Posted on 12/14/2016 12:55:04 PM PST by SeekAndFind
A Freudian slip, or just a usage of a familiar catchphrase? Incoming chief of staff Reince Priebus spoke with Hugh Hewitt earlier today about the top priorities of the incoming Donald Trump administration, and promised that a “repeal and then replace” bill on ObamaCare would be their lead legislative project. That would go counter to some chatter from Capitol Hill of late, where Republicans suggested a commitment to repeal down the road while putting off the replace part of the promise:
HH: A couple of quick questions. Have you guys agreed on the size of the stimulus that you’re going to ask Congress for at the beginning of the legislative session?
RP: Well, no. I think we’re probably going to lead with Obamacare repeal and then replace, then we will have tax, you know, we’ll have a small tax reform package, and then a bigger tax reform package at the end of April. So I think what you’re looking at is between two tax reform packages and reconciliation in the first nine months, you’re looking at what essentially comes down to like three basically different budget packages. And so it’s going to be a ton of work. Not to mention, you’ve got cabinet secretary appointments, a Supreme Court appointment, and you know the Senate calendar, how frustrating that can be. So it’s going to be a busy year starting with the first nine months being very much consumed through Obamacare and tax reform.
Hugh didn’t ask a follow-up on this point, but found it significant enough to highlight on Twitter in response to NRO’s Rich Lowry:
.@hughhewitt he literally said repeal AND REPLACE is coming first? does anyone on Capitol Hill know this?
— Rich Lowry (@RichLowry) December 14, 2016
Yes indeed. Audio here: https://t.co/Mhihunc9DF Transcript coming soon https://t.co/7bGGRIfdMa
— Hugh Hewitt (@hughhewitt) December 14, 2016
Preibus’ comment might be significant, or it just might be following the usual nomenclature. One has to suspect, however, that appointing fierce ObamaCare critic Tom Price to head HHS and Seema Verma at CMS would presage a bold move. On the other hand, making it the lead project either requires that comprehensive repeal-replace legislature is finalized quickly or that it will come in stages. Two weeks ago, I wrote about Price’s legislative approach, which could be adopted immediately — or at least as far as the “reconciliation” process will allow:
Price has attempted to repeal and replace Obamacare since before its passage. Democrats have repeatedly accused Republicans of having no alternative to the ACA for health insurance reform, but Price introduced a bill in July 2009 that would have offered reform on free-market principles rather than a federal government takeover of the insurance markets.
Called the “Empowering Patients First Act,” it included the following:
- Tax incentives for buying health insurance rather than a mandate and tax penalties for opting out.
- Federal block grants to states predicated in part on establishing high-risk pools for people with pre-existing conditions.
- Expansion of health-savings accounts (HSAs) for pre-tax medical expenses. Freeing up interstate insurance sales to allow for greater competition.
If that sounds familiar, it’s because Price had a lot of influence on the latest proposal from House Republicans on an Obamacare replacement. Called “A Better Way,” House Speaker Paul Ryan published it this summer to give Republicans a platform on which to use the election as a referendum on the Obamacare. It includes the same concepts and goals of Price’s 2009 legislation, and Price worked closely with Ryan to keep the focus on free-market reforms mixed with tax credits and state jurisdiction.
Price’s approach would eliminate significant changes to Medicare, however, that will make the issue of entitlement collapse more acute. That could be a feature rather than a bug to Paul Ryan, who wants to tackle that issue sooner rather than later, but Trump has been adamant that he isn’t interested in a revamp of Medicare any time soon.
Hugh’s interview produced more intriguing information, including the revelation that Trump hasn’t started working on a Supreme Court nominee yet. Priebus says that they will have one ready around the inauguration:
HH: Let’s turn to the Supreme Court, Reince Priebus. Has the President-Elect had any interviews in person with would-be nominees, yet?
RP: No. We’re not doing any of that, yet. Obviously, I think that’s going to be something that we’re going to start after the new year, and certainly by the time we get to inauguration, either shortly before or shortly thereafter. We’ll reveal the name of who our nominee will be.
However, expect most of the media to focus on Priebus’ comments about media relations in the White House, Hugh started off by asking whether Trump would continue the “boring Saturday morning addresses” in favor of doing morning drive-time radio on Fridays to drive the news cycle. Priebus says they’re open to lots of changes:
RP: …mundane, boring episodes. And you know, even looking at things like the daily White House briefing from the press secretary, I mean, there’s a lot of different ways that things can be done, and I can assure you we’re looking at that.
HH: And that brings me, Glenn Thrush on Wednesday said there is worry in the White House Press Corps that they’re going to do away with the traditional bullpen, the upstairs, the downstairs. Now I do want the front row given over to Salem Media, but what do you, what are the plans for the press corps and that traditional approach?
