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Finally, the Poor Will Have the Freedom to Die

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While officiating Secretary of the Treasury Jay Gould’s third wedding, Vice-President Torquemada found time to tweet a picture of the wedding of a bunch of millionaires (sitting at the distant tables no doubt) and billionaires and use this as the message:

Class war, indeed. Anyway, what’s the kind of personal responsibility the party of mass murder is talking about?

Senate Republicans are expected to revise their health bill early next week, adding in a provision that could lock Americans out of the individual market for six months if they fail to maintain continuous insurance coverage.

Miss a payment, no health care for 6 months! Sounds like freedom to me!

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  • jamesjhare

    It’s not a mandate. Just a penalty for failing to maintain continuous coverage. Totally not a mandate. It’s like if you won’t serve the pudding unless the broccoli is eaten. You totally get to decide whether you eat the broccoli.

    • N__B

      I believe that the evidence shows that it’s not broccoli but rather meat that is necessary. How can you have pudding if you don’t eat your meat?

  • jim, some guy in iowa

    a more dignified event than the kegger trump threw for Ryan and the boys

  • Hogan

    Clearly Pence has been taking messaging advice from Matt Stoller.

  • PhoenixRising

    I…is there a chance that Mitch McConnell accepted the dare ‘write a bill that makes the ACA everything NFIB said it would be?’

    Because, as a small business owner who insures my family on the individual market, this is what I’m hearing:
    -Blue Cross has the option of selling me a product that doesn’t pay for anything expected, and only a share of the unexpected–without EHBs required–that gets more expensive every year even if all that changes is that we get older.
    -Meanwhile, the market for insurance that pays for RX coverage or mental health or a wide enough network to treat the illnesses we know we have already will be destroyed because those coverages are not appealing to younger, healthier folks.
    -If I fail to pay for an insurance card for a month, even though Blue Cross can sell me an insurance card that transfers no value other than the right to get in the door at any doctor, I can be refused an insurance card for 6 months.

    That’s worse than the status quo ante, so it doesn’t even meet the condition of ‘repealing Obamacare’.

    • farin

      and replace — perhaps with some hideous, incompetently drafted trash heap that’ll get a ton of people killed, but replace, nonetheless.

      • efgoldman

        but replace, nonetheless.

        Sure, why not? You can replace your car with a basketball, or your refrigerator with a ball peen hammer.
        Save a shitload of money, you will.

        • Replace your regular meals with tire rims and anthrax…

    • Zagarna_84

      You forgot 1a, i.e. “actually, though, it’s going to keep getting more expensive every year for a separate reason, which is that for generally-healthy people, the penalty for failing to maintain coverage is so low relative to the cost of maintaining coverage that it will create an actuarial death spiral.”

      Literally the most pressing problem with Obamacare as it currently stands is that the penalties for failing to maintain coverage are way too small to actually persuade anyone who wasn’t already going to be persuaded anyway to sign up. This proposal takes that problem and makes it orders of magnitude worse, because once you’re already out of the market, you have no incentive to get back in until you face a dire health crisis.

      • busker type

        this point is under-appreciated.

  • farin

    They didn’t have a mandate before because all their ideas pretty clearly ran afoul of the reconciliation process — this is a regulation, not a spending provision. I imagine the parliamentarian will just shrug and let them get on with it, but I don’t see any good argument for this bit getting through with 50 votes.

    • GeorgeBurnsWasRight

      I’d say their position is that the majority in the Senate define what the rules mean, kind of like the USSC.

      In addition to Ayn Rand, they seem to be using Alice in Wonderland as their inspiration.

      • efgoldman

        they seem to be using Alice in Wonderland as their inspiration.

        Calvinitics.

  • DamnYankees

    Kevin Drum in his post today put it about as plainly as I can put it:

    Republicans have been saying for seven years that they want to repeal Obamacare, so I can hardly pretend to be surprised that they’re doing it after winning the 2016 election. But now that it’s actually happening, I still find it hard to believe. What kind of people do this just so the rich can get a modest tax cut? How cold-blooded do you have to be? Especially when Obamacare’s modest problems could be fixed with nothing more than a few minor changes and additional funding of $5-10 billion or so. Of course, if we did that the millionaires wouldn’t get their tax cut.

