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» Hatrack River Forum » Active Forums » Books, Films, Food and Culture » Obamacare, I will miss you. (No I won't because you've unpacked your bags!) (Page 1)

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Author Topic: Obamacare, I will miss you. (No I won't because you've unpacked your bags!)
BlackBlade
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"Tomorrow, nine people who get free government healthcare will let us know what the rest of us get." --Andy Borowitz

I'm going with my gut on this, but I think the individual mandate will get scuttled. I was tempted to intrade it as you can still make about $3 per share, but I'm just not much of a gambler. I'm more of an insider trader if I do any trading at all. I like a sure thing.

I would laugh in a schadenfreude kind of way if the part that preempts insurance companies from refusing to cover preexisting conditions remains intact. Of course that probably just means premiums for everybody goes up.

I don't think the individual mandate was a good idea, the precedent is just too disturbing to me. But I do want a public option, if we're going to take a step back for now. The majority of Americans might be against the mandate, but a majority also said they wanted reform a few years back. Going back to the status quo sucks for everybody except those in Congress I suppose.

Of course Boehner has already made noise about cleaning up whatever SCOTUS doesn't strike down. Doesn't surprise me, he represents a clique that is so out of touch with what the average American is dealing with these days.

[ June 28, 2012, 11:30 AM: Message edited by: BlackBlade ]

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Kwea
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Here is a great article on the individual mandate...

You might be surprised to find out who's idea it was in truth.

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Lyrhawn
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I really have no idea how tomorrow will go. Scalia has been on the war path over this issue, and both he and Alito have been scolded by the left wing of the Court, publicly, for their behavior over the last session with regards to judicial overreach and politicization of issues before the Court. It's always been about Anthony Kennedy and how far he was willing to go.

A year ago academia was saying 99% slam dunk it would be safe, but now they're saying flip a coin. Analysts are saying the Q&A from the initial case as it was argued suggests they're leaning toward striking it down, but I've heard others say you can't take Q&A as a sign of what the justices will rule.

My guess?

I'm going to go nuts and say 6-3 decision with Roberts joining the liberal wing. I think if Kennedy votes to keep it and the liberal wing wins, Roberts will jump on board for the sake of trying to save face to keep some semblance of integrity for the Court in a year where their reputation has taken some heavy damage. If you read the decisions Scalia and Alito have written just during this session, and the outrages dissents written by the liberals, it doesn't take a genius to see where most of them fall on current issues.

I'll make another prediction: If it gets knocked down, Obama and the Democrats will curl up into a little ball and throw paper airplanes at the GOP instead of manning up and going to war. It's an issue that could define the election and win reelection for Obama if he was aggressive enough. But he won't be, because it's not his style.

Waiting for tomorrow is like reading the end of a George R. R. Martin novel. You can't trust that everything will work out in the end.

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BlackBlade
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Well wonders never cease!
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odouls268
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"Tomorrow, nine people who get free government healthcare will let us know what the rest of us get." --Andy Borowitz


hehehe that's funny stuff.

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Blayne Bradley
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I just want Obama to expand the court at this rate, 5-4 decisions are awful and the current size is an historical accident.
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Samprimary
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I wanted Obamacare to be struck down by a nakedly political SCOTUS. My reasoning has been coldly utilitarian; I think our country is idiotic — completely idiotic — when it comes to health care, it is a national embarrassment and a frequent delusion of conservatives that we have a good system or even the 'best healthcare in the world,' and it has always seemed like things have to get worse before they can get better. I wanted the conservatives to get every inch of the system THEY desire, because I want the cold reality of that system's 'functionality' thrust in our faces. I want them to face the ungovernable conclusion of their ideas.

But today I did not get what I want, and I'm not really going to complain too much, because I got the next best thing, and certainly the kinder in the short term:

http://content.usatoday.com/communities/theoval/post/2012/06/Supreme-Court-rules-on-Obama-health-care-plan-718037/1

quote:
The Supreme Court upheld the health care law today in a splintered, complex opinion that gives President Obama a major victory.

Basically. the justices said that the individual mandate -- the requirement that most Americans buy health insurance or pay a fine -- is constitutional as a tax.

