3421

This isn’t exactly reeking of thoughtful consideration:

All claims made for it were false. It will add trillions to the federal deficit. It will lead to a de facto government takeover of health care faster than most people realize, and as millions of Americans are added to the Medicaid rolls and millions more employees (including, watch for this, workers of bankrupt state governments) are dumped into the new exchanges.

OMG Socialism bolded.

3422

Actually thats just the truth you bolded. Good job there on that.

3423

Truth of what, brett?

3424

I take you off ignore, and this is the thanks I get? Health insurance regulation isn’t a takeover of health care. A single payer system administered by the government with no other alternatives would be a takeover of heath care, but don’t let reasonable definitions stop you from screaming fear.

H.

3425

GAH! Why do I insist on clicking the “View Post” link. I should know better.

3426

’
You need to read what was actually said, he said it will LEAD TO a defacto takeover of health care by the government, not that the law as it currently is does that. Which is something I completely agree with as what will happen as that is what Obama and the liberal dems want.

3427

Yeah but once he gets done with the required rhetorical boilerplate he has specific proposals in there. That’s more than I can say for, well, any other elected Republican on Earth.

3428

Yes but they are proposals from a republican, which means 90% of dems will reject them without even reading, same as 90% of republicans will reject any dem ideas the same way. Damn I hate how politics in this country works.

3429

Governor Daniels is sort of highlighting one of the interesting dynamics of the Affordable Care Act - the strategic mistake Republicans made in casting the bill in apocalyptic terms. Calling HCR “socialism” and a “government takeover” and all that nonsense whipped up the base which was nice. But the downside is that the ACA passed, and it was more liberal than it might have ended up being. Centrist Democrats in the Senate were dying to cut a deal with the GOP to get some bipartisan cover on this one; they’d have happily sold half the bill downriver in order for it to get the label bipartisan. The Republicans made a tactical decision to try and prevent the Democrats from getting anything called health care reform done; the end result is that not only was HCR done but the end bill ended up being more liberal than it might have otherwise.

Had Senate Republicans took Governor Daniels’ stance it’s likely they could have greatly watered down the ACA. And if you’re a conservative who cares about actual policy outcomes (rather than just a partisan who wants to beat liberals) this would have been a good thing!

3430

Prove it.

3431

Since the bill really is insurance reform and not really healthcare reform, I will tell you that, as much as I consider Washington to be the land of the scam artists on both sides of the aisle, I’d rather have the government in charge of health insurance than a CEO whose entire concern is making as much cash as possible for the shareholders and the BOD. I doubt the government will do worse than denying a child health insurance for a record of constipation, deny a woman’s breast cancer treatments because she didn’t put down on her application, 20 years previously, that she’d had acne treatment, nor would they likely get away with having committees who monitor women’s medical claims to see if they are getting what looks like breast cancer type scans and, if so, try to find ways to kick them out of coverage by examining their applications and other routes (a practice admitted to by two big health insurance CEOs.)

3432

PPACA expands Medicaid. The main economist of PPACA (Jon Gruber) is also the co-author on the definitive work how government health care crows out private health insurance (Cutler-Gruber’s 1996 work). So it’s pretty clear that the expansion of Medicaid will crowd out private HI.

New study causing some tremors this week is the Medicaid churn under the new law by Sommers/Rosenbaumn. They note that this could lead to more adverse selection and some of their solutions increase crowd-out.

Surveys of businesses show that many will or are considering dumping insurance all together and paying the penalty. It’s a pretty easy consideration: Does the pain of HI + cost of HI >penalty for not offering HI.

That’s some of the effects on the private market. There’s a big dispute on how many people will now purchase private HI due to the mandate. Some of the evidence from Mass looks ok but not sure how that extrapolates to rest of country.

There’s also the problem that the HHS has a bunch of huge decisions to make. What they decide constitutes a minimum health benefit or how long the open enrollment period is will be huge factors in determining the impact on private HI. A long open enrollment period + guaranteed issue will effective destroy many private insurance markets, so I doubt they’re that stupid. They’ll have a limited enrollment period with a long lookback, but I’m unsure what they’ve ruled right now.

