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Health/Medical
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Title: Ryancare Is Just A Shittier Version Of Obamacare
Source: ShadowProof
URL Source: https://shadowproof.com/2017/03/08/ ... st-shittier-version-obamacare/
Published: Mar 27, 2017
Author: Jon Walker
Post Date: 2017-03-27 11:32:48 by Tooconservative
Keywords: None
Views: 627
Comments: 25

After having seven years to work on a repeal and replace plan, House Speaker Paul Ryan finally released his bill. For all practical purposes, it is Obamacare, just 35 percent shittier.

This is an impressive feat because, in their pursuit of a lower score from the Congressional Budget Office (CBO), Democrats made the Affordable Care Act as shitty as they could get away with while still calling it “universal” health care.

While many other analyses are focused on how Ryan’s American Health Care Act will make life worse for certain lower income Americans compared to Obama’s Affordable Care Act, pointing out the similarities is more important for understanding its politics.

Under Ryancare, most people will get coverage through their employer, just like Obamacare. In both cases, many of the poor will get coverage through Medicaid. And with both plans, lower/middle income people without employer coverage will be encouraged to use tax credits to help buy regulated private insurance.

Neither Obamacare nor Ryancare has any real price control measures to deal with our dramatically out-of-line health care prices. Both plans leave groups of Americans without insurance they consider affordable. Finally, both are heavily “financed” by a Cadillac tax on expensive employer-provided insurance that is delayed for a decade, resulting in no one expecting the tax to ever go into effect.

There are four major areas where Ryancare does differ from Obamacare, but even here, most of Ryancare’s provisions are only a bad funhouse mirror version of very similar Obamacare policies

1) Medicaid

The most important difference is that Ryancare will change how the Medicaid expansion works and is funded starting in 2020 by freezing enrollment and creating a per capita cap, which places funding limits on each person. Of course, that might never happen. If the GOP doesn’t feel comfortable implementing these changes now, I don’t know how they think it will be easier in the middle of a presidential election.

This Medicaid cut will cause about 4-6 million people to lose Medicaid coverage, according to S&P (which I need to cite since there is no CBO score).

2) Tax credits

The second most important difference is that Ryancare will, in 2020, replace Obamacare’s age/regional based, means-tested, refundable tax credits to buy private insurance with age-based, sort-of-means-tested, refundable tax credits to buy private insurance.

On the plus side, the more modest means-testing design in Ryancare means the tax credits should be slightly easier for the government to administer, will make insurance more affordable for some Americans who currently make too much to qualify for Obamacare credits, and somewhat addresses the issue that means-testing created a big effective marginal tax on lower income people.

The issue is that Ryancare’s “fixes” the problem created by Obamacare only providing lower income Americans enough tax credits to make insurance affordable by basically making tax credits equally insufficient for everyone. And since they aren’t pegged to the cost of health care, the Ryancare tax credits could become less sufficient every year.

3) Individual mandate replaced by late enrollment penalty

Ryancare gets rid of the deeply unpopular individual mandate. In its place, it imposes a late enrollment penalty that’s supposed to nudge people to buy private insurance in a timely manner. If you fail to buy coverage for awhile, you will need to pay 30 percent more when you do buy insurance.

Both systems suffer from the basic flaw that they don’t make insurance truly affordable for everyone but punish you if for some reason you feel you can’t make your premiums. Obamacare has hardship exemptions for the mandate, though.

4) Taxes repealed

Finally, Ryancare repeals almost all of the other Obamacare taxes, meaning it probably won’t pay for itself. Repealing the Obamacare taxes on the rich is just a big giveaway to the rich.

Ryancare is not a change of structure from Obamacare. It’s a change of scope.

The big similarities, and the fact that even the differences are more a matter of size than radical policy redesign, completely undermines the GOP’s ideological and political position. It’s not based around a coherent theory for what is wrong with health care, nor does it offer big new ideas to fix our problems.

By comparison, there are intellectual theories behind how plans like the old Wyden-Bennett bill or Medicare-for-All could improve conditions with big system-wide changes.

The Collins-Cassidy bill at least has a decent story to explain why it might make things better. It replaces Obamacare’s “one size fits all” approach with 50 state experiments to see what works best. Even though it’s a complete repeal without any replacement, it at least has a coherent ideological principle to justify it: the government shouldn’t be so involved.

There is no principle or story behind Ryancare to explain how, even in theory, it could make things better. There is no reason to even hope it could make things cheaper or coverage better. There is no way to look at what is just a shittier version of Obamacare and not conclude it would have an impact similar to Obamacare, just roughly 35% worse for those most impacted.

So now Republicans are left trying to explain why they kept claiming Obamacare was such a terrible existential threat that is completely fixed by cutting rich people’s taxes and making it less generous to some people in need.

