Former New Jersey governor Chris Christie has a theory for why Republicans are under a lot of pressure in the suburbs.
“In some of these competitive House seats in suburban areas, the pre-existing condition issue is one that’s really cutting. And the Republicans to this point, I think, have been pretty ineffective in terms of making their case on why they weren’t going after the pre-existing condition coverage and that we’re going to maintain it. I think you’re being drowned out by the amount of money that Democrats are spending on the issue.”
I kind of love that formulation: “pretty ineffective in terms of making their case.”
The issue itself really isn’t very complicated. No one will sell you fire insurance after your house has already burned down. You can’t get an insurance company to repair your car if you don’t purchase collision coverage until after you’re in an accident. So why would a health insurance company give you an affordable policy after you’ve been diagnosed with diabetes or cancer?
If you’re guaranteed to cost them more than you’ll ever pay in premiums, then they’re not going to insure you, and if you represent a substantial risk, your premiums are going to be astronomical. This is what happens when you use a for-profit industry to address a human right to health care. So, if you tell these companies that they have to give insurance to everybody and you cap how much they can charge, that’s going to bankrupt the entire industry. The only way to make it work is to make young and healthy people buy coverage, too, and then to offer substantial subsidies to make those policies affordable. As a group, the young people will pay much more in premiums than they consume in health care, which basically makes it possible to make a profit even while insuring people who are already sick.
This is the model for Obamacare, and any effort to repeal the law by making it optional to have health insurance will torpedo the entire concept. Your options are to make the Affordable Care Act work, abandon the insurance model of health care completely, or go back to the way things were when millions were denied coverage and access because of cost or preexisting conditions.
The Republicans refuse to take any of those three positions, which makes it very hard to be effective in making their case for anything. They oppose a national health care system and they oppose a mandate that requires people to have insurance. By default, their position is that what we had before is preferable to what we have now, but that’s so unpopular that they’re not willing to admit it. But they voted to undermine and repeal Obamacare several dozens of times and then failed to pass any kind of replacement when they had the chance. Now they’re out on the campaign trail saying that they’re no threat to people’s health care even though they have no plan at all that would make it possible for a corporation to insure sick people without going broke.
Normally, the Republicans are pretty good at obfuscating and they can finesse situations like this by confusing people about the details, but they have spent their time focusing on baseless conspiracy theories rather than health care policy, leaving the entire playing field on the issue to the Democrats.
Public opinion polling has shown consistently that health care is at the top of the voters’ concerns this year, but the GOP is talking about George Soros and Central American rapists who have smallpox and leprosy. Apparently, Chris Christie has recognized that this was a mistake and that you can’t fool people about preexisting conditions unless you put in at least a little effort.
Well Trump has a brand new spanky Willie Horton ad
https://www.realclearpolitics.com/video/2018/10/31/trump_web_ad_targets_criminal_illegal_immigrants_
who_else_would_democrats_let_in.html
Those six and seven year olds and their moms trailing along with them are evil little people, I guess.
https://twitter.com/realDonaldTrump/status/1057728445386539008
Well Ryan’s Reprobates certainly have no “plan” to regulate health insurance, but they are definitely out there using the Big Lie technique which they learned from their master, Josef Goebbels. They support and protect coverage for pre-existing conditions, don’t you know that!? They always have!! That lie is more than enough for the average low-info rube, especially in the rural areas.
I’m pretty sure that one of the items our Repubs crammed through on some reconciliation budget bill was the repeal of the “Hated!” insurance mandate. This destroyed one of the critical legs of the three leg stool Obamacare relied upon and which you so clearly explain. It’s now up to the subsidies alone to entice consumers of the private market insurance products, and there are conflicting views on whether this is adequate to make the dying system “work”. At the very least Repubs have deeply harmed the underlying Obamacare theory and incentives.
