# What is your ongoing opinion of the Affordable Care Act? (Title Edited) **URL:** \ **Category:** Politics & Elections\ **Created:** [January 17, 2013, 11:21pm UTC](https://boards.straightdope.com/t/what-is-your-ongoing-opinion-of-the-affordable-care-act-title-edited/647561 "2013-01-17T23:21:39Z")\ **Posts on this page:** 20\ **Page:** 70
**Author:** ![adaher](https://avatars.discourse-cdn.com/v4/letter/a/dec6dc/32.png) [@adaher](https://boards.straightdope.com/u/adaher)\ **Post date:** [January 31, 2014, 4:20pm UTC](https://boards.straightdope.com/t/what-is-your-ongoing-opinion-of-the-affordable-care-act-title-edited/647561/1382 "2014-01-31T16:20:49Z")
The vote in the Senate to repeal the tax was 79-20: [http://www.boston.com/politicalintelligence/2013/03/22/senate-passes-bill-repeal-medical-device-tax-industry-urges-house-the-same/NNnMVECmYGD9oxTW8dwlaN/story.html](http://www.boston.com/politicalintelligence/2013/03/22/senate-passes-bill-repeal-medical-device-tax-industry-urges-house-the-same/NNnMVECmYGD9oxTW8dwlaN/story.html) Non-binding though, because they don’t want a public fight with Obama over his signature piece of legislation. But you can see that there’s a veto proof majority if they were willing to press the issue. And here’s the clincher: **Massachusetts Senators Elizabeth Warren and William “Mo” Cowan signed on to the repeal, following a flurry of last-minute lobbying from Massachusetts medical device makers of New England Democrats. - See more at: [http://www.boston.com/politicalintelligence/2013/03/22/senate-passes-bill-repeal-medical-device-tax-industry-urges-house-the-same/NNnMVECmYGD9oxTW8dwlaN/story.html#sthash.rrOMftyr.dpuf](http://www.boston.com/politicalintelligence/2013/03/22/senate-passes-bill-repeal-medical-device-tax-industry-urges-house-the-same/NNnMVECmYGD9oxTW8dwlaN/story.html#sthash.rrOMftyr.dpuf)** ---
**Author:** ![lance\_strongarm](https://avatars.discourse-cdn.com/v4/letter/l/87869e/32.png) [@lance\_strongarm](https://boards.straightdope.com/u/lance_strongarm)\ **Post date:** [January 31, 2014, 4:40pm UTC](https://boards.straightdope.com/t/what-is-your-ongoing-opinion-of-the-affordable-care-act-title-edited/647561/1383 "2014-01-31T16:40:11Z")
> [@adaher](#): > > It’ll be paid for with the same Medicare cuts the Democrats used. So cuts to Medicare, which the GOP supported before ACA, then opposed after ACA adopted them, are now supported again? ---
**Author:** ![adaher](https://avatars.discourse-cdn.com/v4/letter/a/dec6dc/32.png) [@adaher](https://boards.straightdope.com/u/adaher)\ **Post date:** [January 31, 2014, 4:48pm UTC](https://boards.straightdope.com/t/what-is-your-ongoing-opinion-of-the-affordable-care-act-title-edited/647561/1384 "2014-01-31T16:48:12Z")
The reason for opposing the cuts was because they were just getting put into another entitlement. If these cuts were so painless as Democrats insist, why did they not implement them 20 years ago? Do Democrats save up budget waste for when they need to fund a new program? But what’s done is done. The cuts are reality, and the public demands health care reform. So might as well use them to fund something better than ACA. ---
**Author:** ![Fear\_Itself](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/fear_itself/32/19637_2.png) [@Fear\_Itself](https://boards.straightdope.com/u/Fear_Itself)\ **Post date:** [January 31, 2014, 4:50pm UTC](https://boards.straightdope.com/t/what-is-your-ongoing-opinion-of-the-affordable-care-act-title-edited/647561/1385 "2014-01-31T16:50:54Z")
> [@adaher](#): > > Doesn’t need to because it spends less. So the GOP plan spends less on subsidies than the ACA? How does that not mean more people with high risk and low income will be unable to afford insurance? > [@](#): > > Give it up on the medical device tax, it’s getting repealed, the Democrats just don’t want to pull the trigger while Obama is in office because he threatened a veto. The next President will sign a repeal in the first 100 days regardless of party. No one likes this tax. It’s designed like crap and threatens tens of thousands of jobs, mostly in blue states. It’s a goner. How will the GOP plan offset the loss of the medical device tax? Conservatives are all about offsetting spending, so it’s either fewer people getting lower subsidies, or it increases the deficit. Which is it? ---
