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Old 05-04-2017, 02:26 PM   #1
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ACHA passes House now heads to the senate

The US House of Representatives has passed a healthcare bill, bringing President Trump's pledge to repeal and replace Obamacare a stride closer.

The American Health Care Act (AHCA) passed with a vote to spare, after weeks of cajoling within the Republican party to muster enough support.

It has been opposed by Democrats and several groups representing patients, doctors and hospitals.

The bill next heads to the Senate, possibly in June.

Republicans needed 216 votes in the House and it passed with 217. No Democrats voted in favour.

Its safe passage through the US lower chamber provides the new president with his first legislative victory, three months into his term.

And it marks a remarkable turnaround after the bill was left for dead in March when Republicans were unable to agree on its provisions.

Obamacare v Republican plan compared
A win for Trump - Anthony Zurcher, BBC News, Washington

Round one of the battle over Obamacare repeal is in the books. Round two is set to begin, with the opponents more powerful and the obstacles more imposing.

It's worth remembering that passage of the Republican healthcare plan in the House of Representatives was supposed to be the easy part. House Speaker Paul Ryan had a sizeable majority at his disposal and the political tools to reward support and punish transgressions.

Instead the American Health Care Act's long, laborious journey exposed divisions within the Republican Party and the limits in Donald Trump's powers of persuasion. These challenges won't disappear. The fault lines will be put under greater pressure and Mr Trump's skills will be further tested when action heads to the Senate.

Unlike the House, the Republican majority there is narrow, and already some in the party are showing misgivings about the current legislation. Democrats, who have more parliamentary tricks up their sleeves, will attempt to disrupt the process at every turn.

Still, a win is a win. It wasn't pretty. It may not last. But Mr Trump and the Republican House leadership will take it.

But the speed at which it has been resuscitated since then, with several amendments aimed at winning over Republican rebels, has provoked criticism.

It is not known how much the revised bill will cost, nor how many people will lose coverage, because the nonpartisan Congressional Budget Office (CBO) has not had time to assess it.

Before the latest revisions, the CBO estimated 14 million more Americans would lose insurance in 2018 alone.

Why is Obamacare suddenly so popular?

Patients tell their Obamacare stories

About 20 million Americans gained healthcare coverage under President Barack Obama's 2010 Affordable Care Act, nicknamed Obamacare.

But Republicans viewed it as an overreach of the federal government and said patients had less choice and higher premiums.
What's the reaction?
Image copyright Getty Images
Image caption Activists hold signs during a "Stop Trumpcare" rally in front of the Capitol in Washington, DC

There were shouts of "Shame on you!" from protesters directed at congressmen and women as they left Capitol Hill.

Democratic Minority Leader Nancy Pelosi said: "Very sad. One of the biggest transfers of wealth in the history of our country. Their desire to give a tax break for the rich just trumped everything."

But Republicans were jubilant.

House Majority Leader Kevin McCarthy said the bill would give Americans greater choice and stop the current Obamacare "death spiral" of higher costs and fewer healthcare options.

The White House Chief of Staff Reince Priebus said it was a "big win for Americans" and would deliver expanded access and lower costs.

Before the vote, the Republican leadership in the House played "Eye of the Tiger", the pre-fight song in Rocky, at a closed-door meeting.
Image copyright Getty Images
Image caption The vote was a victory for House Speaker Paul Ryan (centre)
What's changed from Obamacare?

The new bill repeals the individual mandate requiring those who can afford it to have health insurance. Those have who been without coverage for more than two months would face a 30% surcharge for new policy.
It repeals Obamacare's requirement for companies with 50 or more staff to provide insurance coverage for employees.
It keeps the popular Obamacare element allowing children and young people to stay covered on their parents' policies up until age 26.
It would enable insurers to charge at least five times as much to older customers.
It enables states to opt out of the guarantee to provide healthcare to people with pre-existing conditions.

What next?

