POLL: Trump Wants to Cut Federal Gasoline Taxes. Do You Agree?

Do you agree or disagree with Trump's plan to cut gasoline taxes?


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    50

BlIIlken2

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Dec 4, 2021
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Fire Flames GIF by FSL Ecosystem
 

baltimorened

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Unobligated for the moment may mean you can temporarily use it for something else (if the law allows that) but it has to be returned when the time comes to spend it for its intended purpose.

Suspending the gasoline tax reduces revenues, it doesn't shift them, and it doesn't get paid back.
nope, government fund are appropriated by line item. The administration has to spend it for that purpose. The funds have a time limit where the money has to be committed or it "expires". But committed doesn't mean it's been spent.

Now having said that, the administration can request to "reprogram" funds from one line to another. For example, since a project was expected to start in 5 years, things change, may not need that money any more, but need it for some other thing that has "overrun". But the request has to go back to Congress for approval.

Here's another one for you, but you may have experienced something similar...the government doesn't pay up front, or when the product is delivered. My experience was in DoD and the majority of products are paid via "progress payments". That term should be self explanatory, but funds are provided to the contractor after certain milestones or other contractual provisions. So an appropriation from the 2025 budget for a specific line item might not get under contract until 2027, have a 5 year funded delivery period, and an extended period to get all the bills paid.

As I said, the federal government is a unique animal
 

FLaw47

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Dec 23, 2010
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ok, I'll bite, how does the government pay the difference between revenues and expenses..this year for example?

you're 100 wrong. I'm not a trumpist. I wish he had not run again because I truly believe he's bad for the country, if only for the fact that democrats seem to actually hate him and this hate stops us from getting things that need to be done, done.

I interject when people make statements about activities in the government that I know are not accurate. Right now, especially since the birth of the Hawkeye/nole board, people make anti trump statements , which is fine, but they throw out statements which sounds good to the anti trump crowd but have little bearing in fact. Now I could just go along and ignore the errors but to be fair, you and some other are not hesitant in correcting me when you think I'm wrong. As I've posted numerous times, I do not believe trump is always right, and I don't believe he's always wrong either.

I think you may have misunderstood me - I've never called you a Trumpist nor do I think you are one. I'm merely noting an observed pattern that, when you weigh in on a criticism of Trump, it's very often to do one of the things I mentioned earlier. I have not observed this same behavior (or at least nearly to the same extent) when criticisms of the left arise - you don't typically offer these same clarifications on small errors (or on large ones).

My suspicion is that it's because you're a right of center person (regardless of not having fealty to the GOP) but I don't know. I'll reiterate that I know you're not a Trumper.
 
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baltimorened

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People call you out partially because you seem to only find these incorrect statements in anti trump posts, and never the posts from any of the board MAGA's (or seemingly never, don't doubt there have been some).
could it possibly be because 1. there are more anti trump posts (especially on the new Hawkeye/nole board) and 2 trump is president and most of the criticisms are aimed at trump. (no sense for conservatives to bash Biden, he's gone)I have found incorrect statements in posts from tiger, piggy and JHP for example, but for the most part they've been in a defensive mode - other than when they are hurling insult to or responding to insults. And finally, I might not know enough about the topic to criticize or correct them.
 

baltimorened

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I think you may have misunderstood me - I've never called you a Trumpist nor do I think you are one. I'm merely noting an observed pattern that, when you weigh in on a criticism of Trump, it's very often to do one of the things I mentioned earlier. I have not observed this same behavior (or at least nearly to the same extent) when criticisms of the left arise - you don't typically offer these same clarifications on small errors (or on large ones).

My suspicion is that it's because you're a right of center person (regardless of not having fealty to the GOP) but I don't know. I'll reiterate that I know you're not a Trumper.
I'm a stated conservative..independent. I think both parties have some positives and both have negatives. Right now I think republicans have wasted almost two years doing nothing, or very little: and I think democrats want to see republicans do nothing (understandably) and spend too much time fostering TDS.

It's a shame, because we have so many needs that require Congressional attention and we're simply wasting time.
 

What Would Jesus Do?

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Nov 28, 2010
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nope, government fund are appropriated by line item. The administration has to spend it for that purpose. The funds have a time limit where the money has to be committed or it "expires". But committed doesn't mean it's been spent.

Now having said that, the administration can request to "reprogram" funds from one line to another. For example, since a project was expected to start in 5 years, things change, may not need that money any more, but need it for some other thing that has "overrun". But the request has to go back to Congress for approval.

Here's another one for you, but you may have experienced something similar...the government doesn't pay up front, or when the product is delivered. My experience was in DoD and the majority of products are paid via "progress payments". That term should be self explanatory, but funds are provided to the contractor after certain milestones or other contractual provisions. So an appropriation from the 2025 budget for a specific line item might not get under contract until 2027, have a 5 year funded delivery period, and an extended period to get all the bills paid.

As I said, the federal government is a unique animal
You seem to be arguing against your previous position. A position I did not share but was willing to go along with for the sake of discussion.

So now I have no idea what your point was (or is). Can you AI it for me?
 

FLaw47

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Dec 23, 2010
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I'm a stated conservative..independent. I think both parties have some positives and both have negatives. Right now I think republicans have wasted almost two years doing nothing, or very little: and I think democrats want to see republicans do nothing (understandably) and spend too much time fostering TDS.

It's a shame, because we have so many needs that require Congressional attention and we're simply wasting time.

Yeah, I don't think any of that is in contention.
 

SlipDrip

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May 26, 2015
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ok, I'll bite, how does the government pay the difference between revenues and expenses..this year for example?

you're 100 wrong. I'm not a trumpist. I wish he had not run again because I truly believe he's bad for the country, if only for the fact that democrats seem to actually hate him and this hate stops us from getting things that need to be done, done.

I interject when people make statements about activities in the government that I know are not accurate. Right now, especially since the birth of the Hawkeye/nole board, people make anti trump statements , which is fine, but they throw out statements which sounds good to the anti trump crowd but have little bearing in fact. Now I could just go along and ignore the errors but to be fair, you and some other are not hesitant in correcting me when you think I'm wrong. As I've posted numerous times, I do not believe trump is always right, and I don't believe he's always wrong either.
They move decimals in a computer.
 

SlipDrip

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In the unlikely event that we have a crash that makes having physical gold a great place to be, what do you do for change?

That's why I have nickels. The only coin with a melt-down value equal to its face value. That would change after the apocalypse, of course, but it's still probably the best bet among coins. Copper pennies or silver dollars would be even better if we still made them.

[per Gemini]

As of May 13, 2026, the current market value for one gram of 24K gold is approximately $151.69.
The "melt-down" or scrap value—what a refinery or dealer would actually pay you—is typically lower than the raw spot price to account for refining costs and dealer profit margins. While the pure spot value is ~$151.69/g, current payout rates for 24K scrap are ranging between $117.79 and $141.83 per gram, depending on the buyer.

