Tag Archives: The Affordable Healthcare Law

Obamacare isn’t gonna crash…But it DOES needs adjustments…

The nations’ s healthcare program the Affordable Healthcare program, also labeled Obamacare is doing what it was supposed to do…Increase healthcare insurance for those who could didn’t have access to coverage…

And while the political scrimmaging is going on ?

The fact is the program DOES Need fixing…

That fixing should NOT be a full repeal of the program knocking up to 24 million people out coverage entirely to make premiums lower for those who can pay them without effort…

Are the insurance marketplaces created by the Affordable Care Act really on the verge of collapse, as President Trump and GOP leaders have repeatedly claimed?

Three months ago, this story would have started like this: It depends on where you look and who you ask.

Today, it goes something like this: They are in a fragile state pretty much everywhere.

With Trump threatening to withhold payments to insurers and expressing reluctance to uphold the mandate requiring most people to either buy insurance or pay a penalty, otherwise stable state markets are now in a precarious position. Others are experiencing issues they likely would have anyway, but with a layer of new instability on top. But just because many markets were stable doesn’t mean they were serving everyone well. The messy reality of these two intertwined issues — what keeps the markets stable and who they cover — often leaves politicians on both sides of the aisle telling half-truths about the health of Obamacare’s most public provision. A look at the ways marketplaces are succeeding and failing reveals opportunities for improvement and hints at why the political climate could make those improvements all but impossible.

For the last couple of decades, the term “death spiral” has been used to describe a marketplace spinning out of control. In the face of rising premiums, healthy people bail from a marketplace, causing premiums to rise further, until the prices are unaffordable for everyone and the whole plan falls apart. The Obamacare marketplaces are not in a death spiral, according to various health policy experts, despite numerous Republicans’claims to the contrary. In fact, the term, at least under its pre-Obamacare definition, is largely obsolete. That’s because the ACA fundamentally changed how the markets are organized. Now that the government is subsidizing health insurance, people with incomes just above the federal poverty line are largely protected from rising premiums — 83 percent of the people currently using the markets receive subsidies to help pay for their plans — and, healthy or sick, they are unlikely to flee the markets amid rising premiums.

However, growing costs in the marketplaces frequently determine whether someone with a slightly higher income1 will buy into the market. That’s because under the current system, those people receive low or no subsidies to offset the cost of insurance — they aren’t immune to the price increases…..

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Republican push just for Repeal of Obamacare is almost gone…

Strike while the iron is hot?

On the Affordable Healthcare Law/Obamacare?

That iron is cooling and probably cold….

Between the mounting protests in the streets and at town halls….

Along with polling showing that more American’s are worried about losing their coverage?

The chances of an outright repeal of the program is just about gone….

Rightwingnuts still walkabout an immediate junking of the program…But NOBODY except them are for that anymore…

Repeal and Replace has been the call from the new President….

But any senario proposed on that will wait until next year or 2019 AFTER the midterm elections….

We’ve pointed this out before here….

The Affordable Healthcare program’s worst problem is it’s nickname….

As President Obama tried to do…

The program needs adjustments…

They ARE coming….

Probably another name….

But in the end….

That’s about all….

Ever since Republicans got down to the business of repealing the Affordable Care Act, the Senate has been singled out as the likely problem. Any plan that could zoom through the House would hit roadblocks among Senate Republicans, many of whom have resisted a wholesale repeal of the health law without a robust replacement plan.

But after weeks of loud protests, boisterous town hall meetings and scores of quieter meetings with health care professionals, patients, caregivers and hospital managers in their districts, it is becoming increasingly likely that a consensus in the House may be just as hard to reach.

The most conservative House members are pushing for a fast repeal of the health law with only a bare-bones replacement to follow, possibly just bigger incentives for people to open health savings accounts to fund their own health needs. Other Republicans are more interested in taking their time to come up with a replacement plan that, as of now, they have failed to cobble together beyond a menu of options….

“For the first time Republicans need to demonstrate what they are for and not just being against Obamacare,” said Doug Heye, who served as the deputy chief of staff to former Representative Eric Cantor of Virginia when he was majority leader. Mr. Cantor and House Republican chairmen labored in 2014 to bring a replacement bill for Republicans to get behind, Mr. Heye said, and got nowhere, even with no stakes.