The bill goes to the Senate, probably next month, where it faces a precarious passage.

Although the chamber is Republican controlled, their majority is a thin one and several of their senators have said the bill will need amendments.

The influential Senator Bob Corker said the present bill had "zero" chance of clearing the upper chamber.

Any new revisions made by the Senate would need approval from the House.
Related Topics

http://www.bbc.com/news/world-us-canada-39809168
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Old 05-04-2017, 02:35 PM   #2
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I'm by no means an authority on healthcare... but I'm a little confused. I've looked at signing up for Obamacare, checked out the website... it would be crazy, as it'd be way more expensive than my basic, sh*tty health insurance I get from my job and appears to cover less. But IF I were to pay for it, the basic Obamacare... things like major surgeries and transplants and other life-saving things would all be covered? I don't think they would, not without massive deductibles and thousands/hundreds of thousands in cash out of pocket (not unlike I'd have to under my current basic, sh*tty health insurance), if my understanding of the basic Obamacare policies is correct. And most people don't just have thousands of dollars set aside for these scenarios. The policies I was looking at were like... you have to spend out of pocket about $2,500 up front... and THEN the yearly coverage of about $2,500 kicks in, and if you use all that up, then you're out of pocket beyond that. Sort of a "donut" coverage which... isn't much of a coverage at all.

I've seen things like Jimmy Kimmel crying, talking about how he'd be so sad if his child died because they didn't have Obamacare coverage... I'm not really sure what he's talking about. What am I missing, here? Does he know something I don't about Obamacare, or does he just not understand how it works?
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Old 05-04-2017, 02:53 PM   #3
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I know that some of what Kimmel was talking about was the protection against pre-existing condition exclusions.

Something that the House GOP just decided to roll back, allowing states to decide for themselves what would/wouldn't count as a pre-existing condition.

People with pre-existing conditions can be turned down outright for insurance, or pay more than the average person.

It's my understanding that insurance works best when everyone puts in a little. I mean, the whole point of having insurance is In Case Something Bad Happens. And if there isn't a giant pool of healthy people who kick in, then it all falls to crap.

It's like herd-immunity that way.

Some things that can be considered pre-existing conditions:
Genetic disorders
Pregnancy
C-Section
Rape

Have any of those in your past? And your state is now eligible to green light insurers in your state to deny you coverage.
Or charge you more.

Most of what I'm reading says it's not probable that this will pass the Senate, but that it is possible.
This doesn't matter from where I'm standing, they GOP is complicit in moving things forward.
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Old 05-04-2017, 02:57 PM   #4
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I know that some of what Kimmel was talking about was the protection against pre-existing condition exclusions.

Something that the House GOP just decided to roll back, allowing states to decide for themselves what would/wouldn't count as a pre-existing condition.

People with pre-existing conditions can be turned down outright for insurance, or pay more than the average person.

It's my understanding that insurance works best when everyone puts in a little. I mean, the whole point of having insurance is In Case Something Bad Happens. And if there isn't a giant pool of healthy people who kick in, then it all falls to crap.

It's like herd-immunity that way.

Some things that can be considered pre-existing conditions:
Genetic disorders
Pregnancy
C-Section
Rape

Have any of those in your past? And your state is now eligible to green light insurers in your state to deny you coverage.
OK... in other words, if I had a "pre-existing condition," and I had Obamacare, now I wouldn't even be allowed to pay the thousands of dollars out of pocket to be able to access the tiny, limited donut coverage inside? I guess that's kind of crappy. But it seemed like already crappy beforehand. Sort of a non-issue if you just plain don't have the thousands of dollars to pay out of pocket, though.

It sort of seems like a lot of the loudest Obamacare supporters just see it as some kind of clandestine, "WHOO-HOO! Everyone is covered with an affordable plan!"... but they aren't really looking at what the plans are, or what they're actually covering. They're basically useless, as I understand them (again, unless you have extra thousands of dollars at all times).
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Old 05-04-2017, 03:03 PM   #5
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OK... in other words, if I had a "pre-existing condition," and I had Obamacare, now I wouldn't even be allowed to pay the thousands of dollars out of pocket to be able to access the tiny, limited donut coverage inside?