Gold Market Breakdown (USD)​

UnitSpot Market ValueApprox. Scrap Payout
Per Gram$151.69$118 – $142
Per Troy Ounce$4,715.29$3,600 – $4,400

Factors to Consider:​

  • Dealer Spread: Most local shops pay between 70% and 90% of the spot price for scrap gold. High-volume refineries may pay closer to 95-98%.
  • Form of Gold: 24K bullion bars or recognized coins (like the American Buffalo) will fetch a price much closer to the full spot value than "melt" jewelry.
  • Volatility: Gold is currently showing mild bullish momentum but can fluctuate several dollars per gram within a single trading day.
No real solution to our current fiat system. Reducing spending would destroy the economy so you just have to ride it out. I’m also worried about price of selling. If I was to get rid of gold or silver I’d be trading it directly for services.

If we go cashlesss trading metal might be one of the few ways to transact on the black market. Also why I like junk silver. I don’t see any of my gold ounces being realistic to trade with due to value.
 

baltimorened

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You seem to be arguing against your previous position. A position I did not share but was willing to go along with for the sake of discussion.

So now I have no idea what your point was (or is). Can you AI it for me?
which part, reprogramming?

You asked if money can be shifted around (if it's within the law) and the answer is yes. Funds are appropriated by line item and money has to be spent where appropriated.

But, if you either don't need all of those funds within that line item you can go back to Congress and ask them to allow reprogramming to another line. Think of it as your home budget. You allocate 100/month for air conditioning...but it's a really cool summer so you only use/need 90. So you go to your wife and ask her if you can use the 10 to buy a new fishing pole which she said you could buy, but has gone up $10 in price.

that help?
 

What Would Jesus Do?

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Nov 28, 2010
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which part, reprogramming?

You asked if money can be shifted around (if it's within the law) and the answer is yes. Funds are appropriated by line item and money has to be spent where appropriated.
I did not ask that. You posited that funds would be shifted in response to revenues lost as a result of the gas tax suspension. I accepted that view for sake of discussion because even allowing it didn't change the fact that a gas tax suspension would reduce revenues and negatively impact programs in the long run.

That was the discussion at that point. Can you address that concern?
 

baltimorened

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I did not ask that. You posited that funds would be shifted in responI guess I'm a post behind...se to revenues lost as a result of the gas tax suspension. I accepted that view for sake of discussion because even allowing it didn't change the fact that a gas tax suspension would reduce revenues and negatively impact programs in the long run.

That was the discussion at that point. Can you address that concern?
I guess I'm a post behind.

If you go back to the top of this thread you'll see that I answered this question before and as it's long winded, I'd rather not go through the whole thing again.

But what I sain in a nutshell in response to a post that said the $30 billion or so lost in gas tax revenue would result in addition to the debt and cancellation of road and bridge construction...I said not necessarily.

My reasoning on the points was that the $30 billion will not be spent this year and no construction need be affected because the government already has about $350billion or so of funds from the 2022 infrastructure bill it hasn't committed. So the government hasn't been able to spend the money it has
 

What Would Jesus Do?

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I guess I'm a post behind.

If you go back to the top of this thread you'll see that I answered this question before and as it's long winded, I'd rather not go through the whole thing again.

But what I sain in a nutshell in response to a post that said the $30 billion or so lost in gas tax revenue would result in addition to the debt and cancellation of road and bridge construction...I said not necessarily.

My reasoning on the points was that the $30 billion will not be spent this year and no construction need be affected because the government already has about $350billion or so of funds from the 2022 infrastructure bill it hasn't committed. So the government hasn't been able to spend the money it has
So the upcoming bridges and stuff may go ahead on diverted money, but the $50 is still added to the deficit, sooner or later. If that's what you are saying then we are pretty much agreeing.
 

tarheelbybirth1

Heisman
Jul 4, 2025
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nope, government fund are appropriated by line item. The administration has to spend it for that purpose. The funds have a time limit where the money has to be committed or it "expires". But committed doesn't mean it's been spent.

Now having said that, the administration can request to "reprogram" funds from one line to another. For example, since a project was expected to start in 5 years, things change, may not need that money any more, but need it for some other thing that has "overrun". But the request has to go back to Congress for approval.
Did Congress approve the >$7B that Trump moved in 2019 and 2020 from the DOD budget to wall construction. I don’t remember that happening but I might have missed it.
Here's another one for you, but you may have experienced something similar...the government doesn't pay up front, or when the product is delivered. My experience was in DoD and the majority of products are paid via "progress payments". That term should be self explanatory, but funds are provided to the contractor after certain milestones or other contractual provisions. So an appropriation from the 2025 budget for a specific line item might not get under contract until 2027, have a 5 year funded delivery period, and an extended period to get all the bills paid.

As I said, the federal government is a unique animal
None of that is necessarily “unique”. I certainly don’t pay contractors the full price up front and I’d advise that you not do so either. I’ve paid half up front and the rest at completion. I’ve paid materials and supplies up front, half of the remainder - “progress payments” - at some point during the job, and the rest at completion. I’ve even financed some to be paid off over time months after the job is completed.

Regardless, if you move billions from one line item to pay something else, you’ve created a hole in the budget that has to be filled. That’s a deficit any way you look at it.
 
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tarheelbybirth1

Heisman
Jul 4, 2025
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It's a shame, because we have so many needs that require Congressional attention and we're simply wasting time.
The Democrats - with control - passed health care for tens of millions of people. They passed a trillion dollar infrastructure bill in nine months that was always “two weeks” away for four years under Trump. Spending, btw, that Republicans who voted against it (all of them) take credit for when it’s spent in the areas they represent. Dems passed the $280B CHIPS and Science Act to fund critical computer chip manufacturing and research domestically.

Other than massive tax cuts that went primarily to the people who can’t spend the money they have now, what have the Republicans done? Here’s your take-away…the GOP wants power for the sake of power and to funnel money to the wealthiest people. They have no f’n idea how to actually govern, anymore.
 

baltimorened

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May 29, 2001
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Did Congress approve the >$7B that Trump moved in 2019 and 2020 from the DOD budget to wall construction. I don’t remember that happening but I might have missed it.

None of that is necessarily “unique”. I certainly don’t pay contractors the full price up front and I’d advise that you not do so either. I’ve paid half up front and the rest at completion. I’ve paid materials and supplies up front, half of the remainder - “progress payments” - at some point during the job, and the rest at completion. I’ve even financed some to be paid off over time months after the job is completed.

Regardless, if you move billions from one line item to pay something else, you’ve created a hole in the budget that has to be filled. That’s a deficit any way you look at it.
on your first, I don't have any idea if Trump went to Congress for approval of funds for wall.

on your last sentence, if you have a program that is underrun or has been determined to be no longer necessary, than moving money to another program that needs more money has zero impact on the deficit. Just an example (and I'm just making up the scenario, but principal is the same) DoT had an allocation of $4billion for the California high speed rail. They decided to longer fund this project, so they move the money for helping rebuild the Baltimore bridge. Amount of money is the same, no hole in the budget andd no impact on the deficit.
 

baltimorened

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The Democrats - with control - passed health care for tens of millions of people. They passed a trillion dollar infrastructure bill in nine months that was always “two weeks” away for four years under Trump. Spending, btw, that Republicans who voted against it (all of them) take credit for when it’s spent in the areas they represent. Dems passed the $280B CHIPS and Science Act to fund critical computer chip manufacturing and research domestically.

