# The Repeal of Obamacare/ACA: Step-bystep, Inch-by-inch **URL:** \ **Category:** The BBQ Pit\ **Created:** [January 2, 2017, 5:06pm UTC](https://boards.straightdope.com/t/the-repeal-of-obamacare-aca-step-bystep-inch-by-inch/776146 "2017-01-02T17:06:13Z")\ **Posts on this page:** 20\ **Page:** 3
**Author:** ![Shagnasty](https://avatars.discourse-cdn.com/v4/letter/s/9dc877/32.png) [@Shagnasty](https://boards.straightdope.com/u/Shagnasty)\ **Post date:** [January 2, 2017, 10:22pm UTC](https://boards.straightdope.com/t/the-repeal-of-obamacare-aca-step-bystep-inch-by-inch/776146/41 "2017-01-02T22:22:31Z")
> [@Tee](#): > > The whole industry thrives on porking the public via drug costs. I saw that over twenty years ago as a pharmacy tech, and you think it’s complicated? It isn’t complicated at all. It is just that it is completely regulated, quality controlled, tracked and constantly audited by the FDA. That is why you get $500 screws that look almost identical to the 5 cent ones at Home Depot down the street. There is also the constant threat of massive lawsuits that can and do happen. Everyone is doing the best that they can but some sick people die and some families want payout because 89 year old Aunt Edna didn’t make it to 90. ---
**Author:** ![filmore](https://avatars.discourse-cdn.com/v4/letter/f/7993a0/32.png) [@filmore](https://boards.straightdope.com/u/filmore)\ **Post date:** [January 2, 2017, 10:23pm UTC](https://boards.straightdope.com/t/the-repeal-of-obamacare-aca-step-bystep-inch-by-inch/776146/42 "2017-01-02T22:23:36Z")
If Medicare was expanded so that it covered all ages, how much would the payroll deduction need to be? Currently the payroll deduction is 2.9% (employee and employer together) and covers people 65 and older. If anyone could get Medicare, what would the percentage need to be? Alternatively, what if the government allowed people to buy “Medicare policies” at any age? So instead of getting a policy from Blue Cross, they could get it from Medicare. What would their premiums be? Medicare isn’t the best coverage, so traditional insurance would still be used by many people. But Medicare might be a good safety net for many people if they couldn’t get a traditional policy. ---
**Author:** ![The\_Other\_Waldo\_Pepper](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/the_other_waldo_pepper/32/12370_2.png) [@The\_Other\_Waldo\_Pepper](https://boards.straightdope.com/u/The_Other_Waldo_Pepper)\ **Post date:** [January 2, 2017, 10:31pm UTC](https://boards.straightdope.com/t/the-repeal-of-obamacare-aca-step-bystep-inch-by-inch/776146/43 "2017-01-02T22:31:15Z")
> [@Debillw3](#): > > From context, I’m gathering that you did not, in fact, get to keep your plan. > > Is that because the law said you couldn’t or because the insurance company opted to not offer it anymore? > > Obviously insurance companies had to find money somewhere to offset their new costs, but, if they chose to do so by eliminating your plan, I don’t see what the law has to do with that or why you’d expect the government to be clairvoyant & see that coming. > > If, however, the law banned your plan, that’s a different story. Oh, hey, _my_ plan wasn’t affected by the gol-danged gummint; I liked my plan just fine, and I got to keep it just like I was assured. But all sorts of other folks got assured likewise, and some of them reported that they liked their plans but didn’t get to keep them, which on general principle I find to be roughly as objectionable as slander or false advertising or perjury even when I’m not the one being slandered or false-advertised-to or perjured-about. I, uh, don’t always put things elegantly. ---
**Author:** ![Debillw3](https://avatars.discourse-cdn.com/v4/letter/d/3bc359/32.png) [@Debillw3](https://boards.straightdope.com/u/Debillw3)\ **Post date:** [January 2, 2017, 10:33pm UTC](https://boards.straightdope.com/t/the-repeal-of-obamacare-aca-step-bystep-inch-by-inch/776146/44 "2017-01-02T22:33:03Z")
> [@The\_Other\_Waldo\_Pepper](#): > > But all sorts of other folks got assured likewise, and some of them reported that they liked their plans but didn’t get to keep them, which on general principle I find to be roughly as objectionable as slander or false advertising or perjury even when I’m not the one being slandered or false-advertised-to or perjured-about. That’s fair. But the question about who didn’t let them keep the plan still stands. I’m sure you see the difference I illustrated. ---
