Obamacare Schadenfreude Rises from the Dead

ABC Supreme Court will decide fate of Obama health care law

The Supreme Court agreed Monday to decide a lawsuit that threatens the Obama-era health care law, but the decision is not likely until after the 2020 election.

The court said it would hear an appeal by 20 mainly Democratic states of a lower-court ruling that declared part of the statute unconstitutional and cast a cloud over the rest.

Defenders of the Affordable Care Act argued that the issues raised by the case are too important to let the litigation drag on for months or years in lower courts and that the 5th U.S. Circuit Court of Appeals in New Orleans erred when it struck down the health law's now toothless requirement that Americans have health insurance.

The case will be the third major Supreme Court battle over the law popularly known as Obamacare since its passage in 2010. The court has twice upheld the heart of the law, with Chief Justice John Roberts memorably siding with the court's liberals in 2012, amid President Barack Obama's reelection campaign.

The only question is whether Justice Roberts can find a new excuse to keep it alive.

Obamacare Schadenfreude Resurfaces

Democrats ask U.S. Supreme Court to save Obamacare

The Democratic-controlled U.S. House of Representatives and 20 Democratic-led states asked the Supreme Court on Friday to declare that the landmark Obamacare healthcare law does not violate the U.S. Constitution as lower courts have found in a lawsuit brought by Republican-led states.

The House and the states, including New York and California, want the Supreme Court to hear their appeals of a Dec. 18 ruling by the New Orleans-based 5th U.S. Circuit Court of Appeals that deemed the 2010 law’s “individual mandate” that required people to obtain health insurance unconstitutional.

The petitions asked the Supreme Court, which has a 5-4 conservative majority, to hear the case quickly and issue a definitive ruling on the law, formally called the Affordable Care Act, by the end of June.

Texas and 17 other conservative states - backed by President Donald Trump’s administration - filed a lawsuit challenging the law, which was signed by Democratic former President Barack Obama in 2010 over strenuous Republican opposition. A district court judge in Texas in 2018 found the entire law unconstitutional.
. . .
In 2012, the Supreme Court narrowly upheld most Obamacare provisions including the individual mandate, which required people to obtain insurance or pay a financial penalty. The court defined this penalty as a tax and thus found the law permissible under the Constitution’s provision empowering Congress to levy taxes.

In 2017, Trump signed into law tax legislation passed by a Republican-led Congress that eliminated the individual mandate’s financial penalty. That law means the individual mandate can no longer be interpreted as a tax provision and therefore violates the Constitution, the 5th Circuit concluded.

It will be vewy vewy interesting to see where Judge Roberts fall this time. It was his last minute interpretation of the financial penalty as a tax (despite the Obama administration arguing otherwise while the law was being debated) that allowed the law to stand (5-4) the last time it reached the Supreme Court. Will he take his own reasoning seriously this time, and find it unconstitutional, or will he find some new rationalization for upholding it?

I'm betting the latter.

Obamacare Schadenfreude Revived

It's been a while since we had one of these, CBO Report: 1.4 Million Lost Health Insurance Since 2016 — And Obamacare Is To Blame

The number of uninsured climbed by 1.4 million from 2016 to 2018, according to a report out last week from the Congressional Budget Office. Naturally, this led those on the left to blame the Trump administration for its Obamacare “sabotage.”

But the data in that report — which was released on the same day the Mueller report came out and largely ignored — tells an entirely different story.

All of the increase in the uninsured over the past two years — all of it — is the result of the massive rate increases Obamacare’s mandates and regulations caused. According to the Health and Human Services Dept., premiums in the individual insurance market doubled from 2013 to 2017. They shot up again in 2018.

For those eligible for Obamacare subsidies, the rate increases were meaningless. The amount they had to pay didn’t change much, and in many cases went down.

But for the millions of middle-class Americans who buy insurance coverage on the individual market and aren’t eligible for Obamacare subsidies, the result has been financially devastating.

The CBO report shows the impact, plain as day . . .

But congressional Republicans lacked the guts to kill it.

Obamacare Schadenfreude: Obamacare Still Killing

It Sure Looks Like This Obamacare Program Has Led to More People Dying

To determine whether a government program is successful, it's often necessary to look not only at how well it does what it's supposed to do, but what it's doing that it isn't supposed to. For example, killing people.

Take the hospital readmissions program built into Obamacare. The program derived from a simple observation that hospitals were treating lots of people who would then return for more treatment within the month. Unnecessary readmissions cost Medicare an estimated $17.5 billion a year. If hospitals were treating people effectively, the thinking went, those people shouldn't need to return so soon.

So the health law instituted a Medicare payment penalty for hospitals with too many readmissions for pneumonia, heart failure, and heart attack. Since 2012, Medicare has assessed about $2 billion in penalties on hospitals with too-high readmissions rates.

Hospital groups have argued that these payments are punitive and unfair, particularly to so-called safety net hospitals that serve the poorest, sickest patients. These patients tend to have higher readmissions rates, and the hospitals that treat them were more likely to be hit with payment reductions. (Earlier this year, the Trump administration changed the penalty structure for safety net hospitals.)

But the program has often been labeled a success because it accomplished its primary goal. Readmissions dropped between 2.3 and 3.6 percentage points for the conditions targeted. Readmissions associated with other maladies dropped by 1.4 percent. The authors of one 2016 study suggested that the lower readmission rates "point to how Medicare can improve the care that patients receive through innovative payment models." It offered proof, and hope, that with the right incentives, Medicare could save money and provide better care.

A new study appears to dash that hope, at least as far as readmissions are concerned.

The study, published in the Journal of the American Medical Association (JAMA) and conducted by by researchers associated with Beth Israel Deaconess Medical and Harvard Medical School, looked at hospitalizations between 2005 and 2015. It found that "30-day post-discharge mortality"—the number of people who died within a month of leaving the hospital—increased for heart failure patients after the readmissions penalty program was implemented.

Although heart failure mortality was already on the rise, the rate of increase became more rapid after Medicare started penalizing readmissions. In addition, mortality rates amongst pneumonia patients, which had been stable, increased.

Fewer people were being readmitted to hospitals, but more people were dying.

But Obama and the Democrats meant well, right? That's all the counts.

Obamacare Schadenfreude: It's Dead, Jim!

WaPoo: Federal judge in Texas rules entire Obama health-care law is unconstitutional

A federal judge in Texas threw a dagger into the Affordable Care Act on Friday night, ruling that the entire health-care law is unconstitutional because of a recent change in federal tax law.

I like how they stress that it's a Texas judge . . .

The opinion by U.S. District Judge Reed O’Connor overturns all of the sprawling law nationwide.

Like they had a problem with Hawaiian judges repeatedly overturning President Trumps immigration policy.

The ruling came on the eve of the deadline Saturday for Americans to sign up for coverage in the federal insurance exchange created under the law. If the ruling stands, it would create widespread disruption across the U.S. health-care system — from no-charge preventive services for older Americans on Medicare to the expansion of Medicaid in most states, to the shape of the Indian Health Service — in all, hundreds of provisions in the law that was a prized domestic achievement of President Barack Obama.

President Trump, who has made the dismantling of the ACA a chief goal since his campaign, swiftly tweeted his pleasure at the opinion. “As I predicted all along, Obamacare has been struck down as an UNCONSTITUTIONAL disaster!” the president wrote just after 9 p.m. “Now Congress must pass a STRONG law that provides GREAT healthcare and protects pre-existing conditions.”

