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Trump and healthcare


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According to multiple Trump administration officials, the president’s chief strategist Stephen K. Bannon is advising him to take names and keep a hit list of Republicans who worked for Trumpcare’s defeat.

“[Bannon] has told the president to keep a sh*t list on this,” one official said. “He wants a running tally of [the Republicans] who want to sink this…Not sure if I’d call it an ‘enemies list,’ per se, but I wouldn’t want to be on it.”

One aide described it as a proposed “hit list” for Republicans not sufficiently loyal. Courses of action stemming from any related tally is yet to be determined, but the idea and message is that “we’ll remember you.”

Two senior Trump administration officials say Bannon and Trump have taken a “you’re either with us or against us” approach at this point, and that Bannon wants the tally of “against” versus “with us” mounted in his so-called West Wing “war room.”

“Burn the boats,” Bannon advised Trump. Burning one’s boats is a reference to when military commanders in hostile territories order his or her troops to destroy their own ships, so that they have to win or die trying.

http://www.thedailybeast.com/articles/2017/03/24/bannon-tells-trump-keep-a-shit-list-of-republicans-who-opposed-you.html

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Trump’s Obamacare failure and the backlash ahead

David Smith, The Guardian  /  March 25, 2017

The James S. Brady Press Briefing Room at the White House was crammed as usual but there was an extra frisson of suspense. As the press secretary, Sean Spicer, walked to the lectern, a conversation was unfolding just 27 paces away in the Oval Office. It would invalidate almost everything he said.

Paul Ryan, the speaker of the House of Representatives, told Donald Trump the news he did not want to hear. Weeks of cajoling and arm-twisting to win over skeptics of their healthcare reform legislation had failed. Ryan asked the president to ditch the bill and avoid the humiliation of putting it to a vote in the House. Trump agreed.

It was a chastening defeat for a president whose election campaign was built on his reputation as a negotiator and a winner. His book, The Art of the Deal, brags: “Deals are my art form. Other people paint beautifully on canvas or write wonderful poetry. I like making deals, preferably big deals. That’s how I get my kicks.” When it came to his first major legislation as president and the question “deal or no deal”, the answer was, emphatically, no deal.

In a poetic twist, the president who has espoused a rightwing agenda of economic nationalism, law and order and “America first” was undone by the right wing of his own party. Conservatives said the bill did not go far enough to repeal and replace the Affordable Care Act (ACA).

“Today was a big win for the president. The 44th president, Barack Obama,” declared TV host Lawrence O’Donnell on MSNBC. “And it was, to put it in Trump-speak, a complete disaster for the current president.”

It came hard on the heels of two legal knock-backs to his attempt to ban travelers from certain Muslim-majority counties. That policy too was imposed with a missionary zeal that masked a lack of competence and grasp of detail. But Trump appears to be playing the role of a chief executive intent on shaking up a business and his chief strategist, Steve Bannon, is said to admire a creed from the tech sector in Silicon Valley: “Move fast and break things.”

But Washington politics are different. Add in the Russia affair – the resignation of the president’s national security adviser, groundless claims of wiretapping against Obama and an ongoing FBI investigation into his associates – and the first two months of the Trump presidency reek of chaos, crisis and confusion.

In his rambunctious election campaign, the 70-year-old novice promised to repeal and replace the ACA “immediately”. It was a bad choice for an opening offensive. Healthcare reform is to American presidents what the Russian winter was to Napoleon. Obama got further than most but even then the notion of an American National Health Service remained a distant dream.

With Republicans controlling both the House and Senate, Trump should have had the cards in his favor. In what Democrats regarded as an act of spite, he and Ryan set a deadline to erase the ACA on its seventh anniversary, 23 March. They would supplant it with the slimmer American Health Care Act (AHCA).

But as the negotiations gathered steam, it was clearly not going to be plain sailing. Last month, Trump admitted: “Now, I have to tell you, it’s an unbelievably complex subject. Nobody knew healthcare could be so complicated.” The bill was, in the eyes of many, rushed and deeply flawed, falling well short of Trump’s campaign pledge to provide insurance for everyone.

