Politics Obamacare

The enrollment numbers are likely higher than reported.

 

Here is a solution - let me buy insurance across state lines! Don't limit my choice. There is no reasonable justification for this restriction on choice.
--- merged: Apr 1, 2014 at 1:58 PM ---

I did not see the quote you highlighted in the link you provided. I did see this:

Updated Estimates of the Insurance Coverage Provisions of the Affordable Care Act - CBO

What time-frame should we be using to measure the total impact of the ACA? Seems to me that in order to "sell" the ACA they needed to make sure the law gave the appearance of saving money - and then of course fix it later. Personally I don't like to be "sold" in a deceptive manner. Even you have to admit that early years got front loaded with new taxes, cost shifts and unsustainable low premiums and high subsidies.

 

The most obvious justification is the current lack of minimum levels of coverage and patient protections that would continue with allowing 50 different state insurance regulations. It would also potentially result in insurance companies setting up domiciles in states where they could cherry-pick consumers (young and healthy only), adversely impacting those states with sincere efforts to provide comprehensive coverage (leaving companies in these states with older and sicker consumers)sSo how would you guarantee any level of coverage or protection w/o national standards? You seem to believe that insurance companies would put consumer protections over profit.

BTW, the ACA allows cross-border sales through state compacts starting in 2016, with the same national standards of coverage and protection for in-state...thus eliminating insurance companies "racing to the bottom" to offer cheap junk policies that many states would now still allow.

From the CBO report:

"Those estimates address only the insurance coverage provisions of the ACA; they do not constitute all of the act’s budgetary effects. Many other provisions, on net, are projected to reduce budget deficits. Considering all of the coverage provisions and the other provisions together, CBO and JCT estimated in July 2012 (the most recent comprehensive estimates) that the total effect of the ACA would be to reduce federal deficits. "​

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THe CBO uses the same time frame for projections with the ACA as with any other proposed legislation with a long-term financial impact.

 

ps the CBO doesnt "sell" legislation. it provides a non-partisan analysis.

 

I signed-up yesterday. My wife was on my case because she was concerned about the tax penalty.

It's actually a good thing (I hope). I'm genrally healthy, but I'm not getting younger, and I'm overdue for some "man" exams that guys my age should have. It's the paperwork that I'm not looking forward to.

 

yeah, lets forget about the past screw ups and let them continue onto new projects that they can fuck up. how about we see if they can even build a website and get healthcare off cardiac arrest before they 'fix' the bridges and energy grid.
--- merged: Apr 1, 2014 at 9:36 PM ---

rofl. wife more concerned about loosing dollars than your health ...

 

That might make sense if the IT guys who built the website were responsible for providing health care, but it comes off as bitter and uninformed.

And despite the fuck ups, more than 7 million people, most of whom were uninsured, now have affordable insurance and most with some level of subsidy. Along with the 2+ million of previously uninsured now in Medicaid and the few million who have purchased ACA compliant plans off the market......10+ million people better off than before the ACA.

And that doesnt include the:

• more than 50 million with pre-existing conditions who can no longer be denied coverage in group (employer) plans or the individual market
• more than 6 million seniors who no longer face the "donut hole" in their Medicare prescription drug benefits and have already saved more than $5 billion
• more than 100 million in existing group (employer) plans who will no longer face lifetime caps

 

The ACA provides the minimum protections - given it is the law of the land - why not give me the ability to buy any policy offered anywhere? What is the issue with state lines? I have lived in multiple states in my life and have experience with many different insurance companies - in terms of service and ease of doing business with some are better than others - even when the contract coverage language is similar. All I suggest is giving me choice.

My last two posts have been in the context of improvements. It is true I am fundamentally against the ACA, but I can put that aside in discussing what comes next.

Not good enough - empower the consumer not state regulators. This provision leaves it up to the states.

The entity of the law has yet to be implemented. When is the first full 10 year period expected? There is no point in discussing this further because we won't get into a detailed evaluation of the CBO assumptions used - and time will tell. I will be shocked if the true net will result in a deficit - based on my own analysis. I understand that the CBO report and others disagree.
--- merged: Apr 2, 2014 at 4:51 PM ---

The administration and Democrat Party leaders "sold" the ACA. A major mistake, in my opinion, was not getting any Republican buy in - a wiser approach would have been to build a coalition with some moderate Republicans. I believe you knew the context of my statement - but for some reason you made a choice to obfuscate. Let's be adults, please.
--- merged: Apr 2, 2014 at 5:03 PM ---

Medicaid benefits and tax credits are income????

