Trumpcare Is Already Hurting Trump Country

Just the threat that Republicans may destroy Obamacare has led insurers to pull out or raise rates in some states next year.

Comments: 222

  1. But the thing is Trump Country does not perceive Trumpcare as hurting them. They fully believe it is Obamacare that has hurt them. Trump is nothing if not a great snake oil salesmen and his supporters are eager to buy. There is no way that "illegitimate" President could have possibly done anything that benefits them. But a "real American" like Trump - that's the guy that is on "their" side. So - I have no doubt that if Trumpcare passes and Trump country starts hurting, literally as well as financially, the sufferers will be all too willing to blame Obama - and I guarantee Ms. Clinton as well for their suffering. The GOP is an irredeemable party led by soulless monsters.

  2. Trump has used "white identity" politics to demonize the Affordable Care Act, because a-twice-duly- elected African American President of the United States sponsored this successful legislation. He wants to assure his republican base of supporters that Trumpcare will work, now that a "white man" has been restored to the White House.
    Just like the folk tale of "The Pied Piper" who seduced the infestation of rats in that township with the bewitching melody of his flute, so will be the fate of all die-hard Trump supporters too.

  3. It is truly incredible that many Trump voters who want "Obamacare" repealed are insured by the ACA - it's proper name. Now that's a low information voter!

  4. Dana,
    Extremely well said.

  5. The fact that insurance companies have the power to raise rates on a whim or a fear of future events just shows how bad Obamacare really is- and not the way Democracy is bad- you know, the worst government there is- besides all other forms of government. Bad compared to the health care provided by most modern nations. BAD!

    Richard Nixon offered a better plan for our nation, but T. Kennedy knew it was not adequate, and held out for universal health care. Now almost half a century later our politics have become so corrupted by the special interests siphoning money from our privatized system that Obamacare was the best Obama could accomplish- and that was enough to deplete this extremely talented man of almost all his political capitol.

    Until reasonable people, such as the editorial staff of the NY Times, concede that the overbearing and completely disorganized power of money in our politics has our country in a state of fiscal insanity, the American empire will continue its downward spiral. A more efficient model will take its place somewhere else and the dollar will become worthless paper.

    Health care that is fiscally 60% as efficient as Canada's, 7 times as many Americans in prison per capita as Canada, incalculable waste on defense spending, much of it deals to enrich defense contractors- the list goes on and we just talk about Trump. As if he is the crux of this nation's problems- he is a symptom and a distraction. A money maker for the NY Times.

  6. Well said, someone who really knows the score.The US press core ( bla,bla,bla),rhetoric and superficial coverage ,nothing in depth or against the orchestrated conventional indoctrination.

  7. Trump - 0, Americans - 0. Not only has Trump made the health insurance problem a bigger mess, he's done nothing else in his 100 days to help working and poor Americans.

    Great health insurance for everyone - 0
    Huge infrastructure program to stimulate jobs and economy - 0
    Building a wall (of shame) - 0
    Stopping China's currency manipulation - 0
    Bring manufacturing jobs back to the U.S. - 0
    Improving international confidence in U.S. - 0
    Keeping the U.S. out of Syria - 0
    Help improve education - 0
    Work to stem opioids and drug overdose epidemic - 0

    And the list goes on while the constant roar of Trump noise, missteps, blunders and possible criminal conduct involving Russia's meddling in our Presidential election process leave Trump paralyzed, our nation stunned and progress on important initiatives and programs stalled.

    Mr. Trump simply can't govern and is unfit to be President.

  8. The Republicans do not care about who is hurt by their Trumpcare. They just do not care.

  9. They care only about keeping their wealth to themselves. They're all about money.

  10. Call it RyanMcConnellCare. That's much less likely to pass.

  11. Any political scientists, health-care researchers, sociologists out there who have studies underway of what Trump is doing to the people who voted for Trump? Any comment reader know of such?

    I ask because BBC World Radio ran a very fine series in which their high-level reporters crossed the US visiting centers of Trump support - I remember Nebraska - and in interviews it became clear that some strong supporters are now fully aware that if he sends undocumented immigrants running, then their poultry, beef, and other enterprises are in trouble.

    That series was too soon to do the same for healthcare. Would like to see OpEds by researchers in the relevant fields.

    Only-NeverInSweden.blogspot.com
    Dual citizen US SE

  12. Trump has so far done many things that are a disservice to his supporters, to wit:

    See the Economic Policy Institute's new report on wage theft.

    And keep up to date on EPI’s Perkins Project Policy Watch, which tracks actions by the Trump administration, Congress, and federal agencies that affect working people.

    "For all of Donald Trump’s bluster about helping the working class, the actual policies he’s advanced have hurt workers’ rights and pay, and firmly put him on the side of Wall Street and big business, not working people and honest employers."

    Why? See David Brooks nyt article yesterday which expresses the Republicans' buyer remorse.

  13. @ GH - Thanks very much GH, just what I was looking for. Will also see if Brooks appears in my Swedish newspaper just for fun. EPI sounds exactly like what I was looking for.

    Larry L.
    Linköping SE

  14. I think some kind of national health insurance will come out of this - there's really no alternative if Americans are to receive adequate health care and costs do not rise out of reach. I know that Republicans will not support such a plan, yet. Therefore, I'd like Democrats, or at least some substantial portion of them, to wave around (physically, some spiral bound notebook would make a great prop, and I"m sure Bernie has this) a "National Medicare Plan" (or better name) that they have ready to go once Trumpcare fails. Keep waving it, keep mentioning it, but if possible wait on the details (to increase drama). Do this now, and Republicans will start to be spooked, because they know their plan will fail to provide adequate health care. "Single payer is waiting, when the Republican plan fails." Have P.1 be three statements of health care rights, e.g. "In 21st century advanced states, citizens have a right to good health care."

    This would initially be just a shot across the bow, but if Trumpcare ever comes into being, and people suffer, it will become a real alternative. People LOVE Medicare, they love the simplicity of it, the price. When you compare the simplicity of medicare to all the ridiculous complexity of the Plan Ds, you see the cost savings. If Trumpcare is wildly successful, well ... somehow I don't think it will be.

    Start now to see how Republicans behave with single payer looming as the next step.

  15. Including all these people into Medicare will dramatically raise the price for those who have been paying into the plan for almost 50 years and continue to pay during retirement along with an advantage plan. There will be a push back from these people if it means increased premium prices and degradation of service. Put them into a separate program and exclude the present members of the Medicare program.

  16. Who really cares what the GOP establishment wants? The only thing that matters is what do the American people want, and what is in OUR best interest? Clearly the GOP policies are hazardous to our health & well being....so why do they have a say? Be part of the solution or get out of the way...progress will take place w/ them or without them. Enough of this shocking waste of our precious time and resources.

  17. Aren't people just a bit weary of having plans without details proffered to them by politicians who are, themselves, always well insured? In this, and in other areas (jobs creation first and foremost) the Democrats need to come up with and advertise (yes, buy airtime by the half-hour) to explain their alternative(s).
    1. Single payer, okay. But people want to know its costs --- tax increases by how much and for whom; loss of jobs in the health insurance (not the health care) industry --- which currently employs over 500,000 people largely in urban areas.
    2. Other solutions? They should include requiring that health insurance companies, or the subsidiaries of larger insurance companies which offer health insurance, be not-for-profit. This was once standard: Blue Cross/Blue Shields were once not-for-profit. Most are now for profit. Moreover, the Affordable Care Act (Obamacare) limited profits from health insurance to 20%. Why should companies make profit from the ill-health of the population? Further, it makes no sense to have health insurance regulated by the states. Some (like Wyoming) have too small a population to be a viable pool. Finally, why must Medicaid be administered by the states, but overseen by the federal government? Medicare isn't.
    In short, people want to know what the Democrats' plan is. Most people would like to vote FOR something. And let's stop assuming that people with "only" a high school diploma can't understand such things. It's not true.

  18. Mr. Trump's narrative-- now the GOP party narrative--- about the imminent collapse of Obamacare may be "disingenuous nonsense" but it is a LOT easier to understand and explain than the reality outlined in this editorial. It also underscores that biggest flaw of Obamacare: instead of pushing for some form of single payer insurance the Democratic party kept the insurance companies in the middle. One reason is that INSURANCE companies denied people "access to medical procedures and drugs" instead of "the Government" playing that role. By keeping the health insurance marketplace alive the Democrats sidestepped the "death panels" argument, avoided a major battle with the health insurance lobby, but were left with a system so complicated few voters understood the final product. As a result, "disingenuous nonsense" will prevail... and while those in Trump country will suffer, the insurance lobbyists on K Street will be very happy.

  19. Obama knew that single payer had no chance of passing. He took what he thought was feasible to get enacted and improved the situation though still far from where it should be. As long as profit is the major driver of health insurance we will never ever have a fair, efficient, effective system

  20. @WFGersen hits the nail on the head. Obamacare is the current plan. If the rates go up, or insurers pull out, it's Obama's fault. That's the easy narrative. Forget the subtle undermining going on. And forget Senator Marco Rubio's poison-pill amendment in 2014 that killed the federal funding for excessive risk. These things are too complicated for Trump voters to understand.

  21. It was the Republicans who insisted there be no single payer. The Democrats compromised on this in order to pass the bill. You may lay this wholly at the feet of the Republicans.

  22. Mr. Trump has intentionally endangers the lives of millions of Americans through his reckless commentary and actions. He is doing everything in his power to make Obamacare fail so that he can prove its failure. Yet again, his ego is in overdrive.

    As a healthcare advocate, I have a front row seat to his harmful and desperate attempts to destabilize the individual and small business health insurance marketplace. What most fail to realize is that his words, actions and secret backroom deals with insurers harm not only those who receive their insurance through the ACA, but the rest of us as well.

    Entrepreneurs, self employed professionals and small business owners are being hurt by lack of choice, strangled networks with no quality provider options and skyrocketing costs. We've also seen a uptick of insurance companies denying claims that should be paid because they know the federal government isn't supporting patient rights.

    The only solution I can see is for the state governors to unite against insurers. If the states said "Aetna, you can't sell or administer group policies in our state if you don't offer affordable, quality individual plan options to our constituents" I believe Blue Cross and the rest change their tunes in a New York minute.

  23. Sarah, your recommendation of mandating affordable coverage in the individual market in order for insurers to be able to sell in the group market for an insurer is not an idea that insurers would necessarily object to believe it or not. I worked for a major health insurer for 20 years in pricing and actuarial functions. Insurers love stability and predictability. What this would mean is that your plan would result in much higher group employer premiums that would be used to subsidize and lower premiums in the individual market, and this would make pricing more stable and predictable, because it spreads risk. Insurers die for this. I know that 20 years ago the insurance industry was pushing for your approach in general. BTW, here in Massachusetts we heavily tax employer plans to subsidize the individual market. Reason: the group market is a far younger and especially healthier population than the individual market. They already pay much lower premiums per capita than individuals.