I guess that's kind of crappy. But it seemed like already crappy beforehand. Sort of a non-issue if you just plain don't have the thousands of dollars to pay out of pocket, though.
It's my understanding that ObamaCare was a set of minimum requirements that insurance companies had to meet in order to participate in the market places. Where people could go on their own to get insurance straight from the companies.

As opposed to getting coverage through their employers, who would then deal with the insurance company.

That minimum requirement list has been lifted.
So even if you get insurance through your boss, if you have a pre-existing condition....that insurance company can deny you.
Or charge you more.

We've had RomneyCare, which is what ObamaCare is, in MA for a while now.
People who who don't have insurance are dinged come tax time.
Why? Because the leading reason that people declare bankruptcy is Medical Cost.
There are very few people in our country who aren't one catastrophic illness or injury away from financial ruin.
Which is kind of sad, for what is arguably the richest country in the world.
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Old 05-04-2017, 03:08 PM   #6
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I have had Medicare and Medicaid for years so I don't really understand all this stuff. I am admittedly ignorant.
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Old 05-04-2017, 03:19 PM   #7
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Sh*t's all a waste of money, but whats up with the preexisting conditions? Why would you be denied?
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Old 05-04-2017, 03:20 PM   #8
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Originally Posted by plastroncafe View Post
It's my understanding that ObamaCare was a set of minimum requirements that insurance companies had to meet in order to participate in the market places. Where people could go on their own to get insurance straight from the companies.

As opposed to getting coverage through their employers, who would then deal with the insurance company.

That minimum requirement list has been lifted.
So even if you get insurance through your boss, if you have a pre-existing condition....that insurance company can deny you.
Or charge you more.
I get that part. I think.

Quote:
There are very few people in our country who aren't one catastrophic illness or injury away from financial ruin.
But as I understand it, even without this repeal business, Obamacare on its own wouldn't change that. If the medical bill you get hit with is $250,000... the paltry $2,500 (if that) Obamacare will cover on a very basic policy (AFTER you pay the initial $2,500 deductible) isn't going to save you either way.
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Old 05-04-2017, 03:25 PM   #9
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I had great insurance through my job... the ACA/Obamacare came along and costs went up and my deductible went up and prescriptions were now going through the same deductible cost before they were covered. I couldn't afford my prescription so things got worse than they already were so I had to go out of work (or be fired for missing work). Out of work but still had income and didn't qualify for help with the meds. Now ran out of disability pay, have help with the cost of meds and free care program at the hospital, but no income to pay for meds or gas to get to the hospital for costly mris every three months. This plan just means my tumor is now pre-existing and doesn't get covered, except Maine has it as law that pre-existing conditions be covered... but it doesn't help any because no employer is going to hire someone who can't do much without having to sit and rest after only 20 minutes of expending energy... less if theres people who smell of cigarette smoke around...

The government needs to get out of the i surance business all together....
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Old 05-04-2017, 03:27 PM   #10
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But as I understand it, even without this repeal business, Obamacare on its own wouldn't change that. If the medical bill you get hit with is $250,000... the paltry $2,500 (if that) Obamacare will cover on a very basic policy (AFTER you pay the initial $2,500 deductible) isn't going to save you either way.
Prevention is key.
People who don't have insurance don't go to the doctor for little things, they wait until they're big things.

My horror is only slightly tempered by the fact that living where I do, I have much less to fear.

