Is the Affordable Care Act Doomed?

[Long Run]

I posted two very good articles from TNR taking different positions [????] on the ACA case SCOTUS will decide in this session.

Article 1: If the Supreme Court rules against the subsidy in the ACA, which is just about the best thing to happen to America in the last 10 years, it will be devastating and people will die. Republicans are evil.

Article 2: Don't get ahead of ourselves, the ACA is great and the argument against the subsidy is laughably weak. Only idiots and Republicans, but I repeat myself, could even think that the case holds any water. Even if the Supreme Court goes off the deep end and rules against the subsidy it will hurt the Supreme Court and Republicans worse than it hurts the Democrats, and everyone will see how stupid and evil they are.

[Lord Jim]

Excellent, spot on summaries...

[Lord Jim]

It seems to me that this Gruber is even more of a flim flam huckster than an earlier Gruber...

[BoSoxGal]

I posted two very good articles from TNR taking different positions [????] on the ACA case SCOTUS will decide in this session.

Article 1: If the Supreme Court rules against the subsidy in the ACA, which is just about the best thing to happen to America in the last 10 years, it will be devastating and people will die. Republicans are evil.

Article 2: Don't get ahead of ourselves, the ACA is great and the argument against the subsidy is laughably weak. Only idiots and Republicans, but I repeat myself, could even think that the case holds any water. Even if the Supreme Court goes off the deep end and rules against the subsidy it will hurt the Supreme Court and Republicans worse than it hurts the Democrats, and everyone will see how stupid and evil they are.

[oldr_n_wsr]

Meanwhile, employer-provided health care is being gutted in nearly all large companies.


yrs,
rubato

And why is that?
Only since the ACA was enacted did all these "changes" to health coverage start. While cots of HC went up and both companies and employees hated that, the employees and companies were pretty much satisfied with what they had.

[oldr_n_wsr]

And I still say, The ACA was suppised to get most of the 30-40million uninsured covered. It only has 8million (and that's a high estimate) so far. So much for getting all those uninsured covered.
And what we have how is a crumbling foundation. Anything built on top if it will collapse. Filling the cracks with spackle and paint will not hold it together.

[Big RR]

And I still say, The ACA was suppised to get most of the 30-40million uninsured covered. It only has 8million (and that's a high estimate) so far. So much for getting all those uninsured covered.
And what we have how is a crumbling foundation. Anything built on top if it will collapse. Filling the cracks with spackle and paint will not hold it together.

Oldr--unfortunately, in government (and especially in a democracy/republic) that's how laws are made; we frequently have to take less than an entire loaf and then build from there. Few programs can be passed in perfect form--we have to deal with what we can get. Yes, there are problems, big problems, with the ACA--some of which were entirely foreseeable. But 8 million more people with insurance coverage is nothing to sneeze at. Nor are the other benefits, like coverage until 25 for adult children and removal of preexisting conditions exclusions (yes, I know some states passed these prior to the enactment of the ACA, but only after it appeared the ACA would mandate them; in the decades before the ACA this wasn't even discussed). Sure, we all (or at least most of us) would love a robust and comprehensive system--but this is the best we could do at the time. And we can build on it and sure it up to get a much better system in the future.

However, junking it and leaving those 8 million without insurance again should not be an option; improving it certainly should be, but let's not be stupid. Right now the ACA is the best response to the healthcare problems in our country--problems which will only get worse if nothing is done.

[oldr_n_wsr]

I don't think (and I could be wrong) that the 8 million is totally new signups (aka people who did not have insurance before). I think a good chunk of that 8 million were people who got canceled because of the aca ( I heard it's about 6 million and again I could be wrong)

Prexisting and 26yo coveage were parts I said were good. But the foundation IMO is cracked and will fail. And as far as I can see, a total overhaul is needed and it's usually easier and cheaper to bulldoze and start over. Shore some bricks can be reused (no prexisting and 26yo coveage being two bricks we could salvage, and there may be more).

