Obamacare / Affordable Care Act : classic or dud?

no thread on this (i'm pretty sure) except

Roberts vs Obama: Affordable Health Care Act goes to SCOTUS

the website

https://www.healthcare.gov/

is so swamped you can't sign up for anything

still as much of an insurance-company bonanza as when Bob Dole ran on it.

(yes, it make some improvements over the shit we've had the last 40 years, well chronicled)

The affordable care act is so unpopular with Americans that even our patriotic internet hates it huh

Millions of Americans flocking to that website to verify their incredible disinterest in the whole thing

Big fan.

we should join the civilized world and institute single-payer. oh, i forget -- jesus was anti-healing

i'm self-employed and have a high deductible plan with BCBS TN - something most likely in line withe ACA's bronze plan. there's a chance my monthly premiums will go up by a few bucks if I go through the exchange. but i will likely do it anyway, mostly out of spite.

this truly is the best of all possible worlds

i will likely do it anyway, mostly out of spite.

You are a true American.

USA!!

I'm at the security questions page and none of the boxes have anything in them. What do i do?

Via Balloon Juice:

Commenter Emerald:

HaHaHaHa! I’ve been without coverage for nearly 13 years. (Took care of my Dad for 10 of those).

I qualify for the “Enhanced Silver” plan in California. Cheapest for me would be $3 per month for an HMO. Most expensive would be $159 for the Anthem Blue Cross HMO.

But unless my doctor is in that $3 plan (he might be–he takes more insurance than most), I’ll be deciding between the $94 Anthem EMO or Blue Cross PPO at $122.

Without the subsidies these all would be from $679 to well over $700 per month.

And I’m turning 63 in Dec and have been diagnosed with gallstones.

Commenter MomSense:

Just went to ObamaCare and filled in the information and I am going to get insurance much cheaper. Was paying 1,600 a month for years because I have a pre-existing condition and then because of some life changes I couldn’t afford it anymore so have been waiting and praying to be healthy until I could sign up. Starts at $243 a month so now I am going to decide on the plan! I can manage this!!!

Commenter BotSplainer:

I looked at Kentucky’s exchange. I can insure 4 of us (eldest daughter living away undoubtedly qualifies for enough subsidy to bring her a separate policy under $100) for somewhere between $850 and $950. Even if I get no tax credit at all,…. we’ll get a plan that has a $1500 deductible for the same price as our current tub of shit with a $15000 deductible.

This kind of plan has never been available to me at rates like this. Also, it ensures that my youngest daughter is insurable (she would never pass underwriting on the individual market – a biopsy…

I'm kind of excited to remain underemployed and still have coverage. Maybe not GREAT coverage like I had under my giant corporation job but still.

Those comments are incredible. We have friends with a daughter recovering from leukemia, and she was telling us how without the new laws, her daughter likely would have been denied coverage outright, or at least maxed out on coverage as the medical costs inched into the five or six figures.

Tried 5x to register, no luck. I think I know how GTA: Online players are feeling right now.

To test it, I tried it about ten minutes ago and answered a bunch of questions w/out a glitch.

not working for me, glad it's working for someone tho

I'm kind of excited to remain underemployed and still have coverage. Maybe not GREAT coverage like I had under my giant corporation job but still.

― Tottenham Heelspur (in orbit), Tuesday, October 1, 2013 11:54 AM Bookmark Flag Post Permalink

The law makes me feel like I have a better shot at ever leaving my job to try something more risky (e.g. starting a coffee business).

I'm also wondering how it will work out if H goes on prolonged childcare leave again, i.e. curious whether we can get a plan that's actually cheaper than my office plan, which has pretty high premiums AND high copays/deductible.

The law makes me feel like I have a better shot at ever leaving my job to try something more risky

OTMFM. I've made the argument for a long time that a lot of business owners are probably shitting bricks over ACA if only because of the potential number of employees who are clinging to awful jobs just to keep from losing their insurance.

lol Adam

*fistpump* at more ppl being able to get medical coverage

http://www.wnyc.org/story/faqs-about-health-care-exchanges/

day one glitch watch

http://nymag.com/daily/intelligencer/2013/10/obamacare-glitches-day-one-roundup.html

The original bill's timeline for getting the exchanges up and running was optimistic. That long period of uncertainty while the SCOTUS mulled over the ACA probably didn't assist the development process any.

Fox News, of course, has a "glitch watch" section on its website...

