This might aso be of interest in our discussion of ObamaCare, Trump and Ryan.



Donald Trump campaigned on a promise to repeal President Barack Obama's health care law. In fact, he vowed to ask Congress to deliver a full repeal "on day one." Can he do that?

Well, no one can stop him from asking. But can Congress make it happen? Even a Republican Congress? The answer turns out to be sort of complicated. The legislative basics I'm about to spell out apply to everything Trump wants to do, so if you're following along at home, here's what to watch for over the next few months.

Let's take the easiest option first. The only thing stopping Congress from a simple and total repeal of Obamacare is the fact that Democrats can filibuster any repeal bill in the Senate. Republicans need 60 votes to override a filibuster, and they don't have them.

It's political suicide, which means they have to find some way to save the individual market even with the preexisting-conditions provision in place.
But what if they abolish the filibuster? Democrats got rid of it for lower-court judicial nominees and executive appointees in 2013, and Republicans could do the same for ordinary legislation if they wanted—because, ironically, you can't filibuster a vote to eliminate the filibuster. If Republicans do this, the Obamacare question is simple: It's dead. Congress merely has to pass repeal legislation with a simple majority and send it to President Trump's desk for his signature.

However, this is an unlikely scenario, since plenty of Republicans are wary of abolishing the filibuster. After all, it's a handy excuse to have around should mistrustful tea partiers start wondering why Congress hasn't implemented their entire agenda. Plus, Republicans may need it themselves someday. So let's move on. What can Republicans do with a simple majority?



RELATED: Trumpcare Is Likely to Be Costlier, Less Efficient, and More Annoying Than Obamacare CQ Roll Call via AP Images
It turns out they can repeal a lot. In a 2015 dry run, both houses of Congress passed a reconciliation bill that included a repeal of most things people identify with Obamacare: the subsidies, the individual mandate, the expansion of Medicaid, all of Obamacare's new taxes, and several smaller provisions. These were approved by the parliamentarian and would presumably pass muster again. (Obama vetoed the legislation a few days after it was passed.)

Although this sounds like a pretty thorough dismantling of Obamacare, it's not. The original legislation was more than 1,000 pages long and contained hundreds of obscure but important regulations that Republicans can't touch under reconciliation. Of these, one is by far the most important: preexisting conditions. Obamacare bans insurance companies from refusing to cover people with preexisting conditions, which means that if you apply for coverage, they're required to sell it to you at the same price they'd sell it to anyone else. This particular provision of Obamacare clearly doesn't affect the federal budget, so it can't be repealed via reconciliation.

And that's a big problem for the GOP. More than two-thirds of the country approves of this provision of the law, and Trump has said he wants to keep it. Republicans don't have the votes to repeal it anyway. So what happens if you keep this provision but get rid of everything else?

The preexisting-conditions provision provides Democrats with some leverage—maybe even enough to stop a repeal.
Well, consider me. A little more than two years ago, I was diagnosed with cancer, which is currently being held at bay by about $100,000 worth of treatment per year. If I hadn't been insured before that, I would have immediately bought insurance as soon as I found out. This means that some unlucky insurance company would have been forced to sell me health coverage even though it'd be guaranteed a huge loss on my policy.


Now what happens if lots of other people do the same thing? What if millions of healthy people skip health insurance entirely, buying it only if they get diagnosed with an expensive condition? This would have only a small impact on the employer market, since corporations insure everyone who works for them—which means insurance companies make plenty of money from healthy people to offset their losses from the small number of expensive patients.

But in the individual market, which accounts for about 7 percent of the total, healthy people would stay out while sick people would pile in. Insurance companies could lose tremendous amounts of money, and they'd have only two ways to respond. The first would be to stratospherically raise premiums for everybody. This is what happened in New York after state lawmakers passed a bill in 1992 requiring insurance companies to cover everyone. (Obamacare eventually helped bring down New York premiums.) The second response would be to simply stop selling individual policies. Millions of people would be left with nowhere to get insurance at all.

This is what Republicans have to deal with. It's political suicide, which means they have to find some way to save the individual market even with the preexisting-conditions provision in place. Is it possible?

One place to look is "A Better Way," a set of proposals from House Speaker Paul Ryan. The health care portion is 37 pages long and specifically says, "No American should ever be denied coverage or face a coverage exclusion on the basis of a pre-existing condition." How does he manage that?


RELATED: The Republican Plan to Replace Obamacare is Obamacare Lite. Very, Very Lite. J. Scott Applewhite/AP
First, Ryan's plan wouldn't allow people to stop or start coverage whenever they wanted. Instead, insurance companies would be required to sell policies only to people who have maintained continuous coverage—and Ryan's plan would provide refundable tax credits to help pay for it. In other words, unlike the Obamacare individual mandate, which encourages people to buy insurance by assessing a tax penalty on anyone who remains uncovered, Ryan's plan encourages people to buy insurance by threatening them with the inability to get coverage if they ever get sick.