Without getting deep into the legal weeds, what happened has been long predicted. In his engineered 6-3 decision upholding the law, Justice Roberts relied on the Congress's power to tax to keep the law intact. In Dec 2017, Congress repealed the mandate portion of the law, which was the tax (if you didn't have insurance, and didn't sign up, they fined, or "taxed" you).  Now, there's no tax, so the ruling holds that without the tax, the sign up requirement is unconstitutional, in theory.

Althouse: This won't hold up, but in case you're fired up to talk about it.

I'm sure it will be appealed all the way to the Supreme Court, at which point Roberts will have to think hard about whether to find a new excuse, or to accept his own logic.

Reason #5938 That Trump Was Elected - Obamacare Schadenfreude

Allah Pundit at Hot Air: Oh My: DOJ Will No Longer Defend Parts Of ObamaCare In Court

Man, what a day for bad Obama precedents. First the DOJ follows O’s lead by seizing records from a reporter to find a leaker, then it announces it’ll selectively refuse to defend disfavored federal statutes in court, just like the last administration did with DOMA.

Imagine how furious the left would be at these Justice Department affronts to freedom of the press and the rule of the law if they hadn’t pioneered them. Thanks, Obama!

It feels strange that the executive branch has to try to tank ObamaCare in court to get it undone when Republicans control both houses of Congress and the White House, but we’ve already been there, done that on legislative solutions. Time for Plan B. The catalyst for this decision is a lawsuit filed by various red states against ObamaCare claiming that, by SCOTUS’s own reasoning, the entirety of O-Care is now unconstitutional. How do they figure that? Because, if you remember John Roberts’s opinion from the ObamaCare ruling in 2012, the law is valid only because the individual mandate counts as a tax for constitutional purposes.  Because Congress has the power to tax, it has the power to issue the mandate. And the mandate is the foundation for the entire program. Four justices were prepared to rule in 2012 that the whole law was unconstitutional because the mandate was.

Last year, though, the GOP repealed the mandate’s financial penalty. It used to be that if you refused to buy health insurance, you’d be fined — or “taxed” — a certain percentage of your income by the IRS. The mandate is still technically on the books but there’s no longer any penalty for refusing to comply with it. Which means there’s no tax. And if there’s no tax then there’s no longer any constitutional basis to support ObamaCare. The DOJ now agrees with that view, although rather than insist that the entire program has become unconstitutional, they’re claiming that only certain specific parts are, most notably the requirement that insurers must cover people regardless of preexisting conditions. (The ObamaCare insurance exchanges, for instance, should be left untouched in the DOJ’s view.) The idea is that if there’s no longer any revenue from the mandate to finance coverage for the sick then insurers can’t very well be expected to finance coverage for sick. So the DOJ will no longer argue that they should. If the courts agree with them, the entire program will be effectively eviscerated.

(my bold) Can C.J. Roberts pull another rabbit out of the same, but diminished, hat?

Linked at Pirate's Code in the weekly "Sorta Blogless Sunday Pinup" and links.

Obamacare Schadenfreude: It's Dead, Jim!

It's been a long time, and I've let a bunch of stories accumulate in the Obamacare bin, but I'm going to delete them now: With the individual mandate dead, the rest of Obamacare is unconstitutional

Almost no one saw it coming.

In 2012, Chief Justice John Roberts famously ruled the Affordable Care Act’s provision mandating most people purchase health insurance or else pay a fine constitutional on the basis that Congress has the authority to tax individuals, and the so-called Obamacare “fine” is effectively a tax.

As the now-deceased Justice Antonin Scalia pointed out in his dissenting opinion, in classifying the Obamacare penalty as a “tax,” Roberts ignored history, the language of the healthcare law, statements made by the Obama administration and Democrats in Congress, and common sense. (The obvious difference between a fine and a tax is that the purpose of a tax is to raise revenue, not to force people to behave in a particular way.)

Interestingly, however faulty Roberts’ decision may have been, it now serves as the foundation for a legal argument that could eventually lead to Obamacare’s demise.

One of the most overlooked aspects of Roberts’ opinion, one that could become increasingly important over the next year, is that he joined the Court’s four dissenting justices in rejecting the alternative arguments made by the Obama administration regarding the constitutionality of the individual mandate. Most importantly, Roberts stated plainly the argument the individual mandate is constitutional under the Constitution’s Commerce Clause is false.

In fact, the only basis for the mandate’s constitutionality, according to Roberts, is that it’s a tax — not a fine, penalty, or anything else. This is a vital point, because when Republicans passed their tax reform legislation in December 2017, they included a provision in the law that lowers the individual mandate penalty to $0 beginning in January 2019, effectively eliminating any hope the individual mandate could still be considered a “tax.”

If the tax-less individual mandate is now found to be unconstitutional, it could very likely result in the entire healthcare law being struck down. In their 2012 dissenting opinion, four Supreme Court judges argued the ACA could not survive absent the individual mandate. Although Roberts never addressed the question in his opinion, there are good reasons to believe he should agree to throw the entire law out.
. . .
It’s also worth noting I’ve spoken to well-informed legal experts, including Ken Cuccinelli, the former attorney general of Virginia, who have said the Trump administration doesn’t need to enforce the ACA once the individual mandate penalty is reduced to $0. President Trump has sworn an oath to defend the Constitution, and this law is now or will soon become in violation of the Constitution, even if one continues to accept the dubious argument the individual mandate’s penalty is really a tax.

This means all it would take to end Obamacare is a decision by the Trump administration not to enforce this illegal law by agreeing to settle the lawsuit brought by plaintiffs challenging the constitutionality of the individual mandate. Such a move would likely trigger lawsuits from left-leaning states and intense legal battles, but perhaps in the process, Congress would finally be motivated to repeal and replace Obamacare — something it has failed to do despite its leadership having promised to do so for eight years.

Never discount the Supreme Court's ability to twist law and logic.

The End Of Obamacare Schadenfreude

It's over. With the House and Senate passing the tax bill last yesterday (the house has to make a small change, and revote today), the Obamacare mandate that everyone pay for insurance, or pay a tax is hereby repealed. With the mandate removed, the remainder of Obamacare may flop around like a freshly gutted fish, but it can't last.

Trump secures major victory as Senate Republicans pass $1.5 trillion tax cut bill despite Democrats warning they'll 'rue this day' and protesters screaming 'don't kill us' - paving the way for a final House vote today after earlier hiccup

The Senate passed the GOP’s $1.5 trillion tax cut early Wednesday morning, leaving just one technical hurdle and President Trump’s signature as the final steps before the president’s top legislative priority becomes reality.

There was little last-minute drama in the Senate where the final tally was 51-48 – hardly different from the original version that cleared the Senate earlier this month.

Not a single Democrat voted for it, just as none in the House voted for a similar bill earlier on Tuesday.

Moments after the measure passed, Trump was quick to voice his approval and said if the House succeeds in a final re-vote Wednesday morning, there will be a White House news conference at 1:00 p.m.

'The United States Senate just passed the biggest in history Tax Cut and Reform Bill,' he tweeted just after 1:00 in the morning. 'Terrible Individual Mandate (ObamaCare)Repealed. Goes to the House tomorrow morning for final vote.'

House Speaker Paul Ryan tweeted: 'Great news. The Senate just passed the Tax Cuts and Jobs Act. After years of work, we are going to enact the most sweeping, pro-growth overhaul of our tax code in a generation.'

A wave of protesters provided one of the biggest bursts of emotion. One small group yelled out ‘Kill the bill, don't kill us!’ as the final vote was being taken.

Let me think about it.

OK, I thought about it. No.