“Republicans are going to come back to Washington next week and say what they’ve heard on the ground, at hospitals, at restaurants, at events where people have been concerned about where they go from here,” he said. “How much that shapes things over the next months remains to be seen.”

Further, recent polls show increasing enthusiasm for the health law as Americans see its repeal on the horizon…

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The IRS won’t withold your refund if you don’t have insurance…

The Trump Admin makes smalll changes in which the Affordable Healthcare is administered which soften the Obama mandate filing deadline and will help insurance companies while making it harder for some one to buy insurance by cutting the enrollment period and giving insurance companies leeway to hike deductibles …

It appears that the Trump Admin is helping the big business insurance companies at the expense of the consumer, something that Republicans live by….

The Trump administration is taking its first steps to put its imprint on the Affordable Care Act, reversing plans to withhold tax refunds this year from Americans who flout an insurance requirement in the law while proposing a series of rule changes to encourage insurers to remain in ACA marketplaces.

The Internal Revenue Service has revoked an Obama-era instruction to taxpayers that was taking effect during the current filing season as a way to further compliance with the ACA’s requirement that most Americans carry health insurance or pay a tax penalty. Under the instruction, the IRS had announced that it would no longer process tax returns for people who fail to send a notice with their returns that they have insurance, are exempt from the requirement or are paying the fine.

Instead, the agency said in a statement on Wednesday, tax returns will be processed as always, even for individuals who do not provide the required information. The IRS said the decision, made earlier this month but not previously publicized, was in line with an executive order that President Trump signed hours after his inauguration, giving agencies broad authority to lighten the burden of federal rules under the ACA.

The IRS confirmed the change on the same morning that Health and Human Services officials proposed a set of rules to help protect insurers and shore up ACA marketplaces in the short term while Republicans work on demolishing the law. The proposal drew swift praise from the insurance industry and condemnation from consumer advocates and congressional Democrats….

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Note….

The IRS action will be for this tax session….

The proposed rule changes only allow for 20 days of comments and will mostly go in effect NEXT year , when Midterm elections will be held….So of the rule changes where also under consideration by the Obama Admin….

Update….

The NY Times is out with a piece that gives more details on the GOP moves which would NOT make any structural changes in the Affordable Healthcare Law know as Obamacare , but would help richer people with healthcare insurance while hurting those who are poorer…

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Republican lawmakers get bombarded about Obamacare Repeal back home…

Left from the hallowed hall’s of the nations Capital?

The questions and fear about the Affordable Healthcare Law’s future are coming fast and furious at Republican  US House and Senate members…..

And the these incidents are happening in places where Donald Trump won and some are certained organized by Democrats…

As has been predicted here?

There will be NO MASS changes in President Obama’s signature Obama care Healthcare bill….(Trump has promised that No ONe should lose their coverage)….At least not anytime before the 2018 Midterm elections….And Republicans ARE gonna have to roll out some solutions to keep most Americans and Inurance Companies calm soon…

Liberal-leaning groups are trying to foment a real movement against Trump — and in particular against repeal of Obamacare — sharing spreadsheets of town halls for Republicans across the country in hopes of sparking a grassroots movement similar to the tea party movement of 2009. Videos of screaming constituents were splashed across TV that summer as Congress drafted Obamacare, slowing the law’s momentum and crushing any chance that Republicans would help pass it.

So far, protests against the repeal effort are not nearly as heated as those rage-filled 2009 town halls, some of which ended in fistfights, arrests and hospitalizations. But they show growing angst over the GOP’s uncertain plans to replace the health care law….

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Democrats look to organize a Jan 15th Protest against Obamacare Repeal…

A Repeal is coming….

It will be delayed actually…

But Democrats are gonna make sure the Republicans OWN the Obama created program going ahead….

In a letter Wednesday, Senate Majority Leader Chuck Schumer (D-NY), House Democratic Leader Nancy Pelosi (D-CA) and Sen. Bernie Sanders (I-VT) asked local communities to help them organize protests against the repeal of the Affordable Care Act.

