115th Congress defunds ACA: Senate: 51-48 House:227-198; Executive Order signed 1/20

[FAH1223]

 

[tru_m.a.c]

Medicare may be under assault in the newly convened Republican-controlled Congress

House Speaker Paul Ryan (R., Wis) has long wanted to replace traditional Medicare with a federal voucher system that would help beneficiaries pay premiums to commercial insurance plans. Ryan calls this system "premium support."

"Obamacare rewrote Medicare … so if you’re going to repeal and replace Obamacare, you have to address those issues as well," Ryan said in an interview with Fox News Channel days after the election.

What’s more, some of Trump’s advisers have previously called for changes to Medicare, as well as Social Security and Medicaid. Tom Leppert, the former mayor of Dallas who is on his transition team, once released a plan calling for the privatization of Social Security and Medicare. In a policy paper titled "An American Opportunity," Leppert urged the government "to provide Medicare subsidies for the purchase of certified private plans" while maintaining the current system for those 55 and older.

The makeover will likely begin on the first day the 115th Congress meets, which is when the House of Representatives typically votes on the rules that determine how bills are handled on the House floor for the next two years.

“In the past," writes Charles Tiefer, a professor at the University of Baltimore School of Law and expert on government contracting and Congressional legislating, "Congress had procedurally shielded Medicare and Medicaid from the most alarming kinds of meddling and slashing. Other kinds of spending, like defense and farm subsidies, occur only by annual appropriations. They compete afresh, each and every year, with the rest of the appropriated spending, known as ‘discretionary spending.’"

In other words, Medicare is considered "mandatory spending" and therefore do not have to compete with the general pool of discretionary spending. Changes to these programs can only be made by some "affirmative new legislation." This Congress, Tiefer maintains, will likely change the rules by switching these programs from "mandatory funding" to "discretionary appropriations."

With Medicare competing for long-term funding, Republicans hope to "voucherize" the program by giving Medicare beneficiaries a fixed (and limited) amount to buy insurance policies. Currently, Medicare beneficiaries are enrolled in a full fee-for-care program.

Read more here: Medicare may be under assault in the newly convened Republican-controlled Congress

 

[tru_m.a.c]

The Republican Congress Readies Its Assault On Medicare And Medicaid

Changes in appropriations level have an enormous push behind them. Namely, the annual expiration of the previous year’s appropriations leaves a spending vacuum. Congress has no choice but to enact fresh new appropriation bills to fill the vacuum. These “must pass” bills may include changes in funding levels, such as increases or decreases in particular funds for homeland security. So, procedurally, cuts in such discretionary spending have a smooth procedural path.

In contrast, Medicare and Medicaid are “mandatory spending.” They did not compete with the general pool of discretionary spending, like defense. They continue without annual appropriations or anything annual at all. Congress does not have to, and usually does not, make changes in them, which are only made by some affirmative new legislation that faces procedural hurdles. Because Medicare and Medicaid do not compete with appropriations, Congress does not choose each year between defense and homeland security, on the one hand, and Medicare and Medicaid.

But now, House Republicans are changing the rules. The House rules will require House committee chairs to propose ways of imposing more fiscal discipline on programs like Medicare and Medicaid. The goal is to switch such programs from “mandatory funding” to “discretionary appropriations.”

This rule tracks the ideology of the new Secretary of Health and Human Services, Tom Price, who has been chair of the House Budget Committee. As Secretary of Health and Human Services, Price will testify before Congress on the Administration’s policy about Medicare and Medicaid. So, he will shepherd along the policy of this new House rule.

Secretary (to-be) Price said in a recent speech, “Two-thirds of current expenditures are dedicated to . . . automatic spending programs like Medicare and Social Security, which are not subject to annual appropriations and therefore operate largely outside the control of Congress.”

By bringing Medicare and Medicaid into annual competition for funds with defense, these health programs can be reshaped into weakened and shrunken forms. For Medicaid, the first step will be to end the expansion made by the Affordable Care Act. Some Republican-controlled states have never even opted into it.

But, the really big step will be to “block grant” and reduce its funding. This way, states would get less annual federal aid but would have few or no federal rules about the minimum of coverage. Generally speaking, Republican-controlled states would embrace their new power to slash Medicaid. Democratic-controlled states might avoid slashing Medicaid coverage, but only by providing more state funding. In other words, they would have to tax their citizens more heavily, a difficult and unpopular step, merely to keep Medicaid at its current level.

On Jan. 3, The Republican Congress Readies Its Assault On Medicare And Medicaid

 

[88m3]

What was the Republican face value excuse for not expanding medicaid in states again?

 

[hashmander]

you don't know what you got until it's gone.

the republicans need to execute their vision in its entirety so that america can wake up. it's easy for folks to sit back and say oh they're all the same and no difference between the parties. and that's because the republicans have never had the opportunity to really show themselves to the people. they said one thing to the fire and brimstone base and then got shy when they arrived in washington. i guess that was partly due to a greater mix of moderates and right wingers. now there is more party purity. this country needs to be renewed and the republicans need to cause as much suffering as possible.

 

[Robbie3000]

fukk it. Let's take Trump's presidency to its logical conclusion. There are consequences to elections.

 

[Tony D'Amato]

So what about pre existing conditions

 

[FaTaL]

do they actually have a plan to replace obama care?

 

[hashmander]

So what about pre existing conditions

i don't have any.

 

[Worthless Loser]

From today.

 

[Mr swag]

New York Times said they will repeal it this week and gut the law. Trump will place executive orders to make sure the markets do not collapse.

They need two more republicans to block it. They have only one so far

 

[Regular_P]

From today.

This country has the WOAT electorate for not electing this man.

 

[Jimi Swagger]

Obamacare and the Romneycare (heritage neo con concoction) that it copies is nothing more than a backdoor government handout to businesses, that actually destroys the market. It has taken providers out the market, run up price of insurance, run up price of medicine all because of government subsidization and selling the ignorant rubes of the US on the concept that there is a such thing as a free lunch.

I hope it is competely dismantled and a actual market oriented solution can be implemented, which means Ryan must be far away from developing a solution.

The benefit, lower insurance premiums, more market competition for insurance, which leads to better service as well.

Also not penalizing young able bodied people who prefer alternative medicine and opt out of healthcare insurance. If I work a job, I use the company's group insurance but not when self contracting. Also, as an expat international coverage for insured is limited. Not to mention I am literally a stone's throw away from Mexico where I can get cheaper services and I have found you can negotiate a lower price with a US medical provider out of pocket as they hate dealing with insurance.

I shouldn't be taxed to pay the healthcare of Boomers, Medicaid recipients and obese people's diabeetus test strips.

 

[FAH1223]

do they actually have a plan to replace obama care?

No plan at all.

This country has the WOAT electorate for not electing this man.

 

[ADevilYouKhow]

do they actually have a plan to replace obama care?

Funny...