Bacon's Rebellion

Democracy Thrives in Sunlight

The Obamacare Death Spiral Proceeds as Predicted

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by

James A. Bacon
in

Who knows whether or not Republicans will get their repeal-and-replace of Affordable Care Act through Congress. From the commentary I’ve seen (mainly on “Morning Joe”), the odds seem remote that the Senate will approve whatever the House of Representatives sends their way. In the meantime, we are left with the Obama state exchanges.

The picture just turned more ominous here in Virginia. Innovation Health, which health insurer Aetna created through a joint venture with Inova in 2012, is dropping out of the Virginia market. In addition, United Health has declined to file with Virginia’s insurance department to offer any policies next year, reports CNN Money.

That leaves six insurers remaining, but 27 counties will have only one choice in 2018.

The death spiral is corkscrewing away. Less competition means higher prices. Higher prices drive healthier people out of the market. A higher percentage of sick people runs up costs. Insurers raise rates or drop out. Less competition means higher prices….

There’s not much we can do here in Virginia to affect the outcome of Congressional debate. But there is plenty we can do to make health care more affordable, improve outcomes, and to bring price transparency to the health care system. If we want to make health care coverage affordable for Virginians, lawmakers should focus on ways to improve productivity and innovation. I know I sound like a broken record… broken record… broken record… So I’ll leave it at that.

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23 responses to “The Obamacare Death Spiral Proceeds as Predicted”

  1. TooManyTaxes Avatar
    TooManyTaxes

    Iowa is down to one insurer in 94 of its 99 counties. The rest have two. So much for “If you like your insurance or doctor, you can keep it or him/her.” Premiums are skyrocketing as are deductibles for those who don’t qualify for subsidies.

  2. LarrytheG Avatar
    LarrytheG

    Yes – if you get rid of the mandate to have insurance and the taxes to pay for everyone have access to insurance with no denial of pre-existing and no annual and lifetime caps – then insurance companies will not go broke to offer those things that will not be paid for.

    The country has to decide if everyone is going to truly have guaranteed access to health care or some will and others will not.

    And no secret many who currently have insurance – whether it’s employer-provided or Medicare will vote to deny insurance to others.

    But last I heard – the relaxation of denial of pre-existing conditions and annual/lifetime caps will also extend to employer-provided and with Mr. Trump in charge of the govt now – I’m sure he’ll go along with that so that
    even govt employees and retirees insurance companies will be able to deny pre-existing (or charge a lot more) .. and re-institute annual and lifetime caps.

    Perhaps if that happens to people who get employer-provided – they’ll not be as smug about who’s got and who does not. Eh?

    You will now be able to keep your Doctor! unless of course you have a pre-existing condition or have exceeded your annual/lifetime caps – then it will be up to you to keep your doctor not the insurance company!

    Who knew insurance was this hard!

    here’s an interesting chart:

    https://upload.wikimedia.org/wikipedia/commons/d/d6/Life_expectancy_vs_healthcare_spending.jpg

  3. Kosciuszko Avatar
    Kosciuszko

    The reason the insurance markets are failing is because Congressional Republicans have refused to fund the insurance market subsidies outlined in the ACA.

    http://www.salon.com/2017/03/22/how-republicans-quietly-sabotaged-obamacare-long-before-trump-came-into-office_partner/

    1. James A. Bacon Avatar
      James A. Bacon

      I don’t pretend to be an expert on Obamacare, but my recollection is that those “risk corridor” subsidies were designed in the original legislation to expire. Rubio might have accelerated the phase-out, but they were conceived as a temporary measure to help insurance companies through a transition period.

      1. Kosciuszko Avatar
        Kosciuszko

        I don’t claim to be an expert either, but trusting the article:

        “To get the insurance companies to go along with this danger of losing money, the ACA promised to make them whole for any losses in any of the first decade’s years.”

        So yes, Rubio accelerated this phase-out from the original legislation.