Chief Justice John Roberts -- a conservative appointed by President George W. Bush -- provided the key vote to preserve the landmark health care law, which figures to be a major issue in Obama's re-election bid against Republican opponent Mitt Romney.

The government had argued that Congress had the authority to pass the individual mandate as part of its power to regulate interstate commerce; the court disagreed with that analysis, but preserved the mandate because the fine amounts to a tax that is within Congress' constitutional powers.

The announcement will have a major impact on the nation's health care system, the actions of both federal and state governments, and the course of the November presidential and congressional elections.

A key question for the high court: The law's individual mandate, the requirement that nearly all Americans buy health insurance, or pay a penalty.


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Derrell
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Does this mean I have to buy insurance? How do I go about doing that? Where do I get the money?
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Blayne Bradley
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If you are under 25 iirc your parents are support to cover you, after that you have to select one of the many many many HMO's and just call and ask.

Otherwise I guess you pay a fine.

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Geraine
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Well, its Constitutional, but not under the Commerce Claus.

It survives by being called a "Tax" which the government has power to do.

I will say that while I do not like the ruling, I understand why the SCOTUS ruled this way.

It also scares the living crap out of me. It effectively means that the government can push through anything they want and then place a tax on the people for non-compliance.

It is a double edged sword for the Obama administration, one that I think hurts him this election cycle more than helps him.

If the mandate was struck down, I don't think it would have really affected Obama's election chances as much as this decision.

Obama has been out there for the past three years saying he wasn't going to raise taxes on the middle class and those making less than 250k a year. The poor won't be affected by this ruling since they will be covered under Medicare. You can bet that the GOP will use this "tax" in their ads against Obama.

Oh, and can we stop calling the SCOTUS an arm of the Republican party now?

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Aros
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quote:
Originally posted by Geraine:

It also scares the living crap out of me. It effectively means that the government can push through anything they want and then place a tax on the people for non-compliance.

Hyperbole much?
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Samprimary
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quote:
Originally posted by Derrell:
Does this mean I have to buy insurance? How do I go about doing that? Where do I get the money?

Understanding the TRUTH about Obamacare. http://www.conservapedia.com/ObamaCare
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SteveRogers
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I read the first sentence. Laughed. And then e-mailed it to myself to read the rest later.
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odouls268
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meh.

Arnold for President 2012!

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Blayne Bradley
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http://a.yfrog.com/img644/7743/7ozrf.jpg

Yes! I hope he does this.

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Blayne Bradley
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There has always been a liberal wing and a conservative wing with one or two guys in the middle who are seen as wild cards.

And this is still a problem, especially as some people say that one of them may have ruled this way just because of image issues and public trust.

Having the mandate upheld I believe cements Obama's victory, the republicans can spin it however they like but the fact remains that ObamaCare is now a fact and cannot be ignored. It forces the Republicans to campaign against it, and any successes it will likely result or bring, instead of having the job done for them by the USSC.

It makes it harder not easier for the GOP.

Apparently you are one vote away from having the entire bill tossed out:

quote:

The Act before us here exceeds federal power both in mandating the purchase of health insurance and in denying nonconsenting States all Medicaid funding. These parts of the Act are central to its design and operation, and all the Act’s other provisions would not have been enacted without them. In our view it must follow that the entire statute is inoperative.

According to dissenting opinion.
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Lyrhawn
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Politically it would have been better for Obama if the measure had been struck down. It would have been a winning campaign issue for him.

It would have been much easier to rail against the GOP for removing protections than it will be to campaign ON the ACA. If he chooses to do so at all.

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Samprimary
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either way it was pretty amazing to me to watch the expected noise outcome of this case

ACA struck down: A BLOW OBAMA WILL NOT RECOVER FROM
ACA upheld: A TRAVESTY OBAMA WILL NOT RECOVER FROM

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Blayne Bradley
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Yeah pretty much, I consider it a win because it leaves Obama with something substantial to show the American people that he's been doing his job and Got Stuff Done. If it was struck down people would say he is just being whiny and partisan.
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Xavier
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quote:
Politically it would have been better for Obama if the measure had been struck down.
I completely disagree. He'd have been seen as having lost the biggest political battle he fought. And they'd be right, pretty much. The american people want strength in their president, perhaps to a fault.
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BlackBlade
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quote:
Originally posted by Xavier:
quote:
Politically it would have been better for Obama if the measure had been struck down.
I completely disagree. He'd have been seen as having lost the biggest political battle he fought. And they'd be right, pretty much. The american people want strength in their president, perhaps to a fault.
I'm partial to this idea. He needs to own this moment and campaign on it. The Republican party has no alternative for Obamacare. He can get a lot of mileage off that. He needs to stop throwing paper airplanes at the Republicans. It's time to realize he won on this issue and that Congressional Reps lost their seats getting him this victory. He needs to outline what his legacy period would consist of.

