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New York Times Gives Us OCare Details - A Little Late

Category: Health Care
Posted: 01/13/17 18:16

by Dave Mindeman

Great New York Times article on the basic protrections of the ACA. Why didn't the MSM put more of this out there over the last 6 years?

Anyway, here is a summation of what we got and what we may lose:

1) Obamacare insured millions through new insurance markets.

The health law reduced the number of uninsured Americans by an estimated 20 million people from 2010 to 2016. But if we lose it...With many fewer people buying coverage, the insurance markets are likely to become increasingly unstable. Many insurers will stop offering policies, and the remaining customers are likely to be sicker than current Obamacare buyers, a reality that will drive up the cost of insurance for everyone who buys it, and force more people out of the markets.

2) Obamacare insured millions more by expanding Medicaid.

The health law provided federal funds for states to offer Medicaid coverage to anyone earning less than about $16,000 for a single person or $33,000 for a family of four. Not every state chose to expand, but most did. The Republican plan is expected to eliminate federal funding for the expansion. An estimated 12.9 million people would lose Medicaid coverage, according to the Urban Institute's projections. A GOP proposal would push money back to the states to take care of this - so we go back to health care differences, depending on where you live.

3) Obamacare established consumer protections for health insurance

Here's a partial list: One of the law's signature features prevents insurance companies from denying coverage or charging a higher price to someone with a pre-existing health problem. The law included a host of other protections for all health plans: a ban on setting a lifetime limit on how much an insurer has to pay to cover someone; a requirement that insurers offer a minimum package of benefits; a guarantee that preventive health services be covered without a co-payment; a cap on insurance company profits; and limits on how much more insurers can charge older people than younger people. The law also required insurance plans to allow adult children to stay on their parents' policies until age 26.

4) Obamacare required individuals to have health insurance and companies to offer it to their workers.

To ensure that enough healthy people entered insurance markets, the law included mandates to encourage broader coverage. Large employers that failed to offer affordable coverage, or individuals who failed to obtain insurance, could be charged a tax penalty. The (GOP) bill is expected to eliminate the mandates. Some experts think that eliminating the individual mandate, in particular, could destabilize insurance markets by reducing incentives for healthy people to buy coverage. This mandate is important to keep the other costs down - GOP tells us that not enough healthy people are signing up...while that was true at the beginning, this year saw a big turnaround - In Minnesota, MNSure has over 100,000 sign ups for the private market.

5) Obamacare raised taxes related to high incomes, prescription drugs, medical devices and health insurance.

To help pay for the law's coverage expansion, it raised taxes on several players in the health industry and on high-income earners. The G.O.P. package may roll back those tax increases. Some of the (GOP) plans would limit the tax benefits offered to people who get their health insurance through work. That change would increase tax revenues, but would increase the cost of health insurance for many people who get it through work. Personally, I do not think that the Republicans are willing to balance the costs and expenses with their plan - they will simply let the deficit and debt balloon. Are you getting this, Erik Paulsen?

6) Obamacare made major reforms to Medicare payments.

The law cut the annual pay raises Medicare gives hospitals and reduced the fees Medicare pays private insurance companies. It created new incentives for hospitals and doctors to improve quality. It also set up a special office to run experiments in how Medicare pays doctors and hospitals for health care services. Those experiments are now widespread and have begun changing the way medicine is practiced in some places. (GOP)is expected to leave these changes alone,. although there is still talk of tinkering with it (they can't resist, because, you know, Medicare). This part of the ACA has worked well, primarily because hospitals and doctors made up the costs with fewer uninsured patients.

7) Obamacare made many smaller changes that will probably last.

Obamacare had a range of policies meant to improve health and health care, including requirements that drug companies report payments made to physicians, a provision written by the Iowa senator Chuck Grassley, a Republican; a requirement that chain restaurants publish calorie counts on their menus; and a rule that large employers must provide a space for women to express breast milk. It looks like the Republicans may leave these ancillary parts alone.

Despite the rhetoric, Obama's signature health plan has been an improvement. Reducing premiums and out of pocket costs has always been difficult - yes, there have been mixed results, but most analysts think that this transition period may be ending and stability will take over.

Of course, that would mean that we should resist radically changing things right now....and as we are well aware, radical change in health care is the new order of the day.

But, at least the facts are beginning to get out.
comments (1) permalink

"I'm Not On Obamacare, I'm On The ACA!"

Category: Health Care
Posted: 01/13/17 14:33

by Dave Mindeman

There is a Reddit thread that is going viral that I believe is typical of the misinformation that many people have been given about their health care.