    This whole thing is just profoundly depressing. What the hell kind of country is this?

    • GeorgeBurnsWasRight

      One in the grip of a RWNJ tantrum. And they’ve just gotten even more angry after the election.

  • LeeEsq

    I always wonder how many rightists really believe that you can lower healthcare costs by the power of the Free Market (TM). Based on interactions online and how mantras like Pence keep getting repeated, I think that many of them or maybe even most of them really do believe their own kool aid about healthcare at this point. Governor Brownback’s ability to stay the course of tax cuts despite complete disaster is not encouraging.

    • ArchTeryx

      Well, do remember that after Brownback ran his state onto the rocks for enough years, engines full speed ahead, his legislature finally took the wheel away from him and told him to pound sand.

      • LeeEsq

        It still took more than a few years for the Kansas legislature to get sense and balls. I don’t think we will get lucky with Republicans in Congress doing an about face when America implodes on itself. A massive Democratic majority in both Houses and a Democratic Presidency are needed.

        • GeorgeBurnsWasRight

          It wasn’t so much that the KS legislature ‘got sense and balls’ as that the Republican voters finally tired of the ultra-conservatives and elected a bunch with a more moderate position (by means of running moderates who won in their primaries against the RWNJs).

          The moderates didn’t quite gain the ability to override the governor even with the help of the handful of Democrats still in the legislature. But a few of the ultra RW politicians who didn’t get primaried last time decided the threat was real, and finally turned on our lame duck Gov who’s been an asshole even to his allies. (He’s close to composing Vogon poetry lately.)

          So while few of our politicians is learning, what really matters is whether enough of the voters is learning.

          • Zagarna_84

            Oh, freddled gruntbuggly
            Thy micturations are to me
            As plurdled gabbleblodgits
            To a lurgid bee

            “Groop!” I implore thee,
            My foonting turlingdromes,
            And hooptiously drangle me
            with crinkly bindlewurdles
            Or I will rend thee in the gobblewarts
            With my blurglecruncheon, see if I don’t!

    • weirdnoise

      Ah, the free-market fairy. Consort of fat cats and libertarians. It ignores that a market is hardly “free” when there is (1) asymmetry of information and/or (2) unequal penalty for refusing the transaction. With so many fingers in the pie and the fact that published prices are rare as Republican empathy, the medical establishment holds all the cards. And the price of refusing to pay for care? Well, a doctor might have to wait another month or two before paying off the boat, while the patient might be facing a painful death.

      It’s beyond cynical. Any time someone invokes the “free market” in reference to medical care they should be slapped silly.

      • Daglock

        Here’s my hypothetical. In my spare time, I’m going to go doctor and hospital shopping to get the best deal on coronary bypass surgery. I’m sure I have the wherewithal to compare prices in relation to data on success rates, morbidity, mortality, and god-knows what else is relevant. Of course, in my sparsely-populated state, there are soooo many cardiac surgeons to choose from.

  • Hells Littlest Angel

    Miss a payment, no health care for 6 months!

    This was done to appeal to moderate Republicans, who objected to the original penalty of sending a couple of guys over to your house to break your legs.

    • efgoldman

      This was done to appeal to moderate Republicans, who objected to the original penalty of sending a couple of guys over to your house to break your legs.

      Actually, it was done so they wouldn’t have to hire any more gummint employees.
      They have no problem contracting out the leg breaking.
      No-bid contracts, too.

  • GeorgeBurnsWasRight

    I’m so old that I can remember when “conservative” Christians were horrified by one divorce, and it would be highly unusual for one of them to perform a second marriage after a divorce. Almost all the time the couple had to have just a civil ceremony and then they’d not be particularly welcome back at church, unless there were unusual circumstances, such as being a large donor.

    Back then they cited Jesus’ comment on divorce in Matthew 5:32, and insisted on their interpretation since they claim the Bible to be God’s inerrant Word, and God never changes ‘his’ mind.

    Fast-forward a few decades and we have radically super-conservative Christian Pence (can you think of anyone else who says they can’t be in the presence of a woman unless their wife is present?) who is happy to preside at the third marriage of a twice-divorced man.

    But Pence is super-sure that the Bible leaves him no choice but to condemn and whenever possible punish GLBT folk, cause you know, inerrant unchanging Word.

