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Health Care Melodrama

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Posted on Jan 3, 2011

By Eugene Robinson

If the incoming Republican leadership in the House of Representatives is serious about trying to repeal health care reform, there’s only one appropriate Democratic response: “Make my day.”

Just to be clear, there’s no earthly chance that a bill repealing the landmark health care overhaul could actually make it through Congress and be signed into law. Even if Republicans managed to hold together their new majority in the House, they would face the inconvenient fact that Democrats still control the Senate. And even if a repeal measure somehow sneaked through the Senate, President Obama would veto the thing faster than you can say “pre-existing conditions.”

So this exercise in tilting at windmills can’t even be described as quixotic, since that would imply some expectation of success, however delusional. The whole thing is purely theatrical—and woefully ill-advised.

Yet Republicans promise to stage a vote on repeal before Obama delivers his State of the Union address, expected late this month. “If we pass this bill with a sizable vote, and I think that we will, it will put enormous pressure on the Senate to do perhaps the same thing,” Rep. Fred Upton, who will be the new chairman of the House Energy and Commerce Committee, said on “Fox News Sunday.” “But then, after that, we’re going to go after this bill piece by piece.”

This sounds fine, until you actually look at the pieces. Already in effect are parts of the reform package that no self-interested politician is going to vote to take away.

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No child can be denied insurance coverage because of a pre-existing condition. Coverage can no longer be canceled when the policyholder gets sick. Insurance companies can no longer impose annual or lifetime limits on payments for care. Adult children can remain on their parents’ policies until they turn 26. Policyholders cannot be charged extra for seeking urgent care at an emergency room that is not in the insurance company’s approved network of providers.

Those measures took effect in September. Another set of provisions became law Saturday: requirements that insurance companies spend a certain percentage of the premiums they collect on actual care; a discount on prescription drugs for some seniors covered by Medicare; a rule that gives seniors free screening for cancer and other diseases.

Republican leaders aren’t dumb enough to explicitly propose taking all these benefits away. But Democrats can, and should, force them to have that debate.

The GOP strategy is to go after the elements of the reform package that are less popular. These include a requirement that businesses do a lot of new paperwork for the IRS, a measure allowing federal money to pay for abortions in the case of rape or incest, and the mandate compelling individuals to buy health insurance. “We will look at these individual pieces to see if we can’t have the thing crumble,” Upton said.

But these are fights that Democrats should welcome.

The tax reporting measure, which requires businesses to file a 1099 form with the IRS for every purchase of more than $600, really has nothing to do with health care; many Democrats are as eager to get rid of it as Republicans. As for abortion, the provisions of the reform package are fully in keeping with existing law—and with public opinion.

It seems likely that the constitutionality of the individual mandate will ultimately be decided by the Supreme Court. It takes nothing more than simple arithmetic, however, to calculate that in order to make possible the other parts of the reform package—prohibiting denial of coverage because of pre-existing conditions, keeping kids on their parents’ policies, all those goodies—it’s necessary to bring as many people as possible into the insurance pool. Otherwise, only sick people would buy coverage. Rates would inevitably skyrocket.

I suppose you could call it a “tax” or a “user fee” instead, but a debate about the unpopular mandate is really a debate over rescinding the popular, consumer-friendly measures that are already bringing peace of mind to millions of American families.

Maybe the new House leadership believes it needs to stage this fight to keep the tea party types from going rogue. Smart Republicans must know, however, that they won their public-relations advantage on health care reform by framing it as a big, amorphous beastly thing labeled “Obamacare.”

All along, what Democrats really wanted was for Americans to look closely at the details. Now it looks as if the GOP is ready to oblige.

Eugene Robinson’s e-mail address is eugenerobinson(at)washpost.com.
   
© 2010, Washington Post Writers Group


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By Conden, January 6, 2011 at 9:07 pm Link to this comment

Yeah, I couldn’t care less about the position of either of the elite right wing political parties in power that BOTH want to prop up corporate profits and deny the human right of healthcare to as many people as possible. It is all worthless melodrama untill we are able to put forth single payer.