  24. "The only solution I can see is for the state governors to unite against insurers. If the states said "Aetna, you can't sell or administer group policies in our state if you don't offer affordable, quality individual plan options to our constituents" I believe Blue Cross and the rest change their tunes in a New York minute."

    That's a bet you'll lose. They're dropping states now even without the threats you advocate.

  25. The dysfunctional $2.6Trillion rip-off didn't just suddenly surface when Trump hit the scene. The Medico/Pharmo/Insurance Industrial Complex has been putting profit ahead of the health of most Americans for decades. Washington is an integral part of the problem. State governors are not a part of the solution. Class action lawsuits and malpractice lawsuits are the only protection medical consumers have, and those protections are constantly being eroded.

  26. "has persuaded several big insurance companies to stop selling policies or significantly raise premiums. "

    Sorry NYT no bait and switch on Obamacare allowed nor accepted. Coverage, premium increases, high deductibles, etc. have been 1000% creations of ACA, and you can't now pass it off as Trumps fault. We've been living with this for several years and watched where ACA was headed...it's been downhill for years.

    Keep trying.

  27. The Republicans did everything to ensure Obamacare would face challenges, including allowing people to opt out. If there were a mandate, or the opt out penalty were much higher, Obamacare would likely be fine. Throw in a public option and it would be working quite well. And these are easily fixable flaws.

  28. Insurance companies have been pulling out of the ACA since the second year. They can't stay in business treating people who are newly diagnosed with a medical condition who have never paid a premium. Nor can they survive when even those people don't pay a premium while being treated or after.
    The mandate is a farce. All the worries about the young people not buying insurance are surely dwarfed by the number of people in their 50s and 60s who are betting they can stay healthy until they qualify for Medicare. It doesn't matter whether they pay or not since there is no way to collect from the delinquents. The IRS can only take the fine from your tax rebate and cannot assess the fine as part of tax owed. In addition there are over 30 excuses they can use when asked to pay.
    All of this was known before the law was implemented but administrators put it in place anyway. The emergency rooms are still treating "immigrants" and street people with alcohol induced diabetes and frostbite without payment.
    Doesn't the government realize that we know who is paying for all of this? It's we who take the responsibility to be insured mandate or not.

  29. Premiums were going up, often 20% each year, before Obamacare. Millions were losing their health insurance, or denied the insurance they thought they had after a cancer diagnosis. Medical bankruptcies were soaring.

    Obamacare lowered the rate of rise and protected millions of people. There are fixes to lingering problems, which Republicans have blocked.

    Republicans want to pull money out of health care for a huge tax cot for their wealthy donors. The ACHA is a tax cut bill, not a health care bill.

  30. Thank you, Editorial Board, for your report. I hope you continue to provide the details of what potentially will cause the greatest pain to the people who helped put Donald Trump in office. For sure, these people will lay the blame for their suffering at the feet of everyone but where it really belongs, themselves. They bought the drug Trump was selling that promised to end their problems, and like addicts everywhere, when they crash they run to their pusher for more. Come November 2020 they will line up in droves at voting booths around the country to buy more of whatever drug Ttump will be selling then. Unfortunately no one has yet created rehab for voters who shoot themselves in the foot.

  31. Or maybe we know something you do not.

  32. It may be that 61% of Americans 'know' who is to blame, but with a shocking 84% of Republicans still approving of the job Trump is doing, it is not hard to imagine that they will be willing to blame their problems on Obama and the Democrats - especially if Trump keeps telling them how much he loves them.

  33. What's funny about that number is that he hasn't done anything substantive. And what little he has done isn't going to help them. Talk about delusional.

  34. As a European but having dealt with Americans and US companies during many years, I find it amazing that the country is pretty much divided into two camps, DEMS and GOP. The DEM voters cannot seem to support anything that the GOP stands for or proposes and with the GOP voters behaving in the same manner towards DEMS. The US needs to move away from a two party political system, it is no longer working in 2017...

  35. "He claims that uncertainty in the insurance industry is evidence that Obamacare is collapsing and needs repeal, not that he and his allies have created the uncertainty."

    Trump, with his GOP partners, are venal enough to deliberately muck up ACA markets to make Obamacare failure a self-fulfilling prophecy. This is not just sick, it's evil.

    People's lives are now in limbo, stuck between a rock and a hard place--about to lose the ACA which Republicans (and yes, Trump supporters) railed against for 8 years and having nothing viable in return.

    They say that what doesn't kill you makes you strong--except here, in the case of "Trumpcare," what doesn't kill you now eventually will.

    Tinkering with people's lives and designing ideological policies-- affordable only to the wealthy when you have generous healthcare yourself --is the work of the devil.

  36. The GOP health care plan wants to drop 24 million people from insurance coverage to make $830 Billion available for the richest 1% of American's tax cut. This loss in Federal revenue will increase the National Federal Debt by $1 Trillion dollars, in which the middle-class and poor people will be stiffed in paying for.

  37. Sometimes change happens only when the pain of doing nothing far exceeds the cost of doing the right thing. That's how Europe achieved universal health care after the devastation of WWII.

    Perhaps individual health insurance schemes must fail before we finally do the right thing.

    Medicare for all is the only viable solution for our health care dilemma.

  38. Medicare is not free. I have paid Medicare tax for about 45 years now. For most people, that is $100K over their lifetime.

    That's a "pre payment" for the benefit. How will you make up for this, for over 200 million people including young people who could not have paid in?

    THEN....it still costs $120 a month for Part B and another $50 for Part D (drugs), and that doesn't full cover you AT ALL....you need a Medigap policy. That runs about $350-$450 a month PER PERSON.

    So let's say roughly it is $500 per month, PER PERSON (plus the $100K lifetime pay in) -- so your Medicare runs $1000 a couple.

    The average family has 4 people, so that's $2000 a month or $24,000 a year. FOR MEDICARE.

    And you still have deductibles and co-pays.

    DO THE MATH!

  39. For their Agenda Republicans and Trump have endangered the healthcare of millions. This must be remembered in 2018.

  40. You don't have any shame, do you? The insurance companies are leaving because of uncertainty of Trump Care? Whoever wrote those lines can't really go home at night and feel at peace with himself.

  41. You are correct, Trumpcare is a misnomer. Trump has no healthcare plan of his own and is still bewildered by the complexity of the issue. The current situation would better be called GOPcare.

  42. Of course they are. Why participate in a plan that is being eroded by neglect and uncertainty. (Think that unwatered houseplant after a 2 week vacation.) And we all will find a hidden sum in our next increased premiums due to insurance companies covering their insecurities monetarily.)

  43. If you have a different story, I wish you would tell it instead of just saying, "no".

  44. Those trump voters will only have themselves to blame when they loose their insurance. I hope the Democrats are working feverishly on a single payer plan that they can run on in 2018 and beyond. When the voters who have depended on vouchers, Medicaid or having their kids covered until 26 go to vote in the next election perhaps just like the top wage earners who vote their pocket books they will finally vote in their best interest and elect Democrats who will pass laws that provides healthcare despite pre/existing conditions.

  45. But they will never blame themselves, their so called hero Trumpet who never will care a hill of beans about them, or the fascist masochistic sadistic unAmerican heartless Republican'ts but instead put blame, incorrectly, on Hillary, Obama, and the Dems. They cannot see the forest for the trees.

    Just tell them "Told ya so!"

  46. I wish there were a way to shame the insurers who are pulling out of the markets and raising premiums. My own company, part of a consortium of small (supposedly progressive) nonprofits, is announcing switching to Aetna, and I spoke up about how the company is undermining Obamacare. It fell on deaf ears. Our current insurer agreed to match Aetna's prices, but the consortium is actually "punishing" that insurer for not offering the lower prices in the first place. Once again we are not looking at the big picture but at saving pennies.

  47. We mustn't let labels from GOP'ers distract - the repeal of Obamacare is nothing more than a tax cut bill, that would give just the 400 wealthiest tax-payers (including djt and many in his Cabinet) a tax cut averaging $7 million$/year, each, or $2.8 Billion$/year for the 400 as a group, which is $11+ Billion$ for a djt 4-year term:

    http://www.businessinsider.com/repealing-obamacare-7-million-tax-cut-for...

    Even more benefits accrue to 1%-ers as a whole:

    http://www.businessinsider.com/obamacare-repeal-tax-cut-one-percent-2016...

    This is not about healthcare, it's simply about tax cuts, and tax cuts of this magnitude that take apart government services have never ever been good for people who inhabit Trumpland.

    After all, in 15 of the 30 largest cities in this country, the biggest employer in town is the health industry.

  48. And not just in large cities. Look at small towns too. Drive across the sate of South Carolina, for example and notice that in many small towns the largest building is the regional hospital. When support for these hospitals goes and they close down, more people will die if they have to be driven to a large city for emergency medical care, and all those doctors, nurses and other staff will lose their jobs.

  49. Insurers have been pulling out for years, and rates have been rising for years – well before Trump ever appeared on anyone’s political radar. The attempt to blame on Trump these predictable (and long-predicted) outcomes of ObamaCare is outrageous.

    I don’t support Ryan’s “TrumpCare”: not only does it harm people now dependent on the ACA but taking away an entitlement once having conferred it and after millions depend on it is political suicide – and political suicide is something that Republicans should leave to Democrats.

    The only way to save insurers’ participation in ObamaCare is to mandate their participation by law and strictly regulate their premiums and co-pays. In other words, enslave the insurance industry to the social vision of an elite – one that lost at the polls the right to do anything of the sort. ObamaCare is a strategic failure every bit as much as “TrumpCare” is a woefully inadequate substitution for a poorly-concocted and executed attempt at a panacea.

    It remains that we have failed at fixing healthcare in America – both the ACA AND the AHCA. Until we tackle the lack of strategic viability of the entirety of our dysfunctional and unaffordable healthcare framework, we will keep defending and attacking either one failed half-attempt or the other.

    Instead of complaining about how one or the other is “hurting Trump country”, Democrats need to get back in the game and participate in a fix that has real legs. And Republicans need to buy a clue.

  50. It's very ironic that you exhort Republicans to "buy a clue".

    If Republicans had a clue, they would not be Republicans.

    As someone who has purchased his own health insurance for the past 15 years, I know firsthand how much premiums have risen far above the rate of inflation well before the ACA was adopted.

    Democrats were not invited to participate in any "fix", as they lack a majority in both houses of Congress.

