So what will fix the ACA according to our congresspeople?

[TCJ70]

I've seen a few people (and one very outspoken person) since the Medicare-For-All bill came out go on about how we should be focused on fixing the ACA. Got me thinking, "What fixes are we supposed to be pushing for?"

I haven't seen any specifics put out about what those fixes look like. I've seen plenty of our congresspeople say we need bipartisan efforts. That doesn't seem like a winning proposition at the moment. Regardless. What are the specific fixes that have been proposed? I haven't been able to find them.

[PoliticAverse]

1. The #1 error that was made was not providing a funding source for the "risk corridors". n/t

[TCJ70]

6. Are Dems in congress talking about that? I agree...

...but where is the messaging on it?

[PoliticAverse]

10. They've been talking about it the last several years and Republicans have prevented

it from happening.

[Igel]

19. On purpose.

When all the budgetary aspects were discussed about how it would save money when compared to a projection and when funding was required to make it "revenue neutral" in the short term everything possible was done to make sure it fit in the box.

Savings from the way student loans were funded were included as "revenue" for the ACA.

Similarly, expenses were reduced by simply not including all the expenses.

It was necessary to maintain that one-vote majority and the unanimity of the (D) and pro-(D) senators. The choice was to play kick the can or can the bill.

[Yupster]

22. It would never have passed if there was funding for an

insurance company bailout every year forever. Remember, this was a Democratic Party bill. The Democratic Party senators was not going to support a government bailout for insurance companies if they didn't make enough profit from year to year.

[genxlib]

2. Public Option

To provide competition and a backstop for underserved areas

[TCJ70]

7. Something that definitely should have been in the bill originally. N/t

[Voltaire2]

11. Is insufficient. Without all the states participating

in Medicaid expansion the ACA has too many people in the gap.

But the public option is as unreachable as MFA. If we are going to propose substantive reform I prefer a comprehensive universal all-in system over a patched up hodge-podge over complicated approach.

[emulatorloo]

12. Yes Medicaid expansion needs to be manadatory. No states get to "opt out"

As I remember it was originally mandatory but Changed to optional because Republican reasons

[PoliticAverse]

25. It was changed to "optional" by a 7-2 Supreme Court decision because the ACA threatened...

states with the loss of all their Medicaid funding if they didn't go along with the expansion.

[bornskeptic]

33. It was a 5-4 decision.

http://medicaidexpansion.com/medicaid-expansion-and-the-supreme-court/

[PoliticAverse]

37. The vote to uphold the majority of the ACA was 5-4, the vote to overturn the Medicaid part was 7-2

(7) Roberts, Breyer, Kagan, Scalia, Kennedy, Thomas, and Alito voted states could decline to expand Medicaid without losing funding.
(2) Ginsburg and Justice Sotomayor upheld the ACA's provision to cut off all Medicaid funding to states that didn't expand.

https://en.wikipedia.org/wiki/National_Federation_of_Independent_Business_v._Sebelius

On the question of the expansion of Medicaid, no single opinion commanded the support of a majority of the Justices. However, a majority of the Court did find the expansion in some way unconstitutionally coercive and severed the coercive mechanism from the act.

Chief Justice Roberts, joined by Justices Breyer and Kagan, would have ruled that the Medicaid expansion could survive, but that states must be given the right to opt out of the expansion without losing their pre-existing Medicaid funding.
Justice Ginsburg, joined by Justice Sotomayor, would have upheld the Medicaid expansion in its entirety (with non-participating states losing all their federal Medicaid funding).
Justices Scalia, Kennedy, Thomas, and Alito would have struck down the Medicaid expansion completely (along with the entire Act).

Complete text of the decision (.pdf):
https://www.supremecourt.gov/opinions/11pdf/11-393c3a2.pdf

[genxlib]

15. Agreed on the Medicaid expansion

I did not intend to imply it was the only fix. Just the most apparent.

So I would agree it is insufficient and I would also agree that the Medicaid expansion needs to be system wide as intended.

However, I disagree that the public option is as unreachable as MFA.

The MFA is a massive transition that would require huge changes to the system and funding structure. More importantly, it would be imposing something on a lot of people that don't want it and are satisfied with what they have.