Nolte: Obamacare Mandate Repeal Is the Most Important Civil Rights Victory in Years

For the sin of being born, Obamacare mandates that every American purchase health insurance. If we do not purchase this totally unnecessary, godawful product (more on this below), we are required by law to pay a hefty tax to the federal government.

Somehow, and I do not really care how, this tax actually costs the government money, some $340 billion — with a “B” — every ten years.

Only Bill Ayers’ pal and his merry band of congressional nincompoops could crawl so far up their own backsides that they were able to find a tax that increases the deficit.

But thank heavens they did. Had they not, the Senate would not have repealed the mandate Friday night.

After the humiliation of failing to keep their defining promise to repeal Obamacare, the Senate turned to tax reform, which also looked sketchy due to deficit projections. But then the clouds parted and the stars aligned with the discovery that repealing the Obamacare mandate would save the government this $340 billion.

Talk about a win-win. Here was a way to kill the most hated (and crucial) part of Obamacare and pass tax cuts. And that is exactly what happened — the American people won a sweet two-fer: lower taxes and freedom from a fascist mandate.

Normally I am cautious about celebrating such a thing until it is signed into law. My understanding, though, is that the worst that can happen from here is the House passes the Senate bill — which means the Obamacare mandate is dead, which means this is the most important civil rights victory in years.

If I purchase a car, I am voluntarily taking on certain civic responsibilities that require the purchase of insurance. I have no problem with that. The Obamacare mandate is something altogether different.

For no other reason other than the fact I am born, the mandate is the federal government forcing me to buy something. This is nothing less than a legalized violation of my civil rights.

Forget the fact that Obamacare so over-regulates the insurance industry that we are now required to purchase a ridiculously expensive, one-size-fits-all Cadillac plan with a deductible so sky-high most of us will never use it. That is the least of this outrage, and something the Senate still needs to fix.

What I am talking about is the principle of the state forcing you to purchase something for your own good and for the good of others.

Sorry to be crude, but f**k that.

A Stake to the Heart of Obamacare Schadenfreude?

Yet  another  reminder of why Obamacare sucks: The Healthiest State In The Country Has Some Of The Steepest Premiums

Via Wombat-socho's "In The Mailbox: 11.14.17", the ever sensible Megan McArdle reports that Surprise! Obamacare Enrollment Is Actually Rising. Is there nothing Trump can't fix?

On the other hand, the Wall Street Journal opines that The Individual Mandate Is The Worst Tax Ever
"It doesn’t even further the ACA’s core goal of helping people with pre-existing conditions get coverage."

If you were deliberately trying to design the most arbitrary, painful and pointless tax possible, how would you go about it?

First, you would structure it to inflate the cost of an essential product. Then, you’d create exemptions so vast that only 5% of taxpayers were subject to it. You might even ensure that it hit people only when they were particularly vulnerable—like when they’d lost a job. Finally, you would use it to drive enrollment in entitlements, so that it increased the federal deficit by $338 billion.

and Killing the individual mandate can serve the cause of tax and health-care reform. The CBO estimates that Repealing Obamacare’s Individual Mandate Would Reduce Deficit By $338 Billion, not that anyone seems to care.

The budget office predicts that eliminating the mandate would reduce the deficit by $338 billion from 2018 to 2027 and would decrease the number of those with health insurance by 4 million in 2019 and by 13 million in 2027. Even with this loss, the report says that markets would remain stable in almost all areas of the United States over the next decade.

"We're seeing with the CBO report that repealing the mandate would reduce the deficit by nearly $340 billion over 10 years," says Sally Pipes, president of the Pacific Research Institute. "The report estimates that by 2027, about 13 million fewer Americans would enroll in ACA-compliant plans."

Which is because a lot of people don't actually want to by an "ACA-compliant" plan.

Today I am announcing my intention to amend the Senate tax bill to repeal the individual mandate and provide bigger tax cuts for middle income taxpayers.

The mandate repeal is a promise we all made and we should keep. It also allows an additional $300 billion+ in tax cuts.

— Senator Rand Paul (@RandPaul) November 14, 2017

The Washington Post reports that Senate GOP changes tax bill to add Obamacare mandate repeal and the usual suspects are hemming and hawing:

Sen. Susan Collins (R-Maine), one of the Republicans who opposed earlier attempts to roll back the health-care law, said Tuesday that including the repeal measure “complicates” the tax effort. But she suggested she might be able to support it if the Senate also passes a bipartisan bill to preserve other aspects of the Affordable Care Act.

Sen. John McCain (R-Ariz.), who along with Collins and Sen. Lisa Murkowski (R-Alaska) voted down an Affordable Care Act repeal effort this summer, declined to say whether he would back a tax bill that included repeal.

The Hill: Senate GOP tax bill will include repeal of ObamaCare mandate.

Sen. John Thune drops the mic on Dems objecting to adding individual mandate repeal to tax bill

Dems object that Rs are inserting health care into the tax bill with individual mandate repeal.

"My understanding is the individual mandate is a tax," Thune responds, referencing SCOTUS decision

— Joseph Lawler (@josephlawler) November 14, 2017

The mandate is the heart of Obamacare. Without it, it's really just zombie entitlement.

The Never Ending Obamacare Schadenfreude

UnitedHealth Revenue Grows Despite ACA Exit. As Instapundit quips "What do you mean, despite?"

End To ObamaCare Subsidies Leaves Congress In A Tight Spot. Trump Gives Congress A Kick In The Rear To Finally Act On Health Care.  But is one enough? While liberals complain that "Trump Executive Order On Obamacare Is “Pen And Phone” Legislation", David French (no Trump fan) Trump Was Right to End Unconstitutional Obamacare Subsidies

t’s a sad sign of our times that the constitutionality of any given government action is now seen as a wholly secondary consideration, subordinate to politics and arguments about politics. And so it is with Donald Trump’s necessary decision to halt federal payments of cost-sharing subsidies to insurance companies.

For example, here’s how the Washington Post led off its coverage of Trump’s decision: “President Trump is throwing a bomb into the insurance marketplaces created under the Affordable Care Act, choosing to end critical payments to health insurers that help millions of lower-income Americans afford coverage.” . . .

The Constitution doesn't matter to Dems when it's contrary to their wishes.

18 States Sue Over Trump-Halted ObamaCare Payments. You'll never guess who controls those states. Trump Opposes Bipartisan Obamacare Rescue Plan, where "bipartisan" equals 1 Republican and 47 Democrats.

Trump reverses course on emerging Senate health care deal

A bipartisan Senate deal to curb the growth of health insurance premiums is reeling after President Donald Trump reversed course and opposed the agreement, and top congressional Republicans and conservatives gave it a frosty reception.

Sens. Lamar Alexander, R-Tenn., and Patty Murray, D-Wash., announced their accord Tuesday after weeks of negotiations and five days after Trump said he was halting federal subsidies to insurers. Under the lawmakers’ agreement, the payments would continue for two years while states were given more leeway to let insurers sidestep some coverage requirements imposed by President Barack Obama’s health law.

In remarks Tuesday in the Rose Garden, Trump called the deal “a very good solution” that would calm insurance markets, giving him time to pursue his goal of scrapping the Affordable Care Act, the target of Republican derision since it was signed into law in 2010.
Although top Democrats and some Republicans praised the Alexander-Murray agreement, Trump backed off after a day of criticism from many in the GOP.

In an evening speech at the conservative Heritage Foundation, he said that “while I commend” the work by the two senators, “I continue to believe Congress must find a solution to the Obamacare mess instead of providing bailouts to insurance companies.”

