The Affordable Care Act – It's complicated

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This topic contains 42 replies, has 9 voices, and was last updated by Profile photo of tmerritt15 tmerritt15 2 days, 11 hours ago.

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  • #1339
    Profile photo of mary guercio
    mary guercio
    Moderator

    Thought I’d start a thread on the ACA – the proposed repeal, consequences of that, and what might replace it – if anything.

    Here’s a look at what may transpire with repeal and delay of the ACA.

    http://www.latimes.com/nation/la-na-trump-obamacare-repeal-20161212-story.html

    What will happen to pre-existing coverage eligibility?

    http://www.forbes.com/sites/theapothecary/2016/12/09/tom-prices-empowering-patients-bill-does-impose-guaranteed-issue-but-dont-jump-for-joy/#6b2111271bd1

  • #1346
    Profile photo of Creigh Gordon
    Creigh Gordon
    Moderator

    From what I’ve read, Republicans have caught the car on this one. If they get rid of the mandate (which lots of people hate) but keep the pre-existing conditions clauses, they’ll have to greatly increase subsidies or insurance companies will just pull out of the individual market. And they are not going to increase subsidies…

    • #1348
      Profile photo of mary guercio
      mary guercio
      Moderator

      That’s what I’ve been reading as well. I’ve been following the Forbes Apothecary blog which focuses on health care. There are some smart folks commenting…and after reading 3 separate posts by 3 authors, there have maybe been 4 commentators who’ve been in favor of scrapping the ACA. The overwhelming majority have pointed out with precision, what the problems are with the proposed repeal/delay/replacement being considered by the GOP. If this is a subject that interests you, you may wish to follow this blog (coordinated by Republican Avik Roy, who Chris Ladd has cited in a prior post.)

      I am also interested as many who are on the cusp of being age-eligible for Medicare should be, at the tangential focus on Medicare reform. This has been a pet peeve of Paul Ryan for years, and he finally has the bully pulpit and numbers to charge ahead. Problem is, his plan essentially privatizes Medicare in ways that are certain to drive up individual costs and reduce benefits in order to absorb the administrative overhead inherent in the privatization effort. Here’s a really good article that offers a historical look at Paul Ryan and his interest in privatization of health care – across all services.

      “Experts argued that the plan would put more cost on individuals than they would incur under traditional Medicare and that administrative costs associated with the plans actually eradicated any savings to the government.

      “The Congressional Budget Office estimates that under the Ryan plan the cost-increasing effects would swamp the cost-reducing effects, so much so that by 2030 the overall cost of care for the Medicare population would be at least 41 percent higher than it would be under Medicare and the amount that enrollees would have to pay directly would more than double,” Henry Aaron – a Brookings Institution fellow who co-wrote his own premium support plan in the 1990s– wrote in a paper on premium support.”

      Lots of valuable information in this article for all of us. Supposedly, the changes wouldn’t kick in until 2022 but there is a paucity of detail as to how existing Medicare recipients would be protected….IOW, would benefits be reduced or changed? Deductibles and premiums skyrocket? It’s alarming and it’s real.

      http://talkingpointsmemo.com/dc/your-road-map-to-paul-ryan-s-plan-to-privatize-medicare

  • #1390
    Profile photo of WX Wall
    WX Wall
    Participant

    My best bet is they’re simply going to rename Obamacare Trumpcare and move on. the ACA is a Republican plan. Their biggest problem with it is that Obama and the Dems got credit for it. Nothing in the plan goes against their conservative ideals (except maybe the medicaid expansion).

    Even an idiot like Ryan probably understands that what makes ACA plans expensive is precisely the ban on pre-existing condition exclusions (although I’m probably overestimating the so-called Republican brain trust). So the best thing to do is repeal Obamacare while implementing something surprisingly close to it, maybe with a few small changes (the federal exchanges get privatized in a contract to IBM, and the medicaid money gets block-granted). Call it Trumpcare, sign the legislation, and do a victory lap on the sunday morning talkshows.

