Following AHCA defeat, Trump signals new openness to Dems

[Meathead]

WASHINGTON — President Donald Trump on Sunday attacked conservative lawmakers for the failure of the Republican bill to replace former President Barack Obama’s health care law, as aides signaled a greater willingness to work with moderate Democrats on upcoming legislative battles from the budget and tax cuts to health care.

“It’s time for the party to start governing,” Priebus said. “I think it’s time for our folks to come together, and I also think it’s time to potentially get a few moderate Democrats on board as well.”

Trump faces decisions on whether to back administrative changes to fix Obamacare or undermine it as prices for insurance plans rise in many markets.

“I don’t think the president is closing the door on anything,” Priebus said.

Senate Minority Leader Charles Schumer, D-N.Y., said Democrats stood ready to work with Trump to fix Obamacare if he is willing to drop attempts to repeal the law and not undermine it. He warned that Trump is destined to “lose again” on other parts of his agenda if he remains beholden to conservative Republicans.

“If he changes, he could have a different presidency,” Schumer said. “But he’s going to have to tell the Freedom Caucus and the hard-right special wealthy interests who are dominating his presidency ... he can’t work with them, and we’ll certainly look at his proposals.”

https://www.washingtonpost.com/politics/trump-attacks-conservative-lawmakers-over-health-bill/2017/03/26/f56eb11e-1226-11e7-bb16-269934184168_story.html?utm_term=.2cf1374de366

things could get real interesting real fast

despite his posturing, don doesnt have the option of letting the ACA 'explode'. it doesnt matter how many times you call it 'Obamacare', its owned by whatever presidency is current. if its in bad shape at the end of his first term both he and republicans will lose. big time

hes either got to try again with just the republicans, or he goes nuclear and enlists the dems to fix what we have and move on

the only long-term option for successful health care reform is bi-partisan so hopefully he chooses that route. but thats going to leave a lot of blood on floor in the hallowed halls of congress.

given how wretchedly poor our entire political process had been running the last decade, this could be a very good thing

taking an unconventional approach and crossing over the deeply entrenched partisanship will be explosive. seems like its what we need. this could actually be dons comfort zone, and if anybody is going to be good at it it would be him.

personally, i think its his only chance to avoid a failed presidency

[Tiberius]

That Schumer is a sly fox...

[Magox]

So let's try to define what Schumer was trying to say

 

Senate Minority Leader Charles Schumer, D-N.Y., said Democrats stood ready to work with Trump to fix Obamacare if he is willing to drop attempts to repeal the law and not undermine it. He warned that Trump is destined to “lose again” on other parts of his agenda if he remains beholden to conservative Republicans.

“If he changes, he could have a different presidency,” Schumer said. “But he’s going to have to tell the Freedom Caucus and the hard-right special wealthy interests who are dominating his presidency ... he can’t work with them, and we’ll certainly look at his proposals.”

 

 

Of course this is all going based off the premise that he was being truthful, which is up for debate.

 

But if he was, Schumer brings up two main conditions.

 

A) Not to go along with the Freedom Caucus

 

and

 

B) Not to go with the Wealthy special interests.

 

From my view what that means is

 

A) We still want to give subsidies for lower and middle income folks, protect medicaid and still want to cover people with Pre existing medical conditiosn

 

and

 

B) Don't repeal the taxes on the wealthy.

 

 

This is doable. They could come to a compromise to revamp the subsidies through a similar mechanism but not reduce the total expenditure, keep pre existing medical coverage and maybe go with the idea in creating separate risk pools for them and essentially keep Medicaid in place with a few minor reforms.

 

And with the taxes, they could come to a compromise to not tax those making below $500,000 a year, right now it stands at $250,000.

 

I do believe that Trump will not forget how the Freedom Caucus derailed his first major test. The guy is a major league narcissist, and to be defeated on this bill, it's gotta sting.

[boyst]

[ExiledInIllinois]

He came out of the inauguration gate a wife beater, now he is bringing roses and yelling: "Stella!"

 

Don't fall for it ladies! He's still wearing that God awful ripped Italian-tee.