    The only viable solution would be adopting Single Payer, funding same through the payroll tax, and allowing private insurers to offer supplemental plans similar to the Medicare Advantage plans.

    Anything else is simply a waste of time.

  51. Look at New Mexico and Oklahoma. Neighboring Red States, one with a successful ACA program, the other, Oklahoma with a failed program. Same as most Red States, where their programs died from neglect. Where the ACA was embraced, it was starting to work, slowly but moving in the right direction. Republicans had no interest in making change for the better, only shutting it down, regardless of how it affected their constituents. Their voters were suckered and are now paying the price for those tax cuts for the wealthy.

  52. The only fix that has real legs is single payer for all, with government negotiating drug and treatment prices. Like they have in most other Western countries, where it costs about two thirds as what it costs here, with better outcomes. And I agree that Democrats should push hard for that. Why can't we have the same guaranteed health care that Canadians, Europeans and Australians have?

  53. Congress may dream that the disruption they are causing will be blamed on Obama, but they are counting on Trump taking the blame. If it gets bad enough they will have the cover to impeach him, and still repeal the ACA.

    The Democrats need to start spending money advertising who is really to blame for the misery. And asking angry Republicans to vote in their primaries.

    The worst part is that no one actually believes that any changes in healthcare proposed up until now will do any good, and most believe it will do great harm. Even the authors know it will do harm, at least to everyone's health. It will give a big tax bonus to people who need it the least.

    I am actually watching my government write and re-write different bills that will bankrupt us a decade before Medicare kicks in. If we run out of money before we run into Medicare, it will kill my husband. (Raul Labrador's inane belief aside, lack of care kills a lot of people. Most it just kills slowly.) And what did he do to deserve all this? Got in the way of a 3% tax on the incremental income of the really rich.

    The mills of God grind slowly but they grind exceeding fine. Our leadership provides a lot of grist for those mills. But before they are ground in divine retribution, I'd like their constituencies to wake up and get them out of office.

  54. We may never get to Medicare, paul ryan has always wanted to voucher medicare and let the consumer try to find insurance that will take the vouchers. Prices for coverage will go up and the elderly consumer will havecto pay them, throwing millions of elderly off of health insurance. We are already hearing that medicare is running out of money, untrue Obamacare extended medicare for 11 years, but they are on a roll, and their supporters will believe anything . Trumps,promises are useless. We must get more dem in the congress or repubs who will help their constituents instead of making everything as means to help the rich

  55. "This should trouble not just the 12.2 million people who have bought insurance on federal and state exchanges, but also policy makers..."

    This should more than "trouble" policy makers. It should be a 10-alarm fire signal. The ACA would be so easy to fix if Republican members of Congress would just put partisanship aside and concentrate on the good of the country instead of sabotaging and undermining this law.

  56. There is no way to fix the ACA, as it is BASED ON a flawed GOP plan and require punitive FINES to punish people who can't afford expensive, worthless insurance policies from FOR PROFIT companies .... and depends on HUGE DEDUCTIBLES.

    I have a huge deductible, so basically my Obamacare policy is worthless. I can't use it. It has not paid me ONE DIME in two years.

  57. Unless and until a counterweight is found to the right wing propaganda machine and Ailes effect on "news", the Trump machine will continue to function. The people who support him get their "information" from those sources, seem to buy it without question, and continue to believe that they have found a savior.

    How to reach those folks, to create at least a modicum in doubt about what they are being fed, seems like mission impossible.

  58. Sadly, the loss of health insurance may be the only way to show Trump's voters he only has scorn for those he successfully conned. (And we all will pay the price of poorer health care with rising premiums.)

  59. Nothing new here. Trump/GOP got voted-in on promise of repeal, replace optional. As this editorial amply demonstrates, repeal is happening on two fronts: Congress, and outside congress, self-destruct crash-and-burn. The political cost of promise thus kept is zero, the rewards already proven once at the polls, and therefore guaranteed for the next.

    The only option on table worth fighting for is a repeal that's slightly kinder, gentler, i.e. Trump's first version of bill that Democrats shouted down and Krugman called Obamacare 0.5. Not perfect, but less imperfect by Democrat standards than the one pending before the Senate. It's Democrats' choice, really. If they do nothing (other than kick, scream, bawl, shout, soothsay), the Senate will rightfully conclude the Democrats prefer the rock to the previous hard place, and kick it through (ouch). Voters will, likewise, give the GOP a pass.

    In short, Obamacare is on terminal path, has been for some time. The choice now, is between policy palliative care and policy hospice. The former requires eating humble pie and resurrecting v1.0 through polite WH visit by Ms. Pelosi. The latter, do nothing, cry rivers, clench fists, warn sky fall imminent and watch from fence. Your choice? Aah, another angry op-ed. No, thank you.

  60. Obamacare is failing--because the GOP is continually threatening it. Why should insurance companies support it when it may be gone in 6 months? In the meantime we ALL will pay increased premiums due to insurance companies tacking on an additional sum to cover their own fears of uncertainty.

    Is there one good result of the House's plan? The only one I can see is that it has unmasked the GOP as the party of personal greed, cowardice and a true statement of their disinterest in representing their electorate in legislation. Use voters and legislate for donors--the GOP battle cry!

  61. @Susan
    I'm sorry, but rise in premiums has long been overdue. Whatever low premiums enjoyed in the past, a mirage created by Obamacare, and at the cost of mandated enrollees and giong-for-broke insurance companies. The House plan is a good one. List too long to get into by one comment, and paper too left-leaning to get into by anyone. But its a huuuuge improvement, trust me.

  62. Obamacare was already a compromise based on a conservative (Heritage Foundation, Romneycare) model. It's the Repubs who do and did not want to give an inch and who do and did not want to negotiate. Lesson for the Democrats: do not try to negotiate and placate the Repubs. No concessions will ever be enough.

  63. Trump is hurting everyone as he dismantles everything that helps people with his most powerful tools, ignorance and hate.

  64. "What’s bizarre about the Republican strategy is that it is likely to cause the most damage where many of Mr. Trump’s supporters live."

    But just try and convince them of that...

  65. It's too late, the Kool-Aid has already been drunk.

  66. When I saw his supporters at a Trump rally clapping and cheering at losing their health insurance, I knew it was a lost cause.

  67. That is the ultimate tragedy. They still think he's fighting for them and giving them a voice when, in truth, they've been had -- bigly.

  68. Already this uncertainty is creating havoc. People in their 60's thinking about retiring must be wondering, "I'm feeling good today, but if something happens will I be able to get healthcare insurance in a couple of years?" "Can I risk the farm and all I've worked for and go uninsured for a couple of years if I have to?"

    Corporations and government go on forever but time moves on for people, we get old and die and there is no way around it. We need a decision today. We can't wait five years.

  69. @Steve: Obamacare is punitive to older customers -- they are charged 300-400% MORE than younger customers.

    That is grossly unfair and unaffordable.

    NO insurance can EVER succeed unless it charges everyone the same -- at least, on a sliding scale based on income.

  70. If the nation wants great health care, it must be taken out of the insurance company market economy and away from greedy Republican hands. Who will personally profit from Trumpcare? Health Insurers already decide what level of care a person receives because they alone decide when and if a provider (doctor, hospital, etc.) will be paid for services already rendered. Their decision tree shapes what type of care is given, and true medical innovation dies along with the patient. Trumpcare takes the problems of Obamacare and magnifies them by removing any oversight, limits access and then selecting healthy folks to insure. Great plan. Regardless of what form Trumpcare takes, insurers will be paid and well paid under Republican eyes. Insurance company complaints about "lost income" in small markets in low population states needs to be investigated for veracity. Are CEO's not being paid? Not! Are Republican Representatives and Senators changing the ACA out of duty to constituents or to their own personal bank accounts, or those of their benefactors?

  71. It's time for the patriots in theGOP, if there are any, to break away from their traitorous "leaders" McConnell and Ryan and join the Democrats in getting impeachment under way.

  72. See: Charlie Sykes

  73. Make sure they get Pence, too.

  74. Trump supporters voted against their own best interests.
    They're just getting what they deserve.

  75. Brad, many would agree wholeheartedly.
    But many who did not chose "him" will not be getting what we actually do deserve.
    We are all collateral damage for Republican "policies", in one way or another eventually. What makes men and some women so mean?

    The amount of time and money that this country Wastes on a daily basis is astounding. What we could accomplish with so many resources.....and we just continue to flounder.

  76. And they won't change
    By deflecting blame from himself, he is helping them deflect accountability for creating this situation

  77. Excellent explanation of what is and will be in The future of millions of Americans concerning their healthcare. Republicans appear to be more interested in cutting taxes for the very wealthy and abandoning healthcare for millions of middle and lower income people who desperately want and need healthcare. Thank You so much for your insight and compassionate editorial. The Press must continue to keep this before the country.

  78. Is America winning and getting tired of it yet?
    Just asking.

  79. Markets up since election day
    unemployment rate down further
    etc etc

  80. In tandem, so this is what you do to make America great again?

  81. @ND, You could have said the same thing for every month that Obama was President and yet you chose to believe America was in decline, real unemployment was 44%, the stock market was a bubble etc etc.

  82. The consistency with which his base votes against their own economic interests is not only startling but it is demoralizing. Until and unless the GOP is exposed for the corporate prostitutes they are and the Trump base educated and accepting of this reality I see little hope or opportunity to change editorials like this.

  83. I've figured out the reason for this: 30+ years of indoctrination into the idea that liberals are the enemies of America, to be opposed without quarter in every way. The conservative mind loves to play the victim and needs an enemy, and decades of Rush, Fox, Glenn Beck, Ann "The Beast" Coulter and more have brainwashed conservatives into believing that liberals hate everything "real America" stands for: capitalism, Jesus, guns, white people, the unborn, freedom, the military, marriage, the work ethic, religion, you name it. Thus, steeped in the notion that liberalism is out to ravage everything good in America, conservatives will support any policies they believe liberals oppose or that anger liberals, and oppose anything they are told liberals favor, such as single payer health insurance. The powerful emotional satisfaction of this virulent tribalism trumps (pardon the pun) any benefit the conservative voter might receive from the so-called liberal policies.

  84. Hacks & shills...and the fact that they are bought off so cheaply is even more astounding. I consider these people to be anti-American and we need to remove them from our payroll...these guys are terrible public servants.

  85. It is the 46% of US who do not vote who need to be reawakened.
    His base would then become meaningless.

  86. Why do republicans think dead americans due to a lack of healthcare is good policy?
    Just asking.

  87. Because dead Americans can't vote?

  88. This is why the Republicans think that:
    It's a good policy in their view because most of the dead Americans due to a lack of health care will be poor and non-white.
    As the Republicans make abundantly clear every day, they believe that the United States is a country solely for rich white men. (And perhaps a few women for them to grope.)

