Obama Care vs Republicans

[Lamplighter]

Obama appears to be making some changes to accommodate
those whose "non-ACA-compliant" policies were canceled in 2013.

In his talk today, there were a couple of places where he seemed to be
parsing his words very carefully.
One was when he described the specific policies that would be "grandfathered",
and his sentence ended with something like "and will expire in 2014".
... maybe I heard it wrong.

He also said these insurance providers would have to notify their policy holders
of the specific ways in which these policies do NOT meet the
requirements of the ACA.

I do hope, however, that as part of this political concession, these changes
do not include either the subsidies or the tax credits that are available
in the exchanges for some, based on their income.
Of course, that would undoubtedly set off another chorus of "LIAR"

[Lamplighter]

... maybe I heard it wrong.

I did hear it wrong...

Here is the transcript of what Obama said:

<snip>
Already people who have plans that pre-date the Affordable Care Act
can keep those plans if they haven't changed. That was already in the law.
That's what's called a grandfather clause that was included in the law.
Today we're going to extend that principle both to people whose plans have changed
since the law too[k] effect and to people who bought plans since the law took effect.

So state insurance commissioners still have the power to decide what plans
can and can't be sold in their states, but the bottom line is insurers can extend
current plans that would otherwise be cancelled into 2014. And Americans
whose plans have been cancelled can choose to re-enroll in the same kind of plan.

We're also requiring insurers to extend current plans to inform
their customers about two things:
One, that protections -- what protections these renewed plans don't include.
Number two, that the marketplace offers new options with better coverage
and tax credits that might help you bring down the cost.

So if your received one of these letters I'd encourage you to take a look at the marketplace.
Even if the website isn't working as smoothly as it should be for everybody yet,
the plan comparison tool that lets you browse cost for new plans near you is working just fine.

Now, this fix won't solve every problem for every person, but it's going to help a lot of people.
Doing more will require work with Congress. And I've said from the beginning that
I'm willing to work with Democrats and Republicans to fix problems as they arise.
This is an example of what I was talking about. We can always make this law work better.

It is important to understand, though, that the old individual market was not working well.
And it's important that we don't pretend that somehow that's a place worth going back to.
Too often it works fine as long as you stay healthy. It doesn't work well when you're sick.
So year after year, Americans were routinely exposed to financial ruin or denied coverage
due to minor pre-existing conditions or dropped from coverage altogether even if
they've paid their premiums on time. That's one of the reasons we pursued this reform in the first place.

And that's why I will not accept proposals that are just another brazen attempt
to undermine or repeal the overall law and drag us back into a broken system.
We will continue to make the case, even to folks who choose to keep their own plans,
that they should shop around in the new marketplace because there's a good chance
that they'll be able to buy better insurance at lower cost.
<snip>

[Clodfobble]

Ugh.

My father called tonight to gloat about how Obamacare is "completely falling apart," and haven't I been watching the news in the last two days?! It's "imploding." The whole thing is "going to be dismantled" and The Democrats(tm) will hang their heads in shame!

I dared to disagree with his interpretation of events, and got to listen to another 30 minutes of ranting before I finally got him off the phone. Glurg.

[Lamplighter]

But Clod, in the same vein as InfMonkey described in another thread,
you were given an opportunity for 30 minutes to honor your father

Good on you...

[xoxoxoBruce]

Fuck him, hang up.

[orthodoc]

Acknowledge and redirect ... 'We'll have to agree to disagree. So, how are YOU doing?'

[Lamplighter]

So state insurance commissioners still have the power to decide what plans
can and can't be sold in their states, but the bottom line is insurers can extend
current plans that would otherwise be cancelled into 2014. And Americans
whose plans have been cancelled can choose to re-enroll in the same kind of plan.

This attempt on Obama's part to be "no drama Obama" will become the camel's nose for him.
It's not the particular "fix" that he proposes, it's the event of any "change" in the ACA, itself.
The GOP will attack with the fact that he changed it at all, and more changes will never be enough.

IMO, the salvation for Obamacare now lies with the individual State Insurance Commissioners.
The following is a taken from an interview with the State of Washington's Insurance Commissioner.
I sincerely hope others follow suit, just for the reasons he gives.

Washington Post
Sarah Kliff,
November 16

Wash. insurance regulator supports Obamacare — and rejected Obama’s ‘fix.’ Here’s why.