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By surfnow, January 6, 2011 at 9:02 am Link to this comment

As usual Eugene Robinson gets it wrong. This so called health care reform should be repealed. It does nothing but put even more money into the hands of giant insurance companies, by making private insurance coverage mandatory- but there are still no provisions for any government aid. We needed universal, government paid health-care, but naturally that was immediately ” off the table” with Reid, Pelosi and the other hacks- and Eugene Robinson, of course, is in lock-step.

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By Rixar13, January 5, 2011 at 9:27 pm Link to this comment

“Republican leaders aren’t dumb enough to explicitly propose taking all these benefits away. But Democrats can, and should, force them to have that debate.”

For Profit Health Insurance companies have no business in American Health Care Period… Smile grin

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Lafayette's avatar

By Lafayette, January 5, 2011 at 7:06 pm Link to this comment

SM16: Are you concerned enough about this to set Single Payer aside at this time, so that we can focus on political combat?

We have to live with the presently legislated HC-system. It is deeply flawed and will have to be replaced inevitably.

I say fight the battle on a higher plane, that of changing the way America elects its congressmen and women. This will have much more of an effect on a great many other matters near and dear to progressives.

But that battle can only be won by changing American mentalities. And before that happens far too many people must die from inadequate Health Care, which is an almost certainty. How so?

Our politicians are not blind to the fact that with Pandemic Obesity ravaging the US a tsunami is building that can quite possibly inundate the entire HC-system. The Free Online Health site (which this site mysteriously blocks as a link) lists the following obesity related illnesses:
 

* High Blood pressure, hypertension - One-third of all cases of high blood pressure are associated with obesity High blood pressure is twice as common in adults who are obese than in those who are at a healthy weight.

  * High blood cholesterol - 50% more likely to have elevated blood cholesterol levels.

  * Diabetes Type 2 - non-insulin dependent accounts for nearly 90% of all cases of diabetes. Researchers estimate that 88 to 97% of type 2 diabetes cases diagnosed in overweight people are a direct result of obesity

  * Congestive heart failure - obesity increases the risk of congestive heart failure, a potentially fatal condition in which the heart muscle weakens, progressively losing the ability to pump blood.

  * Heart disease - heart attack, congestive heart failure, sudden cardiac death, angina or chest pain, and abnormal heart rhythm is increased in persons who are overweight or obese.

  * Stroke - There is a link between obesity and stroke; this is particularly the case for people whose fat is situated predominantly in the abdominal region. Overweight people are more likely to have high blood cholesterol levels and high blood pressure, but these associations are not the only explanations for the greater stroke rate.

  * Gallstones and gallbladder disorders.

  * Gout - the condition may develop in people with obesity incidents are remarkably higher, Gout is strongly associated with obesity.

  * Osteoarthritis - Obesity may be a major factor in the development of osteoarthritis, particularly of the knee and especially in women.

  * Some types of cancer -such as endometrial, breast, prostate, and colon

  * Complications of pregnancy.

  * Poor female reproductive health - examples would be menstrual irregularities, infertility, irregular ovulation.

  * Bladder control problems - such as stress incontinence.

  * Psychological disorders -such as depression, eating disorders, distorted body image, and low self- esteem.

I’m no Cassandra, but the above listed obesity-related-illnesses will easily overload our system, which could thus affect a great many people mortally.

This is no joke: Americans are fat, they are dumb (or at the very least very naive about the Health Care situation) and the consequences of their shortsightedness will be devastating .

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By Anarcissie, January 5, 2011 at 6:11 pm Link to this comment

SuperMike1661, January 5 at 9:02 am:

‘I think we proto-revolutionists need to stop wasting our breath about “single payer” for the following reason:  Our cause is faltering, and we need to focus on doable political objectives, like expanding our political base. ...’