    Heck, it would even provide an easy transition plan: thanks to the Republicans, everyone on an Obamacare plan right now can easily “transition” into a Trumpcare plan without loss of coverage (since, well, it’s the same policy :-). Sort of like Obama’s “if you like your insurance you can keep your insurance”…

  • #1438
    Profile photo of mary guercio
    mary guercio
    Moderator

    Here’s a recent article on how the options for the GOP regarding health care repeal. It is more complicated than most perceive. Medicaid will be hit hard and even though current and near to retirment seniors will be “grandfathered” into traditional Medicare, it’s not clear what changes will be introduced to premiums and benefits of this coverage as well. Here’s a great quote from a comment made on a Boston Globe article on the same topic: (sorry no name)

    “Republicans believe healthcare is a “profit industry.” Democrats believe it is a “right”. Depending on which side of that argument you come down it colors your opinions. If it is “for profit”, then it is not “universal.” If it is a “right” then it is not “for profit.” It really is that simple.”

    And, that’s about all that is “simple”. If this is a topic that impacts or interests you, the NYT piece advises vigilance.

  • #1444
    Profile photo of mary guercio
    mary guercio
    Moderator

    One of the despicable (and illegal) maneuvers made to shield members of Congress and federal staff from the costs and limitations of the ACA was a sweetheart deal cut between the White House (Obama et al) and Congress/staff that allows them taxpayer subsidized health coverage (75% subsidy) and their income is not counted. When people criticize Washington for holding themselves to a different standard than what they impose on the rest of America, this is a prime example. Yet, you don’t hear any mention of this from anyone “up there”. Why not?

    m/blogs/congress-blog/healthcare/242140-just-wrong-congress-quietly-takes-obamacare-waiver

  • #1473
    Profile photo of mary guercio
    mary guercio
    Moderator

    There are currently 3 plans being floated to replace the ACA. Here is a link to a Forbes description of each. (follow links in first paragraph to view plans 1,2.) Note that in all of them, health care is essentially totally privatized by virtue of either government subsidy(all plans other than Medicare/Medicaid) or capped vouchers(Medicare) and block grants (Medicaid). Since old people (the ones who VOTE) usually have the most costly care, the plans all include an option for catastrophic coverage in lieu or addition to their capped Medicare voucher. What is not specified is what happens to said senior who either: cannot afford catastrophic coverage, or whose expenses exceed the limits of catastrophic coverage….details are notoriously absent.

    It is important to know what is being considered.

    http://www.forbes.com/sites/theapothecary/2016/12/30/how-aeis-improving-health-and-health-care-plan-would-repeal-and-replace-obamacare/?utm_source=followingweekly&utm_medium=email&utm_campaign=20170102#4142296f3be6

  • #1515
    Profile photo of mary guercio
    mary guercio
    Moderator

    Republicans think there are more Americans who want to repeal ACA than Dems do. Who’s right?

    https://www.theatlantic.com/politics/archive/2017/01/blue-collar-whites-obamacare/512159/?utm_source=nl-atlantic-daily-010517

  • #1528
    Profile photo of mary guercio
    mary guercio
    Moderator

    Medicare Advantage was launched by Republicans in 2004 as an alternative to traditional Medicare. It was subsidized for years for its benefits by taking money from the traditional Medicare receipts. Obama stopped some of that but the problems with accountability have continued through over-billing by over-categorization of illness…to the tune of $128 million. The CMS audited these providers, brought claims but failed to follow through, collecting less than $4 Million in what was owed. That is wrong. The problem persists, and it is draining not only revenue from the Medicare budget but also from the tax payers. Senator Grassley has led the fight on this and needs to be commended and encouraged to go after this money and correct the practice.

    Medicare Failed To Recover Up To $125 Million In Overpayments, Records Show

    BTW, if you are interested in health care issues, you will be well informed by following Kaiser. You can sign up to receive articles at the top of the article.

  • #1529
    Profile photo of mary guercio
    mary guercio
    Moderator
  • #1537
    Profile photo of tmerritt15
    tmerritt15
    Participant

    Note that the AARP has begun their campaign against the proposed changes in Medicare. The AARP campaign also includes the Affordable Care Act. The January AARP Bulletin has a multi-page article covering the law as it stands, and the proposed changes to both Medicare and the ACA. It is worth a read @

    http://www.aarp.org/politics-society/advocacy/info-2016/why-medicare-matters-special-report.html.

    There will be a lot of resistance to the repeal of the ACA and significant modification to Medicare. I believe that the Republicans will find that there will be a great deal of backlash, if they do repeal the ACA.

    • #1541
      Profile photo of mary guercio
      mary guercio
      Moderator

      TMerritt,
      I think ACA repeal is a fait acomppli. Replacement is another thing. There are seven plans floating around the GOP and Ryan insists one will be implemented in ’17. We’ll see. Repubs have invested too much to back off repeal and are counting on a couple of things to ease public outcry. First, they really believe (and could be right) that more people want repeal than not (of course most people haven’t a clue what they’re repealing); and, two, they have total confidence in their ability to spin this as a way to “save” medicare/medicaid because the ACA is “destroying” health care.
      watch.