Did they ever have a glitch watch for the Iraq war? Because...

I'm 100% sure the glitches are part of the shutdown plan. Shut down the government the day this takes effect, make everyone stay home with nothing to do but go on the internet and crash the one health website! Republicans no doubt saw this happening and it's working like a charm!

The thing they realize is that it matters not who gets the blame. "Government" will get the blame! Because ultimately they have found a way to make government employees stand in the way of me and my health care: by temporarily laying them off, forcing everyone to stay home, clogging up the health website, and making it so I can't register.

I guess it's a good argument against centralization. Hopefully they will have it back up and running in a hot minute.

The law makes me feel like I have a better shot at ever leaving my job to try something more risky

OTMFM. I've made the argument for a long time that a lot of business owners are probably shitting bricks over ACA if only because of the potential number of employees who are clinging to awful jobs just to keep from losing their insurance.

Yes, this is all exactly correct. If ACA can break the non-sensical link between a certain type of employment and healthcare, it will help many people beyond just the uninsured.

and making it so I can't register.

You know you have six months, right?

Was gonna say, it's not Glasto tickets

http://www.youtube.com/watch?feature=player_embedded&v=sx2scvIFGjE&list=UUa6vGFO9ty8v5KZJXQxdhaw

You really don't have to think very many steps beyond "everyone gets access to affordable healthcare" before you start seeing net benefits. Re: breaking the nonsensical link between work and healthcare, doesn't this spur innovation? How many people would take a chance on something they're passionate about if it weren't for the spectre of losing health coverage? For instance, an underpaid high school teacher with health problems could quit the job he's hanging onto just for the insurance and go work at, say, a carwash while he puts the bulk of his time into a startup venture that puts more money into the economy.

i'm not sure if obamacare motivating a high school teacher to quit is the best example

LOL

FUCK THESE KIDS, i'm going to use my newfound flexibility to enter the realm of venture capitalism!

and be the one who knocks

Was gonna say, it's not Glasto tickets

Ha, my first thought was hey, if we can navigate buying concert tickets, we can handle this. Not a lot of Americans buying Glasto tickets, tho.

I made a similar joke on fb earlier, but used Bieber as the punchline.

I know, and that had more relevance.

Still, tho

Ugh a disaster

http://articles.philly.com/2006-01-12/news/25410200_1_medicare-spokeswoman-medicare-beneficiaries-medicare-prescription-drug-program

Posted: January 12, 2006

you missed the joke

idgi

seriously guys?

prescription drug package has awful roll-out in 2006; today nobody complains

I got my 2014 rate pamphlet from my health insurance company yesterday, and my new plan's premiums are $28 less a month, but the copays and prescription costs and the deductibles for serious stuff have all doubled. Is that what other insurance companies are doing?

Was this posted? It's been making the rounds:

http://www.hulu.com/watch/539715

(Jimmy Kimmel Obamacare vs. ACA bit)

sarahell do you have an individual plan or an employer plan?

Companies are generally increasing deductibles and going to cheaper plans like HDHPs with built in HSAs, and what your plan did sounds like another way of cost-cutting, trying to empower you to save up the money to pay for the 'gap' in expenses by...saving you a measly $28/month.

I have a corporate exchange plan, so it's probably staying the same, but the price is being jacked up.

I have an individual plan.

hmm - not sure about those. not surprising though. this is why a single-payer system would have been preferable, but yeah, obviously that'll never happen in our lifetimes...

Maybe amazon and google can make single payer happen

as in they pay for it?

I wish!

I'm still not clear -- and none of the information I've received/have been directed to has explained -- how the credit for insurance is calculated or how the low-income exclusion is calculated.

I'm certainly related to people who are having hysterical meltdowns about their individual plans going way up deductible and co-pay wise, but they haven't compared against plans they're able to get through the exchange. I imagine those might be cheaper but not as cheap. I think it is likely that minimum benefits requirements by ACA are leading insurance companies to jack deductibles way up. But it's the companies that are doing this based on....nothing. Or based on their own voodoo cost analysis. They could certainly slim their profit margin down instead.

My understanding is that the places people will be hurt most are in the states where Republican governors are preventing the gov't from helping most.