Grassroots protests erupted across the country, citizen activists hitting the phones and constituents berating congressmen at town hall events. Groups representing hospitals and medical professionals derided the legislation. The non-partisan Congressional Budget Office estimated that the AHCA would lead to 24 million fewer Americans having health insurance over the next 10 years. The bill achieved the rare feat of uniting the far left and far right in opposition.

The biggest holdouts in Republican ranks were the hardline conservatives of the House Freedom Caucus. Trump tried to woo them with White House bowling sessions and trips on Air Force One. In the final week, he made a desperate bid to prove his credentials as “the closer”, offering concessions such as the removal of 10 so-called essential health benefits, including maternity care and emergency services.

But by Thursday, the supposed day of the vote, the wheels were coming off. Trump digressed, greeting commercial truckers to the White House, climbing into the cab of a 18-wheeler to pose at the wheel and honk the horn. Apparently unaware that the vote had just been postponed until Friday, he said: “It’s going to be a very close vote.”

Meanwhile, the scramble continued. Bannon and the White House chief of staff, Reince Priebus, were dispatched to Capitol Hill to try and turn the doubters. Spicer told reporters on Friday that more than 120 members of the House had had a visit, call or meeting at the White House in the past few days. Trump had been making calls from 6am to 11pm, he said.

But even as the press secretary put on a brave face – “Why don’t we continue with a very positive, optimistic Friday?” he said. “The sun is coming out, I feel really good” – Trump and Ryan were about to agree the terms of surrender. The speaker’s funereal expression as he left the White House spoke volumes.

Republicans, who voted more than 60 times to repeal or alter Obamacare over the past few years only to be vetoed by Obama, had got their big chance and blown it. The party’s deep ideological and factional divisions, temporarily papered over amid the euphoria of last November’s surprise win, were back with a vengeance as it struggled to go from opposition to governance.

About a mile and half away, tourists crowded under the magnificent dome of the US Capitol building. As they filed out of the rotunda they saw, outside Ryan’s office, clutches of reporters trading gossip and making mental tallies of votes. Any passing House member was asked eagerly which way they were leaning. The corridors of power in one of the world’s biggest democracies teemed with life.

Trump announced the pulling of the bill in calls to the Washington Post and New York Times. Soon after, digesting the biggest defeat of his career, Ryan admitted that the ACA would remain in place for the foreseeable future, though he claimed it was in a state of collapse – something Democrats fiercely dispute.

The minority party, traumatized by Hillary Clinton’s shock defeat, finally had something to cheer. They called it a moment to “breathe a sigh of relief” for the American people. The Senate minority leader, Chuck Schumer, said sarcastically: “So much for The Art of the Deal.”

The Democrats may have been right about the merits of Obamacare, and the havoc that would have been wrought by “Trumpcare”. But Friday’s debacle may yet be a blessing in disguise for the president.

Bob Shrum, a Democratic consultant and politics professor at the University of Southern California, said: “The truth is it might have been worse for him had it passed because he would have faced a potentially devastating midterm election.

“It’s clear from what he said he was not that personally invested in this. He felt he was obligated to do it for the party. I think his preference was to go first on taxes and maybe infrastructure. The way forward would be to push taxes and then take a leaf out of Ronald Reagan’s book and work with Democrats on infrastructure.”

Trump has said tax reform is next, and years of Republican planning might allow for that legislation to pass more easily. But his ability to work with Congress is in grave question. His unique selling point, as a dealmaker, has taken a huge hit.

Gwenda Blair, a Trump biographer, said of Trump’s supporters: “They voted for a guy who could fix it, the CEO, on The Apprentice for 10 years, who could make a deal with anybody.”

But the tactics that served Trump so well in business – playing the alpha male, holding one-on-one meetings – did not translate to politics, she said.

“Now he’s up against 535 other people [in the House and Senate], other people who have their own independent power base and are not really interested in rolling over. The model of taking one person in a room and beating up on them doesn’t work with 535.”

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He'd have much better luck if he got behind a bill that was put together with more input...with more than 17% approval...one that takes into account the great distrust we as Conservatives have in promises made to us by government actually being fulfilled. There is a long history of "we give a little here to get what we want later"...only 'later' never comes. So now, we're expected to climb on board a weak, unpopular piece of legislation while being told "you'll get what you want in phase 3"? We're skeptical there would even be a phase 2, let alone a phase 3...so we'd be trading the Democrats failed Obamacare with a Republican Obamacare-Lite. Democrats would then be able to wipe their hands of this as an issue because the Republicans would own it.

