General Discussion
Related: Editorials & Other Articles, Issue Forums, Alliance Forums, Region ForumsSo what will fix the ACA according to our congresspeople?
I've seen a few people (and one very outspoken person) since the Medicare-For-All bill came out go on about how we should be focused on fixing the ACA. Got me thinking, "What fixes are we supposed to be pushing for?"
I haven't seen any specifics put out about what those fixes look like. I've seen plenty of our congresspeople say we need bipartisan efforts. That doesn't seem like a winning proposition at the moment. Regardless. What are the specific fixes that have been proposed? I haven't been able to find them.
PoliticAverse
(26,366 posts)TCJ70
(4,387 posts)...but where is the messaging on it?
PoliticAverse
(26,366 posts)it from happening.
Igel
(35,356 posts)When all the budgetary aspects were discussed about how it would save money when compared to a projection and when funding was required to make it "revenue neutral" in the short term everything possible was done to make sure it fit in the box.
Savings from the way student loans were funded were included as "revenue" for the ACA.
Similarly, expenses were reduced by simply not including all the expenses.
It was necessary to maintain that one-vote majority and the unanimity of the (D) and pro-(D) senators. The choice was to play kick the can or can the bill.
Yupster
(14,308 posts)insurance company bailout every year forever. Remember, this was a Democratic Party bill. The Democratic Party senators was not going to support a government bailout for insurance companies if they didn't make enough profit from year to year.
genxlib
(5,535 posts)To provide competition and a backstop for underserved areas
TCJ70
(4,387 posts)Voltaire2
(13,159 posts)in Medicaid expansion the ACA has too many people in the gap.
But the public option is as unreachable as MFA. If we are going to propose substantive reform I prefer a comprehensive universal all-in system over a patched up hodge-podge over complicated approach.
emulatorloo
(44,183 posts)As I remember it was originally mandatory but Changed to optional because Republican reasons
PoliticAverse
(26,366 posts)states with the loss of all their Medicaid funding if they didn't go along with the expansion.
bornskeptic
(1,330 posts)PoliticAverse
(26,366 posts)(7) Roberts, Breyer, Kagan, Scalia, Kennedy, Thomas, and Alito voted states could decline to expand Medicaid without losing funding.
(2) Ginsburg and Justice Sotomayor upheld the ACA's provision to cut off all Medicaid funding to states that didn't expand.
https://en.wikipedia.org/wiki/National_Federation_of_Independent_Business_v._Sebelius
Chief Justice Roberts, joined by Justices Breyer and Kagan, would have ruled that the Medicaid expansion could survive, but that states must be given the right to opt out of the expansion without losing their pre-existing Medicaid funding.
Justice Ginsburg, joined by Justice Sotomayor, would have upheld the Medicaid expansion in its entirety (with non-participating states losing all their federal Medicaid funding).
Justices Scalia, Kennedy, Thomas, and Alito would have struck down the Medicaid expansion completely (along with the entire Act).
Complete text of the decision (.pdf):
https://www.supremecourt.gov/opinions/11pdf/11-393c3a2.pdf
genxlib
(5,535 posts)I did not intend to imply it was the only fix. Just the most apparent.
So I would agree it is insufficient and I would also agree that the Medicaid expansion needs to be system wide as intended.
However, I disagree that the public option is as unreachable as MFA.
The MFA is a massive transition that would require huge changes to the system and funding structure. More importantly, it would be imposing something on a lot of people that don't want it and are satisfied with what they have.
The Public Option would be a much smaller change and would only be available to those that voluntarily choose it as their personal option. And the funding would be the same as currently exists to pay for ACA policies.
It would not be easy but should be a great deal easier than MFA
Demsrule86
(68,667 posts)we hear nothing except single payer talk. How about this stabilize the markets to start with? The ACA as it is now is worth saving. It is all we have and millions depend on it.
When the single payer bill was introduced. it demonstrated that both parties want to replace the ACA. It just wasn't good enough, and to do this in a the middle of an epic battle to save the ACA was a huge political miscalculation. If we lose the ACA, the single payer bill will be an important reason why this happened.
TCJ70
(4,387 posts)...of Republicans voting consistently to repeal the ACA and now you're going to pin a majority of it on the MFA bill. It's fine for you to hold that opinion...it's just a ridiculous one. Republicans are going to work towards repealing the ACA and they may succeed. Saying that is just stating reality and if they get 50 votes there isn't anything we can do about it. It certainly won't be the MFA bills fault.
Why do we hear nothing but single payer talk? Are the Dems not talking about their solutions? Can one guy really take time from all the other congresspeople out there?