I may have some of the particulars wrong here but -- my gf got a letter from Aetna saying that soon her $322 monthly premium would be reduced by approximately $100. she carries a high deductible (paying 100% of coverage up to $5k, then 80% costs between $5k - $8k, and 0% after $8k) and her copays are $35 & $50, IIRC. She gets reduced cost generics pharmaceuticals. The letter then went on to say that if she were to go through the exchange and pick a comparable plan (which i can only assume would be the "bronze"?) that she could save an additional $50. So unless this is all bs, she stands to practically cut her monthly premium in half without affecting her coverage at all.

oh, and thanks to NObamaocare her birth control now has to be covered under her current policy, costing her $15/ month rather than $65/ month.

we're in a state with an asshole Republican governor, btw.

Going through the exchange/marketplace is what sets you up for the income-based tax credits, so if you aren't presently insured this is easily the best way to go. NB: insurance agents who sign you up for policies through the exchange won't charge you a fee for the service; it's paid for by other means. I am among the bare-assed no-insurance multitude, so I'll be looking into it in the next few months.

yeah, that's what's weird. i really don't think she'll qualify for any subsidies. so maybe the idea was more that it's possible she could save more by going through the exchanges, assuming she'd qualify. Aetna wouldn't know her income afaik.

They could certainly slim their profit margin down instead.

This. It will largely depend on whether the transparency of the exchanges cause insurance companies that inflate profits to lose market share in a big way, lowering revenues in a big way. The companies won't reduce profits until forced to, because they are afraid Wall Street will hammer their share price and share price drives the net worth of CEOs and other execs.

Has there been any asshole commentators going on about how the private industry wouldn't have had the server crashes?

Cuz Day One server usage spikes _never_ do not crash systems. The vidja games industry his used to this stuff; GTA Online is the biggest thing ever and Rockstar couldn't handle the server load. EA had SimCity died repeatedly the first week. Blizzard runs the worlds biggest MMO and their Diablo III wouldn't initialize, StarCraft II kept losing it, and Microsoft and Sony are going to be hit hard when the next-gen consoles go online next month.

I imagine you could really create a lot of jobs if you wanted to overhaul America's shitty internet infrastructure...

Here is the screwjob for Texas retail workers that doesn't hurt me (full time) but kills my coworkers. My company has cut insurance for part-timers. Texas hasn't expanded Medicaid. In order to earn enough to be eligible for a subsidy on the Federal Exchange, you would have to be working full-time. If you are working full-time you would have insurance from your employer.

24 hours a week at $7.75 an hour - $9672 - no Medicaid, no subsidy.

30 hours a week at $8.25 - $12,870 - no Medicaid, no subsidy,

35 hours a week at $9.00 - 16,380 - full time status, eligible for huge subsidy, except not because you now have a more expensive plan from this employer.

You can't work 2 jobs because these kind of jobs require ridiculous availability to get any hours at all.

I'm pushing the idea of selling crafts (knit scarfs) and services (cook dinner) to your friends and declaring the income to get the subsidy. While your friends sell you their old things (socks and CD's) and declare the income to be eligible for the subsidy.

On behalf of my working poor co-workers, thanks Rick Perry and Barnes & Noble (and Obama and Republicans and the insurance industry and the bluedogs).

I guess we should all quit and get another education.

The working poor are getting shafted in roughly half the states of the USA, because the law was designed to subsidize them via Medicaid expansion and consequently they were excluded from tax credit piece of it. The Republicans pushed very hard for the ability of states to opt out of the Medicaid expansion. I hope this blows up in their faces and they created a huge army of working poor enemies, voting against Republicans for life.

so i assume governors/ state legislatures can reassess their decision to opt out of the Medicaid expansion under Obamacare at some point? or has that ship sailed?

No take backs.

They could certainly slim their profit margin down instead.

There's not all that much wiggle room. By law, 85 cents of every dollar brought in has to go towards paying customers' claims. And we all know course CEOs and other execs can't survive without $20 mil/yr salaries so...

Pretty disgusting how selfish so many people are with this issue. "My deductible and premiums are going up somewhat!!" "Yes, we need people to make this sacrifice so that 26 million uninsured fellow Americans can obtain coverage" "FUCK THAT AND FUCK THEM" "They'll still have to pay for..." "I said FUCK THEM".

I particularly love when my dad takes hardline stances like that, considering he owes me $3,000

Our old friend Ed Meese led one of the organizations devoted to fighting the law:

http://www.nytimes.com/2013/10/06/us/a-federal-budget-crisis-months-in-the-planning.html?pagewanted=2&_r=0&ref=politics

where's Al Qaeda when ya need em

From a piece on a "conservative Georgia district" encouraging their reps to dig in against O-care... Single-payer is a nonstarter? People understand shit-all about it and don't know what they want.