“Beginning in January, it is likely that Republican leaders will follow through on their threats to ram through a budget bill that will severely undermine the health care needs of the American people,” the letter read.

Republicans are planning to use a procedural maneuver known as budget reconciliation to repeal the law with a simple majority vote in the Senate as soon as January, but Democrats are trying to lay the groundwork for a grassroots movement against the repeal.

Democrats argue that repealing the law will take away insurance for more than 20 million people and take away Medicaid expansion in states throughout the country. Republicans say their plan wouldn’t phase out Obamacare for two to three years. Republicans also promise they will replace it, but have yet to come up with a replacement bill.

In the letter, Schumer, Pelosi and Sanders designated Jan. 15 the day of action and asked activists to “organize a rally or other event” back in the states. Democrats are calling Jan. 15, “Our first stand. Save health care.”….

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The Congressional Budget Office will call out any Obamacare replacemment that doesn’t keep coverage on a certain level….

While some people think the Republicans will just CUT-UP the Affordable Healthcare law (Obamacare) and let the chips fall where they may, knocking millions out of their healthcare coverage?

There is little evidence of such a risky political action….

A Repeal of the six year old may come soon….But a replacement of the program isn’t gonna ready for two years or more…..

During that period of time Republicans will gain ownership of the program and will hard pressed to NOT have the Democrats use the program on them like they did on the Democrats…..

And American’s with insursnce thru the program will be voting in the 2018 midterm elections as stakeholders ….

Any rewrite will NOT be a easy excercise….

The Congressional Budget Office laid out some important ground rules in a blog post Tuesday for how it will judge whatever Obamacare replacement plans lawmakers eventually offer if they repeal the Affordable Care Act next year. The CBO said it would not be giving any proposals credit for covering consumers unless the plans that consumers would be receiving met certain broad standards for coverage.

The post comes as GOP lawmakers are readying their push to repeal Obamacare early next year, but with a two- to four-year delay that they say would give them enough time to settle on a replacement. Over the six-plus years since the ACA was passed, Republicans have struggled to develop consensus around an alternative, in part because of deep disagreements within the party over the government’s role in the health care industry and whether universal coverage should be a goal.

The CBO blog post adds a new wrinkle to the debate, by making clear that lawmakers won’t be able to claim that they will protect the millions of people that stand to lose insurance with an Obamacare repeal if the coverage that comes with their ACA replacement is significantly less generous or wide-ranging.

“Two key questions for policymakers in developing such proposals are what type of insurance products would qualify for tax credits and what role states would have in making that determination,” the CBO said.

The blog post went on to explain the regulations imposed by ACA that determine which plans are eligible for the law’s subsidies and how they compared to the standards the CBO used before the Affordable Care Act to determine whether a plan offered enough for its recipient to be considered covered. It noted that many proposals that have been floated to replace Obamacare offer tax credits for plans, but significantly loosen or eliminate the regulations surrounding insurers…..

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All the sudden Republicans say Obamacare has a “relatively small” foot print?

Here we go with changing of Reality that Trump & Co. and the Republicans in Congress are trying to sell….

The numbers speak for themselves….

The current enrollment numbers (as of February 2016) are roughly: 12.7 million in the marketplace, and very roughly 20 million total between the ACA between the Marketplace, Medicaid expansion, young adults staying on their parents plan, and other coverage provisions.

The 2016 uninsured rate remains at an all time low with the uninsured rate at 11.9% for Americans 18 – 64 and 8.6% for all Americans. 8.6% is down from 9.1% as of 4th quarter 2015, and 15.7% before the Affordable Care Act was signed into law….

Source….

“Obamacare is a malignant tumor that feeds and metastasizes on American liberty,” Rep. Steve King (R-IA) once said of the law.

“Obamacare is doing tremendous damage across America, and in Utah in particular,” Sen. Orrin Hatch (R-UT) said a year ago.

Reacting to a major 2012 Supreme Court decision upholding Obamacare, then-Rep. Mike Pence (R-IN) gravely pronounced: “This ruling erodes the freedom of every American, opening the door for the federal government to legislate, regulate, and mandate nearly every aspect of our daily lives under the guise of its taxing power.”

