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Thread: Major Blow to Obamacare Mandate

  1. #101
    Chaos in fourteen lines Minotaur's Avatar
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    And btw I have been saying that the subsidies will go and this is a first step but keep watching because the next important thing they will lower is Medicaid to states. People really will die simply because the last thing they have to do is the cross state purchase followed by closing the door on those who do not have insurance being able to be covered when they get sick.

  2. #102
    Moderator HayJenn's Avatar
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    Quote Originally Posted by Minotaur View Post
    Many think they are punishing the poor but the poor are still covered by the states. They are punishing those who all have subsidies whether they know it or not if they are making $60,000 or less.

    It is a very cruel mentality HayJenn where they wish for suffering of the poor so much they hurt themselves unaware that they are the ones caught in the middle of wealthy and poor. The very ones who will hurt from removing subsidies or protections. Hell most don't even realize Obamacare is medical protections for them, and not a government insurance. It is crazy because they really will be the ones who are at risk of dying.
    Well what the GOP is advocating for won't make it any better for them.

    I just read this:

    The plan also calls for repealing ObamaCare’s Medicaid expansion “in its current form.” After a transition period, states could choose to keep Medicaid open to the newly eligible people, but they would no longer receive extra federal funding to cover the cost. Instead, states would be reimbursed at the traditional, lower rates. That means states would have to put more money into the program if they wanted to keep the expansion.

    The plan also calls for a “per-capita cap” for Medicaid, which means the traditional, open-ended federal commitment would be converted into a capped payment to states. The amount would take into account the number of people in the program, in contrast to a simple block grant.

    Democrats warn this idea would lead to damaging cuts to Medicaid. Republicans say it is a way to limit federal spending and give more control to states.

    House Republicans also plan to reverse the cuts that ObamaCare made to payments for hospitals serving large numbers of uninsured people, known as Disproportionate Share payments. Bringing back those payments will help states that did not expand Medicaid and are bearing higher healthcare costs because of it.

    GOP leaders provide new details about ObamaCare repeal | TheHill

    What's ironic is that of any state, it seems like Kentucky has benefited the most. And now Mitch wants to yank that all away from his very own constituents.

  3. #103
    Moderator HCProf's Avatar
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    Quote Originally Posted by HayJenn View Post
    Well what the GOP is advocating for won't make it any better for them.

    I just read this:

    The plan also calls for repealing ObamaCare’s Medicaid expansion “in its current form.” After a transition period, states could choose to keep Medicaid open to the newly eligible people, but they would no longer receive extra federal funding to cover the cost. Instead, states would be reimbursed at the traditional, lower rates. That means states would have to put more money into the program if they wanted to keep the expansion.

    The plan also calls for a “per-capita cap” for Medicaid, which means the traditional, open-ended federal commitment would be converted into a capped payment to states. The amount would take into account the number of people in the program, in contrast to a simple block grant.

    Democrats warn this idea would lead to damaging cuts to Medicaid. Republicans say it is a way to limit federal spending and give more control to states.

    House Republicans also plan to reverse the cuts that ObamaCare made to payments for hospitals serving large numbers of uninsured people, known as Disproportionate Share payments. Bringing back those payments will help states that did not expand Medicaid and are bearing higher healthcare costs because of it.

    GOP leaders provide new details about ObamaCare repeal | TheHill

    What's ironic is that of any state, it seems like Kentucky has benefited the most. And now Mitch wants to yank that all away from his very own constituents.
    At this point...I think the best thing to do is allow Trump to tank healthcare to the point where no one can afford insurance and all safety nets have been exhausted. We have allowed insurance companies rape and pillage us for so long that they dictate our health. When it hits rock bottom and Americans are too sick to work and our hospitals have long closed their doors...then maybe single payer will be the only option left and embraced. Insurance companies will eventually price themselves out of the employer market and they too will not be able to afford it. It is disgraceful that we would have to hit rock bottom and become Somalia before the taxpaying citizens are heard.

  4. #104
    Moderator HayJenn's Avatar
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    Quote Originally Posted by HCProf View Post
    At this point...I think the best thing to do is allow Trump to tank healthcare to the point where no one can afford insurance and all safety nets have been exhausted. We have allowed insurance companies rape and pillage us for so long that they dictate our health. When it hits rock bottom and Americans are too sick to work and our hospitals have long closed their doors...then maybe single payer will be the only option left and embraced. Insurance companies will eventually price themselves out of the employer market and they too will not be able to afford it. It is disgraceful that we would have to hit rock bottom and become Somalia before the taxpaying citizens are heard.
    Well I would prefer that we just make Medicare for all so people don't die in the meantime
    Thanks from HCProf

  5. #105
    Junior Member Claudius the God's Avatar
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    Quote Originally Posted by John T Ford View Post
    Whatever you say.

    I'm sure millions of Americans like myself who cannot afford the skyrocketing cost of health insurance thanks to Obamacare will be pleased to know they can opt out of being fined for not being able to afford it.
    If that is your likeness, you should be nearing 65. Medicare awaits you. If you are destitute and live in a blue state, insurance is subsidized. If you are middle class, you will have to pay the premiums just like everyone else does. If you are self-employed, you can no longer be a free rider on the backs of the government as you roll into the ER. Sorry but someone ends up paying for you sooner or later.

  6. #106
    Veteran Member HenryPorter's Avatar
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    Quote Originally Posted by John T Ford View Post
    "For most filers, filling out line 61 would be mandatory. The IRS would not accept 1040s unless the coverage box was checked, or the shared responsibility payment noted, or the exemption form included. Otherwise they would be labeled "silent returns" and rejected.