Mr. Tripcony, the surveyor, said he underwent heart surgery not long ago without health insurance, “a bad blow.” He has been making payments against the cost. He had heard of the online marketplace for insurance that opened on Oct. 1 under the Affordable Care Act.

“I just don’t trust it,” said Mr. Tripcony, who has an equal distrust of President Obama. “I don’t like him, and I don’t feel comfortable with anything he’s got to do with.”

Mr. Tripcony said he had a better idea for a system to provide health care at a fair price. “I think it should be the same for everybody,” he said. “One big company, whether owned by the government or private.”

Informed that he had described the single-payer system that Mr. Obama abandoned when Republican critics called it socialized medicine, he said, “Yeah, I know, it’s crazy.”

He said he might eventually seek health insurance under the new system. “In a couple of months, when they get the Web sites working, I may do it.”

http://www.nytimes.com/2013/10/06/us/politics/conservative-georgia-district-urges-gop-to-keep-up-the-fight.html

this is what i wanted to know:

To determine eligibility for a subsidy, the government uses modified adjusted gross income, or MAGI. To get this figure, start with the line labeled adjusted gross income on your tax return (it's the last line on the first page of Form 1040). Then add in non-taxable Social Security benefits, tax-exempt interest and foreign earned income, and housing expenses for Americans living abroad.

http://www.nytimes.com/2013/10/13/us/politics/from-the-start-signs-of-trouble-at-health-portal.html?pagewanted=1&_r=0

so basically you can subtract student loan interest, IRA contributions and other deductions, and it isn't just your total income.

http://www.nytimes.com/2013/10/13/us/politics/from-the-start-signs-of-trouble-at-health-portal.html?pagewanted=1&_r=0

― balls, Sunday, October 13, 2013 8:43 PM (1 hour ago

yeah it's a disaster on so many levels

the coincidence of the government shutdown and the disastrous obamacare rollout is just that?

Create a Marketplace account

Important: Your account couldn't be created at this time. The system is unavailable.

what is using the marketplace phone number like? can they sign you up entirely over the phone?

i'd love to know. leery of calling. i tried again through the website and got all the way through creating an account, password, security questions, and preliminary address info . . . but then stalled at "Who are you applying for health coverage for?"

apparently you can apply by mail

"Unable to advance the customers’ applications by phone, navigators handed them paper applications. According to Lucchesi and Sands, navigators urged: Go home, fill them out and then in a few days, set up a meeting with one of us. We’ll input your information because online sign-up still will be faster than mailing it in."

wonder how much the glitchy ramp up is due to sabotage patrol on the norquists, kochs, and o'keefes of the world

"The number of visitors to the federal government's HealthCare.gov website plummeted 88 percent between Oct. 1 and Oct. 13"

http://www.washingtonpost.com/blogs/post-politics/wp/2013/10/15/analysis-obamacare-glitches-scare-off-many-web-site-users/

That's accounted for by 100s of unpaid cable news interns moving on to the next time kill boondoggle.

the heritage foundation doesn't like the national implementation of its early '90s health care plan

http://www.heritage.org/research/reports/2013/10/enrollment-in-obamacare-exchanges-how-will-your-health-insurance-fare

it seems to be working in NYS now

Well that's good. Though, I mean, nobody is defending the shitty rollout really. It's clear that volume came in well above projection (they estimated that traffic was about 50x larger than it was when Medicare D rolled out), but it's still fairly pathetic that they still don't have all of the kinks worked out. Liberal friends of mine that want insurance are pissed.

But it's humorous watching conservatives get overexcited that this is proof that the act is a failure. As Alfred posted upthread, Medicare D was actually worse in some ways because it didn't even go live the day that was promised, and it had a much smaller volume of folks in the first week attempting to access the site. And now, Med D is an afterthought.