The Public Option would be a much smaller change and would only be available to those that voluntarily choose it as their personal option. And the funding would be the same as currently exists to pay for ACA policies.

It would not be easy but should be a great deal easier than MFA

[Demsrule86]

3. I would have no idea what Congress thinks...since

we hear nothing except single payer talk. How about this stabilize the markets to start with? The ACA as it is now is worth saving. It is all we have and millions depend on it.

When the single payer bill was introduced. it demonstrated that both parties want to replace the ACA. It just wasn't good enough, and to do this in a the middle of an epic battle to save the ACA was a huge political miscalculation. If we lose the ACA, the single payer bill will be an important reason why this happened.

[TCJ70]

4. In your opinion. It's funny how you completely ignore the last 8 years...

...of Republicans voting consistently to repeal the ACA and now you're going to pin a majority of it on the MFA bill. It's fine for you to hold that opinion...it's just a ridiculous one. Republicans are going to work towards repealing the ACA and they may succeed. Saying that is just stating reality and if they get 50 votes there isn't anything we can do about it. It certainly won't be the MFA bills fault.

Why do we hear nothing but single payer talk? Are the Dems not talking about their solutions? Can one guy really take time from all the other congresspeople out there?

[Voltaire2]

8. It isn't one guy. I guess all 17 sponsors are traitors

Obviously the intent is to blame Sanders for too many republicans voting to repeal the ACA.

[TCJ70]

9. Oh don't get me wrong. I know EXACTLY what certain posters problem really is...

...with the MFA bill. It's just stupid.

[emulatorloo]

13. You seen any posts calling Sanders, Harris, Booker, etc "Traitors"?

I know hyperbole is fun but I don't think this instance is very helpful. Of course ymmv

[Demsrule86]

20. He will be blamed and so will the Democratic co-sponsors...it is inevitable and a damn shame.

We had a chance here to use the ACA to advance universal coverage with a public option...well I won't go down without a fight...I suggest you call you call Congress...we all need to. Let's try to turn this around.

[Demsrule86]

14. Putting out a Democratic replacement bill certainly does not help the effort to save the ACA...I

have heard that talking point from more than a few folks here. I will say this, if we lose healthcare...the shit will hit the fan, and I doubt the, 'it would have happened anyway', explanation will suffice. How many will ignore the fight to save the ACA instead of calling Congress because they erroneously think single payer is around the corner? We need all hands on deck, and this undermines our effort to save the ACA. This is a terrible situation...and a political miscalculation.

[Voltaire2]

23. Which republican votes will change because of this and why?

[ehrnst]

27. And your opinon that M4A is the only path forward

is more valid?

[TCJ70]

28. I've never said that. N/t

[ehrnst]

39. We need to remember the lessons of Obama saying, "You can keep your doctor."

That is why presenting a M4A plan where the costs have been shown by experts to be mistakenly low, will give those that want to tank any talk of UHC a lot of ammunition.

[TCJ70]

40. I don't know what that has to do with my post...

...but we're in agreement about being honest about the costs. I anticipate I would pay more under a MFA/single-payer system.

[PoliticAverse]

5. No it won't. The reason it will have happened is Trump is President and Republicans control Congress

No one was talking about "the single payer bill" 2 months ago and Republicans came within 1 vote.

[Demsrule86]

17. you can say that...but the single payer bill hurts the attempt to save the ACA.

It is essentially a replacement bill. Millions could lose coverage. I believe there will be hell to pay if we lose healthcare. And it won't all be directed at the GOP. This gives them cover.

[Autumn]

21. What attempt is being made to save the ACA? Do you have a link to the bill, the plan or whatever

it is that is being done to save the ACA that talk about Bernie Sanders Medicare for All is destroying?

[ehrnst]

29. Well, if you are promoting M4A as the only way to UHC

then the ACA is pretty much not an option, right?

[Autumn]

30. It's adorable how you got all that nonsense from my 2 sentence post.

see my post #
21. What attempt is being made to save the ACA? Do you have a link to the bill, the plan or whatever
it is that is being done to save the ACA that talk about Bernie Sanders Medicare for All is destroying?