  4. TooManyTaxes Avatar
    TooManyTaxes

    According to CNBC, “But let’s call a time out here and get a handle on the actual number of Americans with pre-existing conditions who could not get insurance coverage prior to Obamacare. Remember that Medicare, Medicaid, and employer-based insurance plans were always barred from rejecting people with existing conditions from their plans. We’re only talking about people who do not work for companies that provide health insurance who are not poor enough for Medicaid and not old enough for Medicare. Obamacare set up a special program called the Pre-Existing Insurance Program as a bridge until Obamacare’s insurance regulations took effect in 2014. But during that period, only 114,000 people signed up for that program. So much for fixing a problem supposedly affecting millions of Americans. Many health experts have noted that the cost of covering these people wouldn’t be cheap, but it would be a drop in the bucket compared to the ACA’s overall costs.” http://www.cnbc.com/2017/05/04/the-gop-is-giving-in-to-fear-on-health-care-reform-commentary.html

    So we are talking at most a few hundred thousand people at risk. That can be addressed.

    1. djrippert Avatar
      djrippert

      You’re on the right track. Providing coverage for people with pre-existing conditions is a good aspect of Obamacare. However, like all gub’mint programs, it had to be expanded to become another brick in the socialist wall. And, of course, all the vested interests had to be served. Remember when the Obamacare advocates claimed they were going to keep those greedy insurance companies in check? Aetna’s stock price has risen from $32 a share to $140 a share during the Obamacare era. All of which should take us back to a certain Obama veto of a bi-partisan bill passed by Congress to limit former president’s pensions if the former president makes more than $400,000 per year. Passed by Congress, vetoed by Obama. Then, just this week Dear Leader made $400,000 – not in a year but in a day. Doing what? Giving a speech to Wall Street interests. I guess it’s a thank you gift for failing to prosecute any bankers after the meltdown of 2008. What a greasy, greedy, two faced scam artist!

  5. LarrytheG Avatar
    LarrytheG

    @TMT – do you believe only a few hundred thousand people have pre-existing conditions?

    and that’s the reason the ACA “fails” because of a few hundred thousand people with pre-existing conditions

    and employer-provided and Medicare which does the same thing – not allow denial of pre-existing don’t have the problem the ACA has?

    and why would you advocate for a system where some folks get insurance and others not and the only difference is the fact the govt would require employer provided and Medicare to cover but not other insurance?

    does that make any sense that a few hundred thousand killed the ACA but millions with pre-existing did not kill employer-provided or Medicare?

    1. TooManyTaxes Avatar
      TooManyTaxes

      Larry, 114,000 people signed up in for the special program offered by the Obama administration for people with preexisting conditions not covered by employer-provided insurance, Medicare or Medicaid. While I would not say those were the only people affected, it’s a damn far cry from the millions and millions that whiny Democrats are crying about. Don’t you think that more people would have signed up if it the people needing help were in the millions and millions? I’d say once more the progressives are lying through their teeth.

      The AHCA is a piece of you know what. It didn’t reduce premiums, while preserving choice of doctors. It didn’t result in robust competition among insurance companies. They are loosing hundreds of millions. And because of the Democrats’ identity politics, we make young people buy expensive policies they don’t want or need. But what can we expect from a plan created by Washington insiders and lobbyists?

      Why not offer young people options that offer more limited coverage for lesser premiums so that they start the habit of carrying insurance? They will buy more robust plans as they age. But Obamacare depended on screwing young people and others so that the Great One could give free things to the “downtrodden classes.”

      1. LarrytheG Avatar
        LarrytheG

        @TMT – not sure what special program you are referring to but most estimates of the total number of people in the country with pre-existing conditions – who WOULD BE affected by any rule that allows insurance companies to deny cover – those number in the millions –

        and the question is – do you think insurance companies should be able to deny coverage to ANYONE who has a preexisting condition as a way to keep down costs for others?

        that’s the dilemma.. right?

        obamacare no more “screws” young people than people being required to pay FICA taxes that go into SS and Medicare Part A -when they are young so that when they get older and need benefits – they have them.

        insurance works the same way. When you pay for auto insurance and don’t have a wreck -you ARE paying for people who DO have a wreck. That’s the way insurance ‘works”.

        You say young people are screwed under ObamaCare.

        Do you have employer-provided insurance TMT? If you do – you’ll find that young people on employer-provided pay the SAME RATES as older people.

        Now my question to you is this. If you have that on your own employer-provided why is it wrong for Obamacare and not for you?