Mike Kreidler has served as insurance commissioner in Washington state since 2000.
Kreidler, an optometrist by training, also served one term in the House of Representatives
and 16 years in the state legislature.

On Thursday, Kreidler was the first insurance commissioner to reject President Obama's proposal
that would give insurers and extra year to sell plans that do not comply with the Affordable Care Act.
He said, in a statement, that he was acting "in the interest of keeping
the consumer protections we have enacted and ensuring that
we keep health insurance costs down for all consumers."

Kreidler and I spoke Friday morning about his decision,
why he thinks it will be difficult for any state to move forward on the Obama proposal
and how he learned of the president's plans.
What follows is a transcript of our discussion, lightly edited for clarity and length.

SK: Putting aside policy concerns for a moment, did you think it would be
logistically possible to allow these plans that were initially barred from the market back in?
MK: If that did happen, they'd have a key interest in wanting to re-rate their products.
They'd be trying to do that when people were already signing up.
That's true for any state, red or blue, they're going to be challenged
to implement this without having a significant impact.

It’s too late in the game, certainly for the state of Washington.
The health plans themselves have said that, as you've heard from AHIP
How do you have one set of rules for some plans and another for others?
It would have been very challenging.

Health carriers in our state were not excited about prospects of this.
And the last thing I wanted to see was the market destabilizing or seeing
significant rate increases impacting the number of people signing up for health insurance.
All of those things were going to be compromised. It’s brought about a lot of consternation.

I strongly support the Affordable Care Act. I know the president wants it to succeed.
And I'm supporting the president by making the Affordable Care Act work in the state of Washington.

SK: How many cancellation notices have Washingtonians received?
MK: There are about 290,000 people in the individual market, and
all of them were sent out discontinuation and replacement notices.
Those notices we don't have authority to regulate, but we did ask the carriers
if we could see them and in a number of cases made suggested changes to them as they went.

There are people out there who are not happy with the fact they received those notices.
Not infrequently the carrier has identified a replacement for them that costs more.
What people don't realize in many cases, and we’ve worked diligently to fix this,
is they need to go look at other plans and what other companies are offering
to see if there's a better fit for them.
<snip>

[Adak]

No doubt that the roll out of Obamacare, has been a disaster, but I can't see getting excited about it.

It's a big plan, and one that has gone through several changes, so the web site creators didn't get the info they needed, in time to do a good job.

Big deal.

I can blame Obama for a lot of things, but the roll out of his healthcare plan, is the least of them. Everyone with a brain knew that sub-ACA plans wouldn't be able to stay in place for long. They would be (obviously), much cheaper, and thus subvert the ACA goal, wouldn't they?

I relish Obama getting skewered for several other mistakes (Benghazi, etc.), but the ACA roll out? No. We just need to settle down and work with the plan. The time for political action against it, should be over, imo. Obamacare might not be good right now, but it could reasonably do a great job, down the road, after it has received the tweaks it needs.

As for his lying about being able to keep your plan if you liked it. Admit it, you never gave a damn about his several blatant lies in the past several years, but NOW you're incensed?

You're a little late for that, imo.

[Lamplighter]

Hey Adak, good on you. You've come to a reasonable position on Obamacare !

Admit it, you never gave a damn about his several blatant lies in the past several years,...

???

ETA: Added after reading the morning news:

Adak's current position on Obamacare seems to be the way to getting elected in Louisana:

Newsmax
11/17/13

...[Republican]Vance McAllister pulled off a startling upset Saturday night
in the special election for Congress in Louisiana's 5th District,...

The candidates disagreed on next-to-nothing.
Both were strongly pro-life, pro-marriage, pro-Second Amendment, and opposed Obamacare.

The sole difference, as several published reports noted,
was that Riser supported outright repeal while McAllister said repeal
would not work until Republicans took the presidency and Senate
and instead supported fixing the healthcare measure.

A few observers speculated that this convinced some 5th District Democrats
(who had no horse in the run-off) to vote for McAllister over Riser.
<snip>

[Adak]

It just seems like people are blaming Obama, because the web site for it, is the shits. Obama didn't create the web site!

The Republicans tried to tell everyone that there was a bad side to Obamacare - higher rates for one thing, and cancelled low cost policies for another - but nobody believed that.

Now under the new changes, I'll have to be insured for:

*mental health - in case I decide to go crazy.
*maternity care - in case I decide to get pregnant.
*breast cancer screenings - some men do get breast cancer, but I don't know any men who get breast cancer screenings.

