4 ms·

Let's Say Obamacare Is Repealed. What Then?

18 points by chang2301 10y ago

scott_c 10y ago
The only thing I liked about Obama care was the pre-existing conditions clause. I think we should keep this and open insurance companies up across state lines. This should bring competition and reduce our overall rates. We also need to be able to have plans where we can specifically choose what kind of care we need (IE: women, men, children, etc). I run my own business and my costs went up 100% this year for a higher deductible and less coverage. If this happens again, I may not be able to afford it.
- deleted 10y ago
  [deleted]
- pLFBbqArowjIwxH 10y ago
  > I think we should keep this and open insurance companies up across state lines. This should bring competition and reduce our overall rates. As I understand it, this is the first step toward removing all regulation on the healthcare industry. Some pro-big-business-controlled state legislature will slowly start removing regulations to lure insurance companies. They'll move to that state, and then they'll be able to sell their product from that state to the rest of the country.
  - jbarciauskas 10y ago
    This is right. There's no other reason to allow selling across state lines, and very little evidence there is a lack of competition that needs addressing in this way. The biggest issue facing the ACA is literally no one wants to offer insurance in a lot of rural counties. Selling across state lines would do nothing to address that or any other real issue with our healthcare system.
- wahern 10y ago
  The only thing I liked about Obama care was the pre-existing conditions clause. You can't separate that clause from the mandate and minimum coverage clauses. All three were designed to keep costs from inflating on the one hand, and coverage becoming useless on the other. It's sort of like saying you like your lunch, but have a problem with having to pay for it. We can quibble about rates for men vs women, but unless you were matured to adulthood in a lab, it's hard to argue that men as a class do not benefit from improved and cheaper access to reproductive healthcare for women. (Also, better reproductive health means fewer criminals, if only because they're born healthier and with fewer mental handicaps.) Opening up insurance across states would be nice theoretically, but you must realize that it's a states' rights issue for a large segment of the GOP, and a cause for concern among Democrats. It would necessarily limit and perhaps destroy the ability for states to meaningfully regulate insurance within their own borders. Unchecked, it would also mean a race to the bottom in terms of regulatory oversight as every provider would only sell insurance from states with the least restrictive regulations. What state do you live in? Coverage in states like California and many other states that haven't fought tooth-and-nail has been fairly stable as far I know. The Kaiser HMO rate at my company actually decreased slightly for 2017, with no change in coverage. And California not only has a rigorous regulatory framework, it even maintains a weird tax on hospital income to pay for uninsured coverage. Also, you don't need a federal law to support an inter-state insurance scheme. States could voluntarily permit policies to be sold from other states. For example, states in different regions could elect to normalize their regulatory schemes and open up their markets to each other. There's plenty of precedent for this. It doesn't require Congressional approval; just coordination among state legislatures like is so often done for other regulatory frameworks.
  - scott_c 10y ago
    "but unless you were matured to adulthood in a lab, it's hard to argue that men as a class do not benefit from improved and cheaper access to reproductive healthcare for women." There are plenty of single men that should not be forced to pay for women's reproductive healthcare. "What state do you live in? " http://time.com/money/4535394/obamacare-plan-premium-price-increases-2017-states/ http://time.com/money/4535394/obamacare-plan-premium-price-i... 8 states rose by at least 30%. "States could voluntarily permit policies to be sold from other states. For example, states in different regions could elect to normalize their regulatory schemes and open up their markets to each other. There's plenty of precedent for this. It doesn't require Congressional approval; just coordination among state legislatures like is so often done for other regulatory frameworks." Great, but Obamacare in its current form needs to go.
- toodlebunions 10y ago
  There is nothing preventing insurance companies from selling across state lines right now.
- scarface74 10y ago
  "I think we should keep this and open insurance companies up across state lines. This should bring competition and reduce our overall rates." No insurance company wants to compete for high risk people. It won't help. Besides, most of the big insurance companies already have plans in most states.
amerine 10y ago
Wasn't the intrastate demands a GOP added addendum to the bill? As well as the removal of the single payer option? I feel like people forget how much stuff changed from the original ACA to the one that passed through congress. Also, I fully expect that I'm remembering completely wrong. I'm human, and in mobile, and about to prep a turkey, sorry.
virmundi 10y ago
Ok, so as much as I didn't vote for Trump, or Hillary, I think the media in general is fear mongering. Trump wants to replace ACA. He doesn't want to just say, "Fuck it! We'll do it live". He want to repeal the law, while invoking a new one. While I admit that it's not a fleshed out plan, the website does provide reasonable guidelines for what his administration wants to perform. Republicans have, half-assedly, been trying to do the same in the House for years. Perhaps all of the saber rattling will lead to a coherent plan. https://www.donaldjtrump.com/positions/healthcare-reform https://www.donaldjtrump.com/positions/healthcare-reform
- maxxxxx 10y ago
  The Republicans never brought forward any proposals for improvement but voted 40 times or so for repealing Obamacare. I don't think they have any plans other than letting the market fix itself and if you can't afford healthcare you just have to do without. In reality, American healthcare is just a big scam and ripoff. On my last trip to Germany my girlfriend had a problem with her eye. We went to an eye doctor there and paid 25 Euro out of pocket without insurance. Doctors in Germany don't starve but they have nice cars and houses. In the US she had recently several surgeries and every hospital bill has had massive errors in the range of thousands of dollars. It's just a racket. How about enforcing some standards of billing accuracy instead of allowing this kind of scam?
  - Kopion 10y ago
    > The Republicans never brought forward any proposals for improvement but voted 40 times or so for repealing Obamacare. I don't think they have any plans other than letting the market fix itself and if you can't afford healthcare you just have to do without. http://www.vox.com/policy-and-politics/2016/11/18/13678690/republican-obamacare-replacement-plans-explained http://www.vox.com/policy-and-politics/2016/11/18/13678690/r...
    - maxxxxx 10y ago
      Why didn't they vote for any of these in the last 8 years?
jgooch 10y ago
Full on capitalism based health care, or full on communistic health care
scarface74 10y ago
Let's see. Both Trump and the Republicans in Congress want to keep the ban on not allowing exclusions based on pre-existing conditions. How will that happen? 1. Insurance companies must cover everyone but can charge more based on pre-existing conditions. Insurance companies know acturatially how much treatment will cost based on a person's condition, so they charge that person and exhorbant amount. People complain and the government either has to subsidize the cost and pay insurance companies the difference or have the dreaded public option - just what the Democrats originally wanted. 2. Alternatively, everyone has to get coverage so you can't game the system and only get insurance when you think you will need it - an individual mandate. Either way, all roads lead back to some form of either ObamaCare, a public option, subsidies that go directly to insurance companies, or people not being insured.