Sorry Everybody, But Trump Hasn't Instigated The Obamacare Apocalypse

The Trump White House has issued two Obamacare-related policy announcements this week: announcements that some characterize as “gutting” or “sabotaging” the health care law. But a sober, factual analysis reveals that the Trump decisions will be fairly modest—and largely positive—in their effect.
. . .
Trump’s executive order simply reverts back to the pre-2016 rules. When some pundits hysterically describe this change as the “sabotage” and “gutting” of Obamacare, they’re talking about rules that were in place for 7.5 of Obama’s 8 years in office.

Iowa abandons bold attempt to jettison ACA rules

Iowa is abandoning its quest to shed major elements of the Affordable Care Act, after federal health officials failed to approve the plan in time for the insurance-buying season that begins in just over a week.

The state’s withdrawal comes two months after President Trump telephoned a top federal health official with instructions to reject Iowa’s proposal.

In announcing the withdrawal of what the state has called a crucial “stopgap” plan to prevent its marketplace from collapsing, Iowa Gov. Kim Reynolds (R) on Monday did not mention the president’s intervention, instead thanking Trump for trying to repeal the ACA and blaming the law itself for what she called its inflexibility.

Much to the Washington Post's disappointment.  The Health 202: Obamacare may lose 1.1 million people because of advertising cuts. Do they really think advertising is that effective?

Warren: fighting for a single-payer healthcare system is a “winning issue” for Democrats nationally in the 2018 midterm elections.

“Healthcare is a basic human right and that means we’re going to get Medicare for all, it means we are going to make the kind of changes we need to make in this country so everyone gets access to healthcare and nobody goes broke doing it,” she said. “I think this is about our values. It’s about what we are willing to get out there and fight for.”

What single-payer means: Britain's National Health Service provokes fury with indefinite surgery ban for smokers and obese. Who among us has no bad habits? Besides Georgia, I mean.

Post Obamacare Schadenfreude Bliss

I didn't really want to do another one so soon, but right after I pushed publish on the last one, Wombat-socho posted this "In The Mailbox: 10.13.17" with this link to an excellent essay by the usually sensible but always interesting Megan McArdle on Trump's decision to revoke the subsidy funding for Obamacare insurers: 

Obamacare Was Built With the Flaws Trump Now Exploits

. . . After threatening it for months, the president has finally ended the cost-sharing reduction payments to insurers, which subsidize the provision of special policies with lower out-of-pocket expenses for people who make less than 250 percent of the federal poverty line. At the very least, this will probably mean a further increase in premiums, and growing instability in at least the parts of the individual market that aren’t eligible for subsidies to offset the increase. At worst, especially if it gets bogged down in lawsuits, it may cause insurers to say “enough is enough,” leaving broad areas of the country without any firm willing to sell individual policies through the Obamacare exchanges.

While the Congressional Budget Office has issued a delightfully counterintuitive forecast that ending the subsidies could actually increase insurance coverage, there’s little question in my mind that these policies are bad for the exchanges.  At the very least, I think we can all agree that they put the exchanges at greater risk. There is also little question that this is at least part of the reason that the administration is pursuing them. And yet, believe it or not, there are still arguments for both.

It has become evident that millions of uninsured Americans are uninterested in buying insurance on the exchanges, because it’s too expensive, or the “narrow networks” don’t cover enough doctors and hospitals. The new options the administration aims to create could be a genuine boon to those people. If you have spent years bemoaning the dire fate of the uninsured, you have to take that benefit seriously.

As for ending the subsidies … what am I, some sort of monster? Do I just hate the poor so much that I can’t stand to see them getting help paying for health care? Well, no. I have no particular objection to the payments as policy. Except for one small thing, which is that they seem to be sort of illegal. . .

Read the whole thing,; it won't hurt that much. Also from  "In The Mailbox: 10.13.17" , Legal Insurrections Trump Throws Another Blow at Obamacare, Reportedly Scrapping Obamacare Insurer Subsidy Payments and Don Surber reports Fake News on Obamacare:

Bleating Democratic talking points.
CBS: "Trump Cutting Obamacare Insurance Subsidies."
Baaa.
CNN: "Trump begins Obamacare dismantling with executive order."
Baaa.
NBC: "White House Says It Will End Key Obamacare Subsidies to Insurers."
Baaa.
President Trump had no choice.
The money was never appropriated.

 And to round out the news, Rand Paul Squashes The Idea That Trump’s New Healthcare Order Will Hurt The Poor

According to Paul, the ability for many low-income workers to come together to form a group represented by one person would give the power to the consumer, allowing many who can’t afford good insurance plans on their own to become a pile of accumulated money that can.

Paul said that this kind of group plan “requires no discrimination,” and “protects against pre-existing conditions,” since the coverage would be the same kind you get at big corporations. Corporations do not refuse you employment because you have a pre-existing condition, or fire you because you get sick.

Paul explained that his plan that was enacted on Thursday allows individuals to have the same purchasing power as corporations, essentially putting purchasing power into the hands of the people.

That makes almost too much sense to be true.

And fresh in from Instapundit, CHARLES SCHUMER WANTS TO HOLD THE PEOPLE OF PUERTO RICO HOSTAGE TO THE FINANCIAL WELLBEING OF HUGE INSURANCE COMPANIES: Dems float putting ObamaCare money in funding deal

Senate Minority Leader Charles Schumer (D-N.Y.) is signaling Democrats will try to get ObamaCare's insurer subsidy payments included in a December funding deal, adding another legislative item to an already packed end-of-the-year schedule.

"I think we're going to have a very good opportunity in the omnibus to get this done in a bipartisan way, if we can't get it done sooner," Schumer told reporters during a conference call on Friday.

"Democrats are going to work very hard to get these cost-sharing payments restored, but remember there are a whole lot of Republicans who want to get them restored, too."

Trumping Obamacare Schadenfreude

A lot of new developments since the last update, but lets get back and remind ourselves why Obamacare sucks for the country (although it can be a pretty sweet deal, especially if you're an insurance company):

Obamacare's death spiral continues: Democrats Need To Admit That ObamaCare Failed. But that would require honesty and self-reflection. As Deadline Approaches, Anthem Pulls Out Of Obamacare Exchange In Maine. Thank Susan Collins. Michelle Malkin reports Obama Lied. My FOURTH Health Plan Died. Mary Katherine Ham  Schools #Resistance troll in back-and-forth over Obamacare. Trolls are notoriously difficult to school. Majority of Households Paying Obamacare Penalty Are Low and Middle-Income. And probably not Obama voters.

Just an ancient history link now Obamacare’ survives; GOP concedes on last-gasp repeal try  The Republican Fight to Repeal Obamacare Is 'Dead as a Doornail.' For Now. So now you tell us Lindsey Graham: I Didn’t Really Know What I Was Doing On Health Care, And Neither Did Other Republicans. You might have thought about that before the last election.  Why The Republican Health-Care Bill Keeps Coming Back From The Dead. Because it needs to.  John McCain Ran On Repealing Obamacare. He Broke His Promise. Yep, and he seems to be heading the same way on tax reform for the same reason. Then he could always vote with some Democrats.  He should just officially change his party registration. But then he wouldn't be a "maverick" (a little lost cow). Pro-Lifers Call Obamacare Repeal Failure ‘Unacceptable’- Failure to defund Planned Parenthood infuriates pro-life groups. It infuriates me too, and I'm not exactly pro-life. GOP Lawmaker: McConnell Snubs 'Judeo-Christianity Land,' Moses by Not Repealing Obamacare. DISPATCHES FROM THE HOUSE OF STEPHANOPOULOS: ABC World News Tonight anchor David Muir Gushes to Kimmel: People ‘Will Remember’ Your ‘Bravery’ ‘Standing Up’ For Health Care. Flashback: George Stephanopoulos discloses $75,000 contribution to Clinton Foundation.

