House Republicans Unveil Long-Awaited Replacement for Health Law

[brooklynite]

Source: New York Times

WASHINGTON — After six years of vague talk about a conservative alternative to the Affordable Care Act, House Republicans on Tuesday finally laid out the replacement for a repealed health law — a package of proposals that they said would slow the growth of health spending and relax federal rules for health insurance.

Opponents began the “repeal and replace” mantra almost as soon as the Affordable Care Act was signed in 2010, and while they have voted dozens of times to repeal the health law, the replacement has been elusive.

In finally presenting one, Speaker Paul D. Ryan of Wisconsin and his Republican team did not provide a cost estimate or legislative language. But they did issue a 20,000-word plan that provides the most extensive description of their health care alternative to date.

Many of the ideas — for “health savings accounts,” “high-risk pools” and sales of insurance across state lines — are familiar. Democrats in and out of Congress have for weeks been rehearsing their lines of attack.

Read more: http://mobile.nytimes.com/2016/06/22/us/politics/house-republicans-unveil-affordable-care-act-replacement.html?referer=http://mobile.nytimes.com/2016/06/22/nytnow/your-wednesday-briefing-donald-trump-janet-yellen-lionel-messi.html

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And in only six years...

[progree]

1. Health Savings Accounts - great tax-avoidance tool for people who can put money aside long-term

Last edited Wed Jun 22, 2016, 02:44 PM - Edit history (1)

Almost every financial planning article I read about HSA's advises using it as a "stealth IRA". They advise paying your out-of-pocket health care expenses using regular taxable account money, and to let your HSA grow -- after all it grows tax free and when you do spend it on medical care say decades in the future, there are no taxes on that "withdrawal". (And you get a nice up front deduction when you put money into the HSA).

http://www.investopedia.com/advisor-network/articles/062116/using-health-savings-accounts-retirement

My point being is that it really isn't doing shit for controlling health care costs, its just another way for people who have money to put aside long-term to shelter savings from taxes permanently. And it helps those in the highest tax brackets the most (the benefits of tax-free compounding and the up-front tax deduction are more-than-proportional to one's tax bracket)

One should watch for these kind of things in Republican proposals -- they typically cut taxes, with by far the vast majority of the benefits going to those in the top tiers of income.

An HSA is like a super-IRA with the best features of a traditional IRA and a Roth IRA -- the up front tax deduction on contributions (like the traditional IRA), with tax-free compounding (like both types of IRAs), and tax free withdrawals like Roth IRAs (if withdrawn to pay medical expenses).

One can withdraw from an HSA to pay non-medical expenses too -- in which case one pays taxes on the withdrawal. Meaning just like a traditional IRA.

Full disclosure: I admit I have an HSA, and both traditional IRAs and Roth IRAs.

[tonyt53]

2. Read through much of it a bit ago. Same nonsense.

While it would not be as costly as what Bernie Sanders had proposed, it would still be very costly. The plan reverses the various planned tax increases and surcharges. Tax credits are fine if a person can wait until the next year to recoup that tax credit when they file their taxes the next year. But most people needed subsidized healthcare can't do that. What Ryan and the GOP House has done is present a bunch of bullshit that will appease their base - and Trumps. Few of that base can even remotely understand what they would be reading if they read it.

[SharonAnn]

5. And for people who are poor and pay little or no federal income tax, it could be useless.

[LastLiberal in PalmSprings]

14. Rep. Grayson had it right:

[seabeckind]

3. Buying across state line would avoid those pesky liberal state regs.

In a couple years every health insurer's hq would be a post office box in SD.

Like the credit card and bank model. That's worked out well. Unless you're a customer.

[kairos12]

8. Yep. A true race to the bottom.

[CrispyQ]

4. What the fuck good is a health savings account if you don't make enough to fund it?

[packman]

7. Exactly - Even if you could manage to squirrel away a few dollars here and there

And could do it for years, one trip to the emergency room to get a doctor prescribed aspirin would wipe it out.

[Triana]

6. They can only refry those beans so many times

and they're still the same beans. And, garbage.

Single-payer/Medicare for all is the ONLY workable solution.

[kairos12]

9. Their reform, same as before, get sick, then die already. You are a burden.

[vkkv]

10. 'Buying insurance out of state' is a scam.

1) Insurance can be cheaper becasue they don't HAVE to provide GOOD insurance.. so yes, it is cheaper.

2) I already buy auto insurance from out of state and it's NOT THAT MUCH CHEAPER!

RepubliScums SUCK.

[progree]

11. Some more very toxic things not yet mentioned in the thread so far

Excerpts from http://www.reuters.com/article/us-usa-election-healthcare-ryan-idUSKCN0Z80AQ

The Ryan plan recycles long-held Republican proposals like ... giving states block grants to run the Medicaid program for the poor.

Block grants - so states can do what they want. Like drug test everybody, put a work requirement on the benefits (e.g. hospital patients should be required to work 12 hours a day in the kitchen), whatever.

The Republican proposal would gradually increase the Medicare eligibility age, which currently is 65, to match that of the Social Security pension plan, which is 67 for people born in 1960 or later.

That again!

... The Republican plan includes medical liability reform that would put a cap on non-economic damages awarded in lawsuits, a measure aimed at cutting overall healthcare costs.

There's the old tort reform thing again.

... Under Obamacare, many states expanded the number of people eligible for Medicaid. The Republican plan would allow states that decided to expand Medicaid before this year to keep the expansion, while preventing any new states from doing so.

Wow, that sounds really fair! If your state had a fuckhead governor/legislature in 2010-2016 who turned down the Medicaid expansion, then your state is fucked for eternity. Not just for 4 generations like in the Bible, but forever.

[NoMoreRepugs]

12. the GOP truly cares for the common man - NOT

[Festivito]

13. SIX YEARS IN THE MAKING. Can't wait for it to be costs calculated.

I think we should laud applaud magnify and trumpet their six year long achievement, loudly and strongly with copious praise.

And, then express such sadness when the GAO reports it to have such awful failings after six years.

If reports are good, without screwing the poor, the elderly, the infirm, I'll praise them also. Because, by then I'll have won the lotto sixteen straight times.

[blm]

15. LOL - That's their chosen distraction for Hastert's arrival at prison today.

,