Current Events > Foiled in Congress, Trump Signs Order to Undermine Obamacare

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_OujiDoza_
10/12/17 12:21:03 PM
#1:


https://t.co/vCNz81xjrh

WASHINGTON President Trump signed an executive order on Thursday that clears the way for potentially sweeping changes in health insurance, including sales of cheaper policies with fewer benefits and fewer protections for consumers than those mandated under the Affordable Care Act.

But most of the changes will not come until federal agencies adopt regulations, after an opportunity for public comments a process that could take months.

With these actions, Mr. Trump said Thursday, we are moving toward lower costs and more options in the health care market, and taking crucial steps toward saving the American people from the nightmare of Obamacare.

This is going to be something that millions and millions of people will be signing up for, the president predicted, and theyre going to be very happy. This will be great health care.

The order resulted from Mr. Trumps frustration with his inability to persuade a Republican-controlled Congress to repeal the Affordable Care Act, a pillar of President Barack Obamas legacy. Supporters of the current health law called the order sabotage, a way to destroy the Affordable Care Act without winning a majority in Congress.

Mr. Trump directed three cabinet agencies to develop rules that would expand access to less expensive, less comprehensive insurance, including policies that could be sold by trade associations to their members and short-term medical coverage that could be offered by commercial insurers to individuals and families.

Many of the new insurance products could be exempt from requirements of the Affordable Care Act that Republicans say have contributed to sharp increases in premiums but that supporters say have created a baseline of care that has protected consumers from junk insurance.

Administration officials said they had not yet decided which federal and state rules would apply to the new products.

Mr. Trumps order could eventually make it easier for small businesses to band together and buy insurance through new entities known as association health plans, which could be created by business and professional groups. A White House official said these health plans could potentially allow American employers to form groups across state lines a goal championed by Mr. Trump and many other Republicans.

The action on Thursday followed the pattern of previous policy shifts that originated with similar directives from the president. Within hours of his inauguration in January, Mr. Trump ordered federal agencies to find ways to waive or defer any provisions of the Affordable Care Act that might burden consumers, insurers or health care providers. In May, he directed officials to help people with religious objections to the federal mandate for insurance coverage of contraception.

Both of those orders were followed up with specific, substantive regulations.

In a summary of the new executive order, the White House said that a broader interpretation of federal law the Employee Retirement Income Security Act of 1974 could potentially allow employers in the same line of business anywhere in the country to join together to offer health care coverage to their employees. As a result, it said, workers could have access to a broader range of insurance options at lower rates in the large group market.

A White House official said that employers participating in an association health plan cannot exclude any employee from joining the plan and cannot develop premiums based on health conditions of individual employees.

But state officials pointed out that an association health plan can set different rates for different employers, so that a company with older, sicker workers might have to pay much more than a firm with young, healthy employees.

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_OujiDoza_
10/12/17 12:21:22 PM
#2:


Two employers in an association can be charged very different rates, based on the medical claims filed by their employees, said Mike Kreidler, the state insurance commissioner in Washington.

Mr. Trump also directed the secretaries of the Treasury, labor and health and human services to find ways of expanding access to short-term limited duration insurance. And the White House said that such insurance is not subject to costly Obamacare mandates and rules.

Short-term policies could be particularly useful to people in counties where only a single insurer is offering plans in the Affordable Care Act marketplace, the White House said.

In 2018, it said, more than 1,500 counties nearly 50 percent of all counties are projected to have only one option on their individual insurance exchanges.

But short-term policies can limit benefits and charge higher premiums to people who have expensive medical conditions, a type of discrimination banned in policies regulated under the Affordable Care Act.

Another part of Mr. Trumps order indicates that he may wish to crack down on the consolidation of doctors, hospitals and other health care providers, a trend that critics say has driven up costs for consumers. Mr. Trump said that administration officials, working with the Federal Trade Commission, should report to him within 180 days on federal and state policies that limit competition and choice in the health care industry.

In battles over the Affordable Care Act this year, Mr. Trump and Senate Republicans said they wanted to give state officials vast new power to regulate insurance because state officials were wiser than federal officials and better understood local needs. But under the executive order, the federal government could pre-empt many state insurance rules, a prospect that alarms state insurance commissioners.

Mr. Trumps initiative is supported by business groups that see association health plans as a possible way to provide more affordable health insurance to their members. These include the National Federation of Independent Business, the National Association of Wholesaler-Distributors and the National Restaurant Association.

