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Source: (consider it) Thread: The US and Health Care
Crœsos
Shipmate
# 238

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quote:
Originally posted by mdijon:
I had no idea. That seems odd to me since I have thought of US States like quasi-countries, and borrowing seems an absolute necessity to most Countries. Is it generally thought to be an odd anachronism in the States themselves that is just too difficult to fix or is it part of a political stand taken by some or other group?

States can (and do) borrow by issuing bonds, like the federal government. Their ability to do so is somewhat limited since they typically have to offer higher interest than the federal government does. The chief reason for this is that the individual states are forbidden from issuing their own currency. (Art. I, § 10 of the U.S. Constitution states, in part, that "No State shall . . . coin Money; emit Bills of Credit; . . .") As such their ability to repay those bonds is not as certain as the federal government, which has more monetary options at its disposal plus a section of the Fourteenth Amendment which forbids the feds from defaulting on their debts.

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Humani nil a me alienum puto

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mark_in_manchester

not waving, but...
# 15978

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quote:
As such their ability to repay those bonds is not as certain as the federal government, which has more monetary options at its disposal plus a section of the Fourteenth Amendment which forbids the feds from defaulting on their debts.
So if they print the money to pay them...they just have to watch out that internationally people don't lose confidence in the currency, which would generate 1930s Germany / Zimbabwe style inflation? (Sorry, I guess this is naive). Are there other issues?

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"We are punished by our sins, not for them" - Elbert Hubbard
(so good, I wanted to see it after my posts and not only after those of shipmate JBohn from whom I stole it)

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Crœsos
Shipmate
# 238

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quote:
Originally posted by mark_in_manchester:
quote:
Originally posted by Crœsos:
The chief reason for this is that the individual states are forbidden from issuing their own currency. (Art. I, § 10 of the U.S. Constitution states, in part, that "No State shall . . . coin Money; emit Bills of Credit; . . .") As such their ability to repay those bonds is not as certain as the federal government, which has more monetary options at its disposal plus a section of the Fourteenth Amendment which forbids the feds from defaulting on their debts.

So if they print the money to pay them...they just have to watch out that internationally people don't lose confidence in the currency, which would generate 1930s Germany / Zimbabwe style inflation? (Sorry, I guess this is naive). Are there other issues?
No, if the states start printing their own money they have to watch out for the feds coming down hard on them for unconstitutional actions, possibly including sedition.

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Humani nil a me alienum puto

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mark_in_manchester

not waving, but...
# 15978

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Sorry, I was following a train of thought where feds were printing. But this is a tangent, and I guess I need an economics book for dummies.

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"We are punished by our sins, not for them" - Elbert Hubbard
(so good, I wanted to see it after my posts and not only after those of shipmate JBohn from whom I stole it)

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Ohher
Shipmate
# 18607

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quote:
Originally posted by Crœsos:
. . . <SNIP> if the states start printing their own money they have to watch out for the feds coming down hard on them for unconstitutional actions, possibly including sedition.

In the current political situation (arguably already at least semi-unconstitutional and semi-seditious, what with 44.3's freely profiting from his Presidency and Russians "guiding" our elections and foreign policies, etc.), one wonders whether, if Republican governors should undertake this step, anyone would come after them at all?

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From the Land of the Native American Brave and the Home of the Buy-One-Get-One-Free

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Brenda Clough
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# 18061

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From the POST, a blistering evisceration of the health legislation.

The money quote: "Now, normally they like to say that this would make the economy grow so much faster that everyone else would be better off, too, but they're not even bothering with that pretense today. Instead, they're just trying to give wealthy investors the biggest tax cut possible by having it apply to last year as well. Perhaps the idea is that that will incentivize people to invent time machines so they can create more jobs in the past.
It's an inspiring piece of legislation for everyone who thought Robin Hood was picking on the wrong people."

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Belle Ringer
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# 13379

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That's the point. Its not a bill about health care. Its about taxes, giving lots of money to the rich.
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Brenda Clough
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# 18061

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This is cheering (and a free click): People are talking and being engaged. Lots and lots of people.