        1. TooManyTaxes Avatar
          TooManyTaxes

          Larry, I’m covered through my wife on the federal employees program. It’s part of her compensation. Earlier when I worked for a big company, she was covered through me. It was part of my compensation.

          And “yes” you are correct that the employee premiums are the same irrespective of age. But what you are missing are the market factors. When an employee gets subsidized medical insurance as part of compensation, the subsidy amount makes the employee’s premium payment worth while irrespective of age. Effectively, the employer’s contribution covers the bulk of any age subsidy. In other words, the young employee’s premium is much smaller than any non-employer paid premium in the market.

          It’s very different in non-employer paid insurance markets without big subsidies. Under the AHCA, younger people are required to pay higher-than-their-predicted cost premiums to subsidize older and sicker people. The subsidy comes largely out of their pockets. And as we’ve seen many younger people simply refuse to pay the high subsidies by not buying insurance.

          My point is that, if the federal or state government was able to allow younger people to purchase less comprehensive insurance at a lower price, while they would not be providing big subsidies to older and sicker people, younger people would be buying insurance. And as they age they will most likely purchase more and more at a younger age than under the present system where the Democrats viewed younger people as a cash cow. But that’s how Democrats view most working people – as cash cows to fund programs that buy votes.

          What needs to be done is to drive out costs. Use more telemedicine. Allow more physicians’ assistants and nurse practioners. Go to no-fault compensation for non-gross negligence events. Require big pharma to sell prescription drugs at the lowest price offered in any OECD country. Promote more exercise programs.

  6. Acbar Avatar
    Acbar

    “The country has to decide if everyone is going to truly have guaranteed access to health care or some will and others will not.” That’s the moral issue in a nutshell.

    But the economic debate, once you get past that, is about pooling. Removing anyone with a pre-existing condition (as determined by the insurer) from the general risk pool into a special high risk pool does two things:. It raises the rates for those “high risk” insureds (depending on how sick they are, the high risk rate could be many times higher than a single ” common” pool for everyone), and, it lowers rates for everyone else. The idea that high risk insurance in the high-risk pool will cost no more for those affected than the general rate they pay today is absurd.

    But, Republicans say, they’ve included $6 billion to subsidize the extra cost of the high risk pool. That offends me, on two grounds: first, it is intended to induce States to get rid of the pre-existing condition ban, but who knows how long it will be available or how adequate it will be while it lasts; and second, it continues the awful practice of offering different federal economic treatment people in different States by, in effect, penalizing those States economically that DON’T elect to end the pre-existing condition ban.

    And then there’s the Medicaid rollback. This says it all: http://www.newyorker.com/humor/borowitz-report/trump-supporters-celebrate-imminent-loss-of-their-health-insurance

    1. TooManyTaxes Avatar
      TooManyTaxes

      Acbar – you raise the point that the $6 billion subsidy could go away. Isn’t that very same argument conservatives in Virginia make about the federal money “promised” to pay for the Medicaid expansion? Federal money can go away.

      These comments (all of ours) raise the issue of moral beliefs. But they beg the question of whose moral beliefs and for what issues. We see people raising moral issues about health care and illegal immigration, but, at the same time, arguments that moral issues about abortion, gay marriage, etc. should not be raised. I’m fine personally with a woman’s choice on abortion issues and civil marriage for gay people. But I’ve observed arguments that taxpayers should fund abortion irrespective of their beliefs and that all hospitals, including religious ones, must offer abortion services. Similarly, I see arguments that people must perform personal services associated with gay marriages or accept self-proclaimed transgender people in locker rooms. Moral objections are often viewed as unacceptable and even bigoted. Don’t we have a double standard on personal morality in the public arena? Maybe it’s time to bury moral arguments on health care.

  7. LarrytheG Avatar
    LarrytheG

    Re: ” The idea that high risk insurance in the high-risk pool will cost no more for those affected than the general rate they pay today is absurd.”

    yep.

    and in addition to that , WHO is going to PAY to subsidize high risk pools?

    isn’t it the same folks who have non-high risk insurance? i.e. taxpayers?

    so the money has to come from somewhere.. either from taxpayers outside of insurance pools or from everyone inside of insurance pools.

    so it boils down to essentially this – do WE want people with high health care costs included in the standard insurance pools where we all pay higher premiums to offset those costs …

    OR… do we not want to do that but instead we’ll pay higher taxes to subsidize high risk pools in addition to our own insurance costs?