Jump forward a few days and find Trump says he called Schumer to broker deal with Democrats for ‘a great HealthCare Bill’, which is basically a way to guarantee further Democratic obstruction. Then something interesting started to happen. Trump found his pen and phone, and started gutting Obamacare: Trump Administration Rolls Back Obama Rule on Birth-Control Coverage. So the nuns don't have to pay for birth control anymore. Trump Executive Order Would Give People An Out From ObamaCare; Dems Want To 'Save' ObamaCare By Closing All The Exits. And  Trump Drains Obamacare’s Regulatory Swamp:

Having provoked much progressive sputtering and head spinning last Friday by issuing new regulations weakening the notorious HHS contraception mandate, President Trump is poised to sign an executive order that will further dry up Obamacare’s regulatory morass. The Wall Street Journal reports that the order will expand enrollee options restricted by the Obama administration — allowing coverage to be purchased through association health plans, encouraging the sale of short-term medical insurance, and permitting pretax funds from health reimbursement accounts (HRAs) to be used for premiums on health plans. The impending order has already drawn satisfying charges of “sabotage” from Obamacare apologists.

Rand Paul Says Trump’s Obamacare Order ‘Has The Potential To Be Amazing’

“Millions of people are going to choose it and it doesn’t force people to do anything,” Paul said. “My plan today that the president enacted costs zero.”

Trump: ‘We’re Going to Have Great Health Care Across State Lines’, then  President Trump Signs Executive Order That Will Allow Sale of Health Insurance Across State Lines

The order is intended to expand choices to current Obamacare plans and increase competition so that costs come down for consumers.

"The time has come to give Americans the freedom to purchase health insurance across state lines, which will create a truly competitive national marketplace that will bring costs way down and provide far better care," President Trump said.

Trump On ObamaCare Insurer Subsidies: Guess What? We Checked The Budget And The Constitution, And …"Surprise! It turns out that Congress didn’t fund direct subsidy payments to health insurers." And then the final (at least so far) cut: Trump declares Obamacare payments illegal; deals second blow to health law. Well, we all knew that the payments were not authorized by Congress, and thus illegal, but democrats had been ignoring that little detail. By way of Wombat-socho's "In The Mailbox: 10.12.17". Powerline explains how Trump Takes An Important First Step On Healthcare
The Washington Post, of course, went into a hissy fit: Trump to end key ACA subsidies, a move that will threaten the law’s marketplaces Trump to end key ACA subsidies, a move that will threaten the law’s marketplaces. Well yes, because they were being illegally subsidized. If you don't like it, fix it. Trump moves from firing shots at Obamacare to all-out war, Trump’s Obamacare order could destroy the health-care system. No, but it could destroy Obamacare, which is a good thing. Throwing a bomb into the insurance markets, Trump now owns the broken health-care system. It's still got Obama's name on it.

The Brits got into the act, with the Daily Mail intoning Trump to end subsidy payments to Obamacare insurers in a move derided by Democrats as 'spiteful act of vast, pointless sabotage'

State AGs ready to sue Trump over health care subsidies. You won't be able to guess which states, right?

It's Dead Jim Obamacare Schadenfreude

Well, that was quick.

The Health care cul-de-sac

. . . sometimes, when a party has spent most of a year producing health care bills that excite almost nobody and that even the senators voting for them can’t effectively defend, it’s worth stepping back and thinking about our national priorities.

This goes for both parties: not only the stepping-on-rakes Republicans, but the suddenly single-payer-dreaming Democrats. If Obamacare repeal is really dead for the year 2017, both left and right have a chance to shake their minds free of the health care debate and ask themselves: What are the biggest threats to the American dream right now, to our unity and prosperity, our happiness and civic health?

John McCain lied — he doesn't really want to repeal Obamacare

Conservatives, long considered obstacles to cooperation by centrists such as McCain, have made the necessary concessions on every major legislative attempt in the House and the Senate to create a coalition capable of repealing and replacing Obamacare. Even the Tea Party Patriots endorsed Graham-Cassidy, a bill that leaves in place much of the regulatory structure established by Obamacare.
. . .
If he truly believes that "any serious attempt to improve our health care system must begin with a full repeal and replacement of Obamacare," McCain knows there is no bipartisan solution to reform that meets his own standards. After voting for repeal, and arguing legislative attempts to achieve full repeal and replacement were essential, McCain is now moralizing about the importance of bipartisanship, after conservatives compromised to deliver on their promises and save a failing system.

McCaincare: The dishonorable Senator from Arizona.

"I won’t stop fighting to repeal and replace," McCain declared during the last election. It would have been more accurate if he had admitted that he won’t stop fighting efforts to repeal ObamaCare.

Trump pins blame on McCain as latest GOP health-care bill sinks Fair enough, but he had help. Susan Collins: “It’s Difficult To Envision” Voting For Graham-Cassidy and Shocker: Maine Socialist Susan Collins Will Vote Against Graham-Cassidy. Et tu Ted? Ted Cruz: 'Graham and Cassidy Don't Have My Vote, and They Don't Have Mike Lee's Either' and Ted Cruz Just Stuck A Fork In The Graham-Cassidy ObamaCare Repeal/Replace Bill. He might just want to spite Lindsay, but I'll give him the benefit of the doubt that it's on principle.

Put that in your pipe and smoke it, fake "principled" conservatives. You're either in favor of the free market and opposed to socialized medicine, or you're an opportunist who just supports whatever it is your supposed "side' is pushing at the moment. You can't have it both ways.

Republicans press ahead with Graham-Cassidy health care bill despite mounting defections in Senate, but then Senate won’t vote on last-ditch Obamacare repeal bill; Republicans made the decision after it was clear their latest plan would fail.

Obamacare Repeal: Is There Life After September 30? The American Spectator says "Yep." Clearly Rand Paul and Ted Cruz think so. I'm not so sure.

Levin takes ‘deceitful SOB’ Kimmel & pal Schumer to the WOODSHED

In vintage Mark Levin form, Levin came out firing Friday night, refusing to let late-night comedian Jimmy Kimmel off the hook for peddling dangerous health care lies and myths all week.

“Now we learn that Jimmy Kimmel and Chuck Schumer have been working behind the scenes,” Levin said, referring to a breaking-news report from the Daily Beast Friday. The Daily Beast report alleges Kimmel and his team worked with the Senate minority leader for months to combat Obamacare opposition.

“Jimmy Kimmel, you’re a deceitful SOB. You should’ve told the American people when you were espousing what you were espousing that you were getting talking points from Chuck Schumer,” Levin blasted.

As Obamacare repeal implodes (again), Democrats prepping for single-payer self-destruction

It's probably true that voters are skeptical of Republicans' ability to fix the mess that is health care, especially when the party is led by an unpopular president whose knowledge of medical procedures seems to be limited to the plastic surgery performed on television personalities. But the public saying, "I'm not so sure it's a good idea to write and pass a bill in a week after Republicans had seven years to fix Obamacare" is far different than "I want the federal government fully in charge on my health care."

Not More Obamacare Schadenfreude Already?

Before I get into it, just a reminder, Obamacare is failing, badly: Health Insurers in New Mexico To Implement Record-High Premium Increases

Insurers will increase premiums next year from a range of 36 to 41 percent for midlevel insurance plans. For all plans, premiums are expected to rise a range of 17 to 49 percent.

