xpostfactoid.bsky.social
Blogging mostly healthcare policy at http://xpostfactoid.substack.com. ACA implementation watcher. CSR czar. AKA Andrew Sprung.
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Disgusting, but was he suggesting the *killer* was a Marxist?
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Aw, bullshit
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It's very expressive dementia. Idiot sapience.
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It's a fitting coda to that Dr. Death's career to strip vaccine coverage from Americans, including American children, as he's done by casting the deciding vote to approve RFK and by continuing to excuse his destruction of public health.
Defunding CSR in blue states is just a cherry on top.
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Cassidy is a longtime proponent of sticking it to blue states, writing provisions that give them the short end of federal benefits. His ghoulish Graham-Cassidy bill, the last of the repeal/replace bills of 2017, was too depraved even for the Republicans of 2017 to bring to a vote.
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The ghoulish Republican ACA repeal & replace bills of 2017 took CSR out of the marketplace and would have dandled plans with Actuarial Values of 58-60% in front of low-income people.
Now, Republicans are aiming that gun at abortion-mandate states only.
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An ACA marketplace without CSR is not viable. CSR vastly reduces out-of-pocket costs for enrollees with income up to 200% of the Federal Poverty Leve. OOP costs are crushing at that income level without CSR.
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Their stupidity is moral, a willful blindness to how their actions hurt their constituents. When it comes to *how* to inflict that harm, they're resourceful and cunning. 7/
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If CMS is not in on the plot -- i.e., poised to ban silver loading or even broad loading (pricing in CSR), the alternative hypothesis is that the people writing this provision are too stupid to know that it's an advantage to abortion states. I'm afraid that's implausible. 6/
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The latter would be a kind of "King v. Burwell" for 12 blue abortion-mandate states, barring them from providing CSR unless they ban abortion in marketplace plans. 5/
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But as Republicans are plainly not trying to create an incentive for states to mandate abortion coverage, Occam's Razor suggests that CMS will turn around and bar states either from pricing CSR into silver plans only or bar them from pricing in CSR at all. 4/
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Not having CSR reimbursed directly is actually an advantage if plans can price the value of CSR directly into plans, especially directly into silver plans only (since CSR is only available with silver) -- because increased premiums = increased subsidies. 3/
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This provision, adopted in a late addition to the House bill, would restore direct reimbursement of insurers for Cost Sharing Reduction subsidies, undoing Trump's cutoff of CSR reimbursement in Oct. 17.
EXCEPT for states that mandate abortion coverage. 2/
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Wow, I hope she can do this to MAGA sellout Ciattarelli
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As long as you stay off team we're toast
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See Jonathan Bernsyein on this
open.substack.com/pub/goodpoli...