I highly doubt in two years you will see an unadulterated Republican replacement to the ACA. The Republicans most likely won't even pass an unadulterated replacement and if they do there is no way they can implement it without headaches that will make the roll out of the ACA look like an NFL kicker hitting a 20 yard field goal. At this point I wouldn't be surprised if the ACA largely remains as is two years from now. Given statements that Trump and other Republicans have made that they want to keep the popular parts they are going to have to fight it out with the peopel who want wholesale repeal. Those same people will also be hard pressed to find agreement on those who want to see expansion of Medicare and government high risk pools as replacement with those who want to see much more privatization. The default of position of ACA might just survive if there isn't agreement on a replacement.
Bold strategy by the GOP... I too am interested in their alternative after essentially 6-7 years. They don't really have many options except give less coverage.
The strategy (as I understand it) is use free market competition to drive down the cost of medical care and to allow competition across state lines to make insurance more affordable while trying to keep the portion of the ACA (pre-existing conditions and keeping young adults on their parents plans till age 26) intact. But its gonna take time. You can't undo something this big in a couple of months.
That's still pretty vague. I just really don't see anything more than a watered down version of obamacare on the horizon. The Paul Ryan plan hasn't gotten into specifics about how much in subsidies the replacement plan would cost in order to get it going for the foreseeable future. All depends on how much gets it undone but it will more than likely take a couple of years.
You're delusional. If nothing else they will remove the penalty and the individual mandate which will deal the final death blow to Obamacare whether they repeal it or not. People should be more concerned about the future of Medicare. The Ryan plan is basically Obamacare for Medicare in the form of private exchanges with premium subsidy vouchers.
Hey, Phil Gramm is only 74. They can roll him back out and he can preach his MSA gospel (someone check if he is still preaching that like it is 1996). People will love the practical aspects of trying to get that plan to do anything useful. Otherwise there was the one Republican employer mandate bill in 1994-5 that looked kind of like Obamacare and couldn't even sniff the floor for a debate. Then there was Romneycare which again looks like Obamacare but "would not be good for the whole nation." Then you have the new, "really great solution" that doesn't actually exist but undoubtedly includes the greatest hits of "Tort Reform" and "Competition Across State Lines" that involves consumers needing to do more research to figure out what works best and what "In Network", "Out of Network", and state licensing will now mean.
So far this is shaping up to be the most conservative cabinet since Reagan, says Politico. As a conservative, this is coming as a surprise to me. Trump has been a moderate New York City Democrat most of his life. His populist rhetoric during the campaign was not ideologically consistent. In fact, it was erratic and constantly changing. When has this guy ever been a conservative or even led anyone to believe that he was? Not during this last campaign. Sure he wants to control the borders, but other than that? He has at best been all over the place on all of these issues. And now he has put together the beginnings of a conservative cabinet that might make Ronald Reagan blush. Obviously, he still has more spots to fill and then the work will not even begin until he is nominated. But so far I am pleasantly surprised. Is this what Trump's supporters thought they were voting for? I am just curious. Because he did not run as a conservative as far a I could see, but so far his cabinet picks appear to indicate that he may very largely govern as one.
If he governors as a status quo conservative, it will piss of many of the working class white voters who voted for him, like I said, it will be interesting the next four years. Everyone should just wait and see what happens.
As you note the rest of it doesn't work without the mandate. Trump himself has said he wants to keep the popular parts. True he says a lot of things but so have many other Republicans said they want to keep the popular parts. Given how complex the ACA is it will be very difficult untangling it and how they untangle it will be a very big fight within the GOP itself. Also given that it took at leas 4 year for full implementation of the ACA any replacement will likely take about that much time. Medicare is a even far more sensitive subject and this also where Trump's populism will run headlong against Ryan and even Price. Many of those who supported Trump were older voters who use Medicare and any attempt to greatly change it will likely be fiercely opposed by much of the coalition that put him in office.
Trump is no ideologue so I don't think there is any risk of that. However, the Departments that these cabinet picks run are largely left to their own devices. But your point is at the center of my question. Is this what his supporters thought they were voting for? I suspect the answer is that they do not care much about this kind of stuff and just want to see our nation's laws enforced, especially our immigration laws. They want to see a real effort to renegotiate trade deals, not just for the benefit of business interests, but for working families as well. And of course they want to see the PC zealots that currently infest our national government either removed or on the receiving-end of a four-year, never-ending beat-down. Further, they want to see any government order, regulation, initiative or whatever that enables or encourages this vile PC culture to be dismantled and disabled. And some other stuff along these same lines. But who the people are that head these agencies, they will trust Trump with that as long as there is hope of the results they are looking for being delivered.
You under estimate the campaign against Medicare. Two key codes in the battle to get rid of Medicare: 1) Nothing will change for anyone over age 50 or so: This keeps the support of the older white voters who believe that they have paid enough into Medicare to cover their own costs ("It's not an entitlement, it's OUR money!") on board 2) "Medicare and Social Security won't be there anyway" this is the ruse used so that when they try to get rid of it young people won't feel like they are actually losing anything.
I'm betting on Petraeus for Sec of State. I'm not sure what this means. There is free market competition now. There are distortions in the market, like insurance, patent law, and regulation, but people are more free to choose their supplier of medical care than they are of electricity for the house. Insurance companies compete against each other, hospitals compete against each other. Competition across state lines is one piece of low-hanging fruit (one I'm sure Obama would have signed if Congress brought such a bill to him), but if that's the only tool in the box I don't think it's going to be enough. Aside from that, what plan is really going to increase competition and drive out costs?
Trump and the guys running the GOP could give a crap This can be true. Older workers all over have voted for two tier benefit plans that leave younger workers without pensions and health care benefits as long as they still have theirs. Private industry workers who a generation ago had pensions are now eager to get rid of teacher and government pensions. As one of the old Robber Barons said: "I'm not worried about the working class. I can always hire one half to kill the other half." Similarly you see contented little guy conservatives, "libertarians" with an ordinary college grad job, white working class racists unconcerned for the moment about other groups getting screwed..
I haven't looked into the specifics as closely as I will if he actually gets picked for the job, but I'm pretty sure his conviction for mishandling classified information makes him ineligible to hold office just as it would have if Hillary had been convicted.
He plead guilty to a misdemeanor is all. And I doubt the Trump constituency cares anyway. This is based on nothing except reports that he's in the running, but I feel it in my bones.