My sympathies are somewhat lessened upon recalling that New Mexico voted solidly for Hillary.

If You Want Medicare For All, Get Used To Eating Rabbit Now

Venezuelans still have access to free health care—except they don’t receive much care. The country suffers an 85 percent shortage of medicine and a 90 percent deficit of medical supplies. Fewer doctors are available to provide care, too. By 2015, at least 15,000 doctors had left the public health care system because of shortages of drugs and equipment and poor pay.

Consequently, infant mortality increased 30 percent, maternal mortality climbed 65 percent and cases of malaria went up 76 percent. People in war-torn countries like Syria receive better health care than Venezuelans do nowadays.

The Alaska Purchase: Graham, Cassidy Try To Buy Murkowski’s Health-Care Vote With Extra Goodies. I'm trying to work up some outrage, but then I remember the Corn Husker Kickback. Politics ain't beanbag. With Timing Tight for GOP’s Health-Law Repeal Effort, Opponents Rush to Mobilize. Jimmy Kimmel Got a Hand From Chuck Schumer in His Fight Against Obamacare Repeal. How Obama is funding the anti-Trump resistance. Big hint, you're the one paying.

And of course, the big news: From the NYT: McCain Announces Opposition to Republican Health Bill, Likely Dooming It. Yahoo: GOP's 'Obamacare' repeal all but dead; McCain deals the blow. Althouse: "Senator John McCain of Arizona announced on Friday that he would oppose the latest proposal to repeal the Affordable Care Act..."

"... leaving Republican leaders with little hope of succeeding in their last-ditch attempt to dismantle the health law" (NYT).

So Lindsey Graham’s being his best friend was not enough.

Ace: Shocker: Maine Socialist Susan Collins "Leaning Against" Obamacare Repeal
Another Shock: JOHN McCAIN, HERO OF CONSERVATISM, WILL VOTE TO SAVE OBAMACARE and John "Build the Dang Fence" McCain Liesplains His Obamacare Reform No-Vote: I Won't Support Any Law That Democrats Don't Support Too, thus guaranteeing he will not vote to alter Obamacare.

Gateway Pundit: Lying RINO John McCain Says He Cannot Support Latest Obamacare Repeal Bill – But Ran on Repealing Obamacare



It's not that he loves Obamacare, it's that he hates Trump so much he'll do anything to spite him. And he loves being praised by the press and Democrats.

Via Wombat-socho's "In The Mailbox: 09.21.17", Twitchy: Will Tough Guy Jimmy Kimmel Accept This Offer From Heritage Action?, Da Tech Guy: The Notion That Graham-Cassidy Has To Pass To Save The GOP Is Ludicrous, Jammie Wearing Fools: New Democratic Party Leader Threatens Fox Host With Violence, JustOneMinute: The Graham-Cassidy Health Care Bill, and Shark Tank: Rand Paul Equates Graham-Cassidy To 2013 Senate Amnesty Bill.

And from "In The Mailbox: 09.22.17", EBL: A Mendoucheous Dotard Probably Doomed Graham-Cassidy Obamacare Repeal, Twitchy: MSNBC’s Ari melber Gets Roundly Fact-Checked Over “Nonpartisan” Jimmy Kimmel Claim, and Legal Insurrection: Stacy’s Crazy Cousin John “Cannot In Good Conscience” Vote For Graham-Cassidy

Remember, Congratulations, Democrats. Obamacare Is Here To Stay And You Own It, Well, them, John McCain, Susan Collins, and Rand Paul. Can Megan inherit?

Ein Bisschen Obamacare Schadenfreude

I haven't had occasion to post two on back to back days for quite a while, but since it's heating up again, it seems necessary. First, via Wombat-socho's "In The Mailbox: 09.20.17" the generally sensible Megan McArdle analyzes the Graham-Cassidy bill to "reform" Obacare: How the Health-Care Debate Would Change If Graham-Cassidy Passes

If Graham-Cassidy passes, it will return us to something more like the health-care politics of yore, because the federal government will be (mostly) out of the health-care-program business (with the huge and growing exception of Medicare). Feds will provide much of the funding. But the states will be the ones in charge of deciding what the system in their state will look like.

Of course, Democrats can one day undo what Republicans are doing, just as Republicans are planning to undo the work of the Democrats. The left can pass another Obamacare, or some different, more expansive plan. But to do so, they will have to go through the whole painful process of passing Obamacare all over again: soothe or pay off all the anxious interest groups; find the extra tax dollars to fund it; reassure voters who have good insurance that they will not lose by the new plan.

This task will be immensely harder in Round 2 than it was in 2010. By the time they get around to it (in 2020, soonest), Democrats will be forced to scavenge for new sources of funding at the same time as every predator on K Street is scouring the landscape to feed our existing defense commitments and rapidly growing entitlement burden.

They will also be trying to whip up support from a public largely exhausted by the last decade of wild promises and underwhelming delivery from both sides of the aisle. Thanks to the experience of Obamacare, that public will be inclined to disbelieve any assurances about how splendid this will be for folks who already have insurance they like. And Democrats will somehow have to overcome all these political obstacles without a once-in-a-lifetime financial crisis handing them unnaturally large congressional majorities.

It is more likely that health-care politics in America will mostly move down to the states, permanently, where they will become vigorous and perennial. This will mean the end of wall-to-wall media coverage of that politics, because the media is nationalizing, while state and local outlets keep dwindling, and it is too hard to get people in California interested in the blow-by-blow details of something happening in Georgia. It will also mean the end of the Democratic dream of a national single-payer system. It will probably mean the end of the dream of single-payer, period, because the obstacles to single-payer at the state level are simply too enormous; it is too hard to control payment when people often cross state borders to seek treatment, and too hard to finance, when states have to run budgets that are at least nominally balanced.

Also from Wombat-socho's "In The Mailbox: 09.20.17", Don Surber in "Let states run health insurance again" concludes "Still, it is a half loaf."

It sounds like a worthwhile step, so why are there (at least) two Republican Senators holding out. Trump: GOP Health Bill Short of Votes Before Deadline. The two senators who will likely decide fate of ObamaCare repeal (Murkowski and McCain). Collins and Rand are assumed out. McCain just enjoys the media spotlight he gets when he obstructs other Republicans. Murkowski?

Alaska has the nation’s highest premiums and benefited from ObamaCare’s Medicaid expansion. Alaska likely would lose out under the latest repeal bill, primarily because it eliminates funding for the expansion and ObamaCare subsidies in exchange for a lump sum of money through 2026.

Last Ditch Obamacare Schadenfreude

Last-chance Obamacare repeal bill includes waivers from insurance regulations

Republican senators trying a last stab at tackling Obamacare are pushing a bill that lets states partly waive key regulations that include protections for people with pre-existing conditions, an issue that has doomed other attempts at repealing former President Barack Obama's healthcare law.

The bill, co-sponsored by Republican Sens. Lindsey Graham of South Carolina, Bill Cassidy of Louisiana, Ron Johnson of Wisconsin and Dean Heller of Nevada, seeks to provide Obamacare funding to states in the form of $1.2 trillion in block grants from 2021 to 2026.

Critics of the approach quickly said that the bill's waivers from key Obamacare insurer regulations would erode protections for people with pre-existing conditions. It also would waive essential health benefits such as maternity care or mental health.