Other than massive tax cuts that went primarily to the people who can’t spend the money they have now, what have the Republicans done? Here’s your take-away…the GOP wants power for the sake of power and to funnel money to the wealthiest people. They have no f’n idea how to actually govern, anymore.
without creating a "contest" on which party has done more.....look up trump's first term bills passed....the health care bill, assuming you're referencing the ACA has failed to achieve most of it's state goals (have your health care costs come down since 2010?) and the programs you mentioned have all been financed by borrowing - increasing the debt.

Now, having said that, I agree 100% that republicans have no f'n idea of how to govern. Or, if they do, they certainly haven't put the knowledge to use.

I personally think both parties are failing the country.
 

tarheelbybirth1

Heisman
Jul 4, 2025
4,091
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on your first, I don't have any idea if Trump went to Congress for approval of funds for wall.
Well, he didn’t. And his SCOTUS said that was “Okie dokie.”

Your confident assertion that "the request has to go back to Congress for approval" was in error.
on your last sentence, if you have a program that is underrun or has been determined to be no longer necessary, than moving money to another program that needs more money has zero impact on the deficit. Just an example (and I'm just making up the scenario, but principal is the same) DoT had an allocation of $4billion for the California high speed rail. They decided to longer fund this project, so they move the money for helping rebuild the Baltimore bridge. Amount of money is the same, no hole in the budget andd no impact on the deficit.
Congress allocated over $7B dollars to the DOD for things the DOD said were necessary, including upgrading housing for our military. Neither Congress nor the DOD determined that those funds were no longer required. At some point, that money has to be made up - those needs still remain. That’s a >$7B hole in their budget no matter how you look at it. A deficit.

Highway taxes are allocated for road infrastructure and maintenance - needs that are currently underfunded. That's precisely why a $1T infrastructure bill was necessary. To cut funding even further simply creates needs that will have to be paid for later. A deficit.
 
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baltimorened

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Well, he didn’t. And his SCOTUS said that was “Okie dokie.”

Your confident assertion that "the request has to go back to Congress for approval" was in error.

Congress allocated over $7B dollars to the DOD for things the DOD said were necessary, including upgrading housing for our military. Neither Congress nor the DOD determined that those funds were no longer required. At some point, that money has to be made up - those needs still remain. That’s a >$7B hole in their budget no matter how you look at it. A deficit.

Highway taxes are allocated for road infrastructure and maintenance - needs that are currently underfunded. That's precisely why a $1T infrastructure bill was necessary. To cut funding even further simply creates needs that will have to be paid for later. A deficit.
OK...just to go further...President Trump reallocated billions in Department of Defense (DOD) funding to the U.S.-Mexico border wall by declaring a national emergency in 2019. He transferred approximately \(\$10\) billion from military construction, counter-drug initiatives, and weapon system budgets to replace and build new fencing, bypassing Congress's limited funding allocation.

[1, 2]
Here is how the reallocations were executed:
  • National Emergency Declaration (2019): After Congress approved only \(\$1.375\) billion for border fencing, Trump declared a national emergency to access other funds, leading to a total transfer of nearly \(\$10\) billion in military funding.
  • Military Construction Funds (\(\$3.6\) billion): The administration took \(\$3.6\) billion from existing, approved military construction projects—including schools for military children and facility upgrades—under a legal authority allowing the diversion of funds when troops are deployed to handle a national emergency.
  • DOD Counter-Drug Account (\(\$2.5\) billion): Under Section 284 of Title 10, the DOD shifted money to "Drug Interdiction and Counterdrug Activities," which was then utilized to build barrier sections, a move that survived early legal challenges.
  • Pentagon Reprogramming (\(\$3.8\) billion): In 2020, the Pentagon transferred an additional \(\$3.8\) billion, which included diverting funds intended for military hardware, such as fighter jets and National Guard equipment

Isn't it interesting that when the supreme court finds for trump it's "his supreme court" whereas when they find against trump it's just "supreme court"
 

tarheelbybirth1

Heisman
Jul 4, 2025
4,091
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OK...just to go further...President Trump reallocated billions in Department of Defense (DOD) funding to the U.S.-Mexico border wall by declaring a national emergency in 2019. He transferred approximately \(\$10\) billion from military construction, counter-drug initiatives, and weapon system budgets to replace and build new fencing, bypassing Congress's limited funding allocation.

[1, 2]
Here is how the reallocations were executed:
  • National Emergency Declaration (2019): After Congress approved only \(\$1.375\) billion for border fencing, Trump declared a national emergency to access other funds, leading to a total transfer of nearly \(\$10\) billion in military funding.
  • Military Construction Funds (\(\$3.6\) billion): The administration took \(\$3.6\) billion from existing, approved military construction projects—including schools for military children and facility upgrades—under a legal authority allowing the diversion of funds when troops are deployed to handle a national emergency.
  • DOD Counter-Drug Account (\(\$2.5\) billion): Under Section 284 of Title 10, the DOD shifted money to "Drug Interdiction and Counterdrug Activities," which was then utilized to build barrier sections, a move that survived early legal challenges.
  • Pentagon Reprogramming (\(\$3.8\) billion): In 2020, the Pentagon transferred an additional \(\$3.8\) billion, which included diverting funds intended for military hardware, such as fighter jets and National Guard equipment

Isn't it interesting that when the supreme court finds for trump it's "his supreme court" whereas when they find against trump it's just "supreme court"
So…you were wrong.

That’s really all you had to say.
 

FLaw47

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without creating a "contest" on which party has done more.....look up trump's first term bills passed....the health care bill, assuming you're referencing the ACA has failed to achieve most of it's state goals (have your health care costs come down since 2010?) and the programs you mentioned have all been financed by borrowing - increasing the debt.

Ok, I've seen you bring this point up about the ACA numerous times and now I have the time and energy to address it so buckle up.

I'll start by reminding you that, in all of your 89 years of glorious experience and accumulated wisdom that make you more rational and generally better than everyone else, you have at no point been covered by private insurance (based on what all you've shared about your life). So on this topic you are at a disadvantage on lived experience and should offer some more credulity to the likes of me.

That being said, you are correct that the ACA did not sufficiently address the made up priorities you imposed upon it. I researched what the stated goals of the ACA actually were at the time it passed (and they largely match my recollection so I'm not just outsourcing my thinking here).