  • #1577
    Profile photo of tmerritt15
    tmerritt15
    Participant

    Chris’ Federalism posting was sufficiently interesting that I felt compelled to make a posting on the subject since Washington State’s experience in this regard may contribute to the discussion. I have posted some links to articles that I have posted in MyDropbox so interested people will not be pay walled.

    In 1993, Washington State attempted to implement a comprehensive health care reform that in many ways was similar to the ACA. In provided for mandatory coverage and pre-existing condition coverage. The Republicans swept the 1994 state elections along with the federal elections. The major reason in both cases was health care reform issues. Of particular importance was the individual mandate and increased taxation for subsidies. Following the 1994 state elections, the Republicans proceeded to dismantle the state health care measure, but retained the popular provisions. The result was a complete collapse of the state private coverage health insurance market. A complete collapse of the market is being predicted if the ACA is repealed. The Seattle Times published an article today covering the history. I converted that to a MS Word docx file and it is at the below link:

    https://www.dropbox.com/s/d9m9rkcpvsi7sof/20170112%20Seattle%20Times%2C%20Health%20Care%20Reform.docx?dl=0

    Following the Washington debacle, I came to the conclusion the implementation of comprehensive health care reform at the state level is virtually impossible. The ACA was based on the Massachusetts system. Massachusetts seems to be making the system work so far. Massachusetts and Washington have similar populations. Hawaii also has an essentially comprehensive health care system. Other that Massachusetts and Hawaii, I do not believe any state has a comprehensive health care system.

    The only possible means developed so far of providing near universal health care are either heavily regulated private insurance are a version of single payer. Obama considered the health care issue in the “Audacity of Hope” and concluded that single payer was not possible in the US. That is the reason he opted for the high regulation approach with exchanges, etc. Even the Public Option proved to be politically impossible. The high regulation approach is not acceptable to the Republicans because of the resultant higher taxation on the wealthy and the attendant mandates.

    Many physicians and others have come to that conclusion as well. Jim McDermott, the recently retired Congressional Representative from Washington’s 7th Congressional District favored the single payer system. Prior to becoming a politician, he was a psychiatrist and of course has a M.D. degree. My basic opinion is that a highly regulated private system will work, but a single payer system is preferable. Nevertheless, a significant public subsidy is required to provide near universal coverage. That necessitates taxation.

    In general, all industrialized nations have implemented a version of single payer or a heavily regulated private health insurance system. Universally, other industrialized nations provide significant public subsidies. These systems provide for near universal health care and have resulted in significantly better public health statistics. But they do have some frustrations associated with them.

    The US on the other hand has used an employment based system that depended on heavy public subsidies in the form of taxation exemption for the corporations. That worked reasonably well in the post-World War II years, when the US Corporations were mainly focused on a domestic market, had little international competition, and employment was near universal. Beginning in 1965, the federal government provided health care for the many of the significant parts of the population that were not included in the employment based system, through Medicare, Medicaid and other programs. Even that approach resulted in a very large uninsured rate, poor public health statistics and extraordinarily high economic costs. Now with increasing competition and large portions of the population no longer fitting into the employment based system due to globalization and automation, that approach is not functioning and is leading to ever higher costs, uninsured rates and ever poorer public health. Even the corporations would like to shed the insurance costs, since international competition would be easier.

    As an aside, I might mention that the mature adult population of ages ranging from 50 to 65 seems to be a crucial subset of the population. Many begin developing significant health issues and due to age, health or other issues may not be easily employable. Thus, they no longer fit into the employment based health insurance system and there is not at this time a system in the US to provide health care at reasonable costs, so health issues are neglected. By the time they reach 65 and are eligible for Medicare or they are able to get coverage such as through ACA, their health condition has worsened considerably and the costs are considerably higher. That is part of what has happened with the ACA.

    To go back to the subject of Chris Federalization Blog, California has a large enough economy and population that implementation of a single payer system may be possible. Nevertheless, as FairEconomist pointed out in the comments following Chris Federalization blog the problem is likely to be increased taxation particularly on the high income people. Also trying to implement a single payer system within the federal system will also create major difficulties. What California decides to do will bear close observation. One thing is sure and that is California will contest the dismantling of the ACA and will look at other options. If California is successful, Washington and Oregon will likely follow.