But consumer groups and the National Association of Insurance Commissioners, representing state officials, have opposed association health plans because they could be largely exempt from state regulation.

Association health plans cherry-pick health groups, making it more difficult for less healthy groups to find affordable coverage, the National Association of Insurance Commissioners told Congress this year.

Some state regulators and insurers greeted the move with alarm and warned that by relaxing standards for association health plans and short-term policies, Mr. Trump would create low-cost insurance options for the healthy, driving up costs for the sick and destabilizing insurance marketplaces created under the Affordable Care Act.

By siphoning off healthy individuals, these junk plans could cannibalize the insurance exchanges, said Topher Spiro, a vice president of the Center for American Progress, a liberal research and advocacy group. For older, sicker people left behind in plans regulated under the Affordable Care Act, premiums could increase.

But to business groups, the executive order offers an opportunity to bind their members together and sell large-group insurance policies that are cheap and attractive. Dirk Van Dongen, the president of the National Association of Wholesaler-Distributors, said that he was delighted with Mr. Trumps initiative and that his group would seriously consider establishing an association health plan.

Small to midsize businesses have very little leverage in the insurance market, Mr. Van Dongen said. Anything that allows them to amalgamate their purchasing power will be helpful.

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hockeybub89
10/12/17 12:22:31 PM
#3:


Ugh what's with this fascist constantly circumventing democracy to push his agenda.
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_OujiDoza_
10/12/17 12:22:35 PM
#4:


Large employer-sponsored health plans are generally subject to fewer federal insurance requirements than small group plans and coverage purchased by individuals and families on their own. They are generally not required to provide essential health benefits, such as emergency services, maternity and newborn care, mental health coverage and substance abuse treatment, although many do.

A decision by Obama appointees in 2011 discouraged the use of association health plans as a substitute for Affordable Care Act policies because officials feared they would be used to circumvent the laws coverage mandates. The Obama administration said that coverage offered to dozens or hundreds of small businesses through a trade or professional association would not be treated as a single large employer health plan for the purpose of insurance regulation.

Instead, the Obama administration said, the government would look at the size of each business participating in the association, so that many small employers would still be subject to stringent federal rules.

The Trump administration now wants to make it easier for small businesses to buy less expensive plans that do not comply with some requirements of the 2010 law.

Large-group plans are still subject to some requirements of the Affordable Care Act. They generally must cover children up to age 26 on their parents plans, cannot impose lifetime limits on covered benefits and cannot charge co-payments for preventive services like mammograms and colonoscopies.

But they are generally exempt from the requirements to provide a specified package of benefits and to cover a certain percentage of the cost of covered services.

The Trump administration is also looking for ways to ease restrictions on short-term health insurance plans that do not meet requirements of the Affordable Care Act. Under a rule issued last October by the Obama administration, the duration of such short-term plans, purchased by hundreds of thousands of people seeking inexpensive insurance, must be less than three months. The rules previously said less than 12 months.

The Obama administration said some insurers were abusing short-term plans and keeping healthier consumers out of the Affordable Care Act marketplaces. People are buying these short-term plans as their primary form of health coverage, and some insurers are pitching the products to healthier people, the Obama administration said.

But the U.S. Chamber of Commerce said short-term policies serve an important purpose for consumers who are between jobs.

The influx of a set of plans exempt from the Affordable Care Act rules will essentially divide the market and make it increasingly unstable, said Rebecca Owen, a health research actuary with the Society of Actuaries.

People who want or need broad coverage could find it increasingly difficult to obtain an affordable policy, experts say. While the administrations goal may be to give people a broader choice of plans, it could have the opposite effect on people who need or want the robust coverage available under the Affordable Care Act.

The easier you make it not to buy comprehensive coverage, the harder you make it to buy comprehensive coverage, said Katherine Hempstead, a health policy expert at the Robert Wood Johnson Foundation.

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_OujiDoza_
10/12/17 12:22:57 PM
#5:


The easier you make it not to buy comprehensive coverage, the harder you make it to buy comprehensive coverage, said Katherine Hempstead, a health policy expert at the Robert Wood Johnson Foundation.

