# House passes "repeal and replace" **URL:** \ **Category:** Great Debates\ **Created:** [May 4, 2017, 8:53pm UTC](https://boards.straightdope.com/t/house-passes-repeal-and-replace/785871 "2017-05-04T20:53:38Z")\ **Posts on this page:** 20\ **Page:** 64
**Author:** ![HurricaneDitka](https://avatars.discourse-cdn.com/v4/letter/h/96bed5/32.png) [@HurricaneDitka](https://boards.straightdope.com/u/HurricaneDitka)\ **Post date:** [July 1, 2017, 9:58pm UTC](https://boards.straightdope.com/t/house-passes-repeal-and-replace/785871/1261 "2017-07-01T21:58:49Z")
> [@Johnny\_Ace](#): > > With a concomitant reduction in covered services. > > Tell ya what…I’ll sell you a mountain bike for $300 or a car for $40,000. You’d prefer the bike, of course, since it’s cheaper, right? The answer to that question depends entirely on how much traveling I’m going to do. ---
**Author:** ![k9bfriender](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/k9bfriender/32/3283_2.png) [@k9bfriender](https://boards.straightdope.com/u/k9bfriender)\ **Post date:** [July 1, 2017, 10:14pm UTC](https://boards.straightdope.com/t/house-passes-repeal-and-replace/785871/1262 "2017-07-01T22:14:47Z")
> [@HurricaneDitka](#): > > The answer to that question depends entirely on how much traveling I’m going to do. In this metaphor, the amount of travelling you plan on doing is how long you plan on living. Still think the $300 bike is a good deal? ---
**Author:** ![Okrahoma](https://avatars.discourse-cdn.com/v4/letter/o/90db22/32.png) [@Okrahoma](https://boards.straightdope.com/u/Okrahoma)\ **Post date:** [July 1, 2017, 10:35pm UTC](https://boards.straightdope.com/t/house-passes-repeal-and-replace/785871/1263 "2017-07-01T22:35:51Z")
> [@k9bfriender](#): > > In this metaphor, the amount of travelling you plan on doing is how long you plan on living. > > Still think the $300 bike is a good deal? Ah then of course not. I want a $4.5M Lamborghini Veneno. But I want subsidies so I only pay $1000 for it. ---
**Author:** ![running\_coach](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/running_coach/32/15836_2.png) [@running\_coach](https://boards.straightdope.com/u/running_coach)\ **Post date:** [July 1, 2017, 10:38pm UTC](https://boards.straightdope.com/t/house-passes-repeal-and-replace/785871/1264 "2017-07-01T22:38:33Z")
> [@Okrahoma](#): > > Ah then of course not. I want a $4.5M Lamborghini Veneno. But I want subsidies so I only pay $1000 for it. Stupid analogy. None of the plans on the exchanges were of a comparable level. ---
**Author:** ![Johnny\_Ace](https://avatars.discourse-cdn.com/v4/letter/j/6bbea6/32.png) [@Johnny\_Ace](https://boards.straightdope.com/u/Johnny_Ace)\ **Post date:** [July 1, 2017, 10:39pm UTC](https://boards.straightdope.com/t/house-passes-repeal-and-replace/785871/1265 "2017-07-01T22:39:29Z")
But wait, there’s more. [http://www.businessinsider.com/cbo-report-senate-healthcare-bill-premium-costs-2017-6](http://www.businessinsider.com/cbo-report-senate-healthcare-bill-premium-costs-2017-6) [QUOTE=Business Insider] According to the CBO, lower premium assistance through the BCRA would cause premiums for older and low-income Americans to increase significantly. For instance, under current law, a 64-year-old making $56,800 a year would see the premium of the current benchmark silver-level plan increase from $6,800 annually to $20,500. That means premiums would eat up 36% of the person’s total annual income, up from 12% now. [/QUOTE] > [@](#): > > According to the CBO, most low-income people would shift to plans with a [lower] actuarial value because they would likely have more comparable premiums to the current, higher actuarial value plans they currently have. Here’s the CBO’s example: > > … > > Put another way, with less financial help from the government, poorer Americans would trade down to less generous plans to keep their premiums roughly the same. These plans, however, would hit them with higher out-of-pocket costs that would eat up a good amount of their income. > > That would mean poorer Americans would be saddled with three choices: high-premium plans with decent coverage, plans that have manageable premiums but high out-of-pocket costs, or no insurance altogether. Brackets added by me. If you think I took it out of context, read the article yourself. It’s not long. ---