[ June 29, 2012, 11:24 AM: Message edited by: BlackBlade ]

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Blayne Bradley
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“Throw them into perilous ground, and they will survive; plunge them into Death Ground, and they will live.” - Sun Tzu.
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Tarrsk
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quote:
Originally posted by Xavier:
quote:
Politically it would have been better for Obama if the measure had been struck down.
I completely disagree. He'd have been seen as having lost the biggest political battle he fought. And they'd be right, pretty much. The american people want strength in their president, perhaps to a fault.
More to the point, the ACA is pretty darn unpopular. Obama would not have been able to use it as a campaign issue the way Lyrhawn describes because there simply wouldn't be sufficient outrage from the electorate at large. On the contrary, Republicans would have a powerful new rhetorical tool: "Obama's signature legislative 'accomplishment' was so radical that it was deemed UNCONSTITUTIONAL by the highest court in the land!!!"

Speaking as a supporter of the ACA, I'd happily take the desired policy outcome over short-term political gain - but I do think that the SCOTUS decision effectively does both for Obama. Or at least, upholding Obamacare hurts the Democrats a lot less than striking it down would have.

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Samprimary
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http://25.media.tumblr.com/tumblr_m6c674XaE11qhvj14o1_500.png
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Blayne Bradley
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^^^素晴らしい!!

It's all about if the Democrats can campaign on it effectively; preferably by cloning General Sherman and sending him south with an army of Zombie Union soldiers under his command.

Apparently South Carolina didn't get the message the first time around.

Some harsh language.

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Samprimary
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Anyway.

Here's the go-to explanation about what "obamacare" is in terms about what the bill pretty much, well, does.

quote:
What people call "Obamacare" is actually the Patient Protection and Affordable Care Act. However, people were calling it "Obamacare" before everyone even hammered out what it would be. It's a term mostly used by people who don't like the PPACA, and it's become popularized in part because PPACA is a really long and awkward name, even when you turn it into an acronym like that.

Anyway, the PPACA made a bunch of new rules regarding health care, with the purpose of making health care more affordable for everyone. Opponents of the PPACA, on the other hand, feel that the rules it makes take away too many freedoms and force people (both individuals and businesses) to do things they shouldn't have to.

So what does it do? Well, here is everything, in the order of when it goes into effect (because some of it happens later than other parts of it):

Already in effect:

It allows the Food and Drug Administration to approve more generic drugs (making for more competition in the market to drive down prices)

It increases the rebates on drugs people get through Medicare (so drugs cost less)

It establishes a non-profit group, that the government doesn't directly control, [1] PCORI, to study different kinds of treatments to see what works better and is the best use of money. ( [2] Citation: Page 665, sec. 1181 )

It makes chain restaurants like McDonalds display how many calories are in all of their foods, so people can have an easier time making choices to eat healthy. ( [3] Citation: Page 499, sec. 4205 )

It makes a "high-risk pool" for people with pre-existing conditions. Basically, this is a way to slowly ease into getting rid of "pre-existing conditions" altogether. For now, people who already have health issues that would be considered "pre-existing conditions" can still get insurance, but at different rates than people without them.

It renews some old policies, and calls for the appointment of various positions.

It creates a new 10% tax on indoor tanning booths. ( [4] Citation: Page 923, sec. 5000B )

It says that health insurance companies can no longer tell customers that they won't get any more coverage because they have hit a "lifetime limit". Basically, if someone has paid for health insurance, that company can't tell that person that he's used that insurance too much throughout his life so they won't cover him any more. They can't do this for lifetime spending, and they're limited in how much they can do this for yearly spending. ( [5] Citation: Page 14, sec. 2711 )

Kids can continue to be covered by their parents' health insurance until they're 26.

