Well, The First Numbers Are In...

[Lord Jim]

Well in that case I stand corrected on this point, my information must have been incorrect. (See how easy that is rube?)

I guess they did manage to at least get that part of this right.

[Andrew D]

This:

Actually, the vast majority of the cancellation letters were required by the ACA. The only individual policies that could continue, i.e., be grandfathered, were policies that were in effect in 2010. Most individual insureds today do not have the same policy they had 3 years ago (I've read it is about a two-thirds turnover). As a result, all of those policies needed to be terminated to comply with ACA -- no choice on the insurance companies' part.

is complete spin.

The truth of the matter is simple: Insurance companies chose mass cancellations as a tactic to bring down the ACA.

Plans in existence as of the ACA's effective date were grandfathered in.

The insurance companies hate the ACA, because the ACA prohibits insurance companies' collecting premiums for "insurance" that isn't worth shit.

The insurance companies used the time gap between the effective date of the ACA and the effective date of the new regulations to engineer millions of unnecessary cancellations.

The insurance companies carefully changed the plans in existence of the ACA's effective date.

Very carefully.

They changed them just enough so that they would not be grandfathered in, but not enough to make them ACA-compliant.

They changed them in precisely the ways necessary to bring about their cancellation, so that they could blame the ACA.

So this:

... no choice on the insurance companies' part.

is the exact opposite of the truth.

The truth is that the choice lay entirely with the insurance companies. They could have continued the plans that were in existence as of the effective date of the ACA.

Instead, the insurance companies which hate the ACA engineered millions of unnecessary cancellations in order to bring down the ACA.

They should be prosecuted under unfair-business-practices laws.

[Econoline]

[Andrew D]

Keeping affordable health care out of reach of tens of millions of Americans is essential to Republican economic policy.

[rubato]

One effect of the ACA has been to increase Medicare utilization even in the states which refused the expansion. The ACA provided a much easier way to sign up for regular Medicare and circumvented the obstructive systems some states had devised to keep enrollment low.




http://www.politico.com/story/2013/10/m ... 98977.html



yrs,
rubato

[Big RR]

rubato--I presume you mean Medicaid, not Medicare?

[Lord Jim]

Another whoops...

A health care 'success story' that isn't

A woman who President Barack Obama cited in remarks last month as an example of what Obamacare “is all about” says she is now facing repeated problems with her own enrollment.

Jessica Sanford, a Washington state resident and self-employed court reporter, has received numerous letters from her state’s exchange program notifying her of increased costs to her plan and tax credit miscalculations, according to CNN.

“Wow. You guys really screwed me over,” Sanford wrote on a Facebook post about the Washington state exchange website. “Now I have been priced out and will not be able to afford the plans you offer. But, I get to pay $95 and up for not having health insurance. I am so incredibly disappointed and saddened. You majorly screwed up.”

Sanford, who said the experience has been “like riding a big roller coaster,” also said she felt “embarrassed.”

“It was a huge disappointment, and especially since my story had been shared by the president,” Sanford said in an interview that aired Tuesday on CNN’s “New Day.” “I just felt really embarrassed.”

Sanford also told CNN that she is “not getting insurance.”

“That’s where it stands right now unless they fix it,” Sanford said.

However, Sanford said she blames the state for her problems, not the White House, adding that she still supports the law.

During Oct. 21 remarks in the Rose Garden, Obama read from a letter Sanford wrote, describing the “stress lifted” in dealing with her son’s medication and doctor visits for his ADHD by enrolling in her state’s health care exchange.

“That’s what the Affordable Care Act is all about. The point is, the essence of the law — the health insurance that’s available to people — is working just fine,” Obama said at the time.

But Sanford said she was then notified by the state that a miscalculation in tax credit eligibility meant her monthly coverage costs would increase from $198 to $280. CNN also notes that Sanford initially paid $169, but had switched plans.

Sanford said she was then notified again of a “system error” and given a higher quote. Alternate plans were out of her budget. Yet another letter explained Sanford would receive no federal tax credit to help cover the cost, which she said she had a “good cry” over.

A spokesperson for the Washington state exchange is “looking into” Sanford’s situation, CNN said.

Read more: http://www.politico.com/story/2013/11/j ... z2l8YF4atf

Well, at least she can take comfort from the fact that she's got plenty of company:

Washington exchange says it's sorry for mistakes on health insurance rates

The Washington state health exchange is mailing notifications — with its apologies — to 8,000 customers who were told their 2014 health insurance would be less expensive than it really will be.

On average, customers will have to pay $100 more per month than they originally thought, said exchange CEO Richard Onizuka, in a statement issued late Tuesday. The problem was a miscalculation of the federal subsidies people would receive for buying coverage.