 

:-/

[Meathead]

So let's try to define what Schumer was trying to say

 

Of course this is all going based off the premise that he was being truthful, which is up for debate.

i read schumer there as doing a bit of posturing and post-victory gloating. im sure he realizes even a wounded president is still president, he cant expect don to just roll over. its still a republican presidency backed by a republican dominated congress, schumer cant dictate all the terms. it was sort of his opening salvo on the negotiations

 

They could come to a compromise to revamp the subsidies through a similar mechanism but not reduce the total expenditure, keep pre existing medical coverage and maybe go with the idea in creating separate risk pools for them and essentially keep Medicaid in place with a few minor reforms.

 

And with the taxes, they could come to a compromise to not tax those making below $500,000 a year, right now it stands at $250,000.

this is a little off-topic for this thread, and i dont know nearly as much about the nuts and bolts of health care reform like you do, but im curious to hear what you think would fix the biggest failure of the ACA right now in much of the middle class having coverage that is too expensive to use. i know a ton of ppl both directly and that ive read about that cant use their coverage bc their premiums and deductibles are so high and they dont get subsidies

 

you also seem to not like the so called essential health benefits requirement, which to me seems highly important. without that wide baseline of services ppl wont get prescreening, they wont be covered for unexpected illnesses, and they will develop bigger and super expensive conditions down the road. sometimes that means ppl will have to pay for coverage they dont need (mammograms for males) but it seems to me that all generally evens out. plus it would be ridiculously complicated to try to provide all those things ala carte and ultimately wouldnt make it worth it when its overall effect on cost to an individual consumer would be minimal in the long run

 

these essential benefits seemed like a huge sticking point that could derail dons attempts to negotiate with the dems if they decide to hold firm, which i think they will. it seems like it would turn off a lot of the republicans, and not just the hard right wingers like heritage and freedom caucus

 

on top of that, they need to find ways to keep multiple insurance providers in every market to foster competition and make sure everybody has reasonable options

 

i dont yet see how they can do all that, keep the subsidies and most of the 'new' health care taxes, address the middle class coverage deductible problem, and do tax reform and the expansion of the military at the same time. unless they just continue to expand the deficit which for obvious reasons seems like a nonstarter

 

I do believe that Trump will not forget how the Freedom Caucus derailed his first major test. The guy is a major league narcissist, and to be defeated on this bill, it's gotta sting.

 

hes definitely a major narcissist, but hes also not really a republican, and that could work heavily in all our favor

 

hes beholden to the republicans only as far as it benefits him, he can actually cross the aisle at any time bc hes not really aligned with either ideology. he can write off big chunks of the republicans he cant get to fall in line, like the ones that just derailed this piece of crap legislation

 

n running his hatchet job businesses he didnt have to answer to anybody, and im sure hes not at all used to not getting his way. hes going to hear about his health care failure until it gets fixed. so hes going to be driven hard to do whatever it takes to get a reasonably working hc system in place and his best bet appears to be embracing a true bi-partisan approach. in this way, we use the dons own shortcomings in the country's favor, and if we're lucky it might finally break this entrenched partisan logjam thats been sabotaging our government and even our culture at large

[Magox]

this is a little off-topic for this thread, and i dont know nearly as much about the nuts and bolts of health care reform like you do, but im curious to hear what you think would fix the biggest failure of the ACA right now in much of the middle class having coverage that is too expensive to use. i know a ton of ppl both directly and that ive read about that cant use their coverage bc their premiums and deductibles are so high and they dont get subsidies

 

you also seem to not like the so called essential health benefits requirement, which to me seems highly important. without that wide baseline of services ppl wont get prescreening, they wont be covered for unexpected illnesses, and they will develop bigger and super expensive conditions down the road. sometimes that means ppl will have to pay for coverage they dont need (mammograms for males) but it seems to me that all generally evens out. plus it would be ridiculously complicated to try to provide all those things ala carte and ultimately wouldnt make it worth it when its overall effect on cost to an individual consumer would be minimal in the long run

 

these essential benefits seemed like a huge sticking point that could derail dons attempts to negotiate with the dems if they decide to hold firm, which i think they will. it seems like it would turn off a lot of the republicans, and not just the hard right wingers like heritage and freedom caucus

 

on top of that, they need to find ways to keep multiple insurance providers in every market to foster competition and make sure everybody has reasonable options

 

i dont yet see how they can do all that, keep the subsidies and most of the 'new' health care taxes, address the middle class coverage deductible problem, and do tax reform and the expansion of the military at the same time. unless they just continue to expand the deficit which for obvious reasons seems like a nonstarter

 

 

 

 

I don't believe that insurance companies should be mandated to cover all 10 minimum essential health benefits, I find it to be overly paternalistic, unnecessary and without doubt increase the costs of many people's insurance who have no need for many of these provisions such as maternity coverage and children's pediatric to name a couple. There are other such as rehabilitative and mental health services that in my view should be made available but not mandatory. That's not to say that these other services aren't necessary for some, but why make it mandatory? It's like auto insurance, there are services that are mandatory and others that aren't.

