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Health Care Premiums And the ACA

Category: Health Care
Posted: 07/06/15 15:35

by Dave Mindeman

There is this constant Republican background noise that turns over every stone they can find that might hold a criticism for health insurance via the ACA.

They have been focusing lately on premium increases. So let's try to introduce some more factual reasoning into this.

First of all, premiums in health care have been increasing forever. The reason we have tried so hard to reform health care and the reason why we passed the ACA is because health insurance premiums have always been increasing faster than inflation, the economy...everything.

And these increases were happening while we have had an alarming number of people who were uninsured. What I have to ask Republicans is, why do you want to go back to that? If you want to repeal the ACA, then you will be dealing with the original problem and so far, I have not seen anything resembling a solution to that from the GOP.

But let's get back to current premium increases.

These increases are coming from our old friends the insurance companies. We still have a private insurance health care system....it just has more regulations and mandates which get more people covered -- but make no mistake, the insurance carriers still set the premiums.

Now, on the one hand, some of these increases are understandable. When the exchanges first went into effect, the insurance companies lowballed the numbers with some expectation of higher volume. So, now that they are getting a fuller picture of the ACA world, they are going to be getting back to being realistic. Health care is still expensive and complicated.

Another reason comes from the fact that the people with pre-existing conditions which were unfairly left out of the insurance pool, now have a guarantee to be included. This brings in a number of sicker people. The idea behind the ACA is that the mandate to cover everybody also involves covering people who are healthy and have not purchased insurance in the past. That would hopefully balance the pool.

Some of the delays in mandates for smaller businesses and other delays have kept some of the healthier people out of the pool. Obviously that will unbalance things and cause premiums to rise. But that should be self correcting as we go forward - (now that we really can go forward after the Supreme Court decision).

Speaking of the Supreme Court, there was also a level of uncertainty which allowed many people to delay getting into ACA coverages because the expectation was that it might all go away anyway. That is now an answered question as well.

I have these Twitter arguments with conservatives who complain about the increasing premiums and when I tell them that my premium is about 1/6 of what it used to be, they come back with - "but that is with a subsidy isn't it". To which I say, "So what?" The whole idea of the ACA is to utilize subsidies to make insurance more affordable. This system is predicated on subsidies as part of the system as a whole. It is basically a grandiose "means testing" method of getting people insurance. I don't think anyone should have to apologize for that. It is how the playing field can be leveled so that we do not have so many uninsured.

And that is where the ACA is working so well. The number of uninsured is dropping each time a poll or analysis is taken. The ultimate goal of the ACA is working.

We still have to wait a few years for the premium aspect to get sorted out. Yes, premiums have gone up right now - but the reality is that without the ACA, they probably would be worse.

I'm sure the Republicans will find more stones to upturn, but this one could have been left under that rock.
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The ACA Survives - But What The GOP Would Do Is Still The (?)

Category: Health Care
Posted: 06/26/15 01:20

by Dave Mindeman

Now that the Supreme Court has again affirmed the ACA, conservatives are left to vilifying Justice John Roberts - the "messenger".

I doubt the Chief Justice is a particular fan of Obamacare but even he seemed to think overturning the law and sending health care into chaos over a bit of botched Congressional language was a poor justification.

But Congress has had years of opportunity to change, fix, rehabilitate or mold this law in any form they wanted but there only method of operation was to criticize it or repeal it without replacement.

The ACA has flaws....but they are fixable. Congressional Republicans could have put their own signature on health care by changing the law into something they could claim for their own.

But they never did that.

Even small things like Rep. Erik Paulsen's elimination of the Medical Device Tax, which has the support of many Democrats, has languished for years because Paulsen offers no replacement cost and continues to pursue a sketchy reasoning for why it should go. He simply does the bidding of successful corporate companies....and seems to be willing to pass the cost on to the rest of us.

Congressman John Kline was going to be trusted with the new and improved Republican healthcare plan. Yet, he never came up with specifics that had any meat to them and was relegated to pointing out the "good" parts of the ACA which the Republicans planned to keep....without offering any means to pay for those same items.

It would seem that the Republicans were hoping that the Supreme Court would do their work for them and just gut the program via legal pronouncement. Now that this plan is not going to happen, they are left with recriminations and attacks on their conservative justice "allies" and a lot of repeated rhetoric meant to satiate their base one more time while they regroup.

The GOP has never had any health care plan other than to go back to the old method of letting insurance companies call all the shots. Denying coverage for pre-existing conditions.....letting the unemployed hope the emergency rooms would take care of them...letting the new college graduates roll the dice that they wouldn't get sick while looking for a job with benefits.....all of that was, and apparently is, acceptable to Republicans because it benefits insurance company profits.

Now, it would seem, the GOP is going to take their "case" to the Presidential election. Hoping that the negative rhetoric will be enough for the American people to elect a GOP President who will work with Congress to gut the law and......

and do what?

That is always the question with Republicans. Always the same question.
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MN's Sex Offender Program Is A Dark Moment In Our Legal System

Category: Health Care
Posted: 06/17/15 23:34, Edited: 06/18/15 01:46

by Dave Mindeman

I, along with many others, have always thought the Minnesota Sex Offender Program was unconstitutional, and so it came as no surprise that a Federal judge ruled in that manner today.

The problem has always come down to having the political will to fix the situation. There are no easy answers, but to hold people indefinitely in treatment programs feels more like the result of a military tribunal than a program to rehabilitate.

Even Governor Dayton is wrong on this one - as he continues to believe that the program is still justified. He can still appeal the ruling but it would feel more like a postponement than an actual legal recourse.

Our legislators have been making overtures about this for years...and we are talking about both parties. Each side tries to force the other into action with criticisms poised and ready.

It has NOT been an exercise in political courage.

The judge has recommendations and others have had reform suggestions over the years. Other states deal with this problem - surely there is a model that Minnesota can live with.

Nobody wants to put sex offenders who have not been rehabilitated back on the street. The cruel reality is that many of them will end up repeating their behavior. But certainly not all of them and therein lies the problem - we are violating the civil rights of the ones that can reform themselves and get back into civil society.

Legislators need to tackle this in a serious manner and refrain from using any of this as political fodder. It is time for a bipartisan "political hands off" agreement.

Fix this problem. Use recommendations. And then let's move on.

This has been a dark moment in our state's legal system. We are better than this.
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