Screw that. Either get rid of the damn thing and put in place something that WORKS (as promised during the campaign...you know, the ability to buy across state lines, etc), or do nothing and let the Democrats ride Obamacare into oblivion. Pushing crappy legislation through just to pass something isn't any better than what the Democrats gave us, and it'll suffer the same results at the polls.

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Paul Kane, The Washington Post  /  March 25, 2017

President Trump and House Speaker Paul D. Ryan made it a binary choice: You’re either for their health-care legislation or you’re for “Obamacare.”

From Reps. Trent Franks (R-Ariz.) to Rodney Frelinghuysen (R-N.J.), spanning the party’s ideological spectrum, the answer came back Friday: No, it’s much more complex. It was filled with several different options and possible routes ahead, and dozens of Republicans agreed with their sentiment.

That left Republicans well short of the votes they needed to fulfill a seven-year promise to destroy the 2010 Affordable Care Act once they were fully in charge, delivering a stinging defeat to both Ryan and Trump.

It also suggested a new dynamic in which both the right and left flanks of the Republican conference are emboldened to challenge leadership. And that could make each future negotiation more difficult as the issue matrix gets more complicated and the pockets of internal GOP resistance continue to grow, not shrink, in the new era of Trump’s Republican-controlled Washington.

Some parts of these botched negotiations looked a lot like the recent past. Franks and his House Freedom Caucus cronies played the role of obstructionists who will buck party leaders no matter if it’s John A. Boehner, Ryan’s predecessor, or now Trump, as well. These ideologues gobbled up tons of attention, resulting in much care from Trump, Vice President Pence and top West Wing advisers.

By lunchtime Friday, Franks still would not commit to publicly supporting the bill — even though he admitted it was far better than current law. “Of course it is, yeah, it’s a lot better than Obamacare, of course it is. There’s not even any comparison,” Franks said a few hours before the legislation went down in flames.

Franks remained upset that conservative proposals were left out of the bill because they would have violated Senate budget rules, meaning that the proposal to replace the ACA was nowhere near to his liking.

“That still is like putting dirt in ice cream,” Franks said.

Other parts of the negotiation, however, were new and quite different from the previous six years of Republican control of the House. Nothing capped this off more than the stunning announcement Friday morning from Frelinghuysen, just three months into his hold on the coveted Appropriations Committee gavel, that bucked leadership.

“Unfortunately, the legislation before the House today is currently unacceptable as it would place significant new costs and barriers to care on my constituents,” he said in a statement.

A 22-year veteran whose family traces its establishment lineage to the Continental Congress, Frelinghuysen won his chairmanship uncontested with the blessing of Ryan and the leadership team. He’s not someone who rocks the boat — he supported impeachment articles against President Bill Clinton — but his pronouncement Friday sent a jolt through the Capitol.

He also joined a long list of influential centrists who rejected the proposal on policy grounds, not out of fear politically. Frelinghuysen has received more than 60 percent of the vote in all but one election.

If anyone should back Ryan — he’s a new committee chairman, he’s safe back home — it would have been Frelinghuysen. Instead, he sent a message to a few dozen other Republicans who have more troubling districts that they, too, should break from the president and the speaker.

In some corners, Republicans saw the past week as a defining moment when lawmakers went from the hypothetical exercise of previous fiscal proposals, which they knew the White House of President Barack Obama would block, into the world of live ammunition in which these proposals could become law.

That gravity, among moderates and some mainstream conservatives as they saw Trump agree to concessions to the Freedom Caucus, altered votes. “Sometimes you’re playing Fantasy Football and sometimes you’re in the real game,” said Rep. Joe Barton (R-Tex.), a Freedom Caucus member whom Trump had won over to support the bill.

By the time Ryan arrived at the White House, delivering the bad news about the whip count for the vote, those Republicans were doing just that. Rep. Barbara Comstock (R-Va.), who brought Ryan into her suburban district outside Washington, broke against the bill, followed by Rep. David Joyce (R-Ohio).