The dark secret still to be found in Obamacare, won't hit us until 2015. In 2014, the insurance carriers in ACA will be reimbursed, if the "pool" of insured they get are unexpectedly poor in health. (say the older folks enroll, but the younger people don't). After a 3% variance, the gov't will reimburse the insurance company, for their losses.

In 2015, this risk abatement feature will disappear, and the insurance company will have to adjust their rates to account for their "pool" of enrolled people - regardless of their health costs. THAT is when the full cost of Obamacare will be known, as it stands now.

Hopefully by then, a much larger percent of the population will be enrolled, and the pool of each company, will be normalized (young vs. old, healthy vs. unhealthy).

There is also a serious Doctor issue with the ACA, where the doc's have to have hospital affiliation - which of course, many doc's in private practice don't have. If that becomes a problem, then lots of doc's won't be seeing patients with ACA insurance.

I know the Republicans will be highlighting the problems of the ACA, in the 2014 elections, but I wish they would wait, and give the ACA a chance to show whether it's good overall, or not, before campaigning against it. We HAVE the ACA, let's kick the tires on her a bit, and take it for a test drive, before we decide on it's merits.

[Lamplighter]

There is also a serious Doctor issue with the ACA, where the doc's have to have hospital affiliation
- which of course, many doc's in private practice don't have. If that becomes a problem,
then lots of doc's won't be seeing patients with ACA insurance.

What do you mean with "ACA insurance"
Private insurance companies will be carrying the vast majority of health care plans.
Only Medicare/Medicaid will be "ACA insurance". Is this what you mean ?

I haven't heard anything of the ACA requiring (all) doc's to have an affiliation with a hospital.
Is that what you are saying ? Maybe you could provide a link...

The only laws I have heard that sound like that are the anti-abortion proposals.

I have read articles about the "doctor-owned hospitals" (DOH's) having
limits placed on Medicare-reimbursement levels by the ACA.

DOH's have been investor-jewels, making >25% profits off of Medicare reimbursements.
IMO, it seems reasonable for the government, via the ACA,
to say how much profit on Medicare-reimbursements will be allowed.

The response of some DOH's has been to stop accepting Medicare patients completely,
and some DOH's have refused referrals from non-affiliated, doctor-owned private practices.

Currently, some DOH's are scurrying about trying to find legal ways around such ACA restrictions.
They have tried separating private-pay from Medicare-patients into "legally separate" practices.
They have tried "legal mergers" with outside practices of private physicians.
They have tried arguing that some DOH's are located in low income population areas,
and so they should be allowed an exemption

... so far the courts have uniformly ruled against them.

[Adak]

You may be right that they are DOH's. This was the topic I was just starting to listen to on the radio, but the football game came on.

They mentioned that in New Hampshire, 40% of the hospitals would not be available for those covered by Obamacare. So far, they've only signed up 259 people in the state, which is less than the number of tags sold to moose hunters, so maybe it's not a big deal, yet.

I do wish they'd get the roll out for Obamacare, rolling along a bit better. We've paid a lot of $$$ for it so far. I'd like to see it taken for a test ride, at least. We might just get a good national health care plan out of it. Imo, we need one.

[xoxoxoBruce]

Originally Posted by Adak

They mentioned that in New Hampshire, 40% of the hospitals would not be available for those covered by Obamacare.

Nothing to do with the law, it's the insurance companies using this as an opportunity to squeeze the hospitals. There will be more of this and the solution is single payer.

[Adak]

Originally Posted by xoxoxoBruce

Nothing to do with the law, it's the insurance companies using this as an opportunity to squeeze the hospitals. There will be more of this and the solution is single payer.

Are you sure of that, Bruce? I have been unable to spend time with it, but what little I have heard is that this was a requirement they put into the ACA.

I agree with you about single payer. When you are trying to steal second base, you can't keep one foot still on first base. You have to go for it big time.

This was something that Hillary had right, when Bill was in office. All the special interest groups railed against it - and naturally killed it.

A great many people think they are thinking when they are
merely rearranging their prejudices. -- William James

[xoxoxoBruce]

The insurance companies, and especially insurance brokers because they deal with most of the people that are buying direct, have taken advantage of the confusion/disinformation to make money. That shouldn't be a surprise. Humana has been particularly nefarious in "guiding" people into much higher premium policies than the ACA requires.

Bulletin... Attention Mr & Mrs America, and all the ships at sea... no company, or broker, is going to tell you all your options.