Imagine living in Flint, Michigan and having the state...which has ignored your request for clean drinking water, suddenly decides to make "lead poisoning" a pre-existing condition.
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A lot just get older and older and angrier and angrier, all the while waiting for the world to bend to their whim, never, ever really being satisfied with any of the "victories" achieved at large and wondering why no one outside of whatever construct bubble they've placed themself [sic] (look, I did it!) in wants to mess with them.
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Old 05-04-2017, 03:44 PM   #11
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I'm by no means an authority on healthcare... but I'm a little confused. I've looked at signing up for Obamacare, checked out the website... it would be crazy, as it'd be way more expensive than my basic, sh*tty health insurance I get from my job and appears to cover less. But IF I were to pay for it, the basic Obamacare... things like major surgeries and transplants and other life-saving things would all be covered? I don't think they would, not without massive deductibles and thousands/hundreds of thousands in cash out of pocket (not unlike I'd have to under my current basic, sh*tty health insurance), if my understanding of the basic Obamacare policies is correct. And most people don't just have thousands of dollars set aside for these scenarios. The policies I was looking at were like... you have to spend out of pocket about $2,500 up front... and THEN the yearly coverage of about $2,500 kicks in, and if you use all that up, then you're out of pocket beyond that. Sort of a "donut" coverage which... isn't much of a coverage at all.

I've seen things like Jimmy Kimmel crying, talking about how he'd be so sad if his child died because they didn't have Obamacare coverage... I'm not really sure what he's talking about. What am I missing, here? Does he know something I don't about Obamacare, or does he just not understand how it works?
I like Jimmy kimmel but that was just ridiculous. The guy is well to do with a steady, secure job. I'm sure he'd have to give up a car or move to a different neighborhood but who's he trying to fool really?
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Old 05-04-2017, 03:50 PM   #12
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If this bill goes through the Senate, it doesn't matter how many times Kimmel moves, or how many cars he sells, or how good his job is, there's a very real chance his kid could get denied medical insurance because he was born with a heart defect.

He wasn't bemoaning his own situation, but that of other people not as lucky as him. The people whose kids will die because they're not as lucky as him.
And let's face it...no matter how hard you work in Entertainment, luck plays a HUGE role in whether you make it to where he is.

Empathy isn't ridiculous.
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A lot just get older and older and angrier and angrier, all the while waiting for the world to bend to their whim, never, ever really being satisfied with any of the "victories" achieved at large and wondering why no one outside of whatever construct bubble they've placed themself [sic] (look, I did it!) in wants to mess with them.
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Old 05-04-2017, 05:33 PM   #13
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I'm a little torn, though. The very nature of insurance is, you know, say with car insurance. You're basically standing in front of the company every month, saying, "I bet you I'm not going to get in any accidents this month," and the insurance company saying, "I bet you will," and meeting in the middle on an acceptable minor fee to pay for any damages in case they happen. The understanding being, you come back in there next month after an accident, that minor fee will not be so minor anymore.

Likewise, with health insurance, you're saying every month you pay your premiums, "I bet you I'm not going to get sick this month," and the health insurance company saying, "I bet you will." Same thing. And like with car insurance, if you have a long and ongoing streak of accidents or tickets, when you say "I bet you I'm not going to get in an accident this month," they will say, "Hah! I bet you will, because you always do." But it's the same sort of thing. "I bet I'm not going to get sick this month" won't work with the health insurance company if you walk in there and it turns out you have cancer, or have had 4 heart attacks in the past. They're going to say, "I bet you will, because you're already sick. But hey... I'll give you the most equitable rate on the high and quantifiable likelihood that you're going to need a whole lot of care this month and that care being pretty expensive." That doesn't sound really unfair to me, from a logical perspective. Why would an insurance company be forced to sell $35 a month insurance to someone they know is going to need $30,000 care every month, or more? That doesn't make any sense.

It only gets sad and muddled with health insurance, because these are people. Not cars. Not houses.