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Amanda B. Reckondwythe

Dressed for Church
# 5521

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Since Cory Booker is mentioned in the link you provided, I'll mention this here although it really belongs on another thread.

If the Democrats have a rising star at all (and I've looked long and hard for one and have come away disappointed), it just may be Cory Booker. Of impeccable birth credentials (born in Washington, DC, for Pete's sake), well educated, well spoken, young and good looking, clean living -- and not afraid to speak his mind. He bears watching.

[ 27. June 2017, 16:25: Message edited by: Amanda B. Reckondwythe ]

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"We're not in Wonderland anymore, Alice." – Charles Manson

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Brenda Clough
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# 18061

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They are talking about going down every day this week at 2pm to the Capitol, to protest. Alas, my knee injury is going to prevent my participating. (I have a great sign too, shaped like a tombstone.)

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Science fiction and fantasy writer with a Patreon page

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Crœsos
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# 238

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quote:
Originally posted by Belle Ringer:
That's the point. Its not a bill about health care. Its about taxes, giving lots of money to the rich.

A wealthcare bill?

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Humani nil a me alienum puto

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Ohher
Shipmate
# 18607

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According to the Washington Post, the wealthcare bill vote is now delayed until after the July 4 recess.

Protest works.

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From the Land of the Native American Brave and the Home of the Buy-One-Get-One-Free

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Brenda Clough
Shipmate
# 18061

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Remember the house version, which went into abeyance for a short time until everyone relaxed and then was suddenly rammed through.

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Brenda Clough
Shipmate
# 18061

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For those following along at home, here is a nice organized chart (and free!) delineating the winners and losers of the current legislation.

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Ian Climacus

Liturgical Slattern
# 944

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May I go off course for a second...

We have a programme on our national broadcaster called "Planet America" which looks, with a dash of humour, at what is going on in American politics.

They investigated the ACA and had interviews with 2 people on it, and it did seem like it was facing some issues with very large premium increases and insurers pulling out of counties, leaving some with no options.

I am *not* saying it therefore needs to go, but surely something needs to be done. Was the ACA some form of compromise that Obama could get through the houses, and the best he could do? Were there plans for further reform?

I can see the Republicans are headed down a worse path...just curious about what you've got now.

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Ian Climacus

Liturgical Slattern
# 944

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quote:
Originally posted by Brenda Clough:
For those following along at home, here is a nice organized chart (and free!) delineating the winners and losers of the current legislation.

Interesting. May I ask some questions? I alert you to the fact my depression is really giving me the shits today so excuse any stupid questions or phrases that don't seem right.

House bill:
quote:
A one-year block will be placed on federal reimbursements for care provided by Planned Parenthood
Why one year? Any by "block" do they mean no funding? No payment from the state to clinics?

On mental health, House Bill:

quote:
States could request waivers to opt out of requiring essential health benefits.
So states can tell providers to not offer "essential" benefits?
I understand paying more for some...I pay more to get psychiatric hospital stays included in my private hospital coverage, but not offering a choice seems very worrying.

House bill:
quote:
States can get permission to let insurers charge more for some pre-existing conditions and to exclude some people altogether.
Very worrying. I know I am excluded from income insurance if I have to leave work due to mental illness because of my history, but applying this to health seems terrible. I realise someone with heart or liver problems will cost the insurer more, but health coverage should surely cover all.
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Golden Key
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# 1468

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Ian--

AFAIK, "yes" is the answer to the questions at the end of your post. It was the best that could be done, at the time. I cringed when I first heard that participation would be mandatory, because Americans don't like to be told what to do--especially by the gov't. And the punishing fines for non-compliance sure didn't help.

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Blessed Gator, pray for us!
--"Oh bat bladders, do you have to bring common sense into this?"--Dragon, "Jane & the Dragon"
--"I'm not giving up--and neither should you." --SNL

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cliffdweller
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# 13338

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quote:
Originally posted by Golden Key:
Ian--

AFAIK, "yes" is the answer to the questions at the end of your post. It was the best that could be done, at the time. I cringed when I first heard that participation would be mandatory, because Americans don't like to be told what to do--especially by the gov't. And the punishing fines for non-compliance sure didn't help.