...both have to be paid for by taxpayers one way or another. Then how do we end up with people using disposable income on premiums, assuming they were not paying for coverage previously, having more disposable income??? Are we saying with insurance their net out of pocket costs are lower? If so, how and when did it happen? Why do we continue with the notion that the ACA creates national wealth - it does not. We need real cost reductions, real productivity gains, real efficiency improvements in the healthcare sector - the ACA does nothing other than shift costs around - some benefit at the expense of others. That in summary is the ACA.

 

Assuming you agree that the ACA patient protection and coverage regulations would be standardized nationally, I dont see the benefit of across state sales. I do see the downside and that is the impact on premiums. Premiums are set based on the state marketplace (including the cost of doctors, hospitals, etc). Allowing young, healthy consumers in NY to buy from insurers in WV would leave the older, less healthy consumers in NY paying more. Or if the elderly in FL (lots of them!) can buy from MS, it would likely raise the premiums for all MS consumers.

I dont have a problem with testing the state compacts as structured in the ACA. If it works w/o upsetting premiums across numerous states, then I would support your proposal (essentially imposing a state mandate).

The CBO analysis is the only non-partisan, objective analysis I have seen. Your analysis as well as Heritage and others are hardly objective. CBO uses multiple assumptions; your's and Heritage, etc. use only a worst case scenario. I'll stick with CBO.

This is nothing new. As I indicated, the same process of analysis is used for all major legislation, but I do find it amusing when conservatives are quick to point to the CBO if it supports their position and even quicker to denigrate and dismiss the CBO if. it doesnt.

Every administration "sells" it legislative programs and priorities. I dont think any administration in history has faced the $tens of millions spent on lies and misrepresentations against it.

IMO, Obama didnt "sell" it the public enough and let the Republicans mischaracterize it and define it. On the bright side, the most recent poll, now shows more Americans support the ACA than oppose it.

 

Because your choice would get abused very quickly by the powerful health insurance companies. The 50 states with 20 different plans per state would be overly complecated to shop for the 'best' plan, and knowing most people they would just pick the cheapest 'rural Wyoming' or 'rural Alaska' plan where they aren't covered for anything. The banking/credit card companies are all in Delaware and North Dakota since they were allowed to do the same thing in the 80s or 90s, they would flood one state with offices and buy out the state legislators to write very favorable laws under the guise of 'state rights'. The rich and powerful know exactly how to dodge taxes and get regulations in their favor.

That would have been nice, if the Republicans would have been sane and reasonable. But, with the rise of right wing TV, purity tests from Rush, primary challenges from Grover Norquest if any Republican increased taxes or didn't sign his pledge, big money campaign donors who wanted things done their way, and the takeover of the Tea Party into an ultra conservative organization attacking moderate Republicans...I don't see how that could have happened.

Hopefully, people will get things checked out earlier and get treated prior to the more expensive options later.

But, yes, I would have liked to have seen some stuff in there to prevent a lot of these expenses in the first place. But, people freak out over trans fat bans, 16 ounce sodas, not texting and driving, and getting sick time to stay at home away from other people. We shouldn't even bring up what would need to be done to slow down sexually transmitted diseases. Telling people not to have sex or use barriers would be crazy.

 

I find it hilarious the someone can argue against a minimum wage standard because of regional cost of living differences in one thread, and then argue that health insurance policies should be portable across state lines, disregarding health care cost variences. (ugly sentence there, eh, BG?)

 

They are not measuring both sides of the equation. They are not presenting an argument of real wealth creation (increased efficiency, productivity, innovation, etc), they focus on the benefactors of a cost shift while ignoring the donors. The net is zero. I know we have had the discussion in the past where you have supported the view that a dollar spent by one class may have more impact than a dollar spent by another - there is no support for this point of view on a macro basis.
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I do not support the government telling me what wage to pay or what wage I am willing to work for.
I do not support the government telling me what insurance I can buy.

Basically, I want freedom of choice. Is that hilarious? Are you suggesting that you want a government making what should be your decisions?