Politics Obamacare

Connecting the dots. What we have are various requirements for plans available to people, in this case based on employer size. Why would they do this? A convoluted mess. Given potential penalties or fines, the various requirements, many in business will seek the minimum standard at the lowest cost. Admit that it is a problem, others have. Perhaps a fix is needed.

Another enormous ObamaCare ‘Oops’ | New York Post

 

I dont see the "skinny" health plans or "mini-meds" as a temporary option for employers (not to replace existing employer plans) for a year as a major "oops' if it gives more employers the additional time needed to comply with the affordability mandate starting in 2015.

And as numerous objective, nonpartisan studies suggest, the impact is likely to be small and the longer term likelihood that employers will reduce plan benefits and pay a penalty or drop coverage completely are very low...despite the "anecdotal" evidence of a doomsday scenario painted by the opposition.

 

Doomsday is not an adjective I would use. All these small impact items do eventually add up.

If one intent of Obamacare was to address affordable healthcare to those without insurance coverage, there are provisions that are in conflict with that intent. An employer (100+) not currently offering a plan to employees would have the options to face a fine/tax, a skinny plan, or a comprehensive plan - given that they are not offering a plan to begin with, which option will they pick. Lowest cost option. Now employees are faced with the option of a fine/tax, what their employer may or may not offer, or the exchange option. If the employer is offering a plan that meets the requirements, the employee will not qualify for a subsidy. Not to mention if the employer plan is only available to the employee and not the employee's family and how the family will be handled. The intent of the employer fine/tax is cover some of the costs of employees going into the exchange and receiving a subsidy. Which then will create a conflict when some claim a subsidy when they are not entitled to it and then the employer may be subject to a fine/tax or provide a response that the employee was not eligible for the exchange subsidy.....and so it goes. A mess! And we have some plans grandfathered, we have some employers exempted, we have some seasonal employers, we have employees who work for more than one employer, employees with large variances in hours and income, etc. etc We have the law as it is written, we have rules and regulations, we have interpretations, we will have court rulings etc. And today most people can't even get an estimate of what their exchange premiums are going to be. Is it that unreasonable to want at least a one year delay?

 

Lets get to the heart of the matter here. You dont want to fix it; you want to shut it down or delay it before giving it a chance to work.

That has been the Republican mantra since its enanctment – 40 attempts to repeal it with no chance of success, followed by he latest fiasco to defund it or delay it through the threat of a government shutdown with a similar zero chance of success. And for three+ years, supplemented with gross mischaracterizations, conclusions based on a handful of selected anectdotal examples, scenarios that are not supported by any evidence and every other means possible to discredit the law.

The Insurance Exchanges for individuals and small businesses are up and running and they arent coming down. For the first time, millions of uninsured Americans will have more options then they have ever had before. There is absolutely no reason to delay it and deny those options to the uninsured.

As with all major new programs, from Medicare to environmental legislation to SCHP to migrating AFDC to TANF, there will be bumps and some level of “confusion” as you like to call it. It either works itself out during the early implementation phase or it is fixed after implementation.

The delay of the employers mandate is far less impactful on far fewer people, but does provide employers (at the request of the business community) with an extended opportunity to come into compliance. And, there is no evdidence to suggest that businesses will only offer a “skinny” plan or chose to opt out of providing any insurance and facing a fine. The RAND and CBO studies put those numbers at insignificant levels. If you have data to contradict these studies, please share it.

The country would be in a much better place if the Republicans took a more constructive approach to making the program better instead of the slash and burn approach that has not and will not succeed, including actions by some Republican governors to do all they can to make it as difficult as possible for their residents to benefit from the program.

Given that the centerpiece of the law is based on Republican ideas (individual mandate and the Insurance Exchanges) along with Republican support for other significant features (covering those with pre-existing conditions, greater mental health coverage as an alternative to more gun control, etc), it is not unreasonable to conclude that they are putting personal and ideological beliefs over the best interest of the country.

So, lets talk again a year from now. If it was an utter train wreck as you predict, I will dance naked through the TFP chat room (never even peaked in there before) and you and Republicans in Congress can justifiably call for its dismantling and have their shot at their own plan (they never took that shot in the Bush years), if it has some successes and some failures, then we can discuss how to fix it. And if it is meeting or exceeding its expectations and just needs minor tweaks, then you can give Obama the credit deserved for taking on the biggest social challenge in the last 75+ years.

 

Inside the Fox News lie machine: I fact-checked Sean Hannity on Obamacare - Salon.com

 

In addition to the lies and misinformation spread by the Fox News crowd, opponents of the ACA have outspent supporters on tv ads alone by 5:1, led by the Koch Brothers' group, Americans for Prosperity.

 

this rollout is embarrassing. just watched a cringe worthy jay carney press briefing. i think boehner might be right when he says more people will lose their insurance than sign up for the exchages after the first month. 300,000 dropped from coverage in FL and 100,000 in CA. Boehner: More people will lose insurance under Obamacare than sign up in exchanges - Washington Times

 

It is true that Blue Cross/Blue Shield (and others) are canceling individual (not group) plans. In many states, the Blues have had a dominant market share (over 50%) and have offered plans with less than comprehensive coverage that they knew would not meed the ACA standards. (see how one company is dominant in most states)

As noted by Kaiser News:

In addition to the subsidies (in the case of Florida, 3.2 of the 3.5 million uninsured will be eligible for subsidies), there will be greater competition among insurers for the first time in many states....just as the Republicans envisioned when they proposed a Marketplace Exchange approach in the 90s.