  • The ACA sought to increase the number of people who were covered: Success
    • The uninsured rate has fallen from 16% to 7.7%. Millions more people are insured than they previously were.
    • This was still negatively affected by the fact that certain states (like my own South Carolina) refused to expand Medicaid, which was a key component of the plan.
    • This was further negatively impacted by the GOP doing away with the individual mandate (though this was a smaller deal than most liberals expected) and by the penalty being pretty modest
  • Instilling essential health benefits: Success
    • Here's where I think you're likely quite blind. The ACA required insurance to have a floor for what it covered. Look at this and tell me which of these things shouldn't be covered by insurance.
    • It's important to recognize that Health Insurance is fundamentally different than other insurances. Before it was legal to deny a person coverage if they had a pre-existing condition, effectively condemning some people to die if they weren't on a group plan. Now, I know that it's not "fair" to the insurers (and I actually agree with this but we're stuck with a private insurance model) but one of my groomsmen is a Type 1 diabetic. He's had it since before I met him (he was 6 when we met). Should my friend just not be able to get insulin?
    • I actually tried to get individual insurance in the summer of 2010. We found a plan that would deny coverage for me if alcohol was involved in an accident at all. Not just if I had alcohol in my system, but if I got hit by an uninsured drunk driver my insurance would not pay for my medical care. That's what the individual market looked like back then.
  • Bending the cost curve (not reducing overall costs): Mixed bag. I'll let you read this summary if you want to.

Look, I get it. The ACA isn't what I would have drawn up in a vacuum either. But it did make a big difference for a lot of people and simply is not the "disaster" that people have been parroting about for 16 years now. In the ACA's defense it had to deal with:
  • The GOP, from the jump, doing whatever they could to make sure the ACA was a failure. At no point did they even attempt to help make the plan any better and the states stubbornly refused to expand medicaid to expand coverage, even with a massive federal discount on the program
  • Joe Lieberman being a piece of sh*t and killing the public option
Edit: I'll also add that the ACA apparently did not increase the deficit.
 
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baltimorened

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So…you were wrong.

That’s really all you had to say.
yep, totally wrong from ai
Congressional prior approval reprogramming is a mechanism where federal agencies, most notably the Department of Defense (DOD), must obtain explicit permission from House and Senate Appropriations Committees before shifting funds between programs, typically when changes exceed established dollar thresholds or violate specific statutory restrictions. This process ensures that executive branch spending remains consistent with congressional intent. [1, 2, 3]

Key Aspects of Prior Approval (PA) Reprogramming
  • Definition: PA reprogramming involves moving budget authority to a purpose other than what was originally intended by Congress.
  • Thresholds: Reprogramming requires prior approval if it exceeds specific thresholds, such as for the DOD, exceeding \(\$15\) million in procurement or when using general transfer authority.
  • Trigger Events: Actions needing approval include:
    • Increasing procurement quantity for major systems.
    • Initiating a new program or cancelling an existing one.
    • Using funds for projects previously denied by Congress.
  • Process: For the DOD, these actions (often via DD Form 1415-1) are submitted through the Office of the Under Secretary of Defense (Comptroller) (OUSD(C)) to the Congressional Defense Committees.
  • Committees Involved: The chair and ranking members of the House and Senate Appropriations Committees (HAC/SAC) and often the Armed Services Committees (HASC/SASC) must review and approve the request
 

TequilasForLoss

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I actually tried to get individual insurance in the summer of 2010. We found a plan that would deny coverage for me if alcohol was involved in an accident at all. Not just if I had alcohol in my system, but if I got hit by an uninsured drunk driver my insurance would not pay for my medical care. That's what the individual market looked like back then.

The ACA isn't what I would have drawn up in a vacuum either. But it did make a big difference for a lot of people and simply is not the "disaster" that people have been parroting about for 16 years now.
In 2012 I took a “full-time contractor” job with the top company in the country at what it does. Dream gig to prove myself and parlay it into being an FTE and staying a long time with great pay. Had to find benefits for me and Mrs. TFL though, and private medical insurance was so bad (and the premiums so high) that we had to do COBRA from my previous employer. That unfortunately happened to be the year that Mrs. TFL needed surgery for something fairly routine, then had a Thanksgiving-morning freak accident that led to surgery. We couldn’t pay what COBRA didn’t cover plus the huge premiums, and I had to bail on the contract to take an FTE gig with a much smaller local company.

Had the ACA Exchange been available then, my career path likely would have been quite different.

Which is to say, the lack of ACA prevented capitalism and got in the way of my ability to conduct my personal business on a path that fit me. (Might I have Klubniked my opportunity anyway? Anything is possible. We’ll never know.)

So that’s my personal reason to believe ACA should be embraced and in fact expanded.

And it’s not just about me. Thousands upon thousands of Americans in the “gig economy” are able to provide better for themselves by doing Instacart, Doordash, Uber, Amazon delivery, freelance gigs on Upwork and Fiver and Thumbtack, etc., because of ACA. They can care for family more easily while *earning* a living. They can school themselves and prioritize education while *working* around their class schedule. They can more easily get a foot in the door of a career segment they love and prove themselves as a freelancer, build a portfolio, then open their own fully blown business and create jobs.

Heck, any/all companies are able to save a lot of money by hiring contractors and part-timers, and are able to be more flexible with their efforts because they can dip a toe in the water of expansion rather than dive in head-first with a group of FTEs.

ACA encourages capitalism.

Lastly, ACA was not designed to fix everything about the business model of healthcare, as @FLaw47 points out. To me, this was a step in the right direction of moving toward Medicare For All, which embraces the public-private model on a theory that most certainly can be expanded to people of all ages. Want basic coverage? You got it. Want more? Buy an add-on plan.

Medicare For All would encourage capitalism. Companies no longer would need to budget huge amounts of time and money into annual healthcare plans. Employers and employees would benefit: A company can focus on its true business mission and prioritize quality, innovation, growth. Workers can focus on their role, their craft, and their salary ans they climb the career ladder instead of factoring in the murky health-insurance numbers being attached to employment. That instead becomes a consumer decision free and clear of how you earn your living. (And freed from the shackles of who your bosses chose to be your health-insurance provider… thus creating another plus for Capitalism.)
 

bdgan

All-Conference
Oct 12, 2021
4,390
4,338
113
Ok, I've seen you bring this point up about the ACA numerous times and now I have the time and energy to address it so buckle up.

I'll start by reminding you that, in all of your 89 years of glorious experience and accumulated wisdom that make you more rational and generally better than everyone else, you have at no point been covered by private insurance (based on what all you've shared about your life). So on this topic you are at a disadvantage on lived experience and should offer some more credulity to the likes of me.

That being said, you are correct that the ACA did not sufficiently address the made up priorities you imposed upon it. I researched what the stated goals of the ACA actually were at the time it passed (and they largely match my recollection so I'm not just outsourcing my thinking here).