Just as a general principle, you can’t expand your political base unless you have something to offer.  Single Payer is rather popular, actually, so I would think progs would want to keep it in stock.

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By SuperMike1661, January 5, 2011 at 2:23 pm Link to this comment

Lafayette, I agree with all you say, but even progressive House members on the Hill say that there is nothing that can be done at this time.

On the other hand, our political base shrinks.  Are you concerned enough about this to set Single Payer aside at this time, so that we can focus on political combat?

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By dihey, January 5, 2011 at 10:38 am Link to this comment
(Unregistered commenter)

It is amazing to observe how many progressives who thought that the health-care legislation was an abomination now spring to its support because the Republicans want to repeal it. As far as I am concerned, good riddance.

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By Lafayette, January 5, 2011 at 8:23 am Link to this comment

SM16: It is not more complex than that. 

Oh, but yes it is. Taking half-steps to an objective never gets you to your goal.

There is no reason on earth why the US should pamper the medical profession just because the AMA throws money at Replicant/BlueDog politicians during reelection campaigns. American doctors are the best paid in the world, which does not mean (unfortunately) that America has the best Health Care system.

It doesn’t. Those kudos go to single-payer Public Health systems as devised and implemented in Europe.

So if we want decent health care we must start elsewhere. That is, in reforming the way money can bend political wills at campaign time—obviously because Americans are so naive they believe the mindless bullshit that is thrown at them by the media.

TV is an excellent means for debating political options in an adversarial manner because very wide audiences can be obtained. Debate is always healthy in a nation with numerous voices all blathering their version of the truth. The only way to separate the chaff from the wheat is by means of good public debate. (Blogs such as this one, as good as it may be, just don’t reach the number of people necessary to make a difference.)

But good public debate is NOT what the media is doing presently. It is selling political platforms as if they were detergents, each claiming to wash whiter-than-white. The content of the publicity is pathetically moronic, full of slander and innuendo to debase the opposition’s character. With much of it is either unsubstantiated or just flagrant mendacity as the Web-site FactCheck.org takes great pleasure at uncovering.

We deserve the best in terms of political debate and not the worst as is shoveled by the heap-load presently. Mushrooms might thrive in the dark, but not minds.

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By SuperMike1661, January 5, 2011 at 4:02 am Link to this comment

I think we proto-revolutionists need to stop wasting our breath about “single payer” for the following reason:  Our cause is faltering, and we need to focus on doable political objectives, like expanding our political base. 

Was “single payer” doable? The answer is that under current political conditions, which we have let fester because we do not do our homework, we could not get the votes for it.  It is not more complex than that.  Specifically, we needed to “buy-off” big pharma and a few other special interests to get the existing bill over the threshold and it got over the threshold JUST barely.  Now we need to fight to reduce the size of the US medical industry behemoth by cost reducing it… a doable objective IF we build our base properly. Plz call me when we decide to start building our base… for this I have ideas….  zzzzZZZZ.

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By Lafayette, January 4, 2011 at 6:54 pm Link to this comment

A SENSE OF SOCIAL JUSTICE

EG: The whole thing is purely theatrical

Let’s hope so. If the Replicants err by exaggerating their present force, then they will be making the very same error that progressives did subsequent to Obama’s presidential election.

Politicians should never count their chickens before they hatch.

Let’s hope that their super-sized egos do indeed prompt the Replicants to overreach. It can only mean goodness to progressive Dems in the 2012 elections.

It may not be apparent presently, but as the economic hurt continues and grows, the political mentality inspired by Ayn Rand’s turgid Atlas Shrugged and engineered by Ronald Reagan’s ascension into the Oval Office may begin to wane.

It would then be possible for America to find, at last, its Sense of Social Justice - without which it remains a wasteland of Income Unfairness and Moral Vacuity.

