5 ms·

> As much as people like to rag on the Republicans, and they deserve it, I don't think they will throw out the good parts. It would politically unpopular to "t

> As much as people like to rag on the Republicans, and they deserve it, I don't think they will throw out the good parts. It would politically unpopular to "throw out" the parts you spoke of. But the question is can we keep those parts and not keep the insurance mandate?

namlem 10y ago
Sure, with even larger taxpayer handouts to insurance companies.
09bjb 10y ago
Not true. The senate has already voted down the pre-existing protections plan, letting young adults stay on their parents' plans, and keeping contraceptive coverage. American's don't follow the actual machinations of the senate much so it's not "politically unpopular" to do this. We think electing a President every 4 years who's a radical departure from what we had before will fix all our problems and prevent us from actually having to pay attention to the details.
- learc83 10y ago
  The Senate can't remove the pre-existing conditions protections or letting young adults stay on their parents plans through budget reconciliation. They can remove funding for subsidies through budget reconciliation, and let the system collapse on its own, but they don't have the votes to overcome the filibusterer they'd get if they tried to remove those protections directly. 1 of 2 things will likely happen. 1. They will repeal and delay. Meaning they will remove funding through reconciliation, but delay implementation until 2020. Then depending on what happens in 2018 who knows what might happen. This is the bad option because it could cause the collapses of the individual market even before it takes effect. 2. They will repeal and replace. Most likely they will replace it with the new Health and Human Services Secretary's plan to keep the preexisting conditions protection plan, as long as you maintain coverage. If you don't maintain coverage you'll go into a high risk pool with higher rates until you maintain coverage for 18 months. Plan 2 is very similar to what we currently have, but it replaces the punishment for not maintain coverage with higher premiums instead of a tax penalty. What they should do is to increase the tax penalty to force more people into the pool and simultaneously add a public option, but that's not going to happen.
  - ubernostrum 10y ago
    plan to keep the preexisting conditions protection plan, as long as you maintain coverage That's a repeal of the pre-existing condition protection, because it goes back to how pre-existing conditions worked pre-ACA (HIPAA -- remember the "P" is for "Portability", not "Privacy" -- guarantees you can avoid denial of pre-existing conditions so long as you maintain coverage continuously or with no break longer than 63 days).
- jfnixon 10y ago
  The Senate voted down a specific pre-existing conditions protection plan. The final bill is likely to contain a pre-existing conditions provision.
joezydeco 10y ago
No. If you exclude preexisting conditions, how do you prevent the case where someone decides to buy insurance the day after they're diagnosed with cancer? You do that by requiring everyone to have insurance when they're well to help cover those that are sick. That's the mandate. If you try to separate them, the system collapses under the weight of even more cost.
- tomjen3 10y ago
  Thats easy, actually. If you suffer cancer it should be the company that you are active with at the time who are responsible for paying for your treatment for that, even if you are no longer with them. You weight until you have cancer to sign up? Well then you have to pay for the cancer treatment, but if you break your leg tomorrow, the insurance company has to pay. Again previous conditions are not an issue, because they won't cost the next insurance company anything. If you get diagnosed with, say, aids and need treatment for the rest of your life, then it should be the company you were with at the time of your illness that has to paid, even if you are no longer with them. Couple this with payment in cash for treatment, so that you can shop for the best/cheapest/whatever doctor (just as you would with car work), a mandatory disclosure of prizes and untangle health insurance from your employer and the system should be much more manageable.
  - lazyasciiart 10y ago
    Among other things, you are relying on no insurance companies ever closing in the future. What happens if they go bankrupt? The government has to bail them out?
  - learc83 10y ago
    That plan won't work because people constantly change insurance companies and there are too many conditions that are life long. Most people develop many pre-existing conditions as they get older. By the time you're 70 you'll have 5 different insurance companies all treating different conditions that you developed at various times in your life. Not to mention what happens when companies go out of business. This plan isn't workable at all.
  - 10y ago
chris11 10y ago
The danger is that the mandates can be repealed budget reconciliation, but banning denials based on pre-existing conditions can't. So if the mandate gets repealed before Obamacare is replaced the ACA health insurance market will probably collapse.
- cderwin 10y ago
  Presumably the repeal wouldn't take effect for some time, allowing an alternative to be put in place before hitting that point.
tzs 10y ago
> But the question is can we keep those parts and not keep the insurance mandate? The state of Washington tried that in the '90s. Passed an ACA-like system. Republicans repealed the mandate, kept the preexisting conditions. Result: within a few years every single insurance company stopped selling individual health insurance in Washington. Seattle Times article from yesterday about this: http://www.seattletimes.com/seattle-news/politics/dismantling-of-states-health-reforms-in-1993-may-offer-lesson-for-obamacare-repeal/ http://www.seattletimes.com/seattle-news/politics/dismantlin... HN submission for discussion: https://news.ycombinator.com/item?id=13393537 https://news.ycombinator.com/item?id=13393537

namlem 10y ago

Sure, with even larger taxpayer handouts to insurance companies.