    The ONE THING this debate IS doing – it’s forcing some people to think about the issue itself a bit more than just the politics… emphasis on “some people”.

    What ALL of us ought to be in favor of – is something that applies to all of us equally – that we do not have a system that discriminates against some and favors others – for no other reason other than stupid ideas about who “deserves” employer-provided protections and who does not. EVERYONE should get the same protections …or not.. then we accept the costs of that decision.

    1. TooManyTaxes Avatar
      TooManyTaxes

      “EVERYONE should get the same protections.” I submit that people accept this only in concept. There is no consensus in America that people have the rights to the same and only the same health care benefits to the extent people are willing to give up their “excess” to fund others’ “lack.” There is strong public opposition to paying a tax on Cadillac plans, and I submit few would give up their own tax free status to fund health care for others, much less give up some coverage to fund coverage for others. Look at labor unions, generally viewed as on the vanguard of liberal politics. They strongly oppose the Cadillac tax or any pullback from current benefits.

      Absent people willingly giving up their “excess,” we, as a society, are not going to accept the costs Larry wants society to bear.

  8. LarrytheG Avatar
    LarrytheG

    TMT – what I am advocating for is EQUAL TREATMENT UNDER THE LAW.

    whatever the govt decides to do – all of us should be treated equally and none of us discriminated against on the law and the rules.

    In other words if you are going to have certain govt protections under employer-provided insurance – others should have the same protections for the insurance they buy.

    The irony here is that you oppose young people who don’t have employer-provided paying the same price for insurance as older yet under your own employer-provided plan – that’s exactly the way it works.

    that’s called community rating and by law – any employer-provided insurance cannot charge more for older subscribers than younger.

    Everyone in the same class pays the same premium.

    why would you accept that rule under your own employer-provided – and probably benefit from it if you are older and then oppose that same rule for others who work and have to buy insurance?

    what I am advocating is that you and I are subject to the same rules… equal treatment.

    If you benefit from lower rates from your employer-provided plan because younger folks pay the same as you do for insurance – why would you oppose others being treated the same way?

    1. TooManyTaxes Avatar
      TooManyTaxes

      Larry the Constitution requires similar treatment under the law only for those who are similarly situated. That means treating all people who have employer-provided health insurance the same. Congress cannot give tax exempt treatment to people who live east of the Mississippi River but not to those who live west of it. It doesn’t require every business to provide health care insurance to its employees. It doesn’t require the federal government to provide people without employer-provided health insurance with health insurance. It doesn’t require the government to provide medical insurance to non-citizens. Obamacare does not permit subsidies for those people. They are not similarly situated. And dissimilar treatment is lawful and is an integral part of the American system of government.

      The government is allowed to provide some people with taxpayer provided medical insurance but not others. The government can discriminate on the basis of age – it provides Medicare to older Americans (age 65 and up) and Medicaid or other special coverage to infants and children. But when the child becomes an adult, the coverage stops. Government can discriminate on the basis of income – some low income people qualify for Medicaid. Others with income above the cutoff don’t qualify. Similarly, some people qualify for premium subsidies under the AHCA. Others don’t. People who are not similarly situated are regularly given different treatment. And absent suspect classifications, such as race, the government also has fairly wide berth in defining the classifications.

      Before my wife and I could bring our children from Korea to the United States we had to prove we could support them and that they were not likely to become public charges. Our family members who had birth children did not have to prove this. We were treated differently, but we were not similarly situated. What the government cannot do is require those adopting children from Asia to be vetted, while exempting those adopting children from South America. They are similarly situated.

      Neither the Constitution nor the statutes support your view of the world. They do not require the treatment you advocate. I fully respect your view and right to advocate for a healthcare policy as you describe. But, in return, please respect the law that doesn’t require what you want. You take people who are not similarly situated under the law and demand equal treatment. That’s not a part of our legal system.

