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The Affordable Care Act II - Because Mr. Obama Loves You All


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This is DOA, and is nearly as ill-conceived as what it's replacing anyway. This should be scrapped, and a largely market based solution should be implemented.

 

Given the Democrats won't play ball, the talking point of Republicans should be a non-stop "We aren't willing to circumvent Constitutional processes like the Democrats did to foist the ACA on you. Here is our plan:" and lay out a plan and how it works.

 

Then stump with "replace Senate Democrats who are blocking your access to healthcare." while the ACA crumbles around them.

 

Keep the ACA as an issue until the mid-terms, and solve the problem with a true libertarian/conservative solution in 2 years with a super majority in the Senate.

 

This.

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a largely market based solution should be implemented.

 

 

thats a capitalistic delusion

 

that model has been tried more than all others combined, almost exclusively in fact, and with all kinds of iterations

 

our experience tells us insurance companies will find new and innovative ways to collude every time. and each time it centers on excluding care for the sick and poor and focusing only on their sweet spot of profit

 

what else would you expect?

 

we need to abandon the fantasy that we can let medical care industries regulate themselves through profit. that has been clearly established

 

when it comes to hc the only viable long term solution is socialist, not capitalist. i realize the righties will despise that. deal wid it

Edited by Meathead
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Obama got his ducks in a line and passed a bill that has benefited tens of millions of Americans.

 

That's all

 

not really

 

the aca as it ended up was better than what we had, which was yet another system that had ended up zeroing in on the well employed and healthy at the expense of the huge lower income group. but it was irreparably damaged due to intentional sabotage from the right simply bc it wasnt theirs. morally disgusting but true

 

now is their chance to put their own stamp on it. again, its revolting that our elected officials play football with our health and lives like this, but hopefully one of these times they will knock it the fk off and actually do what they should and work together hahahahhaaaa hey it could happen

 

the acas biggest flaw imo is unusability by lower middle class folks caught with too much income for enough subsidies and coverage that requires them to pay large premiums or large deductables before they get vital diagnostics and treatments. ive lost count of the ppl i know who have coverage but cant get a colonoscopy or something similar bc it would coast them three or four grand they dont have

 

what we need is to continue on the general path that the aca started and fix the things that werent working. i believe thats by essentially putting everybody in medicare basic and the insurance companies selling rider policies on top of that. insurance industry would shrink by at least half, but so what

 

i do personally think health care should be a right at this point in time. and frankly, with all the super abundance we have on hc resources, shame on anybody who thinks otherwise. its embarrassing how we allow ppl to shrivel and die from stuff that absolutely should not kill them simply bc we are afraid of freeloaders

 

but whatever system becomes the next cycle has to continue to push the ball forward. so far this one doesnt look as bad as i expected, but it still needs a lot of work. taking out coverage for routine visits, exams, and procedures is a huge mistake imo that i hope they address

Edited by Meathead
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not really

 

the aca as it ended up was better than what we had, which was yet another system that had ended up zeroing in on the well employed and healthy at the expense of the huge lower income group. but it was irreparably damaged due to intentional sabotage from the right simply bc it wasnt theirs. morally disgusting but true

 

now is their chance to put their own stamp on it. again, its revolting that our elected officials play football with our health and lives like this, but hopefully one of these times they will knock it the fk off and actually do what they should and work together hahahahhaaaa hey it could happen

 

the acas biggest flaw imo is unusability by lower middle class folks caught with too much income for enough subsidies and coverage that requires them to pay large premiums or large deductables before they get vital diagnostics and treatments. ive lost count of the ppl i know who have coverage but cant get a colonoscopy or something similar bc it would coast them three or four grand they dont have

 

what we need is to continue on the general path that the aca started and fix the things that werent working. i believe thats by essentially putting everybody in medicare basic and the insurance companies selling rider policies on top of that. insurance industry would shrink by at least half, but so what

 

i do personally think health care should be a right at this point in time. and frankly, with all the super abundance we have on hc resources, shame on anybody who thinks otherwise. its embarrassing how we allow ppl to shrivel and die from stuff that absolutely should not kill them simply bc we are afraid of freeloaders

