Senate GOP Releases Revised Version Of Obamacare ‘Repeal And Replace’ Bill

Senate Republicans have introduced their latest version of a plan to repeal and replace the Affordable Care Act.


As expected, the Senate GOP leadership unveiled their revised version of the Better Care Reconciliation Act, the proposed plan to ‘repeal and replace’ the Affordable Care Act, but initial reviews don’t seem to provide them much hope that this bill will do much better than the first version:

WASHINGTON — Senate Republican leaders on Thursday unveiled a fresh proposal to repeal and replace the Affordable Care Act, revising their bill to help hold down insurance costs for consumers while keeping a pair of taxes on high-income people that they had planned to eliminate.

With the revised bill, the majority leader, Mitch McConnell, Republican of Kentucky, is trying to keep alive his party’s seven-year quest to dismantle the health law that is a pillar of former President Barack Obama’s legacy.

Republicans said the revised bill would provide roughly $70 billion in additional funds that states could use to help reduce premiums, hold down out-of-pocket costs and otherwise make health care more affordable. The bill already included more than $100 billion for such purposes.

The new bill, like earlier versions, would convert Medicaid from an open-ended entitlement to a system of fixed payments to states. But in the event of a public health emergency, state Medicaid spending in a particular part of a state would not be counted toward the spending limits, known as per capita caps.

In a departure from current law, the bill would allow insurers, under certain conditions, to offer health plans that did not comply with standards in the Affordable Care Act. Under that law, insurers sell regulated health plans through a public insurance exchange in each state.

A summary of Mr. McConnell’s bill, circulating on Capitol Hill, describes his proposal this way: If an insurer offered “sufficient minimum coverage” on the exchange that remains subject to federal mandates in the Affordable Care Act, it could also offer coverage outside the exchange that would be exempt from many of those mandates.

Policies that comply with the Affordable Care Act would provide more extensive coverage but would also attract sicker people with higher medical costs. To address this concern, the Republican bill would create a fund to make payments to insurers for the costs of covering high-risk people enrolled in health plans on the exchanges.

Senator Ted Cruz, Republican of Texas, has pushed to allow stripped-down plans, and he called the inclusion of the provision “very encouraging.”

“I think we’re making serious progress towards coming together and unifying our conference and getting a bill that can command the support of at least 50 senators and pass into law,” Mr. Cruz said on the radio station KFYI.

“I think failing to get this done would be really catastrophic,” he added, “and I don’t think any of the Republican senators want to see failure come out of this.”

People who enroll in catastrophic health insurance plans would be eligible for federal tax credits to help pay premiums. Such plans typically have lower premiums and high deductibles. But under the Affordable Care Act, consumers generally cannot use the tax credits for such plans.

The bill would, for the first time, allow people to use tax-favored health savings accounts to pay insurance premiums. Republicans said this policy change would increase health care coverage.

The bill also provides $45 billion to help combat the opioid abuse crisis — a provision that is particularly important to two Republican senators who opposed the previous version of the bill, Rob Portman of Ohio and Shelley Moore Capito of West Virginia.

The new draft bill would not include any changes from current law to the net investment income tax or the additional Medicare payroll tax paid by certain high-income people. Nor would it change the limits on the tax deductions that insurers can take for salaries and other remuneration paid to top executives.

The Senate is, in effect, trying to catch up with the House, which on May 4 narrowly approved a bill to repeal and replace much of the Affordable Care Act.

To succeed, Mr. McConnell must win over almost all the holdouts in his caucus, a daunting and delicate task given the litany of complaints he faces and the sharp policy differences that he must find a way to bridge.

But the revised bill is broadly similar to the earlier measure that Senate leaders hoped to vote on before the Fourth of July recess, though the new version includes some additional provisions meant to entice reluctant Republican senators with varying policy concerns.

“It appears that little has changed at the core of the bill,” the Senate Democratic leader, Chuck Schumer of New York, said on the Senate floor. “The Republican Trumpcare bill still slashes Medicaid. The cuts are every bit as draconian as they were in the previous version — a devastating blow to rural hospitals, to Americans in nursing homes, to those struggling with opioid addiction and so many more.”

Like the previous bill, it would end the requirement that most Americans have health coverage, and it would make deep cuts to Medicaid, capping payments to states and rolling back its expansion under the Affordable Care Act. Though some Republican senators expressed concern about how the previous bill would affect Medicaid, Senate leaders stuck with the same approach in the new version.