18 points by chang2301 10y ago

The only thing I liked about Obama care was the pre-existing conditions clause. I think we should keep this and open insurance companies up across state lines. This should bring competition and reduce our overall rates. We also need to be able to have plans where we can specifically choose what kind of care we need (IE: women, men, children, etc). I run my own business and my costs went up 100% this year for a higher deductible and less coverage. If this happens again, I may not be able to afford it.

deleted 10y ago
[deleted]
pLFBbqArowjIwxH 10y ago
> I think we should keep this and open insurance companies up across state lines. This should bring competition and reduce our overall rates. As I understand it, this is the first step toward removing all regulation on the healthcare industry. Some pro-big-business-controlled state legislature will slowly start removing regulations to lure insurance companies. They'll move to that state, and then they'll be able to sell their product from that state to the rest of the country.
- jbarciauskas 10y ago
  This is right. There's no other reason to allow selling across state lines, and very little evidence there is a lack of competition that needs addressing in this way. The biggest issue facing the ACA is literally no one wants to offer insurance in a lot of rural counties. Selling across state lines would do nothing to address that or any other real issue with our healthcare system.
wahern 10y ago
The only thing I liked about Obama care was the pre-existing conditions clause. You can't separate that clause from the mandate and minimum coverage clauses. All three were designed to keep costs from inflating on the one hand, and coverage becoming useless on the other. It's sort of like saying you like your lunch, but have a problem with having to pay for it. We can quibble about rates for men vs women, but unless you were matured to adulthood in a lab, it's hard to argue that men as a class do not benefit from improved and cheaper access to reproductive healthcare for women. (Also, better reproductive health means fewer criminals, if only because they're born healthier and with fewer mental handicaps.) Opening up insurance across states would be nice theoretically, but you must realize that it's a states' rights issue for a large segment of the GOP, and a cause for concern among Democrats. It would necessarily limit and perhaps destroy the ability for states to meaningfully regulate insurance within their own borders. Unchecked, it would also mean a race to the bottom in terms of regulatory oversight as every provider would only sell insurance from states with the least restrictive regulations. What state do you live in? Coverage in states like California and many other states that haven't fought tooth-and-nail has been fairly stable as far I know. The Kaiser HMO rate at my company actually decreased slightly for 2017, with no change in coverage. And California not only has a rigorous regulatory framework, it even maintains a weird tax on hospital income to pay for uninsured coverage. Also, you don't need a federal law to support an inter-state insurance scheme. States could voluntarily permit policies to be sold from other states. For example, states in different regions could elect to normalize their regulatory schemes and open up their markets to each other. There's plenty of precedent for this. It doesn't require Congressional approval; just coordination among state legislatures like is so often done for other regulatory frameworks.
- scott_c 10y ago
  "but unless you were matured to adulthood in a lab, it's hard to argue that men as a class do not benefit from improved and cheaper access to reproductive healthcare for women." There are plenty of single men that should not be forced to pay for women's reproductive healthcare. "What state do you live in? " http://time.com/money/4535394/obamacare-plan-premium-price-increases-2017-states/ http://time.com/money/4535394/obamacare-plan-premium-price-i... 8 states rose by at least 30%. "States could voluntarily permit policies to be sold from other states. For example, states in different regions could elect to normalize their regulatory schemes and open up their markets to each other. There's plenty of precedent for this. It doesn't require Congressional approval; just coordination among state legislatures like is so often done for other regulatory frameworks." Great, but Obamacare in its current form needs to go.
toodlebunions 10y ago
There is nothing preventing insurance companies from selling across state lines right now.
scarface74 10y ago
"I think we should keep this and open insurance companies up across state lines. This should bring competition and reduce our overall rates." No insurance company wants to compete for high risk people. It won't help. Besides, most of the big insurance companies already have plans in most states.