**Author:** ![Kimstu](https://avatars.discourse-cdn.com/v4/letter/k/ecd19e/32.png) [@Kimstu](https://boards.straightdope.com/u/Kimstu)\ **Post date:** [January 2, 2017, 10:36pm UTC](https://boards.straightdope.com/t/the-repeal-of-obamacare-aca-step-bystep-inch-by-inch/776146/45 "2017-01-02T22:36:09Z")
> [@The\_Other\_Waldo\_Pepper](#): > > I was told that, if I liked my plan, I could keep it. :dubious: And you were promised that its costs would always remain the same? Really? Mind you, I’m not saying that all the impacts of Obamacare were adequately understood, predicted or presented. I think there are a lot of legitimate reasons why some people are dissatisfied with some of the consequences. I’m just pointing out that there was never anything “covert” about the fact that it was going to cost money and the money would have to come from somewhere. ---
**Author:** ![The\_Other\_Waldo\_Pepper](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/the_other_waldo_pepper/32/12370_2.png) [@The\_Other\_Waldo\_Pepper](https://boards.straightdope.com/u/The_Other_Waldo_Pepper)\ **Post date:** [January 2, 2017, 10:37pm UTC](https://boards.straightdope.com/t/the-repeal-of-obamacare-aca-step-bystep-inch-by-inch/776146/46 "2017-01-02T22:37:32Z")
> [@Debillw3](#): > > That’s fair. > > But the question about who didn’t let them keep the plan still stands. > > I’m sure you see the difference I illustrated. Well, yeah; as I understand it, some of them lost their plans because the government stopped allowing such plans. All apologies if I didn’t make that clear. ---
**Author:** ![Kimstu](https://avatars.discourse-cdn.com/v4/letter/k/ecd19e/32.png) [@Kimstu](https://boards.straightdope.com/u/Kimstu)\ **Post date:** [January 2, 2017, 10:42pm UTC](https://boards.straightdope.com/t/the-repeal-of-obamacare-aca-step-bystep-inch-by-inch/776146/47 "2017-01-02T22:42:11Z")
> [@Shagnasty](#): > > It isn’t complicated at all. It is just that it is completely regulated, quality controlled, tracked and constantly audited by the FDA. […] There is also the constant threat of massive lawsuits that can and do happen. And, as [numerous studies have consistently shown](https://www.bloomberg.com/news/articles/2013-04-10/the-reason-health-care-is-so-expensive-insurance-companies), it **is** complicated, and expensive, largely **because of _“the enormous administrative overhead costs that come from lodging health-care reimbursement in the hands of insurance companies that have no incentive to perform their role efficiently as payment intermediaries”_**. In other words, **Shagnasty** , health insurance industry bureaucrats like you are a massive part of the problem. Not blaming you personally for just doing your job, but it’s the nature and existence of your job, and the inefficient way it interacts with all the other jobs like yours as well as the jobs of the people who actually provide and receive the healthcare, that makes healthcare in the US so costly. ---
**Author:** ![ThelmaLou](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/thelmalou/32/390_2.png) [@ThelmaLou](https://boards.straightdope.com/u/ThelmaLou)\ **Post date:** [January 2, 2017, 10:46pm UTC](https://boards.straightdope.com/t/the-repeal-of-obamacare-aca-step-bystep-inch-by-inch/776146/48 "2017-01-02T22:46:40Z")
> [@Clothahump](#): > > Not sure what you are referring to. The only Affordable Care Act I know about is the abortion referred to as Obamacare, which is a miserable failure and has caused many more people to either lose coverage (or settle for substandard coverage) than it has allowed to gain coverage. If it’s not the worst legislation to ever come out of Congress, it’s definitely in the top 5. It needs to be repealed in its entirety, and I sincerely hope Trump spearheads the effort to do exactly that. Even factoring out the laughable hyperbole, you are dead wrong. But I won’t belabor the point. ---
