Obamacare / Affordable Care Act : classic or dud?

http://www.nbcnews.com/storyline/obamacare-deadline/obamacare-website-fails-deadline-arrives-n67666

http://www.washingtonpost.com/blogs/plum-line/wp/2014/03/31/obamacare-fails-to-collapse-time-to-move-on-folks/

http://www.washingtonmonthly.com/political-animal-a/2014_03/waiting_for_the_obamacare_alte049701.php

there's no secret to what the gop will offer as an aca "alternative," right? they will impose caps on med/mal suits; emphasize, as a bipartisan measure, new steps to further prevent and prosecute health-care fraud; propose "high-risk" pools; and propose allowing insurers of one state to sell policies to citizens of another state (on the theory that competition reduces prices and increases consumer-choice).

these are humdrum or totally regressive ideas. and they're all stale, across the board (except for further fraud-busting measures, which should be bipartisan and should be applauded).

A friend was trying to go online yesterday to make sure they had an extended deadline and it was too busy all day.

I'm still waiting on snail mail from the regional center...

nice article talking about how enrollment will continue during non-open enrollment parts of the year: http://talkingpointsmemo.com/cafe/obamacare-enrollment-is-far-from-over

http://talkingpointsmemo.com/livewire/obamacare-cuts-kentucky-uninsured-rate-by-40-percent

Impressive

The governor was on Chris Hayes' show last night touting this phenomenon.

LOL @ POTUS-BO for sending this out on April Fool's Day. suck it "conservatives"

Hello everyone,

Last night, the first open enrollment period under the Affordable Care Act came to an end.

And this afternoon, we announced that 7.1 million Americans have now signed up for private insurance plans through the new Health Insurance Marketplaces.

7.1 million.

That doesn't count the more than 3 million young adults who have gained insurance under this law by staying on their families' plans. It doesn't count the millions more who have gotten covered through the expansion of Medicaid and the Children's Health Insurance Program. It doesn't include the more than 100 million folks who now have better care -- who are receiving additional benefits, like mammograms and contraceptive care, at no extra cost.

Now, millions of our fellow Americans have the comfort and peace of mind that comes with knowing they're no longer leaving their health and well-being to chance. For many of them, quality health insurance wasn't an option until this year -- maybe because they couldn't afford it, or because a pre-existing condition kept them locked out of a discriminatory system.

Today, that's changed. And while our long-broken health care system may not be completely fixed, it's without question a lot better. That's something to be proud of -- and there's no good reason to go back.

Regardless of your politics, or your feelings about the Affordable Care Act, millions more Americans with health coverage is something that's good for our economy and our country.

At the end of the day, that is what this law -- and the other reforms we're fighting for, from a 21st-century immigration system to a fairer wage for every American who's willing to work for it -- are all about:

Making sure our country lives up to our highest ideals.

I am thankful to be your President today, and every day. And I am proud that this law will continue to make life better for millions of Americans in the years to come.

Thank you.

President Barack Obama

Great responses to Ted Cruz's FB poll about Obamacare:

https://www.facebook.com/SenatorTedCruz/posts/517779935000978

ahahahaha

According to Byron York, if you are getting Medicaid benefits or you are 26 years or younger and getting coverage on your parents’ health insurance plan, you simply do not exist. There are an estimated seven and a half million people in this country that fall into one of those two categories and now have access to health care that they would not have enjoyed if John McCain had won the 2008 election, but they don’t count.

http://www.washingtonmonthly.com/ten-miles-square/2014/04/if_obamacare_helps_you_you_don049707.php#

am i wrong in thinking that there are millions still without coverage because they 1) can't afford even the most basic plans & 2) their states have rejected medicaid expansion? so they fall into a doughnut hole of sorts, where they're too "rich" for classic medicaid but too poor to afford a plan?

