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ACA Running Thread

It is going to be difficult to get this passed. Freedom caucus is going to see itself as the refinery whose job is it purify the final product. Will be interesting to see what compromise is able to be made.


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Wrangor said:
It is going to be difficult to get this passed. Freedom caucus is going to see itself as the refinery whose job is it purify the final product. Will be interesting to see what compromise is able to be made.


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lol
 
Things will change a lot from this draft bill. Some things to like, some things to make you say hmmmm. FWIW, the steeper age curve is a good thing IMHO. One of the reason why young people didn't buy.

Whats amazing is how uninformed some of these people are. They want to keep the "good" parts of the ACA but remove the tax credits that offset the costs of these "good things". They are convinced that things like selling across state lines and HSAs will lower the costs so much that it will become affordable.

Equally uninformed are the folks who think the ACA just needs to be "tweaked". The issues are so big simple tweaks wont fix it.

Will be fun to watch. Watch the CSR discussion. If CSRs don't get funded, there will be a mass exodus out of the ACA which will spell disaster for repeal and replace.
 
If the RW and healthcare industry gets their way with this issue, one of the most likely outcomes will be a single payer system in the US as millions are priced out of the system, customer care and customer protections erode and all that matters becomes profit.
 
This may be simplistic, but as an interim solution why not have ACA claims pay at Medicare + x% rates? I think we discussed this several pages back. The providers would howl because their gravy train would be ending, but it would be interesting to see how a simple cost measure such as this affects rates and affordability. Would we get a clearer view of what is good/bad about the ACA after testing this?
 
awaken said:
This may be simplistic, but as an interim solution why not have ACA claims pay at Medicare + x% rates? I think we discussed this several pages back. The providers would howl because their gravy train would be ending, but it would be interesting to see how a simple cost measure such as this affects rates and affordability. Would we get a clearer view of what is good/bad about the ACA after testing this?
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The GOP was against this. It was called the public option.
 
awaken said:
This may be simplistic, but as an interim solution why not have ACA claims pay at Medicare + x% rates? I think we discussed this several pages back. The providers would howl because their gravy train would be ending, but it would be interesting to see how a simple cost measure such as this affects rates and affordability. Would we get a clearer view of what is good/bad about the ACA after testing this?
Click to expand...

I think this is part of it. Mandate all insurers get the same deal on ACA members. And pay at Medicare + x%. This will certainly reduce premiums but wont necessarily impact trend and could actually make it worse. We need to package this with pay for value with providers. Fee for service had some pretty poor incentives for docs.
 
One other random thought after watching the crowds boo when the Pubs talk HSA . I think the left will go on the attack when it comes to HSAs and I think thats really shortsighted.

We need consumers to get skin in the game, especially if we will keep the pre-ex rules in place.

Think of an HSA plan indexed to income where the lower the income, the less "high deductible" your "high deductible plan" would be. Simple example....

Create a $1500k HSA plan that cover preventive things pre deductible for the lowest income person. The feds put in 50% of the deductible into the account. At year end, perhaps we allow a small cash out for good consumer choices (generics, sought low cost providers etc). The remaining $ roll over.

As income increases, so does deductible while gov't contribution drops.

Im 100% convinced we need to incent (though carrot and sticK) consumers to make better choices.

We also need to incent docs to deliver care more efficiently. Pay good docs more, pay bad docs less.

We need health care reform this time. Not insurance reform.
 
ACA is best effort to date to reform our HC system in favor of patients, consumers, population. Pubs have made a living since its passage out of demonizing it, in spite of the fact that it is largely a Pub plan.

Best thing at this point from a practical standpoint would be to shore it up. But that's not possible, politically, for the Pubs. So they'll kill it (make it fail) by a thousand cuts (already well into this) and THEN repeal and replace. Winners will be the wealthy and the well. Losers will be the sick and the poor. Winning.
 
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