**Author:** ![Tee](https://avatars.discourse-cdn.com/v4/letter/t/73ab20/32.png) [@Tee](https://boards.straightdope.com/u/Tee)\ **Post date:** [January 2, 2017, 10:47pm UTC](https://boards.straightdope.com/t/the-repeal-of-obamacare-aca-step-bystep-inch-by-inch/776146/49 "2017-01-02T22:47:39Z")
> [@Shagnasty](#): > > It isn’t complicated at all. It is just that it is completely regulated, quality controlled, tracked and constantly audited by the FDA. That is why you get $500 screws that look almost identical to the 5 cent ones at Home Depot down the street. There is also the constant threat of massive lawsuits that can and do happen. Everyone is doing the best that they can but some sick people die and some families want payout because 89 year old Aunt Edna didn’t make it to 90. Horseshit. 25 years ago, in Mass, everyone paid cash for prescriptions; today hardly anyone can afford them out of pocket. If they could, we wouldn’t need the ACA in the first place. ---
**Author:** ![ElvisL1ves](https://avatars.discourse-cdn.com/v4/letter/e/5daacb/32.png) [@ElvisL1ves](https://boards.straightdope.com/u/ElvisL1ves)\ **Post date:** [January 2, 2017, 10:47pm UTC](https://boards.straightdope.com/t/the-repeal-of-obamacare-aca-step-bystep-inch-by-inch/776146/50 "2017-01-02T22:47:58Z")
**Humpy** appears to be outraged that insurance companies can no longer deny coverage for existing conditions, for starters. That \*has \*to go. ---
**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:** [January 2, 2017, 11:01pm UTC](https://boards.straightdope.com/t/the-repeal-of-obamacare-aca-step-bystep-inch-by-inch/776146/51 "2017-01-02T23:01:08Z")
> [@ElvisL1ves](#): > > What the hell makes you think it’s a tax, not a required purchase? Would you be happier if it were, in fact, covered by your taxes? That’s what you’re saying. > > You’re making zero sense here. If healthcare was provided as an entitlement rather than a forced purchase, yes I would consider that a much more desirable scenario. As it stands, the logic of the ACA has no limiting principle and the people could be forced to buy broccoli, or Ford F150s, or goods and services from only Trump owned business, else they be subjected to a tax penalty. That’s bad and should not be possible. ---
**Author:** ![ElvisL1ves](https://avatars.discourse-cdn.com/v4/letter/e/5daacb/32.png) [@ElvisL1ves](https://boards.straightdope.com/u/ElvisL1ves)\ **Post date:** [January 2, 2017, 11:57pm UTC](https://boards.straightdope.com/t/the-repeal-of-obamacare-aca-step-bystep-inch-by-inch/776146/52 "2017-01-02T23:57:59Z")
> [@Bone](#): > > If healthcare was provided as an entitlement rather than a forced purchase, yes I would consider that a much more desirable scenario. You’re “forced” to pay taxes to “purchase” government services. So what? That’s a difference over which you’re willing to take health care coverage away from tens of millions of people who have no reasonable alternative. As stated, you’re making zero sense. ---
**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:** [January 3, 2017, 12:03am UTC](https://boards.straightdope.com/t/the-repeal-of-obamacare-aca-step-bystep-inch-by-inch/776146/53 "2017-01-03T00:03:13Z")
> [@ElvisL1ves](#): > > You’re “forced” to pay taxes to “purchase” government services. So what? So that’s consistent with the constitution as it should be understood. Hopefully the new administration will make good on its promise and kill the ACA. Would you be okay if congress passed and Trump signed into law an act that forced you to only purchase services through Trump owned businesses and if you didn’t you’d be penalized with a tax? > [@](#): > > That’s a difference over which you’re willing to take health care coverage away from tens of millions of people who have no reasonable alternative. Yes. If the people want it, they can do it as an entitlement. > [@](#): > > As stated, you’re making zero sense. No. ---
