# 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:** 61
**Author:** ![Ann\_Hedonia](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/ann_hedonia/32/319_2.png) [@Ann\_Hedonia](https://boards.straightdope.com/u/Ann_Hedonia)\ **Post date:** [August 1, 2017, 3:24pm UTC](https://boards.straightdope.com/t/the-repeal-of-obamacare-aca-step-bystep-inch-by-inch/776146/1201 "2017-08-01T15:24:49Z")
> [@Broomstick](#): > > And yet… Blue Cross works across state lines with little problem (it looks pretty seamless from the customer’s viewpoint, behind the scenes a lot goes on). > > What would happen is that the last companies standing would be incorporated in least-restrictive states with branch offices everywhere else. I think the Blue Cross Blue Shield companies operate as separate entities in each state. And they aren’t any cheaper despite operating a company in each state. The rates of Blue Cross Blue Shield NY are commensurate with other NY insurers, not other BCBS companies. ---
**Author:** ![wonky](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/wonky/32/393_2.png) [@wonky](https://boards.straightdope.com/u/wonky)\ **Post date:** [August 1, 2017, 4:08pm UTC](https://boards.straightdope.com/t/the-repeal-of-obamacare-aca-step-bystep-inch-by-inch/776146/1202 "2017-08-01T16:08:05Z")
I want to thank anyone and everyone who went to a rally or called a member of congress or tweeted at them or took any action at all around the health care fight. Yes, even if you were on the opposite side from me. This was a big fucking deal. Thank you to those who chose to speak up and speak out. Big fights ahead, maybe soon. But thank you for doing democracy. ---
**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:** [August 1, 2017, 11:06pm UTC](https://boards.straightdope.com/t/the-repeal-of-obamacare-aca-step-bystep-inch-by-inch/776146/1203 "2017-08-01T23:06:41Z")
> [@Ann\_Hedonia](#): > > I think the Blue Cross Blue Shield companies operate as separate entities in each state. They used to, but then Anthem and a couple others came up with a legal shell that could own multiple state-level entities. > [@](#): > > And they aren’t any cheaper despite operating a company in each state. The rates of Blue Cross Blue Shield NY are commensurate with other NY insurers, not other BCBS companies. Of course not, because for the most part people living in NY have to purchase insurance in NY. But when someone living in NY can whenever they want buy insurance from, say, Wyoming then you’ll see a race to the bottom. ---
**Author:** ![jasg](https://avatars.discourse-cdn.com/v4/letter/j/f0a364/32.png) [@jasg](https://boards.straightdope.com/u/jasg)\ **Post date:** [August 2, 2017, 12:56am UTC](https://boards.straightdope.com/t/the-repeal-of-obamacare-aca-step-bystep-inch-by-inch/776146/1204 "2017-08-02T00:56:56Z")
> [@Broomstick](#): > > Of course not, because for the most part people living in NY have to purchase insurance in NY. But when someone living in NY can whenever they want buy insurance from, say, Wyoming then you’ll see a race to the bottom. and in the fine print it says that any provider outside of Wyoming is out of network… ---
**Author:** ![Ann\_Hedonia](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/ann_hedonia/32/319_2.png) [@Ann\_Hedonia](https://boards.straightdope.com/u/Ann_Hedonia)\ **Post date:** [August 2, 2017, 1:53am UTC](https://boards.straightdope.com/t/the-repeal-of-obamacare-aca-step-bystep-inch-by-inch/776146/1205 "2017-08-02T01:53:58Z")
> [@jasg](#): > > and in the fine print it says that any provider outside of Wyoming is out of network… Yeah, that’s the thing …the disadvantage to me buying an insurance plan “as is” from a Wyoming insurer is that all the doctors and hospitals and providers would be in Wyoming. So they’d have to offer some sort of plan tooled to the New York market and that would probably be priced like the plans currently for sale in New York, because it costs a lot more to operate a doctors practice or hospital in NYC than Wyoming. Now it is possible that all the insurers will flock to some state that’s favorable to really crappy policies. But it sounds like, from the brief description of the bipartisan that they will be keeping essential benefits requirements which would mitigate that somewhat. Now if they start letting the states screw with the essential benefits then that’s a