This comment thread started when a critic of Obamacare began praising the Senate vote that begins the repeal process. Here are the pertinent excerpts.
(Forgive some of the language...you know, comments)

OCare Opponent: Jesus, where to start? First, we're talking about Obamacare, not the ACA. Secondly, my healthcare is through the ACA, so I'm definitely not the kind of person to look down on others for needing help. I'm just saying that I am glad this is finally happening because Obamacare was a failure from the start. Remember Healthcare.gov? All of this was the brainchild of liberals and they couldn't even get the site run right. We didn't and they couldn't. Again it was a mistake that is finally being fixed.

1st Responder: Wait if you're on Obamacare, why the f--- are you celebrating the outcome of this vote? If the Republicans get what they want, you will lose your insurance.

OCare Opponent: I'm not on Obamacare. My insurance is through the ACA (Affordable Care Act), which was what they had to come up with after Obamacare crashed and burned as bad as it did. So, I'm going to be fine.


2nd Responder: Holy Sh--!

1st Responder: No, seriously, are you f---ing kidding me? THEY'RE THE SAME F---ING THING! Obamacare is just a stupid name for the ACA that the Republicans came up with to make moronic voters like you automatically despise the idea of it just by hearing the name. And it f---ing worked I guess.


2nd Responder: Je--- Chr---! Seriously. All this time and you never once checked for yourself to see what was up with this whole Obamacare controversy? Didn't once bother asking if relying solely on Glen "f---ing" Beck for your political commentary might not be the best use of all the resources you have at your disposal?

The whole thread is on Reddit here.

It is kind of discouraging that we had voters going into this election with that kind of polluted information.

Sigh.
comments (3) permalink

2016 Election Analysis - Part 5: The ACA

Category: Health Care
Posted: 12/09/16 16:40

by Dave Mindeman

The ACA became a major component of the 2016 campaign, both locally and nationally. It was the Republicans favorite thing to bash. To dismiss as unworkable. To pivot to when they got cornered on something else.

But the massive amount of disinformation that has been projected onto this law has been obscene.

Let's start at the beginning. Republicans called the ACA a government takeover of health care. That is incorrect. The Affordable Care Act only provided a marketplace for existing insurance carriers to participate in and made additional mandates that attempted to move this country to full coverage for everybody. These mandates have become the most popular provisions of the law: guarantees for pre-existing conditions, no coverage caps, children can stay on plan to age 26, women pay the same for coverage, and preventive care is free. The big objection was the mandate that forced everyone to get health care or pay a penalty. This mandate was necessary to make the coverage pool broad enough to make it affordable.

In order to get insurance carriers on board, the law made accomadations for them up and down the line. In addition, they tried to incorporate some Republican suggestions - which in the end didn't matter because they had decided that all of them had to vote against it.

So, the law launched without a public option (which would have solved many of its current issues) and with constant criticism and Republican tinkering. The GOP got control of the House later and wiped out the risk pool and our own Erik Paulsen wiped out a revenue source from the Medical Device industry.

Then the insurance carriers apparently went into the pricing of their products in this new environment and were completely unprepared. If you look at the history of the exchange in Minnesota you will see that the initial pricing on premiums was very low. Too low as it turned out because the insurance companies began complaining about losing money. Then they overcompensated and premiums skyrocketed.

In Minnesota's case regarding its Medicaid clients, it was put up for bids with the insurance carriers and Medica lowballed an offer that took UCare (which had done an excellent job) out of the running. Obviously, Medica had not analyzed this very well in their zeal to bring in all this new business and are now complaining about the losses that THEY PRICE INTO THE SYSTEM.

All of these insurance mistakes have conveniently been blamed on the ACA. Why? Because the Republicans insist on it. Bypassing the use of facts, they blame insurance losses on the ACA, they blame high premiums on the ACA, they blame Doctor networks on the ACA.

The ACA is only an exchange that manages a marketplace, directs people to the carrier they choose, and provides subsidies to those that qualify.

It DOES NOT set premiums, coverages, deductibles, and any of the other things that insurance companies have always done...prior to, during, and after the ACA came into being.

Now, insurance carriers are criticizing the ACA because, of course, they want the government to bail them out of their own mistaken stupidity.

The ACA cannot help the insurance companies to cope with universal coverage. The carriers need to analyze the marketplace and come up with fair value. That is their job, that is what they are supposed to do.

If they cannot do it - then single payer can take over and do it right.
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