In a notable change, the bill would keep the two taxes imposed by the Affordable Care Act on people with high incomes: the 3.8 percent tax on investment income and the 0.9 percent payroll tax. The taxes apply to individuals with income over $200,000 and couples with income over $250,000.

Both of those taxes would have been repealed under the previous Senate bill, reducing federal revenue by about $231 billion over a decade, according to the congressional Joint Committee on Taxation.

Mr. McConnell is trying to avoid a repeat of his first attempt to push his bill through the chamber, when he was forced to delay a vote planned for late last month because of opposition from Republican senators.

Meanwhile, The Washington Post is reporting that two Republican Senators plan on offering their own alternative to the BCRA, a move that could even further complicate Senator McConnell’s effort to pass a bill before the Senate’s summer recess:

The Senate GOP’s latest attempt to rewrite the Affordable Care Act showed few signs of gaining traction Thursday, further imperiling the party’s quest to overhaul Barack Obama’s 2010 health care law.

At least three Republican senators said Thursday they remained opposed to bringing up the revised bill, while two rank-and-file Republicans announced plans to offer their own health-care plan just as leaders released an updated bill of their own. Senate leaders need the support of 50 of their 52 members to pass the legislation.

Senate Majority Leader Mitch McConnell (R-Ky.) offered a new draft aimed at meeting specific requests of GOP senators reluctant to support the measure previously.

The new measure has won the backing of Sen. Ted Cruz (Tex.), whose proposal to allow insurers to sell austere plans that do not comply with ACA requirements was included in the latest draft. But Sen. Rand Paul (R-Ky.), who says the measure still does not do enough to unravel the law known as Obamacare, remains opposed to voting on the bill, as do two centrists, Susan Collins (Maine) and Rob Portman (Ohio.).

“My strong intention and currently inclination is to vote no on the motion to proceed,” Collins told reporters

Portman, who came out against the original draft of the bill, also said he was opposed to taking a vote at this point. “I’m in the same position I’ve been in. Looking at the language and looking forward to the analysis.”

The three senators’ continued opposition, coupled with the move by Sens. Bill Cassidy (La.) and Lindsey O. Graham (S.C.) to debut their health-care proposal on CNN moments before McConnell was set to brief members demonstrated how divided the majority remains in its quest to overhaul former president Barack Obama’s signature health-care law.

Graham said he would vote for a procedural motion to start debate on the bill but that he is still working on changes to make the legislation more palatable for states like Nevada, which accepted Medicaid expansion.

“I’m trying to get a bill that will lock down Republican governors,” Graham told reporters after his caucus met behind closed doors.

In a joint interview with CNN on Thursday, Cassidy and Graham said that they would take the billions of dollars the federal government now receives in taxes under the ACA and direct that revenue to the states.

“We’re going to see which one can get 50 votes,” Graham said, referring to the number of GOP senators needed to approve any bill in the Senate, given that Vice President Pence is prepared to cast the tiebreaking vote. Referring to McConnell, he added, “We’re not undercutting Mitch; he’s not undercutting us.”

The surprise announcement just before Senate GOP leaders released a revised health-care proposal Thursday under the Affordable Care Act. The updated measure also allows Americans to pay for premiums with money from tax-exempt health-savings accounts (HSAs), an idea that many conservatives pushed, along with more generous subsidies to offset consumers’ out-of-pocket health costs and treat opioid addiction.

All of this places McConnell’s bill in a rather precarious position to say the very least. As I’ve noted before, McConnell can only afford to lose two of the member of his caucus if the bill is going to pass. Anything more than that and he will end up with fewer than fifty votes and the bill will fail. As things stand, there still appear to be at least three Senators who are inclined to vote against even this revised version of the bill, namely Rand Paul, Susan Collins, and Lisa Murkowski. Additionally, it appears unlikely that Republicans will be able to count on the support of Nevada’s Dean Heller due in no small part to the fact that he is a Republican running in Nevada, a state which Hillary Clinton won in 2016 and where Democrats were able to hold on to the seat vacated by Harry Reid in the same election. Heller is widely seen as the most vulnerable Republican running in 2018 and as a result is uniquely vulnerable on this issue. Even if only these four Senators are the only ones that end up opposing this revised bill, McConnell’s plan is effectively dead on arrival. Added into all of this, of course, must now be the apparent intention of Senators Graham and Cassidy to introduce their own competing bill to the BCRA. While we don’t know any of the details of that bill, the fact that Senator Graham is involved in it indicates that it’s likely to include details that would be more likely to appeal to the more moderate Senators in the GOP rather than the conservatives like Ted Cruz and Mike Lee.