different story. And from a practical point of view, I’m not sure that there is any single magic wand that could be waved so “insurance can now be sold across state lines”. There may be multiple laws and regulations that would need to be changed and some of those may have been enacted at the state level. Or I may be wrong, maybe there is a magic wand. But I’m not sure the insurance companies would play along. They’d have to heavily restructure and invest in a lot of new products. They may not feel that it’s worthwhile to negotiate provider networks in every state. So I’m not convinced it’s a serious threat, I think it’s just one of those things Republicans having been saying because it’s a good sound bite but I’m not sure it’s even workable. ---
**Author:** ![jasg](https://avatars.discourse-cdn.com/v4/letter/j/f0a364/32.png) [@jasg](https://boards.straightdope.com/u/jasg)\ **Post date:** [August 2, 2017, 4:08am UTC](https://boards.straightdope.com/t/the-repeal-of-obamacare-aca-step-bystep-inch-by-inch/776146/1206 "2017-08-02T04:08:01Z")
> [@Ann\_Hedonia](#): > > They may not feel that it’s worthwhile to negotiate provider networks in every state. I am pretty sure they wouldn’t. In many (most?) states policies and networks are county based - not even an entire state network. I’m sure that the main reason behind narrow networks is the pain and cost of negotiating wider provider networks. Plus cross-state is permitted by the ACA and has been tried, it just didn’t work very well. IIRC, a few states allowed it before the ACA but no companies jumped into the market. As one article I read concluded - “Selling insurance across state lines” is a slogan, not a policy. ---
**Author:** ![wonky](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/wonky/32/393_2.png) [@wonky](https://boards.straightdope.com/u/wonky)\ **Post date:** [August 2, 2017, 11:59am UTC](https://boards.straightdope.com/t/the-repeal-of-obamacare-aca-step-bystep-inch-by-inch/776146/1207 "2017-08-02T11:59:41Z")
> [@jasg](#): > > I am pretty sure they wouldn’t. In many (most?) states policies and networks are county based - not even an entire state network. I’m sure that the main reason behind narrow networks is the pain and cost of negotiating wider provider networks. > > Plus cross-state is permitted by the ACA and has been tried, it just didn’t work very well. IIRC, a few states allowed it before the ACA but no companies jumped into the market. > > As one article I read concluded - “Selling insurance across state lines” is a slogan, not a policy. Yep. It’s like someone running for office saying they’ll allow you to park your car across town. I can already do that but why would I want to? ---
**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:** [August 2, 2017, 1:29pm UTC](https://boards.straightdope.com/t/the-repeal-of-obamacare-aca-step-bystep-inch-by-inch/776146/1208 "2017-08-02T13:29:48Z")
Something encouraging! A few grown-ups showed up for work in Congress. This should kick off a Trumpian twittertantrum. [Republicans in Congress Bypass Trump to Shore Up Health Law](https://www.nytimes.com/2017/08/01/us/politics/senators-launch-bipartisan-effort-to-shore-up-obamacare.html?partner=rss&emc=rss&_r=0) > [@](#): > > WASHINGTON — Congressional Republicans moved on Tuesday to defuse President Trump’s threat to cut off critical payments to health insurance companies, maneuvering around the president toward bipartisan legislation to shore up insurance markets under the Affordable Care Act. > > Senator Lamar Alexander of Tennessee, the influential chairman of the Senate Health, Education, Labor and Pensions Committee, announced that his panel would begin work in early September on legislation to “stabilize and strengthen the individual health insurance market” for 2018. He publicly urged Mr. Trump to continue making payments to health insurance companies to reimburse them for reducing the out-of-pocket medical expenses of low-income people. > > In the House, two Republicans, Representatives Tom Reed of New York and Charlie Dent of Pennsylvania, teamed with Democrats to promote incremental health legislation that would also fund the cost-sharing subsidies. > > The moves were a remarkable response to the president’s repeated threats to send health insurance markets into a tailspin. They offered tangible indications of cooperation between the parties after Republican efforts to scrap the Affordable Care Act collapsed in the Senate last week, all but ending the seven-year Republican quest to overturn President Barack Obama’s signature domestic achievement. Lawmakers from both parties concede that the health law needs improvement, as consumers face sharp premium increases and a shrinking number of insurance options in many states… About. Fucking. Time. ---
