Corky,

I liked nave better.

Donner,

"Gee thanks Captain Obvious."

It took me a few hours to research info and get the post how I wanted it.

Then came you.

Such an intelligent thoughtful post (shot out your butt)

Sandwich sales will be going up.

Protestors will be tossing sandwiches now..

Corky,

Just because he hasn't revealed anything, doesn't mean nothing exists.

The smart thing to do is not give his enemies ammo to use against him until we get past this current hurdle.

(continued from above)

When the ACA was written, it said subsidies were for exchanges "established by the State." That made sense when everyone thought states would cooperate but many didn't. So opponents sued, complaining that people who bought insurance through the federal exchange weren't allowed to get those tax credits. The case, King v. Burwell (2015), went all the way to the Supreme Court.

The Court ruled that Congress meant for subsidies to apply nationwide, whether a state or the federal government ran the exchange. That ruling saved the ACA, but it exposed how fragile it really was. One poorly worded sentence, "established by the State.", nearly destroyed the entire law. Another wrench in the grand plan.

Then came yet another one. The individual mandate penalty for not buying insurance was repealed, thus depriving the grand plan of much needed revenue.

Things haven't worked out the way the architects promised. Yes...some lower income Americans gained coverage, but employer group plans have continued climbing. Self-insured have been squeezed. A huge problem was that cost controls were largely ignored. Furthermore, Congress never allowed cross-state competition, which could have lowered costs by putting pressure on insurance providers. ACA would have never passed if they had.

That brick wall for businesses is still there. Employees covered by employer plans are generally ineligible for subsidized exchange coverage, as are their spouses if the employer's plan meets ACA affordability rules.

Something is still broken in the system. Hospitals, pharmaceuticals, administration, and government regulation continue driving up costs and no one has the backbone to fix them.

Democrats won't touch their signature program, and Republicans still haven't offered a serious, workable alternative.

So here we are, decades later, staring at the same brick wall I saw coming forty years ago.

Then came Trump.

Dan,

"I knew. Forty years ago."

As did I.

My accounting career, going back to the 80s, started with automating businesses that were still doing manual accounting. Novell servers, workstations, and local area networks were coming into use. I set up automated accounting systems using provided trial balances and subledgers. I usually worked alone, getting small and mid-sized companies up and running and then trained their employees.

Over the years, I talked with many owners and accounting managers, and something I saw was alarming. Over and over again, every company I worked with had one thing in common. When their annual group health insurance renewal arrived, the premium had typically increased five to ten percent, in that ballpark.

Year after year, those rate hikes outpaced inflation and consumed a bigger share (percent) of sales revenue than nearly every other expense on their books.

That spelled trouble for companies that had, for years, just absorbed the increases while still offering free health insurance for employees. I even knew one company that provided free family coverage until the late 80s.

At that rate, a brick wall was inevitable. It was just a matter of time. Something was wrong then, and it's still wrong now.

The government eventually stepped in with a grand plan called the Affordable Care Act (ACA) or Obamacare which was supposed to fix the system by spreading out risk and making insurance affordable for everyone. It offered federal premium tax credits (subsidies) for people who bought coverage on new state-run insurance exchanges, along with a mandate requiring everyone to have and pay for health insurance. The idea was simple. Healthy young people who often skipped insurance would now pay in, spreading and balancing costs for everyone else.

But there was a problem. Many states refused to create their own exchanges or expand Medicaid. That forced Washington to step in and build a massive federal exchange what we now know as Healthcare.gov (as a backup). It was never supposed to be the main system, but suddenly it was. That was the first wrench in the grand plan.

Then came another one, even bigger.

(continued)

Good night all....

Dan,

"Translation: Am I my brother's keeper?!?"

Give it up with the narrow-minded, faux-religious routine.

I'm a Christian and believe all Americans are my brothers.

Not just the ones I like.

Dan,

"Trump doesn't even have a concept of a plan"?

I've been seeing that line used since 2016.

Since that time, he's served four years as president and four more out of office thinking, strategizing, learning and making plans.

Now he's throwing down the gauntlet about health care and you still think he doesn't have a plan?

You might want to start reading some new material.

Yav,

"Did you think you could shame SNAP recipients?"

Did I ever say that?

You're the one bringing up shame. I've never suggested using Food Stamps is anything to be ashamed of. I used them in my younger days.

My point was simple. The "starving American" narrative doesn't match the data.

The USDA's own reports show plenty of processed snacks, sodas, and convenience foods among top SNAP purchases.

That doesn't look like a population wasting away from hunger.

Like I said....political theatre.

Yav,

"Did you get that from Facebook? From the laughable "Economic Policy Innovation Center"?"

