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NoCoPilot

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PostSubject: Re: Obamacare    Wed Jul 19, 2017 8:59 am

Politico wrote:
But the Trump administration could actively undermine the Affordable Care Act marketplaces or own them and work to improve them
Source
The New Yorker wrote:
To be clear, Obamacare is not exploding; it is not in a death spiral and, if the law is followed, is highly unlikely to fall into one. A death spiral occurs when the pool of people insured by a plan are especially unhealthy and use more than the expected amount of expensive health care. If that happens, the insurance provider raises premiums to cover the costs, healthier people drop out because coverage becomes too expensive, and costs rise even higher. This is negatively reinforcing: as healthy people drop out, the only people left in the pool need so much medical care that no company will cover them. That scenario can’t happen with Obamacare because the vast majority of those covered by the program—roughly eighty-five per cent—don’t pay for the increase in premium cost. Instead, they receive government subsidies, based on their income, that rise with the increase in premium costs. Since the insured don’t see the increase in cost, there is no reason to expect a death spiral in which rising costs scare healthy people away from the insurance pool. (Trump could instruct the I.R.S. not to enforce the penalty on those who opt not to buy insurance, which would reduce the number of participants; that wouldn’t produce a death spiral but would insure that the government has to pay larger subsidies.)

If President Trump really wants Obamacare to fail, he needs to take action to destroy it, and he does have a few tools available. Jonathan Gruber, who helped design the A.C.A., told me that his greatest fear is that President Trump will decide to abandon a second set of subsidies, known as cost-sharing reductions, which limits the amount that some people have to pay in out-of-pocket health expenses. These subsidies apply to about seven million Americans, or more than half of those covered either by the federal or the state insurance exchanges. While these subsidies are called for under the law, they were not explicitly appropriated by Congress, and Republicans in the House sued to prevent the Obama Administration from providing them. That suit is still ongoing, and President Trump could choose not to defend the A.C.A., allowing those subsidies to disappear. Many poor Americans would then have to pay more for their health care and for their insurance. The end of those subsidies would also remove a hundred billion dollars from the health-insurance market, a hit that Gruber believes would force several insurance companies to stop offering plans on the Obamacare exchanges and many counties to lose all of their insurance providers. “It’s the No. 1 risk,” he told me. “It could cause a huge collapse of the exchanges.”
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PostSubject: Re: Obamacare    Tue Sep 26, 2017 9:01 am

The Graham-Cassidy bill is officially dead, with Susan Collins announcing she will not vote for it. Sept 30 is the end of reconciliation, so Republicans lose the chance to pass anything with 50 votes. The Democrats are still trying to use it as a fundraising tool:
Robert Reich wrote:
Dear MoveOn member,

Imagine waking up just a few days from now, turning on the news, and feeling like you've been punched in the gut.

Imagine finding out that, in the dead of night, 50 Republicans (with help from Mike Pence) flipped just three Senate votes and passed the Graham-Cassidy Trumpcare bill—a bill that would take away health care from tens of millions of Americans, drive up insurance premiums, slash Medicaid funding by hundreds of billions of dollars, and eviscerate protections for pre-existing conditions.

That's a terrible thing to imagine—but could come true in just a matter of days.

Now imagine the alternative: The resistance—that includes you—mounts an all-hands-on-deck, 72-hour push to stop Trumpcare ... And together, we win!

Imagine tens of millions of Americans—including those actively fighting cancer or dealing with debilitating chronic conditions—celebrating getting to keep their health coverage. The resistance, once again, shows that we are powerful. Energized, we've set the stage to win a clean Dream Act, block the worst elements of Trump's "Robin Hood in reverse" tax plan, and build the groundwork and infrastructure that progressives need to take back power in 2018 and 2020, as well as setting the stage for a more proactive debate on truly expanding access to health care as a human right.

Republicans have never been this close to passing Trumpcare—to stop them, we need three Republicans to commit to voting against it, and that hasn't happened yet. Though momentum seems to be on our side, with Senator John McCain announcing his apparent opposition to the bill on Friday, this is still WAY too close for comfort. We have just days before a key procedural deadline to ensure we defeat this terrible bill, and a vote is expected as early as Wednesday.

What our future will look like is up to us—and how well we organize. Which is why I'm writing you to ask:

Will you support MoveOn's emergency 72-hour sprint to save health care for 32 million Americans? Click here to chip in $3 or whatever you can afford.