Much of the reception that this bill is going to get will depend, of course, on how the Congressional Budget Office score for this revised version of the bill turns out. Given the fact that most of the changes that the original version of the BCRA made to the Affordable Care Act are still contained in this revised version, such as coverage for pre-existing conditions and the funding of Medicaid expansion, it seems likely that the topline number of how many people are likely to lose coverage will not change significantly. This will make it hard for the Senators who were already opposed to the BCRA to change their position on this revised bill, although it’s possible that some might do so depending on whether or not there are sufficient “sweeteners” in the bill to get them to vote for it. As things stand right now, though, it looks as though McConnell and his lieutenants will have a hard time getting this passed before the summer recess begins.

Here’s the revised BCRA:

Revised Better Care Reconciliation Act by Doug Mataconis on Scribd


FILED UNDER: Congress, Health Care, US Politics, , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , ,
Doug Mataconis
About Doug Mataconis
Doug Mataconis held a B.A. in Political Science from Rutgers University and J.D. from George Mason University School of Law. He joined the staff of OTB in May 2010 and contributed a staggering 16,483 posts before his retirement in January 2020. He passed far too young in July 2021.


  1. Daryl's other brother Darryl says:

    Republicans are brilliant. They are going to cut premium costs by providing insurance that covers NOTHING. But they will convince their rubes that they have cut premium costs.
    I have little hope for the future of this nation when one of the two major political parties…the one that most readily identifies with christianity…is willing to fwck the old and the sick and the poor in order to provide tax cuts for the rich. Combined with their willingness to stand idly by while our biggest adversary attacks us…the end is nigh.

  2. gVOR08 says:

    I’m in the same position I’ve been in. Looking at the language and looking forward to the analysis.

    Exactly the waffling I’d expect from my Senator Portman. The additional money for opioid addiction is targeted squarely at him. If the CBO comes in under 20 million losing insurance, I expect he’ll fold and support McConnell. Not exactly Profiles in Courage material.

  3. Hal_10000 says:

    Slowly but surely, the GOP is moving toward an updated version of Obamacare. A few more iterations and they should be there, come about 2023.

  4. Michael says:

    How are all these opioid abusers not arrested and placed into for profit jails throughout the South and Midwest? Why are we spending money on them to help in repealing Obamacare?

  5. grumpy realist says:

    OT: did anyone see Paul Ryan’s attempt to codify women’s right to bare arms on the Hill?

    My feeling is: if you want to get people to wear long-sleeved outfits in government in the summer, crank up the air conditioning.

  6. Not the IT Dept. says:

    Seven years, you *bleepers*. Seven *bleeping* years.

  7. Moosebreath says:

    Meanwhile, Mitch McConnell is telling Senators don’t worry about the Medicaid cuts, they will never actually occur:

    In other words, the GOP should vote for the free candy (tax cuts) now, and let the Democrats whenever they take power vote for the castor oil (undoing the Medicaid cuts, with the needed taxes to pay for them).

  8. OzarkHillbilly says:

    This is the gang that couldn’t shoot straight.

  9. wr says:

    @grumpy realist: Yes, women in DC will be allowed to wear sleeveless dresses as they are forced to undergo intrusive ultrasounds and carry their rapists babies to term. Feminism for Republicans!

  10. Kylopod says:

    As things stand, there still appear to be at least three Senators who are inclined to vote against even this revised version of the bill, namely Rand Paul, Susan Collins, and Lisa Murkowski.

    If the so-called opposition ends up down to Rand Paul plus two “moderates,” then the bill will pass. There’s no way in hell Paul will allow himself to be remembered as the senator who killed Obamacare repeal. This is the guy who, upon entering the race for the GOP nomination in 2015, almost immediately began flip-flopping on heterodox positions he had previously taken such as support for defense budget cuts. His entire career has been a carefully calculated exercise in maintaining the image of his dad’s hardcore libertarianism while in practice avoiding doing anything to make himself a pariah within the GOP. He wants to have his cake and eat it too–to acquire the reputation of an independent thinker without paying the price. So he’ll make a lot of noise about the bill in order to shore up his libertarian cred but he will not oppose it unless enough other right-wing senators are doing so to make it “safe” for him to join along.

  11. James Pearce says:


    If the so-called opposition ends up down to Rand Paul plus two “moderates,” then the bill will pass.

    My feeling too. Never bet on the heroism of Rand Paul, Lisa Murkowski, or Susan Collins.

