Two ACA related stories from yesterday.
The first is from the Hill on the Cost Sharing Reduction subsidies:
Key House Republicans on healthcare say they want to find a way to fund ObamaCare payments that they previously sued the Obama administration over.
The payments, known as cost-sharing reductions, reimburse insurers for providing discounted deductibles for low-income ObamaCare enrollees. If the payments were canceled, insurers warn they could pull out of the market because of the hole left in their budgets, causing chaos….
top Republicans say they realize they need to fund the payments. Providing that funding would go a long way to stabilizing the market and removing a major source of insurer anxiety
If CSR is funded with 100% certainty, insurers will get into the market. Every other risk can be priced into the premiums that are to be submitted this summer. CSR cut-off risk effectively can not be priced into rate submissions. If CSR is cleanly funded, that would be an excellent indicator that the Trump Administration will at most clip the ankles of the ACA instead of making a studs up tackle straight into its knees.
And now onto Kansas:
Big news: KS legislature has sent Brownback a Medicaid expansion bill. Now has 10 days to sign or veto. https://t.co/0DyqoIrGHS
— Sarah Kliff (@sarahkliff) March 28, 2017
Large but short of veto-reversing super-majorities in both houses of the Kansas legislature just voted for Medicaid expansion. Gov. Brownback will most likely veto the bill because of argle-bargle-cargle reasons. But there is a flurry of states that are pushing forward on Medicaid expansion. Georgia most likely will submit an Indiana style waiver, but Maine may try yet again to expand as they have a demonstrated legislative coalition to expand.
Mustang Bobby
I have no doubt that Brownback will veto the expansion because it goes against his plan to screw the state into the ground, and if the Ingalls family that lived in that little house on the prairie just south of Independence could live without it, then by jingo so can everyone else.
Another Scott
Indeed good news.
Are you missing some closing blockquotes in there?
Thanks.
Cheers,
Scott.
zach
Missing from the Kansas stories is its budget crisis. Brownback tried and failed to propose a budget that drastically cut public school funding (rebuffed politically and by courts where there’s been a long fight over unequal education across the state). He needs money wherever he can find it… Medicaid expansion is state-budget-positive for sure in the short term and taking it means lower tax increases to meet the budget shortfall.
amk
And meanwhile zegs and thugs are still pushing for repeal. Replace? What replace?
Baud
Good.
rikyrah
Always welcoming Medicaid expansion-that means more of my fellow citizens will get Healthcare.
Thanks for keeping us informed, Mayhew.
rikyrah
@amk:
Never forget..
Trumpcare was just a tax cut bill disguised as a healthcare plan.
OzarkHillbilly
I’ll believe it when I see it, but it is still good to hear.
@Mustang Bobby: @zach: Brownback is sure that conservatism didn’t fail, reality failed conservatism. I really don’t know if his delusions have limits.
jacy
One good thing about this whole mess — it showed at least some people that the ACA and Obamacare are the same thing. Anybody who wakes up, it’s a positive. I think it gets harder to say “repeal,” and I hope the “let’s let Obamacare implode” talking point becomes toxic. Republicans are going to have to at least try to figure out how to govern….even if it’s only because that’s their only path to self-preservation.
pk
So are we to assume that Trump is the best thing that happened for Obamacare?
laura
@rikyrah: It was a tax cut for the rich that was was health insurance adjacent.
David Anderson
@pk: Not yet, but to some degree that Obama is not president it enables conservative states to take care of their citizens and their budget at the same time without getting right flank primaries.
Mobil RoonieRoo
The Kansas expansion is one of the more interesting things going on. Veto or not it will affect the conversation greatly,
Patricia Kayden
Great news for consumers. So it looks like some Rs are finally coming to their senses about the ACA. Thanks Obama!!
Baud
@jacy:
It shows the extent to which people took Democrats for granted.
low-tech cyclist
Funny how they never ask how they’re going to fund hundreds of billions of dollars of tax cuts or war funding, but they’ve suddenly got to Be Responsible and find money to pay for this $7B appropriation.
AnonPhenom
maybe, but every day that goes by I’m more convinced that health insurance companies are borrowing the business model of cable television providers and the only thing that will keep them honest, the thing needed to insure competition, is some form of a public option, even if you only make the option available under limited circumstances
OGLiberal
Isn’t Brownback in Christie territory when it comes to approval ratings? I know he won in 2014 but not by much, considering it is Kansas. Is he term limited and doesn’t give a shit? It’s not like there are a lot of brown people in Kansas for Brownback to punch down at. Or are they one of those states where the evil, bloodsucking Mexicans have recently started to invade?
Glidwrith
@low-tech cyclist: This isn’t a sign of acceptance. This is the ‘Thugs getting ready to pull the trigger on the gun already loaded and pointed at the exchanges. Regretfully, they just won’t be able to find the money, and it was just one of those things and see-they-told-you-so that this just wouldn’t work.
Puke.
Davis X. Machina
Maine’s going to have Medicaid expansion on the ballot in November.
If it passes, it can’t be vetoed like ordinary legislation that comes up through the legislature. — LePage has vetoed that six times.
It would have to be repealed by the legislature, or by a citizen-veto referendum.
amk
@Davis X. Machina: Wouldn’t their lives be made lot easier by throwing out the racist pos?
Davis X. Machina
@amk: The good news — he’s term-limited.
Impeachment is a non-starter.
There’s no recall provision in the state constitution.