“If we don’t repeal and replace Obamacare, we will destroy health care in America,” Donald Trump warned a week before the election.

That was then.

This is now:

“It’s a relatively small number of people who really are involved here,” Hatch told reporters earlier this month when he was being pressed for specifics about the GOP plan to repeal and maybe eventually replace Obamacare.

The sudden change in tone comes as the Obamacare buck, as it were, has been passed on to Republicans, who have vowed to repeal it as soon as the new Congress convenes in January. GOP lawmakers are now facing a bevy of concerns about what their current plan – repeal and delay – could mean for the individual markets, which health policy experts warn could collapse in the so-called transition period. The threat of rising premiums and disappearing choices, which has provided much of the ammo for Republican ACA attacks under Obama, is not so panic-worthy given individuals on the exchanges make up just 4 percent insurer market, their new refrain goes.

”We have an Obamacare emergency in a relatively small part of the insurance market, the individual — people who buy insurance individually. That’s about 6 percent of all of the insurance that is bought in the country, 4 percent … is through the exchanges,” Sen. Lamar Alexander (R-TN), who is the chairman of the Health, Education, Labor and Pensions Committee, told TPM last week.

Republicans are right that Obamacare’s exchanges implicate a relatively small part of the overall health insurance market, though it still affects millions of people. But the shift is notable as the nuance and hedging were largely absent from discussions over the last six years when Obamacare’s problems were not GOP lawmakers’ to fix….

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A Republican American Government will have a LOT of work to do before April…

If the history of the recent American Congress efforts are any indication of what’s to come?

They are gonna ahve hard time even getting the basic’s done….

The fight will be between Democrats and Republicans….

Republicans and Conservatives….

And YES…..

Donald Trump & Co. and themselves and EVERYBODY else…

Republicans and President-elect Donald Trump will face a slew of tough legislative deadlines next year.

It will be an abrupt change from 2016, when lawmakers faced few make-or-break dates except for avoiding a government shutdown.

One informal deadline for the GOP Congress is April 30, which would be Trump’s 100th full day in office, not including Inauguration Day.
GOP lawmakers are eager to move as many top policy priorities for Trump as possible in his first 100 days, including repealing ObamaCare on his first day as president.
Tax reform and an infrastructure investment bill are two other possible priorities for the new administration.

The Senate will also be kept busy voting to confirm dozens of nominees to Trump’s administration.

Beyond that informal deadline, Congress faces a number of specific deadlines that will require action.

The first big one comes on March 16, when the current debt-limit deal expires.

It’s the first time Congress will have to raise the $20 trillion debt ceiling since the 2015 budget deal brokered by then-Speaker John Boehner (R-Ohio) and President Obama. That agreement suspended the debt limit for more than a year.

The Treasury Department will likely use “extraordinary measures” to push the deadline for raising the ceiling until at least midsummer.

It will be the first time since before the Tea Party movement that Republicans will deal with a debt-ceiling vote while they control both chambers of Congress and the White House.

As a result, the responsibility will fall on their shoulders to raise the ceiling.

Conservative Republicans repeatedly pushed the Obama White House to agree to spending cuts in exchange for raising the debt ceiling.

This time, they’ll have to negotiate with Trump. And Democrats will have little incentive to offer any help.

Congress also faces an April 28 deadline to fund the government after it approved legislation last week to prevent a government shutdown…..

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The Republican Conservative Freedom Caucus is against waiting on Obamacare Repeal and Other stuff…

Didn’t last long , eh?

Been saying to all who will listen that the Republicans Honey Moon ain’t gonna last to long….

The fight for Obama care is NOT gonna go as smooth as Republicans House Speaker Paul Ryan would lead people to believe…..

Neither is a Donald Trump dream of a ballooning Federal Budget….

The Republican Civil War in Congress was over for the last few weeks….

It’s back….

The Republican congressman who made his name as the instigator of John Boehner’s ouster last year was set to take the reins of the House Freedom Caucus on Monday night.

And first up on Rep. Mark Meadows’ to-do list: Torpedoing GOP leadership’s tentative plans to take as long as three years to replace Obamacare.