But what about people who don't maintain continuous coverage despite the incentives? After all, Ryan's plan specifically says it covers everyone. The answer is high-risk pools run by the states. Each state would run an insurance program specifically for people who can't get insurance anywhere else. However, this pool would mainly consist of the very sick, which means insurance premiums would have to be very high. To help out with this cost, Ryan's plan includes $25 billion in federal subsidies—where the money would come from isn't completely clear—to keep the pools solvent even though premiums would be capped at a moderate level. Unlike the Obamacare subsidies, which are usually paid directly to the insurance companies, Ryan's subsidies would be paid to the states, which would then turn them over to the insurance companies.

Finally, for the very poorest people, Ryan's plan relies on Medicaid, which it suggests it could make more efficient via state-level flexibility and better incentives.

If you haven't yet noticed what this all means, let me spell it out. The key parts of Obamacare and Ryan's plan are the same. They both (a) rely on private insurance, (b) require insurance companies to cover people with preexisting conditions, (c) encourage people to buy insurance continuously by penalizing them if they don't, (d) provide billions of dollars in federal subsidies to make insurance affordable for low-income households, and (e) rely on Medicaid for the very poorest.


In other words, Ryancare is basically Obamacare by another name. This is no coincidence. Health insurance, like any other kind of insurance, fundamentally relies on access to a large, random pool of people. In any given year, the few sick ones are paid for by the large number of healthy ones. But once you tinker with that by allowing healthy people to opt out, the whole system collapses. One way or another, you can save it only by forcing healthy people back into the pool and then providing subsidies to the ones who can't afford coverage no matter what the law requires of them.


RELATED: Voucherizing Medicare Is a Death Ride for Republicans Andrew Harnik/AP
Ryan's plan does that, but would it pass muster in court? After all, Obamacare's preexisting-conditions provision would still be in place, because Republicans can't repeal it. As long as that's the case, someone with an expensive condition would be certain to sue, arguing that they still have the right to buy a plan from any insurer of their choosing regardless of whether they've maintained continuous coverage—and to buy it at the same price as anyone else. That's a strong argument, which means this part of Ryan's plan is likely to be struck down in court. Unless Republicans figure out a way to repeal the preexisting-conditions provision—perhaps by threatening havoc unless Democrats go along—there's a good chance Ryan's plan would fall apart. This would leave millions of people with serious health problems and no coverage, and Republicans taking the blame for it.



Beyond this, there are a number of things President Trump could do to undermine Obamacare without waiting for Congress to act. He could remove resources from the enrollment program, making it harder for people to sign up. He could effectively end the individual mandate by redefining the hardship exemption to include anyone who simply says they can't afford insurance. He could be much more flexible about allowing states to opt out of Obamacare via innovation waivers—and he could do the same for Medicaid waivers. Timothy Jost, a health care law expert, points out that Trump could also encourage insurance companies to drop out of the program, effectively killing it off. The Trump team's words are important, he says, and what insurers do going forward "depends on signals they send over the next couple of months."


So that's the story. If Republicans choose to use extra­ordinary means—either axing the filibuster or bullying the Senate parliamentarian—they can fully repeal Obamacare and replace it with anything they want. Alter­natively, they can leave the preexisting-conditions provision in place—along with all the other regulations they can't touch—and create chaos by repealing everything else. But if they're not willing to do that—and they probably aren't, if only for reasons of political survival—Obamacare's preexisting-conditions provision provides Democrats with some leverage. Republicans need Democratic votes to repeal the provision and pass a workable law, which means that if Democrats hold out they can certainly get a far better deal than Ryan's plan. They might even be able to stop the Obamacare repeal in its tracks. It all depends on how well they play their hand.

I must look up and read that new book, "Rewriting History." I will do so after I haver read "The Republican War on Science," which I just ordered.

The fact remains that Trump is a pathological liar, and he is the prson we were discussing. He is the person who won the election, and his lies are the ones we are going to have to deal with. Whether or not Hillary was/is a liar does not excuse Trump's lies, though you seem to think that Hillary's alleged lies excuse Trump's.

Is it possible for us to discuss this subject without insulting each other ? I am interested in everyone's opinion about what is going to happen to medical care and coverage if ObamaCare is repealed and if the coming administration follows through on the plans to change Medicare. What is your opinion ? What is your prediction. I saw an article that Medicare premiums deducted from one's social security are going to double, and may take as much as 55% of one's social security. I don't know the truth in this prediction, and I don't suppose any of the rest of us do, either. But do you think medical care costs are going to go up ?

Please cut the insults and let's have a serious discussion.

Richard94611, I responded to lindajoy with this post on another thread:

This from Physicians For A National Health Program (PNHP):

"Upgrading the nation'™s Medicare program and expanding it to cover people of all ages would yield more than a half-trillion dollars in efficiency savings in its first year of operation, enough to pay for high-quality, comprehensive health benefits for all residents of the United States at a lower cost to most individuals, families and businesses.