**Author:** ![adaher](https://avatars.discourse-cdn.com/v4/letter/a/dec6dc/32.png) [@adaher](https://boards.straightdope.com/u/adaher)\ **Post date:** [January 31, 2014, 4:59pm UTC](https://boards.straightdope.com/t/what-is-your-ongoing-opinion-of-the-affordable-care-act-title-edited/647561/1386 "2014-01-31T16:59:43Z")
> [@Fear\_Itself](#): > > So the GOP plan spends less on subsidies than the ACA? Well, we won’t know for certain until a real bill is written and it’s scored by the CBO. The GOP often comes up with grand ideas which are MORE expensive, one of them being given everyone a big tax credit to buy private insurance. But the idea is that with insurance cheaper due to deregulating what is required, fewer people will need subsidies. Plus the Medicaid program gets block granted. > [@](#): > > How will the GOP plan offset the loss of the medical device tax? Conservatives are all about offsetting spending, so it’s either fewer people getting lower subsidies, or it increases the deficit. Which is it? Even without the medical device tax, ACA is supposed to reduce the deficit over 10 years. Assuming the Republican plan spends less, it reduces the deficit by even more. Although that’s a big assumption until the CBO scores a real bill. The HOuse intends to bring their alternative to a vote soon, so we’ll hear from the CBO soon I’d imagine. ---
**Author:** ![Terr](https://avatars.discourse-cdn.com/v4/letter/t/839c29/32.png) [@Terr](https://boards.straightdope.com/u/Terr)\ **Post date:** [January 31, 2014, 5:21pm UTC](https://boards.straightdope.com/t/what-is-your-ongoing-opinion-of-the-affordable-care-act-title-edited/647561/1387 "2014-01-31T17:21:30Z")
> [@Fear\_Itself](#): > > So the GOP plan spends less on subsidies than the ACA? How does that not mean more people with high risk and low income will be unable to afford insurance?How will the GOP plan offset the loss of the medical device tax? Conservatives are all about offsetting spending, so it’s either fewer people getting lower subsidies, or it increases the deficit. Which is it? You will have to pass it to find out what’s in it. ---
**Author:** ![Fear\_Itself](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/fear_itself/32/19637_2.png) [@Fear\_Itself](https://boards.straightdope.com/u/Fear_Itself)\ **Post date:** [January 31, 2014, 5:24pm UTC](https://boards.straightdope.com/t/what-is-your-ongoing-opinion-of-the-affordable-care-act-title-edited/647561/1388 "2014-01-31T17:24:24Z")
> [@adaher](#): > > Assuming the Republican plan spends less, it reduces the deficit by even more. By forcing more poor people with high risk to suffer. ---
**Author:** ![Lobohan](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/lobohan/32/79_2.png) [@Lobohan](https://boards.straightdope.com/u/Lobohan)\ **Post date:** [January 31, 2014, 5:24pm UTC](https://boards.straightdope.com/t/what-is-your-ongoing-opinion-of-the-affordable-care-act-title-edited/647561/1389 "2014-01-31T17:24:49Z")
> [@adaher](#): > > They’ll pay according to their risk. That’s fair. What is unfair is making the young pay more than they should so the old can pay less. It’s regressive as well, since young people tend to be poorer than those in the 50-65 range. You don’t understand how insurance works. ---
**Author:** ![adaher](https://avatars.discourse-cdn.com/v4/letter/a/dec6dc/32.png) [@adaher](https://boards.straightdope.com/u/adaher)\ **Post date:** [February 1, 2014, 4:26am UTC](https://boards.straightdope.com/t/what-is-your-ongoing-opinion-of-the-affordable-care-act-title-edited/647561/1390 "2014-02-01T04:26:41Z")
No, I don’t understand how you’d LIKE insurance to work. Insurance works by insurance companies pricing risk. People in Florida pay more for flood insurance than people in Utah. Older people pay more for health insurance than younger people. Younger drivers pay more for auto insurance than older drivers. There are group plans where things even out, such as with employer health care, but even in that case the group is generally healthier than the overall population. what ACA does is take as many people out of their individual and group plans as possible and puts them in a bigger pool, and also a sicker pool. This may be more in line with your thinking on social justice, but it is not typically how insurance works. ---
**Author:** ![jasg](https://avatars.discourse-cdn.com/v4/letter/j/f0a364/32.png) [@jasg](https://boards.straightdope.com/u/jasg)\ **Post date:** [February 1, 2014, 6:24pm UTC](https://boards.straightdope.com/t/what-is-your-ongoing-opinion-of-the-affordable-care-act-title-edited/647561/1391 "2014-02-01T18:24:41Z")
> [@adaher](#): > > No, I don’t understand how you’d LIKE insurance to work. Insurance works by insurance companies pricing risk. or you could say that insurance works when people share risk. > [@](#): > > People in Florida pay more for flood insurance than people in Utah. Older people pay more for health insurance than younger people. Younger drivers pay more for auto insurance than older drivers. Flood insurance is a _wonderful_ example, isn’t it? An insurance free of government interference and a shining example of the free market at work… :dubious: At least a homeowner