  • The ACA sought to increase the number of people who were covered: Success
    • The uninsured rate has fallen from 16% to 7.7%. Millions more people are insured than they previously were.
    • This was still negatively affected by the fact that certain states (like my own South Carolina) refused to expand Medicaid, which was a key component of the plan.
    • This was further negatively impacted by the GOP doing away with the individual mandate (though this was a smaller deal than most liberals expected) and by the penalty being pretty modest
  • Instilling essential health benefits: Success
    • Here's where I think you're likely quite blind. The ACA required insurance to have a floor for what it covered. Look at this and tell me which of these things shouldn't be covered by insurance.
    • It's important to recognize that Health Insurance is fundamentally different than other insurances. Before it was legal to deny a person coverage if they had a pre-existing condition, effectively condemning some people to die if they weren't on a group plan. Now, I know that it's not "fair" to the insurers (and I actually agree with this but we're stuck with a private insurance model) but one of my groomsmen is a Type 1 diabetic. He's had it since before I met him (he was 6 when we met). Should my friend just not be able to get insulin?
    • I actually tried to get individual insurance in the summer of 2010. We found a plan that would deny coverage for me if alcohol was involved in an accident at all. Not just if I had alcohol in my system, but if I got hit by an uninsured drunk driver my insurance would not pay for my medical care. That's what the individual market looked like back then.
  • Bending the cost curve (not reducing overall costs): Mixed bag. I'll let you read this summary if you want to.

Look, I get it. The ACA isn't what I would have drawn up in a vacuum either. But it did make a big difference for a lot of people and simply is not the "disaster" that people have been parroting about for 16 years now. In the ACA's defense it had to deal with:
  • The GOP, from the jump, doing whatever they could to make sure the ACA was a failure. At no point did they even attempt to help make the plan any better and the states stubbornly refused to expand medicaid to expand coverage, even with a massive federal discount on the program
  • Joe Lieberman being a piece of sh*t and killing the public option
Edit: I'll also add that the ACA apparently did not increase the deficit.
I think you're clearly looking at the ACA through blue colored glasses.
  • It was supposed to get more people insured. That definitely happened because Medicaid was greatly expanded.
  • It was supposed to lower costs for the average family by $2,500. No mixed bag there. Costs have continued to increase at higher and higher rates. I recall two parts of the cost reduction plan. One was non profit government subsidized co-ops that would compete with insurers. Every single one of them failed. The other was that more people covered and preventative care covered would make people healthier and require less expensive treatments in the future. I don't think there's much evidence of that happening.
  • Obama promised it wouldn't add one dime to the deficit. The reality is it has added over $200 billion per year to the deficit. The 3.8% investment income tax happened but taxes on medical devices and taxes on insurance companies never happened because congress realized that those taxes would get passed on to policy holders. Taxes on Cadillac plans never happened because congress realized that union/government workers (voters) would be upset. A reduction in reimbursement rates to providers never happened as planned because congress discovered that providers might not accept the insurance.
In the end what we got was more people covered because of Medicaid expansion (and some because of premium tax credits) at a large increase to the deficit.

Republican plans to repeal and replace didn't work either. Our system is a mess and neither side has a solution. IMO that's because all "solutions" involve some sort of compromise that many in congress or the general public aren't willing to make. Are we willing to limit medial liability? Are we willing to limit coverage for expensive unproven late life procedures? Are we really willing to reduce payments to providers and impact healthcare salaries? Will high incomes be expected to pay for those with low incomes? Will drug companies lose patent protection? It's not so simple as to say it will be great because the government runs it.
 

hawkeyetraveler

Heisman
Aug 10, 2010
4,918
19,898
108
I think you're clearly looking at the ACA through blue colored glasses.
  • It was supposed to get more people insured. That definitely happened because Medicaid was greatly expanded.
  • It was supposed to lower costs for the average family by $2,500. No mixed bag there. Costs have continued to increase at higher and higher rates. I recall two parts of the cost reduction plan. One was non profit government subsidized co-ops that would compete with insurers. Every single one of them failed. The other was that more people covered and preventative care covered would make people healthier and require less expensive treatments in the future. I don't think there's much evidence of that happening.
  • Obama promised it wouldn't add one dime to the deficit. The reality is it has added over $200 billion per year to the deficit. The 3.8% investment income tax happened but taxes on medical devices and taxes on insurance companies never happened because congress realized that those taxes would get passed on to policy holders. Taxes on Cadillac plans never happened because congress realized that union/government workers (voters) would be upset. A reduction in reimbursement rates to providers never happened as planned because congress discovered that providers might not accept the insurance.
In the end what we got was more people covered because of Medicaid expansion (and some because of premium tax credits) at a large increase to the deficit.

Republican plans to repeal and replace didn't work either. Our system is a mess and neither side has a solution. IMO that's because all "solutions" involve some sort of compromise that many in congress or the general public aren't willing to make. Are we willing to limit medial liability? Are we willing to limit coverage for expensive unproven late life procedures? Are we really willing to reduce payments to providers and impact healthcare salaries? Will high incomes be expected to pay for those with low incomes? Will drug companies lose patent protection? It's not so simple as to say it will be great because the government runs it.
You ask a lot of valid questions at the end of your post. Those are, to my eye anyway, many Of the major dilemmas. I would quibble with your very last sentence. While some far lefty types want government run healthcare (a la the Uk), I think most people just want some sort of basic health insurance. The doctors and Hospitals would still be private entities, but the government insures all the basics and anything catastrophic.

But yes, the real issues are things like liability, expensive procedures, etc. I would add one: retail price transparency to the consumer and I will explain in a second post.
 
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tarheelbybirth1

Heisman
Jul 4, 2025
4,091
12,703
113
yep, totally wrong from ai
Congressional prior approval reprogramming is a mechanism where federal agencies, most notably the Department of Defense (DOD), must obtain explicit permission from House and Senate Appropriations Committees before shifting funds between programs, typically when changes exceed established dollar thresholds or violate specific statutory restrictions. This process ensures that executive branch spending remains consistent with congressional intent. [1, 2, 3]

Key Aspects of Prior Approval (PA) Reprogramming
  • Definition: PA reprogramming involves moving budget authority to a purpose other than what was originally intended by Congress.
  • Thresholds: Reprogramming requires prior approval if it exceeds specific thresholds, such as for the DOD, exceeding \(\$15\) million in procurement or when using general transfer authority.
  • Trigger Events:Actions needing approval include:
    • Increasing procurement quantity for major systems.
    • Initiating a new program or cancelling an existing one.
    • Using funds for projects previously denied by Congress.
  • Process: For the DOD, these actions (often via DD Form 1415-1) are submitted through the Office of the Under Secretary of Defense (Comptroller) (OUSD(C)) to the Congressional Defense Committees.
  • Committees Involved: The chair and ranking members of the House and Senate Appropriations Committees (HAC/SAC) and often the Armed Services Committees (HASC/SASC) must review and approve the request
This post is completely irrelevant. I think you've lost the trail on your own assertion.

Now having said that, the administration can request to "reprogram" funds from one line to another. For example, since a project was expected to start in 5 years, things change, may not need that money any more, but need it for some other thing that has "overrun". But the request has to go back to Congress for approval.
Does it? Really? That is, in fact, not true. According to SCOTUS, a president can just declare a "national emergency" and redirect funds to any pet project he or she wishes. Trump could declare a "national emergency" due to the multiple ...attempts on his life?... and redirect funds from the Interior Dept to cover a billion dollars for WH security. Correct or no?
 

