# 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:** 5
**Author:** ![elbows](https://avatars.discourse-cdn.com/v4/letter/e/b3f665/32.png) [@elbows](https://boards.straightdope.com/u/elbows)\ **Post date:** [January 3, 2017, 7:18am UTC](https://boards.straightdope.com/t/the-repeal-of-obamacare-aca-step-bystep-inch-by-inch/776146/81 "2017-01-03T07:18:41Z")
> [@John\_Mace](#): > > It’s not analogous for the reasons I stated. It’s not even close. It would be analogous if you had to take out medical insurance for injuries you might cause someone else to have. Except, when you don’t carry health insurance, your medical costs get pushed onto everyone else. So we’re all paying for your bad choice. Just like paying to support a family left without a breadwinner, due to an accident with an uninsured driver. Paying for someone else’s bad choices. ---
**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, 11:24am UTC](https://boards.straightdope.com/t/the-repeal-of-obamacare-aca-step-bystep-inch-by-inch/776146/82 "2017-01-03T11:24:10Z")
> [@John\_Mace](#): > > It’s not analogous for the reasons I stated. It’s not even close. It would be analogous if you had to take out medical insurance for injuries you might cause someone else to have. It is analogous, not a perfect parallel. ---
**Author:** ![Budget\_Player\_Cadet](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/budget_player_cadet/32/205_2.png) [@Budget\_Player\_Cadet](https://boards.straightdope.com/u/Budget_Player_Cadet)\ **Post date:** [January 3, 2017, 11:26am UTC](https://boards.straightdope.com/t/the-repeal-of-obamacare-aca-step-bystep-inch-by-inch/776146/83 "2017-01-03T11:26:16Z")
> [@raventhief](#): > > Clothahump, I am genuinely curious. I have pre-existing conditions, as does my husband. He is working on disability, but it’s a work in progress. I am self employed. We could not get any insurance under the old system, and now we are covered. What, in your opinion, should we do in the event of a repeal, without replacement? **Clothahump** , I too would like to hear the answer to this. ---
**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, 11:32am UTC](https://boards.straightdope.com/t/the-repeal-of-obamacare-aca-step-bystep-inch-by-inch/776146/84 "2017-01-03T11:32:08Z")
> [@raventhief](#): > > Clothahump, I am genuinely curious. I have pre-existing conditions, as does my husband. He is working on disability, but it’s a work in progress. I am self employed. We could not get any insurance under the old system, and now we are covered. What, in your opinion, should we do in the event of a repeal, without replacement? > [@Leaper](#): > > I’m guessing he’ll say that you should ask for help from friends and family, take out loans, and get charitable aid, that it’s not his responsibility to pay for your bad decisions, and that people falling through the cracks is the price we pay for being free. > [@Budget\_Player\_Cadet](#): > > **Clothahump** , I too would like to hear the answer to this. Me, three. ---
**Author:** ![Der\_Trihs](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/der_trihs/32/233_2.png) [@Der\_Trihs](https://boards.straightdope.com/u/Der_Trihs)\ **Post date:** [January 3, 2017, 12:00pm UTC](https://boards.straightdope.com/t/the-repeal-of-obamacare-aca-step-bystep-inch-by-inch/776146/85 "2017-01-03T12:00:38Z")
> [@raventhief](#): > > Clothahump, I am genuinely curious. I have pre-existing conditions, as does my husband. He is working on disability, but it’s a work in progress. I am self employed. We could not get any insurance under the old system, and now we are covered. What, in your opinion, should we do in the event of a repeal, without replacement? Die slowly? The Right is big on the idea that money = virtue; if you can’t pay for it out of pocket then you are obviously evil, and deserve anything that happens to you. ---
**Author:** ![asahi](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/asahi/32/8693_2.png) [@asahi](https://boards.straightdope.com/u/asahi)\ **Post date:** [January 3, 2017, 12:24pm UTC](https://boards.straightdope.com/t/the-repeal-of-obamacare-aca-step-bystep-inch-by-inch/776146/86 "2017-01-03T12:24:51Z")
The ACA is unpopular now because most people don’t really understand it, but they will have a better understanding of it once republicans destroy it and replace it with nothing. But let’s be clear about something: Mitch McConnell and Paul Ryan do not care what the majority of Americans think. They think they have a mandate, and in fact, they do have a mandate in reality – from their special interest groups and the radicals in their gerrymandered voting districts who keep them in power. Not until the great masses of white working class get screwed into socioeconomic oblivion will we be able to stop the mounting disaster that’s about to happen. ---