No more "pre-existing conditions" for kids under the age of 19.

Insurers have less ability to change the amount customers have to pay for their plans.

People in a "Medicare Gap" get a rebate to make up for the extra money they would otherwise have to spend.

Insurers can't just drop customers once they get sick. ( [6] Citation: Page 14, sec. 2712 )

Insurers have to tell customers what they're spending money on. (Instead of just "administrative fee", they have to be more specific).

Insurers need to have an appeals process for when they turn down a claim, so customers have some manner of recourse other than a lawsuit when they're turned down.

New ways to stop fraud are created.

Medicare extends to smaller hospitals.

Medicare patients with chronic illnesses must be monitored more thoroughly.

Reduces the costs for some companies that handle benefits for the elderly.

A new website is made to give people insurance and health information. (I think this is it: [7] http://www.healthcare.gov/ ).

A credit program is made that will make it easier for business to invest in new ways to treat illness.

A limit is placed on just how much of a percentage of the money an insurer makes can be profit, to make sure they're not price-gouging customers.

A limit is placed on what type of insurance accounts can be used to pay for over-the-counter drugs without a prescription. Basically, your insurer isn't paying for the Aspirin you bought for that hangover.

Employers need to list the benefits they provided to employees on their tax forms.

8/1/2012

Any health plans sold after this date must provide preventative care (mammograms, colonoscopies, etc.) without requiring any sort of co-pay or charge.

1/1/2013

If you make over $200,000 a year, your taxes go up a tiny bit (0.9%). Edit: To address those who take issue with the word "tiny", a change of 0.9% is relatively tiny. Any look at how taxes have fluctuated over the years will reveal that a change of less than one percent is miniscule, especially when we're talking about people in the top 5% of earners.

1/1/2014

This is when a lot of the really big changes happen.

No more "pre-existing conditions". At all. People will be charged the same regardless of their medical history.

If you can afford insurance but do not get it, you will be charged a fee. This is the "mandate" that people are talking about. Basically, it's a trade-off for the "pre-existing conditions" bit, saying that since insurers now have to cover you regardless of what you have, you can't just wait to buy insurance until you get sick. Otherwise no one would buy insurance until they needed it. You can opt not to get insurance, but you'll have to pay the fee instead, unless of course you're not buying insurance because you just can't afford it.

Insurers now can't do annual spending caps. Their customers can get as much health care in a given year as they need. ( [8] Citation: Page 14, sec. 2711 )

Make it so more poor people can get Medicaid by making the low-income cut-off higher.

Small businesses get some tax credits for two years.

Businesses with over 50 employees must offer health insurance to full-time employees, or pay a penalty.

Limits how high of an annual deductible insurers can charge customers.

Cut some Medicare spending

Place a $2500 limit on tax-free spending on FSAs (accounts for medical spending). Basically, people using these accounts now have to pay taxes on any money over $2500 they put into them.

Establish health insurance exchanges and rebates for the lower and middle-class, basically making it so they have an easier time getting affordable medical coverage.

Congress and Congressional staff will only be offered the same insurance offered to people in the insurance exchanges, rather than Federal Insurance. Basically, we won't be footing their health care bills any more than any other American citizen.

A new tax on pharmaceutical companies.

A new tax on the purchase of medical devices.

A new tax on insurance companies based on their market share. Basically, the more of the market they control, the more they'll get taxed.

The amount you can deduct from your taxes for medical expenses increases.

1/1/2015

Doctors' pay will be determined by the quality of their care, not how many people they treat. Edit: a_real_MD addresses questions regarding this one in far more detail and with far more expertise than I can offer in [9] this post. If you're looking for a more in-depth explanation of this one (as many of you are), I highly recommend you give his post a read.

1/1/2017

If any state can come up with their own plan, one which gives citizens the same level of care at the same price as the PPACA, they can ask the Secretary of Health and Human Resources for permission to do their plan instead of the PPACA. So if they can get the same results without, say, the mandate, they can be allowed to do so. Vermont, for example, has expressed a desire to just go straight to single-payer (in simple terms, everyone is covered, and medical expenses are paid by taxpayers).

2018

All health care plans must now cover preventative care (not just the new ones).