“The root cause of the miscalculation was corrected within 24 hours,” Onizuka said. “To ensure every consumer’s tax credit is correct, the exchange spent the past week updating the eligibility determination for each tax credit recipient and confirming that all tax credit information is correct based on their income level and household size.”

The corrected tax credit could be less than a dollar per month for some people, but could exceed the $100 per month average for others.

The exchange is asking people who receive notifications to return to its website, the Washington Healthplanfinder, to either approve the higher cost plan or to select a different plan.

People have until Dec. 23 to make the first payments on their plans, so it remains to be seen how – or whether – the miscalculation will change anyone’s enrollment plans.

Under the federal Affordable Care Act, all Americans must have some form of health coverage, or face a financial penalty. The state exchanges, including Washington’s Healthplanfinder, were created to help make the process of buying health insurance easier and more transparent.

Washington has been hailed as one of the states that’s had the most early success with its exchange, trailing only New York State for the most enrollments, with more than 55,000 in the first month. [I don't know where they're getting those bogus numbers from; only 79,000 total enrolled through the state exchanges in the first month according to the Administration's own figures, and 31,000 of those were in California...whoever wrote this article must be using Rube Math....]

http://www.bizjournals.com/seattle/blog ... s-for.html

[rubato]

The stench of desperation pervades the "hate America" crowd who are trying to make health care worse.

Yrs,
Rubato

[Andrew D]

All the whining comes from people whose party needs tens of millions of Americans to be without health care.

[Lord Jim]

The stench of desperation pervades the "hate America" crowd who are trying to make health care worse.

So you're saying that Jessica Sanford is desperate because she hates America and wants to make healthcare worse?

Gee, whiz, and I thought it was because she isn't going to be able to afford healthcare...

I guess we didn't read the same article....

[rubato]

705,252 signed up so far according to the best data available. Actual enrollments.

http://obamacaresignups.net/

Still ahead of the Medicare part D utilisation and at about the same pace as the very successful program in Massachusetts.

If you care about the outputs of government you will look at the relevent facts; we have killed tens of thousands of people needlessly each year because we didn't provide healthcare. Obamacare is the first significant improvement since Medicaid. It is a transition to single-payer or the highly regulated semi-private systems they have in Germany and Switzerland.

You're either supporting the expansion of medical care or you're saying "Let them die"; the Republican Health Plan.


yrs,
rubato


No one criticizing Obamacare can possibly have looked at Medicare part D. Far more complicated and buggy. The only difference is that the Democrats weren't blocking all attempts at government at the time.

[Lord Jim]

705,252 signed up so far according to the best data available. Actual enrollments.

LOL!

And of course, rube, dishonest weasel that he is, tosses in the medicaid sign-up numbers to make look like the Obamacare enrollment numbers are surging at a massive pace, experiencing a six fold increase in just three weeks...

According to rube's own source, (again I have to click on the alternate link to scroll over to see the totals) the actual number of enrollments in a paid program to date is 166,038...

That means that roughly 60,000 more have enrolled in the first 20 days of November then were enrolled (and again, enrolled doesn't mean paid) in the month of October....

That translates into 30,000 every 10 days, and with just 10 days left in the month, that means they'll have to ramp up the pace, (with the Thanksgiving Holiday falling in the last 10 days) just to meet the same lousy number they got last month....

Rube, it is a puzzle and and mystery to me, why it is you continue to pull this crap, when I have made clear to you that every time you do, I will be there right behind you to expose your shameless mendacity...And every time I have backed up my promise with action....

What is the "thought" process at work here rube? Is it, "well, even though he's called me on my efforts to dishonestly distort the sign-ups for the ACA every time I've done it before, maybe this will be the time that he lets me slide"?

Rube, like the old saying goes, the definition of insanity is doing the same thing over and over expecting different results....

Geez, you're a slow learner....

ETA:

Whenever rube posts any numbers on the Obamacare enrollments they should be viewed as having the same level of credibility as the Defense Department Vietnam era casualty figures...

[Econoline]

Just to clarify...

Do the Republicans actually have any goal in mind other than making sure the ACA is an expensive, embarrassing political fiasco for Obama? Is that the sum total of their alternative vision for the U.S. health care system? Because if there's anything else in their long-term plans, I sure haven't seen it.

[rubato]

Medicaid is healthcare. 166,000 via the exchanges and 539,000 via Medicaid. And counting. A huge win for the United States.

The ACA is valuable because more people will have access to healthcare. The whole thing about the exchanges reducing the cost of HI was always a fantasy of the Heritage Foundation. Pure horseshit by people who play "fantasy league" economics.

Only an asshole wants more people to die needlessly when we are more than rich enough to take care of them.