From Wombat-socho's "In The Mailbox: 09.13.17", the usually sensible Megan McArdle discusses
The Latest (Dim, Distant) Hope for Health-Care Reform

Well, the political math certainly looks difficult. Republicans hold a majority in both houses, but their Senate majority is narrow enough to give them precious little wiggle room when it comes to passing a bill. Considering that Rand Paul has already been pretty negative about the bill, that wiggle will have to be more like a tremor: If Rand won't back the proposal, they’ll need either Susan Collins or Lisa Murkowski, who have so far proven unwilling to vote for previous iterations of GOP reform ideas.

Moreover, they’re going to have to shimmy pretty quick. This bill is not, needless to say, going to garner Democratic votes. Democrats don’t want to do anything to Obamacare except pour more money into it, and this particular version is going to hurt blue and purple states that expanded their Medicaid programs.

So to get it through the Senate, the Republican sponsors will have to use a budget process called reconciliation. The reconciliation instructions expire on Sept. 30. In that time, the bill needs to get a CBO score and work its way through the torturous parliamentary procedure for bringing a bill to the floor and voting on it, as well as the lengthy arm-twisting that will probably be required to get enough senators on board. It’s not actually impossible to meet that deadline -- but it doesn’t look all that possible, either.

The Medicaid changes are also going to be a problem for Republican senators from states that took Medicaid money, a group that includes Lisa Murkowski of Alaska (don’t count on that vote), and also true-red, die-hard conservatives like Tom Cotton of Arkansas. Whipping those votes would be a Herculean challenge, and it’s far from clear that leadership has any appetite for that fight.

And yet, readers caught in this interminable saga can’t quite say “It’ll be dead by page 900.” Nevada is an expansion state, but one of its senators, Dean Heller, is co-sponsoring the bill. Something about this bill is appealing to him, and maybe that something will appeal to the waverers among his colleagues.

Yes, but is it a good bill?

There are indeed a lot of things to like in this bill, from a Republican perspective. It shifts money toward red states and away from blue ones, and achieves a longstanding goal of block-granting Medicaid -- ending the perverse incentives created by having the states manage the program while the federal government picks up part of every bill. And it gives states more autonomy, which is consistent with both conservative philosophy and red-state interests. Obviously if you’re fond of Obamacare, this is going to seem a poor substitute. But you may have noticed that most Republican legislators aren’t particularly fond of it.

That said, it still leaves some of the regulations in place that have caused so many problems with the exchanges for individual insurance policies. Tinkering with the money side while leaving those regulations intact is a dangerous game. It’s a good idea to let states figure out how to patch the holes that Obamacare has created -- but given the sums involved, it seems eminently possible that states simply won’t be able to.

So better than Obamacare, but unlikely to pass?

Meanwhile, the Trump Administration is Working in Other Ways to Dismantle Obamacare. The let it die strategy. But Reason is pessimistic: Obamacare Repeal Is Dead. Here Come the Bailouts. I'm inclined to agree.

The Democrats, on the other hand, have become the American socialist party. One might even say that they have become our National Socialist Party.   “The Time Has Come”: ObamaCare Architect Max Baucus Endorses Single-Payer. If it was designed to fail and lead to a call for single payer, it's working. Sanders Will Introduce Universal Health Care, Backed By 15 Democrats

Sanders’s bill, the Medicare for All Act of 2017, has no chance of passage in a Republican-run Congress. But after months of behind-the-scenes meetings and a public pressure campaign, the bill is already backed by most of the senators seen as likely 2020 Democratic candidates — if not by most senators facing tough reelection battles in 2018.

The bill would revolutionize America’s health-care system, replacing it with a public system that would be paid for by higher taxes. Everything from emergency surgery to prescription drugs, from mental health to eye care, would be covered, with no co-payments. Americans younger than 18 would immediately obtain “universal Medicare cards,” while Americans not currently eligible for Medicare would be phased into the program over four years. Employer-provided health care would be replaced, with the employers paying higher taxes but no longer on the hook for insurance.

Comrade Bernie Explains Why We Need Government Run Health Care. Why Sanders’ Single Payer Bill Is The Real Dream Act. But he was honest once: Medicaid for All Would ‘Bankrupt the Nation,’ Warns Bernie Sanders—In 1987. Maybe he sees that as a feature, not a bug.

And Yet, Still More Obamacare Schadenfreude

At this point it's not clear who's schaden and why.  Obamacare continues its decent into the abyss. Obamacare Causes New York’s Largest Hospital Network to Leave Insurance Market.

Northwell Health (the former North Shore-Long Island Jewish Medical Center network ) blamed a flawed provision in the Affordable Care Act — and the lack of action in Washington to fix it — as the culprits for winding down its CareConnect insurance company.
CareConnect enrolled 14 percent of firms in New York’s small group market and 8 percent of customers in the individual ObamaCare market — mostly on Long Island and in New York City.

In 2016, the hospital doled out $112 million “into a risk insurance pool created to prop up insurers that had a disproportionate number of high-risk or money-losing clients.” This pool helps stop the “insurers from ‘cherry-picking’ younger and healthier customers who are less expensive to cover.”

Well, at least that state voted for it. Obamacare Insurer Pulls Out Of Rural Virginia Leaving Coverage Gaps. Rural Virginians probably didn't. Waiting Longer for an Ambulance When Seconds Count? Blame Obamacare. In a business where time is life. Frustration mounts over premiums for individual health plans. They can't say they weren't warned.

GOP Senate Can’t Repeal Obamacare But Will Pass DREAMERS Amnesty "It’s as if the November 2016 election never happened." Kasich, GOP & Senate remain in health care cartels’ pockets. Quite likely. John Kasich’s Obamacare Plan Is A Giant Bailout For A Junk Law:

It’s worth repeating that, as recently as three years ago, Kasich said the following regarding the health care law: “From Day One, and up until today and into tomorrow, I do not support Obamacare. I never have, and I believe it should be repealed.”

Oh, how times have changed. The governors’ plan would not only not repeal Obamacare, it would further entrench the law, by giving tens of billions, and more likely hundreds of billions, of new taxpayer funds to wealthy insurance companies.

Making him about equal to most congressional Republicans. Republicans Wave the White Flag on Obamacare

Alexander is Chairman of the Senate Health, Education, Labor and Pensions (HELP) Committee, which will this week begin hearings whose ostensible purpose will be to explore ideas on how to “stabilize” the individual insurance market. Their real purpose, of course, will be to negotiate the terms of surrender. The committee will hear testimony from insurance executives, state insurance commissioners, and alleged policy experts. But the real action will be on Thursday when testimony will be provided by selected state governors, more than one of whom recently joined Ohio RINO John Kasich in calling for Congress to bail out Obamacare.

But Here’s The Obamacare Grand Bargain That Will Satisfy Both Republican Factions

. . .rather than constructing substantively cumbersome waiver arrangements—the legislative equivalent of a camel being a horse written by committee—Occam’s Razor suggests a simpler, cleaner solution: Preserving the status quo (i.e., the enhanced federal match) on Medicaid expansion in exchange for full repeal of Obamacare’s insurance regulations at the federal level.

A “grand bargain” in this vein would give Senate moderates a clear win on Medicaid expansion, while providing conservatives their desired outcome on Obamacare’s regulations. For this conservative at least, the regulations represent the heart of the law, prompting both its spending on exchange subsidies—to offset the higher premium costs from the regulatory mandates—and the taxes needed to fund that spending. Expelling the regulations from the federal statute books would represent a clear step towards the promise of repealing Obamacare “root and branch,” and return control of health insurance to the states, where it lay from 1947’s McCarran-Ferguson Act until Obamacare.

Here’s The Real Reason Trump Is Angry With McConnell And Ryan. I think he has an abundance of real reasons. The debt ceiling fight? Trump seems to have cut the Gordian Knot on that fight. Here We Go: McCain, Trump Endorse Last-Gasp ObamaCare Repeal Bill. Why would anyone take McCain seriously at this point?

