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Paul Ryan’s honesty problem: How he just exposed GOP’s true Obamacare intentions

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Paul Ryan’s honesty problem: How he just exposed GOP’s true Obamacare intentions

Golden boy inadvertently admits GOP doesn't agree insurers should be prohibited from discriminating against the ill






Democrats are jumping all over Paul Ryan for telling Bloomberg TV that if Republicans repeal the Affordable Care Act, they won’t reimplement Obamacare’s popular requirement that children can stay on their parents’ health insurance plans until they’re 26.



I don’t have a full transcript, but the quote in this Washington Post story actually reveals a great deal more about Republicans’ post-Obamacare health policy than their possible opposition to insuring young adults.



“If you look at these kinds of reforms, where they’ve been tried before — say the state of Kentucky, for example — you basically make it impossible to underwrite insurance. You dramatically crank up the cost. And you make it hard for people to get affordable health care.”



People who follow health care reform closely will correctly note that there’s nothing new here. But for those who don’t, Ryan’s focus on underwriting, not an allusion to so-called “young invincibles” is the key tell. Because underwriting is the main mechanism insurers used to practice price and coverage discrimination against people with pre-existing conditions.



Before the ACA, most states didn’t guarantee coverage to the ill, or prohibit price discrimination against them. Ryan’s correct that guaranteeing coverage and prohibiting price discrimination is a recipe for much higher premiums, but only because he omits the individual mandate, which ensures that state risk pools will be actuarially balanced. Leave out the mandate, and the insurance industry will likely end up existing to sell very costly health plans to sick people.



But Obamacare doesn’t leave out the mandate. And thus, the law can guarantee insurance to everyone without requiring anyone to disclose private details of their health histories to their insurance company, and hold premiums down simultaneously. Anyone who’s signed up for pre-ACA insurance and for ACA-compliant insurance can attest to the fact that the elimination of intrusive underwriting forms is a great advancement. All you have to disclose now is your age and tobacco usage.



But Paul Ryan wants to bring back underwriting. Because Republicans really don’t believe that insurers should be prohibited from discriminating against the ill. He and other Republicans will vaguely claim to support setting up state-based high-risk pools for people with pre-existing conditions. Coverage ghettos of a sort for the ill. That would be better than nothing if they were genuinely committed to financing them. But financing them would cost hundreds of billions of dollars a decade, and the one time House Republican leaders tried to come up with a tiny fraction of that cost for Obamacare’s transitional high-risk pool program, conservatives rebelled and the legislation failed.



I get why Democrats are focused on free insurance for children under 26. It’s very popular. Opposing it is politically very damaging. And “underwriting” is kind of complicated. But the former was just a flub, while the latter actually tells the entire story.

Edited by dinar_stud
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Ha! that story ignores the reality that nearly 6 million people already have lost their healthcare coverage because of Obamacare and that most all that have signed up are merely Medicaid recipients simply rolled over into the plan.


Never mind that the law has been altered in excess of 30 times in violation of its statutory requirement as law of the land. I guess that's what happens when you pass the law without reading the law.


Also lets not forget the last exemption being the employer mandate now pushed  off to the 2016 election cycle. This mandate [ and I know this first hand] is believed to cause in the future the cancellation of coverage for 90- 110 million Americans. Why wouldn't they have altered such a mandate to avoid this tragedy permanently? Instead of realizing the error of their ways and the undue injustice of costing these families more for health insurance, no instead they simply put off the inconvenient truth for political gain now only to be discovered down the road.


Lets not also forget the unconstitutional idea of calling insurance premiums a tax. When in the past did Americans ever pay a federal tax to private companies?


Sorry the ACA is ill conceived and anyone under that age of 26 who needed medical attention in the past was always able to get coverage if they wanted or needed it.


Edited by wciappetta
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Stating as a first point that individuals with a catastrophic illness need help with the financial costs and there needs to be a mechanism for coverage assistance is an agreed given.

Secondly, Insurance is by definition 'the payment of a premium in consideration of the possibility of a future event for which financial assistance is to be provided as agreed in a contract.'

  A pre-existing condition or situation is not a "possible unknown future event", as it already exists and is therefore not a matter for insurance.

If your home is on fire, you cannot buy fire insurance for something already in progress. (at least without fraud)

If you have had an automobile accident, you cannot buy liability nor physical damage coverage retroactively. (at least without fraud).

If you are already known to have a 'catastrophic illness' you could not purchase for that illness. (at least without fraud) - UNTIL NOW - but that is NOT insurance.

A purpose of the ACA / 'Obamacare' Act was to force an un-Insurable event onto the health insurance companies and over time drive them out of business thru the mandatory coverage expenses which historically are not insurable.  Basically, the health insurance companies were to 'assume the debts' for which they had received no prior premiums.

   A federal law for mandatory coverage (without a choice of anykind) could then, of planned necessity, be implemented as a 'single payor' of health benefits by the government since the health insurance companies would be virtually non existent.

The government would then be the payor of ALL medical and be the decision maker of qualifications (age, sociatal benefit, outcome prognosis) for treatment (if any)and compensation for doctors, hospitals,clinics, medications, every aspect of medicine. In the long run, even the pharmaceutical companies would be controled thu 'pricing controls'. (maybe not such a bad idea)

  We agree that a long term or life threatening catastrophic illness most likely requires financial assistance since medical treatment is not free. (someone-somewhere pays or the treatment is no longer available)

 It would seem that a single line entry on "Tax returns" of a nominal annual 'catastrophic health coverage' charge on a per person and employee basis, could greatly mitigate these costs, while lowering regular health insurance premiums, and without the destruction of the entire health care system.

Socialism and socialized medicine is NOT the answer. Individuals do matter.

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