A new tax on "Cadillac" health care plans (more expensive plans for rich people who want fancier coverage).

2020

The elimination of the "Medicare gap"

.

Aaaaand that's it right there.

a useful user

Budget analysis and medical systems analysis indicate that it will save literally billions of dollars and cut down significantly on america's 40,000+ people who die due to being too poor to access proper health coverage, so I guess it's a foregone conclusion that republicans are going to despise it utterly.

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Lyrhawn
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quote:
Originally posted by Tarrsk:
quote:
Originally posted by Xavier:
quote:
Politically it would have been better for Obama if the measure had been struck down.
I completely disagree. He'd have been seen as having lost the biggest political battle he fought. And they'd be right, pretty much. The american people want strength in their president, perhaps to a fault.
More to the point, the ACA is pretty darn unpopular. Obama would not have been able to use it as a campaign issue the way Lyrhawn describes because there simply wouldn't be sufficient outrage from the electorate at large. On the contrary, Republicans would have a powerful new rhetorical tool: "Obama's signature legislative 'accomplishment' was so radical that it was deemed UNCONSTITUTIONAL by the highest court in the land!!!"

Speaking as a supporter of the ACA, I'd happily take the desired policy outcome over short-term political gain - but I do think that the SCOTUS decision effectively does both for Obama. Or at least, upholding Obamacare hurts the Democrats a lot less than striking it down would have.

That's not as true as you think.

The ACA is unpopular.

But people love most of what's actually in the ACA.

If you poll on individual elements, it's wildly popular. If you call it the ACA, people hate it. It's mostly the individual mandates people are ambivalent about.

He could spent the next four months talking about every individual thing like preventing care, pre-existing conditions, etc that the GOP took from all Americans. Frankly, he still should. And he'd trot out thousands of people helped by parts of the law already enacted who lost that help. He would have had a field day with it.

Striking it down would have energized the hell out of the Democratic base. Now it's ho-hum, move on, but the right gets the energy.

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Samprimary
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Nate Silver's (typically well-reasoned) analysis of the situation indicates otherwise, noting that dissatisfactory public branding of Obamacare is already factored into the energy the right has going for it right now.
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Xavier
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quote:
Striking it down would have energized the hell out of the Democratic base.
I don't think you realize how downright demoralizing it is to lose.

If this had been struck down, I'd not have been energized, I'd have been deflated. I'd have felt that Obama isn't going to be able to get anything major accomplished in this political climate despite his best intentions.

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Vadon
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quote:
Originally posted by Xavier:
quote:
Striking it down would have energized the hell out of the Democratic base.
I don't think you realize how downright demoralizing it is to lose.

If this had been struck down, I'd not have been energized, I'd have been deflated. I'd have felt that Obama isn't going to be able to get anything major accomplished in this political climate despite his best intentions.

QFT

Seeing the decision today lit the fire under me and I've applied for more campaign work this cycle. The ACA was just saved by the courts, I do not want to see it taken out next year through a successful repeal attempt. (Even with the prospects of "repeal and replace" I am left to wonder with what would it be replaced? Romney has said he thinks those with pre-existing conditions should be denied coverage.)

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TomDavidson
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Speaking as someone living in Wisconsin, defeat is exhausting.
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Lyrhawn
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I think it depends on how Obama spun it. If he did his "Gosh we lost" speech like it seems he enjoys doing, it would have been awful.

If he came out with guns blazing, calling for single payer and saying he needs to be reelected to appoint better justices on a wildly reactionary activist Republican Court, I think it would have fired people up.

Part of why the ACA is so unpopular is that no one understands it, mostly because Obama and Democrats don't spend much time explaining it. It's a mystery for most people, and the GOP is filling in the gaps with misdirection and vile lies. If he campaigned on it, that would change. Campaigns aren't about telling you why you should like things you already know. They're about crafting a new narrative.

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Orincoro
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I think you're off your nut on this be, really. What in the history of Obama or the dems in general makes you think they'd be capable of rallying like that? They're not republicans... They care about policy, not just winning and losing.

Plus, he *already* campaigned on the issue, won, and got the legislation. You want to go through that again? While people are suffering the negative consequences of not having these protections? The best part of ACA is that even if Obama loses, people will hate having any of it repealed. Even though they say they won't- when it gets put to them, they will.