Insurers still on the Affordable Care Acts online marketplace are most jittery about the possibility of a surge in short-term plans. Many of the large national insurers, like UnitedHealth Group, already offer these plans, and there would be little difficulty in their introducing more because of the executive order, analysts said.

They can cobble these things together pretty easily, said John Graves, a health policy expert at Vanderbilt University.

Individuals may already be attracted to short-term plans because of their low costs. These plans tend to limit benefits or offer policies only to people who do not have expensive medical conditions.

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A_Good_Boy
10/12/17 12:23:01 PM
#6:


I remember when signing executive orders to bypass an ineffective legislative branch was considered a bad thing.
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BLAKUboy
10/12/17 12:24:06 PM
#7:


A_Good_Boy posted...
I remember when signing executive orders to bypass an ineffective legislative branch was considered a bad thing.

It's okay when "Republicans" do it.
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pls
10/12/17 12:24:12 PM
#8:


_OujiDoza_ posted...
including sales of cheaper policies with fewer benefits


This doesn't seem like a bad idea. Some people don't need or want the full package.
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Tmaster148
10/12/17 12:24:23 PM
#9:


A_Good_Boy posted...
I remember when signing executive orders to bypass an ineffective legislative branch was considered a bad thing.


It's only bad if you don't have an "R" next to your name.
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Funkydog
10/12/17 12:25:03 PM
#10:


A_Good_Boy posted...
I remember when signing executive orders to bypass an ineffective legislative branch was considered a bad thing.

Trumps are the best though. He only does good bypassing orders
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Super Saiyan 3 Goku
10/12/17 12:27:43 PM
#11:


A_Good_Boy posted...
I remember when signing executive orders to bypass an ineffective legislative branch was considered a bad thing.

Lawlessness! Government overreach! King Obama!
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#12
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Balrog0
10/12/17 12:28:41 PM
#13:


more context for people who would like it:

http://www.commonwealthfund.org/publications/blog/2017/oct/association-health-plans-executive-order

http://www.commonwealthfund.org/publications/blog/2017/aug/short-term-health-plans
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Tmaster148
10/12/17 12:30:00 PM
#14:


Bullet_Wing posted...
Trump (and others) have been lying for years about how Obamacare is failing and collapsing. Since reality disagrees with them, he's taking matters into his own hands to ensure it collapses. I think he wants to say "told ya so". This is sabotage, plain and simple.

us15ObS


This is basically what Republicans do. Complain something is broken. Go out of their way to break it. Then be like "See it's broken, we gotta remove it".
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_OujiDoza_
10/12/17 12:34:21 PM
#15:


pls posted...
_OujiDoza_ posted...
including sales of cheaper policies with fewer benefits


This doesn't seem like a bad idea. Some people don't need or want the full package.

I don't think it's a bad idea, either.

That said the approach to this has been stupid - you could just as easily position yourself to grandfather in certain policies to what's originally there rather than trying to move heaven & earth to have Obamacare completely erased from history. I mean, when even republicans are shooting down new healthcare proposals it's very hard to claim that republicans are being demonized by the left, etc. on this issue.
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#16
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DifferentialEquation
10/12/17 12:46:25 PM
#17:


As long as whatever Trump is doing is pissing off the left then I'm on board.
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Antifar
10/12/17 12:51:56 PM
#18:


http://www.npr.org/2017/10/12/557349927/trump-uses-executive-pen-to-chip-away-at-obamacare

President Trump signed an executive order Thursday that's intended to provide more options for people shopping for health insurance. The president invoked his power of the pen after repeated Republican efforts to repeal the Affordable Care Act have failed.

"The competition will be staggering," Trump said. "Insurance companies will be fighting to get every single person signed up. And you will be, hopefully, negotiating, negotiating, negotiating.


Why does he think people want to spend time negotiating with insurance companies?
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hockeybub89
10/12/17 12:53:45 PM
#19:


I can confirm from working at a pharmacy that not a single person ever wants to deal with an insurance company.
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Webmaster4531
10/12/17 12:55:07 PM
#20:


Antifar posted...
http://www.npr.org/2017/10/12/557349927/trump-uses-executive-pen-to-chip-away-at-obamacare

President Trump signed an executive order Thursday that's intended to provide more options for people shopping for health insurance. The president invoked his power of the pen after repeated Republican efforts to repeal the Affordable Care Act have failed.

"The competition will be staggering," Trump said. "Insurance companies will be fighting to get every single person signed up. And you will be, hopefully, negotiating, negotiating, negotiating.