**Author:** ![Czarcasm](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/czarcasm/32/4050_2.png) [@Czarcasm](https://boards.straightdope.com/u/Czarcasm)\ **Post date:** [January 3, 2017, 12:36pm UTC](https://boards.straightdope.com/t/the-repeal-of-obamacare-aca-step-bystep-inch-by-inch/776146/87 "2017-01-03T12:36:03Z")
So they are going to _start_ to work on a replacement for ObamaCare after they take office? Is this an admission that all that time since it began when they said they were looking for a replacement for ObamaCare they were lying through their teeth? ---
**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, 12:49pm UTC](https://boards.straightdope.com/t/the-repeal-of-obamacare-aca-step-bystep-inch-by-inch/776146/88 "2017-01-03T12:49:07Z")
There are some lasting benefits of the abominable, failed, hated, worst-piece-of-legislation-since-the-Spanish-Inquisition known as Obamacare (also the Affordable Care Act, in case there is anyone left who doesn’t know those are two names for the same thing) that even the misguided, clueless, ignorant, destructive, Obama-hating, American-people-hating Republicans won’t be able to undo. [A transformation of the delivery of health care may be an enduring legacy for the president, even as Republicans plan to repeal the Affordable Care Act.](http://www.nytimes.com/2017/01/02/us/politics/obama-health-care-affordable-care-act.html?hp&action=click&pgtype=Homepage&clickSource=story-heading&module=second-column-region®ion=top-news&WT.nav=top-news&_r=0) My bolding. > [@](#): > > …Expanding insurance coverage to more than 20 million Americans is among Mr. Obama’s proudest accomplishments, but the changes he has pushed go deeper. They have had an impact on every level of care — from what happens during checkups and surgery to how doctors and hospitals are paid, how their results are measured and how they work together. > > “From the moment I first set foot in the Oval Office in February 2009, the president told me that the law can’t be just about covering the uninsured, but that it also has to be about changing the way care is delivered,” said Nancy-Ann DeParle, who as a White House aide helped lead the effort to pass and carry out the health law.\*\* His [Obama’s] message, she said: “I don’t want to cover everyone and just put them in the same creaky old delivery system.”\*\* > > Changes in the delivery system already affect far more people than the law’s higher-profile coverage gains. To visit IU [Indiana University] Health, the largest health care provider in Indiana, with 15 hospitals and 8,700 doctors, is to see those changes up close. Its leaders have started moving away from fee-for-service medicine, where every procedure, examination and prescription fetches a price. The emphasis now is on preventive care, on taking responsibility for the health of patients not only in the hospital, but also in the community. > > Social work has become a larger part of the medical mission. Collaboration between doctors is becoming a necessity. > > **“I don’t know who could be against it: higher quality and lower cost,”** said Ryan C. Kitchell, an executive vice president and the chief administrative officer of IU Health. > … Ha! That last line made me laugh right out loud. Who, indeed, Mr. Kitchell? > [@](#): > > …“I’ve been a registered Republican my whole life, but I support the Affordable Care Act,” said Dr. Gregory C. Kiray, co-chief of primary care for IU Health Physicians, “because it allows patients to be taken care of.” > … Caring for patients?? Where does that come into it? This a really long article, but this, at the end, is interesting: > [@](#): > > … > Mr. Pence [Indiana gov & the new Veep] expanded Medicaid only after the Obama administration agreed to let Indiana do it in its own way: Instead of getting virtually free coverage, as Medicaid recipients in many other states do, people enrolled in Indiana’s expansion pay up to 5 percent of their income toward it. Mr. Trump appears interested in promoting Indiana’s “personal responsibility” model: He has picked its chief architect, Seema Verma, to run the Centers for Medicare and Medicaid Services. > > Since Mr. Kloski [a patient] had no income when he enrolled, he paid $1 a month; he has since been classified as “medically frail” and does not have to pay anything. > > Medicaid has paid for virtually all of his cancer care, including a one-week hospitalization after the diagnosis, months of chemotherapy, and frequent scans and blood tests. > > **But Mr. Kloski and his mother, Renee Epperson, are still not fans of the health law over all. They believed that it required that Mr. Kloski be dropped, when he turned 26, from the health plan his mother has through her job at Target — not understanding that it was the law that kept him on the plan until he was 26.