[Vision2020] Health care {insurance} reform passed

[Andreas Schou]

On Thu, Mar 25, 2010 at 11:10 AM, Love America <skialaska0 at gmail.com> wrote:
> Unfortunately I have read a lot of it...not fun...if you have some real time
> read the accompanying House Report as well...not a fun treat.   The nice
> promise that the feds will "pick up"- 90+ percent of a state's rise in cost
> is only words.  Like all good laws that "authorize" expenditures, there has
> to be the appropriations laws to follow that.   This law has a lot of hollow
> promises because it is dependent on future Congresses to actually
> appropriate the funds to pay for these programs.   What this law did not do
> is completely set up a "tight" trust fund to actually put the funds into.

There's no Medicaid trust fund, and there's never been one.
Regardless, appropriations have generally been in line with what's
necessary to pay for Medicaid. I don't really know what to tell you,
other than that a Congress can *never* irrevocably bind a future
Congress to a particular funding structure.

> The law will allow the new federal bureaucracy to establish these funds,
> provide a tax mechanism (the tax on those who earn over $200K (individuals)
> and $250K (families), plus the tax on small businesses and individuals who
> do not participate) for revenue but the actions of this bureaucracy will be
> subject to the whim of the President.

Right. Except insofar as states can make administrative challenges to
the structure of the bill as it stands.

> Congress played some nice political tricks that could hurt this effort and this
> reliance on future  appropriations is painful to read.  They needed to set up a trust
> fund like  the DOT, SSI, FAA and others have.  Unfortunately I have a strong feeling
> that states will be nailed with the bill especially if we keep fighting our
> wars.
>
> Next up...what happens to insurance agents such as those who line North Main
> Street?   The law cuts them out of the picture real quick.

It sure does. Any measure that cuts costs by eliminating middlemen
drives the middlemen out of business. What value do they add?

-- ACS