    As Horsey states in his blog of 20161207, maybe California might “save the country.” A link to that blog is:
    https://www.dropbox.com/s/5xkk0m038bo3dxn/20161207blog_California%20has%20good%20reasons%20to%20secede%2C%20but%20a%20noble%20reason%20to%20stay.pdf?dl=0

    Horsey also makes a reference to the Ecotopia series of books by Ernest Callenbach, which I have just reread. One is now out of print, but I found a used copy, very reasonably priced. I found them very interesting in light of the recent election, with some very likely parallels.

    To me the major question seems to be what amount of health care is a basic human right and what health care procedures should only be accessible to the privileged? The Republicans seemingly wish to severely limit the health care available to the non-privileged and to let the marketplace make that determination. Public subsidies are to be very limited, but that in itself is not even possible with the existing employment based system. Democrats want to make health care as near universal as possible, but universal health care continually becomes more expensive with the increasing medical technology. The marketplace approach becomes very much a Darwinian approach, which is not compatible with our ethos as a society. If it was possible to have a rational debate regarding these issues, we might reach a reasonable consensus, but in our polarized society that is not possible at this time.

    • This reply was modified 4 months, 2 weeks ago by Profile photo of tmerritt15 tmerritt15.
    • #1581
      Profile photo of mary guercio
      mary guercio
      Moderator

      Tmerritt – Paul Ryan stated tonight in the CNN town hall that the Republican Party will repeal and replace the ACA by the end of this month – simultaneously. This NYT article affirms that plan. As Chris notes – speed does not usually result in good results on something this complicated. We’ll have a chance to see soon, it appears.

    • #1582
      Profile photo of mary guercio
      mary guercio
      Moderator

      The angle of using “taxation without representation” as the basis for seceding from the federal government is intersting.

  • #1579
    Profile photo of Chris Ladd
    Chris Ladd
    Keymaster

    There are two comments I’d like to add. First, I suspect that the general attachment to single payer on the left might have more to do with not understanding the options, rather than truly preferring single payer. And there really are a lot of options.

    Among the major European players and Canada, you really only get single payer in the UK and Canada. In a single-payer system, the state ends up owning the entire system. It amounts to full nationlization. That can work, but it is bulky and these systems seldom rank among the best either in terms of cost or results.

    Switzerland has a kind of modified version of the ACA. Germany Holland and France use a sort of hybrid, with private or semi-private insurance and private health care providers. Health insurance is funded through a combination of income and payroll taxes. Everyone gets what amounts to a voucher to purchase a policy, with deductibles and copays.

    It’s worthwhile to take a closer look at the structure of the French system in particular, since it is consistently regarded as the best in the world.

    https://en.wikipedia.org/wiki/Health_care_in_France

    Why can’t we have this, even at the level of a single state? For the obstacles you describe (which are real and substantial), this is probably the worst – Americans who have policies through employers today do not understand how much those policies cost, and they don’t even realize how much they are individually paying.

    Almost any potential universal health care plan would result in less out of pocket cost for the average family of four on an employer sponsored plan today. But when you start throwing around the numbers, people faint. You know what might fix this glitch? The repeal of the ACA and the implementation of a GOP plan.

    Most GOP plans would strip the employer tax deduction and replace it with a tax credit. Most version talk about a credit of something like $2500.

    My employer spends about $21K on my health plan. That’s a bit above the average, but not by much. Our deductibles run about $4000. Under the Republican plan, most employers would drop that plan altogether. I’d lose a 25,000 insurance policy that I previously got for $4000. Instead Republicans would give me and millions of current Republican voters a measly $2500 to go replace it.

    See what this might cause?

    Thing is, if they did that people would scream bloody murder. But you know what would come next? Massive public support for a properly-funded plan that would deliver adequate coverage levels. That could even happen at the state level, and it likely would. We would already have a system structured like the French system, just underfunded. All we would need is funding and we’d have millions of middle and upper income Americans screaming for that funding.

    The GOP is about to accidentally drop everyone who isn’t on Medicare into the same miserable sinking boat. This may break things wide open. Maybe. We’ll see.

    • #1580
      Profile photo of mary guercio
      mary guercio
      Moderator

      There is an interesting book that was released in 2008 entitled: “the Healing of America, by T.R. Reed. Still relevant. Anyone interested in critical analysis of universal health care and how it works in other countries should read this.