** > > Mr. Kloski paid a penalty for going uninsured in 2014 rather than even explore whether he might qualify for a subsidy and find an affordable private plan through the marketplaces. > > “There were so many horror stories about how expensive it was going to be,” Ms. Epperson, 47, recalled. “Justin said, ‘I’m not even going to try it, Mom.’” > > \*\*And until they were interviewed for this article, the mother and son did not know that the law was responsible for the expansion of Medicaid that Mr. Kloski benefited from. \*\*Neither voted in last year’s presidential election; Ms. Epperson said that she disliked both candidates, and that even though Hillary Clinton supported the Affordable Care Act, she found Mrs. Clinton’s positions unacceptable on too many other issues, like abortion rights, to support her. > > **Still, she said, she ardently hopes that Mr. Trump and the Republican Congress will continue allowing low-income adults like her son to qualify for Medicaid.** > > “Oh my God, yes,” she said. “Absolutely.” > > As for Mr. Murphy, IU Health’s chief executive, he said that while he did not want to think too much about changes that were still hypothetical, the prospect of losing the Medicaid expansion made him anxious. > > “I worry about lots of things,” he said. “That list is probably 50 long, and this is definitely on that list.” > … Sigh. ---
**Author:** ![jshore](https://avatars.discourse-cdn.com/v4/letter/j/b5e925/32.png) [@jshore](https://boards.straightdope.com/u/jshore)\ **Post date:** [January 3, 2017, 1:21pm UTC](https://boards.straightdope.com/t/the-repeal-of-obamacare-aca-step-bystep-inch-by-inch/776146/89 "2017-01-03T13:21:16Z")
> [@Clothahump](#): > > Since I’m not wrong, belabor to your heart’s content. > [Obamacare’s biggest impacts: Americans losing hours, losing coverage | The Daily Caller](http://dailycaller.com/2014/02/03/obamacares-biggest-impacts-americans-losing-hours-losing-coverage/) I know that conservative ideologues like yourself tend to be allergic to actual data, especially when you have anecdotes from right wing websites instead, but here is an article on what the data shows, with links to the actual study: [More data shows continued drop in number of Americans without health insurance](http://www.cnbc.com/2016/09/13/more-data-shows-continued-drop-in-number-of-americans-without-health-insurance.html) ---
**Author:** ![MEBuckner](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/mebuckner/32/2896_2.png) [@MEBuckner](https://boards.straightdope.com/u/MEBuckner)\ **Post date:** [January 3, 2017, 1:26pm UTC](https://boards.straightdope.com/t/the-repeal-of-obamacare-aca-step-bystep-inch-by-inch/776146/90 "2017-01-03T13:26:08Z")
> [@Calico\_Jack](#): > > Eh, what they really need to do is repeal the 14th Amendment while they still control both branches of government. > > If the states who gave Trump the electoral votes all rallied behind it, then they’d be right on the verge of having the 2/3rd state majority they’ll need, wouldn’t surprise me if becomes a reality within the next 4-8 years. So, in addition to wanting to gut the protection of _all_ American freedoms–freedom of religion, freedom of speech, freedom of the press, the right to keep and bear arms, protection against unreasonable searches and seizures, protection of private property, and so on–because, I presume, you don’t think brown people who are born in this country should be citizens, you’re also pig-ignorant enough to think this can be done by two-thirds of the states. ---
**Author:** ![Broomstick](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/broomstick/32/246_2.png) [@Broomstick](https://boards.straightdope.com/u/Broomstick)\ **Post date:** [January 3, 2017, 1:43pm UTC](https://boards.straightdope.com/t/the-repeal-of-obamacare-aca-step-bystep-inch-by-inch/776146/91 "2017-01-03T13:43:11Z")
> [@watchwolf49](#): > > Seems like the same argument over and over again, just laughable … if the heath care itself wasn’t so damned expensive … maybe health care _insurance_ wouldn’t be so expensive … just a thought … Once upon a time that was true - but back then medicine could do so much less than it can today. When you do want to roll back to? Prior to effective treatment for many cancers? Prior to the discovery/invention of antibiotics? Prior to the discovery/manufacture of insulin for diabetics? It’s time to admit that the US system of insisting on private, third party coverage is a failure and get on board with what the rest of the world has been doing that actually works. ---
