Some Thoughts on ACA and BCRA

I’m not sure if this is worth posting here, but I have some thoughts on health care reform reform.

The Republican arguments have become absurd in interesting ways.

HHS secretary Price said something which makes no sense: “the Senate health care bill strengthens and secures Medicaid for the neediest in our society,” putting the program, which serves more than 70 million low-income people, on “a path to long-term sustainability.”

Republicans regularly describe cuts to Social Security pensions or Medicare benefits as needed to “strengthen and secure” those programs. In those cases, the argument isn’t absurd, because OASDI and Medicare plan A have trust funds which might run out. It makes no sense in the case of Medicaid which is financed by general revenues. I think the dedicated financial streams and trust funds make Social Security and Medicare vulnerable. It is possible to convince people that the trust funds reaching zero will cause something like the bankruptcy of a firm (and also people tend to assume that claims on bankrupt firms are worthless when historical recovery ratios average around 70 cents on the dollar).

The argument for dedicated taxes and trust funds, which I have read here among other places, is that otherwise the programs are like welfare and would be unpopular. The massives support for Medicaid demonstrated now that Republicans are trying to cut it undermines this argument.

Also in the same article Sen Cornyn flat out lies “Mr. Cornyn acknowledged that “there’s uncertainty about what the final outcome will be.” Asked what would happen if the bill did not pass, he said: “I assume we’ll keep trying. But at some point, at some point, if Democrats won’t participate in the process, then we’re going to have to come up with a different plan.” Of course Democrats have begged to participate in the process and have been excluded by Republicans. Robert Pear quoted the lie without noting that it is false. I think this is bad journalism. Also Cornyn is hinting that they might have to (shudder) try bipartisan negotiation. His statement would only make any sense if it were rephrased “If Democrats will participate in the process”. “Keep trying” means keep trying to pass a bill while completely excluding all Democrats. Cornyn is admitting that it was a mistake to be 100% partisan. He wants to blame the Democrats. The result is not just a lie, it is garbled nonsense based on a lie.

Finally Rand Paul is insane. He actually said “it keeps the fundamental flaw of Obamacare. It keeps the insurance mandates that cause the prices to rise, which chase young, healthy people out of the marketplace and leads to what people call adverse selection, where you have a sicker and sicker insurance pool and the premiums keep rising through the roof.” This is so crazy that I can’t think of a reply. All the claims are false — the BCRA would lead to adverse selection, because they eliminate the mandates. The idea that mandates cause selection is plainly insane. It is hard to understand how the statement could be generated by a human brain. And the ACA might survive because of that nutcase. Insane extremism causes sane policy in Bizarro World.

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