UPDATE 6/8/18: Welp. Given last night's bombshell development that Donald Trump's Department of Justice has decided to not only abandon doing their jobs by defending the law of the land but to actually actively argue in favor of tearing away the ACA's prohibition of denying coverage for (or charging more for) pre-existing conditions, it seemed appropriate to dust off this entry from over a year ago.
A couple of important caveats: The individual market has shrunk by one or two milion people since a year ago (due in large part to other forms of Trump/GOP sabotage, I should note), so most of the estimates for the last column are likely a bit smaller as well, although those with pre-existing conditions are the least-likely to drop their coverae for that very reason. Also, a good half-dozen Congressional Districts have had special elections over the past year and now have new members of Congress (SC-05, MT-AL, PA-18 and so on) or currently have vacancies not shown below (MI-13, TX-27, etc).
OK. Here we go. First, just as a refresher: Here's what the Individual Market was supposed to look like under the Affordable Care Act:
Here's what it actually looks like for a variety of reasons, including both legitimate glitches in the ACA itself as well as a whole lot of flat-out sabotage by the GOP over the past 7 years. While there are plenty of other issues which need to be addressed, the most obvious ones are that the tax credits need to be beefed up and applied to enrollees over the 400% FPL threshold, and the mandate penalty should really be increased. In short, two legs of the stool need to be lengthened...to continue the metaphor, we need a couple of shims. Around $12 billion per year or so should do the trick on the tax credit side. As it happens, one of the few useful parts of most of the GOP plans is that they do include a good $120 billion or so in "reinsurance/stabilization" funding over 10 years...which, in practice, would amount to about the same thing. The key is that this funding would have to be added to the existing ACA funding, not replacing it, which is what these plans do instead:
The American Academy of Actuaries has chimed in on the GOP Senate's #BCRAP Obamacare replacement bill, and I have to imagine that they had to bite their tongues clean through while composing this primer explaining the most rudimentary concepts behind "insurance", "risk pools" and "adverse selection" to Paul Ryan, Ted Cruz, Mike Lee and Mitch McConnell:
Risk Pooling: How Health Insurance in the Individual Market Works
Senate Majority Leader Mitch McConnell (R-KY) announced Tuesday that he is canceling half of Congress’ annual month-long August recess, keeping lawmakers in town to finish their drawn-out and so far unsuccessful effort to repeal the Affordable Care Act and tackle other pressing matters.
“Once the Senate completes its work on health care reform, we will turn to other important issues including the National Defense Authorization Act and the backlog of critical nominations,” he wrote.
Tensions are rising between Senate Majority Leader Mitch McConnell’s leadership team and his party’s ideological factions, with a renewed sense of pessimism creeping into the Senate GOP’s efforts to repeal Obamacare.
Three GOP senators — Shelley Moore Capito, Susan Collins, and now Lisa Murkowski — all will vote "no" on the new plan to repeal and then replace the Affordable Care Act.
Why it matters: This guarantees what was already widely expected: that Senate Republicans wouldn't be any more successful with a straight repeal plan, without a replacement, than they were with the repeal-and-replace legislation that stalled yesterday. Republicans could only lose two votes.
What's next: Senate Republicans are still likely to schedule the vote — even if it fails — because they have to prove to conservative groups (and President Trump) that they've tried everything.
Then again, who the hell knows...
UPDATE 7/18/17: REPOSTING since Mitch McConnell is now back to a "repeal with a 2-year delay" strategy:
Welp. I've done everything I can to help stop them, but it looks like the House Republicans have decided to go ahead and vote on their big ol' dumpster fire of a bill after all.
No CBO score. No review. No debate. No transparency. No time for anyone to read the bill. Everything they falsely accused the Democrats of 7-8 years ago (yes, I gave a range of 7-8 years, because there was a solid year of debate, discussion, meetings, arguments and so forth before the final votes were cast).
Maybe they'll pull it off. Maybe they won't. If it passes the House, what'll happen to it in the Senate? Who the hell knows, but the fact remains that anyone who votes for this piece of crap doesn't deserve to hold office any more than the racist, misogynistic, xenophobic con-artist moronic pussy-grabbing asshole who leads their party.