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Lyrhawn
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I've already said I'm not sure if they ARE capable of that, just that it could happen of Obama played it right.

And this is EXACTLY how you campaign. You say you want to do something, you win, you do it, then you dance around the ring at the end the fight. So yeah, traditionally people tout their successes in a campaign. The ACA is the crown jewel of Obama's legislative successes. Of course you campaign on it.

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Orincoro
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I meant campaign on getting reform passed, after reform would have already been defeated. I can't see how you could energize people toward doubling down on a cause that has already suffered a major loss. Republicans could, and do, do that, but they do it because they don't actually have to worry about what policies actually work. They don't have to build anything, just double down on the destruction.

That's why this is a wash for Reublicans- when their fight is only against anything constructive, democratic victories just give them more to fight against. The trick is building things that are strong enough to stand up to a constant onslaught of lies and fear mongering.

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Lyrhawn
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Because you're campaigning on what they took away from you.

If the GOP tomorrow passed a law that took away your right to own a car or something, wouldn't that be a campaign issue?

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Orincoro
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But the supreme court would have taken it away. So who are you rallying against? Activists judges? It's just too far of a remove. I understand *you* and *I* would be volunteering at the local campaign office... But it would be a bitter pill for most voters.
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Samprimary
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oh yeah huh romney DID sign the norquist tax pledge.

http://www.reuters.com/article/2012/06/27/us-washington-summit-norquist-idUSBRE85Q1QC20120627


welp yep

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BlackBlade
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I really have no idea how Norquist got as much pull as he does.
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Lyrhawn
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I dunno, it seems like opinion is turning just a tiny bit on that on the right.

Some GOP congressmen have pulled out of it, some have started to speak in much softer language. There are chinks in the armor.

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BlackBlade
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And I am hopeful that continues but seriously, who does he think he is? Since when is anybody beholden to him? Lindsay Graham speaks out against his pledge and Norquist calls him up and tells him to cool it. It's creepy. His pledge is enforced through money, nothing else. He's in the way of Republicans being able to work with Democrats on fiscal matters, and the timing could't be worse. We need to figure this crisis out not stop to engage in theatrics because this guy likes to feel influential.
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Lyrhawn
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When he was on The Daily Show, other than on the pledge, he actually sounded like a pretty reasonable guy.

He wasn't foaming at the mouth like Rush does or anything.

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Rakeesh
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Perhaps that is the difference between the rabble rousing far-right activist/'entertainer' such as Rush who can certainly get people talking but when it comes to specific policy aims is apparently not the silver bullet...and someone who can get individual (and quite a lot of them) major, national politicians to kowtow?
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BlackBlade
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quote:
Originally posted by Lyrhawn:
When he was on The Daily Show, other than on the pledge, he actually sounded like a pretty reasonable guy.

He wasn't foaming at the mouth like Rush does or anything.

I doubt mafia bosses ever raise their voices too. It's still messed up. There's nothing illegal about it of course, but...
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Orincoro
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I saw the Sopranos, and Goodfellas, and Casino. Fair amount of yelling.
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Kwea
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LOL...

Well, Rush said if this passed he would move to Costa Rica. Wonder if he packed yet....


Funny thing though.....Costa Rica has Universal Health Care.

[Evil]

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Orincoro
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There was a nice twitter feed of people proclaiming their intentions to move to Canada.
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dabbler
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The ACA is favorable to 42% of the polled, as of April after the oral arguments and unfavorable to 43%. I know the media likes to say its really hated, but it's not that bad. The split is 70% democrats favor and 7% repubs. So there's a lot of room to educate the repubs on what's on it to see if that changes their minds.

I like that long descrip. I knew most of it, but not all of it (like that congress is going on exchanges).

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Samprimary
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quote:
Originally posted by BlackBlade:
I really have no idea how Norquist got as much pull as he does.

The neoconservative swell. A whole couple of terms with the country being run under the agenda of a group that really fully trusts in supply side economics, laffernomics, and any other economic hypothesis which posits a benefit to piling favors unto our most well-off and letting everyone else ultimately pay that infrastructural tab.
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Samprimary
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alternate answer: the GOP is broken
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