 

The biggest problem with the ACA is that the incentives skew towards older sicker individuals and not towards younger people. Which means that you have risk pools that are filled with people with higher medical claims that in turn leads to higher premiums. Add that with some of the unnecessary minimum essential benefits, taxes, lack of competition and unfair subsidy distribution system, you have people in the middle class that are getting squeezed out of the market and paying exorbitant premiums.

 

They could do as what Ryan wants to do which is create separate risk pools to place people with certain pre existing conditions into those pools. I posted this earlier but 5% of the sickest of the population accounts for 50% of all the medical costs. You could move a portion of those into these separate federally subsidized risk pools and that would lower the cost of the premiums for the remaining 95% of the population. It wouldn't work exactly that way but in concept that is how it would function.

 

A few other things they could do are some pilot programs where they give customers the choice to either receive the current cost share reduction or programs of those funds shifted into private HSA's, which would incentivize consumers to shop around for medical prices which would create more of a demand for medical price transparency. Also, encourage medical providers through federal carrots to promote transparency. Add in some market based reforms such as tort reform and competing carriers across state lines. Encourage more investments in wellness programs. Take away the shackles off of carriers that they could provide plans to consumers of higher deductible plans that are rich with Doctor, prescription and ER copays. Young people generally don't need low deductible plans. A $10k deductible rich in copay benefits is perfect for someone under the age of 35. These sort of plans with the advanced tax credits would allow lower to middle income younger folks to get health plans below $75 a month premiums.

 

That's the direction that I'd head in.

[Tiberius]

 

 

The biggest problem with the ACA is that the incentives skew towards older sicker individuals and not towards younger people. Which means that you have risk pools that are filled with people with higher medical claims that in turn leads to higher premiums. Add that with some of the unnecessary minimum essential benefits, taxes, lack of competition and unfair subsidy distribution system, you have people in the middle class that are getting squeezed out of the market and paying exorbitant premiums.

 

 

You mean it helps the people that actually need the help. It asks people that don't need health care so much now to contribute now to help others so that later those younger people will be helped in the same way when they get older and need the help. Democrats will never give up that principle and I don't think they should. If that's the "problem" then we see why Republican health care "reform" went no where

[Magox]

You mean it helps the people that actually need the help. It asks people that don't need health care so much now to contribute now to help others so that later those younger people will be helped in the same way when they get older and need the help. Democrats will never give up that principle and I don't think they should. If that's the "problem" then we see why Republican health care "reform" went no where

 

Well, it's that "principle" that is driving rates higher for everyone else. So while the goal may have been laudable, the outcome certainly wasn't. The solutions I provided would make it better for everyone.

[SlimShady'sSpaceForce]

The Donald is going after Dem support because needs votes to pass anything mostly because he can't reign in the far right.

[Tiberius]

 

Well, it's that "principle" that is driving rates higher for everyone else. So while the goal may have been laudable, the outcome certainly wasn't. The solutions I provided would make it better for everyone.

Someone will have to pay for it and that will be a serious sticking point. Almost sounds like you want consumers to pay less and taxes (the rich) to pay more. Paul Ryan and his gang would never go for that.

[Magox]

Someone will have to pay for it and that will be a serious sticking point. Almost sounds like you want consumers to pay less and taxes (the rich) to pay more. Paul Ryan and his gang would never go for that.

 

 

I'm talking about what I would do.

[Tiberius]

 

 

I'm talking about what I would do.

[boyst]

This is a retarded thread full of morons, save for magox who's trying. But, he still read all their blather.