  12. grumpy realist says:

    OT: Next gubernatorial race in Illinois to pit very rich guys against each other.

    If I were Ruler For The Day, I’d ask each of these doofuses how much he would be willing to pay for this election, take the money and put it towards one or more of our immense money holes, and decide the election by flipping a coin. We’d get to the same end result, would avoid a huge amount of junk mail and telemarketing, and actually do some good with the money as opposed to blowing it on election profiteers and lobbyists.

    There is something bleakly tragicomic about a state on the verge of having its bonds classified as junk run one of the most expensive US elections ever.

    Am starting to feel like I’m living in Italy.

  13. Terrye Cravens says:

    I think it might die…I really do.

  14. de stijl says:

    They have to decide between the cost of not repealing Obamacare and passing Trumpcare. Or the middle course.

    To a great extent the calculus changes on geography / demography. Swing staters have a very different equation than those elected from a deep red state who have another choice.

    Also, you need to factor in how palatable support for Trump will look like in 2018. These folks have staff – staff able enough to realize that 2018 is likely to trend against Rs even absent an extremely unpopular president. If Trump + / – is bad it will be a tsunami.

    Will action x cause reaction y?

    Do you push while the iron is hot and you control all the levers?

    Do you wait to see which way the wind is going to blow?

    Do you do the right thing? (Bwa ha ha – ya right! As if!)

    They have to also realize the polling. When then policy polls at 15%, but pursuing the policy polls at 42% you should tread gently. That means they don’t like what you’re advocating, but they appreciate that you’re pissing off the libtards. That gap evaporates if you actually do what they seem to be saying they want you do.

    The dog that caught the car.

  15. David M says:

    At this point it’s just depressing the GOP can’t accept the ACA framework. Make some small adjustments, smooth out some rough edges and declare victory. There are other issues that could be addressed.

  16. Just 'nutha ig'nint cracker says:

    @Daryl’s other brother Darryl:

    They are going to cut premium costs by providing insurance that covers NOTHING.

    No kidding. My suggestion to anyone who is going to go with Plan B (catastrophic only) is to look carefully at what the annual and lifetime coverage caps are going to be. Past versions of catastrophic care only plans covered cancer and other catastrophes, but not at levels that actually paid one’s bills in any given year unless surgical removal of a tumor was all that was needed. With costs expanding as quickly as they do here–because market economics are so good at handling this issue–the ability for your sickness to outstrip your coverage will be almost a sure thing unless someone will underwrite a policy with open ended payout. I don’t see this happening.

  17. Just 'nutha ig'nint cracker says:

    @Michael: Because some significant segment of these opioid treatment people are the sons and daughters of former “tough law and order guys” whose come to Jesus moment was the realization that their kid was going to do 40 years at one of the less nice Club Fed resorts unless the parents “saw the light.”

    I heard one of them on the radio just yesterday. He said, “I’ve always been a strict law and order guy, but this opioid thing–and I’m speaking from personal experience–is something that no one in the entire history of the world has ever had to face.” TRANSLATION: My kid is hooked on pain killers and can’t kick the habit. He’ll end up in prison if my wife and I can’t figure out something to do. I wonder if this is what all those soft on crime libtards and progressives have been carping about all this time.

  18. KM says:

    @Just ‘nutha ig’nint cracker :

    No kidding. My suggestion to anyone who is going to go with Plan B (catastrophic only) is to look carefully at what the annual and lifetime coverage caps are going to be.

    Are you kidding? This is what they’ve been bitching about when they say they lost their insurance and want it back!! These people are penny-wise and pound-foolish, thinking themselves clever for saving a few bucks a month and gambling they never experience a need to use their craptastic coverage. Yes, you pay only $10 a month but its a wasted $10 because the product is not worth what you paid for.

    These are the fools who think diabetes isn’t going to happen to their obese selves, who think they will be young and healthy forever but Medicare/Medicaid will cover them if not. That their child will never get a disease, heart attacks don’t happen and a “catastrophe” won’t have lifelong consequences. They think this is a *good* plan because it’s *cheap*, not because it’s comprehensive or useful.

    I don’t see this happening.

    The line will be out the door before the ink is dry. There has never been a shortage of nearsighted people in this nation. Personally, I think if you opt for this kind of coverage you shouldn’t be legally allowed to declare bankruptcy when the medical bills inevitably catch up to you. You get what you pay for.