Joyce’s district, a mix of suburbs and working-class towns east of Cleveland, actually went for Trump by more than 11 percentage points, as Joyce was reelected by a 25-percentage-point margin. In the past, his biggest political fear has been a primary challenge from the right, yet the slight hint of Trump-fueled challengers to those opposed to the bill did not sway Joyce.

Ohio Gov. John Kasich (R) had accepted expanded Medicaid funding as part of increasing insurance coverage through the ACA. Ryan’s American Health Care Act would phase out the Medicaid coverage.

Joyce made a simple, binary choice about Obamacare: “The American Health Care Act was not a better solution.”

This new combination, with Ryan’s right and left flanks willing to buck him and the new president, presents deep concern for the long-term effort to take up the more complicated effort to overhaul the corporate and individual tax codes.

Before they can even get there, however, Ryan faces an April 28 deadline to come up with a funding stream for the federal agency budgets through the end of the fiscal year. In previous federal spending fights, the Freedom Caucus has refused to lend a hand unless policy riders were attached. Democrats, who have been relied on in the past to backfill those lost conservative votes, have signaled they will not do so this time if the legislation includes funding for controversial measures such as Trump’s request for funding to build a border wall.

That messy task falls to Frelinghuysen’s committee — and it will become much more difficult for the new chairman to ask for loyalty votes on his legislation just a few weeks after he walked away from Ryan on the AHCA. Democrats believe this attempt, and failure, has left Republicans politically in charge of health care from now on. They can’t complain about something if they can’t come up with their own fix.

“If it passes, they have to answer for it,” House Minority Leader Nancy Pelosi (D-Calif.) said early Friday. “If it doesn’t pass, they have to answer for that as well.”

Some Republicans rejected that, but others took a more holistic view. Passing the Ryan legislation would have only led to a very messy fight in the Senate, setting up what might have been an even more contentious fight later in the spring between the two different pieces of legislation.

Said Rep. Mark Amodei (R-Nev.), who opposed the legislation: “Even if it passes today, it’s like — I wanna pick these words very carefully — the adolescent dance school will still continue in full view.”

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“We're going to win so much. You're going to get tired of winning. you’re going to say, ‘Please Mr. President, I have a headache. Please, don't win so much. This is getting terrible.’ And I'm going to say, ‘No, we have to make America great again.’ You're gonna say, ‘Please.’ I said, ‘Nope, nope. We're gonna keep winning.’

:D

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You know me, I haven't liked CNN since Ted Turner sold it. But in this case, my gut feeling is the quote is legitimate and telling.

I don't dismiss the quote, however there is no balance. Reports are cherry picked to make our president look bad. CNN barely mentioned the Devin Nunes report of surveillance, or the immigrant rapists in Rockville, MD. , news that might shine a light on our president's motives.
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1 minute ago, Underdog said:


I don't dismiss the quote, however there is no balance. Reports are cherry picked to make our president look bad. CNN barely mentioned the Devin Nunes report of surveillance, or the immigrant rapists in Rockville, MD. , news that might shine a light on our president's motives.

You're 500 percent right. Both sides distort the truth to the extremes, cherry-picking to support their agenda.

I actually saw dozens of articles across the media on Nunes and that rapist (bear in mind that thousands of U.S. citizen rapists are in play 24/7).

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Now THIS, I can support! Pass this, and THEN worry about how to improve the system. First things first, though REPEAL...and it only takes 1 sentence:

"Effective as of Dec. 31, 2017, the Patient Protection and Affordable Care Act is repealed, and the provisions of law amended or repealed by such Act are restored or revived as if such Act had not been enacted,"

 

http://www.foxnews.com/politics/2017/03/28/alabama-congressman-files-one-sentence-bill-to-repeal-obamacare.html

 

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Schumer and Pelosi say the ACA is strong, viable and well received.  Let the ACA implode.

"OPERTUNITY IS MISSED BY MOST PEOPLE BECAUSE IT IS DRESSED IN OVERALLS AND LOOKS LIKE WORK"  Thomas Edison

 “Life’s journey is not to arrive at the grave safely, in a well preserved body, but rather to skid in sideways, totally worn out, shouting ‘Holy shit, what a ride!’