      And finally, absent a statute or constitutional amendment there is no right to medical insurance or health care. Nor was it historically recognized as a right under natural law. None of the founders of this nation ever talked about a right to medical insurance. People who claim otherwise are wrong. The best they can do is lobby for the creation of such a right — something that is not likely to happen because too many people would have to give up too much to fund such a system. We are more concerned with protecting what we have. Blunt language, but, IMO, the truth.

  9. LarrytheG Avatar
    LarrytheG

    TMT – you do make a persuasive argument about how the govt CAN treat people differently especially with regard to health insurance.

    but you may also be interested in knowing that the changes in the AHC with respect to community rating and pre-existing conditions also apparently apply to employer-provided.

    http://thehill.com/policy/healthcare/331881-obamacare-repeal-plan-could-remove-protections-for-people-on-employer

    ”
    The ObamaCare regulations allow large employers to pick what state’s essential health benefits standards they abide by. Because the legislation created a national standard of essential benefits, though, that provision has mostly been meaningless.

    Under the new GOP bill, however, if a state applied and received a waiver and could set its own essential health benefits, a large employer in any state would be able to change its plans to abide by those requirements, potentially cutting costs.”

    here’s another report from Business Insider:

    ” In particular, a single state’s decision to weaken or eliminate its essential health benefit standards could weaken or effectively eliminate the ACA’s guarantee of protection against catastrophic costs for people with coverage through large employer plans in every state.”

    That means that young folks in your own health insurance will be getting lower premiums and older folks premiums will go up and annual and lifetime caps will be instituted.

    I presume you’re okay with that….pretty sure Mr. Trump will make sure the law also applies to Federal employees health insurance..

    seems to me that you’re basically trying to protect what you have – even if it’s wrong for you to have something other people are denied because of “cost”… as opposed to supporting reform where people who need health insurance have equal opportunity to get it no matter whether their employer offers it or not.

    In the world we currently live in – the only jobs that are careers are govt… most normal folks can’t have a career job.

    1. TooManyTaxes Avatar
      TooManyTaxes

      I know about employers making changes in health insurance. It happened to me. When I was hired 40 years ago, anyone who worked 20 years or more was eligible for both a deferred vested pension and health insurance upon retirement. Guess what? While I was still working there, the Company unilaterally changed the plan so that only those employees who retired at 65 or older got health insurance. Later the Company downsized; I left. I lost. But I guess no one else except those with employer health insurance can lose.

      And how about those many losers who have Obamacare insurance but don’t get subsidies? You can keep your insurance company. You can keep your doctor. Your premiums will go down by an average of $2400 per year. And no one making less than $250,000 will pay higher taxes. But since most of those people were not likely inclined to crown Hillary, they don’t count anyway.

      Free sells well. It often buys votes. Ask the ancient Romans. And that’s what saving Obamacare is all about – keeping the free stuff rolling so that the beneficiaries will keep voting for Democrats. And if the rest of America gets hurt, too bad. As Hillary said they are Deplorables anyway.

      Who is going to pay for all of this free stuff? Who is going to pay for all the good Democratic voters who get jobs handing out free stuff? I’ll listen when organized labor stands up and is willing to see their good benefits taxed and reduced. Until then, I’m not inclined to pay more or give up mine either.

  10. LarrytheG Avatar
    LarrytheG

    Don’t forget WHY Obamacare was created in the first place. It TRIED to provide insurance to people who could not get it in a work environment where more and more companies do not offer employer-provided.

    it was not about “free” stuff.. it was trying to provide to people similar tax credits that people who had employer-provided got – but based on income level and age such that the lower your income the higher the tax credit subsidies but no matter their income level – they did get the minimum essential benefits , could not be denied for pre-existing and no annual / lifetime caps.

    In terms of “free stuff” – it’s no more “free” than health care is for Medicare. You DO PAY for Medicare Part B – the problem is you only pay about 1/4 the actual cost and everyone except lower income folks need to pay more for it.

    How come we donj’t classify health care in the other advanced countries as “free stuff”? It’s not at all.. Everyone has to pay for it.. and everyone is covered… and the costs of that health care is NOT embedded in the products those companies sell in other countries.