  89. But Jay, those dead Americans will not be any of the rich or politically connected. So, their lives (& deaths) won't matter to the GOP.
    Trump, McConnel, Ryan luuuuuuuv the uneducated & gullible to death!

  90. A transition to Medicare for all is the only logical solution. It would even make insurers happy. As they now enjoy selling profitable medicare advantage and medicare supplement policies. The time has come for the solution the rest of the industrialized countries have in place, single payer and universal coverage.

  91. And those insurance companies cheat to make the medicare advantage policies even more profitable. I think the word advantage was supposed to mean the policy holder got better benefits for fewer dollars, but I think the benefits actually accrue to the insurance company.

  92. No, bad idea. As of now you get Medicare after working for over 45 years, paying into it's Trust Fund with every pay check. Dump the rest of the country in before they have paid in for that many years & boom Medicare is not only insolvent but GONE.
    Of course congress wants this, along with making everyone pay into that plan, even though we will never see a penny out of it. Why? Congress has been embezzling from the SS & Medicare Trust Funds, since the inception of each plan $3 trillion so far. Ryan wants to gut the program, but, continue making us pay more & more in, so they can keep stealing from them both. What they don't steal they use to offset some of the deficit.
    Both SS & Medicare are not 'benefits' or 'entitlements' like Medicaid. They are government run retirement & senior health care plans paid for by premiums we pay into both with every paycheck. You want something like it? Build your own. Keep your hands off Medicare, & SS, or your retirement could start, if it starts at all, at around 95, with you needing full employment for every week before that from the age of 18. Then you will get a voucher worth zilch for Medicare, & find SS is busted, no payments at all, for anyone. Congress just wants the premium payments (those 'taxes' out of your paychecks are really premiums) to spend on boondoggles, & private enterprise. Oh the Boomers, who have paid in since the day they started working are not the cause of any 'insolvency'. Embezzlement is. Think on that.

  93. That's single payer

  94. I'll state it again for the umpteenth time. Single Payer.
    See:

    http://www.pnhp.org/

    Included on this page is a bill in the House, HR 676, a Medicare for all bill introduced by John Conyers and with 110 co-sponsors.

  95. Bud
    Just like as in every country which utilizes single payer plans or some variation of them, the taxpayers pay the bill. For an instructive video on the Canadian plan see:

    http://thehealthcaremovie.net/home/

    The Canadian people pay for health care for everyone and they very much like the system.

  96. @Jordan: and Canada is 1/10th our size, but on a landmass that is even larger than the Continental US and enormously wealthy in oil, gas, tar sands, lumber, diamonds -- but with 1/10th as many people to share it with.

    On top of that: Canada is overwhelmingly white and asian, with almost no poor people and no hispanics and 2% black (mostly educated Caribbean immigrants).

    In short, they have no poor underclass such as the US does -- 1/3rd of population, mostly minorities.

    If we imported to Canada about 10 million poor blacks and hispanics and illegal aliens....their single payer system would entirely collapse within six months.

  97. Speaking from experience as a retired health care products entrepreneur, the health insurance debate, including your editorial is off. You are correct that if the federal government would subsidize the insurers with the reinsurance guarantees promised under the ACA, they may be induced to hang in the markets. However, its way more complicated than that. Who knew? The big challenge is that premiums are merely a reflection of health care services costs covered by health plan benefits. Increased deductibles and co payments/co-insurance only reduce premiums by forcing consumers to pay part or all of the these costs. I still don't understand why our leaders - Trump, Congress and others don't allow insurance providers and Medicare itself to offer a Medicare or Medicare-type program to those who are under insured. Those who cannot afford would be subsidized directly and those who can afford would pay for themselves. This would be a much more efficient policy to execute (vs. both ACA and Trumpcare options- neither are solutions.) The reason this is better is because Medicare pays doctors and hospitals at very competitive rates and therefore the base health care costs should be lower than private alternatives. Finally, I realize that this is a 'public option' and therefore will be opposed on philosophical grounds by some. But, the fact is that Medicare isn't going anywhere and baby boomers are entering its ranks in record numbers so public options are a fact of life.

  98. The fly in the ointment of Medicare paying doctors at competitive rates is doctors are increasingly refusing medicare patients or setting up "concierge" plans to make more reasonable money...

  99. Understood. Still, most doctors participate in Medicare and soon, when there are over 85M Medicare beneficiaries, it will be hard to ignore for younger grads to stay out of the medicare market. Also, nothing wrong with concierge plans but they've been around for over 20 years now and they haven't been terribly disruptive. Finally, younger people joining medicare may help convince doctors to stay.

  100. Obamacare has problems. Even though it passed without a single Republican vote, the Democrats and Obama said that the bill was far from perfect and would need significant changes in the near future in order to function properly.

    The problem is we have too many old people in comparison to the number of young people - it is less of a mandate issue.

    The problem is population demographics not the mandate issue. For example the A.C.A. relies too heavily on young healthy people signing up in droves who are willing to pay 300% or more than what their actuarial risk is in terms of price. The demographics of the fact is that there is not a huge base of available young people to adequately subsidize all of us late boomers. I was born in 1958 and me and my peer group need our ACA insurance subsidized by people born in 1988 for example to be affordable. Problem, lots of babies born in 1958 - not so much in 1988. But, under the ACA I rely on that 30 year old to help pay a generous portion my premium as well as all of their premium in effect. In 1988, I was 30, and someone who was 58 was born in 1930. The ACA would have worked great in 1988, because there was a massive pool of young people compared to older people. I agree that rigorous enforcement of a more punitive mandate forcing more young people into the pool helps the funding. But, premium-wise we are really crushing young people at a time when we want them to be able to form their own households and families.

  101. Why do you think it is just or ethical for people who have the most recources (retirees) to insist people with the least resources (young adults) pay for your care?

    This is nothing but a wealth transfer from the least well off to the most well off.

  102. Just how limited is Congressional memory? Some of the biggest factors that pushed the ACA into reality were economic: Americans were filing bankruptcy at record levels not because they were unemployed but because they were uninsured, or underinsured, and experienced a severe health crisis. Large employers were furious with double digit insurance premium increases brought on in part by cost shifting to insurers what the uninsured couldn't pay (and assisted by the industry's move from not for profit to for profit status.) Hospitals in poor and rural areas began eliminating services and closing doors because they didn't have enough paying patients. And the number of Americans working in part time positions without health benefits was increasing dramatically.
    Congress held multiple hearings and did massive hand-wringing over each of these issues. The ACA, although flawed from the start by compromise and winged significantly by the Supreme Court, was designed to solve for these economic issues.
    Our current Congress needs to take a walk down memory lane before it sends the country back to an unworkable health insurance system.

  103. Rates have been rising given the current rules of Obamacare, not due to fear that there will be no Obamacare exchange in the future.

    My increase this year was 77%. Well before Trump even won the election.

    Actually, the insurer did not technically raise the rate of my plan at all. They simply said my existing plan is not being offered next year and the lowest cost alternative plan is 77% more than last year.

    Trying to blame massive increases in Obamacare plans on Trump is a remarkable exercise in untruthfulness.

  104. I am on Medicare and so far it is the easiest to use least restrictive health insurance I have ever had. I was a teacher for 30 years and had excellent health insurance, so that's a compliment from me. It's what everyone in America needs and deserves. I have already witnessed the effects of Trump's threats on the insurance of my one granddaughter under Ohio's medicaid expansion. One county took it away for no real reason when she moved. Now the local hospital is working to reinstate her insurance after she had a medical emergency. The GOP and Trump are making a mess for average Americans. And I'm afraid that it's only going to get worse.

  105. The problem with Trumpcare and Obamacare is the disconnection between the goals of the parties in the interaction. People want (and need) health care for their very survival and wish to insure it with the least impact on all the other things in their list of wants and needs. Insurance companies have as their prime directive their survival as an entity and seek to maximize the profits that accrue to their actions. Insurance companies are under no moral requirement to insure any particular group or individual. The closest parallel is between the US Postal Service and commercial shippers like FedEx and UPS. The commercial shippers can "offload" unproductive routes and customers to the USPS just as the sick and the poor are dumped into the public sector through the doors of the emergency room and systems of first responders nationwide.

    We can optimize health care only when we start by defining our desired end state. If we agree health care to be a right and a just thing to do as a country, then we can find the most efficient way to fund it. We began this exercise in the allocation of scarce resources with the introduction of renal dialysis in the 1970's and will complete it only with the ultimate acceptance of single payer coverage driving the profit out of health coverage nationally.

  106. It seems inevitable that we will eventually go to single payer because the system is not working. It's going to take a major catastrophe for the Republicans to finally get that; although I suspect many already do and are just stalling as long as they can. We need more progressives in DC and in our state legislatures who will gladly push this into reality. The people are ready.

  107. The people will be ready when they quit playing the game of "sock it to me"
    with Republicans.

  108. Perhaps it could happen in New York, but most state legislatures and governorships are help by Republicans. Recently the State Legislature of Kansas passed a bill to expand Medicaid coverage in that state, and Governor Brownback vetoed it.

  109. O.K. I agree the ACA is a better system than what we had before. It is much better than any of the Republican proposals. Trump's statement IS nasty and stupid. BUT we should never forget that compared to the rest of the developed world and especially the wealthy developed nations, the ACA is 2nd or 3rd rate.

    1. It is not universal. Millions still lack any form of health insurance.

    2. Many are covered by policies with high deductible and co-pays they cannot afford.

    3. The cost of our health care is still way above what others pay. The OECD average of cost per person is less than 40% of what we pay--$3463 vs. $8713 in 2013). We pay twice as much as the other wealthy countries.

    4. Our bottom line statistics are barely average and compared to the wealthy countries they are way worse.

    5. The ACA is exceedingly complex. This means it is difficult to run and opens it up to many attacks.

    We had a chance for something much better. At the start of the health care debate, HR676, a 70 page bill which simply gave an improved Medicare to every man women and child, had over 100 sponsors in the House. BUT the Obama administration decided to take single payer off the table from the get go. In spite of his many. many compromises, the ACA failed to get a single Republican vote.

    Whatever we do now, we should keep our eyes on the goal of a simple, universal, efficient health care system.

  110. When making comparisons to other nations and healthcare, the only comparable nation to the US (population size and diversity) is Brazil.

    Comparing the US to homogenous countries in northern europe with populations smaller than Ohio is dishonest at best. Canada and England are not apt comparisons either, they are still very homogeneous (85% white), with much more social cohesion.