FLaw47

All-Conference
Dec 23, 2010
3,506
3,806
113
I think you're clearly looking at the ACA through blue colored glasses.
  • It was supposed to get more people insured. That definitely happened because Medicaid was greatly expanded.
  • It was supposed to lower costs for the average family by $2,500. No mixed bag there. Costs have continued to increase at higher and higher rates. I recall two parts of the cost reduction plan. One was non profit government subsidized co-ops that would compete with insurers. Every single one of them failed. The other was that more people covered and preventative care covered would make people healthier and require less expensive treatments in the future. I don't think there's much evidence of that happening.
  • Obama promised it wouldn't add one dime to the deficit. The reality is it has added over $200 billion per year to the deficit. The 3.8% investment income tax happened but taxes on medical devices and taxes on insurance companies never happened because congress realized that those taxes would get passed on to policy holders. Taxes on Cadillac plans never happened because congress realized that union/government workers (voters) would be upset. A reduction in reimbursement rates to providers never happened as planned because congress discovered that providers might not accept the insurance.
In the end what we got was more people covered because of Medicaid expansion (and some because of premium tax credits) at a large increase to the deficit.

Republican plans to repeal and replace didn't work either. Our system is a mess and neither side has a solution. IMO that's because all "solutions" involve some sort of compromise that many in congress or the general public aren't willing to make. Are we willing to limit medial liability? Are we willing to limit coverage for expensive unproven late life procedures? Are we really willing to reduce payments to providers and impact healthcare salaries? Will high incomes be expected to pay for those with low incomes? Will drug companies lose patent protection? It's not so simple as to say it will be great because the government runs it.

Why are you completely ignoring the essential benefits (and how many people have marketplace coverage)?
 

hawkeyetraveler

Heisman
Aug 10, 2010
4,918
19,898
108
Second post referenced above. tl;dr price transparency in healthcare should be legally required. More below the line.

________

About 6 weeks ago I developed a small red patch under my eye. I figured it was a sty or clogged tear duct which in the past go away with a hot compress for me. About a week goes by and the patch is still there. I call my dermatologist to try to get in, they give me a date 8 weeks out.

I’m on the no pic’s Blue Cross Blue Shield employer plan and I decide to visit an urgent care clinic which I have used in the past for minor stuff. I go in, the nurse practitioner has no idea what it is, but says why don’t we take a quick culture and we will run some tests to see. The swab took like 10 seconds and honestly I didn’t think much of it. I think my copay for the visit was $20 or so. They schedule a follow up for 3 days later. Tests all came back negative and the nurse says she still has no idea and “you will have to see a dermatologist”. Fine, I pay my second $20 copay and attempt to get into my derm a second time. I explain the dilemma and they put me on a waitlist -thankfully someone cancels and I got right in.

I brought the negative lab tests with me and my dermatologist looks at the little patch, literally laughs and says “there was no reason to run all of those tests” and proceeds to explain what it is and prescribe 3 medicines that cleared it up pretty in a matter of days. I was in and out in 5 mins at the dermatology office.

A week goes by and I get a bill from the urgent care clinic that reads as follows:

Lab tests: $1,400
Insurance discount: $400
Insurance covers: $400
You owe: $600

Now had the urgent care told me they were about to run a $1,400 battery of tests for a relatively minor red spot under my eye I never would have agreed to that. I would have either waited for a dermatology opening or found another dermatologist. But there was no communication of the cost. Nor was it medically necessary for them to check for some of the stuff they checked for. Among the many things they tested for was a staph infection…it was entirely obvious I did not have a staph infection. But I’m sure they would be exposed to liability if for some reason I did. So they provide unwanted, unnecessary care because of liability, lack of training and potentially because of corporate profit motives (this urgent care clinic chain owns their own lab).

Long story short I managed to connect with some company execs and got the charges completely waived. But most people lack those connections and are simply stuck paying the bill.

So the tug and pull between liability, profit, lack of price transparency, lack of consumer control over the purchases are a BIG reason why healthcare is broken. The GOP argues that healthcare should remain a free market…but what I am describing is anything but a free market. A typical patient doesn’t have transparent info, they don’t know what they are going to pay post-insurance, they don’t really have control over what is being done. And it will never be a fully free market because without some regulation we would have snake oil salesmen selling BS solutions (looking at you Ivermectin). The fact it cannot be a truly free market is why I have come around to the German model. Give everyone taxpayer subsidized government insurance that protects the basics. Then let people buy up to boutique plans for those that want shorter wait times etc.

But, as the moral of this story, I also think we need to limit medical liability, require transparent pricing and have an escalation procedure for medically unnecessary procedures.
 
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baltimorened

All-Conference
May 29, 2001
5,950
4,385
113
This post is completely irrelevant. I think you've lost the trail on your own assertion.


Does it? Really? That is, in fact, not true. According to SCOTUS, a president can just declare a "national emergency" and redirect funds to any pet project he or she wishes. Trump could declare a "national emergency" due to the multiple ...attempts on his life?... and redirect funds from the Interior Dept to cover a billion dollars for WH security. Correct or no?
without all the backs and forth...you asked about trump diverting money from DoD to build the wall without reprogramming...which he did...so how did he get around the law...well he declared a national emergency...he was sued....lower courts put a hold on the funding and the supreme court allowed the transfer of funding.

so I don't know what point you're making....trump declared a national emergency..the issue went to the supreme court....so he bypassed the Congress via supreme court. They didn't give him carte blanch to just declare an emergency, and move funds, they approved it in this one case.

Doesn't invalidate anything I posted about reprogramming.

And yes, president can declare a national emergency anytime he gets a bug up his a--. And he will be sued and case may well be determined by supreme court.
 

bdgan

All-Conference
Oct 12, 2021
4,390
4,338
113
Why are you completely ignoring the essential benefits (and how many people have marketplace coverage)?
I didn't ignore any of that.
  • More people are covered, mostly by Medicaid but also some others
  • Costs continued to rise instead of coming down for average family
  • The deficit has grown substantially because of this. Costs are high and much of the money to pay for it never materialized.
I disagree with the way you appear to be analyzing coverage through the marketplace. I think 23 million took marketplace coverage for 2026 and almost half of those are Medicaid. The rest might have purchased coverage elsewhere so I don't think all of these people would have been uninsured without the ACA. Some of them certainly would have been uninsured.
 

FLaw47

All-Conference
Dec 23, 2010
3,506
3,806
113
I didn't ignore any of that.
  • More people are covered, mostly by Medicaid but also some others
  • Costs continued to rise instead of coming down for average family
  • The deficit has grown substantially because of this. Costs are high and much of the money to pay for it never materialized.
I disagree with the way you appear to be analyzing coverage through the marketplace. I think 23 million took marketplace coverage for 2026 and almost half of those are Medicaid. The rest might have purchased coverage elsewhere so I don't think all of these people would have been uninsured without the ACA. Some of them certainly would have been uninsured.