You can’t prove that it will lead to govt control anymore. But there are various areas that will effectively bankrupt private insurers and leave only the govt run exchange option. Will be very interesting to see a) if new firms continue to offer HI as a standard benefit and b) if many firms exit HI altogether in 2014-2016.

3433

One of the key takeaways is that Daniels knows that HHS can’t run that many different state networks. So HHS needs states/governors to be partners. The White House holds the whip card of telling states that they have to do something, but governors are pushing back very hard on what that something is.

My guess is that Sebellius grants a ton of waivers but may try to make an exception of a state or two (Hello Mississippi!)

3434

Yeah there’s going to be an interesting dynamic between states & HHS over the next five years.

One interesting amendment - and I can’t recall its name or whether or not it made it into the final bill - was sponsored by Bernie Sanders. Basically it allowed states to opt out of ACA entirely so long as they implemented their own state-level program that met federally set requirements for coverage, etc. Sanders was talking about his amendment in the context of having Vermont implement a true single-payer system within the state. Likewise if Texas wants to deregulate entirely and they can do so while maintaining an acceptable level of coverage over its population they’re welcome to do so.

3435

There’s also the bipartisan Wyden-Brown that lets states get waivers sooner and opt-out more. It will be interesting to see if that works as people on left/right have some reservations or outright opposition.

3436

http://sanders.senate.gov/legislation/issue/?id=68b1428d-c650-4034-aced-7bb1d79a15fb

Are you sure it was Sanders who would propose such an amendment? I cant find anything about it with some google searches, but I did find this link about how he has made a proposal to amend the bill by implementing a nation wide single payer system. Also by his website he has made similar proposals before, so I guess I dont see how it would be consistent for him to also propose that states could basically completely opt out of the system at the same time.

Also he is proposing ‘This amendment would strengthen the public option by (a) striking the provision allowing states to opt out of the public option, ensuring its availability in all 50 states’

3437

Surveys of business owners would reflect their poor understanding of the requirements, not the reality. Just like Brett, the amount of FUD that has been spewed does nothing to actually educate people about the details, such as the 50-employee exemption, the 25-employee exemption, and the fact that Romneycare resulted in MORE businesses offering health care to employees with no noticeable negative impact.

H.

3438

http://voices.washingtonpost.com/ezra-klein/2010/11/sen_bernie_sanders_vermont_sta.html

Ezra Klein: You worked hard on getting the original version of the state waiver into the legislation. Why? Liberals aren’t usually associated with federalist approaches.

Bernie Sanders: As a single-payer advocate, I believe that at the end of the day, if a state goes forward and passed an effective single-payer program, it will demonstrate that you can provide quality health care to every man, woman and child in a more cost-effective way. So we wanted to make sure that states have that option, we wanted it to be available when the bill gets implemented in 2014. But we ran into the most insane objections from the Congressional Budget Office.

http://voices.washingtonpost.com/ezra-klein/2010/11/have_scott_brown_and_ron_wyden.html

Apparently he didn’t introduce it as such, but worked with Wyden to make sure it’s in there.

3439

Ok thank you very much for the info, Im sure you can see how one had a hard time working the two thoughts together with what I read from sanders website.

3440

I’m going to take a victory lap today. Sec. Sebelius called the CLASS ACT in PPACA “totally unsustainable” in testimony to Sen. Finance yesterday. The CLASS ACT was scored as Revenue Raiser by CBO (IE it contribued to “Deficit Reduction” that was touted by the Administration and Ezra Klein among others)

But Secretary Sebelius said that the program could not be implemented as written b/c it requires a massive taxpayer subsidy in the out years. In short, the CLASS ACT is fiscal disaster that was used to purposedly lower the cost of the health care bill. The premiums taken in over the next ten years made PPACA look deficit neutral. But now that’s it law, all the major actuaries and the Sec HHS are sad to report that it’s a fiscal mess that can’t be started b/c it’s unsustainable.