 

but whatever system becomes the next cycle has to continue to push the ball forward. so far this one doesnt look as bad as i expected, but it still needs a lot of work. taking out coverage for routine visits, exams, and procedures is a huge mistake imo that i hope they address

I mostly agree with all of this

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thats a capitalistic delusion

 

that model has been tried more than all others combined, almost exclusively in fact, and with all kinds of iterations

 

our experience tells us insurance companies will find new and innovative ways to collude every time. and each time it centers on excluding care for the sick and poor and focusing only on their sweet spot of profit

 

what else would you expect?

 

we need to abandon the fantasy that we can let medical care industries regulate themselves through profit. that has been clearly established

 

when it comes to hc the only viable long term solution is socialist, not capitalist. i realize the righties will despise that. deal wid it

Not true.

 

Both prior and since the ACA, the distribution of health insurance was restricted through state boundaries and by having coverage choices made by employers based on the regulations of the state. It's a monopolistic market. Currently the fed government strictly dictates coverage, employers give their employees a few choices within narrow guidelines and a handful of carriers set rates in lockstep with each other. It is the fedex / ups model. It guarantees increases every year given the high barrier to entry for new competitors and regulations.

 

If I want to buy insurance that waives maternity care, mental health care, drug addiction care, bone replacement coverage - I can't do it.

 

If I want to pay out of pocket for a service and get a rate comparable to what insurance pays, I can't do it. Hell you can't even get pricing for services in advance.

 

If I want to buy insurance other than what my employer offers, I can but again it's limited to the same regulated coverages.

 

If I want to buy insurance from nearby Indiana, I can't.

 

If I want to get a larger deductible when my HSA account balance grows, I am limited again.usually due to employer choices.

 

If I want to negotiate a better rate because I have better than average health and practice a healthy lifestyle I can't.

 

Get rid of all of the rules and allow new products to come into the market, that will help some.

 

Additionally as a society we have to practice healthier habits and consume less health care and fewer prescription drugs, especially among the elderly.

Edited by keepthefaith
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Not true.

 

Both prior and since the ACA, the distribution of health insurance was restricted through state boundaries and by having coverage choices made by employers based on the regulations of the state. It's a monopolistic market. Currently the fed government strictly dictates coverage, employers give their employees a few choices within narrow guidelines and a handful of carriers set rates in lockstep with each other. It is the fedex / ups model. It guarantees increases every year given the high barrier to entry for new competitors and regulations.

 

If I want to buy insurance that waives maternity care, mental health care, drug addiction care, bone replacement coverage - I can't do it.

 

If I want to pay out of pocket for a service and get a rate comparable to what insurance pays, I can't do it. Hell you can't even get pricing for services in advance.

 

If I want to buy insurance other than what my employer offers, I can but again it's limited to the same regulated coverages.

 

If I want to buy insurance from nearby Indiana, I can't.

 

If I want to get a larger deductible when my HSA account balance grows, I am limited again.usually due to employer choices.

 

If I want to negotiate a better rate because I have better than average health and practice a healthy lifestyle I can't.

 

Get rid of all of the rules and allow new products to come into the market, that will help some.

 

Additionally as a society we have to practice healthier habits and consume less health care and fewer prescription drugs, especially among the elderly.

 

If you want to stand for states' rights while buying insurance across state lines, you can't.

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Not true.

 

Both prior and since the ACA, the distribution of health insurance was restricted through state boundaries and by having coverage choices made by employers based on the regulations of the state. It's a monopolistic market. Currently the fed government strictly dictates coverage, employers give their employees a few choices within narrow guidelines and a handful of carriers set rates in lockstep with each other. It is the fedex / ups model. It guarantees increases every year given the high barrier to entry for new competitors and regulations.

 

If I want to buy insurance that waives maternity care, mental health care, drug addiction care, bone replacement coverage - I can't do it.

 

If I want to pay out of pocket for a service and get a rate comparable to what insurance pays, I can't do it. Hell you can't even get pricing for services in advance.