    • Tyro

      As a religious person myself, I would feel very, very uncomfortable about officiating civil marriages if it were not part of my actual job. I have no idea how Pence justifies it to himself in his own mind.

    • Solar System Wolf

      I’ve been learning quite a bit lately about how Christians justify the deaths that will result from abolishment of the ACA to themselves. I’ve heard that:

      1. All those things Jesus said about giving to the poor only meant voluntary charity, not collective action through the government (which is theft);
      2. When he talked about helping others, Jesus only meant other Christians; and
      3. Jesus didn’t really mean it when he said people should give up everything to follow him (it was just a metaphor meant to apply only to the specific person he said it to).

      I used to think that while I didn’t agree with a lot of what Christianity stands for, it did have some redeeming qualities. If all it really means is “I’ve got mine, fuck you” then I don’t see why it deserves any respect at all.

      • Just_Dropping_By

        All those things Jesus said about giving to the poor only meant voluntary charity, not collective action through the government

        You got any Bible verses that say anything to the contrary? Because I’m not aware of any and things like the story of the rich man trying to follow Jesus and verses like, “Each one must give as he has decided in his heart, not reluctantly or under compulsion, for God loves a cheerful giver,” would seem to confirm that Christian charity is voluntary charity.

      • Daglock

        You underestimated the ability of the bible-thumpers to cherry-pick the new testament to support their political philosophy of, as you so aptly put it, “I’ve got mine so fuck you.”

  • NeonTrotsky

    So basically, if you don’t already have insurance you better not buy it because then you might risk getting locked out of the market entirely for six months? Won’t this just increasingly magnify the price of premiums?

    • Zagarna_84

      Yes, as I noted above, actual policy analysts who’ve looked at this thing have pretty uniformly recoiled in horror.

      One can imagine a massive upper-class tax cut that didn’t also demolish the entire concept of health insurance, or I suppose the reverse, but this bill manages both.

      • Derelict

        Over the last 6 months, conservatives have decided that the entire concept of insurance is wrong and anti-American. Thus all the whinging about paying for contraception or pregnancy or diabetes or cancer when you, personally, do not suffer from these conditions.

        I wouldn’t be surprised if we start hearing actual proposals to simply ban all insurance. Tom Price (Trump’s HHS secretary) has stated many times that he believes health insurance should not exist at all, and that people should get only the healthcare that can pay for directly. I can only guess that modern Republicans have decided that America can only be truly free when 99.9% of its people have been liberated from their money.

    • DrDick

      That is what it is intended to do.

    • gyrfalcon

      “If you like your insurance, you can keep it. If you don’t like your insurance, tough shit, you’ll still have to keep it.”

  • Denverite

    I don’t see how the whole “locked out of the individual market for six months” bit is workable. Presumably you give an insurer notice that you don’t currently have insurance but would like to buy a policy at the earliest permissible time (i.e., in six months), and the waiting period starts. But if that’s the case, what’s the stop someone from backing out if they don’t need the insurance in six months? And if THAT’S the case, what’s to stop someone from giving notice to a new insurance company every month or so, so they always have an option coming up in the next month? Yes, it would be a pain, but I bet there would be services that could do it for you. (Maybe in combination with a short term policy that covers emergency costs for the gap period, and then foists you off on a proper insurer at the end of the month.)

    • efgoldman

      I don’t see how the whole “locked out of the individual market for six months” bit is workable.

      I’m going to save you a shitload of pixels you can save to use in the football threads:

      THEY.
      JUST.
      DON’T.
      FUCKING.
      CARE!!

      End of story.

    • busker type

      lol, get some startup money.

      actually… delete this comment so no one can steal your idea, then get some startup money.

  • dcoffin

    In case you haven’t seen it, a link to the Kaiser Foundation’s study of the effect of the Senate bill on the premuiums (not, so far as I can tell, including deductibles & co-pays). You can look at this down to the county level.
    http://www.kff.org/interactive/premiums-and-tax-credits-under-the-affordable-care-act-vs-the-senate-better-care-reconciliation-act-interactive-maps/

    I live in Indiana. A 50-year old with an income of $50,000 per year, would pay $8,950 more in premiums per year.

  • nobody

    Whenever I hear how the GOP Congress has to pass Obamacare to avoid upsetting their “base”, I don’t really understand this. Trumpcare is going to hurt the “base” as much if not more than others.

