Senate Parliamentarian Rules That Republicans MUST Work With Democrats to Repeal-Replace ObamaCare.

originally posted by: allsee4eye
Obamacare was passed in 2010 as a tax with a simple majority, not with 60 votes. There is no reason it cannot be repealed with a simple majority.

Not true. The ACA passed the Senate with 60 votes: www.senate.gov...

originally posted by: nataylor

originally posted by: allsee4eye
Obamacare was passed in 2010 as a tax with a simple majority, not with 60 votes. There is no reason it cannot be repealed with a simple majority.

Not true. The ACA passed the Senate with 60 votes: www.senate.gov...

I think AllSee4Eye was trying to say that the PPACA was passed via the Reconciliation process, which it was.

originally posted by: rnaa
a reply to: carewemust

See my post above. Can't be repealed the way it was passed, because over 20,000 pages of rules and regulations were added by Health and Human Services AFTER it was passed.

Not true. Over 80% of those rules and regulations existed BEFORE the ACA, and the new rules were actually asked for by the insurance companies to ensure standardization across the risk pools.

See acasignups.net...

Correct.. As Charles Gaba explains at your ACASignups.net link, the long tentacles of the 2,000 page ACA law affected all the existing regulations, in addition to adding it's own pile of rules in an ongoing fashion, year after year, until President Trump put a stop to that process.

Can someone please tell me why healthcare in the US is such a trainwreck, when the rest of the world has figured it out? Why can't the USA, the richest country in the world, afford a version of the NHS?
Oh, wait, someone will wail something pathetic about socialism. Pah. Morons.

originally posted by: rnaa
a reply to: ketsuko

And it was the Dems who f***** up everything by passing it without any Republicans involved at any stage.

That is demonstrably 100% absolute bull feces. It does not resemble the historical truth in any way, shape, or form. It is, in short, a LIE. Your assertion is a foul, clumsy, attempt at misinformation.

The ACA was subjected to months of hearings and bipartisan negotiation. The final product included dozens of Republican amendments which are demonstrably the source of 99% of the ACA's shortcomings. If no Republican voted in favor of the ACA it is not because they didn't know what was in it or didn't have the opportunity to provide input. The Democrats went out of their way to get Republican input, unlike the Republican's this time around.

The ACA is not perfect, but most of its shortcomings must be laid squarely at the feet of obstructionist Republicans, both at the federal level when the bill was negotiated (bipartisan) and at the state level where the agenda was absolutely to engineer it to fail to the detriment of their citizens.

Compare the enormous success of the ACA in California and the non-success in Arizona. That difference is 100% down to the different attitude to providing affordable health care to the citizens of their states between a Dem controlled state and a Rep controlled state. That difference is repeated all over the country. In general, ACA works great in Dem controlled states, and doesn't in GOP controlled states simply because the GOP WANTS IT TO FAIL, not because it is a bad law.

This post is absolutely 100% bull feces..

Yes the republicans were consulted but not out of any attempt at bi-partisan ship, it was so people like you would eat up the idea that its a garbage bill because of the republicans.

If the bill was such a wonderful fantastic awesome idea, the democrats would not have bothered because they had the numbers for passing it, but that meant they would have had to own it 100%, and obviously they did not think it was a great idea. So bring in a few republicans and you can scapegoat them for all time on this horrid bill.

a reply to: AngryCymraeg

Ill take a stab at it..

Part of it is infrastructure, our country is 9.8 million square km.

roughly 330 million people scattered to all corners of that space.

20 million or so illegals.

politicians owned by a large variety of special interests that do not want a good system put in place because then it is harder to game the system and make a ton of money fast.

then add in an un-involved voting populace that checks the news for about 30 mins a night, and it makes things easier when it comes to sway them in the voting booth.

All of this plays a part.

originally posted by: carewemust

originally posted by: nataylor

originally posted by: allsee4eye
Obamacare was passed in 2010 as a tax with a simple majority, not with 60 votes. There is no reason it cannot be repealed with a simple majority.

Not true. The ACA passed the Senate with 60 votes: www.senate.gov...

I think AllSee4Eye was trying to say that the PPACA was passed via the Reconciliation process, which it was.

It was not. There was an amendment to it that passed through reconciliation, but the the bulk of it (including the parts that the Parlementarian says need 60 votes to undo), passed the Senate through the the process of normal legislation and required the 60 votes that it got.

gee, wasn't that nice of the Senate Parliamentarian!!!
ya see, if she had left things alone, the republican plan would have never made it through the senate because the danged republicans can't get their crap together enough to get enough support from their own party..
by doing this the republicans can go back to doing what they do best!!
blame the dems!!!

originally posted by: AngryCymraeg
Can someone please tell me why healthcare in the US is such a trainwreck, when the rest of the world has figured it out? Why can't the USA, the richest country in the world, afford a version of the NHS?
Oh, wait, someone will wail something pathetic about socialism. Pah. Morons.