09bjb 10y ago

Not true. The senate has already voted down the pre-existing protections plan, letting young adults stay on their parents' plans, and keeping contraceptive coverage. American's don't follow the actual machinations of the senate much so it's not "politically unpopular" to do this. We think electing a President every 4 years who's a radical departure from what we had before will fix all our problems and prevent us from actually having to pay attention to the details.

learc83 10y ago
The Senate can't remove the pre-existing conditions protections or letting young adults stay on their parents plans through budget reconciliation. They can remove funding for subsidies through budget reconciliation, and let the system collapse on its own, but they don't have the votes to overcome the filibusterer they'd get if they tried to remove those protections directly. 1 of 2 things will likely happen. 1. They will repeal and delay. Meaning they will remove funding through reconciliation, but delay implementation until 2020. Then depending on what happens in 2018 who knows what might happen. This is the bad option because it could cause the collapses of the individual market even before it takes effect. 2. They will repeal and replace. Most likely they will replace it with the new Health and Human Services Secretary's plan to keep the preexisting conditions protection plan, as long as you maintain coverage. If you don't maintain coverage you'll go into a high risk pool with higher rates until you maintain coverage for 18 months. Plan 2 is very similar to what we currently have, but it replaces the punishment for not maintain coverage with higher premiums instead of a tax penalty. What they should do is to increase the tax penalty to force more people into the pool and simultaneously add a public option, but that's not going to happen.
- ubernostrum 10y ago
  plan to keep the preexisting conditions protection plan, as long as you maintain coverage That's a repeal of the pre-existing condition protection, because it goes back to how pre-existing conditions worked pre-ACA (HIPAA -- remember the "P" is for "Portability", not "Privacy" -- guarantees you can avoid denial of pre-existing conditions so long as you maintain coverage continuously or with no break longer than 63 days).
jfnixon 10y ago
The Senate voted down a specific pre-existing conditions protection plan. The final bill is likely to contain a pre-existing conditions provision.

joezydeco 10y ago

No. If you exclude preexisting conditions, how do you prevent the case where someone decides to buy insurance the day after they're diagnosed with cancer? You do that by requiring everyone to have insurance when they're well to help cover those that are sick. That's the mandate. If you try to separate them, the system collapses under the weight of even more cost.

tomjen3 10y ago
Thats easy, actually. If you suffer cancer it should be the company that you are active with at the time who are responsible for paying for your treatment for that, even if you are no longer with them. You weight until you have cancer to sign up? Well then you have to pay for the cancer treatment, but if you break your leg tomorrow, the insurance company has to pay. Again previous conditions are not an issue, because they won't cost the next insurance company anything. If you get diagnosed with, say, aids and need treatment for the rest of your life, then it should be the company you were with at the time of your illness that has to paid, even if you are no longer with them. Couple this with payment in cash for treatment, so that you can shop for the best/cheapest/whatever doctor (just as you would with car work), a mandatory disclosure of prizes and untangle health insurance from your employer and the system should be much more manageable.
- lazyasciiart 10y ago
  Among other things, you are relying on no insurance companies ever closing in the future. What happens if they go bankrupt? The government has to bail them out?
- learc83 10y ago
  That plan won't work because people constantly change insurance companies and there are too many conditions that are life long. Most people develop many pre-existing conditions as they get older. By the time you're 70 you'll have 5 different insurance companies all treating different conditions that you developed at various times in your life. Not to mention what happens when companies go out of business. This plan isn't workable at all.
- 10y ago

chris11 10y ago

The danger is that the mandates can be repealed budget reconciliation, but banning denials based on pre-existing conditions can't. So if the mandate gets repealed before Obamacare is replaced the ACA health insurance market will probably collapse.

cderwin 10y ago
Presumably the repeal wouldn't take effect for some time, allowing an alternative to be put in place before hitting that point.

tzs 10y ago

> But the question is can we keep those parts and not keep the insurance mandate? The state of Washington tried that in the '90s. Passed an ACA-like system. Republicans repealed the mandate, kept the preexisting conditions. Result: within a few years every single insurance company stopped selling individual health insurance in Washington. Seattle Times article from yesterday about this: http://www.seattletimes.com/seattle-news/politics/dismantling-of-states-health-reforms-in-1993-may-offer-lesson-for-obamacare-repeal/ http://www.seattletimes.com/seattle-news/politics/dismantlin... HN submission for discussion: https://news.ycombinator.com/item?id=13393537 https://news.ycombinator.com/item?id=13393537