And the more I hear about this guy who architected the aca, the more I see how removed from the real world of business and life of the normal people.
But then again, he is a career academic who never lived in the real world.

[Econoline]

I'm unable to find the exact quote because I have the book I know it's in packed away in a storage container, but I think this is reasonably accurate:

"Any government program should be considered a success if it does not have an effect exactly the opposite of that which was intended."
-- Walter A. Willis

[rubato]

Meanwhile, in the real world people will be killed, bankrupted, and disabled by those trying to kill the ACA:

Lack of access to health insurance keeps U.S. premature birth rate near Somalia’s

"...

"The U.S. still has one of the highest rates of preterm birth of any high-resource country and we must change that," said March of Dimes President Dr. Jennifer L. Howse in a statement. In 2010, the U.S. ranked 131st out of 184 countries on preterm birth rate, according to a report by the World Health Organization. In that year our premature birth rate was the same as Somalia's.

Why the relatively high rate? One factor is insurance: the rate of preterm birth among uninsured women stands at 19.8 percent. To the extent that Obamacare allows more Americans to get health insurance, it will have the effect of reducing preterm births.

Another factor is that more women have been electing to have births by c-section earlier in their pregnancy terms, although the March of Dimes notes that that trend seems to be reversing.

Some states are doing a better job of reducing preterm births than others. Vermont, New Hampshire, Maine, Oregon and California all had premature birth rates at or below the March of Dimes' 9.6 percent target, earning them an "A" grade in their report card. On the other hand, Louisiana, Alabama and Mississippi all had rates above 14.6 percent, earning them an "F." In Mississippi, nearly a quarter of births to uninsured mothers were premature. ..."

yrs,
rubato

[rubato]

In any year there are changes as some people lose employer-provided HC because the employer stopped providing it or raised the rates until it was unfeasible. Several fortune 500 companies have been gradually gutting their HI plans year by year for the past 3. Some people take jobs, some lose them &c. IN any case we are looking at a huge increase in the number insured by nearly all estimates.


http://acasignups.net/

ACA QHPs as of 11/07/14: 7.1M Current / 8.3M PAID / 9.6M Total

Estimated Total, all sources: appx. 28 Million
(7.1M Exchange QHPs,
8.0M Off-Exchange QHPs,
11.0M Medicaid/CHIP,
2.0M assorted)

[Joe Guy]

Another factor is that more women have been electing to have births by c-section earlier in their pregnancy terms....

ya think?....

[oldr_n_wsr]

And some people need ot go through the whole thing again.
http://news.yahoo.com/open-enrollment-b ... 42076.html

PORTLAND, Ore. (AP) — The second open enrollment period for buying health insurance under the federal Affordable Care Act starts on Saturday. For the first time, Oregonians will be using the federal insurance exchange portal to shop for coverage, instead of the state's own failed Cover Oregon website.

Oregon's health insurance marketplace will be in a unique position: because of the switch to the federal portal, all Oregonians who previously enrolled in private health insurance will have to re-enroll via HealthCare.Gov to keep their coverage. That's in addition to uninsured Oregonians who will apply for the first time.

Oregon residents who already are covered cannot automatically roll over to the same or similar plan as the one they had last year — as people in other states who relied on the federal exchange last year can elect to do.

Altogether some 300,000 Oregonians could be enrolling in via HealthCare.Gov starting this weekend — 105,000 who enrolled through the state exchange last year and about 202,000 who remain uninsured according to a recent study.

That means there likely will be a lot more scrutiny of the various plans offered by 15 insurance carriers in Oregon, officials said.

Those who want coverage come January must enroll by Dec. 15.

Oregonians who already have insurance can switch carriers or plans, or stay with the same plan, throughout open enrollment, which runs Nov. 15 to Feb. 15. Under the federal health care overhaul, insurance companies can no longer deny coverage to people with pre-existing conditions.