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RayLan's avatar

By RayLan, January 4, 2011 at 4:31 pm Link to this comment

@Anarcissie,
“The Republicans are not against government.”
Well their continual cant is against government this and government that - at least lets say they claim they don’t want ‘big’ government (whatever that means).
What it boils down to of course, in complete hypocrisy, is they just don’t want to subsidize the average citizen’s needs - just their corporate greedy interests -which being continually at war, serves them quite well. The military expense is ‘big’ by any standard. They don’t like the TARP Bush set up, supposedly. Where were these two-faced
obstructionists at the time?

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By Michael Cavlan RN, January 4, 2011 at 1:25 pm Link to this comment

Queenie


Could not agree more. Kill this corporate monstrosity.

Universal Single Payer Healthcare. THAT is the compromise position for this
Nurse. Nothing less.

Member of Minnesota Chapter Mad As Hell Nurses

Question is, why the hell does this Eugene Robinson fellow get “ink” on Truth
Dig?

Hell, these apologists for the corporate Democrats and Republicans and the
corporate system they BOTH protect are given all the “ink” and TV time and
radio airspace they could ever want on the corporate media.

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Anarcissie's avatar

By Anarcissie, January 4, 2011 at 1:06 pm Link to this comment

The Republicans are not against government.  They have mostly been firm in their support of foreign wars and imperialism, ‘defense’ spending, the Drug War at home, extended police surveillance, the prison-industrial complex, and gigantic bailouts for banks, brokerage houses, and other malefactors of great wealth.  Same as the Democrats.

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Queenie's avatar

By Queenie, January 4, 2011 at 12:40 pm Link to this comment

Go ahead, repeal the damned thing! Make my day.

ONE PAYER HEALTH CARE FOR ALL!!!!!!!!!!!

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By glider, January 4, 2011 at 12:06 pm Link to this comment

the worm,

“Allowing the financial industry to ‘borrow’ from the ‘public sector’ (i.e. me and you) at 1% and buy bonds that pay 3% interest (Banks take your $1 and make $2 off each one they ‘borrowed’ from you. But, here’s the real deal: You gave them the $1 they ‘borrowed’, and you pay them the $2 interest they ‘earned’ on the bonds”

Well said !!! and this is really the basis of the Fed’s and Obama’s economic recovery strategy.  Remember this the next time Ben tells us they are keeping rates low for the foreseeable future in order to encourage “loans to small businesses”  (Hahahah!)

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By glider, January 4, 2011 at 11:45 am Link to this comment

What an idiot! 

“simple arithmetic…to make possible ... prohibiting denial of coverage ... of pre-existing conditions, keeping kids on their parents’ policies, it’s necessary to bring ... people ... into the insurance pool”

Eugene, why do you say “bring” rather than “force”? Regarding the “necessary” part have you heard of a system called Single Payer?  One of the “all parties” that Obama “brought, and had arrested, at the table” to determine the best course.

“this exercise in tilting at windmills can’t even be described as quixotic, since that would imply some expectation of success, however delusional. The whole thing is purely theatrical”

No idiot ER.  Quite the contrary.  However misguided these Republicans are they are to be admired to fight for what they believe in.  Something entirely foreign Democrat “leaders”, if you do not believe as I do that the Democrats don’t really believe in what they tell the public because they are tools of their Corporate sponsors.  That is the real difference.

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By mrfreeze, January 4, 2011 at 11:30 am Link to this comment

Just a quick, real life comment:

I have a friend who is being “forced” to pay a surcharge through his wife’s (employer-based) insurance because he is “eligible” (not required) for insurance through his job. The problem is, his wife’s policy is a “family” policy.

So, for those of you who feel there aren’t “mandates” now, you’re fooling yourselves. Also, my friend is paying almost $200 per month for the “supplement.” Let’s do the math: $2400 per year extra because the insurance company is forcing him to pay for extra coverage. The so-vilified new program wouldn’t cost anywhere near that amount.

Real life….not Media/Corporate driven bullshit argumentation.

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By madisolation, January 4, 2011 at 8:55 am Link to this comment

Republicans want to repeal the Health Insurance Industry Enrichment Act? Fine with me. Go for it.