I'm not sure how you can say you're not ignoring the essential benefits, one of the biggest components of the ACA, when two posts in a row don't note them at all.
 

FLaw47

All-Conference
Dec 23, 2010
3,506
3,806
113
Second post referenced above. tl;dr price transparency in healthcare should be legally required. More below the line.

________

About 6 weeks ago I developed a small red patch under my eye. I figured it was a sty or clogged tear duct which in the past go away with a hot compress for me. About a week goes by and the patch is still there. I call my dermatologist to try to get in, they give me a date 8 weeks out.

I’m on the no pic’s Blue Cross Blue Shield employer plan and I decide to visit an urgent care clinic which I have used in the past for minor stuff. I go in, the nurse practitioner has no idea what it is, but says why don’t we take a quick culture and we will run some tests to see. The swab took like 10 seconds and honestly I didn’t think much of it. I think my copay for the visit was $20 or so. They schedule a follow up for 3 days later. Tests all came back negative and the nurse says she still has no idea and “you will have to see a dermatologist”. Fine, I pay my second $20 copay and attempt to get into my derm a second time. I explain the dilemma and they put me on a waitlist -thankfully someone cancels and I got right in.

I brought the negative lab tests with me and my dermatologist looks at the little patch, literally laughs and says “there was no reason to run all of those tests” and proceeds to explain what it is and prescribe 3 medicines that cleared it up pretty in a matter of days. I was in and out in 5 mins at the dermatology office.

A week goes by and I get a bill from the urgent care clinic that reads as follows:

Lab tests: $1,400
Insurance discount: $400
Insurance covers: $400
You owe: $600

Now had the urgent care told me they were about to run a $1,400 battery of tests for a relatively minor red spot under my eye I never would have agreed to that. I would have either waited for a dermatology opening or found another dermatologist. But there was no communication of the cost. Nor was it medically necessary for them to check for some of the stuff they checked for. Among the many things they tested for was a staph infection…it was entirely obvious I did not have a staph infection. But I’m sure they would be exposed to liability if for some reason I did. So they provide unwanted, unnecessary care because of liability, lack of training and potentially because of corporate profit motives (this urgent care clinic chain owns their own lab).

Long story short I managed to connect with some company execs and got the charges completely waived. But most people lack those connections and are simply stuck paying the bill.

So the tug and pull between liability, profit, lack of price transparency, lack of consumer control over the purchases are a BIG reason why healthcare is broken. The GOP argues that healthcare should remain a free market…but what I am describing is anything but a free market. A typical patient doesn’t have transparent info, they don’t know what they are going to pay post-insurance, they don’t really have control over what is being done. And it will never be a fully free market because without some regulation we would have snake oil salesmen selling BS solutions (looking at you Ivermectin). The fact it cannot be a truly free market is why I have come around to the German model. Give everyone taxpayer subsidized government insurance that protects the basics. Then let people buy up to boutique plans for those that want shorter wait times etc.

But, as the moral of this story, I also think we need to limit medical liability, require transparent pricing and have an escalation procedure for medically unnecessary procedures.

Nurse Practitioners are especially bad about ordering tests that aren't necessary (as a generalization).
 
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baltimorened

All-Conference
May 29, 2001
5,950
4,385
113
Why are you completely ignoring the essential benefits (and how many people have marketplace coverage)?
I don't think he's ignoring the benefits. There are benefits - I particularly like the fact that you can keep children on your policy up to age 26....but the ACA did not live up to it's promises...and that wasn't Obama or democrats fault...the ACA was kneecapped when the individual mandate was struck down.

So,
This post is completely irrelevant. I think you've lost the trail on your own assertion.


Does it? Really? That is, in fact, not true. According to SCOTUS, a president can just declare a "national emergency" and redirect funds to any pet project he or she wishes. Trump could declare a "national emergency" due to the multiple ...attempts on his life?... and redirect funds from the Interior Dept to cover a billion dollars for WH security. Correct or no?
no, imo
 

baltimorened

All-Conference
May 29, 2001
5,950
4,385
113
In 2012 I took a “full-time contractor” job with the top company in the country at what it does. Dream gig to prove myself and parlay it into being an FTE and staying a long time with great pay. Had to find benefits for me and Mrs. TFL though, and private medical insurance was so bad (and the premiums so high) that we had to do COBRA from my previous employer. That unfortunately happened to be the year that Mrs. TFL needed surgery for something fairly routine, then had a Thanksgiving-morning freak accident that led to surgery. We couldn’t pay what COBRA didn’t cover plus the huge premiums, and I had to bail on the contract to take an FTE gig with a much smaller local company.

Had the ACA Exchange been available then, my career path likely would have been quite different.

Which is to say, the lack of ACA prevented capitalism and got in the way of my ability to conduct my personal business on a path that fit me. (Might I have Klubniked my opportunity anyway? Anything is possible. We’ll never know.)

So that’s my personal reason to believe ACA should be embraced and in fact expanded.

And it’s not just about me. Thousands upon thousands of Americans in the “gig economy” are able to provide better for themselves by doing Instacart, Doordash, Uber, Amazon delivery, freelance gigs on Upwork and Fiver and Thumbtack, etc., because of ACA. They can care for family more easily while *earning* a living. They can school themselves and prioritize education while *working* around their class schedule. They can more easily get a foot in the door of a career segment they love and prove themselves as a freelancer, build a portfolio, then open their own fully blown business and create jobs.

Heck, any/all companies are able to save a lot of money by hiring contractors and part-timers, and are able to be more flexible with their efforts because they can dip a toe in the water of expansion rather than dive in head-first with a group of FTEs.

ACA encourages capitalism.

Lastly, ACA was not designed to fix everything about the business model of healthcare, as @FLaw47 points out. To me, this was a step in the right direction of moving toward Medicare For All, which embraces the public-private model on a theory that most certainly can be expanded to people of all ages. Want basic coverage? You got it. Want more? Buy an add-on plan.

Medicare For All would encourage capitalism. Companies no longer would need to budget huge amounts of time and money into annual healthcare plans. Employers and employees would benefit: A company can focus on its true business mission and prioritize quality, innovation, growth. Workers can focus on their role, their craft, and their salary ans they climb the career ladder instead of factoring in the murky health-insurance numbers being attached to employment. That instead becomes a consumer decision free and clear of how you earn your living. (And freed from the shackles of who your bosses chose to be your health-insurance provider… thus creating another plus for Capitalism.)
look at other nation's health care systems before you jump on the Medicare train. The counties that have "free" healthcare have high tax rates to pay for it...I'm not saying it would be more cost effective for you, but we need to do the math.
 

bdgan

All-Conference
Oct 12, 2021
4,390
4,338
113
Second post referenced above. tl;dr price transparency in healthcare should be legally required. More below the line.

________

About 6 weeks ago I developed a small red patch under my eye. I figured it was a sty or clogged tear duct which in the past go away with a hot compress for me. About a week goes by and the patch is still there. I call my dermatologist to try to get in, they give me a date 8 weeks out.