P.T.CHESHIRE

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42 minutes ago, j hancock said:

Politicians sure do like their Kool-Aid.

or Xanax

"OPERTUNITY IS MISSED BY MOST PEOPLE BECAUSE IT IS DRESSED IN OVERALLS AND LOOKS LIKE WORK"  Thomas Edison

 “Life’s journey is not to arrive at the grave safely, in a well preserved body, but rather to skid in sideways, totally worn out, shouting ‘Holy shit, what a ride!’

P.T.CHESHIRE

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Historian Richard E. Neustadt, in "Presidential Power: the Politics of Leadership" writes: "When contemplating General Eisenhower winning the Presidential election, Truman said, 'He'll sit here, and he'll say, 'Do this! Do that!' And nothing will happen. Poor Ike -- it won't be a bit like the Army. He'll find it very frustrating.'" No doubt, Trump is experiencing this frustration. Reportedly, Trump recently lamented that real estate is easier than politics.

As for Obamacare, Trump is right to point out that Obamacare is on life support right now, and rising premiums, copays and deductibles were forecast even if Hillary Clinton had won the presidency. Remember, too, that Obamacare was intended to "fail," given the Democrats' real goal of a Canadian-style taxpayer-paid health care. Harry Reid openly said so.

The Las Vegas Sun reported in 2013:

"In just about seven weeks, people will be able to start buying Obamacare-approved insurance plans through the new health care exchanges.

"But already, Senate Majority Leader Harry Reid is predicting those plans, and the whole system of distributing them, will eventually be moot.

"Reid said he thinks the country has to 'work our way past' insurance-based health care during a Friday night appearance on Vegas PBS' program 'Nevada Week in Review.'

"'What we've done with the ACA is have a step in the right direction, but we're far from having something that's going to work forever,' Reid said.

"When then asked by panelist Steve Sebelius whether he meant ultimately the country would have to have a health care system that abandoned insurance as the means of accessing it, Reid said: 'Yes, yes. Absolutely, yes.'"

Former Democratic National Committee Chair Howard Dean also said the end game is the so-called "public option"

. During the 2008 presidential campaign, Dean talked about the health care proposals of Democratic candidates Barack Obama and Sen. Hillary Clinton: "I think while someday we may end up with a single-payer system, it's clear that we're not going to do it all at once, so I think both candidates' health care plans are a big step forward."

Obama, then a state senator from Illinois, said: "I happen to be a proponent of a single-payer, universal health care program. I see no reason why the United States of America, the wealthiest country in the history of the world, spending 14 percent of its gross national product on health care, cannot provide health insurance to everybody. ... A single-payer health care plan, a universal health care plan. That's what I'd like to see. But as all of you know, we may not get there immediately. Because first we've got to take back the White House, we've got to take back the Senate, and we've got to take back the House." 

Later presidential candidate Obama reiterated his stance, that  "starting from scratch" he'd have a single-payer system.

Edited by 41chevy

"OPERTUNITY IS MISSED BY MOST PEOPLE BECAUSE IT IS DRESSED IN OVERALLS AND LOOKS LIKE WORK"  Thomas Edison

 “Life’s journey is not to arrive at the grave safely, in a well preserved body, but rather to skid in sideways, totally worn out, shouting ‘Holy shit, what a ride!’

P.T.CHESHIRE

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  • 2 weeks later...

Reuters  /  April 13, 2017

The Trump administration on Thursday issued a final rule that will shorten the Obamacare enrollment period and give insurers more of what they say they need in the individual insurance market, likely making it harder for some consumers to purchase insurance.

It could also raise out-of-pocket medical expenses because it gives insurers more flexibility in determining the value of their coverage.

The rule, which takes effect later this year, comes as President Donald Trump and Republicans in Congress have renewed efforts to repeal and replace the Affordable Care Act after an effort to pass a bill in the U.S. House of Representatives failed last month.

Issued by a division of the U.S. Department of Health and Human Services and first proposed in February, the rule aims to aid insurers, who have lost hundreds of millions of dollars in the individual insurance markets set up by Obamacare. Several major insurers, including Humana Inc and Aetna Inc, have announced plans to exit some state exchanges in 2018.