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By Inherit The Wind, January 4, 2011 at 7:28 am Link to this comment

“Democrats” “Fight” in the same sentence?????  ER, you got to be kidding me!

The Dems in the Senate can and should stop this crap cold.  But history tells us they won’t. Now the GOP and Dims are miles apart. The GOP will stand firm, and Dims will inch a little closer to them.  The GOP will stand firm again, and the Dims will move a foot closer.  After countless repeats, and Dim movement of many miles, the GOP will move a micro-millimeter left.  The Dims will move to within two micro-millimeters of the GOP, the GOP will move another micro-millimeter, then the Dims will move that last micro-millimeter and everyone will cheer bi-partisanship!

That’s how it goes.  Dims move miles, GOPers move microns and when they meet, every says “BI-PARTISANSHIP” and the GOP gets 99.999999% of what they wanted.

Coda: Then there will be GOPers who whine that the GOP “sold out” to Dims…like Lindsey Graham after the Lame Duck when the GOP got EVERYTHING it wanted and more, including a roll-back of the inheritance tax in return for…extending unemployment for 1/2 the time the tax cut was extended for, and passing START, which every Non-Senate GOPer endorsed and should have been a no-brainer.

ER: I hope you are right but I know you are wrong.  I’ve laid out the Dim actions in the Senate for the 4 years they’ve held control, and for all the years before that going back to Jan 1995, a 16 year history of acting like cowed, whipped dogs. 

Why do you expect them to change?

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RayLan's avatar

By RayLan, January 4, 2011 at 5:29 am Link to this comment

The Reps sure know how to obstruct government - if they are so against government why do they run for office and create this monstrosity of time-consuming inefficiency? Why don’t they just start a civil war and overthrow it?

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By the worm, January 4, 2011 at 1:21 am Link to this comment

“Mandated customers” are not required for these ‘reforms’:

“No child can be denied insurance coverage because of a pre-existing
condition. Coverage can no longer be canceled when the policyholder gets sick.
Insurance companies can no longer impose annual or lifetime limits on
payments for care. Adult children can remain on their parents’ policies until
they turn 26. Policyholders cannot be charged extra for seeking urgent care at
an emergency room that is not in the insurance company’s approved network
of providers.”
“... requirements that insurance companies spend a certain percentage of the
premiums they collect on actual care; a discount on prescription drugs for some
seniors covered by Medicare; a rule that gives seniors free screening for cancer
and other diseases.”

But more importantly, the ‘certain percentage’ requirement means that 20% of
your premium (and of the tax payers’ subsidy for those ‘mandated’ who cannot
pay) can go to -

1 lobbying by the insurance industry
2 serving on ‘Boards’ to set rates for you and me
3 donating to ‘sympathetic candidates’
4 CEO ‘bonuses’
5 efforts to cut costs (i.e. cut care, prescribe care, limit care)

You and your premiums and you and your tax money will fund activities 1 - 5.

From the insurance companies’ perspective, this is the beauty of the non-
reform of health care: All private for profit insurance companies receive
subsidies from the federal government and hundreds of thousands of ‘new’ (i.e.
mandated customers).

From the people’s perspective, we are ‘mandated’ to pay for a non-value-added
activity (i.e. the paper shuffling on the insurance companies) at the rate of
20/80.

We will essentially be paying $100 for $80 worth of actual health care.

And this during a period when health care costs are “driving budget deficits”.

Think of it: Your President and mine, agreed to pay private insurers $100 for
every $80 of actual health care and then called it ‘reform’.

And this during a period when health care costs in the US are twice what they
are in any other developed nation and no more - in fact often less - effective.

If the Republicans rid of this disaster, few from the right, left or center will give
a hoot.

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By the worm, January 4, 2011 at 1:08 am Link to this comment

The non-reform of health care is number 6 among Obama’s TOP 9 slaps in the
face to America’s middle class.