Voltaire2
(13,159 posts)Obviously the intent is to blame Sanders for too many republicans voting to repeal the ACA.
TCJ70
(4,387 posts)...with the MFA bill. It's just stupid.
emulatorloo
(44,183 posts)I know hyperbole is fun but I don't think this instance is very helpful. Of course ymmv
Demsrule86
(68,667 posts)We had a chance here to use the ACA to advance universal coverage with a public option...well I won't go down without a fight...I suggest you call you call Congress...we all need to. Let's try to turn this around.
Demsrule86
(68,667 posts)have heard that talking point from more than a few folks here. I will say this, if we lose healthcare...the shit will hit the fan, and I doubt the, 'it would have happened anyway', explanation will suffice. How many will ignore the fight to save the ACA instead of calling Congress because they erroneously think single payer is around the corner? We need all hands on deck, and this undermines our effort to save the ACA. This is a terrible situation...and a political miscalculation.
Voltaire2
(13,159 posts)ehrnst
(32,640 posts)is more valid?
TCJ70
(4,387 posts)ehrnst
(32,640 posts)That is why presenting a M4A plan where the costs have been shown by experts to be mistakenly low, will give those that want to tank any talk of UHC a lot of ammunition.
TCJ70
(4,387 posts)...but we're in agreement about being honest about the costs. I anticipate I would pay more under a MFA/single-payer system.
PoliticAverse
(26,366 posts)No one was talking about "the single payer bill" 2 months ago and Republicans came within 1 vote.
Demsrule86
(68,667 posts)It is essentially a replacement bill. Millions could lose coverage. I believe there will be hell to pay if we lose healthcare. And it won't all be directed at the GOP. This gives them cover.
Autumn
(45,120 posts)it is that is being done to save the ACA that talk about Bernie Sanders Medicare for All is destroying?
ehrnst
(32,640 posts)then the ACA is pretty much not an option, right?
Autumn
(45,120 posts)see my post #
21. What attempt is being made to save the ACA? Do you have a link to the bill, the plan or whatever
it is that is being done to save the ACA that talk about Bernie Sanders Medicare for All is destroying?
ehrnst
(32,640 posts)Granted, no one is talking about Bernie, here. But why should they?
http://www.politico.com/story/2017/03/house-pelosi-obamacare-235792
https://www.theatlantic.com/politics/archive/2016/12/how-democrats-plan-to-fight-against-obamacare-repeal/510056/
https://www.democraticleader.gov/newsroom/372017/
https://www.washingtonpost.com/news/powerpost/wp/2017/07/18/here-are-the-three-easy-things-that-chuck-schumer-thinks-can-shore-up-obamacare/?utm_term=.022a19f2b53e
Got some 'adorable' rebuttals?
Again, if one is campaigning for M4A, how is that shoring up the ACA? And how is "M4A is the only way to UHC!!!!!!!" in any way, shape or form saying to preserve the ACA, which is as far down the road to UHC as we've ever been.
If it matters more whose name is on it, than what the solution is, then how is that supporting the solution?
But since you asked:
Right now Im protecting the Affordable Care Act, Pelosi said. None of these things, whether its Bernies or others, can really prevail unless we protect the Affordable Care Act.
https://www.washingtonpost.com/powerpost/pelosi-single-payer-isnt-a-litmus-test-for-democrats/2017/09/12/51a50046-97c9-11e7-87fc-c3f7ee4035c9_story.html?utm_term=.61a1690ee3c5
Autumn
(45,120 posts)ehrnst
(32,640 posts)Right now Im protecting the Affordable Care Act, Pelosi said. None of these things, whether its Bernies or others, can really prevail unless we protect the Affordable Care Act.
Autumn
(45,120 posts)And Nancy hasn't been distracted at all from protecting the ACA and she's all over the place protecting DACA. IMO it's demeaning to attempt to convince people that our leaders can't focus on more than one issue, especially important issues like the ACA, DACA and Bernie's Medicare for all.
ehrnst
(32,640 posts)I'm thinking that people, as evidenced here on DU, can't tolerate them supporting anything but M4A, because they are either confusing it with UHC, or they consider anyone who doesn't support M4A as "corporate shills"
See the demonizing of Pelosi here on DU for her not saying it would be a litmus test, or supporting it.
Similarly, I hear people erroneously saying that Democrats aren't doing squat to shore up the ACA, as some sort of evidence that the only people concerned about UHC are the ones signing onto Sanders' bill.
Perhaps that faulty perspective comes is more indicative of the point of view that reps can't do two things at once.