RP: We’re, and I hate blowing things off, because I’m not doing it on purpose, it just so happens that we’re actually talking about those things right now. And what the new tradition, I guess you could say, should be in the Trump White House. You know, this was the first front row assigned seat issue, as I understand it, started in the Obama administration. In the Bush administration, you just took a seat, and I guess there were a couple of people that have had reserved spots. But for the most part, the more formalized reserved seating piece came in over the last eight years. That issue is being talked about. The point of all of this conversation is that the traditions, while some of them are great, I think it’s time to revisit a lot of these things that have been done in the White House, and I can assure you that change is going to happen, even on things that might seem boring like this topic, but also change as far as how we’re going to approach tax reform, the American worker, how we protect them and business all at the same time why skyrocketing our economy.
This is being interpreted as Priebus suggesting that daily briefings will be eliminated, but it sounds more like he’s suggesting that seating charts won’t be continued at them. That’s hardly revolutionary, but since it involves the media, expect these comments to be the Bright Shiny Object of today’s news cycle. Unless Jay-Z and Beyoncé drop by Trump Tower, that is.
I trust Trump more than I trust them.
The man has business savvy.
I suspect a lot of the governors couldn’t balance their checkbook.
This is a free enterprise nation. It’s called Capitalism.
Where there is money flowing into a market, there are going to be businesses competing to get a slice of that money.
Businesses will compete for it. Each will carve out a segment.
Look at Medicare. The government pays only so much for services, but there are more than a few companies that compete for the business. They have structured different plans. People opt for different plans.
Some contract with hospitals. Some have their own facilities.
If Medicare is that competitive, and it is rather iron clad due to the government determining how much it will pay, then general insurance is going to be competitive too.
Look at all the pharmacies out there competing for our medication business. They each get paid pretty much the same by the government, but they still compete and offer different services, in addition to the medication services.
Some offer flu vaccine shots. Some have other deals.
More competition, will open up more choices. Plans, fees, other services tossed in, this is the goal. It will happen.
Repeal O’care, period. Keep two things that are decent about it: no pre-existing conditions and letting dependents up to age 26 go on Mom & Dad’s plan.
Other than that, a dose of the free market is ALL that is needed to repair our medical care system.
1) Blow off the artificial boundaries between the states for medical insurance. Let more companies compete, and that’ll drive prices down.
2) Let people pick and choose what they want to be covered for - it is rather ridiculous for all men, and women over 50, to be covered for maternity care...though if someone wants it, let them pay for it and have it.
3) Streamline the drug approval process. If a drug is safe for use in Japan or Western Europe, then it is safe here - why blow the cost sky-high.
4) THIS IS A MUST-DO: Enforce the Sherman Anti-trust Act against the pharmaceutical companies, hospitals and doctors. NO UNFAIR COMPETITION! No hidden, monopolistic practices. No penalties for buying generic drug X from Canada or Mexico at a cheaper cost than here - don’t worry, the prices will even out very quickly.
5) Limit damages for pain and suffering to $250K or $500K - that’ll lower malpractice awards, which will lower malpractice insurance rates, which will lower medical costs AND ALSO lessen the extraordinarily expensive practice of defensive medicine. PERHAPS you can have the 1,000 or so most common injuries, diseases and conditions looked at by a panel of medical experts, and come up with recommended treatments and diagnostics - and if a doctor/hospital follows those guidelines, they CAN’T be sued outside of gross or criminal negligence.
Do those things, and our medical costs will plummet, and better care (including innovation) will become lots more common.
Oh, and if someone cannot afford the free-market price, let them qualify for Medicaid and use docs and hospitals that are willing to accept a bit less per patient and make up for that with volume - SOMEONE will do so, I promise.
In the meanwhile, if the states can put a stop to unconstitutional federal taxes, taxes which Congress cannot justify under its constitutional, Article I, Section 8-limited powers, then they would probably find a tsunami of new revenues to experiment with their own versions of healthcare and many other things.
“Congress is not empowered to tax for those purposes which are within the exclusive province of the States.” —Justice John Marshall, Gibbons v. Ogden, 1824.”
”State inspection laws, health laws, and laws for regulating the internal commerce of a State, and those which respect turnpike roads, ferries, &c. are not within the power granted to Congress [emphases added].” —Gibbons v. Ogden, 1824.
"The States should be left to do whatever acts they can do as well as the General Government." --Thomas Jefferson to John Harvie, 1790.