That sounds about right. Heard someone suggest that the White House should allow in the long-term more basic cheaper plans, but it concerns me that they could get caught in a Republican race to the bottom bind that way with insurance plans that don't really provide anything. Not sure where the happy medium is. There is also so much variance between states-- with so many Republican southern states opting out of the Medicaid expansion. Plus the cost iof insurance plans are varying widely across the country. I heard a cynic say US healthcare costs will remain higher than those of Canada and Germany, no matter what (even if Obamacare changes do limit the rate of increased costs here somewhat).

that "doughnut hole" points to the fact that ACA didn't really address the root issue plaguing US healthcare: the exorbitant and often times arbitrary costs involved relative to what the rest of the world pays. Yes, more people can now have access to outrageously price-gouged healthcare, super.

Theoretically, getting more more folks with insurance and medicaid who are not just showing up in the ER will help push down healthcare costs a bit. But it will take more.

yep. they tackled the one problem which can be addressed in a pro-business way, and ingorned all the rest. Shocking.

so the most recent conservative talking points re: ACA seem to be

1. The bulk of the 7 MIL sign ups had been kicked off their previous plans in 2013 and forced to sign up for new plans under ACA, so the net gains are minimal.

2. No one who's signed up for ACA has actually paid for their plans yet, so those numbers aren't even real.

My assumption is that both points are complete BS, not even sure what #2 is supposed to mean really. Has anyone seen these addressed anywhere or do they only exist in the fevered minds of republicans?

the latter. no one's paid yet because premiums aren't due yet. grasping at straws, Repubs are.

re: #1, people didn't get kicked off old plan and then just told to go sign up at healthcare.gov. They were mapped onto new ACA-compliant plans, which didn't happen via the exchanges (though some could've decided on their own they wanted to actively shop for their new plan rather than be passively placed on one)

I mean my employer represents 1 company working in 5 states and we have 9 million members. Roughly 75% of those 9 million had non-grandfathered plans and so had to be mapped onto ACA ones. That's 6.75 mil right there who "had to sign up for Obamacare cause got kicked off old policy". ie the 7 mil figure mostly doesn't include these people.

Mapped on to a new ACA-compliant plan, or had to seek out a new plan from the marketplace? I think the numbers are marketplace-only.

My numbers there are out of date, just checked and we have 14 mil members. So that's 10.5 mil that got "kicked off" their old policy.

that "doughnut hole" points to the fact that ACA didn't really address the root issue plaguing US healthcare: the exorbitant and often times arbitrary costs involved relative to what the rest of the world pays. Yes, more people can now have access to outrageously price-gouged healthcare, super.

― A True White Kid that can Jump (Granny Dainger), Wednesday, April 2, 2014

i think the admin knows this. it has used the aca to begin creating an atmosphere less friendly to fee-for-service reimbursements (which is what keeps health care costs, and utilization, so high) and more friendly to alternative approaches (which reward efforts to keep patients healthier and with less utilization (like "ACOs")).

I'm more worried about the high deductibles I keep reading about (and a relative who's not an Obama hater told me about).

No one with an existing plan had to seek out a new plan from the marketplace

Good to know

Without a fundamental reconfiguration, you can either have a system that allows insurance companies to avoid risk via declining to offer coverage to certain people, in turn allowing for lower premiums or deductibles... or you can have a system that forces insurance companies to offer coverage to all and take on all that risk, which gets transferred to the consumer in the form of higher premiums or deductibles. Can't have both.

eh, not sure that's true. prohibiting insurers from rejecting applicants because of pre-existing conditions won't raise premiums and deductibles, if everyone's forced to buy insurance (the pool of money from premiums swells, allowing insurers to cover the increased costs from high-risk insureds). but your broader point was true; the current incentive system in healthcare is all screwed up. it rewards constant, duplicative utilization. it should be moved to a system in which groups of physicians are rewarded, with bonuses, for keeping patients healthier, and using less medical resources. that's the idea behind these ACOs, if they can ever really get off the ground.

true, forcing everyone to get health insurance is a way around some of that transferrence of risk from insurer to consumer. I don't know the numbers (and not sure I would 100% trust any "expert" "estimate" anyway), but as ACA is being and most likely will be practiced, not enough healthy people will sign up to fully defray those costs of insuring higher risk people. What would do the trick is single payor system, ie "fundamental reconfiguration".

obv the more healthy people that do sign up, the better it will be as far as premiums/deductibles go. Which is why the efforts to sabotage that aspect of ACA rollout specifically is so heinous.