 

If I want to buy insurance other than what my employer offers, I can but again it's limited to the same regulated coverages.

 

If I want to buy insurance from nearby Indiana, I can't.

 

If I want to get a larger deductible when my HSA account balance grows, I am limited again.usually due to employer choices.

 

If I want to negotiate a better rate because I have better than average health and practice a healthy lifestyle I can't.

 

Get rid of all of the rules and allow new products to come into the market, that will help some.

 

Additionally as a society we have to practice healthier habits and consume less health care and fewer prescription drugs, especially among the elderly.

 

What exactly are "healthier habits", and who decides the sweet spot for resources/ pharmaceuticals the elderly use? The irony, the original PPACA bill passage include doctor/ patient compensated planning time for seniors, and we got the term coined "Death Panels"...

 

Panels are vogue now?

If you want to stand for states' rights while buying insurance across state lines, you can't.

The Across State Lines notion creates quite the quandary for States Rights conservatives... if anything I'd expect the Ryan plan to Block Grant Federal money to each State and defer to them to create their own coverages systems, or, leave it to States to collect taxes from citizens to fund Heathcare initiatives and create incentives to do so. Edited by B-Large
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If you want to stand for states' rights while buying insurance across state lines, you can't.

I suppose but if for example states in close geographic proximity wanted to pass reciprocal agreements so that people had more insurer choices they are free to do that. It's done with in-state college tuition, why not health insurance?

What exactly are "healthier habits", and who decides the sweet spot for resources/ pharmaceuticals the elderly use? The irony, the original PPACA bill passage include doctor/ patient compensated planning time for seniors, and we got the term coined "Death Panels"...

 

Panels are vogue now?

The Across State Lines notion creates quite the quandary for States Rights conservatives... if anything I'd expect the Ryan plan to Block Grant Federal money to each State and defer to them to create their own coverages systems, or, leave it to States to collect taxes from citizens to fund Heathcare initiatives and create incentives to do so.

 

At a very basic level there are a set of blood test scores, weight, smoker/non smoker designations that could be used and medical professionals can probably come up with an expanded set of criteria. As it stands today life insurance and long term care insurance policies and rates are often scored based on health status. If there were incentives for lower health insurance rates, some portion of the population would likely improve their health to earn the discount.

 

Taking prescriptions is often a choice. I know so many people who are over-medicated, some of which have been wise enough to look for other remedies that can help them get off meds. One example diabetics that take the hard road to lose weight and improve their diets and health and can then get off or almost completely get off insulin.

Edited by keepthefaith
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If you want to stand for states' rights while buying insurance across state lines, you can't.

 

States rights do not include setting up trade barriers with other states if you subscribe to the original meaning of the Commerce clause.

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Good read.

 

I agree that the other two "phases" will probably make it even better to those who were repelled by all the Government mandates (taxes?) :lol:

 

Mark Sanford favorably citing Spicer's reference to bill as "work in progress" and says it is "an opening bid" for conservatives to counter

 

 

 

 

It's a lot more complex than what most people know. In order to understand on what is able to get through and passed you have to understand how the reconciliation process works. Even some of the more thoughtful posters on this board weren't really aware of the mechanics and limitations of budget reconciliation.

 

You can repeal and replace portions of the law but much of the core tenets that most Americans and it appears what Trump wants as well want for their healthcare you have to accomplish legislatively. So if you are a realist, you understand that in order to do that you have to get 60 votes and the more you pull away from covering those with pre ex and not assisting folks from getting coverage the less overall votes you will be able to garner. I saw TYTT advise that Republicans should wait until the midterms and hope to get a super majority. They have 51 right now, and typically the party in power does worse in the midterms.