amerine 10y ago

Wasn't the intrastate demands a GOP added addendum to the bill? As well as the removal of the single payer option? I feel like people forget how much stuff changed from the original ACA to the one that passed through congress. Also, I fully expect that I'm remembering completely wrong. I'm human, and in mobile, and about to prep a turkey, sorry.

virmundi 10y ago

Ok, so as much as I didn't vote for Trump, or Hillary, I think the media in general is fear mongering. Trump wants to replace ACA. He doesn't want to just say, "Fuck it! We'll do it live". He want to repeal the law, while invoking a new one. While I admit that it's not a fleshed out plan, the website does provide reasonable guidelines for what his administration wants to perform. Republicans have, half-assedly, been trying to do the same in the House for years. Perhaps all of the saber rattling will lead to a coherent plan. https://www.donaldjtrump.com/positions/healthcare-reform https://www.donaldjtrump.com/positions/healthcare-reform

maxxxxx 10y ago
The Republicans never brought forward any proposals for improvement but voted 40 times or so for repealing Obamacare. I don't think they have any plans other than letting the market fix itself and if you can't afford healthcare you just have to do without. In reality, American healthcare is just a big scam and ripoff. On my last trip to Germany my girlfriend had a problem with her eye. We went to an eye doctor there and paid 25 Euro out of pocket without insurance. Doctors in Germany don't starve but they have nice cars and houses. In the US she had recently several surgeries and every hospital bill has had massive errors in the range of thousands of dollars. It's just a racket. How about enforcing some standards of billing accuracy instead of allowing this kind of scam?
- Kopion 10y ago
  > The Republicans never brought forward any proposals for improvement but voted 40 times or so for repealing Obamacare. I don't think they have any plans other than letting the market fix itself and if you can't afford healthcare you just have to do without. http://www.vox.com/policy-and-politics/2016/11/18/13678690/republican-obamacare-replacement-plans-explained http://www.vox.com/policy-and-politics/2016/11/18/13678690/r...
  - maxxxxx 10y ago
    Why didn't they vote for any of these in the last 8 years?

jgooch 10y ago

Full on capitalism based health care, or full on communistic health care

scarface74 10y ago

Let's see. Both Trump and the Republicans in Congress want to keep the ban on not allowing exclusions based on pre-existing conditions. How will that happen? 1. Insurance companies must cover everyone but can charge more based on pre-existing conditions. Insurance companies know acturatially how much treatment will cost based on a person's condition, so they charge that person and exhorbant amount. People complain and the government either has to subsidize the cost and pay insurance companies the difference or have the dreaded public option - just what the Democrats originally wanted. 2. Alternatively, everyone has to get coverage so you can't game the system and only get insurance when you think you will need it - an individual mandate. Either way, all roads lead back to some form of either ObamaCare, a public option, subsidies that go directly to insurance companies, or people not being insured.