  19. KM says:

    @Just ‘nutha ig’nint cracker:

    Because some significant segment of these opioid treatment people are the sons and daughters of former “tough law and order guys” whose come to Jesus moment was the realization that their kid was going to do 40 years at one of the less nice Club Fed resorts unless the parents “saw the light.”

    I get scolded when I don’t show the proper level of sympathy and insist on jail time for abusers and that we shouldn’t be insisting on Narcan as Epipens to “alleviate” the issue. I’ve had 3 members of my (admittedly large) extended family die from overdoes in the last 2 years. We just buried a second cousin a few months shy of his 23rd birthday. It was his 5th OD and his children were in the house. This was a brilliant young man who refused to admit he had a problem, refused treatment and didn’t care what it did to his family.

    I’ve long accepted there are addicts you can help and addicts you can’t. That they are your family and not some nameless “thug” in an inner city makes no difference. If you OD twice, you’d made a choice that you want that drug more then you want life. At least if you are in a cell, you’re alive. I’d rather have jailbirds in the family then corpses.

  20. michael reynolds says:

    @Michael: @Just ‘nutha ig’nint cracker:

    Dude: Opioids white; Crack black. Treatment for opioids; prison for crack. There’s nothing complicated going on here.

  21. Kylopod says:

    @James Pearce: Back in 2010 when Murkowski lost the GOP primary and then went on to be reelected in a write-in campaign, I thought (hoped) there was a chance she’d develop into a sort of Republican version of Joe Lieberman, who had a comparable experience in 2006 (losing the primary and winning the general election as an independent) after which he proceeded to be a thorn in his former party’s side for much of the rest of his tenure. I stopped looking for courage in the GOP a long time ago, but why can’t they at least have a few concern trolls?

  22. OzarkHillbilly says:

    @grumpy realist: They both begin with an “I”, maybe that’s what drives them crazy.

  23. OzarkHillbilly says:

    @Just ‘nutha ig’nint cracker:

    He said, “I’ve always been a strict law and order guy, but this opioid thing–and I’m speaking from personal experience–is something that no one in the entire history of the world has ever had to face.”

    I guess in his lily white world, he never heard of the crack epidemic.

  24. de stijl says:

    @michael reynolds:

    It’s the old stand-up trope:

    “Did you ever notice that black people dance like this (demonstrates smoove moves), and white people dance like this (spazzes out)?”

    Or one of my go-to nonsequiters from Homer Simpson:

    “Did you ever notice that black people have names like Carl and white people have names like Lenny?”

    Drug abuse in my tribe is a health care crisis. Drug abuse in your tribe is a crime.

  25. de stijl says:

    @de stijl:

    And it has been playing out that way since drugs have been regulated in this country. If well-bred white women are addicted to patent medicines laced with laudanum and cocaine we create the FDA. If lazy, shiftless blacks or browns are using heroin we draft new criminal laws and incarerate the lot.

    And now we’re implementing class based laws, marijuana is either legal or entirely decriminalized because “people like us” use it or our kids do. No one should have to face a life-long penalty for a youthful indescretion.

    My ex-urban (white) nephew is in a halfway house because he is a Oxy addict who got caught selling Adderal. Where he black and urban, what would be his situation?

  26. michael reynolds says:

    @de stijl:
    Marijuana was first outlawed in the US when it was strongly associated with black musicians, jazz men. Now I can (and do) literally get it delivered, just like pizza, but with better on-time delivery.

    Addictive drugs – Oxy and other opioid pills, heroin, cocaine in its various forms, alcohol and tobacco – are public health problems, regardless of the color of the addict. After decades handing down insane prison sentences we’ve now legalized the most benign of ‘drugs’ in much of the country which pretty much proves the point that those sentences were savage and uncivilized, not to mention being major contributors to the hostility between African-Americans and the police, as well as contributing to the destruction of black families by warehousing black men in prisons.

    The drug war was stupid and cruel from day one. It doesn’t match the atrocities of slavery or the genocide of the Indians, but it’s an echo. A vile business for which we should be ashamed.

  27. teve tory says:

    @michael reynolds: The older I get, especially living here in the south, the more i see that any problem that is perceived as being a minority problem is almost doomed to persist.

  28. roger says:

    @David M: Because the ACA is attached to Obama and they want to dismantle everything related to Obama.

  29. de stijl says:

    @michael reynolds:

    The optimist in me wants to see that the opioid / prescription drug “crisis” as the turning point towards a more empathic and efficient and outcome based drug / intoxicant policy.

    The pessimist in me sees it as another race and class based distinction that allows one form of abuse while still criminalizing and stigmatizing another.