Why does he think people want to spend time negotiating with insurance companies?

The moron thinks that's the solution to everything. Basic supply and demand is a mystery to Republicans.
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Tropicalwood
10/12/17 12:55:52 PM
#21:


Antifar posted...
http://www.npr.org/2017/10/12/557349927/trump-uses-executive-pen-to-chip-away-at-obamacare

President Trump signed an executive order Thursday that's intended to provide more options for people shopping for health insurance. The president invoked his power of the pen after repeated Republican efforts to repeal the Affordable Care Act have failed.

"The competition will be staggering," Trump said. "Insurance companies will be fighting to get every single person signed up. And you will be, hopefully, negotiating, negotiating, negotiating.


Why does he think people want to spend time negotiating with insurance companies?

Everyone knows sticker price is sucker price, you a sucker antifar
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Antifar
10/12/17 12:59:34 PM
#22:


A normal person: "I love haggling with Comcast, I just wish I could replicate that experience with something I need to survive on the line."
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DifferentialEquation
10/12/17 1:03:10 PM
#23:


Antifar posted...
A normal person: "I love haggling with Comcast, I just wish I could replicate that experience with something I need to survive on the line."


My insurance company has been completely pleasant to deal with whenever I've had to. Never needed to spend more than 5 minutes on the phone with them. Comcast was a nightmare, though. I spent almost 4 hours on the phone with them once as they undid one of their own fuck ups.
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Giant_Aspirin
10/12/17 3:10:14 PM
#25:


_OujiDoza_ posted...
including sales of cheaper policies with fewer benefits and fewer protections for consumers


the Republican way
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_OujiDoza_
10/13/17 10:31:33 AM
#26:


A little more insight:

https://t.co/8wxfbImnHN

Trump Unveils Full-bore Obamacare Sabotage

Donald Trump and his party have never been able to figure out a viable alternative to Obamacare. Having failed to repeal and replace the law, they have set out to wreck it. The Trump administration is taking two steps to accomplish this goal. First, it is opening two loopholes to allow healthy people to purchase unregulated insurance, splitting the market and loading more costs onto people with expensive medical needs. Second, it announced tonight it is ending cost-sharing payments to insurers who take on low-income customers.

Both these changes are designed to put pressure on insurers, increasing premiums by an average of 19 percent, and even splitting up the individual insurance markets. Whether they will succeed is yet to be seen. States committed to making Obamacare work will find solutions that keep their markets intact. (Indeed, there has been a marked difference in the premium levels of states that are trying to help cover their citizens and those that arent.)

Whats more, by withholding payments promised in the law, the administration is exposing itself to a lawsuit it could very well lose. (New York Attorney General Eric Schneiderman, California Attorney General Xavier Becerra, and others have already announced their intention to sue.) Premiums are going to rise in the meantime, because insurers are subjected to greater uncertainty and the now-demonstrated knowledge that the administration is deliberately sabotaging the law they are operating under.

The exchanges in 2017 had stabilized financially, as insurers found a profitable price point. The Republican Party has, as a matter of theological principle, refused to accept the possibility that Obamacare might succeed at its stated ends. If Obamacare were truly collapsing, sabotage would not be necessary. It is the laws success, not its failure, that has made Trump so determined to wreck it. The White House has released a statement confirming its intention to end the payments, written in the pidgin English indicating the presidents own authorial hand:

apufcAE

vg6o97B

The trouble is that every plan Trump has supported would throw even more people off their insurance than his sabotage would. There is no political or policy incentive for them to give him political cover for policies to deny Americans health insurance. Their incentive is to highlight the sabotage that he is boasting about, and fight.

The Medicaid expansion, which accounts for a majority of the laws coverage gains, remains in place and is not vulnerable to administrative sabotage. Individual consumers are going to experience a lot of financial pain as a result of Trumps action. As premiums rise in response to the sabotage, the main public recourse will be to replace the Republican-led government with one capable of passing a workable and humane health-care law.