 

 

1982 spacer.gifRonald Reagan R 41 42 nd 42 nd 42 -26 +1

1986 LD Ronald Reagan R nd 64 nd 63 64 nd -5 -8

1990 spacer.gifGeorge Bush R 75 73 54 nd nd 57 -8 -1

1994 spacer.gifWilliam J. Clinton D 43 40 40 44 43 48 -52 -8

1998 LD William J. Clinton D 65 62 63 66 65 65 +5 0

2002 spacer.gifGeorge W. Bush R nd 66 66 66 68 67 +8 +2

2006 LD George W. Bush R 37 42 39 44 37 37 -30 -6

2010 spacer.gifBarack Obama D 44 44 45 45 45 45 -63 -6

2014 Barack Obama D 42 42 41 43 42 41 -13 -9

 

 

If you look here which thats where I got the chart from up above. The number on the far right is how many Senate seats that were produced either a net gain or loss for the party in power.

 

The best year for Senate seat pickups was George Bush in 2002 with a plus 2. The Senate map is favorable for Repubs, but as deeply unpopular as Trump is and the historical fact that midterms usually aren't that good for the party in power and the anecdotal evidence that Dems are pretty fired up, I would say that is highly unlikely. Plus the base of the party wants a repeal and they wanted it yesterday. Personally I would have rather of seen them do tax reform first, but the president doesn't have that much political capital as it is. My guess is that they will try to take advantage of the majority that they have now and try to get through this healthcare reform first, tax reform and infrastructure and then hope they retain control in 2018 to get through a few other things.

 

When I speak to many of my friends from the left and right, I think they believe that only their constituency's views matter and the idea of compromise is a nonstarter. Whether you like it or not, this country is split pretty evenly down the middle. We saw what happened to Democrats when they jammed the law on a partisan basis. Look above at how many seats Obama cost his party. Healthcare was a big part of it, along with some of the paternalistic social views that they imposed on the country which didn't go over well with flyover country.

 

The lesson that the GOP I would hope should have learned is that when you are dealing with something so important, so impactful as healthcare, passing this on a purely partisan basis, not only is it not representative of what the country as close to a whole would want their elected leaders to do, but the political price is fraught with peril.

 

This is the bill that they released, my hope is that they will get the input of all their GOP members, which I'm predicting will move a little further to the right. Get enough votes to push to initially get it through and then once the negotiations begin with the left it will go further to the left than where it is right now.

 

I predict they will keep the tax credits but modify it. RIght now the income level to receive the tax credits is up to $75,000 per individual and $150,000 for a couple. And it doesn't cut off if you have income slightly above that, a portion of that phases out per $1,000 above that amount. My guess is that they will lower the threshold, probably closer to $60,000 per individual with the same gradual phasing out mechanism.

 

They will keep the pre ex subsidies and send these funds to the states so that they can distribute that to the carriers that participate in these programs.

 

They will attempt to add the competing across state lines, not to the bill because you can't with reconciliation.

 

Medicaid won't substantively change that much than what they have proposed now. All Democrats are adamantly opposed to this and I know of at least 4 Repubs in the Senate and some Republican governors who oppose changes that lessen coverage.

 

This isn't my dream bill, but it's much better and realistic than I thought they would have presented. My fear was that they were going to go more in the direction of what Rand would have wanted, which would have been cheered by some on the right but would have never have come close to becoming a reality. What would have happened is they would have repealed as much as they could have and then nothing would have gotten through the Senate and house and we would have basically gone back to what we had before the ACA but even worse because of the market disruptions it would have caused. Hopefully, the Freedom Caucus and Rand and co. take a constructive role and follow what Reagan's advice of

 

"My 80 percent friend is not my 20 percent enemy"

Edited by Magox
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I was fully against Obamacare (I shouldn't have to pay for insurance being in my early 30's) until I had a younger brother who out of the blue come down with Mitochondrial disorder that caused food to pass 4 times slower though the small intestine signaling to the brain that there was a blockage causing constant nausea and vomiting up food or stomach acid every day. The kicker is that the nausea signal is always there regardless if he eats. He was only 23 at the time (it hit him out of nowhere) so he could stay on his parents health insurance. He had just gotten his Masters degree in 2010, but obviously couldn't work as it hit him really fast and was able to stay on his parents until he was 26. Thanks to medicaid expansion through the ACA he qualified while trying to get disability (a long process for anybody who has been through it). He's been to Cleveland Clinic, Mayoclinic, and Temple University until he finally got a diagnosis that is impossible to cure at the moment. The only thing that keeps him going is anti nausea that he says takes his nausea level from a 9 to a 5. It still sucks but he's able to at least get out of bed. Now, if the GOP just went to the old way of insurance he'd be **** out of luck as they'd likely take him off medicaid and insurance companies wouldn't except him with his preexisting condition. He's lost all his top teeth due to throwing up stomach acid.

