Politics Obamacare

All well and good. I would have preferred (and still hold out hope for) a single payer system, but the truth is, it would never have passed through either House of Congress. ACA was drafted by a bi-partisan committee who were never even considering working on a single payer plan. And I agree that ACA does not appear to adequately address the issue of lowering the cost of of healthcare, focusing largely on spreading the cost of insurance premiums over a wider base, expanding Medicaid and eliminating Medicare fraud and waste, but, warts and all, it at least addresses the problem of increasing insured access to healthcare. Perhaps the rest can be worked on slowly, if Republicans ever start cooperating.

The majority of lies about ACA have come from the Right. Outrageous to the point of absurdity. What ACA is and isn't, what it does and doesn't do - is quite transparent and has been from the beginning for those interested enough to find out about it. Those who kept their heads in the sand are naturally surprised as each new wrinkle is discovered. Some pleasantly so.

It's not perfect and it's certainly not what Liberals and Democrats wanted but it's a step in the journey away from a system that was untenable.

 

Not quite, Ace.

Obama delayed implementation of one (or more) provisions of the law....in the same manner that many past presidents, both Democrat and Republican, have done in the past when more time was needed to finalize regulations.

Congress creates the laws, the Executive Branch implements the laws and delaying a provision(s) does not materially change the law is common as long as the delay is not unreasonable (ie Bush delaying Clean Air Act implementation indefinitely.)"Faithfully executing the laws.." has always provided presidents with some level of discretion and judgement.

 

My understanding of the out-of-pocket costs are $6,350 for individual and $12,700 for family plan where in the past there generally was no maximum. Which is why 2 million people/families a year faced personal bankruptcy as a result of a significant medical emergency.

Considering the cost of major (or even minor) surgery resulting from an unanticipated accident or health issue, I would pay the price, knowing that for the first time, out-of-pocket costs are limited (albeit high for many families) rather than face bankruptcy.

 

Defeatist attitude. We already have Medicare/Medicaid. We have a convoluted SCHIP program for low income children. If we take the step of unconditionally insuring all children..then we have all elderly, all children and many impoverished people covered. We could put that under one umbrella - and then address the rest. It could be done. Imagine if Obama as a Senator had the attitude the Cruz has as a Senator! some people have conviction and some don't. some will act on their convictions and take the heat others will avoid it.
--- merged: Oct 16, 2013 at 3:23 PM ---

Is your issue with the use of the word "material"? If not material changes what word would you use, "minor"? is that really the basis of our disagreement on this point?

 

A bit more expensive than I thought it would be. Is there any chance of the premiums coming down once everyone has signed up or are those out-of-pocket calculations already based on the projected number of people they expect to sign up?

Conversely, could they go higher if a substantial number of people choose to opt out and take the tax hit?

 

Are you suggesting that 2 million people/families every year reached annual and or lifetime caps on their insurance plans?
Are you saying that providers of medical services would not reduce fees and costs under these circumstances?
Are you saying there were no alternatives for these people/families other than bankruptcy?

I doubt you mean to saying the above even if you are implying it - perhaps just a bit of an exaggeration. Many people have a number of reasons for declaring bankruptcy which may include unexpected medical expenses along with other reasons.

 

Defeatist or Realist? Ace, it didn't have the votes to pass this time around. Why Obama snubbed single-payer - Salon.com

Universal health care for Americans is inevitable. It's just not time yet.

And Cruz, for all his "attitude" is not going to come out on top of this - due to, lo and behold, Obama's conviction that stepping backwards is not an option.

 

Medical debt is the number one cause of personal bankruptcy in the US.

 

The last data I saw put it at 2+ million families, many of whom had health insurance, but either had no annual out-of-pocket limit (about 15% of employer based plans) or had the insurance rescinded when they became seriously ill (now illegal for insurance companies to recind policies) or had no insurance....by far the leading cause of personal bankruptcy.

An earlier study (2007):

--- merged: Oct 16, 2013 at 3:47 PM ---
The study released [pdf] by the American Journal of Medicine.

 

If you were still single and had no insurance bought the cheapest non-catastrophic plan on the Insurance Exchange, your out of pocket would have dropped from $10,000 to $6,350.

My employer plan is similar to yours, although I didnt have many plans (3) from which to choose -- one of which had no out of pocket limits. Somewhere around 10-15% of employers only offer plans with no out of pocket limits.

That will change now.

 

It still appears to top the list in 2013.

NerdWallet Health finds Medical Bankruptcy accounts for majority of personal bankruptcies | Health

Biggest cause of personal bankruptcy: Medical bills - TODAY.com

 

The above is a talking point, intended to mislead. It is not your fault that much of the information that is reported is never questioned.

Clarifying the Research on Medical Bankruptcy - Economics - AEI
--- merged: Oct 16, 2013 at 6:46 PM ---
I predict more people will end up being insured or end up with less coverage under Obamacare than prior to Obamacare.

The games have already begun with "Skinny Plans" -

Obamacare penalties spawn 'skinny' plans - Brett Norman - POLITICO.com

We will see more and more companies offer these "skinny plans" in place of regular plans and to avoid penalties. In addition a young healthy person may be better off with a "skinny plan" than an exchange plan. Assume a 25 healthy individual, facing a premium of $3,000 per year with co-pays and deductibles compared to a "skinny plan", compared to paying a penalty. Doing the numbers a young healthy person would be better off with no coverage and pay the fine. With an exchange policy or a "skinny plan" out of pocket costs will be very high before coverage, for healthy individuals odds are that they won't hit these levels. Treating a broken arm in the emergency room is a risk many will be willing to take without insurance.. ​

 

Here is a checklist of what employers who offer group plans will be required to provide under the law, in terms of both coverage and affordability:


Large Employer Affordable Care Act Compliance Checklist | Regence


The employer mandate was delayed for one year to give employers more time to come into compliance. A study by the Rand Corp matches (or projects lower adverse impact) than a CBO study.