Barbara
@laura: Saying that it was “health insurance adjacent” buys into the misleading marketing effort that Ryan and company pushed — that this bill “repealed” the ACA. First, it’s just important to understand that as many people benefited by the Medicaid expansion provisions of the ACA as they did from the private exchange provisions, and that these numbers would be even higher if all states had expanded. The bill proposed by Ryan would not simply have rolled back private exchange and Medicaid expansion that were enacted by ACA, it basically gutted the original Medicaid program by turning it into a program with set funding (it wasn’t quite a block grant as drafted, but the intention is similar). So:
1. Eliminate Medicaid expansion entirely over time.
2. Turn ACA subsidies that vary by age and income into much less generous tax credits that vary a little by age and not at all by income.
3. Significantly cut existing Medicaid program by capping federal contributions to a fixed amount, forcing states to choose between protecting pregnant women versus nursing home residents.
4. Give 70% of the “savings” from the first three measures to people who make $250,000 and above, and more than 40% of the savings to people with more than $1 million in earnings. Give a few pennies to people who made more than $50,000 and take money (on average) from everyone else.
Reverse Robin Hood. That is who Paul Ryan is, a fundamentally sociopathic person who seems to believe that he will atone for his own very significant receipt of public expenditures by bowing and scraping and taking money from OTHER people and giving it to the wealthy. He will never reduce his own benefits as a congressional representative. I mean, you have to go back to the era of Dickens to find similar examples of his outlook (as well as, really, his idol, Ayn Rand).
As more states expand the harder it will get to repeal, ever. We are now at 31 states plus D.C., with 20 states not having expanded. So I really hope Florida and Georgia get their act together, because once they are in, the game is over. The South Florida Republicans were already balking at the AHCA, because their districts have a higher number of people obtaining private exchange coverage than any other in the nation. Governors and senators understand all of this even if individual House reps can go back to severely gerrymandered districts and pretend otherwise.
MattF
@OGLiberal: Says here that Brownback’s approval rating is 26%. One assumes that there’s at least a one percent margin of error.
Barbara
@OGLiberal: Brownback is on the way out to some federal post, but in any event, he is messianic in outlook. He is like the early Christian ascetics. If whipping themselves did not bring about God’s gifts, then, obviously, they needed to starve themselves and put a hairshirt on as well. Questioning the premise underlying the entire enterprise was never an option.
artem1s
So how much of the new Twittler ranting about not being done with healthcare is covering for GOP moderates who don’t want to spend their next break being harassed at town halls? I’m assuming it only being spewed about to give them cover for 2018. I think they really believe they can still go home and spew the same old line, “the Dems made us do it” BS. I’m really really hoping that they get beat up for conning their base into believing that Obamacare and ACA were different things. Like Molly Ivens said, ‘Once you figure out they have been lying to you about race…’ Hopefully at least some of the Cult45 will figure out that their GOP rep has been lying to them about that one thing…
MattF
@artem1s: WaPo sez the impetus for ‘reconsidering’ healthcare is from the right-wing reps who have been promising to repeal O-care for the past seven years. But the politics hasn’t changed and there’s no schedule and no road to get there, so most observers see it as gobble-gobble.
sdhays
@Barbara: At least those early Christian ascetics you mention whipped and starved themselves rather than others. I think Brownback himself is doing just fine, especially if/when he gets raptured to a federal position.
rikyrah
@pk:
Folks realize they don’t mind the CARE now that that OBAMA fella is no longer President.
West of the Cascades
Trump could make a studs up tackle straight into the knees of the ACA and it still wouldn’t be a red card in CONCACAF.
rikyrah
@Davis X. Machina:
That is so cool.
rikyrah
@Barbara:
tell it over and over and over again.
amk
@Barbara: Dem cong critters never did propagandize the benefits of Obamacare.
Barbara
@sdhays: Yeah, there always seems to be a Deus Ex Machina when these guys are facing a failure they can’t get out of. They used to call it a sinecure.
zach
@OGLiberal:
Having few people in the minority that you’re attacking is actually hugely beneficial for those tactics: (1) you can lie because few people actually known anyone black/latino/muslim to know you’re full of crap, (2) there are few people whose votes you’re 100% certain to lose by going full bigot. The GOP is really successful in KS with voter fraud nonsense and anti-immigrant stuff… see Kris Kobach’s influence with Trump re: the Wall and related crap during the transition.
Barbara
@OGLiberal: What are you talking about? Kansas City, Kansas and Topeka, Kansas have substantial minority populations. Remember that lawsuit styled as “Brown v. Board of Education”? Where do you think that was brought? Kansas had enough “dark people” to establish segregated schools. And yes, Kansas is a place where many Latino immigrants have gone to — as in many farm states or states meat processing or packing industries. Census Quick Facts tells me that around 18% of the population of Kansas is Hispanic, and that 61% of the population of Kansas is white, not Hispanic. Why do you think Kris Kobach is focusing on Kansas? Think about 40% of potential voters being black or Latino or “other” and if 80% of them voted Democratic?
Barbara
@OGLiberal: @Barbara: OGLiberal, my apologies. It seems like my Census go to website is having problems and keeps giving me national information even though I keep asking for Kansas. So I don’t actually know the current demographic make up of Kansas. Those numbers are for U.S. nationally.
Linkmeister
Are the Cost-Sharing Reduction subsidies the same thing that Rubio got removed from the 2015 (and forward) budgets? As I understand it, there are something called “risk corridors” which were meant to be paid to insurance companies until the pool of insured got big enough, and Rubio blocked them two years ago. Are the CSRs those payments? It sure sounds like they are.
David Anderson
@Linkmeister: no. Rubio killed risk corridor funding, a short term stability program that no one not in the finance department of an insurer cares about.
CSR reduces deductible for working poor
burnspbesq
Is Seamus Coleman coming to DC to testify on the Hill against Ryan’s next proposal?
Linkmeister
@David Anderson: Ah. Thank you.