Yrs,
Rubato

[Andrew D]

The expansion of Medicaid is an integral part of the Affordable Care Act.

Including people who have enrolled in the expanded Medicaid which is an integral part of the Affordable Care Act is entirely appropriate.

And if the Republican leaders of the ignorant and backward States were not doing their best to sabotage the Affordable Care Act, the results would be even better.

[Andrew D]

Just to clarify...

Do the Republicans actually have any goal in mind other than making sure the ACA is an expensive, embarrassing political fiasco for Obama? Is that the sum total of their alternative vision for the U.S. health care system? Because if there's anything else in their long-term plans, I sure haven't seen it.

Bingo!

The Republicans have no serious plan for providing affordable health care to the tens of millions of Americans who now suffer without it, because the Republicans do not want to provide affordable health care to the tens of millions of Americans who now suffer without it.

[Lord Jim]

Pure horseshit by people who play "fantasy league" economics.

I couldn't agree more rube...

It's exactly the fantasy league horseshit that this was sold to the American people on by Obama, Pelosi, Reid, and a host of other Congressional Democrats, (many of whom are now as nervous as a Christian Scientist with an appendicitis about what the failure to deliver on this promise will do to their re-election prospects.)

Medicaid is healthcare. 166,000 via the exchanges and 539,000 via Medicaid. And counting. A huge win for the United States.

Now laying aside the fact that the number of people who have had their health insurance cancelled currently exceeds even this combined number by a significant multiple, let me try to explain this for your wee small Administration suck-up brain:

If the paid exchange numbers (7 million total, 2.7 million young and healthy signed up and paid by March 31st) aren't met, premiums and deductibles in the exchanges start going up. Extend the open enrollment date, and they start going up. Keep the enrollment date the same and the further away from that goal the actual number is, and premiums and deductibles go up. (Even more than many people are already finding to be the case.)

If premiums, start to spike more and more people will not be able to purchase insurance. Surely not even you are stupid enough to think that replacing millions of poor people who were using the emergency room as their primary medical care option with millions of Jessica Sanfords (middle class people who can no longer afford insurance) using the emergency room as their primary care option will make "America healthier"?

On top of this, those who do manage to scrape enough money together to afford these much higher premiums now will no longer have that money available to spend on other things, damaging every other sector of the economy, and throwing more people out of work. But that's a good thing, right rube, since those newly unemployed will now be able to qualify for Medicaid?

In fact, if we could just make everybody poor enough then everybody would qualify for Medicaid, and again, that would be a good thing, right rube? I'm sure that logic seems flawless when one applies the principles of Rubenomics...

(And we haven't even gotten to the effects of the employer mandate yet...that should help make even more people eligible for Medicaid. You should be delighted.)

The fact of the matter is that for all of these reasons, the separation of the paid exchange numbers from the Medicaid numbers has been seen by even the minimally objective, (which you aren't) or even the minimally honest (which you aren't) as the one and only appropriate way to judge the success of the program. That's why even the Administration breaks down the numbers that way, (I'm sure they'd prefer not to) and that's why the media covers them that way and that's why so many Congressional Democrats in vulnerable districts or Senate seats are so nervous.

Lately a handful of shills have taken to trying to claim the Medicare numbers as a success, but most of them, (unlike you) realize they're just engaging in pure spin, and are only doing it because they're desperate to try to find something, anything, that they can point to that on the surface at least looks kinda sorta positive about this, because the rest of it (at this point anyway) looks so awful...

The proof of this, is that until the paid sign-ups turned out to be such an embarrassment, they weren't doing it...

So let me re-iterate, if you continue to put up those dishonestly misleading numbers, I will continue to correct you.

I would suggest that you stick to the sanctimonious gasbag bromides,("The Republicans want people to die", etc.,) because the actual facts of how this is unfolding don't do anything to help your case.

making sure the ACA is an expensive, embarrassing political fiasco for Obama

You can say a lot of things about the Congressional Republicans, (I certainly have) but not a single one of them voted for this mess, and many of them pointed out the flaws and problems that now appear to be getting validated by actual events...

The Republicans did not mislead the country by getting a program passed based on the promises that if you liked your healthcare plan you could keep it, (which turned out to be absolutely false; the Administration promulgated regulations designed to squeeze the grandfathering provision down to as few policies as possible, and of course anyone who bought a policy after 2010 wouldn't be covered by that anyway...the attempts to put this all on the insurance companies were nothing but ass covering BS...even Obama realized eventually that that wasn't going to fly) or that you would be able to get better insurance at less cost, (which has turned out to be largely false with some exceptions, and will turn out to be completely false if the paid enrollment targets aren't met.) nor did they design a sign-up system for the program that's turned out to be a bad joke...