But of course there is no way for it to work financially without mandatory participation. And all sorts of other programs work precisely like that-- social security is not optional, paying taxes toward fire and police protection is not optional. But yes, getting past the mandatory part of it is a huge part of the problem.

The premium increases really didn't have anything to do with ACA, except the fact that ACA didn't go far enough. Premiums went up for the exact reason they have always gone up-- because they can. ACA didn't "make" them go up, but it did allow them to. ACA primarily fixed the access problem-- making it possible for everyone to get health insurance-- w/o addressing the cost. The best way to do that is some version of single-payer-- even more controversial than universal health care. Unfortunately, that doesn't seem to be the way the GOP is going.

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"Here is the world. Beautiful and terrible things will happen. Don't be afraid." -Frederick Buechner

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Brenda Clough
Shipmate
# 18061

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Obama himself likened the ACA to your starter home. It was the best you could afford at the time. It is too small, in a less than charming area of town, and the kitchen is sadly lacking. The roof leaks and it needs some work. Nevertheless, it gets your foot into the door. The plan is for you to live in it for a while, amass your resources, and then move on up into a better house, hopefully before your children become so large that they drive you crazy and before the roof entire blows off into the street.
The ACA is acknowledged to be imperfect. The hope was to improve it. The intransigence of the GOP (not to mention their active malevolence sabotaging it) has made this impossible. But it is still better than what we had before.

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Science fiction and fantasy writer with a Patreon page

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Brenda Clough
Shipmate
# 18061

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Planned Parenthood is a separate whipping boy for the GOP. Keep in mind that the Hyde Act bars the government from funding abortions. PP truthfully affirms this, and supplies health and reproductive services to both genders across the nation. (The PP president went into their San Diego clinic earlier this year, and was astonished to see the waiting room full of men. Then she learned that it was Vasectomy Day, one of their most popular offerings. I envision it as an assembly line sort of operation...)
Nevertheless, the anti-abortion people have been demonizing it for years, and at this point it is clear that there is no reasoning with them.
I believe that the unspoken point of contention is not babies or abortion, but sex. You had, or intend to have, sex. BAD BAD BAD. This must be stopped. We need to control you and your sex, you slut. If you insist on having sex then you deserve all the bad things that can happen to you, and we will see to it that your misery is maximized.

[ 01. July 2017, 15:36: Message edited by: Brenda Clough ]

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cliffdweller
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# 13338

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spot on, Brenda (both posts).

Of all the ridiculous hypocrisy of the GOP, perhaps the most outrageous is the way they feign this "pro-life" position and get teary-eyed about "those precious babies"-- all the while putting forth the most cruelly pro-death legislation imaginable. And yes, babies-- both born and unborn-- will be among those lives lost due to the ACA repeal.

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"Here is the world. Beautiful and terrible things will happen. Don't be afraid." -Frederick Buechner

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Brenda Clough
Shipmate
# 18061

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The moment that baby is born it is, by their design, without health care. The mother meanwhile had her pregnancy designated a pre-existing condition, and probably got no prenatal care. In this country a problem-free delivery probably cost her $20K.
So -- it's not the mother, not the fetus, not the infant. What is left, that they are so revering and protecting? Clearly the act itself, the p in the v that led to all this.

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Ian Climacus

Liturgical Slattern
# 944

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Thanks for the explanations, all.
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sabine
Shipmate
# 3861

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bumping. . .to report that the US Senate just voted 50-50 to bring forth the odious Repeal and Replace health care bill to the floor. Tie broken in favor of the ayes by Mike Pence (who always rates a [Projectile] from me).

sabine

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"Hunger looks like the man that hunger is killing." Eduardo Galeano

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sabine
Shipmate
# 3861

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Here is a link to the action, which is just a vote to debate the bill on the floor, not a vote to pass the bill

sabine

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"Hunger looks like the man that hunger is killing." Eduardo Galeano

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Brenda Clough
Shipmate
# 18061

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I have many friends who are thinking of emigrating.