      The Healing of America PDF

    • #1826
      Profile photo of Creigh Gordon
      Creigh Gordon
      Moderator

      I don’t think I agree with your characterization of single payer as “the state owning the entire system.” Sometimes it does, as in our Veterans Administration system or the UK’s NHS. Other times the single payer pays private providers, as in our Medicare system.

  • #1586
    Profile photo of tmerritt15
    tmerritt15
    Participant

    Thanks to both of you Mary and Chris. You given this “orphan” a little more “gruel”. Chris, I’ll take a look at the article in Wikipedia. During the original ACA debate, PBS had a presentation on various forms of health care coverage. I may still have it on my TiVo; I’ll take a look. Mary, I’ll also take a look at “The Healing of America”. After digesting them, I’ll likely have more thoughts. I’ve got to run now.

  • #1621
    Profile photo of mary guercio
    mary guercio
    Moderator

    Those of you who have job-related health insurance may want to read this analysis of changes that may be coming your way as a result of changes to ACA. You may find yourself surprised, but at least be informed.

    Large Employer Health Plans Could Also See Some Impacts From Obamacare Overhaul

  • #1622
    Profile photo of DS
    DS
    Participant

    Politico takes a look at the state of the healthcare debate inside the GOP. Tl,Dr: Sure glad the six years they’ve had to come up with a replacement were spent wisely.

  • #1635
    Profile photo of mary guercio
    mary guercio
    Moderator
  • #1636

    This is what my Member of Congress wrote to me in response to my letter saying that he’d had six years to come up with a replacement and that as a business owner in the individual market, I’d sure appreciate it if he didn’t repeal the ACA without a plan.

    January 18, 2017

    Dear Mrs. Callan,

    Having previously shared with me your thoughts on the new healthcare law, I write today with an update about the Affordable Care Act (ACA) and recent congressional activity.

    As Chairman of the Subcommittee on Oversight & Investigations, I was charged with leading congressional oversight efforts to examine every aspect of the failed law. From the disastrous Healthcare.gov website rollout, to the giveaways for special interest groups, there is plenty that still remains to be unraveled. Having understood from the outset that this law would costs billions if not trillions, I released an investigative report entitled “Rate Shock” revealing how the American public would see triple digit rate increases in the individual, small and large group insurance markets under the ACA. Since the report’s release, even more Americans have seen their premiums, taxes and fees skyrocket, including deductibles that double the cost of insurance coverage. The bottom line is this: the law is broken and it can’t be fixed. The American healthcare system was broken before the ACA and the new law made it worse, that’s why we need to find a better way. The current framework needs be replaced to provide relief and I’m going to stay focused on working to put Americans back in charge of their health care, not the federal government. We need to build a system that works to deliver affordable care when needed, by a doctor of your choosing at a price you can afford and there are many innovative ways to get there without busting the bank.

    Instead of trying to salvage a failed program, the focus should be on reforms that emphasize universal access to coverage (not government-mandated coverage), strengthen Medicare, open up a competitive insurance market, reward individuals for staying healthy and move those who are sick into care as quickly as possible and the chronically ill into programs that make sense for their illness. Our goal here must be to make sure that everybody can buy coverage or find coverage if they choose to. It won’t and can’t be a one-size-fits all model and it won’t be driven by mandates from the federal government. Towards that end, I am working with like-minded colleagues on legislation to allow you to shop anywhere in the country to find an insurance plan to fit your needs without the mandates for coverage that force you into coverage you don’t need at prices you can’t afford. I also am advancing lower cost by allowing individuals to join in group plans to expand purchasing power; end frivolous lawsuits that add to the cost of care; promote new quality measures to eliminate the $600 to $800 billion wasted annually on procedures that make healthcare more expensive, but leaves patients no better off; and ensuring that insurance companies will never again prevent an individual from getting coverage for a pre-existing condition.

    It is an honor to represent you and Pennsylvania’s Eighteenth District in Congress. To stay in touch with what I’m working on and latest news from Congress, you can follow me on Twitter @RepTimMurphy or you can find me on Facebook at http://www.facebook.com/RepTimMurphy. I also encourage you to sign up for my e-newsletter by visiting http://www.murphy.house.gov.