[Meathead]

lmao. boyst you are so freaking mental. its a riot

[Meathead]

thanks for the explanation magox. im operating at such a disadvantage on this topic bc i simply dont know much outside of my sphere of experience and what ive read. for instance, i dont know what the cost breakdown actually is for having everybody pay a little something for essential services vs using an ala carte approach with various levels of coverage. thats pretty important information that could swing the logical course, but i simply dont know it

 

what i do know is that i dont like eliminating things like mental health services. i dont recall the exact statistics, but something like half of all ppl will experience serious psychological difficulties at some point in their life. if you think about your own experiences over time and others around you, its not hard to see that ppl could easily find themselves in that situation and would benefit from help. ive been there and happily used my insurance to get counselling and medications when i needed them and they absolutely helped get me back on track. ive known lots of ppl that would benefit from that, most didnt do so due to the stigma attached to psychological counseling, and others bc they didnt have any coverage for it. i feel like its in the publics interest to have access to those services and having it in your insurance program would encourage or at least not discourage someone from getting the help they need to get back on track

 

unfortunately i know almost nothing in detail about these risk pools, but it sounds like we would just be putting all the ppl who need care into a situation where they will end up paying large amounts to get that help when they need it. i would think its better to have everyone participate so that those funds are in place on an ongoing basis and available when everyone inevitably will need them. of course thats a very long term perspective, it assumes a system that is a going concern so that ppl how contribute when they are young and healthy have access twenty or thirty years down the road. personally, thats what i would like to set up for all americans, similar to social security. i believe its time, we have the resources, it just a matter of committing to doing it

 

given my limited in-depth knowledge on this topic, i would have to look to someone like you to figure out how that all would work. i just feel like its embarrassing that we have more health care resources by far than any country in history, and yet we still have ppl going broke or dying bc they couldnt get the care they need. we will all get sick eventually, its just a matter of when. i would prefer everyone has the ability to get those issues addressed when the time comes

 

i suppose that makes me a bleeding heart on health care. ok fine, so be it

[Doc Brown]

I've always felt the Tea Party was too radical so I'd much rather moderate Republicans work with moderate Democrats to get things done. A bipartisan infrastructure bill would be a good start.

[TH3]

 

 

I don't believe that insurance companies should be mandated to cover all 10 minimum essential health benefits, I find it to be overly paternalistic, unnecessary and without doubt increase the costs of many people's insurance who have no need for many of these provisions such as maternity coverage and children's pediatric to name a couple. There are other such as rehabilitative and mental health services that in my view should be made available but not mandatory. That's not to say that these other services aren't necessary for some, but why make it mandatory? It's like auto insurance, there are services that are mandatory and others that aren't.

 

The biggest problem with the ACA is that the incentives skew towards older sicker individuals and not towards younger people. Which means that you have risk pools that are filled with people with higher medical claims that in turn leads to higher premiums. Add that with some of the unnecessary minimum essential benefits, taxes, lack of competition and unfair subsidy distribution system, you have people in the middle class that are getting squeezed out of the market and paying exorbitant premiums.

 

They could do as what Ryan wants to do which is create separate risk pools to place people with certain pre existing conditions into those pools. I posted this earlier but 5% of the sickest of the population accounts for 50% of all the medical costs. You could move a portion of those into these separate federally subsidized risk pools and that would lower the cost of the premiums for the remaining 95% of the population. It wouldn't work exactly that way but in concept that is how it would function.

 

A few other things they could do are some pilot programs where they give customers the choice to either receive the current cost share reduction or programs of those funds shifted into private HSA's, which would incentivize consumers to shop around for medical prices which would create more of a demand for medical price transparency. Also, encourage medical providers through federal carrots to promote transparency. Add in some market based reforms such as tort reform and competing carriers across state lines. Encourage more investments in wellness programs. Take away the shackles off of carriers that they could provide plans to consumers of higher deductible plans that are rich with Doctor, prescription and ER copays. Young people generally don't need low deductible plans. A $10k deductible rich in copay benefits is perfect for someone under the age of 35. These sort of plans with the advanced tax credits would allow lower to middle income younger folks to get health plans below $75 a month premiums.

 

That's the direction that I'd head in.

 

Everyone would do themselves a favor by fully understanding risk pools. You can't parse things up - it doesn't work. In order for HC to work effectively the payment mechanism has to account everyone. What you are creating above is simply a new tax code full of loopholes, deductions, work arounds.