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Science fiction and fantasy writer with a Patreon page

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sabine
Shipmate
# 3861

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A while back I typed "How do I..." into Google, and before I could type another word, the option popped up: "emigrate to Canada." Guess there have been a few searches on the subject.
sabine

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"Hunger looks like the man that hunger is killing." Eduardo Galeano

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Brenda Clough
Shipmate
# 18061

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A blog post I wrote on the subject three years ago.

And a follow-up, written last November.

This is now become a country that has set its face against the poor, the weak, and the old. We long ago of course lost pity for the prisoner and the outcast. Christ's gospel is dead here. The US is no longer a Christian nation.

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Golden Key
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# 1468

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Ummm, IMHO and that of many others, it never was a Christian nation--nor was it meant to be.

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Blessed Gator, pray for us!
--"Oh bat bladders, do you have to bring common sense into this?"--Dragon, "Jane & the Dragon"
--"I'm not giving up--and neither should you." --SNL

Posts: 17647 | From: Chilling out in an undisclosed, sincere pumpkin patch. | Registered: Oct 2001  |  IP: Logged
no prophet's flag is set so...

Proceed to see sea
# 15560

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Yes slavery doesn't go well with Christianity. Southern Baptist and related racist organizations were't either. Lurched toward later. Lurched firmly away later-er. Oxymoron to consider reallt that any country is.

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Maybe I should stop to consider that I'm not worthy of an epiphany and just take what life has to offer
(formerly was just "no prophet") \_(ツ)_/

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Brenda Clough
Shipmate
# 18061

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You would never know it, from the subset of Christians who loudly insist that it was Christian from its founding (never mind all those Deists, and you had better never read anything that Washington or Jefferson wrote). This frothing anxiety to impose their own version of religion, via legislation, onto the populace, springs from that belief.
I would mind less if their strictures actually had anything to do with what Jesus advocated. But no, their minds are all firmly fixed in their crotches. For example, today's POST headline: "Trump Calls for Ban on Transgender People Serving in Military."

[ 26. July 2017, 13:57: Message edited by: Brenda Clough ]

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Penny S
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# 14768

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So what does he want us not to look at this time?
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Hedgehog

Ship's Shortstop
# 14125

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USA Today today is reporting:
quote:
The Senate voted Wednesday to defeat a bill that would have repealed Obamacare within two years without any immediate plan to replace the sweeping health care law.

Senators voted 45-55 in favor of the bill, falling six votes short of the 51 needed to pass it. Seven Republicans voted against it: John McCain of Arizona, Dean Heller of Nevada, Susan Collins of Maine, Rob Portman of Ohio, Lamar Alexander of Tennessee, Lisa Murkowski of Alaska and Shelley Moore Capito of West Virginia.



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"We must regain the conviction that we need one another, that we have a shared responsibility for others and the world, and that being good and decent are worth it."--Pope Francis, Laudato Si'

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Brenda Clough
Shipmate
# 18061

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A detailed and thoughtful analysis of why John McCain failed so badly yesterday.

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RuthW

liberal "peace first" hankie squeezer
# 13

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If anyone wants to follow along with all the votes, use one of your 10 free monthly clicks on the Washington Post's tracking. So far:
quote:
Senate plan with Cruz and Portman amendments
Vote failed 43-57 (required 60 votes)

Repeal and delay with Paul amendment
Vote failed 45-55 (required 50 votes)

Return to committee process
Vote failed 48-52 (required 50 votes)

The first two failed because the Republicans couldn't agree. The third was a proposal put forward by the Democrats that failed; this was a purely party-line vote.