But there is nothing more comical than acting as though the American boob can understand the mechanics of health insurance regulation or Obamacare specifically. Hell, I seriously doubt that most members of Ryan’s Reprobates and Mitch’s Monsters understand it! Their blather about it certainly doesn’t cause me to think they understand it. And they certainly haven’t stood in the way of Der Trumper’s multi-prong assault upon the law or any of the monkey wrenches he has thrown into it. Nor have Dem candidates spent any time implicating Der Trumper in the destruction of Obamacare.
Also comical is the idea that this coming Congress could accomplish anything on this front whatsoever. But I suppose that unlike the nihilist Radical Repubs, a Dem House could at least pass a reform bill aiding the operation of Obamacare and sent it to the Repub senate graveyard–at least then Dems would have something to campaign on in 2020, and it would look like they were at least trying. Repubs were too corrupt and stupid even to do that. Whether their Big Lie technique (aided and abetted by the useless corporate media) works on the incompetent white electorate will be seen very shortly.
. . . but the tax penalty for not obtaining insurance (i.e., the enforcement mechanism for the mandate) was repealed, effective 2019. New enrollment period for subsidized ACA “Marketplace” policies opened at midnight and lasts 45 days, to December 15 (/PSA).
Also, this seems wrong:
Ah, thanks, so it’s an honor system, without any teeth. That’s a repeal in effect. Curious why the effective date was 2019 and not immediate.
You’ve seen some Dem candidate run an ad arguing Trumper has been intentionally sabotaging Obamacare to make it fail?
. . . Unmotivated to research and document it, but doubt it’d be hard to document Dems saying what you say none are saying, whether in ads, tweets, statements, news reports — or all the above would be my bet.
Pretty hard to “make the case” when these pesky things called “facts” are working against you.
I’m hoping that something actually happens about health care in the new congress. We just got a notice about an increase in our premiums, to a little over $18,000 a year for the two of us (we make just over the subsidy limit). That’s obviously unaffordable so we’re either going to go with an underwritten policy and be nervous about it or go without entirely.
. . . tactic for decades, now. Why would this be any different?
RE:
What is to stop them from decimating the ACA during the lame duck session? Don’t they have another budget reconciliation to exploit?
Doesn’t the filibuster still apply to senate bills?
Ahh — reconciliation. Uh oh.
Here’s hoping you are wrong. If they do the Dems should likely be talking about it., no? I haven’t heard anything.
Nor have I, but the R’s have a tendency to do this stuff in secret and then spring it on everyone at the last minute. That was the whole reason McCain voted no–his famous thumbs down–was because the bill didn’t go through regular order. There’s no one to take that kind of stand now.
The obscene tax bill passed during this Congress got McCain’s vote, and it didn’t go through regular order. Nor did much of the other horrible bullshit which went through the Senate this Congressional term.
Did the shenanigans the Republicans pulled with Federal Judicial nominees reflect regular order? Fuck no. I believe he voted for every one of those radical asshole nominees, even the nominees who did not get the blue slip from their in-State Senators. I can’t remember McCain denying his vote for any of them. Some champ of regular order, eh? He really showed Trump what for.
I’m very happy McCain voted against repealing the ACA, but he lied about why he did it. It’s reasonable to deduce that he voted No because he was a big drama queen who liked the press attention and saw an opportunity to burnish his Mavericky credentials, and these career-long traits overcame his thirst for taking health insurance from 20 million Americans.
Repeal and replace was a reasonable talking point in ’16. For close to 2 years now the Rep majority and Trump have failed to repeal and never once delivered a working white paper of a replacement policy to take the ACA’s place.
Health care is the number 1 issue of this cycle because people are aging, people have been able to receive health care that allowed them to rise to a level of maintenance that was unattainable before the ACA not to mention lives saved & quality of life improved. People don’t want to just have the ACA stick around they want more and better health care and they’re savvy enough to understand that it can be affordable when fixes are delivered upon.
But the Rep continue to turn their backs on health care. Meanwhile the polling continues to trend up in favorability for the ACA. There’s only one answer as to why the Rep have lost on health care. They don’t have any better way to achieve what the ACA has and they can’t go Medicare for all or something similar because that would mean…socialism! A trap of their own making.