We could, there's a general misunderstanding of what single payer health care is in the US though. We also have some costs the NHS doesn't, for example we pay to develop drugs, the NHS just buys the generics we originally sunk billions into bringing to market.

originally posted by: nataylor

originally posted by: carewemust

originally posted by: nataylor

originally posted by: allsee4eye
Obamacare was passed in 2010 as a tax with a simple majority, not with 60 votes. There is no reason it cannot be repealed with a simple majority.

Not true. The ACA passed the Senate with 60 votes: www.senate.gov...

I think AllSee4Eye was trying to say that the PPACA was passed via the Reconciliation process, which it was.

It was not. There was an amendment to it that passed through reconciliation, but the the bulk of it (including the parts that the Parlementarian says need 60 votes to undo), passed the Senate through the the process of normal legislation and required the 60 votes that it got.

Looks like ObamaCare was passed via regular order, then augmented later that month via reconciliation. No wonder it's such a mess!

From January 2016

"" The Senate did not use the reconciliaton process to pass the ACA. The act, comprising 906 pages, is the basic comprehensive substance of Obamacare. It was passed on a bill that was filibustered, and a supermajority vote of 60 was required to end that filibuster (by invoking cloture under Senate Rule 22). It was signed by the president on March 23, 2010, and became Public Law 111-148. 

A second bill, which was a reconciliation bill, was passed after that date to make a series of discrete budgetary changes in the ACA. That act, the Health Care and Education Reconciliation Act of 2010, was signed by the president on March 30, 2010, and became Public Law 111-152. It comprises 54 pages, 42 of which dealt with health care. 

Like the reconciliation bill in 2010, the reconciliation bill that President Obama vetoed this month (January 2016), made discrete budgetary changes in existing law. That vetoed bill did not “repeal” Obamacare. It amended several of the law’s budgetary components while leaving the basic structure of the law in place.""

Source: www.washingtonpost.com... l?utm_term=.9b0ff08a87b3

originally posted by: carewemust

originally posted by: ketsuko

originally posted by: olaru12
a reply to: carewemust

Didn't the GOP tell the dembs that they don't need or want them to be involved in "repeal and replace"??

And it was the Dems who f***** up everything by passing it without any Republicans involved at any stage. So I fail to see why they should need Democrats to unwind this monstrosity.

And basically part of it is that I now have to buy insurance for prostate exams even though I don't have one just like you have to be insured for maternity care.

The "people", advising Obama and the Dem Congress in 2008/2009 were very special. Experts and deceit and deviousness!

When ObamaCare was passed, using reconciliation, the bill was a stripped-down 2,300 page document. Smaller than today's 25,000+ pages, but still mind-boggling. The plan (and it worked!) was for Health and Human Services to add layers upon layers of "Rules" to the legislation, to shape it into what we see today. Actually ObamaCare is STILL being phased-in, if you can believe that!

Yes...everyone is required to purchase baked-in maternity coverage even if they can't make a baby. And everyone is required to purchase baked-in mental coverage, even if they don't have a brain.

That's why you need an interested and empathetic congress to make improvements on a bill of any complexity, not a bunch of bi-partisan dogmatic fools.

originally posted by: Willtell

originally posted by: carewemust

originally posted by: ketsuko

originally posted by: olaru12
a reply to: carewemust

Didn't the GOP tell the dembs that they don't need or want them to be involved in "repeal and replace"??

And it was the Dems who f***** up everything by passing it without any Republicans involved at any stage. So I fail to see why they should need Democrats to unwind this monstrosity.

And basically part of it is that I now have to buy insurance for prostate exams even though I don't have one just like you have to be insured for maternity care.

The "people", advising Obama and the Dem Congress in 2008/2009 were very special. Experts and deceit and deviousness!

When ObamaCare was passed, using reconciliation, the bill was a stripped-down 2,300 page document. Smaller than today's 25,000+ pages, but still mind-boggling. The plan (and it worked!) was for Health and Human Services to add layers upon layers of "Rules" to the legislation, to shape it into what we see today. Actually ObamaCare is STILL being phased-in, if you can believe that!

Yes...everyone is required to purchase baked-in maternity coverage even if they can't make a baby. And everyone is required to purchase baked-in mental coverage, even if they don't have a brain.

That's why you need an interested and empathetic congress to make improvements on a bill of any complexity, not a bunch of bi-partisan dogmatic fools.

And, you need a Senate Parliamentarian with no political ax to grind. Turns out that the one we have now, Elizabeth MacDonough, was appointed under Harry Reid, and is a big fan of AL Gore.