Next up tomorrow we'll probably see a vote on "skinny repeal":
quote:
From the Post:
  • Repeal the individual and employer mandates, as well as the taxes on medical device companies
  • Leave the Medicaid expansion, subsidies, and marketplace regulations such as preexisting conditions protections in place
The CBO has not scored the plan as a whole, but pieces have been scored in the past. Eliminating the individual mandate, for instance, would cause 15 million more people to become uninsured over the decade.
Eliminating the mandates will massively destabilize the individual market. Insurance companies will still be forced to cover anyone who buys insurance, but young and/or healthy people will exit the market, insurance premiums will go up, more people will exit the market, and the whole thing could completely come to pieces. This is the worst option that's been put forward. Naturally it has the greatest chance of passing. [Roll Eyes] [Mad]
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Brenda Clough
Shipmate
# 18061

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Your third option "return to committee" was in fact advocated by John McCain in yesterday's speech. Alas, he didn't actually, you know, vote for it.

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RuthW

liberal "peace first" hankie squeezer
# 13

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Because he doesn't actually believe all that bullshit about "the world's greatest deliberate body" and "regular order." He put party before country, just like the rest of the hyenas.
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Dave W.
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# 8765

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quote:
Originally posted by RuthW:
This [skinny repeal] is the worst option that's been put forward. Naturally it has the greatest chance of passing. [Roll Eyes] [Mad]

I'm not sure it is the worst one. I think the individual market is doomed anyway; even if Congress gave up its attacks on ACA entirely, Trump and Price have enough discretion (e.g. stopping cost sharing reduction payments) to destabilize it. The skinny repeal at least doesn't eliminate Medicaid expansion or cut its future spending, and although the individual market seems to draw more attention, Medicaid was where the ACA achieved most of its coverage increases and where the Republican plans would do the most damage.

But from what I've read, skinny repeal isn't meant to be a final proposal anyway; it's just a way of getting 51 votes so McConnell, Ryan, and crew can cook up the real thing in the House-Senate conference committee. At that point they can switch their vote-cadging spiel from "don't worry that this is terrible policy, someone will fix it later" to "this is your last chance - vote for this horrific policy or be forever branded an Obamacare-loving traitor."

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Dave W.
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quote:
Originally posted by RuthW:
Because he doesn't actually believe all that bullshit about "the world's greatest deliberate body" and "regular order." He put party before country, just like the rest of the hyenas.

John McCain's just treating us to an encore performance of his one-man show, "John McCain's Straight Talk Express", starring a man who would have you believe that he really thought Sarah Palin was a good choice for Vice President.
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Golden Key
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# 1468

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I wonder if Joe Lieberman has forgiven him for that? He was NOT a happy camper about Sarah being chosen, rather than him.

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RuthW

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quote:
Originally posted by Dave W.:
The skinny repeal at least doesn't eliminate Medicaid expansion or cut its future spending, and although the individual market seems to draw more attention, Medicaid was where the ACA achieved most of its coverage increases and where the Republican plans would do the most damage.

Medicaid is where the ACA has done the most good for people, yes, but if the individual market is destabilized, that could screw things up for a lot of people. From Vox:
quote:
“We just heard from the nonpartisan Congressional Budget Office that under such a plan, as reported in the press, 16 million Americans would lose their health insurance and millions more would pay a 20 percent increase in their premiums,” Sen. Chuck Schumer (D-NY) said on the Senate floor.
Screwing up the individual market is likely to have a knock-on effect on the insurance market as a whole.

quote:
But from what I've read, skinny repeal isn't meant to be a final proposal anyway; it's just a way of getting 51 votes so McConnell, Ryan, and crew can cook up the real thing in the House-Senate conference committee. At that point they can switch their vote-cadging spiel from "don't worry that this is terrible policy, someone will fix it later" to "this is your last chance - vote for this horrific policy or be forever branded an Obamacare-loving traitor."
Good point. And this is very scary. But the Republicans could still lose at this point -- Collins, Murkowski and Heller being the most likely "no" votes, I'm guessing. Collins and Murkowski have voted independently before, and Nevada's Gov. Sandoval has told Sen. Heller to vote "no." My friend who is a Nevada state employee assures me that Heller will do what Sandoval tells him to do, and that Heller doesn't dare piss off the culinary union either. So -- fingers crossed.
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sabine
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John McCain was the third person (with audible gasps from the Senate) no vote to kill the skinny repeal. All current versions are dead now.

