What happens first? Obamacare Repeal or Obamacare Implosion?
About a month ago I explained that "we must unite to defend health insurance legislation that is “the craziest thing in the world”, and that sometimes "catches fire", that its premiums rise more than 20 percent on average every year, that is in a "death spiral", and that is vanishing in large parts of America."
Since then Obamacare insurers packed up and left Iowa.
And western Missouri.
And now maybe Nebraska.
Medica Health, Nebraska’s last remaining Obamacare compliant individual insurance provider, has not yet decided whether it will continue to offer plans next year, according to the Omaha World Herald.
Should Medica join the ranks of providers that have left the state’s Obamacare exchanges, some 100,000 Nebraskans will be left without an option for Obamacare insurance.
At last count, only four of the original 24 Obamacare co-ops remain.
Even if you are one of the lucky ones with a stable Obamacare system, the rate hikes will be pretty steep this year again.
This doesn't mean that Obamacare can't limp along for a many years before simply petering out. In fact that appears to be its destiny.
Unless the GOP repeal it.
Senate Republicans remain publicly pessimistic about their prospects of repealing and replacing Obamacare this year with several raising concerns this week about the party’s central campaign promise even as one of their leaders vowed to pass such a bill this summer.
Sen. Richard Burr (R-N.C.) made the most direct prediction on Thursday, telling a news station in his home state that “I don’t see a comprehensive health care plan this year.”
So the danger of a GOP repeal isn't very high in the short-term, but that doesn't mean there isn't any danger to Obamacare from the GOP, such as longer enforcing the individual mandate.
I've been warning for months now that the Trump administration is doing everything possible to disrupt, undermine and otherwise sabotage the ACA exchanges as much as possible. Yes, the GOP in general has been doing so for 7 years now, but they've really shifted it into overdrive now that they hold all the cards.
Now the good news
There is a possible silver lining in Obamacare's demise - Medicare for all.
In addition to a new poll showing it would be extraordinarily popular, California's single-payer bill—the Healthy California Act—would also cut costs while providing coverage for all.
That is the conclusion of a new analysis (PDF) published on Wednesday by the Political Economy Research Institute (PERI).
"We estimate that, through implementation of Healthy California, overall costs of providing full health care coverage to all Californians could fall by about 18 percent relative to spending levels under the existing system," the authors of the report note.
The California bill passed the Senate and now goes to the Assembly.
New York may be on the verge of passing universal health care as well.
If NY and CA pass Medicare for all, then Obamacare will essentially be replaced in two states where it was most successful.
It would seal the fate of Obamacare, but also pave the road to a better system.
I find it deliciously ironic that it could be progressives, not Republicans, that would deliver the coup de grâce to Obama's Legacy.
Meanwhile, Medicare for all bill has 112 cosponsors in the House.

Comments
CA and NY
I thought I read that NY passed single payer too. When I worked with government, I always used to tell my staff. If it makes sense, it must be wrong. Double check it.
"Religion is what keeps the poor from murdering the rich."--Napoleon
It's passed one house of their legislature
in both states.
At least that's what I read. It might have been dated.
NY hasn't passed it yet
I'm not keeping my fingers crossed that this will happen all things considered.
"You can't just leave those who created the problem in charge of the solution."---Tyree Scott
Always remember
One of the biggest reasons to not have elected Hillary: She would have repealed the Sanders Amendment and increased the subsidies to the insurance companies to save the ACA. (according to Tim Kaine, who presented it as his idea)
On to Biden since 1973
Jeesh!
Can you imagine just how hated Hillary would be right now if she had won?
And how much worse TOP would be?
Impossible! TOP couldn't be worse.
I've seen lots of changes. What doesn't change is people. Same old hairless apes.
Oh yes it can!
Oh yes it can!
Please mind: I've said what you said, many times.
Only to be proven wrong time and again.
The folks over at TOP seem to have a limitless capacity for pissing all over what they once had. They are complete experts in casting pearls before swine and turning silk purses into sows' ears.
"US govt/military = bad. Russian govt/military = bad. Any politician wanting power = bad. Anyone wielding power = bad." --Shahryar
"All power corrupts absolutely!" -- thanatokephaloides
TOP would be worse in two ways
1. They would be on a crusade against misogyny, because that's the only reason not to love Hillary, especially against Bernie supporters and progressives in general.
2. They would be smug, which is one of the few things they aren't now.
They're on #1 today,
It's fun at times, in an unhealthy sort of way, but quickly gets boring. The rec list is usually content free. The obscure diaries are still the best.
"Obama promised transparency, but Assange is the one who brought it."
Medicare for all.
I love it. But beware the "cosponsors" bullshit. Those assholes vote for shit when it can't pass so they can get progressive donations, volunteers, and dollars. When they are in a position to do something, they "evolve."
Shush gjohnsit.
Don't you know this was all planned by Obama and is part of his 12th dimensional chess strategy to bring us universal health care?
I fully expect the ACA exchanges to collapse
due to Rep neglect and sabotage. The question is, what happens next? I expect the GOP to allow low or no regulation insurance plans, which would be a similar industry to the fake diploma mill "colleges" that are so prevalent today.
People would soon learn, however, that their new $300 a month "policy" only covers Beri-beri, and then only if it's diagnosed on a Tuesday in Burkina Faso. Hospitals would shut down, doctors and nurses would quit or be laid off, and healthcare wouldn't happen. Then, we might finally be ripe for single-payer, that would be an FDR moment.
Someone once said something to the effect that the loss of civilization is only about 5 or 6 meals away. Take away healthcare, and you'll find a similar result.
"Obama promised transparency, but Assange is the one who brought it."
Maybe, just maybe, this is almost like a purgative:
our culture needed to experiment with this horrible gift to the Medical/pHarma/Insurance Complex, to it's bitter end, to finally realize we have several alternative options which are homegrown, work and so much better.
First is of course MediCare for Everyone; the VA comes to mind and a few others. But we don't have to rely on those "socialist" European models as we have a few of our own.
Just speculating out loud here.
You may choose to look the other way, but you can never say again you did not know. ~ William Wiberforce
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