As a result, the ideological Republicans aren’t happy, the more pragmatic Republicans who would need to implement it aren’t happy, the non-partisan groups aren’t happy, and even the political hacks don’t know how to sell it. The Republican PR team is honestly left pointing to the fact that Ryancare has fewer pages as proof it is better.

Selling Obamacare was almost impossible for Democrats; selling just a shittier version of Obamacare should be even more difficult for Republicans.

(Note: I feel the need to refer to the plans as “Ryancare” and “Obamacare” because fittingly, AHCA is an extremely similar but slightly shittier acronym than ACA, which would lead to confusion.)

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#1. To: Tooconservative (#0)

Rand thought it cute when he named the new bill, Obamacare Lite.

Now, the asshole will live with the original Obama Heavy.

I don’t think he will find that cute.

But then, who know.

He is after all, a libertarian weirdo …

Gatlin  posted on  2017-03-27   11:36:12 ET  Reply   Trace   Private Reply  


#2. To: Gatlin (#1)

I don’t think he will find that cute.

In Kentucky he certainly will. So will Massie.

Kentucky would have been hardest hit with major increases in insurance and in numbers of people thrown off insurance.

Don't forget, the real CBO scoring is yet to come out.

Why was it that Lyin' Ryan was in such a rush to ram it through the House before the CBO score came out?

Tooconservative  posted on  2017-03-27   11:43:20 ET  Reply   Trace   Private Reply  


#3. To: Tooconservative (#0)

"This Medicaid cut will cause about 4-6 million people to lose Medicaid coverage"

The author has no f**king idea how many people will lose Medicaid coverage. Medicaid money will be block-granted to the states. Once the states have this money (no matter the federal formula used to distribute it) it's up to them what they do with it. They might even use it fund other things -- like public sector pensions.

But conservatives want to get rid of federal funding of Medicaid and turn it over 100% to the states. Block-granting is a good way to do that.

misterwhite  posted on  2017-03-27   12:21:44 ET  Reply   Trace   Private Reply  


#4. To: Tooconservative (#0)

"The issue is that Ryancare’s “fixes” the problem created by Obamacare only providing lower income Americans enough tax credits to make insurance affordable"

The tax credits are meant to offset the penalty created by not allowing individuals to use pre-tax money to buy insurance.

Conservatives have been asking for this for years -- Corporations buy health insurance for their employees using pre-tax money. Why can't individuals do the same?

misterwhite  posted on  2017-03-27   12:26:14 ET  Reply   Trace   Private Reply  


#5. To: misterwhite (#3)

The author has no f**king idea how many people will lose Medicaid coverage. Medicaid money will be block-granted to the states. Once the states have this money (no matter the federal formula used to distribute it) it's up to them what they do with it. They might even use it fund other things -- like public sector pensions.

Even so, they would have lost federal Medicaid insurance and (maybe) got TexasCare or MississippiCare or whatnot.

I think CBO is slanted and pretty inaccurate but the GOP and Dems agreed (foolishly) many years ago to evaluate their legislation by it. Then they tied the knot around their necks with the Byrd rule codified into law which makes passing a lot of measures very difficult due to their CBO score, especially in the Senate. This is why tax reform is now more difficult after RynoCare has failed. They wanted to count the savings from RynoCare to offset the tax cuts. About as dishonest as completely federalizing the college loan program and using its "savings" to offset 0Care's costs (the federal college loan program is now over $100 billion in the hole and ready for a bailout).

Tooconservative  posted on  2017-03-27   12:27:26 ET  Reply   Trace   Private Reply  


#6. To: misterwhite (#4)

Conservatives have been asking for this for years -- Corporations buy health insurance for their employees using pre-tax money. Why can't individuals do the same?

I've been self-employed. Of course I favor it.

I also favor making major medical costs tax-deductible.

For that matter, I'd probably go for the feds providing free catastrophic health insurance for the entire country with a deductible in the range of $50,000-$75,000. And people could just decide how much additional insurance they want on top of that.

Tooconservative  posted on  2017-03-27   12:29:56 ET  Reply   Trace   Private Reply  


#7. To: Tooconservative (#0)

"but punish you if for some reason you feel you can’t make your premiums."

Spoken like a whiny, bleeding-heart liberal. Try not making a couple of car payments or house payments and see what happens.

This penalty is in there to keep people from dropping their health insurance and re-signing when they get sick.

Idiot.

misterwhite  posted on  2017-03-27   12:30:26 ET  Reply   Trace   Private Reply  


#8. To: Tooconservative (#0)

"Finally, Ryancare repeals almost all of the other Obamacare taxes, meaning it probably won’t pay for itself."

Oh, no! Please don't repeal my taxes! Not that! Nooooooooo!