Dan,

"Why does every major developed country with UHC pay a lower percentage of their GDP for better longevity results?"

Why is America's infant mortality rate 33 out of 38?

Clearly, our health care system isn't delivering the results or value it should.

I get the impression Trump is at least trying to address some of these structural issues.

We didn't get here overnight, and blaming one party or the other won't fix it.

It's time to work together to focus on the problems, to find real solutions.

Dan,

Forcing healthy people to subsidize a system that never addressed the real drivers of cost such as bloated pricing, complex billing and insurer profits, was a big mistake but would not have passed if it had.

Dan,

So...are you saying continuing the extensions without any changes to ACA is morally and fiscally responsible?

UHC is off the table right now and you know it. Insurance companies are doing just fine.

What else do you suggest other than waiting for a generation to die?

Dan,

I can talk about several things. Not sure which way to go.

Higher taxes, longer lines, broken cost structure, adding millions more people to a system that alteady struggles to remain solvent?

Boomers dying off won't fix a broken system. At some point later might be a time to address some issues but that's a while off.

Waiting for boomers to die is not the reform we need now.

Nixon,

"It is clear the GOP has no interest whatsoever in fixing the problem. They've had over TWENTY years to fix the problem instead of just voting to kill ACA piecemeal and what have they proposed?"

The GOP didn't write the ACA. Democrats pushed it through without a single Republican vote.

Since then, every attempt to propose reforms has been blocked or they frame it as a plot to repeal ACA. Even sometimes make it racial to shut down the debate.

Dems will say anything to generate noise to get what they want.

You can't "fix" something when one side treats it as untouchable and uses it as a campaign prop instead of a policy.

Dan,

Eventually companies will just stop offering health care benefits altogether.

When companies can't afford to continue eating the cost or employees complain their payroll deduction is so high, it is inevitable companies will have to do something.

Then more people will be forced onto Obamacare.

Is that what dem leadership is actually hoping for?

Dan,

"Starvation isn't the barometer. Food insecurity is."

Neither are.

It's Congress not doing what's good for all Americans, and not just the ones who vote for them.

Dan,

If the extensions are continued as is, how many more years will it be before someone else tries to address it.

How much worse will the built in problems get?

As is now evident, dem leadership doesn't care.

Dan,

Or maybe as you put it, Not my Problem?

Dan,

So what is your opinion on the working and Middle Class issue with Obamacare we've been hearing about for years?

Answer that question without deflecting.

You don't care?

Yav,

"Starving people is just fine with you."

The USDA who manages SNAP put out this list in 2024 of items purchased by Food Stamps and prioritized them in order.

Top Items Purchased with Food Stamps

Rank Item Purchased Rank Item Purchased
1 Soft Drinks 11 Candy
2 Fluid Milk 12 Infant Formula
3 Ground Beef 13 Frozen Pizza
4 Bag Snacks 14 Refrigerated Juices/Drinks
5 Cheese 15 Ice Cream
6 Baked Breads 16 Coffee and Creamers
7 Cold Cereal 17 Cookies
8 Fresh Chicken 18 Water
9 Frozen Snacks 19 Shelf Stable Juice
10 Lunchmeat 20 Eggs/Muffins/Potatoes

"starving" Really?

There are struggling families, sure.

But the narrative of widespread "starvation" in America is political theater, not reality.

Snoofy,

"So, it's not always appalling to use food as a weapon.
It's not appalling when your side does it.
Got it."

I believe in why Trump is doing it. It's not blind loyalty to Trump.

That actually makes it a different situation.

The Dems leadership is doing what they know best. Pandering to the poor for votes.

Trump isn't pandering. He has a limited time in office and wants to make a lasting contribution to all Americans.

The temporary, enhanced premium tax credits that raised subsidies and expanded eligibility under the American Rescue Plan Act (ARPA) of 2021 and were later carried forward by the Inflation Reduction Act were written to sunset at the end of 2025, returning subsidy rules closer to pre-ARPA levels unless Congress acts to extend or make the enhancements permanent (sources: [1], [1], p1_s3). The Affordable Care Act's original premium tax credit remains part of law and would continue after 2025, but many households would face substantially higher premiums if the ARPA-era enhancements expire (sources: [3], p1_s2).

It's due to expire the end of this year, regardless. Democrats are determined to extend the enhancements and Trump is determined it won't happen.

I side with Trump who wants to fix the existing problems with it.

Snoofy,

"Trump Says He will Defy Court Order"

Sometimes you've got to throw a little tea in the harbor, too.

Btw...do you think every use of the autopen during Biden's term was handled correctly (legally)?