The proposal “will meet with major resistance from Freedom Caucus members,” the North Carolina Republican vowed in an interview, calling it “the first big fight I see coming for the Freedom Caucus.”

“It should be repealed and replaced, and all of that should be done in the 115th Congress” — the two-year period starting in January through 2018 — and “not left to a future Congress to deal with,” Meadows added.

Politico reported last week that GOP leaders on both sides of the Capitol are coalescing around a two- or three-year repeal strategy, which would allow them ample time to come up with a replacement and give insurance companies time to adjust. The Senate is particularly keen on a three-year phaseout, though nothing is set in stone.

But during a retreat in Virginia’s Blue Ridge Mountains over the weekend, Freedom Caucus members fumed at that idea. Most said they wouldn’t settle for anything longer than a two-year replacement process, the time frame both chambers approved last year in an Affordable Care Act repeal bill that President Barack Obama vetoed.

Meadows even suggested that Republicans could replace the law early next year, ahead of the fall enrollment period for 2018. Many leadership sources don’t believe that timetable is feasible….

House leaders will need Freedom Caucus votes for any repeal plan, since Democrats are expected to vote as a bloc against any attempt to overturn or weaken Obama’s signature domestic achievement.

Theoretically, the group could block a three-year replacement plan if its members vote as a bloc; Democrats are certain to unite against any effort to scuttle or weaken Obama’s signature domestic achievement….

“There’s a push to try to change the group to a more policy-driven” body, he said. “Much of what we’ve been defined by is what we’re against, not what we’re for. So we will see a real focus going forward on a list of 10 to 20 proposals that we are supportive of.”

Some of those include a series of bills limiting executive branch powers. Meadows wants the Freedom Caucus to back a bill to overturn “Chevron deference,” a Supreme Court precedent that requires courts to accept an agency’s interpretation of ambiguous laws. The Freedom Caucus also wants to give Congress jurisdiction over what it estimates is about $600 billion the federal government collects in fines and fees that aren’t currently subject to congressional appropriations.

The group is also crafting a bill to require the executive branch to write all rules and regulations pertaining to a particular law within a three-year window after it passes Congress, Meadows said. The idea is aimed at barring future administrations from reinterpreting decades-old statutes….

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Republican Senators admit Obamacare isn’t going anywhere anytime soon…

Donald Trump & Co. may be peddling the idea that they are just gonna repeal the Affordable Healthcare Act from day-one….

But the President and Executive branch can’t do that…..

Congress passes the Laws…..

And Congress can only repeal them….

Any move to hurt tens of millions of American’s Healthcare and to send Insurance companies into a tailspin after they have settled in on the healthcare program is sure to rile the political waters for Republicans who now ‘own’ the issue they used against Democrats…..

Republican senators who spent years railing against the president’s signature health care law are now trying to find consensus on how they want to make good on their years-long campaign promise to dismantle it – and the growing consensus is that it is going to take time to find a replacement.

“Its gonna take us awhile to make that transition from the repeal to actually replacing it with more affordable health coverage, which provides people better access,” Sen. John Cornyn (R-TX), the Senate majority whip, told reporters Tuesday. “There is a lot to do so it’s not going to happen overnight.”

Republicans’ inability to coalesce around a replacement plan in the six years after Obamacare was passed means they have no easy alternative to queue up with a repeal, which they have vowed to make the top of their agenda next year. Their current inability to settle on a clear repeal and replace plan also reflects the trade-offs that have been dogging the GOP in last half-decade. Within the Republican caucus are deep, philosophical rifts over basic questions about health care policy and the government’s role in providing access to coverage.

Lobbing critiques at rising premiums while on the campaign trail was far easier than what comes next as Republican confront the reality that along with their much bemoaned individual mandate, fully repealing Obamacare also would mean unraveling popular provisions and benefits that have become available under the law and expanded health care coverage.

Rank and file Republicans Tuesday voiced an array of concerns about what moving too fast could mean for millions of individuals who had attained health care coverage through expanded Medicaid programs in the states and about what would happen to individuals with pre-existing conditions, who under the ACA were able to obtain health insurance. Instead of repealing and replacing Obamacare suddenly, Republicans in the Senate are now discussing a way to “transition” from Obamacare to their alternative, which is still to be determined….