Autumn
(45,120 posts)are just looking for a scapegoat should the worst happen. I have seen no one say that they support nothing but Bernie's Medicare for All plan. I don't get into those threads i don't know enough about Pelosi's actions and votes to weigh in on her, the people I know and read from CA here seem to like her, occasionally some troll ot zombie sign up and posts crap like that but they get the boot. There's one that I saw doing that and all that remains is it's unanswered question in ATA. Intelligent people don't take those trolls serious.
The party has ben defending the AC since Obama signed it into law. During that time many bills, laws issue have been discussed but all of a sudden Bernie puts up a bill for healtcare it gains interest and ... hair in fire! Distraction!!
You know as well as I do that talking about Bernie's Medicare for all does not in any way shape or form distract us or our Reps and Senators from protecting and improving the ACA yet in any thread it's posted a dozen times that he is distracting us, he's destroying the party, health care so on and so forth. That's not a faulty perspective, we both know what that is.
ehrnst
(32,640 posts)I said it distracted the public from what needs to be done to support the ACA.
Your own posts were in there complaining that you hadn't seen Dems fight for the ACA, or offer fixes to it other than fight the repeal, so that's a good illustration. And yes there is derision about a "public option" as being centrist compared to M4A.
That kind of "it's going to be so much better, I promise" can potentially come back to bite us in the ass.
When Obama said, "you can keep your doctor" I smacked my forehead. I knew that people were not going to be guaranteed that - because anyone on employer provided health care NEVER has the guarantee that the employer will always offer a policy that their doctor is in network with. And that one phrase became ammunition for the GOP to use that Obama was lying to them about the ACA.
One of the lessons learned from the '93 health care reform was that the message, "cover the uninsured" did not address the concerns of worried people who had insurance that they could afford and liked. Obama simply tried to instill hope and confidence that what was coming was better than what they had now, and wouldn't harm their access. But that cost him, and by extension the ACA, vital support.
Remembering that, imagine what the GOP will do with a plan that the CBO says that the taxes needed to make this work will cost way than Sanders' plan says. And yes, the GOP will suddenly bestow upon the CBO all sorts of credibility when that happens, as we have seen them do before.
They will have ammunition to say that the Democrats don't have a real plan to address the current problems with Health Care coverage either, and we want to take the whole country down the path of Green Mountain care, which failed in part because of the tax increases that were required to sustain it.
And yes... Green Mountain Care was a state, not a federal program, but the association with Sanders, and the idea that single payer in VT wound up costing way more than was told to voters will be used by the GOP. Mistakes in cost analysis cost Vermont residents their single payer, and Sanders' refusal to discuss any lessons learned from it don't bode well for his plan.
Autumn
(45,120 posts)Autumn
(45,120 posts)Of course that will do nothing to save the ACA, the Republicans will have killed it by then, they came within one vote the last time and they say they have the vote this time.
The only fix I have seen mentioned is Bernie needs to shut up, he's single-handedly destroying the the ACA.
Demsrule86
(68,667 posts)others to stick their necks out...do you really believe...if millions lose healthcare ...people will say 'ah the Dem single payer replacement bill did not help the GOP to repeal the ACA of course not...why it would have happened anyway'. Read this site, and you can see it is already starting. You bet I think the single payer bill played a role if this happens...we stopped them the other times...didn't we? But what is different now? Also, there is mounting evidence that the GOP will use single payer to attack Democrats in the coming elections...why would you put something out that can't happen for years and give the GOP an opening to attack? This is and was a bad idea.
Voltaire2
(13,159 posts)Do you have any evidence to back that up?
ehrnst
(32,640 posts)It helps to look for these things before insisting that they don't exist:
http://thehill.com/policy/healthcare/341616-ten-house-democrats-propose-plan-to-fix-obamacare
Create an annual $15 billion reinsurance fund. ObamaCare had a reinsurance program for three years from 2014 to 2016 to provide payments to insurers that enroll higher-cost, sicker individuals.
Continue ObamaCare's insurer payments, which reimburse them for giving discounts to low-income patients. Insurers have blamed the uncertainty over whether these payments will continue as a reason for their proposed double digit rate increases in 2018.
Have "robust marketing strategies" to ensure that more people enroll during open enrollment periods.
Allow a buy-in option for Medicare for people nearing retirement age.
Expand tax credits by age, geography and income to help people buy insurance. Currently, about 84 percent of ObamaCare participants get a subsidy.
Expand the availability of catastrophic health plans that include essential health benefits and coverage for primary care for younger enrollees. These plans, meant to protect people from worst-scenarios, tend to have low monthly premiums and high deductibles.
ehrnst
(32,640 posts)So there is indeed support for some aspects of the ACA on the part of the GOP.
Which is more than there is for Single Payer.