Insurers welcomed the rule but said there is still too much uncertainty in the market. On Wednesday, Trump told the Wall Street Journal that he may withhold Obamacare payments to insurers that amount to about $7 billion a year to force Democrats back to the negotiating table.

Marilyn Tavenner, president and chief executive of America's Health Insurance Plans, said that funding for the payments must continue uninterrupted. Otherwise, she said premiums will rise 20 percent across the market and more insurers would drop out of the exchanges.

The changes under Thursday's final rule include a shortened open enrollment period for Obamacare plans. They also make it harder for people to enroll outside that period, which is allowed under certain circumstances such as a pregnancy or a move.

The rule could also allow insurers to collect unpaid premium payments and make it tougher for people to move in and out of insurance plans.

Insurers say "gaming the system" has created an unprofitable mix of healthy and sick customers.

The rule also gives states broader authority by removing the federal government's role in overseeing doctor and hospital networks included in insurance plans. Republicans have said any healthcare reform or overhaul must give states more flexibility.

The Affordable Care Act enabled 20 million Americans to gain insurance, mostly through the individual insurance markets set up by the law or through an expansion of Medicaid, the government health insurance program for the poor and disabled.

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So we have 20 million on subsidized health care who still can not go to a doctor (but get treatment at the ER), because of their high deductible. But that's good?

Edited by 41chevy
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"OPERTUNITY IS MISSED BY MOST PEOPLE BECAUSE IT IS DRESSED IN OVERALLS AND LOOKS LIKE WORK"  Thomas Edison

 “Life’s journey is not to arrive at the grave safely, in a well preserved body, but rather to skid in sideways, totally worn out, shouting ‘Holy shit, what a ride!’

P.T.CHESHIRE

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...and how many millions are there like me, who HAD great insurance that was very affordable and covered everything I might need, but lost it due to Obamacare? The extra taxes and fees imposed in order to subsidize the insurance of others priced my policy beyond what was reasonable for what it was. That and I couldn't add my wife to the policy after I got married. Now, to buy insurance would cost nearly 20 times as much, with a deductible 4 times as high "in network" (which would be damn near impossible given where we live...so realistically more like 8 times as high). On what planet does that make sense to spend significantly more to receive significantly less than an alternative I had already deemed to be not a wise expenditure? Now they want to tack an ADDITIONAL 30% on for the first year? At that rate, they can kiss my ass, because I won't be buying into their bullshit.

Obamacare has to go, but replacing it with something worse isn't a good alternative either. There are plenty of people out here who would buy insurance IF it was affordable, and IF it actually covered anything. Problem is, when the deductible is so high the chances are slim the insurance is ever going to pay, why fork over tons of money paying premiums on a worthless policy? That money could be put to better use in a savings account earning less than 0.5% interest.

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The Washington Post  /  May 16, 2017

The Trump administration said Monday that it will dismantle part of the Affordable Care Act that created online insurance marketplaces for small businesses and tried to foster a greater choice of health plans for their workers.

Moving to end the ACA's small-business enrollment system by 2018 represents the first public step by the Health and Human Services Department to implement an executive order President Donald Trump signed his first night in office, directing agencies to ease regulatory burdens of the health-care law.

In starting with the Small Business Health Options Program, or SHOP, the administration is targeting an aspect of the ACA that has been troubled from the outset and never lived up to its proponents' expectations. As of early this year, federal figures show, nearly 230,000 people were covered through SHOP health plans - a fraction of the 4 million that congressional budget analysts had predicted as the small-business marketplaces began in 2014.

Although that means relatively few Americans will be directly affected by the decision, its symbolic impact is large.

The specifics of the impending change are a work in progress, and federal health officials said Monday that they plan to propose a new federal rule to take effect in January. The basic idea is to narrow, but not eliminate, the federal website for small-business insurance so that companies could still go online to apply for government tax credits under the law. However, they no longer would use that website to select health plans. The site instead would show the names of available insurers and tell companies to deal directly with brokers of the health plans.

"We're still working out the details on that," said a senior official at HHS' Centers for Medicare and Medicaid Services, who spoke on the condition of anonymity about decisions that have not been finalized. "The goal here is to reduce the burden," he said, noting that the current method is cumbersome for insurers.