in Florida can sell out and move to Utah. How does that work with a bum ticker or pancreas??? Likewise young people can get a less risky car or even use a bike or bus (if they don’t want to wait to get older). > [@](#): > > There are group plans where things even out, such as with employer health care, but even in that case the group is generally healthier than the overall population. what ACA does is take as many people out of their individual and group plans as possible and puts them in a bigger pool, and also a sicker pool. This may be more in line with your thinking on social justice, but it is not typically how insurance works. Hey, since we are all created equal, why don’t we continue with just one big group? ---
**Author:** ![adaher](https://avatars.discourse-cdn.com/v4/letter/a/dec6dc/32.png) [@adaher](https://boards.straightdope.com/u/adaher)\ **Post date:** [February 2, 2014, 5:12am UTC](https://boards.straightdope.com/t/what-is-your-ongoing-opinion-of-the-affordable-care-act-title-edited/647561/1392 "2014-02-02T05:12:29Z")
Of course. But insurance companies’ risk pools are divided into different levels of risk. They don’t just throw everyone into one pool and charge everyone the same price. Under ACA, young people pay more. Healthy people pay more. It makes sense for people who are otherwise young and healthy, and who have good money, to just operate on a cash basis with providers. Or, they can buy catastrophic plans only and just pay the tax. Or not, since the IRS cannot collect it easily. ---
**Author:** ![adaher](https://avatars.discourse-cdn.com/v4/letter/a/dec6dc/32.png) [@adaher](https://boards.straightdope.com/u/adaher)\ **Post date:** [February 2, 2014, 5:34am UTC](https://boards.straightdope.com/t/what-is-your-ongoing-opinion-of-the-affordable-care-act-title-edited/647561/1393 "2014-02-02T05:34:47Z")
According to a think tank, the REpublican alternative costs less and covers more people: > **[So It Turns Out That The Senate Republican Plan To Replace Obamacare Raises...](https://www.forbes.com/sites/theapothecary/2014/01/31/so-it-turns-out-that-the-senate-republican-plan-to-replace-obamacare-raises-taxes-and-thats-a-good-thing/)** > > When Republican senators Tom Coburn (Okla.), Richard Burr (N.C.), and Orrin Hatch (Utah) proposed on Monday a plan to repeal and replace Obamacare, I called it “the most credible plan yet” devised to achieve that goal. On Thursday, a new think tank... Of course, I will trust what the CBO has to say about that more than some think tank. But let’s say the CBO shocks us all and agrees that it does cost less and covers more people. Would there be ANY good reason for liberal Dopers to not support it? ---
**Author:** ![DMC](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/dmc/32/18049_2.png) [@DMC](https://boards.straightdope.com/u/DMC)\ **Post date:** [February 2, 2014, 8:47am UTC](https://boards.straightdope.com/t/what-is-your-ongoing-opinion-of-the-affordable-care-act-title-edited/647561/1394 "2014-02-02T08:47:25Z")
> [@adaher](#): > > But let’s say the CBO shocks us all and agrees that it does cost less and covers more people. Would there be ANY good reason for liberal Dopers to not support it? Well, if car A is cheaper than car B, which would you buy? There’s not a lot of details to Coburn’s plan, although they are very specific about prohibiting tax credits (which are too low to allow the poor to buy insurance on the individual market) to be used for any plan that covers abortions, except for those resulting from rape, incest, and protection of the mother’s life. They also allow a larger gap in premiums, thus making insurance even more expensive for older and less healthy people. So, low tax credits along with higher premiums for unhealthy poor people? Not really working for me. ---
**Author:** ![adaher](https://avatars.discourse-cdn.com/v4/letter/a/dec6dc/32.png) [@adaher](https://boards.straightdope.com/u/adaher)\ **Post date:** [February 2, 2014, 8:57am UTC](https://boards.straightdope.com/t/what-is-your-ongoing-opinion-of-the-affordable-care-act-title-edited/647561/1395 "2014-02-02T08:57:27Z")
But what if it covers more people? Isn’t that the primary goal of a health care bill? If you cover more while costing less, that sounds to me like a better plan, regardless of the details. ---
**Author:** ![adaher](https://avatars.discourse-cdn.com/v4/letter/a/dec6dc/32.png) [@adaher](https://boards.straightdope.com/u/adaher)\ **Post date:** [February 2, 2014, 9:06am UTC](https://boards.straightdope.com/t/what-is-your-ongoing-opinion-of-the-affordable-care-act-title-edited/647561/1396 "2014-02-02T09:06:18Z")
Heck, according to the President’s own SOTU statement: “So again, if you have specific plans to cut costs, cover more people, and increase choice — tell America what you’d do differently. Let’s see if the numbers add up.” He’d be obligated to support it if the CBO agrees that the GOP’s numbers add up. ---