Excerpt:
“"Here I was, just a few years out of law school, helping to advise Vice President Gore on the procedure for counting the ballots in his own election. It was very exciting!""

Source Article: spectator.org...

The article also says that Mitch McConnell can fire her too, like Majority Leader Trent Lott did with his Senate Parliamentarian in 2001.

Senate Parliamentarian Elizabeth MacDonough, and the top people at the Congressional Budget Office are both "Deep State" pro-Obama, pro-ObamaCare.

The Republican Senate should understand this, ignore the "noise", and simply do what they promised to get elected!

originally posted by: rnaa
a reply to: ketsuko

And it was the Dems who f***** up everything by passing it without any Republicans involved at any stage.

That is demonstrably 100% absolute bull feces. It does not resemble the historical truth in any way, shape, or form. It is, in short, a LIE. Your assertion is a foul, clumsy, attempt at misinformation.

The ACA was subjected to months of hearings and bipartisan negotiation. The final product included dozens of Republican amendments which are demonstrably the source of 99% of the ACA's shortcomings. If no Republican voted in favor of the ACA it is not because they didn't know what was in it or didn't have the opportunity to provide input. The Democrats went out of their way to get Republican input, unlike the Republican's this time around.

The ACA is not perfect, but most of its shortcomings must be laid squarely at the feet of obstructionist Republicans, both at the federal level when the bill was negotiated (bipartisan) and at the state level where the agenda was absolutely to engineer it to fail to the detriment of their citizens.

Compare the enormous success of the ACA in California and the non-success in Arizona. That difference is 100% down to the different attitude to providing affordable health care to the citizens of their states between a Dem controlled state and a Rep controlled state. That difference is repeated all over the country. In general, ACA works great in Dem controlled states, and doesn't in GOP controlled states simply because the GOP WANTS IT TO FAIL, not because it is a bad law.

It's a bad law. The government has no right to force citizens to purchase a service or commodity.

It is failing.

Democrats shut down any attempts at GOP input.

It is failing.

Government has no place in telling people the coverage they must purchase,

It is failing.

Premiums and deductibles are spiraling out of control, but subsidized in Democrat states so the damage is not immediately visible.

IT IS A BAD LAW.

And the Dems are responsible for 100% of it.

originally posted by: AngryCymraeg
Can someone please tell me why healthcare in the US is such a trainwreck, when the rest of the world has figured it out? Why can't the USA, the richest country in the world, afford a version of the NHS?
Oh, wait, someone will wail something pathetic about socialism. Pah. Morons.

False narrative. The rest of the world has not 'figured it out.'

a reply to: Aazadan

We also have some costs the NHS doesn't, for example we pay to develop drugs, the NHS just buys the generics we originally sunk billions into bringing to market.

That is just not true.

Britain subsidizes drug research/development too, in exactly the same way that the USA does - through grants to university and commercial projects etc. Sure, we spend more on research than Britain does, but we have a bigger economy to support that.

The NHS and Medicare Part D negotiations with Pharmaceutical suppliers are completely different and have nothing to do with research and development subsidies.

a reply to: Teikiatsu

It's a bad law. The government has no right to force citizens to purchase a service or commodity.

It is an imperfect law. The government absolutely does have the right to ensure the welbeing of ALL its citizens. That is why it 'forces' citizens to purchase military services and gives them the choice to purchase health insurance or make an equivalent contribution to the insurance pool. Insurance works by spreading cost across a large pool, whether life insurance, health insurance, car insurance, pet insurance or whatever.

It is failing.

Define failing. Because 22 million NEW insurance company customers say it is working quite well.

That was one of the ACA's most important goals by the way: providing coverage to the uninsured. It has spectacularly exceeded its hoped for target. Obamacare is NOT failing. Period.

Democrats shut down any attempts at GOP input.

No they didn't. Repeating a lie over and over again doesn't make it any less of a lie. Democrats practically begged Republicans to participate in a meaningful way and they flat out refused. Never-the-less Democrats tried to take into account some of the Republicans biggest grievances (like grandfathering in old non-compliant policies) and ended up making the bill much less effective.

It is failing.

Define "failing". Because 50 million Americans with pre-existing conditions previously denied affordable coverage or any coverage at any price say it is working quite well.

That was another major goal: eliminate the pre-existing condition death trap. Once again, it has spectacularly exceeded its goal. That is NOT failure.

Government has no place in telling people the coverage they must purchase,

That isn't what 'the Government' is doing. The Government is not telling people what coverage they must purchase. It is telling the Insurance Companies the minimum coverage they can offer. Just like the Government tells developers the minimum engineering requirements a building must have, or a highway must be built to, or safety standards for airplanes, or radiation leakage from a microwave oven or what ever.

It is failing.