Some asshole I was arguing with the other day went as far as to say there are few signs that this will be improved and suggested this could be Obama's "Iraq". gtfo.

i thought that ACA insurance policies don't go into effect until January, or am I getting confused with just the tax issues part

http://acasuccessstories.tumblr.com/

As the start date for the new regulations looms at January 1, most of [the 14 million people in the individual-insurance market] are receiving cancellation notices. That is a terrifying experience in a country where the cancellation of health insurance has been a disastrous life event roughly on par with losing a job. They are receiving those notices because the regulations Obama promised, and which were the most popular parts of his plan — ending the lifetime caps, the preexisting condition discriminations, and other risk winnowing — ended the individual-insurance market as we know it.

http://nymag.com/daily/intelligencer/2013/10/you-like-your-plan-you-can-keep-it-sort-of.html

Are you serious, what you just said!? Are you really serious!? After what we’ve gone through and what we’ve gone through in the last three and a half years? Have you — you can sit there and say, that you had a legitimate alternative after these years? We’ve gone through 44 votes, 48 votes now, of you trying to dismantle the legislation. You call that cooperation? I don’t!

https://www.youtube.com/watch?v=9owwg1LALxk

i thought that ACA insurance policies don't go into effect until January, or am I getting confused with just the tax issues part

earliest effective date is Jan 1, but you can enroll now

I answer questions from insurance agents as part of work, and my god it's scary how little they even know about ACA. I'm still getting questions about what xtra charge someone with such and such condition should expect...

Yeah. The Corner is ablaze with protestations of doom.

So is The Blaze for that matter

I answer questions from insurance agents as part of work, and my god it's scary how little they even know about ACA. I'm still getting questions about what xtra charge someone with such and such condition should expect...

― A True White Kid that can Jump (Granny Dainger), Tuesday, October 29, 2013 9:02 PM (1 hour ago) Bookmark Flag Post Permalink

my girlfriend got a letter from her new employer insurance company that literally was written as if the ACA didn't exist. She had to call them and remind them that things are changing on January 1st.

I have a question -- I have an individual plan that if I do nothing will just renew into a different plan where I'll be paying a lower premium but have slightly higher costs for co-pays, prescriptions, deductibles, etc. But, I am eligible for financial assistance if I go through the marketplace. Can I just go to the marketplace and sign up for the same plan that way?

HealthCare.gov: How political fear was pitted against technical needs

“They were running the biggest start-up in the world, and they didn’t have anyone who had run a start-up, or even run a business,” said David Cutler, a Harvard professor and health adviser to Obama’s 2008 campaign, who was not the individual who provided the memo to The Washington Post but confirmed he was the author. “It’s very hard to think of a situation where the people best at getting legislation passed are best at implementing it. They are a different set of skills.”

Every project ever.

good luck, lolmerica

http://www.theblaze.com/wp-content/uploads/2013/11/BYA1XZfCEAAZdEi.jpg

https://www.youtube.com/watch?v=OBlEurEYHTM#t=15

i guess people like their catastrophic only, high deductible, limited doctor visit, no copay plans more than the president bargained for?

it never fails to blow my mind how much people WHO HAVE insurance have to pay

like, ON TOP OF the premium

i thought the point of insurance was that you pay the premium and then if the thing you're insured for happens, you don't have to pay. does any other kind of insurance work like this? like yeah, i've got car insurance except that i have to pay the first $5000 of repairs. how is that insurance???

like yeah, i've got theft and damage insurance for my phone except i have to pay the first $200 of the replacement cost. THAT'S NOT INSURANCE.

Car insurance only covers accident repairs. You still have to pay for everything.

Insurance is like getting a phone with subsidized cost with a mobile plan. Or not. You can't get fun games with insurance.

lol is iphone insurance the only kind of insurance you've had tracer?

also you might want to examine yr phone insurance, it probably doesn't cover what you think it covers.

so did anyone read this? The "you" in the headline seems to openly address the quiddities stockbroker readership.

Tom Scully, 56, is slightly taller than average and has tousled graying hair, an athletic build and a lopsided smile. He typically projects a combination of confidence and bemusement, but on this rainy September afternoon, he was frenzied. Scully was scheduled to deliver the keynote address at an event hosted by the Potomac Research Group, a Beltway firm that advises large investors on government policy (tag line: “Washington to Wall Street”)....

Before he even began his speech, one attendee said he feared that only three million new patients, far fewer than estimated, would be signing up for insurance. “No way,” Scully said. “Way more — way more. At least 15 million, maybe 20 million. The Democrats have a huge incentive to make this work.” Another asked if Scully was worried about Congressional repeal. “It’s just not going to happen,” he said. “Don’t pay attention to Rush Limbaugh.” When Scully finally began his speech, he noted that the prevailing narrative among Republicans — assuming that many in the room were, like him, Republican — was incorrect. “It’s not a government takeover of medicine,” he told the crowd. “It’s the privatization of health care.” In fact, Obamacare, he said, was largely based on past Republican initiatives. “If you took George H. W. Bush’s health plan and removed the label, you’d think it was Obamacare.”