The latest version of Trumpcare is really bad—it's the worst one so far. The Center on Budget and Policy Priorities said that the bill is even "more radical" than the previous versions of Trumpcare.1 Insurance companies have come out against it, as has a national organization of Medicaid program directors, with includes members from the reddest of red states.

In short: The Graham-Cassidy bill is pretty much the worst piece of legislation that I've ever seen. And the polling shows that the bill is as unpopular as it deserves to be. Just 24% of Americans support the latest version of Trumpcare, while the Affordable Care Act is supported by 54%.

I could give you reason after reason why this latest version of Trumpcare shouldn't be considered. (Is tens of millions of Americans losing their health care reason enough? How about taking away protections for pre-existing conditions?)
Nobody talks about WHY the Republicans want to repeal Obamacare. However these bills they keep bringing to the floor aren't written by Republican congressmen -- they're written by the insurance industry and the pharmaceutical industry. They're not "developed in secret" as claimed in the news. They're delivered in big cardboard boxes by outside lobbyists. Republicans are being offered big campaign contributions to get behind an industry-friendly bill.

Which is exactly why Democrats are dreaming to think that Bernie Sanders' "Medicare For All" proposal has any chance of support. It's opposed by all-powerful lobbyists who would make sure any senator or representative who voted for it would be defeated in the next election.
Ben Winkler wrote:
Dear MoveOn member,

Two years ago, Bernie Sanders tried to create a Medicare for All single payer health care bill. It was supported by exactly zero other U.S. senators.

This week, he re-introduced the bill, and a third of the Democratic caucus is on board—including virtually every senator thought to be planning a run for president in 2020.

And it isn't just liberal Democrats from deep blue states getting on board. Joe Manchin of West Virginia—a state that Donald Trump carried by 42 points—says Medicare for All should be explored. Joe Manchin! The Democrat who once shot a bullet through a global warming bill in a campaign ad!

There's never been this much momentum for single payer, and we need to keep it going. Will you chip in $5 a month to help mobilize the ongoing grassroots support we need to make single payer a reality?

Yes, I'll chip in monthly.

No, I'm sorry, I can't make a monthly donation.

When President Obama was elected and began work on health care reform, single payer was dismissed as a pipe dream. That's why today's Bloomberg News headline reads, "Bernie Sanders is changing the Democratic Party."

But while we've made huge progress, some Democrats remain hesitant. We need to show these senators that there's support for Medicare for All in their states, and that the American people are ready to finally get the profit out of our health care system.

So here's the plan:

Building support from lawmakers. We'll advocate for Democratic senators and representatives—and even Republicans—to co-sponsor Bernie's Medicare for All bill or offer their own bills that guarantee health care as a fundamental right. Already, more than 100,000 MoveOn members have lent their support to Bernie's effort, and thousands made Senate phone lines ring off the hook, thanking progressive champs and encouraging the hold-outs to act.
Educating the public about Medicare for All. We'll do this with our in-house Video Lab team that has already produced videos on this issue that have been viewed millions of times, and through our spokespeople on cable television and MoveOn members who can talk to their own communities about this bill.
Ensuring that universal health care for all is a top electoral issue. In the 2018 midterms, we will hold Republicans accountable for trying to take away health care from tens of millions of Americans; and in the lead-up to 2020, we will encourage all candidates for Congress and the presidency to offer their own programs for quality coverage for every American.
Taking back the House in 2018—and the Senate and the White House in 2020. Simply capitalizing on outrage isn't enough; we must show that we can win with a positive agenda that has health care for all at its core.
Beating back attempts to take away our health care. While we're on the offense, we also have to protect what we have. With news that a new version of Trumpcare has just been announced, we need to make sure that Republicans can't push through devastating legislation that takes us backwards.

This is a sea change. Four years ago, the idea of a serious push for single payer was unthinkable. Now it's happening.

Will you chip in $5 a month to help keep the momentum going?
Lobbyists have an iron grip on Congress. The only way meaningful healthcare reform will ever pass -- and Obamacare was way too much of a giveaway to be the reform that is needed -- is if the decision is taken away from Congress or campaign finance reform passes first, making it illegal for lobbyists to make non-anonymous or targeted donations.