  111. ND - It seems to me a larger country would have economies of scale. Anyway, in aggregate, the OECD countries are much larger than the US.

    There are 30 countries in the OECD. Some like Sweden have a larger percentage of foreign born. Others like Australia have at least as much obesity, smoking and drinking than the US.

    What they ALL have in common is a universal, government run health care system that is vastly more efficient (better results at much lower cost) than ours.

  112. The single-payer/Medicare option was withdrawn from the ACA because it would have been impossible to pass the bill with it; witness Republican intransigence that NOT ONE REPUBLICAN voted for it. Doesn't that fact say where the loyalties of Republicans lie? Not with citizens, but with the big insurance and pharma companies.

  113. The one consequence of the House bill is the eroding of the ACA--just like that houseplant unwatered and neglected during vacation. The bill will NOT pass the Senate--it's only virtue is a "win" (Phyrric victory possibly) although how the GOP can consider that fulfilling "Repeal and Replace" is served by "Gut and Destroy" is beyond me.

    For all of us this bill--most of all--let's us know the GOP is just like Trump, in it for themselves. They should lose the moniker "the Party of Family Values" as their bill has the intent of robbing our poorest families to give to the wealthy--possibly the biggest wealth transfer in US history. The health part? That's a mere bandaid for slashing wounds.

  114. My question is why isn't the President and his ability to make deals talking to insurance companies to find ways to keep them in the exchanges? Why isn't he? Because dismantling Obamacare is more important then actually creating affordable health care for Americans. Once again it all about politics over what is best for the country. The ACA gives the Secretary of Health and Human Services a lot of power to enact policy on health care. Why isn't that happening? Why isn't Section 1333 of the ACA which allows insurance companies to sell across state lines (a major campaign proposal for Trump) already being put into action? It is because the President and Republicans who worked so hard to discredit the ACA would rather hurt people by repealing then fixing the problems.

    Lastly, the lack of understanding of how insurance works as a business undermines our ability to have a real discussion on what works best for our country. Most people are required by law to purchase auto insurance to drive a car but we push back when the law says we are required by law to purchase health insurance. We want our cake and eat it to. We want cheap, comprehensive insurance at incredibly low prices but push back when we are told that for insurance companies to make insurance financially viable you need a large pool of healthy people to keep the thing solvent. America needs to decide what we want. We can't have it all. Sometimes you have to make hard decisions.

  115. Obamacare is dead. There is no fixing it. The democrats had 8 years to fix it - they did absolutely nothing. They are proposing absolutely nothing to fix it now. And they have the gall to blame Trump and the Republicans for the failure of Obamacare.

  116. The FEDERAL GOVERNMENT does not require car insurance. It is a state issue.

    And you do not have to drive nor own a car. If you do not own a car or drive, then you do not have to buy car insurance.

    That is the stupidest comparison and yet liberals haul it out over and over again.

  117. What do we learn from this essay?

    1) That there hoggish stubbornness of the Republican Party, demonstrated over the last eight years when they slammed against Obama repeatedly but never bothered to develop workable policies and proposals of their own, will cost them.

    2) That Americans should not have to rely on private, profit-driven insurance corporations to provide them with healthcare. Health insurance in the US should be insured and funded by the US government.

  118. Party Over Country hurting the economy? Transfer of wealth from the bottom 90% to the top 1% hurting the country?
    Perhaps. But there is no way those who vote GOP will believe it.
    They will say they are better off because they have more FREEDOM.

  119. Well, if in four years Trump's supporters can look at their insurance policies and honestly say that they have a great plan at a better price than today.. well go ahead and vote Republican again. if not... then they need to ask themselves "has the GOP really had my best interests in mind?"

  120. The ACA is done there is no need to keep beating a dead horse it would have died on its own no matter who won. Where I live you cannot find a doctor and if you do it is better to go to the emergency room and say you are not covered. The emergency room is free, at the doctors office you pay on a $5000 to $7000 deductible. People should be supporting any revision of healthcare. I lived for sixty years and the only thing people had was employer healthcare, medicare or medicaid. If the Democrats really care about the people they would join the Republicans and create a workable healthcare system for everyone.

  121. a workable healthcare system for everyone.
    The rest of the world have it - why not here ?!

  122. Thanks for your opinion. How about the Republican ask the Democrat to join them for the sake of the people they serve, not the 1% rich tax breaks, and give Medicare for all to cut down the cost.

  123. "If the Democrats really care about the people they would join the Republicans and create a workable healthcare system for everyone."

    The Democrats created the ACA. It's certainly imperfect but it is a workable system for everyone. It was the Republicans who refused to join them in creating it. Seven years ago, ECT, were you urging Republicans to do what you are now insisting the Democrats do?

    The ACA has the intention of really and truly helping people. The current Republican plan hurts many and is really a tax cut for the wealthy in disguise.

    Should the Republicans actually come up with a better plan -- like single-payer -- I'm sure they would find great support from Democrats.

  124. During the campaign, Trump promised more, better and cheaper coverage for Americans. That isn't happening due the action, or more appropriately, inaction of Congress and the President to repeal, replace or fix Obamacare, or however they want to phrase it. The fact is, they are not improving healthcare for Americans, but compromising the physical and financial health of people at risk. Its all so painfully obvious to anyone but the blind and politically stubborn.

  125. This will never make sense to me. America pays far more for healthcare than any other country as a percentage of GDP and generally has poorer outcomes. If Republicans truly wanted to cut costs, they would support single payer a system that would reduce costs and bureaucracy. Their policies have little to do with what makes sense and more about overturning Obama policies and punishing those lay about democrats who had the temerity to elect a black man president. Who can disagree with healthy school lunches, clean water and air and cars that get better better gas mileage? Dismantling regulations that are already in place, that have already been paid for and are for the good of the many is just plain stupid and not in the interests of the country as a whole, but yet the Republicans press on. It's just another shot in the foot, like the costly shutting down of the government or the war on women's rights. Unfortunately, Trump voters seem to care less about the facts and more about the marketing. The people that the repeal of ACA will hurt most are the Trump voters in the middle of the country who wear their ignorance like a badge of honor. I am less afraid of what Congress will actually do, because in fact they seem unable to do anything, than the ill effects their policy decisions will have, because they give big corporations such as healthcare companies, the ability to act with impunity under the cover of political uncertainty.

  126. Incorrect.

    We dont have generally worse health care outcomes than nations of comparable size and diversity. We have the best outcomes when compared to nations actually comparable, like Brazil.

    Dont compare a large multi ethnic multi cultural to homogeneous countries with small populations and a single culture.

  127. That wasn't a flaw, it was part of the design process ....

    The destruction of any interest by insurers to participate in the ACA health insurance marketplace was deliberate.

    The only impact the GOP measures is their ability to get their way. They certainly don't care about life expectancy, a healthy enviornment, or avoidance of Death Panels.

  128. Did you actually write Trump and or Congress are persuading insurance companies to increase rates or exit the program? These are for profit companies and will do what most profitable for their share holders. If they are losing money on Obamacare they will stop offering it or increase rates.

    How unprofessional to suggest anything else.

  129. "These are for profit companies and will do what (is) most profitable for their share holders (sic)." In this case, as the article clearly suggests, those companies are in a panic to protect their profiteering ways far in advance of any real threat. That's both myopic and paranoiac, and it reflects the truly ugly side of capitalism/corporatism run amuck, where profits trump values and social responsibility every time.

    How naive to suggest anything else.

  130. Of course they are for profit. So stop suggesting that Trump and the Congress are forcing these companies to drop Obamacare.

  131. lets start with the obvious Health care for all is a need and a right.
    The Republicans argue why should pay for someone else,s misfortune or good fortune if a pregnancy.Why should the young pay for the old
    I could argue why should I pay for their education which I do in two different counties. Why should I pay for wars I do not agree with, underfunded flood insurance, agricultural subsidies etc.
    The answer is because we are a nation with common values and a constitution that is based on a common pursuit of happiness.

    Let us also agree Insurance companies are not reliable partners , they will walk away from any market that does deliver excessive profits and or are high risk.
    Proof Flood insurance.
    Democrats must propose and fight for a public option based on the Medicare infrastructure. It must be self funding including subsidies currently provided for individuals and insurance companies.
    They must fight for reduction in drug prices to European levels .
    Then they must recognize that health care is complicated and politicians are incapable of formulating an efficient health care system , we need an expert commission to come up with a plan using countries like Germany who deliver far better, more cost effective , as a reference point.
    I realize that some of these ideas have been voiced by some Democrats but as yet there is no full throated coordinated , comprehensive response from Democrats.
    Come on Perez do your job.

  132. Missing from the article is the extortion Trump administration officials are attempting, flat out saying to insurers that the GOP will make sure the subsidies get paid if they will back the AHCA.

  133. The biggest reason for this kind of debate is exactly what you keep doing in this editorial and elsewhere. Although President Obama has been gone for over 4 months, you keep referring to the ACA as "Obamacare". That is a red flag to Republicans who then lose all sense of morality and honesty when they see or hear that. If you simply refer to the health law of the land by its real name instead of its political name, you may be surprised how much more progress may be made, especially with those "vote against their own interest" partisans.

  134. Editorials such as this assume that the Republicans are pursuing the goals that they say they are pursuing, e.g., good health for all Americans at an affordable cost. Then, the argument goes, since the Republicans are advocating particular policies that harm many Americans, they Republicans will advocate less harmful policies after they take note of the consequences.

    I think a more elegant explanation is that the thought-leaders in the Republican party are committed Social Darwinists who, when they look at America, see the baleful consequences of the "welfare state" inaugurated by FDR. In their view, all but those who have clawed their way to the top have become addicted to the resources that flow to them from the government. Democrats are sick people who cannot be relied on to change: the "takers." But the Republicans might sincerely believe that by disabling the government's ability to transfer good things, viz, insurance subsidies, to some people, they are helping them stand up, be strong, and win in the struggle for existence.

    That ideology openly expressed would not win elections. So, the trick is to capture those voters who do share belief that life should be like a war of all against all, while fooling a sufficient number of voters into thinking that they will keep THEIR benefits even as the benefits of "others" get taken away.

  135. Quite right. The GOP consternation over the AHCA is how to provide a tax cut to 1/4% of the voters and still get reelected. Their bet is some of the tax cut will go toward ads in their campaigns that will cleverly craft this giveaway as a boon.

  136. Steve is absolutely correct. My sister is a rabid Trumpista, and is quite forthright about this ideology: helping support poor children simply enables the unfit to have more of them, drug addicts are responsible for their own behavior and so should have no public support for rehab, etc. She feels that she has done everything right and moral in life and yet suffered some difficult times (international custody battle), so why should people who haven't done the right and moral thing NOT suffer?