[ehrnst]

31. I'm 'adorable' enough to use the google:

Granted, no one is talking about Bernie, here. But why should they?

http://www.politico.com/story/2017/03/house-pelosi-obamacare-235792

https://www.theatlantic.com/politics/archive/2016/12/how-democrats-plan-to-fight-against-obamacare-repeal/510056/

https://www.democraticleader.gov/newsroom/372017/

https://www.washingtonpost.com/news/powerpost/wp/2017/07/18/here-are-the-three-easy-things-that-chuck-schumer-thinks-can-shore-up-obamacare/?utm_term=.022a19f2b53e

Got some 'adorable' rebuttals?

Again, if one is campaigning for M4A, how is that shoring up the ACA? And how is "M4A is the only way to UHC!!!!!!!" in any way, shape or form saying to preserve the ACA, which is as far down the road to UHC as we've ever been.

If it matters more whose name is on it, than what the solution is, then how is that supporting the solution?

But since you asked:

“Right now I’m protecting the Affordable Care Act,” Pelosi said. “None of these things, whether it’s Bernie’s or others, can really prevail unless we protect the Affordable Care Act.”

https://www.washingtonpost.com/powerpost/pelosi-single-payer-isnt-a-litmus-test-for-democrats/2017/09/12/51a50046-97c9-11e7-87fc-c3f7ee4035c9_story.html?utm_term=.61a1690ee3c5

[Autumn]

32. Exactly so!! Thank you so much for the links answering my question.

Our leaders can co sponsor Bernie's Medicare for All bill and protect the ACA at the same time as your links clearly show. They have been protecting it since day one while the Republicans have attempted time and time again to repeal it. There is deep concern with a few people here that the American people talking about Bernie's Medicare for All bill will distract our leaders from protecting the ACA. I that I have faith in them protecting it because they are more than capable of talking and chewing gum at the same time.

[ehrnst]

34. Maybe you missed this

“Right now I’m protecting the Affordable Care Act,” Pelosi said. “None of these things, whether it’s Bernie’s or others, can really prevail unless we protect the Affordable Care Act.”

[Autumn]

36. No, I saw that. I think all of our elected leaders are protecting the ACA. Even the co signers.

And Nancy hasn't been distracted at all from protecting the ACA and she's all over the place protecting DACA. IMO it's demeaning to attempt to convince people that our leaders can't focus on more than one issue, especially important issues like the ACA, DACA and Bernie's Medicare for all.

[ehrnst]

38. I'm not saying that they can't do both.

I'm thinking that people, as evidenced here on DU, can't tolerate them supporting anything but M4A, because they are either confusing it with UHC, or they consider anyone who doesn't support M4A as "corporate shills"

See the demonizing of Pelosi here on DU for her not saying it would be a litmus test, or supporting it.

Similarly, I hear people erroneously saying that Democrats aren't doing squat to shore up the ACA, as some sort of evidence that the only people concerned about UHC are the ones signing onto Sanders' bill.

Perhaps that faulty perspective comes is more indicative of the point of view that reps can't do two things at once.

[Autumn]

41. I haven't read your posts but it is being said. I'm of the opinion that some people

are just looking for a scapegoat should the worst happen. I have seen no one say that they support nothing but Bernie's Medicare for All plan. I don't get into those threads i don't know enough about Pelosi's actions and votes to weigh in on her, the people I know and read from CA here seem to like her, occasionally some troll ot zombie sign up and posts crap like that but they get the boot. There's one that I saw doing that and all that remains is it's unanswered question in ATA. Intelligent people don't take those trolls serious.

The party has ben defending the AC since Obama signed it into law. During that time many bills, laws issue have been discussed but all of a sudden Bernie puts up a bill for healtcare it gains interest and ... hair in fire! Distraction!!

You know as well as I do that talking about Bernie's Medicare for all does not in any way shape or form distract us or our Reps and Senators from protecting and improving the ACA yet in any thread it's posted a dozen times that he is distracting us, he's destroying the party, health care so on and so forth. That's not a faulty perspective, we both know what that is.

[ehrnst]

42. I didn't say it distracted them. I said the opposite. You seem to keep misreading that.

I said it distracted the public from what needs to be done to support the ACA.