    Does the “base” really want to lose all those subsidies to buy healthcare or lose access to Medicaid? Much of the “base” are elderly whites living in socialized nursing homes. Are they anxious to be thrown out onto the streets to die?

    I can understand the “base” wanting things like harsh crackdown on immigrants and PoC and such. It hurts others without affecting themselves. But why would the “base” support policies that hurt the “base” such as Trumpcare?

    • mds

      This formulation still works if “base” = “those whose taxes will be noticeably reduced by this and by the subsequent tax-cut bill.” GWB was kidding on the square about the real GOP base. Have you seen the list of all the Republican politicians, including US senators, attending the latest Koch confab this weekend? Guys like Ben Sasse and Jeff Flake were too busy licking plutocrats’ asses clean to, say, hold a townhall about the AHCA back in the states they purport to represent. They know who their base is.

    • Tehanu

      Uh … they think it won’t happen to them? They think Dump actually cares what happens to them, will see how terribly someone is treated, and will step in to fix it? My bet is that Dump will have a photo-op with ONE person and will nudge his billionaire buddies to make a big splashy contribution towards that one person’s costs, and the rest of the “base” will, from their new locations under bridges or in tent cities, applaud and say, “Well, he’ll get around to me next!” before dying of exposure.

    • NeonTrotsky

      Aside from a handful of wealthy donors, it’s worth noting that there really isn’t a constituency for Republican healthcare policy. I think it is significant that Trump ran in opposition to cutting medicaid(a complete lie, like many other things he said, but it resonated with people when all the other candidates were talking about voucher programs or whatever) Some hardliners appear to genuinely believe that the public opposition to this is based on it not being conservative enough and not cutting medicaid enough(While others like Paul and maybe Lee are just true believers), but McConnel is smarter than that and its why they’ve tried to push this through quickly and under the radar. Also, a lot of Republican voters are against Obamacare in the abstract because they blame it for everything that is wrong with the healthcare system(e.g. its expensive), even though many of them receive healthcare either through a government program or at least get subsidies, and they probably just don’t recognize that would go away under this plan. They think it will just take healthcare away from undeserving(read: black) people.

    • SIS1

      You incorrectly assume that the “base” understands how screwed they are going to be. There are people who KNOW ‘Obamacare’ is bad, and assuming they are on the individual market, know that its because of Obamacare that premiums have increased, or they have high deductibles. Now, we understand that the Republican bill will lead to higher deductibles and skimpier plans that will increase their out of pocket expenses, but they don’t, and since they don’t trust the liberal press and the conservative press has been and will continue to lie to them, they don’t believe claims by liberals that the Republicans are about to screw them. After all, why would they?

    • Redwood Rhiadra

      The “base”, in my experience, isn’t getting those subsidies, or Medicaid. The “base”, in fact, is going without insurance and paying the tax penalty because of the sacred principle that “Government Health Care Is Evil”. I’ve heard this from quite a number of Trump voters now. (Never mind that insurance plans on the exchanges are in fact offered by private companies and not the government – they deny this.)

      So ultimately, they do not believe that Trumpcare will hurt them. And it *will* hurt all the “blacks and Mexicans” getting “free” health care from *their* taxes.

  • Michael Masinter

    David Super has an excellent post up at Balkinization; its gist is that the draft Senate bill is just a starting point for what McConnell will pass, with provisions that can be softened so that so called Republican moderates can claim that they made the bill better before voting to pass it even though as amended it will still be an unmitigated disaster: https://balkin.blogspot.com/2017/06/this-is-not-health-care-bill-you-were.html

    • Zagarna_84

      I’ve pointed this out elsewhere, but I’ll do it again here: there’s some serious irony/hypocrisy in the fact that the same party that has been demanding “rulemaking reform”* so as to slow the enactment of new rules by agencies to a halt, is the same party that is trying to reorganize 1/6 of the American economy with next to no notice and no opportunity for public comment.

      I know, I know, irony is dead, etc etc, but it galls me all the same.

      *See, e.g., the abysmal “Regulatory Accountability Act,” which has somehow actually managed to acquire a nontrivial amount of support from right-wing Conservadems to give it a patina of bipartisan respectability.

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