    The realist in me knows that drug policy does not change unless upper middle class white people are at risk for incarceration or getting fired.

  30. de stijl says:

    @michael reynolds:

    Have you been watching Snowfall?

  31. teve tory says:

    has something changed in the last few weeks to the coding on this site? OtB now seems to take forever to officially finish loading.

  32. Argon says:

    @Daryl’s other brother Darryl:

    Republicans are brilliant. They are going to cut premium costs by providing insurance that covers NOTHING. But they will convince their rubes that they have cut premium costs.

    Well, it is true that such plans would actually cut premium costs. It’s just that many people will find that’s not a bargain after they become ill. It’s akin to playing Russian roulette.

    Additionally, it ensures the more comprehensive health plans will drop into a death spiral. Sadly, that’s a feature, not a bug in the eyes of the GOP.

  33. michael reynolds says:

    @de stijl:
    No, it’s on my list. At the moment I’m on Cyprus doing research for an adult novel. Why, at this very moment I’m researching the quality of local weather (too damn hot) and the quality of local beer (not good.) But cool history, excellent watermelons and avocados, and it really works for the story, so I’m prepared to overlook the stays-hot-all-night humidity and the insipid lager.

  34. michael reynolds says:

    My position from the start has been that Obamacare was as good a deal as we were ever going to get given the realities of American politics and our weird, hybrid healthcare system. The Republicans are proving the point. Everything they’ve come up with so far is far worse.

  35. Moosebreath says:

    @michael reynolds:

    “The Republicans are proving the point. Everything they’ve come up with so far is far worse.”

    That’s only because you are approaching the issue from people having health care as the desired outcome. If you are indifferent to it, but your desired outcome is cutting taxes for the wealthy (which is after all the Republicans desired outcome regardless of what is the issue), then the Republican plan is far better.

  36. de stijl says:

    Eat the sheftalia – pork (Greek side) or lamb (Turk side). Trust me on this.

    Find a local’s joint.

    Plus you can always get Heineken or Guinness. Not the best choice, but it works in a pinch.

  37. de stijl says:

    @michael reynolds:

    I’m enjoying a frosty Torpedo IPA from Sierra Nevada with my lunch sammy. It’s a bit one note, but that one note is hoppy. Nothing to write home about. I ran out of Summit (Great Northern) Porter last night and now I’m bummed.

  38. Mister Bluster says:

    @teve tory:..OtB now seems to take forever to officially finish loading.

    This annoying glitch is intermittent. Not sure when I first noticed it. My DSL service at home is provided by Frontier, the local land line telephone company. So is the Wi-Fi connection at the local Buffalo Wild Wings.
    The Micky Ds here uses AT+T. Panera and other coffee shops use different service providers.
    I have experienced the digital ass dragging at all of them and other coffee shops in town.
    To know that you are having the same problem confirms that what ever is going on is not likely “at my end”.
    Don’t know if we can pin this on Republican President Pork Chop Pud or his henchmen but I would not be surprised if they have recruited the Ruskies to hack OTB or any other site that does not follow “the party line”.

  39. de stijl says:


    Yeah. We’re inefficient at negotiating health care because we want people to have good health care and not have to bankrupt themselves after they receive it.

    Every one of us will be sick, everyone of us has had a family member need health care; this is not a lottery – it’s baked into the bargain. We live, we get sick, we die. No exceptions.

    Some of us don’t like the bargain and pretend that medical care is optional or being ill while you’re poor is some moral failure.

    Those people are the majority party of both houses and own the presidency.

    The best we can hope for is they do not poison the well.

  40. James Pearce says:


    How are all these opioid abusers not arrested and placed into for profit jails throughout the South and Midwest?

    Because they’re prescription drugs?

  41. de stijl says:

    @James Pearce:

    Do you actually think that all or most of opioid / prescription drug addicts have a scrip?

    You may want to do more research.

  42. Moosebreath says:

    @de stijl:

    “being ill while you’re poor is some moral failure.”

    In their minds, I have FTFY.

  43. James Pearce says:

    @de stijl:

    Do you actually think that all or most of opioid / prescription drug addicts have a scrip?

    Depends on how far along they are in their addictions, don’t you think?

  44. de stijl says:

    Lunch sammy was pulled pork on a toasted Kaiser roll with an apple cider vinegar, mustard, Famous Dave’s sauce mixed up thingy. Sides were baked beans and Classic Lay”s.

    God bless the USA!