  137. I can't help but wonder if your interpretation gives them more credit than they are due. Maybe they really just don't care what happens to the poor, the sick and the elderly.

  138. Yes, the effects are true of what Republicans are doing/not doing to Obamacare as described herein.

    But, Trumpcare is really just a Trojan horse for tax cuts. The overriding objective of Republican Party leaders and congressional representatives is to make room in the Federal Budget for massive tax cuts by cutting $880 billion from Medicaid, plus cutting $673 billion in subsidies for the poor, plus repealing Obamacare taxes of $575 billion mostly on wealthy people and corporations.

    Republicans in the Senate will probably walk away from the additional billions in cuts that the C.B.O. hasn't even estimated yet which the House built into Trumpcare_V2 by creating waivers for essential benefits and the pre-existing condition exclusion. But, they will not walk away from taking $1.4 billion from the poor and cutting their own taxes by another almost $600 billion.

    They are not going to support Medicare (or now some other optimists are saying Medicaid) for all. They are not going to support any form of single payer. We are much more likely to see Ryan and McConnell try to cap Medicare to free up even billions more for tax cuts.

    So, they are happy to let Obamacare die on the vine. But, they can't wait too long because that delays their ability to pass tax cuts that don't make it too clear that they want to operate the Federal Government on a trillion or more borrowed dollars each year.

    Only getting them out of office will stop them from what they are doing to Obamacare

  139. There's that sad old meme about politics: "Things won't get better until after they get a whole lot worse."

    The states seeing Obamacare collapse are the lower-population rural states with more older, sicker people and fleeing young, and typically they didn't accept the medicare expansion. It is costlier to provide services and the people are generally poorer. Without generous subsidies, it's DOA.

    RyanNoCare inevitably dooms a lot of people to lack of healthcare they can possibly afford; it does amount to Congress being a "death panel." Lower-income but not really poor people in the 50 - 65 age range who do not have good company-supported healthcare are the real losers -- and this describes much of Trump voters. These poor schmucks are still supporting their representatives who are literally planning to kill or disable many of them.

    It will take time for them to cope with the realities, time for that to affect Congress. But the Republicans cannot be so dense as to think that blaming Obama will continue to work ... can they?

  140. Of course they can be so dense!

  141. Here is how the capitalist system is working in our area regarding medical care. One of the few general care physicians left decided he was working too hard for too little money despite the fact that most patients ended up seeing his PA rather than the doctor himself: he turned to "concierge" medicine. One could pay $1750 a year up front to be guaranteed being able to get an appointment and he would take a maximum of 500 patients. Since even most of us old folks only see a GP once or twice a year, that means he only has to see four or five a day and still make a fortune. And that annual fee is just to get in the door. Plus he no longer accepts insurance. He is the second one to go concierge and there may be more. The rest of us will be relegated to waiting months for an appointment with the few regular practicing doctors that are left although one can get in to see a specialist within a few days or weeks. We will be moving to a border state soon, so I guess we can go to Canada to get medical care faster when we need it!

  142. I disagree with this article. In fact, I would like to see insurance companies out of the business of selling health insurance altogether with a Single Payer system.

  143. Letting others pick up the tab is Trumps way. His "success" was because people over invested in his leadership making him "too big to fail".
    Many banks know this.

  144. Let me be the first to declare that: “Obamacare is Dead”. It was killed by Trump and the Republican Party without even firing a shot. Both are still trying to load their guns. The only question remaining is what to name the new Healthcare System? How about “Republicancare”,”Trumpcare” or hold a National Contest to “Name the XXXXcare.

    Keep in mind our Healthcare System is presently controlled by Hedge Fund Managers who own Hospitals, Health Insurance and Big Pharma. They claim to reduce my medical bills by 70% and yet all are making big bucks as they "Represent" me. Yet no one even suspects Collusion.

    Our new mantra should be “Single Payer, Single Payer, Single Payer, Single Payer”

  145. The slanted NY Times really should be ashamed of themselves, again. Trumpcare is NOT law. It has not been passed and likely won't be by the Senate in its current form. You guys know that. Why the slanted headlines?
    Both Obamacare and Trumpcare are bad deals for many people. Obamacare just robs Peter (the middle class and upper middle class) to pay Paul (the poor and those who chose not to work). We need to control healthcare costs in a huge way. Until we do this nothing is going to work. And start telling the truth NY Times. Your MO is getting really tired.

  146. Oh, I am so tired of this, whenever anyone reads something they don't like, the source is "slanted".

    Wake up! If the fools would have just let the ACA continue and -- heaven help us -- actually work to improve it, we'd have a pretty darn good healthcare system for all.

    Then, we could have moved on to trimming healthcare costs (good luck with that, since the industry lobbyists have Congress in their grip).

    And by the way, you can rob me (Peter) to pay Paul any day of the week to give health care to the poor and unfortunate, rather than robbing me blind to pour money into the defense industry for bombs to send to the desert so we can make more jihadist enemies.

  147. Ryancare or TrumptyDumptycare, whatever... threatens the health insurance companies. They are risk-adverse, so they adjust their businesses accordingly. This is how the free markets work, and how the free press reports it.

    BTW, what kind of healthcare do you have?

  148. As for those polls, the propaganda machines have not weighed in yet. Before declaring the advent of Trumpcare a political victory for Democrats, better wait until Trumpcare is a reality and an election is taking place. Polls tend to be influenced more by spin than the misery of a segment of the population.

  149. Everyone knows that the ACA would need tweaking. Democrats need to stand for the American people and be specific and proscriptive on how they will improve the ACA. Or they need to go all in on medicare for all.

    Trump won the presidency because he said he had a plan and the people wanted someone to do something. If democrats want to win they need to stand for something...they need to go all in and they need a plan and they need to shout their plan from every rooftop and every microphone.

  150. Trump Country needs to get shaken up. If watching Republican health care policies result in peoples' families and friends being allowed (encouraged?) to sicken and die and not receive the medical care they need, well perhaps then and only then will these people understand what THEY have voted for. Take off those stupid red hats and open your eyes.

  151. In other words the Republicans have found good way to kill off their base.
    Nothing surprising about that.

  152. It is unlikely Trump's supporters would do anything other than blame Obama or the Swamp. These low educated individuals only receive their "news" from Fox entertainment. Recently, either the NYTimes of the Washington Post reported that, these stations have not even addressed many issues either from trump or the WH. That makes it unlikely they know what caused the loss of Healthcare.

    Trump as a unique behavior, that either blames Obama or Clinton for everything, he is always beyond reproach. His response is similar to a 5 year old, that answers "not me" to the broken lamp.

  153. When will the CBO rate the latest nonsense from the House's Trumpcare proposal?

    That's what shut down the previous attempt to destroy Obamacare.

  154. Managed Care is income redistribution. The rich help pay for the poor. Republicans owe their souls to big business and the upper 5% of income earners. Income redistribution cannot be allowed to stand. And here is the genius of the Republicans actions, they have convinced middle America that they are trying to help them and that the ACA is the problem. Trump's base will believe trump and not the information provided here. We have seen this kind of slavish devotion before, when Joseph Goebbels put his kids to death at the end of WWII because he did not want them living in a world without Hitler.

  155. I don't feel sorry for anyone who voted for Trump. I feel sorry for the people who didn't vote for him and are adversely affected by his idiocy.

  156. The most disgraceful component of all this is The Donald's personal involvement with it. Far from affording Americans with great health coverage for everybody at low, low costs (as per his campaign promises), he signed off on both versions of the Republican plan- one worse than the other- neither of which delivers anything remotely resembling the goodies he had cynically advocated. It's clear that for this particular chief executive a legislative victory (for which he'd inevitably claim credit) is anything that erases the legacy of his popularly-elected Kenyan predecessor. And the fools who bought his promises continue to support him, unaware or unconcerned that those promises turn out to have meant absolutely nothing.

  157. Trumpcare = AHCA = Anti-American Health Care Act

  158. I used to work for one of the "Big Six" insurance companies in Southern California (in the 90's) and what I observed was a gross error made by executives which led to the dismantling/sale of the company - most of the employees laid off, but the executives ushered to safety in other divisions of the company. When are we going to understand how this works in America? Those with power (meaning $$) use the system to their exclusive advantage -- membership into the club. If you aren't a member you pay a higher tax rate, receive worse services, can't afford to fight for your rights in a court of law, become employed in a "right - to work" state (which means you have no rights), no longer have a union representing you, etc. The constitution was shredded some time ago - up is down, there is no right or wrong - just winners and losers. If you follow the "rules" you were taught growing up, that automatically makes you a loser. Our "representatives" in Washington don't work for our interests - they are there to serve the wealthy. All the rest, and all of this daily discussion about the White House, the GOP and the Democrats, is just window dressing. As entertaining as it is, I don't forget for a minute what is really taking place. Where I work now -- recently I watched the boss discount a luxury appliance package (fridge alone is $12K) down to cost + 5%, because the customer is a member of the club and expects this arrangement. You bet it's rigged!

  159. By handing all three branches to the GOP/Wizard of Oz Party, we will not receive a heart, courage or a way back to Aunty Em. This version is a horror show, where the Wiz stays behind the curtain, inept and cruel, while we carry our needs on down the road. I don't worry about Trump voters anymore, because we are going to be united as Americans, in pain, very soon. Whether it's loss of healthcare, school funding, stock market decline, climate change or a crazy military endeavor...unavoidable hard times await all of us beyond the "honeymoon" of this anti-administration. And get home to Kansas? Why it's already fallen to the supply siders and their flying monkeys. Impeachment is not red sparkly shoes. Somebody tweet Glenda so I don't lose my mind.

  160. Kansas here. We have been living the Trump plan, for years. This state is beyond bankrupt. If not for all the upstanding folks living on the Federal government teat ( " farm" subsidies, shady tax deals, etc.) , this would indeed be third world living. You really can't fix stupid AND stubborn. Yes, I feel extreme empathy for the children ( severely underfunded schools, etc.) and those too poor to move out. BUT, I am finally out of compassion for those that continue to reflexively vote GOP, then act surprised when their situation, and lives, worsen. Eventually, you get exactly what you vote for.
    They will blame the " libruls" and Obama for their plight. Seriously.

  161. Some thoughts. [1] Everyone who voted for Trump is getting the shaft now that they and their votes are not needed. [2] Everyone who blames Obamacare for their jacked up premiums and threats of reduced care should remember that Obamacare is the only thing that the Republican "We ain't going to do nothin' for nobody not rich" Congress did to stop healthcare. [3] There's too many get rich doctors. Give them a choice: treat everyone or lose their licenses to practice. [4] Single payer is the way to go for all Americans.