**Author:** ![ThelmaLou](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/thelmalou/32/390_2.png) [@ThelmaLou](https://boards.straightdope.com/u/ThelmaLou)\ **Post date:** [January 3, 2017, 12:08am UTC](https://boards.straightdope.com/t/the-repeal-of-obamacare-aca-step-bystep-inch-by-inch/776146/54 "2017-01-03T00:08:52Z")
> [@Bone](#): > > If healthcare was provided as an entitlement rather than a forced purchase, yes I would consider that a much more desirable scenario. As it stands, the logic of the ACA has no limiting principle and the people could be forced to buy broccoli, or Ford F150s, or goods and services from only Trump owned business, else they be subjected to a tax penalty. That’s bad and should not be possible. It’s analogous to the law that says you have to buy PRIVATE car insurance. Some people erroneously think the ACA/Obamacare (two different names for the same thing, in case anyone here doesn’t know that :rolleyes: ) is a government health insurance program. IMHO it definitely would be better if health insurance were an entitlement paid for by taxes (like Medicare), but it is a law that makes people buy private insurance or pay a monetary penalty. This was a compromise because the Republicans would not ever agree to a tax-supported health insurance program (e.g., Medicare for everyone) _on principle_. They do not believe it is the gummint’s job to give a shit about the welfare of its citizens. It’s every person/family for him/herself and if you don’t have the money or a job, fuck you. ---
**Author:** ![ElvisL1ves](https://avatars.discourse-cdn.com/v4/letter/e/5daacb/32.png) [@ElvisL1ves](https://boards.straightdope.com/u/ElvisL1ves)\ **Post date:** [January 3, 2017, 12:11am UTC](https://boards.straightdope.com/t/the-repeal-of-obamacare-aca-step-bystep-inch-by-inch/776146/55 "2017-01-03T00:11:01Z")
> [@Bone](#): > > So that’s consistent with the constitution as it should be understood. The difference being … what? :dubious: > [@](#): > > Hopefully the new administration will make good on its promise and kill the ACA. Providing it through private firms rather than the government matters more to you than getting real help to real people. Wow. > [@](#): > > Would you be okay if congress passed and Trump signed into law an act that forced you to only purchase services through Trump owned businesses and if you didn’t you’d be penalized with a tax? C’mon, man. :rolleyes: I know \*you \*think _you’re_ making sense. But you haven’t even paid enough attention to the Obamacare Is Evil party line to even quote it coherently. ---
**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:** [January 3, 2017, 12:26am UTC](https://boards.straightdope.com/t/the-repeal-of-obamacare-aca-step-bystep-inch-by-inch/776146/56 "2017-01-03T00:26:31Z")
> [@ElvisL1ves](#): > > The difference being … what? :dubious: The difference being it would be consistent with the constitution as it should be understood. If you don’t find that important that’s not surprising. > [@](#): > > Providing it through private firms rather than the government matters more to you than getting real help to real people. Wow. You’ve misunderstood. If healthcare for all were to be provided like Medicare that would not be treading new ground. And yes, principles matter to me. > [@](#): > > C’mon, man. :rolleyes: > > I know \*you \*think _you’re_ making sense. But you haven’t even paid enough attention to the Obamacare Is Evil party line to even quote it coherently. C’mon yourself? I don’t think the ACA is evil in the slightest. I think it’s well intentioned but ultimately poor public policy. But you didn’t answer the question. Would you be okay to be forced to purchase Trump provided goods and services, and if you declined you’d be penalized with a tax? My guess is you’d be opposed, but you seem to avoid answering direct questions for some reason. ---