Please keep forcing me to pay for the health care of people who refuse to work, who use my food stamp money to buy junk food, who are fat and lazy, who live an unhealthy life style, who don't get health check-ups, who get sick and use expensive emergency room services, who use drugs ... and especially those who are here illegally.

misterwhite  posted on  2017-03-27   12:38:08 ET  Reply   Trace   Private Reply  


#9. To: Gatlin (#1)

"Now, the asshole will live with the original Obama Heavy."

Exactly. He's telling people that Obamacare Heavy is preferable to Obamacare Lite because he has a political point he wants to make. And that he believes this make him relevant.

Look at me! Look at me! I am somebody.

misterwhite  posted on  2017-03-27   12:42:04 ET  Reply   Trace   Private Reply  


#10. To: Tooconservative (#6)

The problem is this: We have free Medicaid at one end for the poor, free Medicare at the other end for the elderly, and a whole bunch of schmucks in the middle who have to pay for that care plus care for themselves.

If that's not bad enough, hospitals are forced to treat everyone even if they can't pay, and insurance companies are forced to insure people who are already sick.

Then Obamacare came along and made that worse.

Now fix it and make everyone happy.

misterwhite  posted on  2017-03-27   12:52:35 ET  Reply   Trace   Private Reply  


#11. To: Tooconservative (#2)

"Don't forget, the real CBO scoring is yet to come out."

CBO scoring on the number of individuals affected by a bill is wildly inaccurate (if Obamacare is any example). They're more accurate predicting costs and savings.

But even then their forecast only covers Phase I. The savings realized by regulatory reform (Phase II) and increased competition (Phase III) is not included.

misterwhite  posted on  2017-03-27   13:02:31 ET  Reply   Trace   Private Reply  


#12. To: misterwhite (#8)

Please keep forcing me to pay for the health care of people who refuse to work, who use my food stamp money to buy junk food, who are fat and lazy, who live an unhealthy life style, who don't get health check-ups, who get sick and use expensive emergency room services, who use drugs ... and especially those who are here illegally.

You seems to misunderstand our basic finance as a nation.

All the goodies of the 0dinga presidency were made by vastly expanding the national debt, not by raising tax revenue from a mostly stagnant economy.

You haven't been paying for any of those things. Most of what you are paying likely goes into paying interest on that huge national debt that was run up by 0dinga and his cronies.

Tooconservative  posted on  2017-03-27   13:49:27 ET  Reply   Trace   Private Reply  


#13. To: misterwhite (#9) (Edited)

Exactly. He's telling people that Obamacare Heavy is preferable to Obamacare Lite because he has a political point he wants to make.

I don't consider it 0bamaCare Lite. I consider it as the GOP's consent to permanent welfare expansion of food stamps and Medicaid to the entire able-bodied working class. Not to actually pay the costs of that policy but to an ongoing and vast expansion of debt.

Look at me! Look at me! I am somebody.

I think the sheer glamour of hanging out at LF has gone to your head.

Tooconservative  posted on  2017-03-27   13:52:12 ET  Reply   Trace   Private Reply  


#14. To: Tooconservative (#13)

"I consider it as the GOP's consent to permanent welfare expansion of food stamps and Medicaid"

Food stamps? What does health insurance reform have to do with food stamps? And I see Medicaid contracting under AHCA, not expanding.

misterwhite  posted on  2017-03-27   14:10:16 ET  Reply   Trace   Private Reply  


#15. To: Tooconservative (#12)

"You haven't been paying for any of those things. All the goodies of the 0dinga presidency were made by vastly expanding the national debt"

Whew! For a minute there I thought I and my children would be paying for it with our taxes.

Glad to hear the money is coming from this thing you call "the national debt".

misterwhite  posted on  2017-03-27   14:13:33 ET  Reply   Trace   Private Reply  


#16. To: Gatlin (#1)

He is after all, a libertarian weirdo …

Exactly! Always talking about all that "individual freedoms" stuff? Who the hell does he think he is? After all,the government is willing to allow us to have all the freedom they think we need!

BOYCOTT PAYPAL AND CLOSE YOUR PP ACCOUNTS NOW! ENCOURAGE OTHERS TO DO SO,TOO!

ISLAM MEANS SUBMISSION!

Why is democracy held in such high esteem when it’s the enemy of the minority and makes all rights relative to the dictates of the majority? (Ron Paul,2012)

American Indians had open borders. Look at how well that worked out for them.

sneakypete  posted on  2017-03-27   14:15:22 ET  Reply   Trace   Private Reply  


#17. To: misterwhite (#3)

The author has no f**king idea how many people will lose Medicaid coverage.

Neither does anyone else.

As far as I can tell,there are three different sides to this argument,and all three sides are lying about it.

I'd like to give you the straight scoop on this issue,but it's a mystery to me. The more then explain it,the less I understand.