The Non-Reform of Health Care gives private sector insurers a windfall:
mandated customers, with a taxpayer-paid overhead rate of 20% for ‘mandated
customers’ (20% of our premium spent on administration, CEO salaries,
bonuses, sitting on Boards to set rates and decide who’s covered, lobbying for
the insurers’ benefit, advertising and propagandizing to redefine more and
more as ‘health care service’ while delivering fewer and fewer services—-
essentially, giving our tax money to insurers to do with it what they will). *The
American people wanted a government administered plan like Medicare - for
everyone. (72% - CBS/New York Times poll June 2009)

Positives are to be had from repeal or destruction of the Non-Reform of Health
Care. However, the private-for-profit insurance industry will not allow the
Republicans to take away their windfall, their ‘mandated customers’ and their
taxpayer subsidized revenue stream.

So, while those on the right, left and center would love to see this fiasco called
‘reform’ go down, it will not.

Obama’s Top 9 Insults to America’s Middle Class

1. Shifting private debt to the public sector (thereby freeing corporations, esp
the financial industry, but also financial arms of GM, GE, etc, and saddling the
middle class with the obligation to ‘pay it off’).

2. Watching private sector profits reach un-precedented levels (while
investment goes abroad, hiring moves abroad, and manufacturing continues to
disappear and un-employment continues).

3. Raising the defense budget 6% (so, when “cuts” come, the defense industries
will be safely sandbagged).

4. Allowing the financial industry to ‘borrow’ from the ‘public sector’ (i.e. me
and you) at 1% and buy bonds that pay 3% interest (Banks take your $1 and
make $2 off each one they ‘borrowed’ from you. But, here’s the real deal: You
gave them the $1 they ‘borrowed’, and you pay them the $2 interest they
‘earned’ on the bonds. All the money they ‘invest’ came from you – a ‘loan’ –
and all the money they make comes from you – you have to cover the interest
on the bonds).

5. Allowing the financial industry to ‘borrow’ from the ‘public sector’ (i.e. me
and you again) at 1%, to loan to me and you at 4%, 12%, 18% or more
mortgages, credit cards and other lines of credit (pocketing 3%, 11% and 17% on
your and my money – first given to them by us, then ‘paid back with interest’ by
us).

6. Giving private sector insurers a windfall: mandated customers, with a
taxpayer-paid overhead rate of 20% for ‘mandated customers’ (20% of our
premium spent on administration, CEO salaries, bonuses, sitting on Boards to
set rates and decide who’s covered, lobbying for the insurers’ benefit,
advertising and propagandizing to redefine more and more as ‘health care
service’ while delivering fewer and fewer services—- essentially, giving our tax
money to insurers to do with it what they will). *The American people wanted a
government administered plan like Medicare - for everyone. (72% - CBS/New
York Times poll June 2009)

7.  Expanding the war in Afghanistan. (64% of the American people opposed
expanding the war in Afghanistan and wanted to disentangle from Bush-era
‘War on Terror’ and ‘preventive war’ policies. Still, over 60% of Americans
oppose the war.?

8.  Keeping the six too-big-to-fail banks – now bigger than ever; kept deposits
at risk by maintaining huge grey areas between commercial and investment
banking; didn’t ‘punish’ the financial industry - now even more profitable, with
bonuses among the biggest ever.

9. Supporting ‘The Compromise’ – giving billionaires $10 for each $1 to an un-
or under-employed person or family.

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By G.Anderson, January 4, 2011 at 12:19 am Link to this comment

without single payer health care reform is a give away to the insurance companies. They
will reap billions from this legislation. Yes so your children can be on your policy until
their 26. The increase in profit will more than cover it along with your increase in
premiums. The Republicans aren’t about to repeal it, because their owners the
plutocracy, like what it does for their bottom line.  The Dims have nothing to crow about
many progressives want the bill repealed too. Hopefully the legal mandates to require
the public to purchase health insurance will be unconstitutional then the bill will be dead
anyway. Then maybe we will get another crack at single payer.

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