Jan. 15th, 2017

shadowkat: (Default)
Well, dlgood was right -- they found a way to repeal the Affordable Care Act through "the budget reconcilation".

NPR actually explains the process in DETAIL.


epublicans and the incoming Trump administration have been careful not to talk about exactly what they plan to do to the Affordable Care Act beyond repealing virtually all of its coverage expansions and the taxes that help fund them. But they seem to be coalescing around a strategy of repeal and delay, in which they would pass a bill to kill many of the major provisions of law by a certain date, then set to work on crafting and passing a replacement before that date arrives.
In House Majority Leader's Home District, Many Depend On Health Law He Wants To Scrap
Shots - Health News
In House Majority Leader's Home District, Many Depend On Health Law He Wants To Scrap

It would be quicker for Congress to simply repeal the health law outright. But Republicans can't do that, because they would need 60 votes in the Senate to fend off Democrats' delaying tactics, and they will have only 52 GOP members. So instead they will be limited to using a special budget strategy that will let them pass their bill with 51 votes.

That's called budget reconciliation, and the strategy does not let lawmakers repeal the entire law — only the parts that directly impact federal spending. It's been widely discussed as something the Republicans might attempt, but there has been less focus on how long the process takes.

No one in Congress can simply introduce a budget reconciliation bill. The word "reconciliation" refers to the process by which congressional committees that control permanent spending programs such as Medicare and Medicaid, as well as tax policy, take action to reconcile that spending with the terms of the annual budget resolution.

That means the first action must be to pass a budget resolution, which Congress failed to do last year. That is the resolution McConnell was referring to in his Monday remarks to reporters.

The budget resolution, which is essentially a planning document for spending and taxes for the coming fiscal year, does not go to the president for a signature. But like a regular bill, it does have to be passed by both the House and Senate in the same form. And while the budget resolution also may not be filibustered in the Senate, lawmakers have up to 50 hours to debate it and unlimited time to vote on proposed amendments, which in practice can take up to another full day.

Once that measure is agreed to by the full House and Senate, the action moves back to congressional committees. The budget resolution often includes reconciliation instructions to committees. Those instructions order proposed legislative changes to the programs the committees oversee, to meet the terms of the budget. That process triggers the reconciliation bill that goes to the president.



And this article explains their perspective and why they desperately want to repeal the law:

Everything You Need to Know About Why Conservatives Want to Appeal ObamaCare or the ACA




Wait a second. Isn’t Obamacare actually a Republican plan?
While Democrats were pushing for Obamacare, Rep. Paul Ryan, the Republican from Wisconsin, was pushing for an ambitious Medicare reform that bore a strong family resemblance to Obamacare. Both Ryan’s Medicare reform and Obamacare envisioned giving beneficiaries a subsidy that they could use to purchase insurance coverage on a regulated marketplace or exchange, with an eye toward harnessing the power of competition to hold down costs. So why did Ryan oppose Obamacare if he was so enthusiastic about this approach in Medicare? Was it because he—along with all other anti-Obamacare Republicans—is a hypocrite?

Well, no. In Medicare, Ryan hoped to move a single-payer health entitlement in a more market-oriented direction. To put it crudely, the goal of Ryan’s Medicare reform was to move from more socialism to less socialism. For better or for worse, there is now a consensus that the federal government should finance a large chunk of medical expenditures for all older Americans, and that’s been true for decades. There is no such consensus for non-elderly adults, which is why Obamacare, which sought to move us in the direction of establishing a universal health entitlement, was so hotly contested. The problem with Obamacare, for Ryan and others on the right, is that it moved America’s health system in the wrong direction, from less socialism to more socialism.

Yuval Levin, the editor of the conservative policy journal National Affairs, has said that the debate over health reform is about “which way, not how far.” That is, while wonks on both sides agree that the pre-Obamacare health system was royally screwed-up, they disagreed about how to fix it. Liberals wanted to make the system more centralized and orderly—sure, there can be competition, but only insurance plans that meet strictly defined standards set by credentialed professionals can compete. Conservatives wanted to make the system more of a free market, in which government subsidies to help people buy coverage are visible and, ideally, capped. By capping subsidies, consumers would have a strong incentive to shop wisely, and insurers and providers would be pressured into coming up with new ways to offer more value for the money. Another way of putting this: While liberals think health care is too important to leave to the messy, trial-and-error process of the free market, conservatives think a trial-and-error discovery process is the only way the health system can get better, cheaper, and smarter over time.

There is nothing wrong in principle with establishing marketplaces where people can buy insurance. There are conservative plans that feature marketplaces too! Yet the Obamacare exchanges do much more than just provide a place where people can compare different plans. They shift responsibility for regulating the individual insurance market from state governments to the federal government, even in the case of the partner exchanges established by states in accordance with federal rules. The Obamacare exchanges aren’t best understood as simple marketplaces, where the main role of regulators is to ensure transparency. Rather, they serve as central planning boards that establish coverage mandates and review rates. You might think that’s a good thing or a bad thing, but it definitely limits opportunities to offer new types of coverage and new models for care delivery.

Of course, the exchanges are only part of how Obamacare expands insurance coverage. Just as important is its mammoth expansion of Medicaid, a program that conservatives have long criticized for delivering poor health outcomes and for its joint state-federal structure, which encourages overspending.

When you look at Obamacare as a law that greatly increases federal regulation of the insurance market and federal spending while doubling down on Medicaid, it should be clear that it is not ideal from a conservative perspective.


Sigh. I read this stuff, and I find myself wanting to lock the right-wingers in a room with nothing but Michael Moore Documentaries, and documentaries on poor Americans, people dying of cancer, etc for the next year and a half. They won't be permitted to leave until they agree to divest themselves of all worldly things, and do nothing but charitable works.
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1. Didn't like the last episode of Sherlock ss much as the middle episode, too plotty. Although the ending was good. It just kept leaping about, and was clearly working to redeem Sherlock and get across his humanity in the face of his dysfunctional family.

Curious -- anyone who knows the novels, how far have they leaped away from them?

2. Vampire Diaries - the relationship between Damon and Stefan reminds me a great deal of Angel and Spike, except less ambiguous and more defined. It also does a nifty job of talking about how the past can destroy you or heal you. Not to mention the power of love. I like the brother dynamic a great deal, and this past episode was among the better ones. Good television last week.

3. This is Us was also good last week in how it explored the family dynamic and the various inter-relationships within it. It can feel a bit over-the-top at times but overall it works for me.


I'm on the fence about doing the Women's March in NYC next Saturday, apparently this is an all day thing? And it's around the old work place in mid-town Manhattan. We'll be leaving the workplace on Friday, not sure I want to head back to it on Saturday to march up to an area that I've been steadfastedly avoiding for the last year. Also there's going to be over 50,000 people doing this. Ack.

I don't do parades people. Me and crowds are unmixy things.

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