those efforts will fail, tho, especially as the law begins to just be part of the netting of the state's support systems. plus the admin built protections into the law, to prevent a cost "death-spiral" in the event that fewer-than-needed "healthies" signed-up early in the process.

anyway, i agree: a single-payor system (or, absent that, a public-option) is better than the ACA. but the ACA is better than what we had before. it's a big, big deal.

oh for sure, I agree. It's laughable that a) ACA is being painted as a "government takeover" of healthcare and b) that an "employer takeover" of healthcare (which, if you want to stretch things characterizations in the same way conservatives are so fond of doing, the prior system was) is preferable!!

the ACA is also having the effect that a number (not sure how significant overall) of people are actually filing income tax returns in order to qualify for subsidized care who previously just did not file.

is it helping your business? I hope so!

when i took my continuing education last fall, one of the main units was about the ACA and taxes and the opening infographic said "congratulations, you are now part of the health care industry!"

ballpark dollar figure on all the effort wasted trying to discredit the ACA? hundred$ of million$? billion$? ten$ of billion$? hundred$ of billion$? good thing we have fiscal conservatives around to keep costs down

Hey, without spending that kind of money, where would we get the kind of top talent we have now?

with so many Republican southern states opting out of the Medicaid expansion.

well this is the crux of it, isn't it? the ACA was counting on this not being an option. but the Supreme Court said states could opt out. so suddenly there's no provision for people between the cut-off for existing Medicaid means-testing and the lowest rung of the bronze plans.

in tennessee there was a bill that would have made it against the law for schools to provide information to parents about the ACA. it almost passed.

i love how states have the right to ensure that more of their own citizens needlessly suffer and die

if there was a dude with a giant gun roaming the state killing thousands of people he'd be a legendary mass murderer, but when it's politicians refusing to pass legislation their adoring fans beg them to run for president

Hey, let's not bring the fossil fuel companies into this.

jesus hated the sick and the poor. vote GOP

So, I sent off my ID to the local processing center a month ago. I was told I should expect to hear back from them in 2 weeks.

Still haven't heard a peep.

how all the bastards let their healthcare industry overlords write it

In one TV ad, Obama blistered Tauzin for the kind of inside corruption that's made Washington famous.

"The chairman of the committee, who pushed the law through, went to work for the pharmaceutical industry, making $2 million a year," Obama announced to the camera, his sleeves rolled up for action. "That's an example of the same old game-playing in Washington. You know, I don't want to learn how to play the game better; I want to put an end to the game-playing."

A year later, he would find that game not so unpleasant after all.

After he became president, Obama would indulge Tauzin in the same closed-door dealings he once lambasted. The drug industry agreed to taxes and rebates involving $80 billion in savings over 10 years. In exchange, Obama reneged on three crucial promises: to speed generics to market, to allow the importation of cheaper drugs, and to retain the right to negotiate Medicare drug prices.

http://blogs.villagevoice.com/runninscared/2014/04/obamacare-sabotage.php?page=all

maybe when we elect hilary, she'll enact single-payer, right guys?

fuck presidents and forget em

Bill did!

My girlfriend (soon to be graduate student, just completed community college supplemental ed for said grad school, works at a restaurant) was able to get a solid plan for 20$ / month since she makes $10-12K per year. I spent several years in my earlier 20s uninsured (in a similar situation as she is now) with no decent healthcare options available for less than 150-200/ month. I wasn't pleased with the limitations of the ACA (would have preferred a public option to compete with private healthcare) but I am really happy that she doesn't have to live without a healthcare safety net. It really is a scary way to be, uninsured

So has anyone else sent in hard proof and never heard back? I sent in my driver's license months ago and haven't gotten a single thing in the mail. Each time I call the number, I end up getting someone new, who seems to have never encountered a case like mine before. WTF? I just want to buy health insurance! On top of that, I just got sick, and instead of going to the doctor I'm just going to have to sit around at home and hope I don't get my roommates and friends sick as well. :(

I'm pretty sure credit companies were in the room w the drug & insurance industries when writing this bill.