BOYCOTT PAYPAL AND CLOSE YOUR PP ACCOUNTS NOW! ENCOURAGE OTHERS TO DO SO,TOO!

ISLAM MEANS SUBMISSION!

Why is democracy held in such high esteem when it’s the enemy of the minority and makes all rights relative to the dictates of the majority? (Ron Paul,2012)

American Indians had open borders. Look at how well that worked out for them.

sneakypete  posted on  2017-03-27   14:17:30 ET  Reply   Trace   Private Reply  


#18. To: misterwhite (#15)

Whew! For a minute there I thought I and my children would be paying for it with our taxes.

You're paying for it in the form of interest on the national debt and the expansion of a debt that will probably never be paid down but will instead be used as a constant inflationary pressure against your earnings and savings. And the Federal Reserve is ready to tell you that your cost of living is entirely flat but that they must never raise interest rates on the big banks (which might endanger their monopoly and the power of their lobbyists).

Tooconservative  posted on  2017-03-27   14:23:04 ET  Reply   Trace   Private Reply  


#19. To: sneakypete, misterwhite (#17)

I'd like to give you the straight scoop on this issue,but it's a mystery to me.
That’s like Jim Jordan of the Freedom Caucus said while making the rounds on TV yesterday and again this morning to Bill Hemmer on FOX News …
Only 17% of the American people said they like the new healthcare bill.
He neglected to say that the other 83% had never bothered to read the bill to find out what’s in it so they could have an opinion….therefore, “it’s a mystery to them.”

Gatlin  posted on  2017-03-27   15:59:12 ET  Reply   Trace   Private Reply  


#20. To: sneakypete (#16)

.... stuff?

Nah....they are always talking "La La Land" shit about a utopia and other common falsehoods about the ideas of Libertarianism.

Gatlin  posted on  2017-03-27   16:02:28 ET  Reply   Trace   Private Reply  


#21. To: Gatlin (#19)

He neglected to say that the other 83% had never bothered to read the bill to find out what’s in it so they could have an opinion….therefore, “it’s a mystery to them.”

Are you trying to claim that you read it and understand all the finite details as well as the consequences?

BOYCOTT PAYPAL AND CLOSE YOUR PP ACCOUNTS NOW! ENCOURAGE OTHERS TO DO SO,TOO!

ISLAM MEANS SUBMISSION!

Why is democracy held in such high esteem when it’s the enemy of the minority and makes all rights relative to the dictates of the majority? (Ron Paul,2012)

American Indians had open borders. Look at how well that worked out for them.

sneakypete  posted on  2017-03-27   17:07:19 ET  Reply   Trace   Private Reply  


#22. To: Gatlin (#19)

He neglected to say that the other 83% had never bothered to read the bill to find out what’s in it so they could have an opinion….therefore, “it’s a mystery to them.”

So...what you're really saying is we have to pass RynoCare to find out what is in it?

Tooconservative  posted on  2017-03-27   17:35:57 ET  Reply   Trace   Private Reply  


#23. To: stoner (#0)

Self Ping

Si vis pacem, para bellum

Rebellion to tyrants is obedience to God.

There can be no divided allegiance here. Any man who says he is an American, but something else also, isn't an American at all. We have room for but one flag, the American flag... We have room for but one language here, and that is the English language... and we have room for but one sole loyalty and that is a loyalty to the American people."Theodore Roosevelt-1907.

I am concerned for the security of our great nation; not so much because of any threat from without, but because of the insidious forces working from within." -- General Douglas MacArthur

Stoner  posted on  2017-03-28   11:31:19 ET  Reply   Trace   Private Reply  


#24. To: Tooconservative (#18)

"and the expansion of a debt that will probably never be paid down"

Gosh. That can't go on forever. So when they DO pay it down, how will they do that?

With taxes. So don't give me your bullshit about we're not paying for it.

misterwhite  posted on  2017-03-28   11:45:42 ET  Reply   Trace   Private Reply  


#25. To: misterwhite (#24)

So when they DO pay it down, how will they do that?

With taxes. So don't give me your bullshit about we're not paying for it.

I see you're mad at me for pointing out these people treat you like a chump.

They raided the Social Security funds and "borrowed" them, leaving you a pile of IOUs. You are now paying interest on that debt but the debt itself remains for you, your children, your grandchildren. They did the same with the Bush wars and 0bama wars and the entire military-industrial complex several times. You are paying the interest on those debts but you are not paying down the principal. And the same is true of the vast expansion of welfare programs in the 0bama years. 0bamaPhones, 0bamaFoodStamps (cash-convertible via debit cards), 0bamaCare, etc. And none of it was paid for. The federal debt was doubled and you are paying the interest on it but not the principal. That debt is your gift to your children and grandchildren.

Thanks, grandpa.

Tooconservative  posted on  2017-03-28   12:22:47 ET  Reply   Trace   Private Reply  


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