Sen. John McCain (R-Ariz.) said Wednesday that he supports a newer version of an ObamaCare repeal-and-replace bill, throwing some support behind the last-ditch effort.
McCain said he backs a bill from Sens. Lindsey Graham (R-S.C.) and Bill Cassidy (R-La.) that would convert ObamaCare spending into block grants for states. …
“If it’s not through regular order then it’s a mistake, but it doesn’t mean I wouldn’t vote for it,” McCain said when asked about his previous statements.

. . .
Just how likely will passage be? Graham-Cassidy doesn’t have any legislative text, so it technically doesn’t qualify for reconciliation — yet. It will have to reduce Medicaid spending in some form to qualify, which may not gain back Susan Collins and Lisa Murkowski, although excluding a Planned Parenthood defunding clause might just be enough to get them to back it.

Health Insurers Struggle to Win Reprieve of Obamacare Tax

Health insurers won a victory in 2015 when a tax that was part of the Affordable Care Act was suspended. Now as they fight to repeal or delay the tax again before it comes back into effect, the odds don’t seem to be in their favor.

Insurers, businesses and conservative groups are scrambling for ways to at least delay the health-insurance tax, or HIT, following the collapse of health-care legislation in July. They seemed poised for victory just a few months ago, when the health-insurance fee, and most of the other levies enacted to help fund Obamacare, were targeted in repeal bills passed by House Republicans and considered by Senate Republicans.

The health-insurance tax, which is scheduled to go back into effect in December, is an annual fee owed by insurers such as Anthem Inc., UnitedHealth Group Inc. and Aetna Inc. that varies based on their share of net premiums written nationally -- the aggregate amount owed would total $14.3 billion in 2018. Those opposed to the tax are trying to pitch the message that repealing it could prevent higher premium costs for consumers.

The HIT took effect in 2014, but an omnibus bill passed at the end of 2015 temporarily suspended it starting last year.

A tax on health insurance? The rule of thumb is you tax what you want to discourage. . .

Locked money: the main reason to end Obamacare

In order to provide free or subsidized healthcare insurance for millions, Obamacare raised capital gains taxes to 23.8%.  It also found revenue in a number of other places, but the capital gains tax increase accounts for roughly 91% of the revenue necessary to pay for Obamacare.

A good reason, but not the best. The best reason is the freedom of individuals to choose their own health care.

Sen. Chris Murphy Has A ‘Stealthy’ Plan To Get To Single-Payer Of course he does. He's a Democrat. It's not all that stealthy, though.

Back in 2009/2010, Democrats were pushing for a “public option,” a plan to compete with private health plans but one run by the government. As in Murphy’s plan, people would buy it on the Obamacare exchanges. Granted, Murphy’s new plan isn’t identical to the public option but it is similar. And as he admits, the goal is to move the country toward single-payer.

Granted, Murphy’s new plan isn’t identical to the public option but it is similar and has the same goal. The creator of the public option admitted it was designed to move people toward single payer.

What’s striking is that back when the public option was actually under consideration, Democrats from President Obama on down claimed it was all about “choice and competition.” There was no government takeover planned. Obamacare was not a trojan horse for single-payer. Where did anyone get this crazy idea? But a few years later this similar proposal is now being framed as a stepping stone to the ultimate goal: single payer.

And yet, to this day, it’s difficult to find many mainstream news outlets that count this as one of the ways Democrats lied to the American people during the Obamacare debate. They’ve all belatedly acknowledged that “If you like your plan you can keep it” was a fiction, but the fact that leading Democrats also tried to sneak a stepping stone toward single-payer into Obamacare without admitting it is something they don’t talk about, even now when it is undeniable.

Lingering Obamacare Schadenfreude

Obamacare continues to spiral down as the Last Obamacare Insurer In Iowa Wants 57% Rate Hike Next Year. But that doesn't mean business is bad for all;  New Centene CEO is another example Obamacare's architects getting rich off Obamacare. Another Obamacare architect,  Jonathon Gruber, Fired after Fraudulent Billing Probe.

Vermont Attorney General T.J. Donovan said his office has concluded an investigation into the invoices and billing practices of Dr. Jonathan Gruber, an economic consultant who contracted with the state to provide policy expertise, research and economic modeling for Vermont’s abandoned single-payer healthcare system.

Former Gov. Peter Shumlin sought to create the single-payer system, known as Green Mountain Care, but eventually walked away from the plan after determining it would cost too much. The attorney general’s office’s began the investigation into Gruber’s billing after receiving a referral by State Auditor Doug Hoffer.

Donovan said Thursday his office and Gruber reached an agreement to settle the state’s potential legal claim that Gruber submitted false claims to the state under Vermont’s Civil False Claims Act. Donovan said his office concluded that Gruber’s conduct violated the Vermont Civil False Claims Act. Gruber denied a violation, but in order to resolve the case, he agreed to forgo any further payments from the state that he might be owed.

Speaking of Gruber, Obamacares litany of lies are resurfacing, and consumers will pay the price.
Medicare Expansion: What Could Go Wrong? Using Medicaid as an example, plenty. Estimated $72 Million in Medicaid Payments Made to Ineligible Beneficiaries, and that's just Kentucky. I expect it's far from the worst offender.

The unintended consequences of a poorly drafted law. Trump Officials Confront New ObamaCare Reality, Key Obamacare subsidies will continue being paid to insurers despite Trump threats to end them.  The Key Reason Trump Keeps Funding ObamaCare “Ransom”, constitutionality be damned. 

Trump could moot this dispute at any time by refusing to make the CSR payments to the insurers. However, the CBO report predicts a number of unintended consequences if he does. It could save $118 billion in CSR payments over the next decade, but insurers – still stuck with the statutory requirement to lower out-of-pocket costs in Silver plans – would have to raise their premiums by as much as 25 percent, the CBO predicts. Enrollees only pay a set fee for insurance at all levels based on their income, benchmarked on the Silver plan, so taxpayers would end up footing the bill not just for the increased subsidies on these specific Silver plans but all plans. That would increase subsidies by $365 billion in the same time period, resulting in a net increase of deficit spending of nearly $200 billion.

Repealing ObamaCare Is The Key To Restoring Economic Growth That might be an overstatement, but it would help. McCain: 'I Still Believe' Obamacare Can be Replaced; 'I Believe We Must'. Then why did you stop it; just to spit on Trump?  Health Care: Is It Time to Replace the Majority Leader? I have no emotional attachment to Mitch. Could A Democratic Corruption Scandal Help Repeal ObamaCare? If Bob Menendez is tossed out of the Senate for corruption, Gov. Christy gets to name his successor. It could be the final nail in Obamacare's coffin.

Keith Ellison: Pelosi Supports Single-Payer But Doesn’t Want To Say So In Public.

“Is anybody taping me right now? OK, so, you may have heard that Nancy [Pelosi] is not for it, but that’s not really true,” Ellison said. “Nancy has to represent a very diverse caucus. She does not like getting out ahead of the caucus too fast. So she’s trying to get, she’s, you know, you know, she actually likes the concept.”

“She’s trying to get, you know, you know, she actually likes the concept. She says it’s the best way to do it. She says it’s the cheapest way to do it, but she’s got to make sure that she brings our Blue Dog friends along,” Ellison added. “And by the way, for any of us progressives who get mad at the Blue Dogs, if we didn’t have them, some of them would be replaced by Republicans.”

So why should that be a big secret?