I don't know, I don't think anyone should ever be refused treatment for anything. Likewise, I don't believe it should ever be a "Come back when you have the money" thing for necessary kidney transplants, heart transplants, etc.. I think there should probably be waivers or discounts that should be applied to people in certain situations... but I think at the end of the day they still need to walk home with the bill. I don't know that me or you or anyone else needs to pay for it, and with a ballooning population I'm not even sure that's a sustainable business model if it was adopted on full-scale (i.e., a poor person with basic Full Obamacare getting a $500,000 heart transplant and taxpayers having to pay for it entirely).

Last edited by Andrew NDB; 05-04-2017 at 11:08 PM.
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Old 05-04-2017, 05:55 PM   #14
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All of these recent happenings make me feel even more that America needs true, universal health care. Not a nationwide mandate that everyone have health insurance, and pay a fee if they don't.

I'd rather live in a society that thinks it worthwhile to take care of its citizens than one that puts the profits of corporations first.
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Old 05-04-2017, 05:57 PM   #15
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It's ridiculous that USA don't have universal health care.
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Old 05-04-2017, 06:00 PM   #16
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Its stupid to make insurance mandatory... less government demand/involvement.
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Old 05-04-2017, 06:06 PM   #17
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It's ridiculous that USA don't have universal health care.
It really is.

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Its stupid to make insurance mandatory... less government demand/involvement.
We wouldn't need insurance if we had true healthcare

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Old 05-04-2017, 06:11 PM   #18
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All of these recent happenings make me feel even more that America needs true, universal health care. Not a nationwide mandate that everyone have health insurance, and pay a fee if they don't.

I'd rather live in a society that thinks it worthwhile to take care of its citizens than one that puts the profits of corporations first.
But how do they make it work? Where does the money come from? There's no such thing as free medicines, or doctors and surgeons working for free.

Let's say they run the numbers. I mean, really run the numbers. I'm just going to throw a number out there, but I don't think it's really too far off: $500. $500 a month from every working class citizen -- that's the cost of full, universal healthcare in the US. (not Obamacare as it exists now... which doesn't actually cover much of anything and leaves most/all of the debt on the sick person). i.e., the cost for the entire nation to pay for every surgery, every transplant, every prescription, every cancer treatment for anyone and everyone that's sick that takes place every day.

Would you proudly pay that every month on top of your bills, for universal healthcare? Because it doesn't realistically sound like there's any other way for such a thing to work unless we get into stuff like, "Well why don't they just tax the hell out of the rich, make them pay for everything? Yeah, that's it!"

There is other things that I wonder about, though. Does an chest X-ray REALLY need to cost $500? Does an MRI REALLY need to cost $1000? Does a simple meeting with the doctor really need to cost $300? An ambulance ride, $1000? I don't know. I don't think they do. Maybe those kinds of things should be taken a much closer look at, kind of like how people point to "We need to raise the minimum wage through the roof!" instead of looking at the real core problems of things like rent ballooning up 600% in a decade.
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Old 05-04-2017, 06:49 PM   #19
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Andrew NDB for president!!!
Now why can't a common sense approach like this work in Washington D.C?

$$$$ that's why greed>common sense
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Old 05-04-2017, 06:50 PM   #20
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Sh*t's all a waste of money, but whats up with the preexisting conditions? Why would you be denied?
So, if you have a pre-existing condition, you are riskier to the insurance company. Usually your medical expenses are higher than a healthy person and they lose money on you in the sense that they pay out more for your care than you pay in to them for premiums.

Thats kind of the gamble of insurance. You pay in so that if something bad happens they pay the enormous cost of your treatment...usually more than you've paid in. They hope you remain healthy so you continue to produce income for them to cover losses on others.

They always want to exclude people who are riskier because they are a sure loss.



My question is....are they still thinking of funding the new healthcare thing by taxing the portion of my employer sponsored insurance that my employer pays as income to me? If so I'm f@cked on taxes.


Also are they still changing Medicaid to a Block grant? If so alot of those folks will get f@cked because States will only have so much to give their Medicaid recipients. Might not be enough to cover everyone who has Medicaid currently.
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