 

I feel horrible for him as he's at the point where a feeding tube may be necessary. He'll never be able to live a normal life all of us take for granted. He was terrified when Trump got elected, but was glad to see the bill proposed by the GOP yesterday as it will keep him on medicaid through 2020 and hopefully have disability by then. All I'm saying is you gain a new perspective when it happens to you or someone close to you. I really hope Rand Paul and the far right conservatives in the House and Senate (Ted Cruz's ilk) don't sway Trump into the disaster we had before Obamacare.

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Doc, if you were paying attention during the past twelve years at least, most Republicans were in favor of Health Care insurance reform which included providing services for people with preexisting conditions. It's not a Dem/Rep issue. It's not.

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I was fully against Obamacare (I shouldn't have to pay for insurance being in my early 30's) until I had a younger brother who out of the blue come down with Mitochondrial disorder that caused food to pass 4 times slower though the small intestine signaling to the brain that there was a blockage causing constant nausea and vomiting up food or stomach acid every day. The kicker is that the nausea signal is always there regardless if he eats. He was only 23 at the time (it hit him out of nowhere) so he could stay on his parents health insurance. He had just gotten his Masters degree in 2010, but obviously couldn't work as it hit him really fast and was able to stay on his parents until he was 26. Thanks to medicaid expansion through the ACA he qualified while trying to get disability (a long process for anybody who has been through it). He's been to Cleveland Clinic, Mayoclinic, and Temple University until he finally got a diagnosis that is impossible to cure at the moment. The only thing that keeps him going is anti nausea that he says takes his nausea level from a 9 to a 5. It still sucks but he's able to at least get out of bed. Now, if the GOP just went to the old way of insurance he'd be **** out of luck as they'd likely take him off medicaid and insurance companies wouldn't except him with his preexisting condition. He's lost all his top teeth due to throwing up stomach acid.

 

I feel horrible for him as he's at the point where a feeding tube may be necessary. He'll never be able to live a normal life all of us take for granted. He was terrified when Trump got elected, but was glad to see the bill proposed by the GOP yesterday as it will keep him on medicaid through 2020 and hopefully have disability by then. All I'm saying is you gain a new perspective when it happens to you or someone close to you. I really hope Rand Paul and the far right conservatives in the House and Senate (Ted Cruz's ilk) don't sway Trump into the disaster we had before Obamacare.

Sorry to hear about your brother. Great example of how Obamacare has actually helped real people.

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I was fully against Obamacare (I shouldn't have to pay for insurance being in my early 30's) until I had a younger brother who out of the blue come down with Mitochondrial disorder that caused food to pass 4 times slower though the small intestine signaling to the brain that there was a blockage causing constant nausea and vomiting up food or stomach acid every day. The kicker is that the nausea signal is always there regardless if he eats. He was only 23 at the time (it hit him out of nowhere) so he could stay on his parents health insurance. He had just gotten his Masters degree in 2010, but obviously couldn't work as it hit him really fast and was able to stay on his parents until he was 26. Thanks to medicaid expansion through the ACA he qualified while trying to get disability (a long process for anybody who has been through it). He's been to Cleveland Clinic, Mayoclinic, and Temple University until he finally got a diagnosis that is impossible to cure at the moment. The only thing that keeps him going is anti nausea that he says takes his nausea level from a 9 to a 5. It still sucks but he's able to at least get out of bed. Now, if the GOP just went to the old way of insurance he'd be **** out of luck as they'd likely take him off medicaid and insurance companies wouldn't except him with his preexisting condition. He's lost all his top teeth due to throwing up stomach acid.

