Repeal, Delay, Replace

That’s the Republicans’ plan to undo the legislative atrocity that is ObamaCare.

[Update a few minutes later]

Democrats plan a fight to save ObamaCare. I agree with Stephen Green:

If you — or GOP lawmakers — aren’t mentally prepared for the howls, the accusations of racism/sexism/etc, the tales of woe, and the panic-mongering, then you don’t understand how Democrats play this game.

The ugliness hasn’t even begun to begin.

Sadly true.

12 thoughts on “Repeal, Delay, Replace”

  1. I think Dick Morris has a far better solution:

    Here’s what the Republicans should do:
    • Effective immediately repeal any requirement that anyone has to buy health insurance or any mandate that any employer purchase it for him.
    • Let people choose how much insurance they want and repeal the ObamaCare requirement that everyone buy expensive, full soup-to-nuts coverage.
    • Continue ObamaCare requirements that bar discrimination against people with pre-existing conditions and that make parental plans cover children through age 26.
    • Make health insurance premiums deductible on federal tax forms
    • Allow inter-state competition among insurance firms to broaden choice and reduce costs
    • Continue subsidies to those who qualify –whether or not they buy policies through the ObamaCare exchanges.
    • Let people keep their ObamaCare policies if they like.
    And then, let ObamaCare wither away from the inside out.

      1. The strength of the idea is that it removes government control over what policies cover. Creating a nationwide market has to remove states control though because each state manages their insurers.

  2. Well since the life expectancy has gone down in the US with Obamacare; I think ACA needs to die early, so that others may live.

  3. 1) Require the entire gamut of deductibles to be covered.
    2) Require the insurers to put some sizable chunk of the premiums directly into individual HSAs.

    Those are both “Requirements on insurers”. The second one has the obvious direct effect of increasing premiums. But the -first- one means that everyone that’s young or vaguely healthy can turn right around and say “Hey, I have $X000 in my account now, I’d like to shift to $X000 as a deductible”. Which had better have a lower premium.

    3) Allow tax exempt contributions to the HSAs. If it is a Public Good then treat it like one. Not looking for everyone to have $2000 in their HSA, looking for everyone to have enough in their HSA that they can reasonably be considered ‘self-insured’.

    4) Shield the contents of the HSAs from the medical side. Refuse to allow the price to always be “Everything in there, and $1 from the actual insurance company”. I’ve been completely flabbergasted by a variety of billing procedures involving the “price” changing after the fact … multiple times.

    5) The underlying root problem of the entire insanity of pricing in the medical field is the price-fixing structures/requirements of Medicaid/Medicare. Start converting those to payments to everyone’s HSAs.

  4. Thinking outside the box: Don’t let hospitals charge anything from patients. Use a barber shop model. Fill hospitals with doctors all competing for a patients business. The doctors rent the hospital facilities. Patients get 20 years to pay their bills, within a payment range. meaning some things get paid off on the first payment, but also capping how much will be paid in 20 years.

    Eliminate whole classes of healthcare that requires a doctor. Let something less than a doctor be included as a business competitor.

    Insurance is an entirely different thing that doesn’t require ‘a plan’ because insurance is a fairly simple mathematical thing.

    1. In the last few years, Google has been at least as useful as our doctors. The few times we’ve had to visit, we already knew what the problem was and what to do about it, and we just needed a doctor to sign a piece of paper to allow us to buy the drugs in question.

      End the ‘prescription’ scam and you can slash the cost of medical care overnight.

  5. The real problem with “delay” is that it makes a mess of the exchange policies in the meantime. They should set the delay till 2018 – this coming year is that last year with exchanges. Immediately defund any planning for exchanges after that. That sets a time limit for the “replace” part, and doesn’t wreck people’s policies for next year.
    Part of the problem is that if they aren’t willing to do away with the filibuster completely, they only can use reconciliation. That allows them to wreck Obamacare but not get rid of regulations or craft a replacement. They will need to work with the Democrats and Schumer has already said that he’s looking forward to blackmailing them with a looming time limit.

    1. he’s looking forward to blackmailing them with a looming time limit.

      This ‘looming time limit’ insanity has always been a complete ‘we have no actual strategy level thinkers’ problem.

      1) Name bills as soundbites themselves, then use the darn name.
      2) Split the problems up in ways that are convenient for “our side”.
      3) Rack up, then report rampantly, tallies of the proceedings.
      4) I don’t mind dollar value increases as long as their are significant structural changes.

      “No Ma’am, that’s incorrect. The distinguished colleague you’ve been quoting voted 47 times to block the ‘2017 5% Increase in Medicare Funding Act’ right before he shamelessly told you he’s in favor of funding Medicare. Yes, I heard him try to argue that we have to do this as a comprehensive reform so the giant cabal of for profit insurers make a large profit as usual, but that’s pretty typical for a Democrat. Oh, he didn’t word it exactly like that? Well, that’s what ‘comprehensive reform’ means here, you -should- be able to figure that out.”

  6. I wonder if someone knowledgeable could link a fairly simple article on (a) what exactly can be done with reconciliation and what cannot? and (b) what powers exactly does the President have over regulatory agencies when many of their employees are civil servants he can’t fire?
    We all have lots of plans on what should be done, without (me at least) really understanding what can be blocked by Democrats in Congress and in the regulatory agencies just all saying No.

    1. What can and can’t is in the eyes of the beholder. The wikipedia page on “Reconciliation_(United_States_Congress)” wasn’t too bad. (Although they did gloss over how crucial reconciliation was, exactly, to not just ‘Amending’ the PPACA, but passage in the first place.)

      Setting a budget for pieces of Obamacare (to zeroish) could (if well written) be pretty clearly something that would pass historical muster, even if the Democrats would oppose it with amazing histrionics.

      Changing regulations, etc. is on trickier ground – but the retort should always be “Well, if you don’t think this is acceptable, I’m willing to simply rule the initial passage of Obamacare void too….”

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