Define failing. Because millions of worthless insurance policies have been removed from the marketplace and in their place a range of practical, actually worthwhile policies.

Again, that was another goal of the ACA: get rid of sham worthless policies that people paid way too much for and literally got no practical coverage for. These scams no longer exist due to ACA regulations. Once again: spectacular success, not failure.

Premiums and deductibles are spiraling out of control, but subsidized in Democrat states so the damage is not immediately visible.

Insurance companies ARE increasing premiums due to uncertainty caused by GOP and Presidential faffing around. Trump's EO to stop enforcing the mandate means that they have to do that. That is 100% on the GOP and Trump.

States that have lots of competition in their insurance marketplace (hey! competition! that's a Capitalist concept! I thought the ACA was socialist poison!), are actually keeping premium rates fairly steady. Its those states where the competitive market has failed that are experiencing the biggest rises.

Now, by far most Americans get insurance through their workplace, and group insurance premiums have been very stable over the last few years.

Of those that buy it individually, most buy it through an Obamacare marketplace and are, for the most part, shielded from the premium rises through subsidies (for example, Oklahoma average plan $620 - after subsidy $69). The others, who either buy directly from an insurance company or do not qualify for a subsidy amount for about 3% of the market. Another issue is whether a particular state runs its own marketplace. States with their own marketplace have experienced much lower premium rise that those states that have refused to participate and therefore rely on the Federal marketplace. Those 'refusnik' states tend to have refused to expand Medicaid as well. And guess which party runs which states and owns 100% of any, shall we say, "less than ideal success" of the ACA in their state?

That individual direct buyer market (the 3% of the market - except it is really less than that because some of that 3% live in states where the ACA is keeping premiums down) is what we are talking about being affected by the premium rises. That 3% is what we are talking about when we are saying yes, the ACA is flawed, because yes, these folks are strongly affected by rising premiums. But it is worth remembering that those premiums are still lower than they would have been had the ACA never been passed.

IT IS A BAD LAW.

It is an imperfect law and needs fixing. No law, especially one that affects close to 20% of the economy in GDP terms could ever possibly be perfect straight out of the box. The ACA was hobbled from day one by a lot of compromises offered to placate the obstructionist Republicans and those holes need to be fixed.

THE ACA IS A GOOD, ALBEIT FLAWED LAW.

And the Dems are responsible for 100% of it.

If I were a Democrat, I would be happy to accept 100% responsibility for the ACA, but it just isn't true. But it is true that the Republicans will eat 100% of the responsibility for its destruction if they somehow manage to do it.

And finally, define failure. Insurance companies are recording record profits ($30 billion buybacks and dividends in two years) and share price (80% for Anthem; 165% for Aetna over 2 years) on the back of their millions of new customers.

In a capitalist system, how is that failure?


Selected references:

Obamacare Pre-Existing Conditions

The success of the Affordable Care Act is a hugely inconvenient truth for its opponents

Top Health-Insurance Scams

Obamacare Premiums Rise as Insurers Fret Over Law’s Shaky Future

How Many People Are Affected by Obamacare Premium Increases? (Hint, It’s Fewer Than You Think)

Did Obamacare premiums double in most states this year? No

Inside those big Obamacare rate increases: State hostility to the law costs residents plenty

a reply to: Teikiatsu

False narrative. The rest of the world has not 'figured it out.'

Not a false narrative at all. Just an exaggeration.

A more accurate assertion: Much, if not most, of the world has figured it out.

a reply to: rnaa

The US also pays in the private sector, it costs $5 billion in private money to bring a drug to market. That's after all the subsidies. That money has to be repaid, with a profit, otherwise the drug companies can't continue to make new drugs. The NHS cuts deals with drug companies to get them at a lower rate. Such a deal won't really work in the US unless we either extend patent protections or get other nations to stop using generics.

originally posted by: Aazadan
a reply to: rnaa

The US also pays in the private sector, it costs $5 billion in private money to bring a drug to market. That's after all the subsidies. That money has to be repaid, with a profit, otherwise the drug companies can't continue to make new drugs. The NHS cuts deals with drug companies to get them at a lower rate. Such a deal won't really work in the US unless we either extend patent protections or get other nations to stop using generics.

I said that.

Both the American and British governments contribute to research and development through both the private sector and the university systems. Neither the British NHS nor the American Medicaid Part D have anything to do with research and development.

The British NHS and the American Medicaid Part D are COMPLETELY SEPARATE to research and development funding processes. It is not the reason for their existence. Attempting to charge research and development to either scheme is a false narrative and spreads Medicaid opponent's false propaganda talking points.

The NHS and Medicaid Part D attempt to obtain the best deal for their clients. Medicaid Part D needs to do a much better job of negotiation to lower costs as that is the fastest rising cost associated with rising premiums.