I’m on the no pic’s Blue Cross Blue Shield employer plan and I decide to visit an urgent care clinic which I have used in the past for minor stuff. I go in, the nurse practitioner has no idea what it is, but says why don’t we take a quick culture and we will run some tests to see. The swab took like 10 seconds and honestly I didn’t think much of it. I think my copay for the visit was $20 or so. They schedule a follow up for 3 days later. Tests all came back negative and the nurse says she still has no idea and “you will have to see a dermatologist”. Fine, I pay my second $20 copay and attempt to get into my derm a second time. I explain the dilemma and they put me on a waitlist -thankfully someone cancels and I got right in.

I brought the negative lab tests with me and my dermatologist looks at the little patch, literally laughs and says “there was no reason to run all of those tests” and proceeds to explain what it is and prescribe 3 medicines that cleared it up pretty in a matter of days. I was in and out in 5 mins at the dermatology office.

A week goes by and I get a bill from the urgent care clinic that reads as follows:

Lab tests: $1,400
Insurance discount: $400
Insurance covers: $400
You owe: $600

Now had the urgent care told me they were about to run a $1,400 battery of tests for a relatively minor red spot under my eye I never would have agreed to that. I would have either waited for a dermatology opening or found another dermatologist. But there was no communication of the cost. Nor was it medically necessary for them to check for some of the stuff they checked for. Among the many things they tested for was a staph infection…it was entirely obvious I did not have a staph infection. But I’m sure they would be exposed to liability if for some reason I did. So they provide unwanted, unnecessary care because of liability, lack of training and potentially because of corporate profit motives (this urgent care clinic chain owns their own lab).

Long story short I managed to connect with some company execs and got the charges completely waived. But most people lack those connections and are simply stuck paying the bill.

So the tug and pull between liability, profit, lack of price transparency, lack of consumer control over the purchases are a BIG reason why healthcare is broken. The GOP argues that healthcare should remain a free market…but what I am describing is anything but a free market. A typical patient doesn’t have transparent info, they don’t know what they are going to pay post-insurance, they don’t really have control over what is being done. And it will never be a fully free market because without some regulation we would have snake oil salesmen selling BS solutions (looking at you Ivermectin). The fact it cannot be a truly free market is why I have come around to the German model. Give everyone taxpayer subsidized government insurance that protects the basics. Then let people buy up to boutique plans for those that want shorter wait times etc.

But, as the moral of this story, I also think we need to limit medical liability, require transparent pricing and have an escalation procedure for medically unnecessary procedures.
True story:

I had back problems so I went to see a neurologist who told me I was getting old. I half laughed at him and asked how much that diagnosis cost me. He didn't answer but suggested I come see him again in a year. IIRC the bill was about $400 but insurance covered all but $50.

I retired early and had to buy my own insurance after that. It was quite expensive, so I purchased a high-deductible BC/BS plan which meant that I would have to pay out of pocket for my return visit. I called the office and asked how much it would cost and they said it would depend on my insurance negotiated. I told them BC/BS high-deductible plan and they said they still couldn't answer because there were hundreds of different BC/BS plans. I called BC/BS and they couldn't answer but they have ONE guy who should know. The problem was he had a big backlog and it might take some time to get back to me. I probably waited 6 weeks to get a return call and he still couldn't give me an answer. The system is certainly a mess. I assume it's because of the combination of federal, state, and industry regulations because things wouldn't work that way if insurance didn't exist and everybody had to pay out of pocket.
 

hawkeyetraveler

Heisman
Aug 10, 2010
4,918
19,898
108
True story:

I had back problems so I went to see a neurologist who told me I was getting old. I half laughed at him and asked how much that diagnosis cost me. He didn't answer but suggested I come see him again in a year. IIRC the bill was about $400 but insurance covered all but $50.

I retired early and had to buy my own insurance after that. It was quite expensive, so I purchased a high-deductible BC/BS plan which meant that I would have to pay out of pocket for my return visit. I called the office and asked how much it would cost and they said it would depend on my insurance negotiated. I told them BC/BS high-deductible plan and they said they still couldn't answer because there were hundreds of different BC/BS plans. I called BC/BS and they couldn't answer but they have ONE guy who should know. The problem was he had a big backlog and it might take some time to get back to me. I probably waited 6 weeks to get a return call and he still couldn't give me an answer. The system is certainly a mess. I assume it's because of the combination of federal, state, and industry regulations because things wouldn't work that way if insurance didn't exist and everybody had to pay out of pocket.
Yep. If there was a reasonable way to have a truly free market without healthcare fraud I would be all for it. But you know the Snake oil salesmen would go wild. I’m a big free market capitalist in most areas of life. But the reality is healthcare does need some regulation. So the market truly isn’t free and I don’t see how it could be (We already have multi-billion dollar healthcare scams). Imagine what it would be if there was no regulation.

I just don’t see a way out except to essentially offer basic health insurance to everyone and let people buy up to better plans.
 

bdgan

All-Conference
Oct 12, 2021
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I'm not sure how you can say you're not ignoring the essential benefits, one of the biggest components of the ACA, when two posts in a row don't note them at all.
My original comment acknowledged that more people are covered (mostly Medicaid) and more preventative things are required to be covered. I didn't spell out things like annual physical or colonoscopy but I thought that was covered under "preventative". No, I don't think there's evidence that the forced inclusion of preventative items has saved money and lowered premiums.

You'll think these two stories are totally unrelated but here goes:
  • Many years ago new cars were sold with only a 12 month, 12,000 mile warranty. My state passed a law that required new cars to have a minimum 18 month, 20,000 mile warranty in order to "protect consumers". I looked at the sticker price of the car and it included an add on option of a few hundred dollars for the state mandated warranty. My point is that the state didn't protect me. They just forced me to purchase an extended warranty.
  • Biden's Inflation Reduction Act addressed the Rx donut hole by limiting out of pocket drug costs to $2,000. I assume the goal was to protect consumers from higher drug costs. When my insurance renewal came the out of pocket Rx max for the next year was reduced to $2,000 but my deductible for Eliquis went from $200 to $450. The point is I don't think the federal government protected me. They just squeezed the balloon and pushed the cost elsewhere.
 
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bdgan

All-Conference
Oct 12, 2021
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I don't think he's ignoring the benefits. There are benefits - I particularly like the fact that you can keep children on your policy up to age 26....but the ACA did not live up to it's promises...and that wasn't Obama or democrats fault...the ACA was kneecapped when the individual mandate was struck down.

So,

no, imo
I disagree with mandatory coverage to age 26. A bachelor's degree typically goes from 18-22 yrs old. I think kids should be on their own after that.

I'm not sure about the individual mandate. A few years ago I was checking insurance premiums in my state and they were flat for all age groups. A 60 year old paid the same premium as a 25 year old. Then I looked at another state where premiums were much higher for seniors not yet on Medicare but they were much lower for young people. It seems to me that the individual mandate doesn't lower premiums, it just shifts cost from older people to younger people.