 

Come on everyone - say this first when you talk about HC. Every other country worth talking about has a HC structure that delivers HC to all its people from cradle to grave for half the cost of what we pay to insure about 2/3 of our people with poorer results

 

The US is an outlier by quantum proportions.

 

​Why do we set the bar so low - are we saying we cannot do as well as other counties?

[Tiberius]

 

Everyone would do themselves a favor by fully understanding risk pools. You can't parse things up - it doesn't work. In order for HC to work effectively the payment mechanism has to account everyone. What you are creating above is simply a new tax code full of loopholes, deductions, work arounds.

 

Come on everyone - say this first when you talk about HC. Every other country worth talking about has a HC structure that delivers HC to all its people from cradle to grave for half the cost of what we pay to insure about 2/3 of our people with poorer results

 

The US is an outlier by quantum proportions.

 

​Why do we set the bar so low - are we saying we cannot do as well as other counties?

Because since we are the wealthiest country on the face of the earth our rich people have more money to use on lobbying

[Magox]

thanks for the explanation magox. im operating at such a disadvantage on this topic bc i simply dont know much outside of my sphere of experience and what ive read. for instance, i dont know what the cost breakdown actually is for having everybody pay a little something for essential services vs using an ala carte approach with various levels of coverage. thats pretty important information that could swing the logical course, but i simply dont know it

 

what i do know is that i dont like eliminating things like mental health services. i dont recall the exact statistics, but something like half of all ppl will experience serious psychological difficulties at some point in their life. if you think about your own experiences over time and others around you, its not hard to see that ppl could easily find themselves in that situation and would benefit from help. ive been there and happily used my insurance to get counselling and medications when i needed them and they absolutely helped get me back on track. ive known lots of ppl that would benefit from that, most didnt do so due to the stigma attached to psychological counseling, and others bc they didnt have any coverage for it. i feel like its in the publics interest to have access to those services and having it in your insurance program would encourage or at least not discourage someone from getting the help they need to get back on track

 

unfortunately i know almost nothing in detail about these risk pools, but it sounds like we would just be putting all the ppl who need care into a situation where they will end up paying large amounts to get that help when they need it. i would think its better to have everyone participate so that those funds are in place on an ongoing basis and available when everyone inevitably will need them. of course thats a very long term perspective, it assumes a system that is a going concern so that ppl how contribute when they are young and healthy have access twenty or thirty years down the road. personally, thats what i would like to set up for all americans, similar to social security. i believe its time, we have the resources, it just a matter of committing to doing it

 

given my limited in-depth knowledge on this topic, i would have to look to someone like you to figure out how that all would work. i just feel like its embarrassing that we have more health care resources by far than any country in history, and yet we still have ppl going broke or dying bc they couldnt get the care they need. we will all get sick eventually, its just a matter of when. i would prefer everyone has the ability to get those issues addressed when the time comes

 

i suppose that makes me a bleeding heart on health care. ok fine, so be it

 

No, the idea of separating the risk pools from sicker and healthier people wouldn't necessarily drive up the actual paid rates from the enrollee because they would/could do two things:

 

A) Subsidized by the government (which is already in the conservative proposals)

 

B) They the insurance providers and the government could look to see if they could price these enrollee's with Medicare reimbursement rates. What that means is that those Medical providers that are willing to accept plans offered through this program would have a reimbursement rate that of Medicare enrollees. All that means is that Medical providers that accept these plans accept less money from the insurer for those services, such as doctor visits, lab testing, ER services, hospital stays etc etc.

 

Everyone would do themselves a favor by fully understanding risk pools. You can't parse things up - it doesn't work. In order for HC to work effectively the payment mechanism has to account everyone. What you are creating above is simply a new tax code full of loopholes, deductions, work arounds.

 

Come on everyone - say this first when you talk about HC. Every other country worth talking about has a HC structure that delivers HC to all its people from cradle to grave for half the cost of what we pay to insure about 2/3 of our people with poorer results

 

The US is an outlier by quantum proportions.

 

​Why do we set the bar so low - are we saying we cannot do as well as other counties?

 

Yes, you can parse things up if there is a mechanism to subsidize the plans. And the fact that you are bringing up tax codes, loopholes, deductions shows that you have the slightest clue in what I'm talking about, because the risk pool subsidy isn't income based but rather based on their medical condition.

 

Why is that you are incapable of bringing anything rational to the table?