And I can't see the beneficiaries of such donations voting to ban them.
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PostSubject: Re: Obamacare    Thu Nov 16, 2017 3:21 pm

The Republican-passed House tax reform plan includes a poison pill to kill Obamacare, as the campaign donors have demanded.  It removes the individual mandate that expands the pool of the insured to include non-sick people.

Without that mandate premiums will rise for the rest of us catastrophically.

In fact, all the uncertainty in the exchange markets has caused my health insurer (2016-2017) to pull out of the market completely for 2018.  That leaves three options: a catastrophic coverage only that covers zero preventative care, prescription drug or yearly exams.  A full-featured insurance that clocks in at over $2600 per month.  And the one we chose, a crappy company (previously known as “Group Death” because you have to stay within their very limited network, and wait times to get in can be months) which is still $200/mo more than we were spending last year — with $5000 deductible before insurance picks up ANYTHING.

Thank you Paul Ryan.  Thank you Mitch McConnell.
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PostSubject: Re: Obamacare    Thu Nov 16, 2017 3:48 pm

You have my sympathy, NoCo. Even with Medicare, it is proving to be difficult to find a medical "insurance" company that will do anything at all for a reasonable price. Our Medicare Part B is going to cost us $6,500 per year (twice the norm) and it does fuck all.

Stupid Fucking Republicans.
Stupid Fucking "insurance" companies (the quotes are because in this country, we don't really have insurance companies; we have thieves in corporate garb).
Stupid fucking medical corporations who, in league with the "insurance" companies, kill or financially destroy millions of people every year.
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PostSubject: Re: Obamacare    Thu Nov 16, 2017 6:07 pm

Said it before, say it again. Americans are advertised to that there’s a pill for everything (even not eating right or exercising). Insurance companies are for-profit companies. If they pay out more than they take in, they won’t stay in business.

Make insurance optional, make it expensive, make it cover nothing.

Watch it die.

What will replace it? Big tax cuts for the wealthy. And the specter of people dying in the streets.

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PostSubject: Re: Obamacare    Wed Nov 22, 2017 1:44 pm

NoCoPilot wrote:
Insurance companies are for-profit companies.  If they pay out more than they take in, they won’t stay in business.

I may be wrong, but aren't Blue Cross and Blue Shield non-profit corporations? I know they used to be.
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PostSubject: Re: Obamacare    Wed Nov 22, 2017 2:54 pm

_Howard wrote:
I may be wrong, but aren't Blue Cross and Blue Shield non-profit corporations? I know they used to be.
"Non-profit" in their case means the profits made are returned to the members.  And the profits are huge.
Quote :
A nonprofit organization is one that does not earn profits for its owners. The money earned by a nonprofit organization is reinvested in the company to pursue its mission.
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I used to work for a Blue Shield affiliate.
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PostSubject: Re: Obamacare    Tue Nov 28, 2017 3:37 pm

Ever heard of IRMAA? That stands for Income-Related Monthly Adjustment Amount.

It can best be defined as a post hoc income tax.

For example, Medicare Part B, which is for doctor's vists, lab work, etc., is not covered by that Medicare deduction they take from your paycheck. Part B has a premium you must pay, which is $134 per month (per person) for most people.

Here's the surprise: Depending on the amount you earned in the year before you get Part B, you get to pay an IRMAA. Which for us will be ten cents less than the premium, or $133.90 per month (per person), effectively doubling the premium. The total cost to us for Part B will be much more than what we would pay for the same services without insurance.

It gets better. When you get Medicare Part D (the drug insurance), IRMAA can also raise her ugly head. Now, ALL Part D policies are private insurance. But the government still adds an IRMAA. Since I have to pay for another IRMAA, my premiums for Part D can more than double (depending on which insurance company I go with).

Even without IRMAA, the Plan D will cost me more in premiums and co-pays than the retail prices of the two common generic medications I take. Hundreds more a year.

But wait! There's more!

If you do not sign up for Part B and Part D when you should (and it can be difficult to determine exactly when that is if it isn't the day you turn 65), there is a penalty. For Part B, the premium is raised ten percent for every year (or part of a year) you go without it, For Part D, the premium is increased one percent per month that you go without it. These premium increases are permanent (well, as permanent as the insured person)
Interesting note: if you buy a COBRA when you  leave employment, the time which you have the COBRA does not count as you being insured, and the penalty clock is ticking.

We are looking into private insurance.
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