**Author:** ![Broomstick](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/broomstick/32/246_2.png) [@Broomstick](https://boards.straightdope.com/u/Broomstick)\ **Post date:** [January 3, 2017, 1:54pm UTC](https://boards.straightdope.com/t/the-repeal-of-obamacare-aca-step-bystep-inch-by-inch/776146/92 "2017-01-03T13:54:30Z")
> [@raventhief](#): > > Clothahump, I am genuinely curious. I have pre-existing conditions, as does my husband. He is working on disability, but it’s a work in progress. I am self employed. We could not get any insurance under the old system, and now we are covered. What, in your opinion, should we do in the event of a repeal, without replacement? > [@Leaper](#): > > I’m guessing he’ll say that you should ask for help from friends and family, take out loans, and get charitable aid, that it’s not his responsibility to pay for your bad decisions, and that people falling through the cracks is the price we pay for being free. > [@Budget\_Player\_Cadet](#): > > **Clothahump** , I too would like to hear the answer to this. > [@ThelmaLou](#): > > Me, three. > [@Der\_Trihs](#): > > Die slowly? The Right is big on the idea that money = virtue; if you can’t pay for it out of pocket then you are obviously evil, and deserve anything that happens to you. Add me to this list - my spouse and I both have pre-existing conditions that have existed since childhood (his cropped up about 8 weeks after his conception). ---
**Author:** ![Broomstick](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/broomstick/32/246_2.png) [@Broomstick](https://boards.straightdope.com/u/Broomstick)\ **Post date:** [January 3, 2017, 2:09pm UTC](https://boards.straightdope.com/t/the-repeal-of-obamacare-aca-step-bystep-inch-by-inch/776146/93 "2017-01-03T14:09:52Z")
> [@](#): > > Mr. Pence [Indiana gov & the new Veep] expanded Medicaid only after the Obama administration agreed to let Indiana do it in its own way: Instead of getting virtually free coverage, as Medicaid recipients in many other states do, people enrolled in Indiana’s expansion pay up to 5 percent of their income toward it. Mr. Trump appears interested in promoting Indiana’s “personal responsibility” model: He has picked its chief architect, Seema Verma, to run the Centers for Medicare and Medicaid Services. So now Pence is taking credit for Mitch Daniel’s Healthy Indiana Plan (HIP)? What a loathsome slimeball. Although I am getting a bit peeved about how the media is portraying the program. HIP existed before the ACA and it _worked_ (I speak from experience on this). Not perfectly, but it most certainly did get people covered. The state wanted to continue the program rather than abolish it and force everyone on it to do something else, which would have been quite disruptive. It’s a better deal than what people can get on the exchanges at least in this state, and I suspect in many others. I’ve seen bitching about the notion of those on the plan, even the very poor, having to pay _something_ towards their health coverage but speaking as someone who has been on this program for nearly a decade now the costs are manageable. I don’t feel oppressed because my spouse and I have to pay $25/month to have us both covered. And by covered I mean we can get all of his diabetes and other maintenance medications without co-pays, we can visit a doctor when we need to without worrying about choosing between that and eating this week, and when the spouse spent most of December in the hospital we didn’t have to worry about being financially wiped out an hour after we first set foot in the ER. As of last year we can also see the dentist and get new glasses when we need them. Which, all in all, means we’re better off than a lot of other people. Of course, our health care costs more than $25/month (at least his does - I’m relatively cheap to take care of). The rest of the cost is through the state government subsidizing the cost of this. Oh, no! A government program that _actually works!_ And yeah, that government subsidy comes out of taxes. Well, shit, why don’t we just move to state-paid single-payer already? If a thoroughly Republican state like Indiana can make something like this work why can’t the rest of the country? ---
**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, 3:13pm UTC](https://boards.straightdope.com/t/the-repeal-of-obamacare-aca-step-bystep-inch-by-inch/776146/94 "2017-01-03T15:13:53Z")
> [@Broomstick](#): > > … If a thoroughly Republican state like Indiana can make something like this work why can’t the rest of the country? Wish I knew. \ ---
