• Shoved down our throats – Updated

    Evidently, there is going to be a big vote on health care reform in the House.  It’s going to be on January 12, which is 8 days away.

    There will be no hearings on the bill.  No markups out of committee.  No extended period for everyone to read it.  No bipartisan meeting to discuss it.  There will be no CBO scoring of the bill.

    It will be – and when you read this, please add lots of sarcasm in your head – “shoved down our throats”.

    I’m all for continued debate and further reform.  But theater masquerading as serious policy is no longer just silly.  It’s doing harm.

    UPDATE:  Seriously?  You should see the emails I’m getting defending this.

    I used sarcasm because I think the argument is as ridiculous now as it was then, but I find it amazing that many of the same people who argued that it was “shoved down our throats” and “there was no debate or discussion” now argue that no debate is necessary because there was so much debate before. Or, “the hearings have been held on under Obamacare.”

    So there was no debate, but we need no debate now because there already was debate. And we shouldn’t have a bill without a CBO score, but now we need no CBO score.

    You just can’t make this stuff up.

    UPDATE #2:  There will be no amendments allowed.  Remember when that kind of thing was a problem?

    • I believe the bill is a few pages long. The other repeal acts I have seen take about 5 mins to read.

      I do want open debate but regardless of House normative manners, don’t you think that the issue has been debated pretty openly. It is ironic don’t you think, that people know alot more about PPACA today than during the Chamber debates. I watched those debates… most of it was as follows:

      Democrats accusing Republicans of wanting to let people die. As one liberal representative from Flordia said on the Floor during the debates, “The republican plan is…DIE QUICKLY!”

      Republicans accusing Democrats of creating another entitlement and mortgaging our futures

      The issue is not “healthcare reform or not”. This issue the bill is tackling is “Obama-care or not”. I think it is safe to say that something will be done in response, after the repeal. OR maybe we could take the Democrats attitude when passing PPACA “Let’s pass it to see what’s in the bill”. At least, you can concede that Republicans know exactly what the Repeal Bill will do.

    • It took 13 months to pass the ACA. Health care reform was a primary topic in the presidential debates. It’s possible that Republicans were surprised when it came up as a topic, but I think they mostly just dont have a plan. They do not want to admit that they do not have an idea for covering the uninsured.


    • “At least, you can concede that Republicans know exactly what the Repeal Bill will do.”

      I wouldn’t concede that. Do Republicans know that the Repeal Bill will add to the deficit? Do Republicans know how many new uninsured the Repeal Bill will create? Do Republicans know how the Repeal Bill will affect seniors?

      Personally, I don’t take anything the Republicans say or do about repealing “Obamacare” seriously until they atone for their own sins, namely, Medicare Part D. Let them repeal that first before they act all tough about repealing Obamacare.

    • @Jeff

      You are speaking in ancillaries. Repeal Obamacare does exactly what it is meant to do. As well, you cannot honestly say you know what PPACA will do for all of the questions you just mentioned. So it is a battle of estimates. Historical reasonableness shows that Obamacare will cost far more the expected. That is a honest analysis on BOTH sides. FYI, supporters have PPACA have moved from cost savings to its health policy benefits because the cost argument is failing in the public domain.

      My point still holds. Republicans know what the Repeal Bill will do. It will Repeal Obamacare. As well, this is the exact the outcome the Democrats wanted. They wanted to pass it (not reading it) to “solidify” PPACA in the mindset of the government so it would be difficult to change. It is basically the inertia faculty.

      I would not assume that Republican’s dont have a plan. That is basically a ad hominem. Republican’s do have a plan. They are implementing it. It starts with repealing Obamacare. It might not go to well (I am agnostic on this point) and we may not like it, but it is still a plan.

      • It’s trivial to come up with simple bills in the sense Aaron G describes. For example, the Dems could counter with a “repeal the repeal” bill. I can see the counter argument: “But that leads to this massively complex change to the health system, as embodied in the PPACA.” Sure. But repeal of the PPACA also leads to a massive undoing of a much-studied (to the extent these things can be), carefully thought out (see Gruber’s work, as well as the simulation models of the Urban institute, RAND, among others), and even tested (Massachusetts) plan.

        I don’t think it is OK that some who voted for it didn’t read the bill. I did. It isn’t that hard. In broad structure (which is mostly what matters) it isn’t that complex. I’m not afraid of big bills. That the repeal bill is simple is not a compelling argument for it.

    • Aaron G:

      Here is the bill:

      Not even enough print for a dog to poop on.


    • Democratic Congresswoman Debbie Wasserman Schultz of Florida was on Face the Nation last weekend. She said that one of her constituents told her that because of the ACA, she was able to include her children on her insurance plan and saved her family roughly $3000 in premiums as a result. I personally know someone who now has health insurance because Obamacare allowed her Dad to include her on his insurance policy again. These are the kind of issues that would come up if the bill were debated. It would allow supporters of the bill to bring up examples where the provisions in effect today are already doing some good. Instead, the Republicans are denying a debate on the bill, because it denies Democrats the opportunity to point out these types of successes. The GOP knows this, and they don’t want to risk the “good news” getting out.