Scully then segued to his main point, one he has been making in similarly handsome dining rooms across the country: No matter what investors thought about Obamacare politically — and surely many there did not think much of it — the law was going to make some people very rich. The Affordable Care Act, he said, wasn’t simply a law that mandated insurance for the uninsured. Instead, it would fundamentally transform the basic business model of medicine. With the right understanding of the industry, private-sector markets and bureaucratic rules, savvy investors could help underwrite innovative companies specifically designed to profit from the law. Billions could flow from Washington to Wall Street, indeed.

Scully, who has spent the last 30-some years oscillating between government and the private sector, is hoping to be his own best proof of the Obamacare gold mine. As a principal health policy adviser under President George H. W. Bush, he helped formulate many of those past Republican initiatives... During the past three years, as other Republicans have tried to overturn Obamacare, Scully searched for a way to make a killing from it.

http://www.nytimes.com/2013/11/03/magazine/the-president-wants-you-to-get-rich-on-obamacare.html

lol is iphone insurance the only kind of insurance you've had tracer?

rumbled

actually i have renter's insurance too but that's it

did read it but if the point is that obamacare created a new generally for profit utility then yes, i was awake in 2009 also

didn't rather

i guess people like their catastrophic only, high deductible, limited doctor visit, no copay plans more than the president bargained for?

Stepping up to a plan that wasn't absolutely terrible, even w/ tax credit subsidy, would have cost me about 40% of what I spend on rent per month.

I'll pay the fine, fuck it. The plans I could afford would have done almost nothing for me in the event of an emergency - I can't pay $5k any more than I can pay $15k.

:-/

no offense but that sounds kind of short sighted

does any other kind of insurance work like this? like yeah, i've got car insurance except that i have to pay the first $5000 of repairs. how is that insurance???

― TracerHandVEVO (Tracer Hand), Wednesday, November 6, 2013 4:31 AM (7 hours ago)

actually yes! And it depends on what kind of car you have and how old it is. Unless I get hit by someone with insurance and their insurance company agrees they are at fault, all repairs to my car are out of pocket for me because my car is almost 25 years old. However, applying the concept of "salvage value" and "totalling" to a human life would be pretty "small o underscore capital o"

Possibly, but I see no upside to paying $125/month (I think) for a high deductible, shit co-pay plan for my two doctor visits/year that I average.

Going to $250-260/month got co-pays in the realm of $30 and deductibles down to $2500-3000 - but, again, I go to a doc in a box twice a year at the most.

It just doesn't make financial sense for me. If I needed a long hospital stay or a major surgery I'd be fucked in any case, so I'll just go to the county hospital and they can try to squeeze the money out of me.

are you self-employed?

If I needed a long hospital stay or a major surgery I'd be fucked in any case, so I'll just go to the county hospital and they can try to squeeze the money out of me.

i don't get this. surely you'd rather owe $5k than $15k?

Milo, would you declare bankruptcy over 5k in medical debt?

That's a pretty big hypothetical Matt.

Also, good luck with this one, Milo.

milo what if you get a hernia? etc etc? i understand being annoyed at the cost but without insurance you could literally end up bankrupting not just yourself but your relatives.

that was what finally made me realize why insurance was kind of non-negotiable: my parents were like, who do you think is going to have to pay for it if you get clipped by a taxi and need surgery?

That's a pretty big hypothetical Matt.

Not really, no

well, insurance doesn't mean that you won't have to pay a large amount of $ if something horrible happens to you. A friend of mine, who was insured through Healthy San Francisco, got hit on his bike by a city vehicle and his medical bills are probably up to a million dollars at this point.

Milo don't you shoot guns as a hobby?

The plans I could afford would have done almost nothing for me in the event of an emergency

So presumably the subsidies for low-income earners either didn't apply to you or the amount was inadequate to make the insurance affordable. If it's the first case, then you may need to look at your finances and figure out how to lower your expenses. If it's the second, then the subsidy levels in the law may not be generous enough to accomplish its stated goals.

If it's the second, then the subsidy levels in the law may not be generous enough to accomplish its stated goals.

Um, pretty sure it's the latter! No surprises there!

Not really, no

What if he only had $5k in med debt but $15k in revolving credit debt? Or $100k in mortgage debt + $5k in med debt?