    How come we import VWs, Volvos, Toyotas and Kias yet we do not export to those same countries our domestic brand Chevy’s and Fords? It’s because our cars are more expensive because they have embedded health care costs in the price. So.. in a way – when we buy a Toyota – we are helping to pay for he health care of folks in Japan!

    finally -you said that you lost benefits when you changed jobs. If we had insurance separate from employers – that would not happen to you

    pensions and health insurance are better off to belong to you.

    but it won’t work the way ObamaCare works right now if it covers all pre-existing conditions with no annual/lifetime caps but does not mandate everyone get insurance.

    That’s the choice we have to make… if we don’t mandate everyone have insurance then we’ll have to re-institute caps and increased costs for the sicker, older and those with pre-existing conditions.

    If they INCLUDE employer-provided in the changes.. I bet people on employer-provided will ble much more involved in the debate and much less inclined to say that ONLY other people who want “free stuff” is the problem..

    we have a bad system that has arbitrarily created winners and losers in the 21st century where fewer and fewer companies offer employer-provided – and more and more don’t have insurance.. and when they get sick they go get “free stuff” that those who do have insurance – pay for.

    that kind of a system is doomed to fail…

    you won’t be able to protect it by trying t keep others from changing it.

    it’s going to happen… it’s inevitable.. and we have some small chance that now that it’s in the Senate – a more fair and workable system will emerge and my bet is that it’s going to have elements that look like ObamaCare.

    1. TooManyTaxes Avatar
      TooManyTaxes

      Larry – why do you think that health insurance costs are imbedded in the cost of American products manufactured by big companies that have health insurance benefits, but not the cost of universal, single-payer coverage paid by taxes would not be? You seem to be assuming that. It makes no sense.

      The problem is not who pays per se, but the excessive costs in the American system. And those costs have only increased under Obamacare. Why would anyone think that further involvement by the federal government in health care would do anything but push up costs even higher? Why would we want to put health care for most of America in the hands of the federal government when we see Social Security, Medicare and public sector pensions all facing substantial financial crises?

      I don’t want to separate medical insurance from jobs. And neither does anyone else who has or whose spouse has coverage, including every union member in America. Why? Because it’s a significant part of their compensation. And any substitute will be less generous and will not be made up by higher compensation. You want people to give up what they have to give free stuff so that the beneficiaries will vote Democratic. The AHCA was all about buying votes. It created a new class of losers, those who pay for their own insurance, those who pay higher premiums and deductibles, those who pay higher taxes. What about the people who live in 94 Iowa Counties who are likely to have no insurance companies offering individual coverage? Oh yeah, Iowa didn’t vote for Hillary.

      And “no” not everyone has to pay for it. The American tax system exempts millions and millions from paying anything. Even FICA is offset for many with the Earned Income Tax Credit. It’s only some people who have to pay. And those are the people who the lefties ignore.

      Life creates winners and losers. Some people are just smarter. Some people are just in the right place at the right time. Some people have family connections that jump them to the top faster. Some people have musical or athletic talent. JFK reminded us that life is not fair.

      The left says its evil to charge women more for medical insurance. Yet men pay more for life insurance and auto insurance. Sounds to me like more Identity Politics. You argue for some older people to pay more for Medicare Part B. Maybe older people need to pay somewhat more across the board. Maybe we are trying to get too much money from young people. I don’t know.

      Let’s keep fringe benefits untaxed, but allow everyone who doesn’t get employer medical insurance to deduct the full cost of their insurance premiums. That would level the playing surface substantially.

  11. LarrytheG Avatar
    LarrytheG

    re: ” Larry – why do you think that health insurance costs are imbedded in the cost of American products manufactured by big companies that have health insurance benefits, but not the cost of universal, single-payer coverage paid by taxes would not be? You seem to be assuming that. It makes no sense.”

    it’s paid for by taxes on people and not embedded in the cost of the products. Consider a VW from Germany. How would healthcare costs be embedded in that cost? How about a chevy?

    “The problem is not who pays per se, but the excessive costs in the American system. And those costs have only increased under Obamacare. ”

    the first part you got right but wrong on the second. Obamacare does not increase the cost of healthcare … it increased the cost of insurance because it required no denial of pre-existing and no annual/lifetime caps.

    That’s by the way – applied not just to Obamacare – it applied to Employer-provided also.. and the GOP intends to take it out of BOTH.