**Author:** ![bobot](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/bobot/32/21622_2.png) [@bobot](https://boards.straightdope.com/u/bobot)\ **Post date:** [July 1, 2017, 10:43pm UTC](https://boards.straightdope.com/t/house-passes-repeal-and-replace/785871/1266 "2017-07-01T22:43:30Z")
> [@k9bfriender](#): > > … > Saving on your premiums is not the same as saving money. You might think it will, but unless you are always super healthy and never actually use the insurance you are paying on, you will almost certainly come out behind. No wonder Trump was successful at running casinos! Wait a minute, whadd’ya mean he ran those into the ground, too?? ---
**Author:** ![vivalostwages](https://avatars.discourse-cdn.com/v4/letter/v/d07c76/32.png) [@vivalostwages](https://boards.straightdope.com/u/vivalostwages)\ **Post date:** [July 2, 2017, 1:33am UTC](https://boards.straightdope.com/t/house-passes-repeal-and-replace/785871/1267 "2017-07-02T01:33:19Z")
> [@bobot](#): > > No wonder Trump was successful at running casinos! Wait a minute, whadd’ya mean he ran those into the ground, too?? > **[How Donald Trump got fired by a California casino](https://www.desertsun.com/story/news/politics/2016/03/21/donald-trump-spotlight-29/81860676/)** > > The presidential candidate has campaigned on his reputation for great deals. He was bested by a small Indian tribe with big plans. ---
**Author:** ![vivalostwages](https://avatars.discourse-cdn.com/v4/letter/v/d07c76/32.png) [@vivalostwages](https://boards.straightdope.com/u/vivalostwages)\ **Post date:** [July 2, 2017, 4:00am UTC](https://boards.straightdope.com/t/house-passes-repeal-and-replace/785871/1268 "2017-07-02T04:00:15Z")
> [@k9bfriender](#): > > Sad stories should not drive policy. > > Sound statistics and research should drive policy. > > Sad stories, however, are important to put a face on the statistics, to remind you that these are real lives, not just numbers, that you are are effecting with your actions. The stories are intertwined with the statistics and the costs, also. It’s personal. > **[Toddler’s Staggering Hospital Bill Shows Just What’s At Stake In Obamacare...](https://www.huffpost.com/entry/hospital-bill-obamacare-alison-ethan-chandra_n_59520b47e4b02734df2d00a1)** > > Alison Chandra says if the Affordable Care Act is repealed, her family may face a devastating choice: bankruptcy or her son's life. ---
**Author:** ![Tee](https://avatars.discourse-cdn.com/v4/letter/t/73ab20/32.png) [@Tee](https://boards.straightdope.com/u/Tee)\ **Post date:** [July 2, 2017, 4:22pm UTC](https://boards.straightdope.com/t/house-passes-repeal-and-replace/785871/1269 "2017-07-02T16:22:53Z")
> **[How Republicans Can Fix American Health Care](https://www.theatlantic.com/politics/archive/2017/06/how-republicans-can-fix-american-health-care/532251/)** > > The bills before Congress get it wrong—what’s needed is incremental reform in a conservative direction. > [@](#): > > As the health-care industry becomes ever more closely tied to the public sector, the GOP—as the party of the private sector—should accept the responsibility to become the party of skepticism about the claims and perquisites of that industry. If the GOP is to be the party of seniors, it cannot also be the party that rationalizes every price demand of the pharmaceutical sector. Putting this quote here because it illustrates the state of leadership of the country on this issue. The Republican party is pulled in different directions, diametrically opposed in the examples of seniors vs. drug companies, big spenders vs. small government conservatives, and economic interests vs. free marketeers and cost cutters. The legislators are captive to demographic whims in the form of Kentucky, for example, ready to punish anyone who tries to extend health care access for poor people, even though there’s a need for it, they’re using it and they kind of like it. It’s 3D gridlock all the way, no one in leadership is leading and it’s kind of hilarious, except we all have to live here. ---