 

I feel horrible for him as he's at the point where a feeding tube may be necessary. He'll never be able to live a normal life all of us take for granted. He was terrified when Trump got elected, but was glad to see the bill proposed by the GOP yesterday as it will keep him on medicaid through 2020 and hopefully have disability by then. All I'm saying is you gain a new perspective when it happens to you or someone close to you. I really hope Rand Paul and the far right conservatives in the House and Senate (Ted Cruz's ilk) don't sway Trump into the disaster we had before Obamacare.

 

the plan before the aca and this one currently being promoted by republicans would doom your brother and many thousands of other families to watching a horrible misery filled deterioration straight to death

 

thats not hyperbole, thats not political spin, that is cold hard reality

 

but for most ppl it never hits home until its them. its thoroughly disgusting but thats what it is

 

american health care needs to cover everybody and needs everybody paying into the well. its pretty sick that we can require everyone to get auto insurance but we dont require everyone to get health insurance

Not true.

 

Both prior and since the ACA, the distribution of health insurance was restricted through state boundaries and by having coverage choices made by employers based on the regulations of the state. It's a monopolistic market. Currently the fed government strictly dictates coverage, employers give their employees a few choices within narrow guidelines and a handful of carriers set rates in lockstep with each other. It is the fedex / ups model. It guarantees increases every year given the high barrier to entry for new competitors and regulations.

 

If I want to buy insurance that waives maternity care, mental health care, drug addiction care, bone replacement coverage - I can't do it.

 

If I want to pay out of pocket for a service and get a rate comparable to what insurance pays, I can't do it. Hell you can't even get pricing for services in advance.

 

If I want to buy insurance other than what my employer offers, I can but again it's limited to the same regulated coverages.

 

If I want to buy insurance from nearby Indiana, I can't.

 

If I want to get a larger deductible when my HSA account balance grows, I am limited again.usually due to employer choices.

 

If I want to negotiate a better rate because I have better than average health and practice a healthy lifestyle I can't.

 

Get rid of all of the rules and allow new products to come into the market, that will help some.

 

Additionally as a society we have to practice healthier habits and consume less health care and fewer prescription drugs, especially among the elderly.

 

you refuted my point that market driven health insurance is a capitalistic delusion by posting more capitalistic delusions

 

you shouldnt be able to negotiate a cheaper rate bc you are more healthy now. things can change in an instant. do you pay triple tomorrow bc the doctor found a genetic abnormality making you now unable to absorb calcium? do you pay triple now bc your condition makes your bones brittle and suddenly you need that bone replacement coverage?

 

again, the incentives of pure capitalism will always result in insurance companies finding their sweet spot that allows them to charge as much as they can to cover the healthiest ppl. we can never let the market alone decide those issues

 

the solution always comes back to the same thing for a reason: everybody is covered and everybody pays

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the plan before the aca and this one currently being promoted by republicans would doom your brother and many thousands of other families to watching a horrible misery filled deterioration straight to death

 

thats not hyperbole, thats not political spin, that is cold hard reality

 

 

 

 

Sorry sir, that is an amazing display of hyperbole ................and blindness

 

I have been on every side of the coin of healthcare over 4 decades, providers and insurance

 

and your dismissal of healthcare realities before ACA and of the Republican (initial) plan is simplistic propaganda.

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Sorry sir, that is an amazing display of hyperbole ................and blindness

 

I have been on every side of the coin of healthcare over 4 decades, providers and insurance

 

and your dismissal of healthcare realities before ACA and of the Republican (initial) plan is simplistic propaganda.

Actually he is 100% right and you are a brain washed, propaganda spewing idiot who couldn't tell the truth from a lie if you were paid by the RNC to do so

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Actually he is 100% right and you are a brain washed, propaganda spewing idiot who couldn't tell the truth from a lie if you were paid by the RNC to do so

[This is an automated response.]

 

This ridiculous verbiage is brought to you by...

 

Created by DC Tom-bot, beta version 0.7.

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