Oregon abandoned its troubled exchange in April. Residents' individual data isn't being transferred to HealthCare.gov for reasons of privacy and security, state officials said.

Two other states, Nevada and Massachusetts, also will mandate already-insured people to re-enroll after similar problems.

In Oregon, hundreds of thousands of people shopping for health plans spells more competition for insurance carriers — and possibly, better deals for customers.

The state already has one of the most competitive health insurance markets in the country, Oregon Insurance Commissioner Laura Cali has said. And new health insurance rates, announced this summer by state regulators, show a much tighter ranger of premiums.

Moda, the company that captured nearly two-thirds of the market share for private health insurance because of its low prices in 2014, will see a 10.6 percent rate hike on average in 2015, according to the Oregon Insurance Division. That means Moda will now be in the middle of the pack in terms of premium prices, so the more than 70,000 Moda enrollees might want to shop around.

Some other carriers will see rate decreases in 2015. Plans from Providence Health and Trillium Community Health will both drop by about 14 percent on average, for example.

Here are a few tips on shopping for health insurance in Oregon:

.Do your research: When comparing plans, don't just look at the premiums, but also at deductibles and co-pays, and at what is covered by the plan.

.What's in the plan: Different plans have different hospitals, doctors, and specialists in their networks and those networks can change year to year. To make sure a doctor is included in a plan's network, call the insurance company and the doctor's office. Also, make sure the plan you want covers the prescription medications you need.

.Keeping the same plan: Your insurance company wrote to tell you your current plan will be offered in 2015 and you want to keep it? You still must re-enroll via HealthCare.Gov to continue your coverage.

.Do I qualify for a tax break? Americans making less than 400 percent of the federal poverty level are eligible for a subsidy, also called advanced premium tax credits. Those who don't believe they qualify for a subsidy can buy coverage outside the exchange, directly through carriers.

.Get help: find an insurance agent or a community partner to help you enroll or re-enroll. There are over 650 agents trained on how to use the insurance exchange and working with them is free. You can find one at http://www.CoverOregon.com or by calling the Cover Oregon call center at 1-855-268-3767. For help with enrollment, you can call the federal call center at 1-800-318-2596

In Mississippi, nearly a quarter of births to uninsured mothers were premature. ..."

And here I thought Obamamcare was going to solve the uninsured problem.

[Gob]

I think I see your problem ;

One-out-of-three voters agree that Americans are too dumb to comprehend the new national health care law.

Jonathan Gruber, a key architect of the law, has been caught on video saying the law was deliberately written in a confusing way so “stupid” American voters wouldn’t understand the real cost to them and thus would be less likely to oppose it.

Thirty-two percent (32%) of Likely U.S. Voters agree that the American people are too stupid to understand the true costs associated with Obamacare, according to a new Rasmussen Reports national telephone poll. Just 52% disagree and another 16% are not sure. (To see survey question wording, click here.)

Among voters who favor the health care law, only 18% think Americans are too stupid to understand the actual costs associated with the law. Those who oppose the law, however, by a 46% to 42% margin do think the American people are that stupid.

Most voters have said in regular surveys since the law was passed by Congress in March 2010 that it will increase the cost of health care in America and that it is likely to cost more than its supporters have projected. This helps explain why most voters continue to view the health care law unfavorably.


The survey of 1,000 Likely U.S. Voters was conducted on November 12-13, 2014 by Rasmussen Reports. The margin of sampling error is +/- 3 percentage points with a 95% level of confidence. Field work for all Rasmussen Reports surveys is conducted by Pulse Opinion Research, LLC. See methodology.

[Lord Jim]

I think I see your problem ;

One-out-of-three voters agree that Americans are too dumb to comprehend the new national health care law.

Jonathan Gruber, a key architect of the law, has been caught on video saying the law was deliberately written in a confusing way so “stupid” American voters wouldn’t understand the real cost to them and thus would be less likely to oppose it.