    • Here is the bill:

      4 This Act may be cited as the ‘‘Repealing the Job-
      5 Killing Health Care Law Act’’.


    • Just calling it Obamacare reflects an abysmal hyperpartisanship that underscores exactly how little the GOP says about Healthcare reform that is factually reliable. They just make crap up as they go along, for the perceived political of it all. It’s all about power to the GOP – getting it, keeping it, and using it, while keeping the truth from a public that would puke if it had a clue about how corrupt (and corrupting) that type of power lust can be (and almost always is) when superior financial resources allow it to succeed.

      The point is that the GOP spent a year, right down to the final vote, saying that there had not been enough debate about HCR — and now they are saying that the very debate they decried as inadequate is sudenly entirely adequate to displace any debate whatsoever about repealing HCR. What are they repealing? The mandate? The taxes imposed on health insurers and medical supply companies? Or the provisions that will prohibit insurers from denying coverage for people with pre-existing conditions or cancelling your insurance when you get sick? Or the arbitrary limits on coverage that most health insurance policies contain. We can only assume that it is the provisions which people want that they are interested in repealing, since their plan for an alternative to HCR is still completely unknown and undisclosed. “Plan? Hah, we don’t need no stinking plan . . . ”

      The hypocrisy of the GOP, and of the individuals and media personalities who support the anti-Obama political agenda of the far right that now controls the GOP lock stock and barrel, is boundless and more than a little disgusting. All of this will come back to haunt them, as Dems peel off moderates, and apathetic voters who stayed home in 2008 come back out to register renewed disgust at the pitiful excuse for governance that the GOP is peddling. The numbers are already showing how unpopular the new GOP congress is — the last election was a perfect storm of protest vote against the lack of better results in reducing unemployment, the apathy of left wing voting constituencies (typical of midterm elections) and the exploitation of the fears of older white voters by a right wing media outlet that served as a 24/7/365 feee advertising division for the GOP, and well funded corporate interests unleashed by the 5-4 Citizen’s United SCOTUS decision. Until the GOP loses back most of the 60+ seats they gained last November in the 2012 election — which I predict will happen as sure as the Mayan calendar will end on December 21, 2012 — we will have to put up with the hypocrisy and tone deafness of the current GOP leadership. But it will be instructive, for sure.

    • @Aaron G:

      You are not helping your cause by basing your entire argument on a wingnut talking point that takes a Pelosi quote completely out of context.

      “We have to pass the bill before we know what’s in it…” did/does not mean what you argue it does. Rather, Speaker Pelosi meant exactly what Craig infers above: once the PPACA goes into effect, the citizens will see and reap its benefits. It passed, and they are.

      You either misunderstood Pelosi’s statement (which is forgiveable), or you are deliberately repeating false talking point propaganda (which is not).

    • @ JR71
      Here is the video and text. My wording was not correct. I have heard “we” not “you”. The wording I heard was “we” which is understandable by my conclusions; however, everyone can agree that I should not have to know what is in a bill by passing it. I should know before hand.

      Confirmed here at the Speaker’s Website-

      Actually, it was not my entire point. If you re-read it (I hope you do because you apparently missed my point), the Republican Bill is doing exactly what it is intended. No one really knows what PPACA is going to do. It costs 1 trillion dollars and is about 2000 pages long. You are asinine to assume that you know what it is going to do. Health Affairs to CBO does not know what it is going to do.

      As well, you are completely wrong…. Completely Wrong! in asserting that people are “coming around”.

      Confusion about healthcare reform is on the rise

      As well, JR71, I like how you make such a assertion when you obviously have limited understanding of what is in the timeline of implementation. The measures that could start to have any impact on popular opinion were instituted this month or the end of last year (depending if HHS met the deadline on rulings/regulations). Many of these, while laws, have yet to be worked out because implementing the PPACA provisions is often “to be Determined by the Secretary” and she is behind on rulings (We still do not really know what CMS means by ACOs).

      So you think people are coming around when, confusion is on the rise, polling leans against healthcare reform, and the implementation has hardly impacted the average healthcare user. So, who are you calling me a wing nut?

    • @ Aaron G

      Two quick questions:

      1. What is the evidence that “Historical reasonableness shows that Obamacare will cost far more the expected?” There is no snark behind the question, I’m really trying to find out what you mean by historical reasonableness.

      2. You say that Republicans do have a plan and its starts with repealing Obamacare. What are the next steps in the plan?

    • Complain about the cost if you must, Aaron. But I don’t buy the complaint that a health-care bill is bad because it’s 2,000 pages long. I can’t imagine a more complex legislative undertaking than a bill that aims to expand coverage, control costs, absorb and stratify the interests of users, private insurers, care providers, government regulators and grandstanding lawmakers. It takes a long time to read? Boo hoo.

    • Sure

      1) -http://blog.heritage.org/2009/08/04/health-care-reform-cost-estimates-what-is-the-track-record/

      This is just healthcare. Video is good at explaining the strategy in scoring from the CBO offices that both parties use to our neglect and harm.