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Balrog0
10/13/17 10:34:38 AM
#27:


https://www.kff.org/health-reform/issue-brief/impact-of-cost-sharing-reductions-on-deductibles-and-out-of-pocket-limits/

x4J76Af
3Ij0kgX
eo4SC7P
T10Cvsd
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Howl
10/13/17 10:36:49 AM
#28:


Good Obamacare is a garbage healthcare policy.
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Balrog0
10/13/17 10:37:50 AM
#29:


Howl posted...
Good Obamacare is a garbage healthcare policy.


your premiums will go up 20% in 2019 if the CSR payments stop
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Balrog0
10/13/17 10:39:49 AM
#30:


_OujiDoza_ posted...
The Medicaid expansion, which accounts for a majority of the laws coverage gains, remains in place and is not vulnerable to administrative sabotage. Individual consumers are going to experience a lot of financial pain as a result of Trumps action. As premiums rise in response to the sabotage, the main public recourse will be to replace the Republican-led government with one capable of passing a workable and humane health-care law.


lol does this guy not even know about 1115 waivers?

https://www.kff.org/medicaid/issue-brief/section-1115-medicaid-demonstration-waivers-a-look-at-the-current-landscape-of-approved-and-pending-waivers/

A number of states have waivers pending at CMS that include provisions not previously approved including work requirements, drug screening and testing, eligibility time limits, and premiums with disenrollment for non-payment for traditional Medicaid populations. Some of requests are part of expansion waivers, while others would apply to traditional populations.
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BLAKUboy
10/13/17 10:40:34 AM
#31:


I'm pretty sure Howl has just turned full-on satire at this point. And he's not even good satire like Differential.
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Howl
10/13/17 10:41:19 AM
#32:


Balrog0 posted...
Howl posted...
Good Obamacare is a garbage healthcare policy.


your premiums will go up 20% in 2019 if the CSR payments stop


I pay literally 0$ per month for my healthcare through the state so I don't have any eggs in the basket in this debate.
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E32005
10/13/17 10:42:11 AM
#33:


BLAKUboy posted...
A_Good_Boy posted...
I remember when signing executive orders to bypass an ineffective legislative branch was considered a bad thing.

It's okay when "Republicans" do it.

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Questionmarktarius
10/13/17 10:45:27 AM
#34:


A_Good_Boy posted...
I remember when signing executive orders to bypass an ineffective legislative branch was considered a bad thing.

A law that even allows for this much executive leeway is automatically a bad law anyway.
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#35
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Questionmarktarius
10/13/17 1:01:46 PM
#36:


ACA has always been nothing more than a Cloward-Piven strategy to topple the private insurance industry and spur public demand for a single-payer system from the ashes.
Half-assed republican attempts to appease backers and cronies by meddling at the margins will just accomplish the initial goal faster.
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Rexdragon125
10/13/17 1:18:10 PM
#37:


Obama built X.
Trump must smash X.

Our president is a toddler.
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#38
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CADE FOSTER
10/13/17 2:58:47 PM
#39:


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MacDaMurderer
10/13/17 3:03:39 PM
#40:


Millions and millions
Billions and billions
Many many
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Howl
10/13/17 3:08:04 PM
#41:


byron posted...
byron posted...
Howl posted...
Balrog0 posted...
Howl posted...
Good Obamacare is a garbage healthcare policy.


your premiums will go up 20% in 2019 if the CSR payments stop


I pay literally 0$ per month for my healthcare through the state so I don't have any eggs in the basket in this debate.

You're on medicaid?

@howl


No
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#42
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Zeeak4444
10/13/17 3:39:39 PM
#43:


Anyone else notice Trump and his supporters seem to be the only people to talk about how their winning?

I guess if no one else is saying it you have to yourself.
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Trigg3rH4ppy
10/13/17 5:11:32 PM
#44:


Howl posted...
Balrog0 posted...
Howl posted...
Good Obamacare is a garbage healthcare policy.


your premiums will go up 20% in 2019 if the CSR payments stop


I pay literally 0$ per month for my healthcare through the state so I don't have any eggs in the basket in this debate.

Lmao so you're a leech yet you think you deserve to have an opinion on the matter?
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_OujiDoza_
10/13/17 6:18:52 PM
#45:


Trigg3rH4ppy posted...
Howl posted...
Balrog0 posted...
Howl posted...
Good Obamacare is a garbage healthcare policy.


your premiums will go up 20% in 2019 if the CSR payments stop


I pay literally 0$ per month for my healthcare through the state so I don't have any eggs in the basket in this debate.

Lmao so you're a leech yet you think you deserve to have an opinion on the matter?

Got em
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