consultants are sandburs



Wednesday, March 15, 2017

Paul Ryan explains - - -

- - - why his favorite comic book has no superhero.

(gettyimages item, from Fortune, here)

And Fortune, that link, in turn explains:

The act also maintains the unlimited tax exclusion for employer-sponsored health plans. This tax break essentially subsidizes employer-based coverage by excluding the value of health benefits from employees' taxable income.

Since those purchasing coverage in the individual market enjoy no such tax break, the policy has helped entrench a system in which coverage is tied to employment. And it's contributed to the runaway growth of health costs. After all, a dollar of taxed wages is worth less than a dollar of untaxed health benefits. Americans have put those generous health benefits to use, driving up demand for health care and thus its price.

The GOP bill would also preserve Obamacare's expansion of Medicaid to childless adults making up to 138% of the poverty level until the end of 2019. Thereafter, anyone who was in the program thanks to Obamacare's expansion of eligibility could stay in.

The only saving grace for the bill's treatment of Medicaid is that it begins to transform the program's funding formula from an open-ended federal commitment into a "per capita allotment" system, wherein states receive a set amount of federal funding for each Medicaid enrollee.

[...] Since its release Monday evening, the bill has taken a beating—from Republicans. But the members of the GOP, moderates and conservatives alike, have to remember that a repeal-and-replace effort that devolves into infighting will just leave Obamacare in place.

The American Health Care Act is Republicans' imperfect first crack at a replacement plan. It won't be their last.

... won't be their last. That's more threat than promise.

And, yup, expect no superhero in the process; it's not built for that, it's to lull you with repetition.

Were they to replace it, i.e., Obama/Romneycare, they'd have to move on with other mischief for the well off wanting more, while if they keep Obama/Romneycare -[please never forget the old days when it was only Romneycare, in Elizabeth Warren's state when Romney one-termed there as guv]- if they keep Obama/Romneycare twisting in the wind they can do their mischief in the background while Kellyann Conroy disclaims being in the evidence business and other shell game distractions common in politics get played by the Trumpster jesters. In that context, do remember the sordid saga of Bill and the intern, played out while Bill and Newt (the intern being absent from the real business) were screwing us citizens. Same old, same old - never changes, stained blue dress and all. More threat than promise.

And, exactly why Ryan likes the comic book so much? He doesn't need an intern.

And, that Fortune quote, if you believe citizens drove up healthcare costs because of tax detail, and it happened like that and not because of provider greed, then you are a bigger clown and fool than the guy in the image holding the comic book.

And if Fortune's reported Medicaid "per capita allotment" sounds to you like "vouchers" routed through state legislatures instead of direct, come forward to collect your gold star.

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