I certainly agree on the website roll out screw up, but that is a process issue, not a policy issue. And, I agree that some consumers will pay more (and get more comprehensive coverage they may not want).

Already in numerous states where the state-run exchanges are working (CA, KY, MD, NY, OR, WA...), thousands have enrolled and thousands more have been able to sign-up for the expanded Medicaid (e.g. Oregon cut its number of uninsured by 10% in the first three weeks alone).

I'll give it a month or so before I am really concerned that the ACA rollout is impacted beyond repair.
--- merged: Oct 23, 2013 at 3:38 PM ---
sam...do you think it is good for Alabama consumers that Blue Cross/Blue Shield has a 92 percent market share? or 79 percent in Alaska? or 78 percent in Arkansas? or 81 percent in Mississippi? or 86 percent in Nebraska? or 93 percent in South Carolina?

 

no i dont think it's good. i guess the question would be, is that due to a government policy problem or an insurance problem? maybe blue/blue is the best bang for buck in those areas...

 

I think it is a combination of outdated and conflicting state and federal laws regulating the health insurance industry.

And as I noted, the Republicans thought the Marketplace approach was the best solution as well.

Another question for you?

Should a single woman your age, with a similar health history, pay as much as twice as much for the same coverage? Gender rating (discrimination) was common before the ACA, even though women tend to take better care of themselves, smoke less, drink less, eat healthier, etc?

Gender rating, along with providing little or no access to affordable insurance to consumers with preexisting conditions or canceling policies when a consumer faced a serious illness or disease, a closed market (1 or 2 companies in a state control 90+% of the market), etc. are examples of how the health insurance industry has been allowed to operate. It is wrong and needs to stop and I havent heard a better proposal from the right.
--- merged: Oct 23, 2013 at 4:33 PM ---
On the botched ACA rollout, this offers a little perspective as well:

5 other botched rollouts of government programs - The Week

 

I get the impression that a lot of people had "healthcare insurance" that was pretty much worthless (but made a tidy profit for some businesses and gave a false sense of security) and that, if nothing else, this is exposing the true, exorbitant cost of healthcare in the USA.

The question remains - how best to bring the price down?

 

I think the problem in part, is that like you, many (most?) dont use their health insurance for preventive care, the feature that distinguishes it from homeowners insurance. They wait until they have a significant illness and the result is higher treatment costs. The ACA encourages and incentivizes preventive care with the goal of lessening the likelihood of the need for those more expensive treatments.

The Pregnancy Discrimination Act amended the Civil Rights Act to prohibit gender discrimination on the basis of pregnancy (and related "reproductive plumbing" issues as you characterize it.) But it only applies to group (employer based) health plans, not the individual market.

The health insurance company practice of charging women more than men for the same coverage costs women $1 billion a year, according to analysis of advertised premiums in a new report released today by the National Women’s Law Center
New NWLC report: Discriminatory health insurance practices cost women $1 billion a year | National Women's Law Center

 

America. Wow.

There is an easier way.

 

You need understand the American group think and how we deal with problems, when we choose to deal with problems. Look at our response to 9/11. Some radical morons, mostly Saudi citizens, who were based in Afghanistan being led by an extremists Muslim who the US once funded and supplied with arms planned and executed a plan to blow up several buildings in the US. They succeeded in taking down the World Trade Centers but failed to take out the White House. Total US causalities were around 3500, which was truly awful. Seriously one of the saddest days in US history, certainly in my life time. Our response? Invade both Afghanistan and Iraq at a cost in the trillions of dollars incurring far more causalities then the event itself. Now, twelve plus years later, we still have military troops on the ground in both countries. We had our military building bridges, schools water and power plants etc... we'd blown up in Iraq while a bridge in a major US city collapsed due to lack of maintenance and age and countless other infrastructure issues nationally gets worse daily. Makes sense right?

Look at the way the Obama camp used technology to raise funds and get elected and re-elected. By nearly every account I've read it was ground breaking use of databases and new technology. When it came time to roll out Obama's signature legislation what route did they take? They hired a Canadian company (damn you Canada, damn you to hell!) who I think had been fired by Toronto, to build the platform, using ten year old tech., for enrollment in the new system. Makes sense right?

 

Rogue, I'm not sure I disagree with anything you've posted. My point is merely when anyone looks at the big picture of how the US tries to deals with stuff it usually boggles the mind. Look it how the GOP has handled things in recent months. They wanted to kill the ACA so they stalled legislation that would have had no (and didn't) effect the start of it. They ended up shutting down almost all the federal government and came within hours of default. Now they're done with that strategy, if you can even call it a strategy and now they're bitching about the way the ACA is being handled. They're demanding hearings on why it's not being started fast enough and smooth enough. If they don't like it why would they want it work at all? Yet alone hold hearings to get it up and running faster.