**Author:** ![GrumpyBunny](https://avatars.discourse-cdn.com/v4/letter/g/bc8723/32.png) [@GrumpyBunny](https://boards.straightdope.com/u/GrumpyBunny)\ **Post date:** [January 3, 2017, 12:51am UTC](https://boards.straightdope.com/t/the-repeal-of-obamacare-aca-step-bystep-inch-by-inch/776146/57 "2017-01-03T00:51:59Z")
> [@Shagnasty](#): > > No it isn’t. I live in Massachusetts and ObamaCare is modeled after Mitt Romney’s plan (he is a Republican for those that don’t know). The Massachusetts plan seemed to work for a while but then went to shit quickly when it was adopted nationally. The complaints are real despite all the shrieking that it simply cannot be so. > > \ > > My position is that healthcare needs real reform and ObamaCare is not the solution. I don’t know what the real solution is and I doubt that any individual does because the problem is so complex but it is in everyone’s best interest to avoid reflexively showing their political badges on matters of social policy that are so complicated. The only way to solve a problem like this is to work through it analytically and slowly. I’m a healthcare analyst. I live in Massachusetts; I’m originally from Florida. And I agree with you that the ACA didn’t work when it was rolled out nationally. Because: 1.) Politics. The Republicans’ message was so negative and pervasive about this. The end result was many red states going with the party line and declaring, “We ain’t gonna expand no Medicare!” (Never mind the 50% uninsured population, half of whom are asthmatic, have cancer, or are pre-diabetics that make up the state. BTW, uncontrolled chronic health problems are bad for hospitals’ bottom line) 2.) Industry creativity – the pseudo-coverage known as “high deductible plans” do nothing to help anyone’s health, nor does it provide much in the way of coverage or security. And the creative tricks used to reduce coverage of medications used for standard care need to stop, too.[Declaring every medication used to treat a condition “non-preferred” is fucking wrong.](https://www.nytimes.com/2014/09/18/upshot/how-insurers-are-finding-ways-to-shift-costs-to-the-sick.html?_r=0&abt=0002&abg=1) And 3.), no one took on the drug companies. The drug companies have been coddled and allowed to run amok, and will never, ever have a conversation about how to combine reasonable pricing and making reasonable profits until America starts to import drugs from India. To my mind, we need single-payer, universal coverage. Some form of universal coverage has worked in every westernized country, and serves to keep citiziens healthier by treating problems as they come up rather than when they are at the ER. The infrastructure for single payer already exists with Medicare, which has been successful for fifty years. (Medicare also needs some updating; but that’s another post.) Negotiations with drug companies so that epi-pens aren’t $600 a pop, and sixty-year-old drugs don’t cost $1200 per month. Import drugs if the pharmaceutical companies won’t negotiate. Existing insurance companies can process claims (as they do for Medicare) and sell add-on plans to employers, to be employee perqs. There are dozens of countries we can look at to analyze how to implement this, but I’d suggest one that was analyzed in [this Commonwealth Fund report](http://www.commonwealthfund.org/publications/issue-briefs/2015/oct/us-health-care-from-a-global-perspective). ---
**Author:** ![John\_Mace](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/john_mace/32/185_2.png) [@John\_Mace](https://boards.straightdope.com/u/John_Mace)\ **Post date:** [January 3, 2017, 1:00am UTC](https://boards.straightdope.com/t/the-repeal-of-obamacare-aca-step-bystep-inch-by-inch/776146/58 "2017-01-03T01:00:55Z")
> [@ThelmaLou](#): > > It’s analogous to the law that says you have to buy PRIVATE car insurance. Nope. We’ve been over this only about 1,000 times but let’s do it again, just for you: 1. States have plenary power. The Feds do not. 2. You only have to buy insurance if you own a car and drive on public roads. But most importantly: 1. You only have to buy liability insurance-- that is, insurance in case you cause harm to someone else. So no, it’s not analogous to states mandating car insurance. ---