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Update….

— Senate Finance Committee Chairman Orrin Hatch, who has jurisdiction over federal health care programs, now says it will take up to three years to repeal the Affordable Care Act – a timeline that would guarantee the law is once again a marquee issue in the 2018 and 2020 elections. “We know that to correct it is going to take time,” the Utah senator told Kelsey Snell yesterday afternoon. “I don’t see any reason for anybody to be too upset about it.”

— Wise Republicans are trying to get out front of what they see as inevitable voter backlash if they run roughshod with reconciliation, without trying to win Democratic buy-in (or at least making a show of trying to). “There will be a multiyear transition into the replacement,” Senate Majority Whip John Cornyn (R-Texas) said in a separate conversation with Kelsey. “This is a failed piece of legislation and it is coming apart at the seams, but it is going to take us a while to make that transition from the repeal to actually replacing it.”

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Republicans in Congress are NOT in a hurry to Repeal Obamacare….

We know that Donald Trump has told President Obama that he will NOT repeal the entire law already….

It has also been pointed out here that Republcan Governors are using the program to balance their budgets…

NO ONE is gonna wipe the law out entirely….

THAT is JUST NOT gonna happen….

So ANOTHER Trump promise isn’t gonna be….

“Are you really going to take insurance away from this many people and leave them with only a tax credit? I think there’s a powerful argument that they won’t do that,” said Thomas Bulleit, a partner specializing in healthcare policy at the law firm of Ropes & Gray.

The other big question facing Republicans is what to do about the Medicaid expansion, which was adopted by 31 states, including Ohio, Michigan and Pennsylvania, three Rust Belt states that helped push Trump to victory on Tuesday.

Kentucky, McConnell’s home state, also expanded Medicaid under ObamaCare. At the beginning of last year, nearly 500,000 people in Kentucky had gained coverage under Medicaid or the Children’s Health Insurance Program because of the healthcare law, according to the Department of Health and Human Services.

Republican healthcare experts say it’s unlikely that Congress will reverse the Medicaid expansion in these states. More likely lawmakers will enact reforms to curb its costs and give states flexibility to administer smaller payments from Washington…..

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American Healthcare Uninsured rate drops below 10%…

Last night someone I know was ranting about how he was gonna vote for Trump because Trump would get rid of Obamacare….His drug cost had gone thru the roof!….He was having to switch to generic’s…..

My retort was THAT was not gonna happen….

I followed by saying the Affordable Healthcare law’s program was on the whaole a VERY GOOD thing , but admitted that like HIS President?

It’s needs fixes….

The fact that Healthcare costs have actually dropped and MORE Americans HAVE coverage didn’t register with him….(My kids have coverage because of Obamacare)

It has with  20 Million more American’s with coverage and that’s one the reason’s I’m voting for Hillary Clinton….

The share of Americans who don’t have health coverage fell below 9 percent during the first half of this year, the lowest percentage ever recorded, according to survey results published by the Centers for Disease Control and Prevention on Thursday.

The uninsured rate held steady from the end of 2015, slightly declining to 8.9 percent, or 28.4 million people, the CDC report says. The share of uninsured Americans fell more than 5 percentage points since 2013, the year before the Affordable Care Act’s coverage expansion took effect.

This latest survey of the uninsured population underscores what the Affordable Care Act, also known as Obamacare, has achieved in its first three years of being fully online. The uninsured rate had hovered around 15 percent in previous years, until the health care reform law’s expansion of Medicaid to poor adults, and introduction of subsidized private health insurance for low- and moderate-income families became available.

Twenty million previously uninsured Americans gained coverage since President Barack Obama’s Affordable Care Act was enacted in 2010, the Department of Health and Human Services reported in March.

The American public hasn’t gotten the message, however, even though surveys from the CDC, the Census Bureau, Gallup and other sources have consistently shown a dramatic drop in the uninsured rate in recent years….

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Trump Can’t just call Congress together to repeal the Healthcare Program…

...from Washington Post.….

