AND made sure there was money there to see that no one got hurt.

It's similar to how states start lotteries and say the money will go to fund schools, while at the same time cutting an equal (or usually greater) amount of money from the school budget than they expect the lottery to provide.


And in states where there was no Medicaid expansion? They've already proven their willingness to screw over their residents. A slush fund would be Merry Christmas to politicians' pockets.
 
2017-07-31 07:26:21 PM  
Just add a farking Medicare buy-in for anyone under 65, available through all 50 states.  Problem farking solved.
 
2017-07-31 07:43:01 PM  

hobbes0022: Just add a farking Medicare Medicaid buy-in for anyone under 65, available through all 50 states.  Problem farking solved.


FTFY

Seriously folks don't realize how much better a Medicaid buy would be, it operates even more efficiently than Medicare and it already has price structures set up for young healthy people.  Bonus: We don't have to wait for Democrats to take over congress/the White House to get started, call your state reps!
 
2017-07-31 07:59:23 PM  

Nied: hobbes0022: Just add a farking Medicare Medicaid buy-in for anyone under 65, available through all 50 states.  Problem farking solved.

FTFY

Seriously folks don't realize how much better a Medicaid buy would be, it operates even more efficiently than Medicare and it already has price structures set up for young healthy people.  Bonus: We don't have to wait for Democrats to take over congress/the White House to get started, call your state reps!


I didn't know, thanks for the info.
 
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