Aimless OTM.

xp

Supposedly, the fines for refusing insurance will help fund the subsidies for those who participate. If there is a massive refusal, then the subsidy funding ought to be readjusted to reflect that fact, since the revenues from the fines should be much higher than anticipated.

i think you can be exempt from the fine if insurance is 40% or more of your adjusted gross income or if you are not required to file a federal tax return. I think the original idea -- or one that bleeding hearts like me wanted to be the original idea -- was that Medicaid/Medicare would cover the lower income people who couldn't afford the cheaper plans

/Not really, no/

What if he only had $5k in med debt but $15k in revolving credit debt? Or $100k in mortgage debt + $5k in med debt?

Aimless OTM.

xp

But that's not what he said, he said that 5k in debt was functionally the same for him as 15k (and of course it could be much more than that).

I think there is something to Milo's point here - if you can only afford the cheapest plans, you migh also probably not the kind of person who has an easy time keeping an extra $5k in dry powder in case of a catastrophe. If anything, the low-cost, high-deductible plans are probably more ideal for a young healthy person with good income/assets who just doesn't care about anything other than catastrophic events.

That said, not having 5K lying around doesn't mean that 5K = 15K = 100K in terms of the consequences.

well, insurance doesn't mean that you won't have to pay a large amount of $ if something horrible happens to you. A friend of mine, who was insured through Healthy San Francisco, got hit on his bike by a city vehicle and his medical bills are probably up to a million dollars at this point.

That's why the caps on out of pocket pay are the second best part of the law.

xp - well if you are barely scraping by financially as it is, and you are healthy enough not to need medical care on a regular basis, then paying for health insurance that you don't immediately need, and potentially being penalized for not doing so -- that's adding insult to injury. It feels like being penalized for being poor.

That said, not having 5K lying around doesn't mean that 5K = 15K = 100K in terms of the consequences.

this is key

perceptually, though, any of those amounts would equal being financially fucked

you can't afford not to afford care

Medicaid/Medicare would cover the lower income people who couldn't afford the cheaper plans

They do to some degree, right?

I think this was discussed either way upthread or in a politics thread, but some states are not complying with this

If I needed a long hospital stay or a major surgery I'd be fucked in any case, so I'll just go to the county hospital and they can try to squeeze the money out of me.

I'm not understanding why you'd be fucked if you had insurance

because he can't afford an insurance plan that would cover enough of the costs to make it so he isn't financially fucked!

even if ACA works as intended, our system is such a ridiculously fucked up one, only a matter of time before it needs another major overhaul. which is why I'm getting fuck out of health care industry asap.

there are debt relief options out there and obviously debt relief is more effective for 5k than 100k

for any non-emergency condition, he could just go out and get insurance and then get the surgery or whatever, and then cancel coverage.

which is why ACA is flawed. Insurance works on either risk management or the vast majority of a population buying in. I think private insurers should be able to decline offering insurance to anyone they deem to be a bad risk BUT there needs to be valid public option for those declined to fall into.

and a public option that is affordable (even free) to poor people

takers!

I think private insurers should be able to decline offering insurance to anyone they deem to be a bad risk BUT there needs to be valid public option for those declined to fall into.

so it's structurally baked in that the government takes care of the expensive cases and the private insurers take care of the cheap cases? hmm

not to mention the incentive for private insurers to bump the expensive cases they already have OFF their roles -- the govt will take em!

well, that's why it's called the Affordable Care Act. The concept of insurance has been warped for a long time.

so it's structurally baked in that the government takes care of the expensive cases and the private insurers take care of the cheap cases? hmm

either way we are all paying for everyone else's healthcare, whether it's premiums or taxes. Something like Germany's system seems far better than anything we've come up with.

not to mention the incentive for private insurers to bump the expensive cases they already have OFF their roles -- the govt will take em!

you can't just "bump" expensive cases off your roles

like even before ACA, you couldn't do that

I'm admittedly in the same boat as milo. don't qualify for medicare, and the cheapest plan available for me through the state marketplce is $300 a month, which is a big chunk of my income. Want to support the system but it might just make more sense to pay the fine

There are no bronze or catastrophic plans available in your state? No federal subsidies?

those are the bronze plans... i really need to look them over again, but the NYS site goes down every other day