Your own posts were in there complaining that you hadn't seen Dems fight for the ACA, or offer fixes to it other than fight the repeal, so that's a good illustration. And yes there is derision about a "public option" as being centrist compared to M4A.

That kind of "it's going to be so much better, I promise" can potentially come back to bite us in the ass.


When Obama said, "you can keep your doctor" I smacked my forehead. I knew that people were not going to be guaranteed that - because anyone on employer provided health care NEVER has the guarantee that the employer will always offer a policy that their doctor is in network with. And that one phrase became ammunition for the GOP to use that Obama was lying to them about the ACA.

One of the lessons learned from the '93 health care reform was that the message, "cover the uninsured" did not address the concerns of worried people who had insurance that they could afford and liked. Obama simply tried to instill hope and confidence that what was coming was better than what they had now, and wouldn't harm their access. But that cost him, and by extension the ACA, vital support.

Remembering that, imagine what the GOP will do with a plan that the CBO says that the taxes needed to make this work will cost way than Sanders' plan says. And yes, the GOP will suddenly bestow upon the CBO all sorts of credibility when that happens, as we have seen them do before.

They will have ammunition to say that the Democrats don't have a real plan to address the current problems with Health Care coverage either, and we want to take the whole country down the path of Green Mountain care, which failed in part because of the tax increases that were required to sustain it.

And yes... Green Mountain Care was a state, not a federal program, but the association with Sanders, and the idea that single payer in VT wound up costing way more than was told to voters will be used by the GOP. Mistakes in cost analysis cost Vermont residents their single payer, and Sanders' refusal to discuss any lessons learned from it don't bode well for his plan.

[Autumn]

43. I never said you said that. However I'm done with talking about this subject. It repeats itself. nt

[Autumn]

16. A Democratic majority in 2018 and having the White House in 2020.

Of course that will do nothing to save the ACA, the Republicans will have killed it by then, they came within one vote the last time and they say they have the vote this time.
The only fix I have seen mentioned is Bernie needs to shut up, he's single-handedly destroying the the ACA.

[Demsrule86]

18. We don't know how many votes there were actually...McCain stepped up and made it unnecessary for

others to stick their necks out...do you really believe...if millions lose healthcare ...people will say 'ah the Dem single payer replacement bill did not help the GOP to repeal the ACA of course not...why it would have happened anyway'. Read this site, and you can see it is already starting. You bet I think the single payer bill played a role if this happens...we stopped them the other times...didn't we? But what is different now? Also, there is mounting evidence that the GOP will use single payer to attack Democrats in the coming elections...why would you put something out that can't happen for years and give the GOP an opening to attack? This is and was a bad idea.

[Voltaire2]

24. So McCain is going to change his vote because Sanders and 16 other Democrats introduce MFA?

Do you have any evidence to back that up?

[ehrnst]

35. But here are ten that you are apparently not aware of:

It helps to look for these things before insisting that they don't exist:

http://thehill.com/policy/healthcare/341616-ten-house-democrats-propose-plan-to-fix-obamacare

The Solutions over Politics plan would:

Create an annual $15 billion reinsurance fund. ObamaCare had a reinsurance program for three years from 2014 to 2016 to provide payments to insurers that enroll higher-cost, sicker individuals.

Continue ObamaCare's insurer payments, which reimburse them for giving discounts to low-income patients. Insurers have blamed the uncertainty over whether these payments will continue as a reason for their proposed double digit rate increases in 2018.

Have "robust marketing strategies" to ensure that more people enroll during open enrollment periods.

Allow a buy-in option for Medicare for people nearing retirement age.

Expand tax credits by age, geography and income to help people buy insurance. Currently, about 84 percent of ObamaCare participants get a subsidy.

Expand the availability of catastrophic health plans that include essential health benefits and coverage for primary care for younger enrollees. These plans, meant to protect people from worst-scenarios, tend to have low monthly premiums and high deductibles.

[ehrnst]

26. Well "repeal and replace" tanked, didn't it?

So there is indeed support for some aspects of the ACA on the part of the GOP.

Which is more than there is for Single Payer.

[Orsino]

44. I'm sure a bill will be along any week now. n/t