    Instead, however, filling out that line will be optional."


    Major Blow to Obamacare Mandate: IRS Won't Reject Tax Returns That Don't Answer Health Insurance Question - Hit & Run : Reason.com

    If this is indeed true, this will provide relief to millions of Americans who have lost their insurance due to Obamacare.

    It appears filers now can opt out from answering the question about whether they have insurance and not fear their 1040 will be rejected by the IRS.

    Now millions Americans who cannot afford the skyrocketing cost of health insurance thanks to the catastrophic disaster known as Obamacare, will no longer be penalized for not being able to afford health insurance.

    Thanks President Trump.
    This is all about your huge lie about replacing the ACA. Just a lie for the stupid to believe. The 22 plus million who have insurance thru the ACA, everyone who voted for Hillary including the 3 million more who vote for Hillary than Trump who want Republicans to replace the ACA with better less expensive insurance, will call the lying shitbag Republicans out if they don't keep Trumps promise. Your Republican assholic plan to let the ACA die without replacing it ain't gonna work.

  7. #107
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    Quote Originally Posted by HayJenn View Post
    Well I would prefer that we just make Medicare for all so people don't die in the meantime
    The problem with Medicare for all is that it will be Medicaid for all with its inadequate payments and the need for financial subsidization or participation by the States that is currently depleting their treasuries. State treasuries are currently being bankrupted due to the need to finance pensions and Medicaid.

  8. #108
    Moderator HCProf's Avatar
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    Quote Originally Posted by TheWahoo View Post
    The problem with Medicare for all is that it will be Medicaid for all with its inadequate payments and the need for financial subsidization or participation by the States that is currently depleting their treasuries. State treasuries are currently being bankrupted due to the need to finance pensions and Medicaid.
    I think we can make it work. First, we have to realize there will be a tax increase for everyone. We could also pay premiums out of our paychecks to cover it. We do not need to turf this to the State level. The payer mix as it stands today, Medicare is leading reimbursement at over 50% with most hospitals. We are half way there. I have no problem paying extra taxes for something that would benefit me personally, most feel that way. What is getting old, at least for the middle class, is paying the tab for everyone else and receiving nothing in return.

  9. #109
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    Quote Originally Posted by HCProf View Post
    I think we can make it work. First, we have to realize there will be a tax increase for everyone. We could also pay premiums out of our paychecks to cover it. We do not need to turf this to the State level. The payer mix as it stands today, Medicare is leading reimbursement at over 50% with most hospitals. We are half way there. I have no problem paying extra taxes for something that would benefit me personally, most feel that way. What is getting old, at least for the middle class, is paying the tab for everyone else and receiving nothing in return.
    I definitely agree that we should be able to develop an approach or system that will assure health care for all. But that must be a private/public payment partnership, not a sole government operated system. Frankly, if our facilities had to operate singularly on governmental programs, we would not survive or would have to control or eliminate the services provided. Medicare barely covers the costs to provide services and Medicaid payments aren't even close to costs. Moreover, they are costs as defined by the government, not costs as typically defined by most businesses. Commercial payers are subsidizing the inadequacy of governmental payments. Get rid of commercial payers, the results are not going to be pretty.

    I will agree that Medicare is a primary payer, but my experience is not to the level of 50% (underscore, my experience). Medicare tends to show high utilization based on inpatient admissions, but not related ancillary services and outpatient services. For example, elderly patients tend to be surgical risks, so they tend to show a low surgical utilization. Additionally, Medicare patients can cause readmit problems when it comes to payment under the prospective DRG payment system. That is exacerbated when the primary determinant for DRGs is length of stay. Two of the most important people in the administrative side of hospital operations are the record coders and the discharge planners.

  10. #110
    Moderator HCProf's Avatar
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    Quote Originally Posted by TheWahoo View Post
    I definitely agree that we should be able to develop an approach or system that will assure health care for all. But that must be a private/public payment partnership, not a sole government operated system. Frankly, if our facilities had to operate singularly on governmental programs, we would not survive or would have to control or eliminate the services provided. Medicare barely covers the costs to provide services and Medicaid payments aren't even close to costs. Moreover, they are costs as defined by the government, not costs as typically defined by most businesses. Commercial payers are subsidizing the inadequacy of governmental payments. Get rid of commercial payers, the results are not going to be pretty.

    I will agree that Medicare is a primary payer, but my experience is not to the level of 50% (underscore, my experience). Medicare tends to show high utilization based on inpatient admissions, but not related ancillary services and outpatient services. For example, elderly patients tend to be surgical risks, so they tend to show a low surgical utilization. Additionally, Medicare patients can cause readmit problems when it comes to payment under the prospective DRG payment system. That is exacerbated when the primary determinant for DRGs is length of stay. Two of the most important people in the administrative side of hospital operations are the record coders and the discharge planners.
    The payer mix is pretty close to 50%...when boomers my age retire..(53), the mix is predicted to be up around 75% of Medicare reimbursements. The cost of healthcare is a result of massaging the numbers to cover the uninsured. We have been inflating our fees for decades. If everyone were insured, it would drive those costs down. One of the problem expenses will be salaries...when it goes to single payer. Doctors will not work for the same salary as you see in France or other universal healthcare Countries. Nurses as well...right now, full time nurses can earn up to 6 figures depending on the department or shift they work. I personally feel we have given the insurance companies enough opportunities to assist in repairing the healthcare industry and they have focused on greed instead. Get rid of them..or reduce them to supplemental insurance only. This is not working with for profit companies driving consumer needs.

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