    Sincerely,

    Tim Murphy
    Member of Congress

  • #1647
    Profile photo of mary guercio
    mary guercio
    Moderator

    From the Forbes series, Apothecary, on various aspects of repeal/replacement of the ACA. NOTE: I do not agree with the authors in all their deductions, predictions, and opinions, but it is useful to read opposing POV in the health care debate. The comments section is small and generally, not always, the Forbes author will respond to direct questions.

    http://www.forbes.com/sites/theapothecary/2017/01/19/what-does-insurance-for-everybody-mean/?utm_source=followingimmediate&utm_medium=email&utm_campaign=20170119#31fdfcb827dd

  • #1708
    Profile photo of mary guercio
    mary guercio
    Moderator
  • #1771
    Profile photo of mary guercio
    mary guercio
    Moderator

    It appears Republicans have repackaged their “repeal” to “repeal and replace” to now, “repeal and repair”. I wonder what’s next? “Repeal and pray”…

    https://www.bloomberg.com/politics/articles/2017-02-01/republicans-rebrand-obamacare-strategy-from-repeal-to-repair

  • #1824
    Profile photo of mary guercio
    mary guercio
    Moderator

    Given what we know is planned for cuts to health care, it is instructive to see how health care cuts in the UK has impacted their nation. It is seriously bad.

    https://www.theguardian.com/society/2017/feb/17/health-cuts-most-likely-cause-major-rise-mortality-study-claims?utm_source=esp&utm_medium=Email&utm_campaign=GU+Today+main+NEW+H+categories&utm_term=213681&subid=20116704&CMP=EMCNEWEML6619I2

  • #1825
    Profile photo of Aaron Dow
    Aaron Dow
    Participant

    I.e., everything Obamacare, minus the money that manages to make it kinda work.

  • #1832
    Profile photo of mary guercio
    mary guercio
    Moderator

    For those who are interested, here’s the template for the 13 pg document Ryan is distributing among his colleagues as they go home on recess.

  • #1835
    Profile photo of mary guercio
    mary guercio
    Moderator

    How the GOP plans to re-structure Medicaid and what that will mean for number of people covered, what benefits will be available, and at what cost. What apepars certain is that fewer people with the least income, poorest health, will be the most vulnerable to the GOP plans.

    https://www.theatlantic.com/politics/archive/2017/02/house-gop-obamacare-plan-block-grants/517104/

  • #1837
    Profile photo of mary guercio
    mary guercio
    Moderator
  • #1845
    Profile photo of mary guercio
    mary guercio
    Moderator

    From Kaiser, ACA considerations regarding premium rate adjustments by age and how that would be offset – or, not.

    GOP Fix To Insurance Markets Could Spike Premiums For Older Customers

  • #1867
    Profile photo of Flypusher
    Flypusher
    Moderator

    And Trump supposedly just came to that realization!

    • #1869
      Profile photo of mary guercio
      mary guercio
      Moderator

      With the news that Trump is going to cut the budget for all departments except veterans affairs, ss, and medicare, in order to compensate for the 10% increase to the defense budget, there are so many programs to worry about – science, FEMA, NASA, CHIP, where will it end?

  • #1876
    Profile photo of mary guercio
    mary guercio
    Moderator
  • #1892
    Profile photo of mary guercio
    mary guercio
    Moderator

    What those “inside the medical profession” really have to say about health care.

    https://www.doximity.com/doc_news/v2/entries/6669145

  • #1904
    Profile photo of mary guercio
    mary guercio
    Moderator

    Consumer Reports has a good piece describing how people in different circumstances will be impacted by the new “AHCA”.
    http://www.consumerreports.org/healthcare-reform/insured-through-your-job-medicaid-the-aca/

  • #1991
    Profile photo of Aaron Dow
    Aaron Dow
    Participant

    • #1992
      Profile photo of Aaron Dow
      Aaron Dow
      Participant

      On that same poll:

      60% Favor
      23% Oppose
      17% Unsure

      Republicans: 46% Favor
      Independents: 58%
      Democrats: 75%

      Clinton Voters: 80%

    • #1995
      Profile photo of mary guercio
      mary guercio
      Moderator

      Question is do these membrs of Trump’s base matter to him now?

  • #2104
    Profile photo of tmerritt15
    tmerritt15
    Participant

    Mary – Have you been following the debate in California regarding single payer health care? If you have would you please share your thoughts? NY is also apparently looking at single payer.

    Below are two links, one from the LA Times and one from the NY Times Magazine.

    http://www.latimes.com/business/hiltzik/la-fi-hiltzik-single-payer-20170526-story.html

    http://nymag.com/daily/intelligencer/2017/05/new-york-and-california-consider-single-payer-health-care.html

    I know you sometimes have trouble with the ads in the LA Times. If you do I’ll extract the article.

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