Gonna be one busy mo-fo!
“Hello, Obamacare, Obama speaking? No, sir, veterinary services are not covered. Thank you for calling, and have a nice day…Hello, Obamacare, Obama speaking…”
Congress already passed the bill, there is no role in implementation from them from here on, or at least there shouldn’t be, because the CBO scored the bill passed as reducing the deficit. If the President has to keep on coming back for more money, then it was all a lie. So Congress is out of it now.
The state governments are implementing it when they chose to do so. Of course OBama won’t be to blame if California screws up its exchange. But he is responsible for the 33 odd state exchanges he does have to set up. He’s also solely responsible for the impact of the regulations emanating from HHS.
So your view of reality is that when Congress passes a law, all aspects including its implementation are forever funded at the amount necessary to implement it? That’s a nice idea. Maybe we should consider adopting your reality.
Wrong in many ways. For one, exchanges are only part of the law. State governments are also involved in many other aspects.
For another, the federal exchanges having to be set up at all is a consequence of a deliberate GOP strategy.
For a third, the creation of them and writing of regulations for them requires…guess what…paid government employees. Do you know which branch of government is responsible for whether HHS has enough lawyers to write all the regulations?
Once again adaher, that is just an admission of the irresponsibility of the states that by “pure coincidence” have the least competition and decided to not help with the exchanges.
Only in a parallel universe would the people see the obstructionism and lack of help from the states that punted as a winning strategy, or they would blame Obama for the clear active obstructionism.
You don’t really know how waste works do you? :dubious:
Suffice to say, yes, only Obamacare can eliminate waste because that’s what its designed to do, and to provide better health care. This is what’s called a “plan”. The GOP doesn’t have one of those, so therefore they can’t eliminate waste. You seem to think in your erroneously naive way that “waste” is a thing that just lingers in the background, ready to give credit to anyone who’s first to seize it and trash it, like an old can of pickles in the back of the refrigerator. The very fact that waste can be identified and eliminated is because smart people looked through what’s being spent and said “we can do better”. The GOP does not want to do better, therefore there is no waste to them to eliminate. Unless you count the whole thing, which they are very happy to get rid of so nobody except the rich can afford to live
I understand your point, but ACA was scored by the CBO with the funding in the bill, and Democrats not only insisted it was reduced the deficit, they went so far as to call those who doubted it liars. So yeah, when they come back for more money, that means THEY were the liars.
If they choose to be.
Which was foreseen. They went forward with the bill anyway, assuming they could force states to do this that, or the other thing. That’s why the spin that SCOTUS upheld the law is so disingenous. They struck down the part that coerced states into doing the federal government’s bidding. It is entirely Democrats’ fault that they thought such a thing was constitutional. Not only did they think it was constitutional, but they thought that questioning it was crazy. Yet they lost on that part of the bill by a 7-2 vote.
Failures on multiple levels there. They failed on their analysis of the constitutionality, they failed on their ability to predict how states would react.
The number of regulations isn’t a problem, it’s how well they’ll work in practice. And who wrote ACA? Should not Congress have appropriated money in the health care bill to expand HHS? Why didn’t they? Becuase they were trying to game the CBO?
adaher: Just to ask, assuming there’s no government shutdown, do you approve of Republicans using the debt ceiling in the same way as a means to defund the ACA?
adaher, you appear to fundamentally misunderstand how budgeting and appropriations work in the US government. It is not the case that subsequent votes on appropriations for a program only happen when the program is over-budget. CBO estimates, budget resolutions, and appropriations bills are all separate animals. Something can save even more money that the CBO estimated from its passage in 2010, for example, and still require an appropriations bill in 2013 in order to be properly implemented. Your claim that the only reason Congress is involved in Obamacare is because it is overbudget is not just wrong on the facts, it’s wrong for really fundamental reasons that make it hard to take the rest of your analysis seriously.
You’ve also badly misread the Supreme Court’s ruling, by conflating the Medicare expansion with the insurance exchanges. You’re also conflating the argument everyone thought was frivolous (that the individual mandate was unconstitutional) with the secondary argument about the Medicare expansion about which there was very little commentary.
You’re right about one thing though: the bill’s drafters should have been much more cynical about the extent to which GOP governors would seek to sabotage it regardless of the effects on their states. Unfortunately for you, that’s a complete non-sequitur to my point, which is that those state governors will in fact have a lot of control over whether the program is successfully implemented or not.
If i had a device that saved me a bunch of money, I might very well spend more money and buy another. And save more money. Which would not mean it had failed.
(You gotta give it to him in small bites, Judge Parker, otherwise the boy gets confused.)
What’s to understand? It’s very simple:
(Repeat in every thread.)
Absolutely not. You don’t screw with the debt ceiling.
It’s not overbudget, so much as it only reduces the deficit if we count the money appropriated in the bill. Anything Democrats neglected to include(such as an HHS expansion to handle implementation), is money left out of the CBO calculations.
Medicaid. There was less commentary, but the Democrats were confident of the bill’s constitutionality, in full, and the Medicaid expansion was a key part. The exchanges, they knew from the start that states might not want to participate, and it turned out that it wasn’t just Republican states that opted out. That’s a big failure to anticipate reality, no way around that.