The official said the announcement was made now because insurers selling ACA health plans are deciding this spring and summer whether to continue next year.

Kevin Counihan, chief executive of the ACA's HealthCare.gov during the Obama administration, said it's unclear whether the 2010 law allows the Trump administration to legally make such a change. The law's language is vague on whether the small-business part of the law must mirror the enrollment system for people buying coverage on their own, he said.

"The irony in some of this," Counihan said, is that "they've now added more steps in the goal of being simpler" - because businesses would need to use two websites, one to check whether they qualify for ACA business tax credits and another to work with a broker or an insurer.

The SHOP exchange has long been troubled. The separate marketplaces for businesses with 50 or fewer employees were intended to correct difficulties that many such companies had encountered with insurers because their size made it difficult to spread out the risk if an individual worker had high medical costs. As a result, small companies were much less likely to offer a choice of health plans or any coverage at all.

But the Obama administration was late in building the SHOP part of HealthCare.gov. Officials also postponed an ACA requirement that workers in small businesses be offered a choice of health plans. "Arguably, it never took off in the first place," said Sabrina Corlette, a research professor at Georgetown University's Center on Health Insurance Reforms.

And even before Trump took office, Corlette said, the Obama administration had begun unraveling the SHOP exchanges through a late 2016 rule change: It removed a requirement that health plans with many people enrolling in the ACA's individual marketplaces also had to sell coverage plans in the small-business marketplaces.

A spokeswoman for America's Health Insurance Plans, the industry's main trade group, said Monday that the further changes the Trump administration is planning "will simplify the enrollment process for small groups in many states."

But John Arensmeyer, chief executive of the Small Business Majority, condemned the idea of ending the online enrollment and requiring business to go to a broker or insurer to get coverage.

"Forcing small employers to make this extra effort just to enroll in SHOP will make it likely that SHOP usage dwindles to little or nothing," he said, calling the plans "just one more example of how the Trump administration would rather undo key parts of the Affordable Care Act."

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Some  health related news from our President and his views on exercise. From the book Trump Revealed

Quote

After college, after Trump mostly gave up his personal athletic interests, he came to view time spent playing sports as time wasted. Trump believed the human body was like a battery, with a finite amount of energy, which exercise only depleted. So he didn’t work out. When he learned that John O’Donnell, one of his top casino executives, was training for an Ironman triathlon, he admonished him, ‘You are going to die young because of this.

I knew there was a reason I hated the gym. :D

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"23 million more uninsured"...but I ask what good is HAVING insurance if you can't afford to USE it? Sure, you're complying with the law and avoiding the penalty...but if you need treatment, the cost probably won't even rise to the level of the deductible you were forced to accept to get the premiums down to where you can barely budget for them...and because you've been paying these absurd premiums, you have no money left in the budget to cover the cost of the treatment and the insurance you've been paying for won't help because the deductible hasn't been met.

I'd rather be uninsured than to buy into this current boondoggle. I WAS insured before Obamacare. If I'm given the choice in what I want covered, and premiums and deductibles are both reasonable given my age and current state of health, then I will once again be buying insurance. As long as it remains stupidly expensive covering everything I would never need and many that I'm just morally opposed to while leaving me to foot the bill anyway for the things I MIGHT need? I'll do without the useless coverage.

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  • 1 month later...

America's broken healthcare system – in one simple chart

The Guardian  /  July 2, 2017

The US spends more money on healthcare than any other wealthy nation. But it hasn’t resulted in better health

Healthcare in America is more expensive than in any other rich country. In 2016, the average American spent $4,571 on their health – a figure five times higher than the average out-of-pocket spending of other countries in the Organization for Economic Cooperation and Development (OECD).

That fact hasn’t changed much over the years: compared to 35 other countries, Americans have spent more on their health every year since 2000. Even once you factor in government spending, healthcare in the US is still more expensive than elsewhere. Total health spending last year, including private out-of-pocket and government spending, was $8,985 per person in the US while the OECD average was just $3,633.

And yet all that health spending hasn’t resulted in better health. The life expectancy of the average American is 78.8 years, putting the US a fraction ahead of the CzechRepublic, where out of pocket spending was just $236 last year.

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