      Paul Ryan’s Plan

    • @beejeez

      You obviously did not read it. Can you connect with all of the references As someone who cares a lot about everyone here and this country, I’d to be able to understand what I vote for and what my politicians vote for. It is a fallacy to assume that complex problems need complex solutions. Rather, simple ones are often the ones that win out.

      Here have been two attempts to map PPACA

    • @ Aaron G

      1. Thanks for the links. But, regarding historical reasonableness, if it is always difficult to account for the fiscal effects of tinkering with the health care system, are you contending this is a one way street? In other words, do you believe that such prognosticating would be equally difficult for any health care reform proposal, not just the PPACA?

      2. If everyone uses the CBO to our detriment, do you trust the CBO’s estimate of the Ryan plan?

      3. I only did a brief overview the Ryan health care plan. Its seems fairly detailed although there were some important omissions. On a cursory review, it seems that there are many shared aspects between PPACA and Rep. Ryan’s ideas. I’m mainly thinking of the state health insurance exchanges. The real difference lies in the changing of the health insurance premium tax treatment versus a largely employment based individual mandate. Is that the main source of your desire to see this plan implemented as opposed to the PPACA?

    • CG, I can’t speak for Aaron G, but on your second question it is important to dig into the details of a bill and how the CBO scores it. They use a fixed 10 year window, and they score things on a cash basis, meaning money in the door and money out the door, any liabilities created are ignored. So in the case of the PPACA the Democrats abused those things by inserting the unrelated CLASS Act, since on a cash basis it generates a surplus in early years and a corresponding deficit in later years, years which conveniently fall outside the 10 year window. This leads to the absurdity of people claiming that a deficit neutral plan like the CLASS Act reduces the deficit.

    • This is truly an excellent post – I will be sure to shove it down the throats of all I know.

      We all know the republicans want to repeal this as much as they want to end legal abortion – which is to say, they don’t. They simply see another issue to wedge themselves into power and they are going to make the most of it with the no information voter, those who react instinctively to anything Obama.

      I almost hope Obama comes for eliminating Social Security – that would ensure the safety of the program well into the next century.

    • Aaron G- The Kaiser poll actually shows people having lower unfavorable opinions about the ACA. Nearly every poll shows that people like the individual components, except for the mandate.

      On costs, your sources assume worst case scenarios.

      Ryan’s plan was ignored by all other Republicans. Actually, they ran away from it. If you think it can work to control costs, then so can the ACA. Ryan’s plan depends on vouchers, the value of which can be changed by politicians.


    • Hmm, let’s see. The Republicans had the Executive branch and both houses of Congress and high polling numbers with the American people for at least a Congressional session of two. Where did they put their attention? Didn’t seem to be on HCR, unless you count that Medicare Rx drug benefit that they couldn’t pay for…

      Guess they were too busy trying to privatize Social Security and starting two wars to trouble themselves with reforming the health care system. Or was the Glorlous Free Market System supposed to do that on its own but, well, it just didn’t seem to do the trick?

    • @ CG

      1- Possibly; however, we know that PPACA was done intentionally to score higher than what is rational. They removed parts of the bill. They left areas to be determined later aka dont have to fund. I argue against any bill that was made intentionally to look good by gaming the scoring methods of CBO. It was apparent that the scoring was wrong because the obvious Doc Fix was not included. Since I work in healthcare, to me, the Doc Fix should be the first item on any healthcare reform list. It is a pressing issue.

      2- It is not a attack on CBO. It is just like accounting. You can game GAAP and FASB. Is that the fault of the rule writers or the people who abuse the rules? I tend to think the rule abusers. Ryan has not shown the willingness to manipulate the numbers to make his plan work. As well, I believe his plan was developed with some CBO staff, though I cannot confirm it right now.

      3- I am agnostic on the repeal of PPACA. I support any market driven mechanisms in healthcare reform. I am not necessarily against a IM but I am against it at this point. I don’t believe it will reduce costs from the RAND and HA studies I have seen (and common sense). As well, I do not believe it is legal, which surpasses any desire I may want in legislation. To me, I’d would rather attempt cheaper and simpler approaches than creating a new trillion dollar entitlement. Most of these approaches have never been tried but are constantly discussed by Reinhardt to Porter. I like the principle of exchanges. This is why I am agnostic on PPACA because it has caused good things… it also has caused a lot of bad/ bad to come

    • Austin, here’s the difference:

      Husband: “Honey, I’m buying a new TV.”
      Wife: “What? We can’t afford that!”
      Husband: “Too bad, I’m doing it anyway.”
      Wife: “This is outrageous! Don’t we usually discuss these things first?”
      Husband: “Nope, no discussion allowed. I’m doing it.”
      Wife: “Don’t you dare buy that TV!”
      (Husband leaves, comes back with a TV.)
      Wife: “I told you not to buy that thing! I’m taking it back right now!”
      Husband: “What? I thought we were supposed to talk about these things first!”