It’s not sabotage. States are not required to go along with every federal initiative. Are states ‘sabotaging’ immigration enforcement? How about drug enforcement? The constitutional lines between state and federal power have been understood for 200+ years. How could Democrats not anticipate that a partisan bill wouldn’t result in resistance? And this is legitimate resistance, not sabotage as you put it. Governors have a million things to worry about, implementing the health care law gets prioritized below things that are more important to them. You know, like bringing jobs to their state.
You are unfamiliar with basic facts of how budgets work.
The authorization to spend $X on a program is independent of the issue of whether the savings $Y for that program is greater than, less than, or equal to $X. The fact that Y is greater than X in this particular case does not magically remove the authorization requirements.
You know, the Repubs tried UHC back in the very early 1970’s and they never tried again, which to my mind is more damning than “we didn’t win this time, we’ll try again later”, even if later is a couple decades down the road.
I would quibble with the premises there, but it doesn’t matter because this is entirely beside the point (which is that Congress, and specifically the House of Representatives, will have a substantial influence on whether the bill is implemented properly, and that has nothing to do with CBO estimates).
AFAIK, every state to have opted out of involvement with the exchanges and every state to have refused to give more people Medicaid coverage has involved Republicans in the legislature backing a Republican governor or blocking a Democratic governor’s attempt to opt into the Medicaid expansion. Which state am I missing?
To be fair, we’re talking about a bunch of different states and a bunch of different aspects of implementation. Some of them are good faith “legitimate resistance” as you term it. Some of them are not. Supporting the GOP campaigns to tell college kids not to buy subsidized health insurance is not putting Obamacare at a low priority. It is attempting to sabotage its success, for example. There are others.
As for the exchanges, again I don’t disagree that Obama and team failed to anticipate the backlash. But no one in their right might thought that health insurance exchanges were going to be the polarizing state issue of 2013; if anything, that aspect of the program was the one the GOP should have liked most. Indeed, it still isn’t really the issue. None of the GOP governors has offered a coherent rationale for why exchanges are bad policy in and of themselves. They oppose them either to ride the general tide of GOP-created angst about “government takeover of healthcare” or to actively prevent the program from being a success because, as various Republicans have warned, once people start to use a program they like it will be hard to take it away from them.
This is how we know it is NOT a train wreck. If it was, surely the best strategy for Republicans would be to pop some corn and watch a Democratic disaster unfold before them. What could be better for Republicans than to see Obamacare fail by itself? But they know that this won’t happen. Therefore their only play is to kill it in its crib before people start to benefit from it and then realize that the Republicans voted to undo a popular program over 40 times.
Or, it could be a train wreck but could survive anyway if a motivated enough minority wants to keep it.
It’s also necessary for Republicans to win this debate now, even if they don’t repeal it, because Democrats want to make lemonade out of the lemons if it fails and claim that it was single-payer all along that was needed. The Republicans need to put the failure of Obamacare on Democrats so that the public won’t listen to them when they try that tack.
Of course it’s possible ACA will be implemented well, most of the liberal predictions will come true, and Republicans will suffer for trying to kill it. And the Iraq war could have been a cakewalk. Competence matters, and Republicans aren’t as stupid as you think. They know that Obama is a) a very poor executive, but b) a very good base-riler who can dodge blame for his failures long enough to get a lot of people addicted to the program.
Cite?
Heh. Wait for the 2014 elections, the GOP has a very favorable map. Let’s see if they manage to screw it up.
This was reported in the LA Times a few days ago, now the NY Times has picked it up. this isn’t fearmongering, it’s not even necessarily a big problem, but what it is is proof of something every single Doper should already know: there is no free lunch.
WASHINGTON — Federal officials often say that health insurance will cost consumers less than expected under President Obama’s health care law. But they rarely mention one big reason: many insurers are significantly limiting the choices of doctors and hospitals available to consumers.
From California to Illinois to New Hampshire, and in many states in between, insurers are driving down premiums by restricting the number of providers who will treat patients in their new health plans.
When insurance marketplaces open on Oct. 1, most of those shopping for coverage will be low- and moderate-income people for whom price is paramount. To hold down costs, insurers say, they have created smaller networks of doctors and hospitals than are typically found in commercial insurance. And those health care providers will, in many cases, be paid less than what they have been receiving from commercial insurers.
Some consumer advocates and health care providers are increasingly concerned. Decades of experience with Medicaid, the program for low-income people, show that having an insurance card does not guarantee access to specialists or other providers.
What this also demonstrates is that throwing accusations of “LIAR!” around can backfire:
**The current concerns echo some of the criticism that sank the Clinton administration’s plan for universal coverage in 1993-94. Republicans said the Clinton proposals threatened to limit patients’ options, their access to care and their choice of doctors. **
When you start swearing up and down that you can keep your doctor and those who say otherwise are dirty liars, what happens when well, patients can’t keep their doctor? On SDMB, we hold people accountable for saying things that are wrong. Will we extend that same standard of accountability to politicians?