A link if you want to hear the gasps

sabine

[ 28. July 2017, 14:44: Message edited by: sabine ]

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cliffdweller
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I always love it when McCain 1.0 shows up. Praying he goes out strong, leaving a worthy legacy.

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Crœsos
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McCain could have achieved the same result by simply staying in the hospital in Arizona, but he's an incorrigible drama queen so we had last night's / this morning's moment of drama. Still, McCain (finally) came through on this one so I'm willing to take back 30% of the bad things I've ever said about him.

In descending order of importance in the preservation of the Affordable Care Act (at least for the moment), I'd rank the various players thusly:

  1. The American people, who spent a lot of time calling Congress and demonstrating in the streets. Nothing stiffens the spines of legislators like knowing people back home will definitely hold you accountable on this one.
    -
  2. Congressional Democrats, who never wavered in preserving a signature accomplishment of their party. It takes a lot of party discipline to resist the beltway media's promise of accolades to reward bipartisanship simply for the sake of bipartisanship (and policy outcomes be damned).
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  3. Senators Collins and Murkowski, who were willing to stand up for their constituents' interests from the start, against a lot of push-back from their fellow Republicans.
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  4. John McCain, who seems to have felt that "someone should do something about this" and finally realized that he was "someone" who had a vote in the U.S. Senate.


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Humani nil a me alienum puto

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Brenda Clough
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Let us not omit Senator Mazie Hirono (D-Hawaii), diagnosed with stage 4 liver cancer three months ago, who hauled herself to the Senate floor to vote NO, without any fanfare or backslapping from the media. So there's three recipients of the Iron Ovary right there.

[ 28. July 2017, 18:26: Message edited by: Brenda Clough ]

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Science fiction and fantasy writer with a Patreon page

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Crœsos
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And so we now move on to the next Republican plan to get rid of the Affordable Care Act: sabotage by the executive branch.

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Humani nil a me alienum puto

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Hedgehog

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quote:
Originally posted by Crœsos:
And so we now move on to the next Republican plan to get rid of the Affordable Care Act: sabotage by the executive branch.

Why should it be any different than the rest of the country, being sabotaged by the Russian Flunkie in the Executive Branch right, left and center?*

*Although only the right doesn't realize it.

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"We must regain the conviction that we need one another, that we have a shared responsibility for others and the world, and that being good and decent are worth it."--Pope Francis, Laudato Si'

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lilBuddha
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quote:
Originally posted by Crœsos:
And so we now move on to the next Republican plan to get rid of the Affordable Care Act: sabotage by the executive branch.

I think that link qualifies for a two link seperation. My mobile feels soiled, now.

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If it's not here soon, I might be done
No it won't be too soon 'til I say goodnight moon

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Brenda Clough
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At this point, after all the current events, health care is now solely owned by the GOP. Anything bad that happens to the system can no longer be blamed upon Hillary or Obama (whom it is customary to blame for everything, including the Battle of Hastings and the check-engine light coming on in your car). They own it, solely, and failure will redound unpleasantly upon them at the voting booth. In other words, Li'l Donny can fulminate, but it is possible that the natural ass-covering tendency of politicians will save us.

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Ohher
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quote:
Originally posted by Brenda Clough:
Let us not omit Senator Mazie Hirono (D-Hawaii), diagnosed with stage 4 liver cancer three months ago, who hauled herself to the Senate floor to vote NO, without any fanfare or backslapping from the media. So there's three recipients of the Iron Ovary right there.

Ah, didn't you get the memo? Sen. Hirono is female, and therefore Need Not Apply for media fanfare and backslapping. Nor was sexism a factor in any way, shape, or form in the Clinton defeat.

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From the Land of the Native American Brave and the Home of the Buy-One-Get-One-Free

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