**Author:** ![madsircool](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/madsircool/32/3432_2.png) [@madsircool](https://boards.straightdope.com/u/madsircool)\ **Post date:** [January 3, 2017, 3:48pm UTC](https://boards.straightdope.com/t/the-repeal-of-obamacare-aca-step-bystep-inch-by-inch/776146/95 "2017-01-03T15:48:55Z")
> [@ThelmaLou](#): > > There are some lasting benefits of the abominable, failed, hated, worst-piece-of-legislation-since-the-Spanish-Inquisition known as Obamacare (also the Affordable Care Act, in case there is anyone left who doesn’t know those are two names for the same thing) that even the misguided, clueless, ignorant, destructive, Obama-hating, American-people-hating Republicans won’t be able to undo. > > [A transformation of the delivery of health care may be an enduring legacy for the president, even as Republicans plan to repeal the Affordable Care Act.](http://www.nytimes.com/2017/01/02/us/politics/obama-health-care-affordable-care-act.html?hp&action=click&pgtype=Homepage&clickSource=story-heading&module=second-column-region®ion=top-news&WT.nav=top-news&_r=0) > > My bolding. > > Ha! That last line made me laugh right out loud. Who, indeed, Mr. Kitchell? > > Caring for patients?? Where does that come into it? > > This a really long article, but this, at the end, is interesting: > Sigh. Get treatment for your dementia before its too late. ---
**Author:** ![FuriousGeorge](https://avatars.discourse-cdn.com/v4/letter/f/ecae2f/32.png) [@FuriousGeorge](https://boards.straightdope.com/u/FuriousGeorge)\ **Post date:** [January 3, 2017, 4:01pm UTC](https://boards.straightdope.com/t/the-repeal-of-obamacare-aca-step-bystep-inch-by-inch/776146/96 "2017-01-03T16:01:43Z")
> [@Broomstick](#): > > > [@watchwolf49](#): > > > > Seems like the same argument over and over again, just laughable … if the heath care itself wasn’t so damned expensive … maybe health care _insurance_ wouldn’t be so expensive … just a thought … > > Once upon a time that was true - but back then medicine could do so much less than it can today. When you do want to roll back to? Prior to effective treatment for many cancers? Prior to the discovery/invention of antibiotics? Prior to the discovery/manufacture of insulin for diabetics? > > It’s time to admit that the US system of insisting on private, third party coverage is a failure and get on board with what the rest of the world has been doing that actually works. Once upon a time what was true? Are you saying that health care costs WERE so damned expensive but not anymore? Are you implying that all of a sudden health care costs are reasonable and the problem is the mustache twirling insurance companies lighting their cigars with poor peoples’ co-pays? ---
**Author:** ![Chimera](https://avatars.discourse-cdn.com/v4/letter/c/8e8cbc/32.png) [@Chimera](https://boards.straightdope.com/u/Chimera)\ **Post date:** [January 3, 2017, 4:13pm UTC](https://boards.straightdope.com/t/the-repeal-of-obamacare-aca-step-bystep-inch-by-inch/776146/97 "2017-01-03T16:13:17Z")
Honestly have no clue how you get that from what Broomstick said. ---
**Author:** ![FuriousGeorge](https://avatars.discourse-cdn.com/v4/letter/f/ecae2f/32.png) [@FuriousGeorge](https://boards.straightdope.com/u/FuriousGeorge)\ **Post date:** [January 3, 2017, 4:33pm UTC](https://boards.straightdope.com/t/the-repeal-of-obamacare-aca-step-bystep-inch-by-inch/776146/98 "2017-01-03T16:33:04Z")
> [@Chimera](#): > > Honestly have no clue how you get that from what Broomstick said. That’s why I am asking. Cuz I don’t get the connection between the quote and “Once upon a time that was true” ---
**Author:** ![elucidator](https://avatars.discourse-cdn.com/v4/letter/e/8edcca/32.png) [@elucidator](https://boards.straightdope.com/u/elucidator)\ **Post date:** [January 3, 2017, 4:37pm UTC](https://boards.straightdope.com/t/the-repeal-of-obamacare-aca-step-bystep-inch-by-inch/776146/99 "2017-01-03T16:37:54Z")
Mud and leeches are still freely available, as they were in the time of the Founders. Good enough for them, good enough for you! ---
**Author:** ![raventhief](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/raventhief/32/4_2.png) [@raventhief](https://boards.straightdope.com/u/raventhief)\ **Post date:** [January 3, 2017, 7:00pm UTC](https://boards.straightdope.com/t/the-repeal-of-obamacare-aca-step-bystep-inch-by-inch/776146/100 "2017-01-03T19:00:43Z")
> [@FuriousGeorge](#): > > Once upon a time what was true? Are you saying that health care costs WERE so damned expensive but not anymore? Are you implying that all of a sudden health care costs are reasonable and the problem is the mustache twirling insurance companies lighting their cigars with poor peoples’ co-pays? I think it’s “once upon a time healthcare was much less expensive, but since then healthcare has advanced in both care and in cost. If you want healthcare is be much less expensive, how far do you want to go to bring costs down?” [Previous page](https://boards.straightdope.com/t/the-repeal-of-obamacare-aca-step-bystep-inch-by-inch/776146.md?page=4) [Next page](https://boards.straightdope.com/t/the-repeal-of-obamacare-aca-step-bystep-inch-by-inch/776146.md?page=6)