**Author:** ![Bone](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/bone/32/407_2.png) [@Bone](https://boards.straightdope.com/u/Bone)\ **Post date:** [July 2, 2017, 5:39pm UTC](https://boards.straightdope.com/t/house-passes-repeal-and-replace/785871/1270 "2017-07-02T17:39:29Z")
> [@k9bfriender](#): > > Saving on your premiums is not the same as saving money. You might think it will, but unless you are always super healthy and never actually use the insurance you are paying on, you will almost certainly come out behind. This isn’t quite right. In a macro sense, people would overall save money without health insurance and most people will never use enough services to come out ahead. That’s kind of the way insurance works, unless they are making money on the float and their combined ratio is over 100% like P&C insurance. The reason this is worth it to the individual is because people don’t make decisions in a macro sense, and in the event that person is the one who needs more than they are paying in premiums, usually that’s a life changing event which insurance is designed to mitigate. But for a young, otherwise healthy person, insurance is almost certainly does not have a positive cost benefit from a dollars and sense perspective. It could easily though in an overall sense, depending on how each individual values risk. ---
**Author:** ![k9bfriender](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/k9bfriender/32/3283_2.png) [@k9bfriender](https://boards.straightdope.com/u/k9bfriender)\ **Post date:** [July 2, 2017, 5:51pm UTC](https://boards.straightdope.com/t/house-passes-repeal-and-replace/785871/1271 "2017-07-02T17:51:25Z")
> [@Bone](#): > > This isn’t quite right. In a macro sense, people would overall save money without health insurance and most people will never use enough services to come out ahead. That’s kind of the way insurance works, unless they are making money on the float and their combined ratio is over 100% like P&C insurance. The reason this is worth it to the individual is because people don’t make decisions in a macro sense, and in the event that person is the one who needs more than they are paying in premiums, usually that’s a life changing event which insurance is designed to mitigate. > > But for a young, otherwise healthy person, insurance is almost certainly does not have a positive cost benefit from a dollars and sense perspective. It could easily though in an overall sense, depending on how each individual values risk. Insurance companies do invest the money that is paid in i premiums into the stock market. Car insurance companies used to pay out more in claims than they took in in premiums (as was explained to me by my insurance company lawyer and broker when I had a claim made against me in 2002), I do not know if this is still true, nor whether this was the standard for health insurance, but I see no reason why it shouldn’t be. In any case, if the concern that HD has is just saving money, then you are right, he shouldn’t be looking for the 4% reduction in premiums, he should just not get coverage at all. The penalty is only about $1000, which I would assume is a much better deal than getting a 4% reduction in future premium rates. If he is unlucky enough to need the insurance that he forwent, well, at least he saved money. If he takes the 4% reduction in premiums, and has much poorer insurance that still leaves him out of pocket more than he can afford to pay, then there really is no difference between that and no insurance. ---
**Author:** ![ElvisL1ves](https://avatars.discourse-cdn.com/v4/letter/e/5daacb/32.png) [@ElvisL1ves](https://boards.straightdope.com/u/ElvisL1ves)\ **Post date:** [July 2, 2017, 5:56pm UTC](https://boards.straightdope.com/t/house-passes-repeal-and-replace/785871/1272 "2017-07-02T17:56:53Z")
> [@HurricaneDitka](#): > > You didn’t find my “I think it might save me money” argument compelling? Did it include “and fuck everyone else”? ---
**Author:** ![elucidator](https://avatars.discourse-cdn.com/v4/letter/e/8edcca/32.png) [@elucidator](https://boards.straightdope.com/u/elucidator)\ **Post date:** [July 2, 2017, 7:38pm UTC](https://boards.straightdope.com/t/house-passes-repeal-and-replace/785871/1273 "2017-07-02T19:38:14Z")
That’s the silver lining. Or the mayonnaise on the shit sandwich, depending on whether you’re eating or serving. ---
**Author:** ![Bone](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/bone/32/407_2.png) [@Bone](https://boards.straightdope.com/u/Bone)\ **Post date:** [July 2, 2017, 8:54pm UTC](https://boards.straightdope.com/t/house-passes-repeal-and-replace/785871/1274 "2017-07-02T20:54:08Z")
> [@k9bfriender](#): > > Insurance companies do invest the money that is paid in i premiums into the stock market. Car insurance companies used to pay out more in claims than they took in in premiums (as was explained to me by my insurance company lawyer and broker when I had a claim made against me in 2002), I do not know if this is still true, nor whether this was the standard for health insurance, but I see no reason why it shouldn’t be. Yes typically all insurance companies will seek