    “Why would anyone think that further involvement by the federal government in health care would do anything but push up costs even higher? Why would we want to put health care for most of America in the hands of the federal government when we see Social Security, Medicare and public sector pensions all facing substantial financial crises?”

    every single advanced economy country on the planet has insurance controlled by the govt – and it costs 1/2 of our system and they all live longer. Why do you ignore this?

    Social security is fine if you’d get the ideologues out of the issue. The ideologues opposed the CONCEPT of social security. The only thing wrong with SS is that we have people living longer and we need to make tweaks to it to fix that … and a primary fix is to change the CPI calculation. This could be done right now if it were not for the ideologues who are looking to damage SS and cause it to fail.. like they are the health care issue

    “I don’t want to separate medical insurance from jobs. And neither does anyone else who has or whose spouse has coverage, including every union member in America. Why? Because it’s a significant part of their compensation.”

    TMT – you’re just flat wrong. Insurance like pensions needs to be portable. ONly people who work for the govt want insurance to stay with the employer. Most people in the real world change jobs and when they do they’re screwed on insurance.. if they end up with an employer that does not have insurance and in the 21st century economy that’s becoming more and more the case.

    “And any substitute will be less generous and will not be made up by higher compensation. ”

    no it won’t. If you can change jobs easily – you have the ability to go after better jobs and employers will have to work harder to attract and keep qualified workers.

    “You want people to give up what they have to give free stuff so that the beneficiaries will vote Democratic. The AHCA was all about buying votes. It created a new class of losers, those who pay for their own insurance, those who pay higher premiums and deductibles, those who pay higher taxes. What about the people who live in 94 Iowa Counties who are likely to have no insurance companies offering individual coverage? Oh yeah, Iowa didn’t vote for Hillary.”

    nope. you’ve been reading too much partisan crap… Iowa fails because it’s an older population with fewer young people… You’re totally ignoring the other states like Massachusetts, New York, Oregon , Colorado where Obamacare does fine.

    “And “no” not everyone has to pay for it. The American tax system exempts millions and millions from paying anything. Even FICA is offset for many with the Earned Income Tax Credit. It’s only some people who have to pay. And those are the people who the lefties ignore.”

    you need to look at the tax law guy. People who work , pay FICA tax and people who earn as little as 10,000 a year end up paying taxes.. way more in taxes than they get back in earned income tax..

    and you attribute the EIT wrongly. THe GOP is a bigger supporter of the EIT than Dems … go read… something besides FOX news and other right wind propaganda.. the GOP prefers that over minimum wage laws. They LIKE it because you cannot get it unless you work!

    “Life creates winners and losers. Some people are just smarter. Some people are just in the right place at the right time. Some people have family connections that jump them to the top faster. Some people have musical or athletic talent. JFK reminded us that life is not fair.”

    I totally agree but the economy is moving to jobs that do not provide employer-provided insurance… many more service workers and people who are independent contractors.. You imply that this is their fault and that therefore because they are less smart they deserve what happens.

    TMT – you pay for people who don’t have enough income or health care.
    the more you fight against reform – the higher the costs that you’ll end up paying.

    “The left says its evil to charge women more for medical insurance. Yet men pay more for life insurance and auto insurance. Sounds to me like more Identity Politics.”

    You argue for some older people to pay more for Medicare Part B. Maybe older people need to pay somewhat more across the board. Maybe we are trying to get too much money from young people. I don’t know.

    sounds like more partisan idiocy.. you’re comparing apples and oranges here instead of admitting that health insurance is far more expensive than auto insurance…

    “Let’s keep fringe benefits untaxed, but allow everyone who doesn’t get employer medical insurance to deduct the full cost of their insurance premiums. That would level the playing surface substantially.”

    wow! well that’s a start! They actually looked into doing that initially but it would cost more than Obamacare did in lost tax revenue!

    how about this – you buy employer insurance with taxed money instead of 40% discount AND you pay according to your age and health status so if you are older and sicker you pay 5 times more than younger workers?

    Isn’t that what you advocate for others?

  12. LarrytheG Avatar
    LarrytheG

    tmt – do me a favor when you respond – send me an email so I know. I do not get notice from BR when you comment.

    thanks

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