Saturday, April 22, 2017

Two stories about health insurance: The GOP wants to kill Obamacare but George Will predicts a single-payer system

GOP to try again with a zombie ‘Trumpcare’ plan, and hurtle towards a government shutdown next week. AZBlueMeanie (Blog for Arizona) reviews lots of reporting on what is rumored to be another stab by the House, this time from the Freedom Caucus folks, at undoing Obamacare and replacing it with an even worse version of Trumpcare. 24 million people thrown off health insurance is not enough for these folks. They want to ditch the essential health benefits, community ratings, and, in a related move, subsidies (“cost sharing reductions”).

Republicans want to let states waive two key Obamacare provisions

The amendment takes aim at two Obamacare policies that have long been on the Freedom Caucus’s hit list: community rating and essential health benefits.

There are always those cost-sharing reductions, or CSRs, that are the subject of the House v. Price lawsuit – formerly known as House v. Burwell – pending before the court of appeals. Democrats want the CSR’s addressed in the Continuing Resolution (CR) to fund the government next week. But Trump could decide to blow up Obamacare out of spite.

Right now those subsidies are facing a huge threat. Trump can try to cut off those payments, which would disrupt Obamacare’s insurance markets and maybe cause them to collapse entirely. And Trump is threatening to do just that — he could end the federal government’s defense of CSR payments in a lawsuit working its way through federal court.

Democrats are trying to force Trump’s hand, tying the CSR payments to a must-pass government spending bill. Democrats will demand that funding for the payments be included in the spending bill that must pass next week to avoid a partial government shutdown.

“If congressional Republicans agree to pay the CSR subsidies, that renders the issue being litigated effectively pointless. The payments will be made, Congress will have approved them — there is effectively nothing left to sue over.”

Worst case scenario next week: Congress wastes its limited time trying to pass a bad zombie “Trumpcare” plan that will likely fail, only because Trump demanded it, then Congress fails to pass a CR spending bill in time to keep the government from shutting down on Friday. And Trump could use the “nuclear option” to disrupt health insurance markets over the CSR payments and sabotage Obamacare out of spite.

Egberto Willies writes that George Will predicts Obamacare to become single-payer because of this inconvenient fact. He includes a video of part of the conversation between Nicole Wallace and George Will on Brian Williams’ The 11th Hour. (h/t Daily Kos)

George Will realized that America’s health care reality means that not only is Obamacare unrepealable but that we are on our way to a single-payer system. He seemed resigned to the fact that the failed market-based health care system he wants to retain is likely dying a slow qualified death.

“Barack Obama said as a candidate that he would prefer a single-payer plan but couldn’t get there,” George Will said. “As President when they were going through the Obamacare agonies, he said, look upon Obamacare as a starter home. The beginning, the thin end of an enormous wedge heading toward that. What does Donald Trump say? ‘Single-payer works fine in Scotland.’ So I don’t see any particular animus he has as you say against a single-payer plan. And, what we’ve learned in this debate about repealing Obamacare is that the essence of Obamacare is the expansion of Medicaid. Who has benefited from that? Probably disproportionately white working-class males …”

Nicole Wallace (on video) said “Trump voters.” And Will confirmed “Trump voters.”

AZBlueMeanie’s review took 14,861 characters in 1,725 words. Willies’ story took 2,435 characters in 288 words. From these numbers Scriber infers that a single payer system is about 8.5 times simpler than its competition.

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