  162. There is no sympathy for the fools who believed for a second that the promises of " a really terrific plan" would ever materialize especially in the hands of the Republican majority.
    The Republican Party has never been a benefactor to the underprivileged so why would they suddenly change their positions. Tax cuts for the wealthy and reduced budgets for services was what the Liar-in-Chief relies on to protect his own rather plump posterior among Republicans

  163. Liar-in-Chief - "If you like your doctor, you can keep your doctor. If you like your health care plan, you can keep your health care plan." and "I can make a firm pledge. Under my plan, no family making less than $250,000 a year will see any form of tax increase. Not your income tax, not your payroll tax, not your capital gains taxes, not any of your taxes."

    That Liar-in-Chief?

  164. And still the Congress gets its gold plated health insurance. No effort is made to extend this coverage or the choices to the average American. Are we not worthy of decent affordable health care? We pay their salaries, perks, and elect them to serve us, not themselves, yet they, like the animals in "Animal Farm" treat themselves as more equal than the ordinary American. What's wrong with this picture?

    As human beings Americans should have access to the health care they need when and where they need it. All of us, not some of us. As human beings we should not have to worry that an accident, a serious illness, or just getting old and dying will leave us or our families impoverished because of the care we'll need. Doctors, hospitals, and other providers should not be allowed to opt out of accepting insurance payments or, if we go to universal access single payor, those payments. The problem with the ACA is that it's a great deal for the health care industry but not for most Americans who cannot afford the premiums, co-pays, deductibles, and other associated costs.

    Trumpcare doesn't exist yet. In truth, America does not have a health CARE system. We have a wealth care system: we get the best care our wealth, or lack of wealth, can buy. And the system has so many gotchas in it that no matter how hard we try, we're stung by at least one or more of them when we need to use it.

  165. One last time: Trump voters DON'T CARE. They'll gladly suffer if it keeps benefits from Those People.

  166. "Support the mission of the New York Times" is the new advertising slogan.
    The "mission" seems to be "Trump resistance" at all cost,with the ends justifying the means.Paralysis of the federal government is not a worthy goal.
    Allegations based on unnamed sources, without any quotations from anyone is not "honest journalism".
    For example, two unnamed associates of Comey say that Comey said that Trump said something but apparently no one will commit to a quotation from anyone.
    This is modern day McCarthyism.

  167. The Republican Congress paralyzed the federal government from 2010 to 2016. The current president started and perpetuated the birther conspiracy against President Obama without a single fact to support his position. The current president continues to accuse President Obama of committing crimes against him. Just saying.

  168. Obama let the insurance companies run his Obamacare initiative. What you see now is the result of HIS poor policy. This further division through a Russian collusion theory (for HRC losing the election and a need to blame someone) has stalled any compromise with the healthcare. The leftists do not care what they do to the people of this country and they are smart. They know what is going on.

  169. This carefully crafted piece of journalism will be dismissed by the people getting hurt as 'fake news.' The article is indeed a tad unfair to Trump supporters; they are stronger than that.

    Trump voters are ready for the hurt. The corrosive acid of hate - imbibed from daily doses of hate radio, Fox, and hate church have destroyed their cognitive abilities. All they want to know is, "Did Trump stick it to (fill in the blank)."

    And as long as Trump has Sessions, Bannon, Price, Miller, Anton around him, the answer is always YES! The Trump voter draws sustenance from knowing that the lives of blacks, browns, Muslims, non-Christians are getting worse, that we live in constant wariness if not in morbid fear (as yet). People with Ph.D.s tell me that they voted for Trump just to prevent Hillary from appointing supreme court justices. That is it. They will willingly endure everything else.

    I don't underestimate Trump voters; they will shoot their remaining foot just to show the rest of us up. They want to ensure that the super rich get to keep their money shielded from taxes. Because, any day now, they will strike it rich. And they don't want their money to go to "those" people's food stamps.

    Trump happened because the American center is soft and happy, the left is smug and entitled, and all of us are self-absorbed entertainment junkies. Trump happened because too much of the US turned into too much of Ukraine.

    Kalidan

  170. It's pretty clear now why trump proclaimed his love for the poorly educated.

  171. If Obamacare collapses, one man's name comes to mind--Joe Lieberman. Caucusing with the democrats, but hailing from the capital of the insurance lobby, he virtually denied the public option by threatening to filibuster the bill unless the public option was removed.

    Sure would have been handy in states where Insurance companies are dropping out of the exchanges or giving stunned consumers massive premium
    increases.

    Add to the fact he ran as the Joe Party after losing the democratic primary, and openly companied for John McCain due to the horrible snub of having Al Gore endorsement of Obama.

    He has zero integrity to be FBI director and I hope the good Senators of California remember than if he gets the appointment.

  172. Eventually some Democrat will have the courage to denounce the "free-market" myth. We all experienced "free market' healthcare before Obamacare was even a thought. Snowballing rates, loss of the insurance benefit, denial of benefits. Crazy stuff. Now, Republicans have succeeded in creating a narrative in which their responsibility for stifling the ACA, denying Medicaid expansion, and sub-rosa enticements of insurers to leave markets are all laid at the feet of Obama, the Black President. Democrats are guilty of failing to support the ACA, maybe to keep some racists voting Democrat?
    Americans need to be reminded that the "free market" crashed the financial-mortgage markets a few years ago, that government exists to protect the majority from the uber-rich corporatists, that privatizing healthcare will take billions of dollars out of the provision of healthcare to enrich a few rich men. Americans must look to all "services" that have been privatized and demand that they provide evidence that the services are performed better for less money as they pretend. Americans must be disabused that profits are the right of corporations, and that corporations have the right to exist and to "speak" in the public arena. Corporations are formed to provide specific services at the will of the people, and can be dissolved at the will of the people. In most democracies, corporations are not permitted to close shop and leave without punitive penalties.

  173. Wake up, Trump voters. He's just not that into you!

  174. "What’s bizarre about the Republican strategy is that it is likely to cause the most damage where many of Mr. Trump’s supporters live." I think Faux-Prez Frump gambles on their sticking with him anyway and blaming it all on Obama. It's a gamble I pray that he loses.

  175. I see no good outcome here. So long as Republicans control the Congress and Executive branch the ACA will be in jeopardy. Social Security, Medicare, Medicaid, and the Affordable Care Act all came to fruition under a Democratic Congress and Executive branch. And being a rather pragmatic individual, I see us having to wait until the Democrats are back in control.

    Doesn't mean we shouldn't fight for our fellow citizens but........

    As an aside, I'm sitting on my porch and my wife is watching Trumps speech to the Coast Guard Academy graduates on her phone.  I can only say, God help us!

  176. So-called president trump's reassuring words still ring in my ears ... "Obamacare is an utter disaster folks. I will repeal it entirely and replace it with something much much better, believe me ... and very quickly". Ringing ringing ringing ... like an unanswered telephone.

  177. Congratulations conservatives on harming your own.

  178. Our disgust and hatred should be directed at not only the Republicans but the healthcare insurance industry that raises rates without a documented reason. There is no documented proof indicating just how their profits margins are dwindling as the Baby Boomers age with some form of healthcare insurance. I feel there is some fraud taking place in the insurance industry.

    With so much money the lobbyist has spread around there has to be one person with a decent heart to ask the question, why?

    This individual is Bernie Sanders.

  179. All of the people with decent hearts have no power. Currently, the top 4 health insurance companies stocks in our country are trading:

    1. Cigna $161
    2. Aetna $141
    3. Anthem $177
    4. United $171

    If this doesn't tell us everything we need to know about the healthcare industry in our country, nothing will. The uncertainty that they fear is not being able to turn as large a profit as they have been. For profit healthcare is a blatant con. How can one "shop around" in a system that has no set prices, and no set measure of quality vs value? These companies don't care about providing healthcare to consumers, only dividends to shareholders. I hope there is a special place in hell for people who take advantage of weakness and vulnerability, because here on Earth we sacrifice the weak to reward the greedy.

  180. The current price does not tell the whole story.

  181. The failings of the disastrous Obamacare debacle have been predicted since 2010, before anyone had an inkling of a Trump presidency. Is there any level to which Trump detractors won't sink to blame all the maladies of the modern world on his election? Sad!

  182. Where is that great, cheap health insurance, Don the Con (American Traitor)?

  183. How does a law that isn't completely written yet, do anything?
    The issue of insurance companies leaving the market place was forecasted when the ACA was passed. Think of all the insurance companies that were leaving the ACA prior to Trump even getting the into the presidential race.
    The states you mentioned, still have those same insurance companies, they just don't sell their product under the umbrella of the ACA.

  184. You may want to investigate the concepts of risk adjustment and risk corridors, and the GOP Congress' active sabotage of the ACA, before making silly criticisms.

  185. Nice NYT Editorial. Except you're preaching to the choir.
    It wouldn't be an assumption to say that most readers here saw this coming -- even during the elction campaign, when repealing "Obamacare" was all Trump could rant about.
    The only problem is, the Republicans had no follow-up plan, even though they had 7 years to think of one.
    And ultimately all they could come up with after all that time, is a plan that will devestate the poor, working-class, and whatever is left of the middle-class when it comes to affordable health coverage.
    But the worst part about this is the only ones who will gain from "Trumpcare", is the upper1% wealthy and those Republican Senators who drafted this monstrosity.
    Even now, Paul Ryan can't stop himself from grinning ear-to-ear and patting himself on the shoulder, even though MILLIONS of Americans will suffer.
    You tell me.
    Are we winning yet?

  186. Duh, this is how the free market works! The healthcare insurance companies don't want to take risks, so they stop offering policies, or charge more. President Obama was widely criticized in how he dealt with the health insurance companies. Unfortunately, these companies are a piece of the puzzle.

    What puzzles me most is why the supporters of this "so-called president" continue to support him They fail to see how his unpredictability (which is what they love him for) will cause the collapse of affordable healthcare (which is what they have, under President Obama's ACA).

  187. Trump lied, healthcare died.

  188. As usual these days, you got it all wrong agin. You can keep your doctor, and your plan. Obama care was a lie and a poorly written law from the start. The insurance company's are quitting because they are not in existence to lose money, but to make it.

  189. "Mr. Trump has threatened to stop making about $7 billion in payments to insurance companies to help lower the cost of co-pays, deductibles and other out-of-pocket costs for lower-income and middle-class families".

    HUH? What am I missing here?

    Let me get this straight... insurance companies get less $$, so they lower costs to consumers. Trump-o-nomics I guess.