You really believe you can fix private insurance company for profit system of health care, only minimal government involvement needed? The system is a gigantic fraud wasting trillions of dollars a year, so a few get wealthy.
I believe what I’ve seen and that’s zero effort on the Rep part to even tweek the ACA on up to bringing our health care up to the standards of the rest of the industrialized world with a not for profit system. Zero effort and that’s the tell.
This is all based on Trump idiotically announcing “Obamacare is a disaster” (just like he announced that the Iran treaty “is a disaster”) based on nothing other than pure, ignorant, jealous spite.
(I mean, it’s not all based on that; there are a fair number of donor class people who object to all health care reform because the entire idea offends their conservative sensibilities. But, as BooMan laid out above, it’s not the kind of position anyone can ever honestly sell voters on — it’s exclusively about the donor class.)
The elites would have to pay more money if,they were not allowed to use insurance companies to screw with us. There’s only so much to go around after all. So Trump is their carnival barker and the rubes believe it all until grandma or daddy gets sick and the bills pile up and no one can pay them. Nice game though. Maybe it is catching up to them.
I pick ” abandon the insurance model of health care completely”. Why should we make insurance companies and their executives rich, while we pay very high premiums and deductibles and co pays and…? Besides it is more than twice as much as any other industrialized nation pays per capita. It is simply stupid.
Yeah, I agree the Repubs have really screwed themselves, isn’t that the greatest. WTF is all the crap about George Soros? I read that since 1979 when he founded the Open Society Foundations he has contributed over thirty billion dollars to them. The republicans have the Kochs, the Adelsons and Mercer’s. We have ole George. Leave us alone.
Besides aren’t the Clintons enough to rag on? I see now they are coming after Mueller. Gotta keep,it all churning.
I’ve never seen a better shorter summary of the entire health care debate than this. Countries like Switzerland make a system like Obamacare work. But, there they have really tough sanctions that FORCE young healthy people to buy health insurance. If you don’t purchase government approved health insurance, you can be fined, or even jailed, and your wages can be garnished. They take that seriously. The health insurers are required to provide basic coverage at affordable rates, and the government sets coverage standards.
Obamacare tried to do some of these things, but the coercive portions of the bill were wildly unpopular here and the sanctions were terribly weak. Plus, we can’t even approach the blanket regulation of the Swiss insurance industry, even under Democratic administrations, so Obamacare provided crappy “Bronze Plans” with huge deductibles at a cost that was still much too high for many families. It was also confusing as hell.
SO, Obamacare was always going to be in trouble once the GOP decided to demagogue the issue. The only alternative is going to be single-payer. The GOP however, rather than letting the system fail slowly over time and attack Democrats for it after it failed, jumped in with screaming “death panels” attacks that backfired when people realized “hey! There are no death panels!” Even if Obamacare tanks totally, they will be the ones blamed because they attacked and tried so hard to repeal it as well as because they have no alternatives.
>”If you’re guaranteed to cost them more than you’ll ever pay in premiums, then they’re not going to insure you, and if you represent a substantial risk, your premiums are going to be astronomical. This is what happens when you use a for-profit industry to address a human right to health care.”
This is the fundamental truth underlying everything to do with the health care debate and it was painfully obvious from the beginning. That the entire populace doesn’t accept this and act accordingly is one of the most depressing things imaginable.
>The Republicans refuse to take any of those three positions, which makes it very hard to be effective in making their case for anything.
This! But this has been true since 2009. How on earth did the last 10 years of successful GOP backlash happen?
I am far from the expert on this but from my vantage point it happened due to the high premiums, the high deductibles and then we made the elites pay an investment tax on it. Think you can get away with that without making someone pissed off enough to want to kill the whole thing?
It’s as simple as what Nancy Pelosi said: “we have to vote for it [for you voters] to find out what’s in it.”
Everyone knew this was true.