— Trump really has no idea how government actually works cont.:He vowed yesterday to call a special session of Congress to repeal and replace Obamacare as soon as he’s elected. Outside Philadelphia, he said: “I will ask Congress to convene a special session so we can repeal and replace,” he said. “We will do it and we will do it very, very quickly.” The Los Angeles Times notes the Constitution gives the president the authority “on extraordinary occasions, to convene both houses or either of them.” But the last one was nearly 70 years ago. Not to mention, if Trump won, Congress would come into session anyway! Asked about his plan by a pool reporter, Trump said he has not reached out to Congress yet, adding: “We will very soon.”

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The Affordable Healthcare Law has increased the number of American with Healthcare Insurance…

Obamacare IS doing what it was designed mostly to do….

Provide MORE Americans WITH Health Insurance….

Like EVERYTHING?

It needs adjustments….

But  the Republican push to get RID of the program isn’t viable anymore….

When congressional candidates last hit the campaign trail in 2014, one word seemed to be at the top of the agenda for virtually every Republican: Obamacare. But that was before most of the law’s provisions took effect. Two years later, the health law seems to have faded as a campaign issue.

New data released this month might give a hint as to why: The uninsured rate — the share of the population without health insurance — dropped in every congressional district in the country between 2013 and 2015, according to the American Community Survey.

Obamacare’s troubles are far from over. Recent months have brought a spate of headlines about big insurers pulling out of the law’s health insurance marketplaces, and (somewhat misleadingly) about soaring insurance premiums. The law, formally known as the Affordable Care Act, remains as polarizing as ever: Two-thirds of Democrats say they have a favorable view of the law, and 76 percent of Republicans view it unfavorably, according to an August poll from the Kaiser Family Foundation, which researches health care policy.

But on one metric, at least, the law seems to be working: More people are getting coverage…..

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Healthcare for ALL American’s would be a Heavy and Complex Lift…

Let me add  that any health-care system or non-system faces enormous underlying pressures no matter how (or indeed whether) coverage is distributed.

Many of the pressures are social, political, demographic or economic in origin while others begin in the continued advances of science, technology and medical practice.

Different sides invoke the experiences of (say) Canada, Britain and Scandinavia to support their own views, but all countries struggle with how best to distribute limited resources to satisfy ever-growing and ultimately insatiable demand.

Health care inflation is partly due to perverse incentives to pharmaceutical developers, investors, manufacturers and distributors (who need big payoff for the occasional triumph to justify investing in a much-greater range of very unlikely experiments), partly to financial greed, speculation and manipulation, and partly to self-generating institutional bloat (non-profit hospitals always merging and competing with duplicating equipment).

But some is due to complicated moral choices: How do you pay hard-working health-care workers justly? When does an ever-expanding spectrum of care to progressively older and frailer populations become “too expensive”? Which diseases’ cures deserve the most research?, and which ones must lie by the wayside? Who lives?, who suffers?, who dies?, and when? When is the plug pulled, and who should pull it?

When does the whole system become too expensive for the payers of taxes and social insurance ?

When do yo u ration and how ? (through price?, through scarcity? through delays and waiting times?, by explicit rules?

A democratic, legislative process is the only conscionable way to answer such questions, since at least it’s designed to reach consensuses that all will accept, no matter how grudgingly.

But in many ways, the democratic (or republican) legislative process is (whether you follow Hobbes. Locke, Rousseau, Hume, Hamilton, Jefferson, Madison, Bagehot, Marx or Lenin) a system where making such choices becomes nearly impossible.

How does a legislator answer the distraught family of someone suffering from an orphan disease? If there’s a National Institute for X and a National Institute for Y, then why not ones for Q, V, W and Z, whose victims are suffering no less acutely in desperate hope of some relief?

DSD….

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16.3 M people have signed up for Healthcare due to Obamacare…

And the uninsured rate has dropped to a low of 9%….

Not bad for a program that was suposed to be a failure by Republicans….

There have already been record gains in lowering the uninsured rate under ObamaCare. A survey from the Centers for Disease Control and Prevention last year found that 16.3 million people had gained coverage since 2013, a number that combines gains from the law’s marketplaces and its expansion of Medicaid.

The country’s uninsured rate has fallen to a record low of 9 percent since the passage of the Affordable Care Act…

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