  190. My experience--as a community college instructor in a GOP-dominated western state...the old adage "cutting off your nose despite your face" comes to mind. For many....the thought of any "undeserving" person (usually a stereotyped minority or immigrant) getting *any* of their "hard earned tax dollars" is enough for them to reject any kind of social program that they themselves would benefit from. Its the politics of resentment...their own self-interest be damned.

  191. There's racism and bigotry underlying the voters' hatred for social programs.

    Is there any documented evidence of there being complaints against the Homestead Act? Against The New Deal programs?

    It's when social programs started benefiting minorities that this concept of "welfare nation" started becoming a rallying cry for those on the right.

    People who haven't seen the racism in the Republican agenda before Trump came into politics have either not been paying attention or have willfully deluded themselves.

  192. I think the expression is
    "Cut off your nose to SPITE your face."

  193. TO SPITE your face

  194. I must disagree: it is NOT bizarre that these policies and efforts by the Republican party and Mr. Trump are hurting the very people who support them. Neither Trump nor Republicans, generally, care about their voters. Trump has a long history of fraud and breach of contract and bullying in his business dealings. It is not far-fetched to realize he did the same during the election. The party itself has always been about tax cuts first and foremost, good policy and good governance be damned. They are screwing their supporters, quite deliberately, and they are hoping they can spin it enough so that Democrats take the blame. It's what they've done; it's what they do; it's what they will do.

  195. Many of the people that I talk to in Wisconsin (Trump/Scott Walker country) just say "oh well" to this. They don't care if Trump takes ALL of their scoops of ice cream, as long as they can make "the elites" (people who shun Fox News & and read the NYT) feel miserable watching him gorge down his two scoops in front of your one scoop. Sort of Steve Banonish nihilism. Those damn Union Workers and lazy teachers with good health care benefits are obviously the cause of our nation's economic problems. Let everyone be as put upon and miserable as me.

  196. You touch on an interesting psychological mystery, at least to me: I find it amazing the level of misery people are willing to inflict on their own children and parents in order to punish the neighbors who have more than they feel they deserve.

  197. Obamacare was doomed from the get-go because it relied on raising most of its funds from rich taxpayers. This was just dumb -- of course they are going to organize an effort to pull the whole thing down to get their old tax rate back; of course they will be successful even if the effort takes years; of course they will not give a damn if a bunch of older, working class uninsurables are harmed.

    It remains to be seen just how far the Senate will go to destroy Obamacare and how big the effect will be at the ballot box. But this is the lesson we should learn (and I am a Democrat who believes in single-payer for everyone over 45): Democrats should never, ever again build a massive social policy around "soak the rich." The concentration of resources in the hands of the top five percent are too large for such an approach to be successful. Deal with it.

  198. People whose heads have been filled with nonsense will believe anyone they consider to be in support of those beliefs. Donald Trump and the republicans have been sold a bill of goods to the point that West Virginian coal miners believe that their jobs were tossed away by Obama when the mine owners themselves have replaced them with new technologies that require fewer and fewer miners and more and more mountain tops to take off. With all that said and done Trump, looking out for the miners welfare, deliberately cut mine safety and health regulations that benefits only the owners and leaves the miners unprotected. Now heap on all this pile of business gifts the republican house passes a health bill probably something like what neanderthals had when they first popped into human form. republicans are not the friends of anyone in this country who considers themselves workers. Trump wants to bring jobs back but to this day his products manufactured under the Trump logo are made in countries where Trump can generate the most profit. When workers in this country get down to Bangladeshi levels in pay and benefits maybe he'll bring them back. Until then the republicans will work at fever pitch to make sure American workers get on even footing with Bangladesh.

  199. ALL Americans desire better!

  200. This is exactly what they want. Cause enough chaos in the healthcare system/Affordable Care Act that insurers walk away and they say, "see, we told you it wasn't working".

  201. To All Elected Democratic Congresswomen and men:

    NOW is that time to go into all red states, hold local own hall meetings, and explain, in great detail, the nuances of healthcare.

    No industry jargon. No polysyllabic words. Just plain, east-to-understand facts as to how and why the Republican plan will hurt families who are currently benefiting from the ACA.

    Get out. Meet. Speak. Communicate. And do it persistently and relentlessly. This is the third rail of 2018...

  202. Wealth insurance...

  203. It may be "disingenuous nonsense" but Trump voters will believe it.

  204. So what's is more appealing to rural voters negatively impacted by Trump's actions:

    1. Blame a former black Democratic President for their problems

    or

    2. Blame Trump and the Republicans.

    I am sticking with 1.

  205. Elections have consequences.

  206. Yes, Etienne, but is it right that your vote counts more than mine? If we went by the popular vote, we could all celebrate elections having consequences!

  207. I agree.

  208. What nonsense on stilts. Big insurance companies dropping out of the individual healthcare market is the natural, and intended, consequences of OBAMACARE.

    This was always the intent, to get private companies out of the market, so there would be clamoring for the govt (single payer) to rescue Obamacare.

  209. There has always been a clamoring for single payer. Why shouldn't Americans have what citizens of sixty other nations have? Aren't we the greatest?

  210. On the contrary, Obamacare is based on the Swiss model. It actually ensconces private insurance in the center of our health system.

  211. They elected this nightmare. Let them live through it if they can. I can not muster any empathy for these people.

  212. As with any new, big program, there is nothing wrong with the ACA that couldn't be fixed by a congress with the country's best interests at heart, rather than blind partisanship. Heritage conceived, Gingrich endorsed, Romney tested. The only problem? Put forward by Barack Obama, giving expanded meaning to GOP bête noir. They used it to beat him over the head for 6 years, never believing they'd be called on to actually follow through, and now, all they are doing is casting about for ANY alternative, no matter how bad. They disgust me. I grew up in an Ike household, but I'd vote for the ayatollah before I ever vote for another Republican.

  213. what you mean is that there is nothing wrong with this program that a few hundred billion dollars can't fix.

    but where are you going to get the money ?
    are you planning on providing it ?

    *do not spend my money for me*

  214. Ah. The feral response. Progressive taxation was agreed upon a century ago, but today the reactionary right has forgotten that taxes are the dues we pay to live in a civilized society. And they carefully ignore that compared to the rest of the "developed" world, we already pay far more for health care, and have lower quality, thanks in part to NOT having some form of an ACA. Perhaps you'll enjoy Somalia.

  215. Your analysis underestimates the power of propaganda. Between now and the next election, Fox and minions will be brainwashing the necessary voters. The economic problems that created the Trump voters were avoidable if the 2008 stimulus had been stronger and longer, but Republicans obstructed. Did that thought ever reach the Trump voter? Or did Fox spend years blaming one man from Kenya?
    And so it will continue. Trumpcare will be great, Obamacare is a failure: vote for Trump and send a message to repeal it at last. God Bless America and true Americans like you, and send Trump a 100 dollars as a loan to get that wall started.

  216. The fix for PPACA (Obamacare) is HR 676 The United States National Health Care Act, or the Expanded and Improved Medicare for All Act. Introduced by Representative John Conyers of Michigan, Senator Bernie Sanders of Vermont has announced he will introduce a companion bill into the United States Senate.

    This Bill now has 110 Sponsors in the House, more than half the Democratic Caucus, and the number is rising. Some groups, like Brand New Congress- recruiting both Democrats and Republicans to run in 2018, have made the Bill a signature issue. Most Americans are coming to realize the importance of the reforms in the ACA and realize it is but an interim step toward joining the rest of the developed world in providing Healthcare for all of our people.

    Here is the Bill and sponsors on the official Congressional website:
    https://www.congress.gov/bill/115th-congress/house-bill/676/cosponsors?q...

    What the Republicans are offering is a Train wreck and 2018 needs to be a referendum among other things on healthcare for all. We can afford this, it is doable, the support is broad and getting more so every day.

    We all know the price of people living without adequate coverage- the man involved in the Times Square incident yesterday is likely suffering both mental illness and addiction. How much do we pay in needless suffering, injury and death because we do not make sure everyone has access to the full range of healthcare?

    It is time to act.

  217. In those states that took the ACA seriously it was working. those inadvertently to kill it through neglect, they got what they wished, no matter what the cost in human and voter suffering. It is as simple as looking at the impact on states like New Mexico and Oklahoma. Bordering are States, New Mexico took the program seriously, encouraged competition and encouraged people to sign up. The plan there is strong. In Oklahoma, the Republicans did everything in their power to make a failed program. It did and their voters suffered. Elected officials could not care less as long as their ideology held strong. The voters who are now hurting, I feel bad for them. However, this is what they get, something of their own choosing. Will they vote with their pocketbooks and their health, or will they vote for a misguided set of ideologies? Their choice, their lives, literally!

  218. As this editorial so clearly points out, the writing is on the wall. When so many people would be negatively affected, why do the Republicans insist they have a "cure?"

    Who can wake them up?:Who can get them to focus on their true priority which is serving all Americas regardless of politics?

    They have no conscience.

  219. Paul Ryan repeats over and over again about Iowa and its scanty "Obamacare" coverage. Nothing gets said about the coverage of millions who have benefitted. Who is paying for Paul Ryan's lying TV ads dehumanizing the ACA? And why?

    Paul Ryan went to a soup kitchen after the event was finished and put on an apron for a photo shoot when he was running on the ticket with Romney.
    He's a self serving outlandish know-it-all who will do anyhting to mislead the public right out of healthcare benefits.

    It's too bad there wasn't more positive press about "Obamacare" when Obama was in office. (Now, by the way, there was a politician that was treated unfairly, Coast Guard graduates. But not the worst in "all history" - we save that for Donald Trump, wink wink)

  220. Health care has been an issue since FDR. It divides the country. Setting aside racial or ethnic biases, opponents of ACA may not see the necessity of being “my brother’s keeper.” Some view illness and accident as an individual problem. Some resent social programs—Medicaid, Medicare, Social Security, etc.
    Those who advocated for a single payer suffered attacks as socialists or worse. Who will pay for the cost of the programs?
    President Eisenhower once said, “Every gun that is made, every warship launched, every rocket fired signifies, in the final sense, a theft from those who hunger and are not fed, those who are cold and are not clothed.”
    Our country spends more on armaments than the next five countries combined. This nation that battled powerful enemies like Germany and Japan, and who faced down the superpower Soviet Union, are now reduced to spending trillions on diminutive opponents. It says a great deal about us that there is never enough money showered on war and penny pinch money on improving the lives of our citizens.

  221. What a spectacle at just how fast the so-called “successful businessman” in the oval office is proving unfit for the job, and how spineless and feckless a group of cowards McConnell, Ryan and the rest of the GOP are in coming to terms with this reality. It’s a shameful national embarrassment.

  222. A way needs to be found to go to single payer, before the Congressional Republicans complete the destruction of health care.