**Author:** ![DMC](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/dmc/32/18049_2.png) [@DMC](https://boards.straightdope.com/u/DMC)\ **Post date:** [February 2, 2014, 11:36am UTC](https://boards.straightdope.com/t/what-is-your-ongoing-opinion-of-the-affordable-care-act-title-edited/647561/1397 "2014-02-02T11:36:49Z")
> [@adaher](#): > > But what if it covers more people? Isn’t that the primary goal of a health care bill? > > If you cover more while costing less, **that sounds to me like a better plan** , regardless of the details. The text in bold is pretty telling. If someone has a plan that covers 100% of the population and only costs $50 a month, but covers only 10% of all medical costs, it’s not a plan most people would support. Or it could be $50 a month, but have a $40K deductible. Coverage and cost aren’t the only drivers that matter. ---
**Author:** ![adaher](https://avatars.discourse-cdn.com/v4/letter/a/dec6dc/32.png) [@adaher](https://boards.straightdope.com/u/adaher)\ **Post date:** [February 2, 2014, 12:11pm UTC](https://boards.straightdope.com/t/what-is-your-ongoing-opinion-of-the-affordable-care-act-title-edited/647561/1398 "2014-02-02T12:11:30Z")
Okay, fair point. But I don’t think your particular objections outweigh the cost/coverage issue. If more people are covered and it costs less, the fact that abortion or contraception aren’t funded is a pretty minor objection. Health care for women who are sick is far more important than contraception for women who are healthy. Your objection to older people paying more also doesn’t outweigh the assumed benefits of the GOP alternative, since they’d only be paying a premium appropriate for their risk profile. There is no good policy reason to have young people pay more. They tend to be less wealthy than older people. Now if the coverage being offered was really too bare-bones to be acceptable, then yeah, that could make the plan worse. And the GOP plan will achieve cost savings through deregulation of the exchanges. But I dispute that the insurance then offered will be inadequate. It just means that elderly people will be able to buy insurance without maternity coverage and younger people will be able to buy catastrophic-only plans. That’s a feature, not a bug. ---
**Author:** ![Fear\_Itself](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/fear_itself/32/19637_2.png) [@Fear\_Itself](https://boards.straightdope.com/u/Fear_Itself)\ **Post date:** [February 2, 2014, 5:06pm UTC](https://boards.straightdope.com/t/what-is-your-ongoing-opinion-of-the-affordable-care-act-title-edited/647561/1399 "2014-02-02T17:06:58Z")
You’ve already told us how the GOP plan achieves savings; by denying care to high risk low income patients. Most people find than unacceptable. ---
**Author:** ![jasg](https://avatars.discourse-cdn.com/v4/letter/j/f0a364/32.png) [@jasg](https://boards.straightdope.com/u/jasg)\ **Post date:** [February 2, 2014, 5:17pm UTC](https://boards.straightdope.com/t/what-is-your-ongoing-opinion-of-the-affordable-care-act-title-edited/647561/1400 "2014-02-02T17:17:22Z")
> [@adaher](#): > > Of course. But insurance companies’ risk pools are divided into different levels of risk. They don’t just throw everyone into one pool and charge everyone the same price. Employee insurance is done exactly that way. All employees thrown into one group, paying the same amount. Only the self or unemployed folk miss out on that group risk sharing. ---
**Author:** ![adaher](https://avatars.discourse-cdn.com/v4/letter/a/dec6dc/32.png) [@adaher](https://boards.straightdope.com/u/adaher)\ **Post date:** [February 2, 2014, 6:32pm UTC](https://boards.straightdope.com/t/what-is-your-ongoing-opinion-of-the-affordable-care-act-title-edited/647561/1401 "2014-02-02T18:32:04Z")
> [@Fear\_Itself](#): > > You’ve already told us how the GOP plan achieves savings; by denying care to high risk low income patients. Most people find than unacceptable. That’s not true. There is a continuous coverage requirement. You can’t be discriminated against if you are moving from one insurance plan to another. The first enrollment period will not allow discrimination. All people with preexisting conditions have to do is enroll that first year and maintain continuous coverage. The way it achieves savings is from lower premiums and lower subsidies. [Previous page](https://boards.straightdope.com/t/what-is-your-ongoing-opinion-of-the-affordable-care-act-title-edited/647561.md?page=69) [Next page](https://boards.straightdope.com/t/what-is-your-ongoing-opinion-of-the-affordable-care-act-title-edited/647561.md?page=71)