Insurance policies, at least employer sponsored plans, are set up a plan year at a time. This allows employers to either continue with the current coverage, or opt to go with other coverage. That being typed, the exchange plans would still be in place for a year from the issue date. IE: Issue Date of 01/01/16 would (probably) be in effect from 01/01/16 to 12/31/16.
I hope this answers your question. Insurance and other employer-sponsored plans is what I do in real life.
“Repeal it and reintroduce a law that would contain 1 or 2 of ObamaCare’s lesser features but *without* the mandates or fines.”
The only features most people care about are:
* coverage for preexisting conditions
* extension of coverage for children on parents’ policies
* subsidies for low income
You can’t really have any of those without the mandates and fines.
Nope,no subsidies.The others? Maybe.
What does “nope” mean? You don’t think people care about that?
People on the right probably don’t but the people getting the subsidies most certainly do.
In the first place, Medicare decides what it will pay for services. It publishes a schedule and doctors by law can't charge more. They are also limited to their ability to refuse Medicare patients. So Medicare has mandated its own network. It controls its own costs. The out-of-state insurance company that I contact doesn't have that. It has no network in Missouri and no way to control its costs.
Second, the insurance company is only managing claims for Medicare. They aren't paying claims out of their own pocket, they are telling the government that they processed X million dollars of claims and the government reimburses them. The insurance company gets paid for its services. So from an insurance company point of view it's pretty easy money. They bear none of the risk. They get paid by the government for each client they sign up. The more they sign up then more they make. Nice gig. But the out of state insurance company bears all the risk. It pays claims out of its own pocket. It makes money when the premiums they collect exceed the claims they pay. Networks are a vital part of allowing them to control their costs, predict their risk, and set their premiums. If I come along from a state where they have no network then they pay what the doctor charges. Their risks are not limited and their expenses are not predictable. In all likelihood I would cost them more than their average client so their chances of making any money off the premium then charge is very slim. So there is no incentive for them to take me on as a client. And again since my costs are higher there is no incentive for me to sign up with them.
Ok, then you are obviously convinced no new networks can be set up.
LOL
Thanks.
Why not the major tax reform before April? The longer they wait the longer it takes for the economy to get better.
I am suspicious of Paul and Mitch here.
New networks can be set up. But it's an expensive process. Why would the insurance company do that for a single client?
Every insurance company starts out with one policy holder.
That’s not the last one, but it is one.
I’m betting you don’t run an insurance company.
I’m betting you know better than to say a company won’t set up shop for one person.
There were enough subsidies in place before Obola exploited the stupidity of the American people to slip the bill through.
I need to disagree with you here D1. The essence of insurance is to spread risk. Maritime insurance is a great example: while the vast majority of ships depart/sail/arrive without a hitch, there is some number that experience loss, including sinking. This risk can be measured, assessed and spread, providing for a liquid market of both insured and underwriters.
Health is a different matter altogether. Disease, accidents, genetics, etc that require various degrees of medical attention are nearly 100% of the population. Perhaps it falls just short of death as being a sure certainty.
So, health insurance companies have no way of spreading risk if everyone eventually files a claim. The only reason health insurance came about was as a un-taxed benefit offered to circumvent wage price mandates during WWII. (Without the ability to pay more to attract workers, companies resorted to offering benefits like health coverage.)
Health insurance covered during the span of employment is somewhat measurable, because it's not a life-time benefit. That is, perhaps the risk during a given employment period is 5%, but it's nowhere close to 100% when dealing with the simple facts of life ie getting older.
The solution isn't really competition, it's to recognize that insurance cannot operate where practically 100% of the insured will eventually file a claim, cause losses, etc.
The solution, which might drive FR free-market adherents crazy, is a combination of policies which allow for insurance provisions below a certain age threshold, then are simply rolled into a state/fed obligation once the likelihood of a claim climbs past 50%.
Sorry but the kids on mom and dad’s plan is the very worst thing about it!
That has to go before it bankrupts the 50 somethings.
Those kids can vote, sign a legal contract, join the military, take on loans, get married, have kids and all sorts of other stuff, but you have to lay fir their insurance till they’re 26? Complete bullshit.
Have to pay for the kids? No - that is ONLY if Mom & Dad ALLOW it. It is OPTIONAL. Maybe you have a kid who graduated from college and is in grad school full time, and simply doesn’t make the money necessary to pay for the insurance and all of their other expenses. If Mom & Dad want to help out their kid, who is ANYONE to tell them that they can’t? If the parents can’t or don’t want to do so, then they simply don’t. THAT is the essence of freedom - even if it is a choice that you or I wouldn’t necessarily make.
Again, this is NOT required, it is OPTIONAL even now. I see no reason to change it.
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