**Author:** ![wolfpup](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/wolfpup/32/10618_2.png) [@wolfpup](https://boards.straightdope.com/u/wolfpup)\ **Post date:** [January 3, 2017, 1:09am UTC](https://boards.straightdope.com/t/the-repeal-of-obamacare-aca-step-bystep-inch-by-inch/776146/59 "2017-01-03T01:09:48Z")
> [@Bone](#): > > C’mon yourself? I don’t think the ACA is evil in the slightest. I think it’s well intentioned but ultimately poor public policy. But you didn’t answer the question. Would you be okay to be forced to purchase Trump provided goods and services, and if you declined you’d be penalized with a tax? My guess is you’d be opposed, but you seem to avoid answering direct questions for some reason. I haven’t been following all of this conversation but I would like to interject here. No, I would not be OK with being forced to purchase Trump goods and services, and I would object strenuously to such a proposition. Yet OTOH, I live in a country in which all citizens participate in a universal single-payer health plan, and I have no problem with that whatsoever. In fact as you probably know, I’ve been arguing in favor of the Canadian health care model here (and elsewhere) for years. I’ll try to explain the difference. And I now have a new perspective on the issue, too. I’ve argued for years about my personal observations on how my various relatives and friends, including very elderly ones, have been very well served by the single-payer system in Canada. I was fortunate in being healthy myself despite getting older and now being retired. That all changed two weeks ago. Two weeks ago I became a first-hand player in the health care system that I’ve praised for so long as a third-party observer. Two weeks ago the Canadian health care system saved my life. Literally. Via a costly procedure that I would never have been able to afford, nor would I have been predisposed to buy or been able to afford the kind of individual insurance that would have fully covered the cost. As hard as I’ve argued for this system before, now it’s personal. > [@Bone](#): > > And yes, principles matter to me. Principles matter to me, too. My principles include a belief in a fundamental common social responsibility for health and human life and a compassionate perspective thereof. No snark intended, but I find it hard to imagine a contrary principle that has an equal moral imperative. Certainly the desire of wealthy individuals to hold on to as much of their money as possible is mere ideological persiflage compared to matters of life and death and the fundamental values of the society we live in. ---
**Author:** ![Debillw3](https://avatars.discourse-cdn.com/v4/letter/d/3bc359/32.png) [@Debillw3](https://boards.straightdope.com/u/Debillw3)\ **Post date:** [January 3, 2017, 1:11am UTC](https://boards.straightdope.com/t/the-repeal-of-obamacare-aca-step-bystep-inch-by-inch/776146/60 "2017-01-03T01:11:59Z")
> [@ThelmaLou](#): > > It’s analogous to the law that says you have to buy PRIVATE car insurance. Maybe in a sense, but, on a whole, I disagree. As a citizen of the United States, if I cannot afford car insurance on top of my other expenditures (or simply don’t want to), I have no obligation to purchase it. I’m not expected to pay extra for that inability or disinterest. I just can’t have a car (which I don’t). With the ACA, however, there is no “opt out”. It’s either buy the insurance or pay a penalty. It doesn’t matter if I refuse to go to a doctor or hospital in the first place or if I can’t afford it, I have no choice but to buy it or face a cash penalty. I’m forced, regardless of circumstances, to pay something. There’s a big difference between “you don’t have to pay anything if you go without a car” and “you have to pay, regardless of whether you opt to go without healthcare”. [Previous page](https://boards.straightdope.com/t/the-repeal-of-obamacare-aca-step-bystep-inch-by-inch/776146.md?page=2) [Next page](https://boards.straightdope.com/t/the-repeal-of-obamacare-aca-step-bystep-inch-by-inch/776146.md?page=4)