**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:** [August 2, 2017, 7:22pm UTC](https://boards.straightdope.com/t/the-repeal-of-obamacare-aca-step-bystep-inch-by-inch/776146/1209 "2017-08-02T19:22:20Z")
The thing is, even as Democrats and sensible Republicans get together to fix Obamacare, Trump can keep on stomping his feet and screaming that HE WANTS it repealed (maybe replaced, maybe not) for the benefit of his dwindling support base. That’s all that matters anyway: **he tried** , but all the other kiddies took his stuff away and wouldn’t play with him and put a toad in his PBJ sandwich and wouldn’t let him have the nap mat HE wanted. As long as he kept his campaign promise, they will love him and stick up for him. ---
**Author:** ![ElvisL1ves](https://avatars.discourse-cdn.com/v4/letter/e/5daacb/32.png) [@ElvisL1ves](https://boards.straightdope.com/u/ElvisL1ves)\ **Post date:** [August 2, 2017, 8:20pm UTC](https://boards.straightdope.com/t/the-repeal-of-obamacare-aca-step-bystep-inch-by-inch/776146/1210 "2017-08-02T20:20:23Z")
But he can’t admit failing. He’s a winner, he always wins, at least in his own mind, and that’s what it’s all about. Are you tired of all this winning yet? ---
**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:** [August 2, 2017, 8:25pm UTC](https://boards.straightdope.com/t/the-repeal-of-obamacare-aca-step-bystep-inch-by-inch/776146/1211 "2017-08-02T20:25:39Z")
> [@ElvisL1ves](#): > > But he can’t admit failing. He’s a winner, he always wins, at least in his own mind, and that’s what it’s all about. > > Are you tired of all this winning yet? He won’t admit failing, and the point is that in his eyes and the eyes of the deplorables, he won’t have failed. He never fails in his own eyes. He kept his promise. Whether or not it came to pass doesn’t matter. And if his constituents lose their medical care, they’ll just blame Obama and Hillary’s emails, and Trump will have changed the subject by then. ---
**Author:** ![Tatterdemalion](https://avatars.discourse-cdn.com/v4/letter/t/43a26b/32.png) [@Tatterdemalion](https://boards.straightdope.com/u/Tatterdemalion)\ **Post date:** [August 2, 2017, 8:56pm UTC](https://boards.straightdope.com/t/the-repeal-of-obamacare-aca-step-bystep-inch-by-inch/776146/1212 "2017-08-02T20:56:48Z")
> [@ElvisL1ves](#): > > Are you tired of all this winning yet? Winning or Whining? ---
**Author:** ![Ann\_Hedonia](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/ann_hedonia/32/319_2.png) [@Ann\_Hedonia](https://boards.straightdope.com/u/Ann_Hedonia)\ **Post date:** [August 3, 2017, 12:41am UTC](https://boards.straightdope.com/t/the-repeal-of-obamacare-aca-step-bystep-inch-by-inch/776146/1213 "2017-08-03T00:41:38Z")
> [@Tatterdemalion](#): > > Winning or Whining? “We’re going to whine. We’re going to whine so much” We’re going to whine at trade, we’re going to whine at the border. We’re going to whine so much, you’re going to be sick and tired of whining, you’re going to come to me and go “Please, please, we can’t whine anymore”. Now THAT is actually true, so you know that’s not what he really said. ---
**Author:** ![Tatterdemalion](https://avatars.discourse-cdn.com/v4/letter/t/43a26b/32.png) [@Tatterdemalion](https://boards.straightdope.com/u/Tatterdemalion)\ **Post date:** [August 3, 2017, 3:50am UTC](https://boards.straightdope.com/t/the-repeal-of-obamacare-aca-step-bystep-inch-by-inch/776146/1214 "2017-08-03T03:50:26Z")
> [@Ann\_Hedonia](#): > > “We’re going to whine. We’re going to whine so much” We’re going to whine at trade, we’re going to whine at the border. We’re going to whine so much, you’re going to be sick and tired of whining, you’re going to come to me and go “Please, please, we can’t whine anymore”. > > Now THAT is actually true, so you know that’s not what he really said. Yes, I know. Depressing isn’t it. ---