No, it was the Administration and their allies on The Hill that did all of that. So if at the end of the day, the ACA turns out to be "an expensive, embarrassing political fiasco" it will be they who own it, and rightly so.

[Lord Jim]

Look, let me state again, that I am not rooting for this thing to be an economy damaging failure. I don't want to see that kind of pain inflicted on my fellow Americans. (Some may recall that when Obama first came into office, and Rush Limbaugh was talking about how he was "hoping that Obama fails" I went on the record condemning him for it, and said that it was the wrong attitude because when a President fails, the country fails with him. I had seen many folks hoping for Bush to fail, and I wasn't going to play that game.)

And it's still possible this thing could turn around... Maybe after the first of the year, (I don't expect much improvement during the Christmas Season when people have a lot of other things on their minds and a lot of other expenses) the website will finally be functioning properly and the government and the insurance industry (which has been planning to do this btw) will finally be able to launch a massive PR campaign to get people signed up, and for the final 3 months paid enrollments will have a massive surge and the target numbers will be hit...

And maybe when the employment mandates kick in they will already have been baked into the cake and millions of people won't find that their employers are moving them to less attractive plans requiring higher contributions, deductibles and co-pays...(And maybe thousands of small businesses with less than 50 employees who currently provide insurance for their employees even though they are not required to do so won't stop doing so because they can not afford the additional costs required by Obamacare.)

But at the moment, based on the actual existing information and the numbers, and their most likely trajectories, the situation looks very bleak. This is simply a fact, and denying that, or trying to put lipstick on the pig, or engaging in some "look at the shiny object" distraction, or disingenuous blame deflection, is nothing but intellectually dishonest spin.

[Crackpot]

I personally don't see the numbers as they are at the moment to be all that bad or all that surprising as there are few that would pay for a service that they won't receive for months. I expect a modest but respectable bump through through December followed by moderate growth and a bunch of last minute sign ups (the website better be able to handle that.

Failure to achieve decent December numbers IMO will be the first reliable indicator of failure if it come to that.

As for republicans not working to undermine Obamacare... How do you explain congressman Upton's bill to "fix" the "if you like it you can keep it" fiasco? Or even the gal ogle of votes to defund or repeal The legislation? (Including a government shutdown) heck if republicans were doing their jobs and fixing the law rather than pointless grandstanding this country would be in a better position on a bunch of fronts not just health care. (They might have even gained seats last election)

[rubato]

Expanding Medicaid is a huge improvement over the prior status. Even if that was all that the ACA did it would be better than any Republican-led new social policy since reconstruction. And the ACA is improving utilisation of Medicaid even in the backwards states which are rejecting the expansion.

http://www.dailykos.com/story/2013/11/1 ... -expansion#
Much of the focus has been on two things. First, commentators have been arguing about the portents of how many people have signed up for the exchanges, noting that it both has roughly matched Massachusetts' sign-up rate and that sign-ups have fallen short of federal projections. The other strand has noted that the Medicaid sign-up rates have been a success.

But there's something else that's interesting in those Medicaid numbers as well -- lots of new people are getting covered in states that have refused to expand Medicaid. Of the roughly 392,000 people who enrolled Medicaid between October 1 and Nov. 2, about 111,000 enrolled in states that aren't expanding.

"Wait, how does that work?" you say. "I thought Rick Perry and people like him were going to stop that sort of nonsense at the state line."

But he can't. These are people who were eligible for Medicaid before the ACA, but either didn't know they were eligible, or gave up going through their state's onerous application procedures.The ACA streamlines these procedures through its "no wrong door" policy of making states provide multiple ways to apply for Medicaid -- including through Healthcare.gov or the equivalent state portal. The Supreme Court decision that made expansion optional didn't touch these improvements.

I wrote about this about a month ago:

Better administrative procedures aren’t a cure all. According to Kaiser Foundation's numbers, 8.4 million people won’t be covered under the Medicaid expansion in the foreseeable future in states that opted out, thanks to the Supreme Court’s decision. (about 5.1 million won't even be eligible for the subsidies on the exchanges, while the rest will at least have those).

But if Kaiser’s analysis is right, standardizing and easing application procedures across the board will significantly increase enrollees – by roughly 2 million people across the states that haven’t yet accepted the Medicaid expansion (more than 500,000 in Texas alone).

Texas had 11,000 new people sign up for Medicaid last month thanks to these changes. Again, this isn't a cure-all -- states that aren't expanding Medicaid have about 51 percent of the currently uninsured population and only 28 percent of the new Medicaid sign-ups. However, by cutting punitive bureaucracy and making it easier to apply, the ACA is already helping hundreds of thousands of poor people in the red states, despite the efforts of their reactionary governors.

We've got a long way to go, but things are getting better.

Now get that federal Web portal working, Obama.