That's the chief finding of a new fiscal study by Gerald Friedman, a professor of economics at the University of Massachusetts, Amherst. There would even be money left over to help pay down the national debt, he said."

http://www.pnhp.org/news/2013/july/%E2%80%98medicare-for-all%E2%80%99-would-cover-everyone-save-billions-in-first-year-new-study

Friedman said the plan would be funded by maintaining current federal revenues for health care and imposing new, modest tax increases on very high income earners. It would also be funded by a small increase in payroll taxes on employers, who would no longer pay health insurance premiums, and a new, very small tax on stock and bond transactions.

"œSuch a financing scheme would vastly simplify how the nation pays for care, restore free choice of physician, guarantee all necessary medical care, improve patient health and, because it would be financed by a program of progressive taxation, result in 95 percent of all U.S. households saving money," Friedman said.

Don't you think that medical care should be a right for every citizen and not a privilege for only those that can afford it and the poor who get it for free anyway? I am 63 years old and cannot afford the $378.98/monthly premium and $6000.00 deductible on the only plan available to me in Texas, BCBS Bronze plan which then only pays 60%.

Even my doctor brother says that Medicare for All is the way we should go and cut the middle man (private, for profit health insurance corporations) out. It works in Canada and Canadians are 97% satisfied with their health care system despite the myths and propaganda put out by the private, for profit health insurance industry.

http://www.vox.com/2016/10/9/13222798/canadians-seeking-medical-care-us-trump-debate

"One salient reason they offer: Even if Canadians wanted to escape their system, most probably could not afford US medical care. "Prices for U.S. health care services are extraordinarily high, compared with those in all other countries, and this financial barrier is magnified by the extraordinary strength of the U.S. dollar. Private insurance for elective services, being subject to very strong adverse selection, is, not surprisingly, nonexistent."

As the lead author on the paper, University of Michigan's Steven Katz, told Vox, "A hip replacement [in the US] would cost nearly $100,000 out of pocket plus travel and living expenses." Waiting get one for free in Canada is easy compared to that, he added. "Canadians are happier with their system than we are and life expectancy and other health indicators are higher."

According to Horn News:

Here are just five reasons Obama deserves to be impeached:

Reason #1: Failing to secure American borders


Obama has made it easier than any president in U.S. history for illegal immigrants to remain in America. Under his immigration enforcement programs, up to 87 percent of illegals are basically safe from any deportation actions, according to a report from the Migration Policy Institute. The MPI report found that many of these illegals even have criminal records.

Obama has also failed to take action on so-called “sanctuary cities” like San Francisco, which refuse to cooperate with the federal government to apprehend illegal immigrants.

Reason #2: The disastrous Bowe Bergdahl trade

In 2014 Obama shocked Americans when he agreed to release five Taliban commanders in exchange for Army Sgt. Bowe Bergdahl, who abandoned his post in Afghanistan. The prisoners released by Obama included a founder of the Taliban movement who had ties to Osama bin Laden, and a man who was still “encouraging acts of aggression,” according to his Guantanamo case file.

Reason #3: Veterans dying waiting for care

Obama has broken a promise America made to millions of its veterans. Reports emerged last year of veterans who were dying while waiting for medical appointments at Veterans Affairs hospitals. Some hospitals were even keeping secret waiting lists so administrators could meet performance objectives.

While President Obama promised to clean up the mess and make sure our veterans get the care they’ve earned, his efforts have been nothing short of incompetent. A year after the scandal first broke, the number of veterans on waiting lists had actually increased by 50 percent.

Reason #4: The IRS targeting scandal

As Rush Limbaugh said, President Richard Nixon only dreamed about doing what former IRS director Lois Lerner did under Obama’s watch. Under Lerner’s leadership, the IRS was accused of targeting conservative non-profit groups, including those with “Tea Party” in their names. Lerner eventually resigned in disgrace and was even declared in Contempt of Congress.

But an investigation by Obama’s Department of Justice clearer her of wrongdoing in the IRS scandal and she’s never been punished. In Lerner’s case, the Obama administration made a clear effort to avoid upholding the law.

Reason #5 The Benghazi cover-up

Sen. James Inhofe (R-Okla) has called the Obama administration’s actions surrounding the 2012 attacks on an American diplomatic compound in Benghazi, Libya the “greatest cover-up in American history.”

Four Americans died in the attacks, including Ambassador J. Christopher Stevens.

Obama and his former Secretary of State Hillary Clinton have been accused of lying about what they knew about threats to the compound, and of failing to provide adequate security.

There also appears to have been a coordinated effort by the Obama administration to blame the attacks on a spontaneous reaction to a controversial YouTube video, even though officials knew the attack was coordinated in advance.

More from Petition2Congress:

https://www.petition2congress.com/9248/51-reasons-to-impeach-obama