investment return on their premiums prior to paying claims. But while car insurance (P&C) typically loses money on every policy and makes up the difference in investment income, this is not typically true for health insurance companies. The type of claims are much different in health insurance, and while both are regulated by each state’s department of insurance, rates for P&C typically are set very close to cost if not below cost, but this isn’t really true for health insurance companies. Here you can see a trend of around [96% to 98% combined ratio (page 1)](http://www.naic.org/documents/topic_insurance_industry_snapshots_2013_industry_analysis_report.pdf) for health insurance. Over that same period, you can see for P&C the combined [goes well over 100% in some years.](http://www.naic.org/documents/topic_insurance_industry_snapshots_2013_pc_report.pdf) 2013 shows below 100%, as does 2014, but after that combined ratios have steadily increased which isn’t present in health insurance. ---
**Author:** ![vivalostwages](https://avatars.discourse-cdn.com/v4/letter/v/d07c76/32.png) [@vivalostwages](https://boards.straightdope.com/u/vivalostwages)\ **Post date:** [July 7, 2017, 9:08pm UTC](https://boards.straightdope.com/t/house-passes-repeal-and-replace/785871/1275 "2017-07-07T21:08:40Z")
Here’s one way to offset some medical bills: Declare bankruptcy! > **[They said it's esophageal cancer, inoperable; we're calling hospice.](https://www.dailykos.com/stories/2017/7/6/1678313/-They-said-it-s-esophageal-cancer-inoperable-we-re-calling-hospice)** > > This Fourth of July was my first as a political candidate. It was surreal, like nothing I've ever done before. I've been to plenty of parades, but to be the one smiling and waving at folks, walking the crowds - being cheered! - just... incredible... * * * ---
**Author:** ![Trinopus](https://avatars.discourse-cdn.com/v4/letter/t/2bfe46/32.png) [@Trinopus](https://boards.straightdope.com/u/Trinopus)\ **Post date:** [July 8, 2017, 1:54am UTC](https://boards.straightdope.com/t/house-passes-repeal-and-replace/785871/1276 "2017-07-08T01:54:59Z")
If enough people do that, Congress might pass laws limiting our ability to do this, just as they’ve put limits on our ability to use bankruptcy to vacate our college loan debts. These guys are not our friends, and certainly no longer our servants. ---
**Author:** ![vivalostwages](https://avatars.discourse-cdn.com/v4/letter/v/d07c76/32.png) [@vivalostwages](https://boards.straightdope.com/u/vivalostwages)\ **Post date:** [July 8, 2017, 3:05am UTC](https://boards.straightdope.com/t/house-passes-repeal-and-replace/785871/1277 "2017-07-08T03:05:27Z")
And where is **Bricker**? ---
**Author:** ![Bricker](https://avatars.discourse-cdn.com/v4/letter/b/977dab/32.png) [@Bricker](https://boards.straightdope.com/u/Bricker)\ **Post date:** [July 8, 2017, 3:21am UTC](https://boards.straightdope.com/t/house-passes-repeal-and-replace/785871/1278 "2017-07-08T03:21:52Z")
> [@vivalostwages](#): > > And where is **Bricker**? Right here. What’s up? ---
**Author:** ![Chimera](https://avatars.discourse-cdn.com/v4/letter/c/8e8cbc/32.png) [@Chimera](https://boards.straightdope.com/u/Chimera)\ **Post date:** [July 8, 2017, 3:31am UTC](https://boards.straightdope.com/t/house-passes-repeal-and-replace/785871/1279 "2017-07-08T03:31:22Z")
They can’t get their own people on board because the ones who might be most vulnerable don’t want to vote for it and the far right tea party / libertarians won’t vote for it unless it is even more vicious. They’ve promised their base for seven years that they would repeal and replace it, without being able to produce a plan to do so. Now since they refuse to compromise with the Democrats or even involve them in the process, they have to get all of their narrow majority to agree to a plan and vote for it. And they’re finding that they can’t agree on one. ---
**Author:** ![vivalostwages](https://avatars.discourse-cdn.com/v4/letter/v/d07c76/32.png) [@vivalostwages](https://boards.straightdope.com/u/vivalostwages)\ **Post date:** [July 8, 2017, 6:58am UTC](https://boards.straightdope.com/t/house-passes-repeal-and-replace/785871/1280 "2017-07-08T06:58:14Z")
> [@Bricker](#): > > Right here. What’s up? Waiting for you to respond to the links in post number 1252. [Previous page](https://boards.straightdope.com/t/house-passes-repeal-and-replace/785871.md?page=63) [Next page](https://boards.straightdope.com/t/house-passes-repeal-and-replace/785871.md?page=65)