I have spent the bulk of 2017 writing about the different Republican plans to repeal the Affordable Care Act.That's just what I want done with it. Carry on smartly.
Graham-Cassidy, in my view, is the most radical of them all.
While other Republican plans essentially create a poorly funded version of the Affordable Care Act, Graham-Cassidy blows it up.
Any of the others would have been suitable, too: all of these efforts--every single one of them--can only be taken as interim compromises (as all legislation can never be a final answer, compromise or not) until the final goal is reached (and even on reaching the goal, see "final answer" just above). After all, the last step cannot be taken until the first is.
ReplyDeleteI also disagree with the foolishness that this is the last chance to pass a repeal and replace bill or anything else. A last chance exists only as prelude to dying or to abject surrender. The only thing that happens if this bill fails is that passage of something by reconciliation gets more difficult.
For all that, I agree that Graham-Cassidy is the best of the lot that have been on offer.
Eric Hines
I'd love to blow up ObamaCare. I just don't want to blow up the individual health care market:
ReplyDeleteThe individual mandate and subsidies would disappear, but the mandate to cover everybody would stick around.
And from Laszewski :
Even though the payment of insurance subsidies would be uncertain from state to state, the requirement that insurers cover anyone applying for coverage no matter how sick they are would remain on the books.
...the requirement that insurers cover anyone applying for coverage no matter how sick they are would remain on the books.
ReplyDeleteAlso removed is the requirement to charge the same premium for a preexisting condition as for "normal" coverage.
And: what folks on both sides of this question miss (and I have a hard time believing that these intelligent people are missing it accidentally--especially those of the Left who insisted all along that they're smarter than us) is that even a preexisting condition is insurable under a fee-for-risk-transfered principle. Certainly the risk is greater than for a non-preexisting condition, and so it should get a higher premium, but it remains a risk and not a certainty. Take the heart condition that is used as the canon for this. Not everyone is going to have their heart attack at the same time. Or the secondary canon, asthma: not everyone is going to have a critical asthma attack at the same time. The risk easily can be amortized across time in the risk pool.
Further, with the individual mandate rendered unenforceable, customers will be nearer to controlling their choices. That supports a free market, it doesn't blow it up.
Getting government all the way out of the way would be better, but getting the Feds out of the way and putting it in the hands of the State governments is a good step in the right direction. Why do you suppose some governors are opposed to receiving this responsibility?
Eric Hines
Some risks remain risks and not certainties; others do not. Cancer, multiple sclerosis, kidney failure, congestive heart failure, Lou Gehrig's disease, Alzheimers are all conditions that, once they exist, will require expensive treatment, often for a long period of time.
ReplyDeleteI don't see how a setup that would allow me to forgo health insurance my whole life, knowing I can sign up for it if I'm diagnosed with a serious and/or expensive health problem, can be financially sound. Perhaps if premiums become more reasonable people will become more willing to sign up for health insurance when they're healthy. Perhaps if the insurance companies charge higher premiums to people who sign up when they're sick than they do to people who already have health insurance when they become sick, that will provide an incentive (a form of guaranteed re-issue, if I understand the terminology correctly).
If the bill passes, we'll get a chance to see how it all works out.
Elise said...
ReplyDeleteI'd love to blow up ObamaCare. I just don't want to blow up the individual health care market
The equine has left the stable. For all intents and purposes, that's exactly what Obamacare did (and was designed to do, with the hope that it would secondarily blow up the large group market as companies dumped their workers on the exchanges).
I'm not convinced the individual health insurance market can't regenerate itself, but it won't happen without some sensible laws to get the ACA damage out of the way.
ReplyDeleteWe're going to have to deal with the problem that health insurance is in essence a lifetime bet, not something that can easily be re-evaluated from scratch once a year.