Politics Obamacare

Go back in time 34 years? Why? I believe in making things better - it is best done incrementally. Doing better today compared to yesterday is not a knock on yesterday. I think we can do better than the ACA - regardless of how we do it, we need to fix the ACA mess. Problem is that many will not even acknowledge obvious problems.

a single payer system would address preexisting conditions. Periods of guaranteed insurability could address preexisting conditions. The ability to transfer from a group plan to an individual plan with no penalty....there are many options. I have no issue with the core concept of addressing preexisting conditions.

In particular I have no problem with Medicaid for children, the disabled and those in true temporary need. I do have a problem with a broken Medicaid system that in some circumstances results in worse medical outcomes even compared to the uninsured - assuming this is true, I acknowledge there are some flaws in the way this conclusion was arrived at - but I am aware of anecdotal evidence that supports the conclusion.

Our experience over the past 30 years tells me we need to improve the way this is handled.

Outside of a single payer system, I believe a mandate is Unconstitutional. The right-wing theory is based on every able-bodied person take responsibility and contribute to the system so that costs are shared. In theory I support this concept and I think we can accomplish the goal without a mandate. The problem I have with the ACA is the dramtic differences in what comparable people will pay based on arbitrary income cutoffs and very large subsidies. I appreciate the affordability problem and I believe the ACA fails to address this issue at all. If we drive down costs (like we do in most every other facet of business) premiums and actual healthcare would be affordable for all. There are countless examples of good and services that were at one time unaffordable but are generally affordable for all now.

 

Ace...the difference between us is that I live in the world of political reality and not ideological extremes.

By any measure, and despite its self-imposed setbacks and the unrelenting obstruction and constant mischaracterizations by the right (of which you are guilty on multiple counts), the ACA is significantly better than the current system and helping far more people in ways large and small than the relatively few who might not benefit. And, it is investing $billions is making the health care system more efficient to help drive down the cost, some of which has already been demonstrated.

But it is clear that some on the right will always put ideology and partisanship above the opportunity to improve the law in a manner that would benefit even millions more until such time as a single payer system would be acceptable to the American people.

 

When it comes to the ACA, the GOP is like the boy who cried wolf

Ace...how many times have you cried wolf?

 

ah the law that is so good it has to be delayed to save democrats from losing elections. i can't believe people are still trying to defend it. at least i will be able to afford insurance for a couple more years!

 

Trying to defend it? I am defending it!

Republicans have nothing -- absolutely nothing -- to offer as an alternative.

 

Do not mess with an expert on the Canadian Health Care system.

 

Boehner and others have expressed their outrage at Obama's "abuse of executive power" to extend the deadline and more whining of how it is another example of the ACA's "failure."

Even though Obama's action is no different than Bush extended the deadline for Medicare Part D enrollment in 2006...with no complaints of "executive abuse" from either party in Congress.

Six million newly insured plus another two million newly enrolled in expanded Medicaid.....not as far reaching as one would hope, but 8+ million is not a bad first year, given the fuckups at the launch. Sadly, those most needing the coverage are low income residents (marginally above poverty line) in red states, FL and Tx most notably, where they are a pawn to the politics of the Republican majority in their state.

 

isn't the real test getting less uninsured than we had before obamacare? when will this happen or will it happen?

 

Obamacare working? Uninsured rate lowest in years, poll finds - CBS News

The uninsured rate for the first quarter of 2014, since the ACA health insurance exchange policies were implemented, is expected to be the lowest it has been since 2008...a rate of 15.9%. It is important to remember that the rate of uninsured had been rising annually for the last 20+ years and was expected to be over 20% by 2020 w/o the ACA. With the ACA, and the provisions not yet implemented (small businesses), the rate is expected to be closer to 10% in 2020.

Not universal, but far better than before the ACA and the rate of uninsured climbing higher and higher every year. Now we expect to see that rate decline every year.

But that is still only half the story. The other half is the patient protection provisions of the Patient Protection and Affordable Care Act.

For the first time, every insured American has new rights and protections under the law.

 

A large percent of the increased number of people with coverage are those covered under Medicaid. If Medicaid expansion was the goal we could have simple passed a bill to do that or simply more aggressively signed people up for Medicaid who qualified.

Avalere Health : 1.1M to 1.8M New Medicaid Enrollees as a Result of ACA

One concern some states have is the long-term impact of Medicaid expansion. How are these long-term costs going to be addressed? It is a simple question, why ignore it?

We could have enhanced patient rights in a better way.
The mandate is un-Constitional in my opinion and in the opinions of many experts.
The penalty disproportionately harms those who can least afford it.
We still have an employer-centric health insurance set-up.
Heath insurance companies are guaranteed profits.
Millions will remain uninsured.
Health care costs are not going to go down.
There is a shortage of healthcare providers to service the poor and people in many areas.
Etc.
Etc.

When is the Senate and President going to go to work on fixes? Or do they think everything is o.k.?

 

Three out of four (6 million out of 8 million) are newly insured through new private insurance policies.

And not counted are the estimated 8-10 million children and spouses with pre-existing conditions who can no longer be excluded from a worker's group (employer sponsored) plan. These dont count as new policies.

I have pointed in several earlier posts that there are numerous provisions in the ACA to address the long-terms costs of both Medicaid and Medicare. I agree more is needed and needs to be a bi-partisan effort to improve Medicare/Medicaid and NOT to gut and privatize Medicare/Medicaid. I am not convinced that Republicans are interested.

In addition, another new study in the journal Health Affairs finds that those who are eligible for the ACA's expanded Medicaid expansion are in better physical and mental health and suffer from lower rates of expensive chronic medical conditions than those who were enrolled in Medicaid before the ACA.

More of the same old rhetoric without offering any solutions.

I have said repeatedly that the law will need to be fixed and you have repeatedly ignoring the fact that millions of Americans have already benefited monetarily from the ACA in the form of $billions in rebates for insurer overcharges, reduced costs for prescriptions for seniors in Medicaid Part and millions with pre-existing conditio0ns no longer are excluded and millions others no longer face financial hardship as a result of new out-of-pocket limits.

By most objective measures (# covered, $ saved, $ invested in new health technology, etc), the benefits to all far outweigh the disincentives to a relative few (those who want to keep their cheap, unregulated insurance).

 

CBO came out with enrollment projections last month:

While the costs are high ($1.5 trillion for the coverage provisions), note that the CBO once again projected that the "total effect of the ACA would be to reduce federal deficits."