  45. teve tory says:

    To know that you are having the same problem confirms that what ever is going on is not likely “at my end”.

    I use connections all over town and for the last few weeks OtB, and only OtB, pulls up the page, but then keeps ‘loading’ for 2-3 times as long as it used to. I’m guessing it’s something external OtB is calling that’s having issues lately. IDK.

  46. de stijl says:

    @michael reynolds:

    It’s not just sheftalia, btw. You’ll get fixin’s. Rice, salad, lemon wedge, some squid appendage if you ask for it.

    It’s a goddamned meal! Throw back an ouzo (hate the stuff myself) some got-rut greek-style wine.

    Besides it’s research. It’s a meal a character will have.

  47. Just 'nutha ig'nint cracker says:

    @OzarkHillbilly: What would the problems of dead-end black people have to do with his family!!!–his own son!!!!!!?

  48. MarkedMan says:

    @teve tory: For the past week or so OTB has also been awful on iOS devices. It loads on my Mac Safari browser, but 60-70% of the time on my iPhone or iPad I get a popup add that can’t be dismissed and need to close the tab. This applies even if I try in private mode, so it isn’t cookies or anything like that.

  49. de stijl says:


    No probs this week with Android.

  50. Just 'nutha ig'nint cracker says:

    @de stijl: “… being ill while you’re poor is some moral failure.”
    Wait, you’re implying that poverty isn’t some sort of moral failure; what kind of weak willed Arminianist are you? Everyone knows that the poor are cursed of God for their moral failures.

  51. OzarkHillbilly says:

    @Mister Bluster: I blame Obama.

  52. HarvardLaw92 says:


    I’m usually loathe to sidestep ads on sites I like which are supported by advertising, but I agree that it has gotten completely out of control here.

    Get the AdBlock browser for iOS. For me, it has done a pretty decent job of just shutting the ads down completely.

  53. HarvardLaw92 says:


    Get the A D B L O C K browser for iOS.

  54. DrDaveT says:

    @de stijl:

    Throw back an ouzo (hate the stuff myself) or some rot-gut greek-style wine.

    Surprisingly, they’re making some world class white wines on Santorini now. Look around.

    Even more surprisingly, Turkey is making plausible red wines. My personal favorites are from Turasan Winery, made from indigenous varieties BOĞAZKERE and ÖKÜZGÖZÜ. (Sorry about the caps; the lower-case didn’t have the accent marks. Pronounced bo-AHZ-ka-ray and oh-KOOZ-go-zoo.)

    Local Cypriot wine… maybe not.

  55. de stijl says:

    @Just ‘nutha ig’nint cracker:

    Had to look up Arminius.

    I think it boils down to more Calvinist than Calvin. That’s based on exactly two minutes of scanning the Wiki article.

    (I used to work with a guy who went to Wheaton and at the time I didn’t know Wheaton was like the Calvinist college. I actually remember when he told me because he had a look like I should paying attention to that. I saw the look, I just didn’t get what it meant.

    He was a good cat. Great, in fact. I didn’t understand at the time, but I probably introduced he and his wife to more blasphemous thought than they’d ever been previously exposed to.)

    I apologize to L&N for exposing you to ideas that straight people can be gay friendly and that atheists don’t necessarily hate Christians. Candian soorry.

  56. de stijl says:

    @Just ‘nutha ig’nint cracker:

    Fave pull-quote from the Arminianism – Calvinist wiki article:

    “The debate centers around soteriology, or the study of salvation, and includes disputes about total depavity, predestination, and atomement.”

    Total depravity? This I have to look up.

  57. de stijl says:

    @de stijl:

    s/b Canadian soorry, not “Candian” soorry. GD phone.

  58. MarkedMan says:


    Get the A D B L O C K browser

    Read more:

    I’ve considered it, but this is literally the only site I go to that has the problem. And I understand that almost of the sites I go to are funded by advertising, so I would prefer an ad-blocker that has a “reverse white list” i.e., one that allows ads on all but specified sites. As far as I know, that doesn’t exist.

    What the heck. People probably prefer me not posting on iOS. My grammar and spelling are bad enough…

  59. Just 'nutha ig'nint cracker says:

    @de stijl: Among the Baptists with whom I grew up, we used the term “absolute” instead. Think Trump and you’ll be close to the idea (which is what gobsmacks me about the statement “over 65% of white Evangelical Christians approve of agenda of the Trump Administration”).