Thirty-two percent (32%) of Likely U.S. Voters agree that the American people are too stupid to understand the true costs associated with Obamacare, according to a new Rasmussen Reports national telephone poll. Just 52% disagree and another 16% are not sure. (To see survey question wording, click here.)

Among voters who favor the health care law, only 18% think Americans are too stupid to understand the actual costs associated with the law. Those who oppose the law, however, by a 46% to 42% margin do think the American people are that stupid.

Most voters have said in regular surveys since the law was passed by Congress in March 2010 that it will increase the cost of health care in America and that it is likely to cost more than its supporters have projected. This helps explain why most voters continue to view the health care law unfavorably.


The survey of 1,000 Likely U.S. Voters was conducted on November 12-13, 2014 by Rasmussen Reports. The margin of sampling error is +/- 3 percentage points with a 95% level of confidence. Field work for all Rasmussen Reports surveys is conducted by Pulse Opinion Research, LLC. See methodology.

[MajGenl.Meade]

I signed up for a KP Bronze policy while I was still in South Africa. When we got here, got online to change my address (to apartment in Kent) on 6/6/14. The system offered me a better policy at lower cost - KP Silver. So I approved that change effective 7/1/14.

Since then - phone calls beyond innumerable to KP, Healthspan and the Marketplace. Our Bronze was cancelled eff 6/30 but the Silver never went into effect. Our address was not changed. Back and forth back and forth back and forth.

By September we were on a list called the "We believe you" list - KP or rather Healthspan didn't know we were covered but "they believed" us... The premium billing group confirmed we had the Silver plan - Customer Service said we didn't. But Customer Service had our new address (our house) while Billing still sent bills to the apartment. Billing can only change our address if the Marketplace says so. The Marketplace said "if same zip and same county" don't call us - call your Customer Service. Round and round and round

Today - Customer Service knows we have Silver (they learned this 11/6 - this is since 7/1 or 6/6/ depending on how you're counting). Billing still refuses to send our premium bill to our address even though Customer Service confirmed it to them.

Still 'n all. At $112/ month I'd like to thank all you tax payers and Democrats out there for subsidizing my family plan. Obamacare works (in the right place)

[Lord Jim]

[quote="Gob"]I think I see your problem;) ;

Oh, you mean the Healthcare Fairy...

[MajGenl.Meade]

Marketplace must have lost your point (or did I?)

I think I see your problem ; etc etc

[Lord Jim]

Oh bloody hell...

[rubato]

Jon Gruber is not a reliable source on Jon Gruber; public attention has gone to his head and he has recently begun free-associating just to keep the klieg lights on. Or has been whored along with McConnell.

http://delong.typepad.com/sdj/2014/11/j ... .html#more

Jon Gruber in 2011: Yes, Subsidies Are Available to People Purchasing Health Insurance on the Federal Exchange

Back in 2011 when Jon Gruber was writing Health Care Reform: The Graphic Novel he assumed that subsidies were available to all purchasing on any exchange--whether a state-initiated §1311 exchange, a joint exchange, or a federally-initiated §1321 exchange did not matter: families will pay no more than 9.5% of their income to purchase health insurance--not families living in states that have established §1311 exchanges: families full stop:










The truly remarkable thing about Halbig/King is that conservatives care much more than liberals do that the health exchanges actually work. Health exchanges are a last-ditch conservative attempt to keep private health-insurance markets from collapsing under the weight of increasing adverse selection and decreasing willingness to provide a large tax subsidy for employer-sponsored insurance. If the exchanges fail, the liberals try again in another decade with single-payer--Medicare for all--in order to attain near-universal coverage. If the exchanges fail, conservatives are out of arrows.

I have never understood why conservatives interested in health policy have not drawn a line in the sand here--have not said to their political masters: "Yes, we know that you have a strong partisan interest in destroying the signature accomplishment of a Black Democratic president. But the substantive policy stakes are too high."

yrs,
rubato