**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:** [August 4, 2017, 4:26pm UTC](https://boards.straightdope.com/t/the-repeal-of-obamacare-aca-step-bystep-inch-by-inch/776146/1215 "2017-08-04T16:26:09Z")
You know how with bacteria if you don’t kill em all well and truly, you just breed stronger ones? It might work the same way with laws. > **[Experts Warn Repeated Attempts At Eradicating Obamacare May Have Created...](https://www.theonion.com/experts-warn-repeated-attempts-at-eradicating-obamacare-1819580127)** > > WASHINGTON—After persistent efforts by Republicans to wipe out the healthcare law over the past seven years, experts warned Wednesday that the repeated attempts at eradicating Obamacare may have created an ultra-resistant super law. “Given the... ---
**Author:** ![tim314](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/tim314/32/3468_2.png) [@tim314](https://boards.straightdope.com/u/tim314)\ **Post date:** [August 5, 2017, 12:28am UTC](https://boards.straightdope.com/t/the-repeal-of-obamacare-aca-step-bystep-inch-by-inch/776146/1216 "2017-08-05T00:28:25Z")
> [@Ann\_Hedonia](#): > > “We’re going to whine. We’re going to whine so much” We’re going to whine at trade, we’re going to whine at the border. We’re going to whine so much, you’re going to be sick and tired of whining, you’re going to come to me and go “Please, please, we can’t whine anymore”. > > Now THAT is actually true, so you know that’s not what he really said. Well, we already know Trump fails at [spelling](https://www.nytimes.com/2017/05/31/us/politics/covfefe-trump-twitter.html) and [pronouncing](https://www.washingtonpost.com/news/post-politics/wp/2016/10/05/trumps-pronunciation-of-nevada-draws-scrutiny/?utm_term=.c3b2ac336942) words… maybe this explains a lot. ---
**Author:** ![Skypist](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/skypist/32/169_2.png) [@Skypist](https://boards.straightdope.com/u/Skypist)\ **Post date:** [August 14, 2017, 3:19am UTC](https://boards.straightdope.com/t/the-repeal-of-obamacare-aca-step-bystep-inch-by-inch/776146/1217 "2017-08-14T03:19:43Z")
Don’t forget that the so-called Freedom Caucus is still trying to force millions of Americans off their health insurance. > **[House Freedom Caucus launches petition to compel Obamacare repeal vote](https://www.cbsnews.com/news/house-freedom-caucus-launches-petition-to-compel-obamacare-repeal-vote/)** > > Members of the conservative House Freedom Caucus are trying a new strategy - trying for a straight repeal of the Affordable Care Act > [@](#): > > The House Freedom Caucus hopes to bring the clean repeal bill to a vote in September. ---
**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:** [August 14, 2017, 3:05pm UTC](https://boards.straightdope.com/t/the-repeal-of-obamacare-aca-step-bystep-inch-by-inch/776146/1218 "2017-08-14T15:05:51Z")
I tell ya, it’s getting to be like stomping cockroaches around here - you can’t keep up with the distractions and as soon as you step on one bad idea another two scuttle out of the shadows. ---
**Author:** ![wonky](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/wonky/32/393_2.png) [@wonky](https://boards.straightdope.com/u/wonky)\ **Post date:** [September 15, 2017, 2:40pm UTC](https://boards.straightdope.com/t/the-repeal-of-obamacare-aca-step-bystep-inch-by-inch/776146/1219 "2017-09-15T14:40:18Z")
They’re back. Graham-Cassidy is the latest abomination that is getting some traction. Short summary: Block grants expansion Medicaid and ACA subsidy dollars to states, ends after 2026, but not guaranteed funding before that. Per-capita caps Medicaid. Massive loss of coverage predicted (and predictable). Massive loss of dollars to states. They appear to have 46-48 votes right now. They need 50, plus Pence. ---
**Author:** ![Richard\_Parker](https://avatars.discourse-cdn.com/v4/letter/r/35a633/32.png) [@Richard\_Parker](https://boards.straightdope.com/u/Richard_Parker)\ **Post date:** [September 15, 2017, 4:14pm UTC](https://boards.straightdope.com/t/the-repeal-of-obamacare-aca-step-bystep-inch-by-inch/776146/1220 "2017-09-15T16:14:21Z")
> [@jsgoddess](#): > > They appear to have 46-48 votes right now. Whoa! That is way more than I had heard reported. Is anyone a definite “no” other than Sen. Paul? [Previous page](https://boards.straightdope.com/t/the-repeal-of-obamacare-aca-step-bystep-inch-by-inch/776146.md?page=60) [Next page](https://boards.straightdope.com/t/the-repeal-of-obamacare-aca-step-bystep-inch-by-inch/776146.md?page=62)