  60. de stijl says:

    @Just ‘nutha ig’nint cracker:

    1. I ‘m a bad choice to talk about theology. To me, it’s like arguing about Pokeman – which monster will beat what monster?

    Only the people talking about Pokemon usually know they’re talking about a made-up thing.

    2. I used to have an obscure joke about anabaptists. Too clever, if you know what I mean. Also too 2005.

    What is the difference between a Baptist and an anabaptist? Anabaptists are skinnier.

    (Ana used to be code for pro-anorexia sites on 10 years ago internet. Yeah, that was a thing. Prolly still is.)

  61. de stijl says:

    Does “total depravity” basically boil down to that you cannot be saved except for the grace of God because of The Fall?

    I thought the bedrock of Protestantism is that we do not need intermediaries (priests) and that we alone are the interlocutors between God and man.

    And that salvation derived from contrition and the stated desire to be saved.

    That seems unreconcilable.

    This is one of reasons I gave up on this stuff. Soteriology is wicked confusing.

  62. DrDaveT says:

    @de stijl:

    I thought the bedrock of Protestantism is that we do not need intermediaries (priests) and that we alone are the interlocutors between God and man.

    That part’s right…

    And that salvation derived from contrition and the stated desire to be saved.

    …but that part’s not. Protestants generally hold that salvation is an act of unmerited grace on God’s part. Some Protestants (e.g. Calvinists) believe that the individual has no say at all in whether or not they are saved, and others (e.g. most flavors of Baptist) believe that the offer is open to all, but that individuals can reject salvation — decline the gift — or accept it, but that nothing else matters. They particularly reject the Catholic idea that there is something an individual can do — such as be repentant, or confess sins — that somehow earns salvation.

  63. Mister Bluster says:

    — such as be repentant, or confess sins —
    …or buy indulgences:

    As soon as the gold in the casket rings; the rescued soul to heaven springs.
    Johann Tetzel

  64. de stijl says:


    I was raised in what was then ELCA Lutheran and went to confirmation / catechism classes. (It didn’t stick.) But I would have remembered this because even at 11 – 12 I was already saving up the B.S. stuff. And I was a good student.

    The conditions for salvation, if mentioned at all, were elided. Perhaps more subtly than my 11 yo brain could grok.

  65. Joe says:

    Watching the press and reviews roll in on the current Senate bill (that’s what this string is about, right?), I think that if the Republicans can find 50 votes in favor, those may be the only 51 (Pence) people in America who think this is a good idea.

  66. HarvardLaw92 says:


    Never interrupt your enemy when he’s shooting himself in the face

  67. OzarkHillbilly says:

    @de stijl:

    Total depravity? This I have to look up.

    Don’t bother. It’s just a picture of me.

  68. OzarkHillbilly says:

    @Joe: You are forgetting the .01%

  69. teve tory says:

    Hospitals are against this bill. Doctors are against it. Insurance companies just came out against it. Red-state governors are against it. It has like a 17% approval rating. It’ll kick 20 million people off their health care. People will die.

    But it’s about to pass the senate.

    The republican party–you will never find a more wretched hive of scum and villainy.

  70. Just 'nutha ig'nint cracker says:

    @de stijl: Absolute Depravity would be the disease and Grace is the cure. Protestantism’s (at large) problem was that by the time of the Reformation, Roman Catholicism was teaching that ONLY priests could transact an individual’s business with God. The “heretics” believed that individuals could confess their own sins, receive Grace on the basis of their own faith, and whatever else might go into the whole business. Martin Luther’s principle gripe seemed to be that the Church had established an interesting and lucrative franchise operation in agents who sold “indulgences”–blanket forgiveness of all sins past and present–think Nixon Pardon.

    You’re right, for people who aren’t interested in believing, it gets arcane fast. Personally, I think Scientology is much cleaner and easier to believe, but I can’t do “thetans,” and as Evangelicalism warps classical Christian doctrine, I’m having more problems identifying with what Americans understand to be “Christianity,” too.

  71. Tyrell says:

    I have offered some of my ideas on here about improving the health insurance and health care problems. One is to offer more choices, options, and flexibility to meet differing needs, situations, and preferences. We need to make health insurance exciting ! More of the young, healthy people would then sign up.
    One plan will not fit all.
    I am working on more ideas and proposals.
    “We build excitement” Pontiac
    “Fixing the Three Biggest Flaws In Obamacare’s Medicaid Expansion” ( Forbes)
    “Three Ways To Fix ObamaCare” The New Yorker

  72. Mister Bluster says:

    @Tyrell:..forward your ideas to