Just 4 People Have Enrolled In Obamacare In Delaware

whoah, comments on that article are super-gloaty

Pretty sure bronze plans aren't 300 bucks. I have what amounts to a silver/platinum plan with free doctors visits and free yoga and all kinds of holistic shit with freelancers union and it's only 345 and that's pre-ACA. There are already ways to get bronze level plans for 150 ballpark from Freelancers, Fractured Atlas and other sources.

maybe a testament to how well romneycare is going to work out is "conservatives" lying about how expensive it's going to be, by always leaving out the subsidy effect? if romneycare sucked so much, they wouldn't have to lie at all . . . unless "conservatives" just can't help being deceitful, that is

this seems like a good, concise summary:

Here Are The Five Big Reasons Obamacare Is Changing People's Insurance Premiums

last paragraph of that is key

xxxp - On the national exchange, I think bronze plans (for me) were ~$250 before subsidy.

Milo you're in Texas, right? You can still get a nonACA plan. Though come 2015 you'd have to switch to ACA anyway, as I understand it.

so if you wanted high deduct plan and you're relatively young and no significant med history, your premium would be way lower than $250

last paragraph of that is key

actually, that's how i came to the story, because digby was praising the article as a whole but taking issue with the final paragraph.

here's the final paragraph:

ACA supporters need to argue not that these people don't exist or that their circumstances only changed because of greedy insurance companies; they need to argue that their losses are more than offset by the gains of the sick and uninsured who will get better and more affordable coverage under the law.

here's digby:

I'm sure that many people are moved by altruism and fully understand that some must pay more so that others can have insurance. But many of the people I know who are being hit with higher premiums live in or near expensive cities where many salaries above the cut-off for subsidies (around 45k for a single person) don't go very far. After factoring in housing and transportation they don't actually have a lot of disposable income. So this is going to hurt.

I have been talking about this for a long time. Lecturing middle class workers and small business people who are already feeling squeezed about how they should be happy to be the only people who will have to sacrifice for the greater good in this scheme just doesn't strike me as a big winner. Unfortunately, it seems to be the only rationale on offer.

Lecturing adults is always a sign of shaky leadership.

xp yeah that seems to be one of the biggest flaws with the act -- it seems to shift a lot of the burden for paying for the poor onto the barely-not-poor. I wouldn't say it's a fatal flaw, but it's something that should be worked out with further reforms imo.

wonder how the romneycare website would be operating right now if the republicans hadn't shut the federal government down the day the website went live

exactly the same????

i mean i get that you're 14 or whatever but good lord

Lecturing middle class workers and small business people who are already feeling squeezed about how they should be happy to be the only people who will have to sacrifice for the greater good in this scheme just doesn't strike me as a big winner. Unfortunately, it seems to be the only rationale on offer.

yes yes yes exactly -- I want to OTM this a hundred times; wrote something similar today.

That's not 100% accurate though. Those groups aren't the "only people who will have to sacrifice." Anyone who has or would have had an individual plan, is relatively young, and in good health is going to have to sacrifice no matter their income. Granted, a $30k worker will feel it more than a $300k worker.

exactly the same? are you 13?

Denial-of-service tool targeting Healthcare.gov site discovered

Big Dog snags a headline

"I personally believe, even if it takes a change to the law, the president should honor the commitment the federal government made to those people and let them keep what they got,"

Interesting.

hmm did the "federal government" make that commitment? i guess so, in a way...

two uh opposition takes, one to take sort of seriously:

http://www.forbes.com/sites/stevenhayward/2013/11/11/obamacare-will-be-repealed-well-in-advance-of-the-2014-elections/

and one to just take in for the laffs

http://pjmedia.com/michaelwalsh/2013/11/11/unaffordable-care-act/3/

Ugh, these people are the worst: http://talkingpointsmemo.com/dc/feinstein-cosponsors-landrieu-s-bill-to-unwind-obamacare-market-reforms

Charles Pierce mourns the beginning of what might be the end:

If the Democratic party, through its elected leaders, bails on the health-care law even so far as go out of its way to let people keep their lousy insurance plans that do not come up to the Affordable Care Act's specifications, that's pretty much the ballgame. There will be barbering and compromising until hell won't have it and, eventually, the only thing left will be the Medicaid expansion, and we all know the vast influence that poor and lower middle class people have over the political process. (And, as Steve M shrewdly notes, the Democrats will get blamed for the deleterious effects of any changes now anyway.)

i hope pierce is overreacting. after five years of kenya, bill ayers, pastors, you lie!, filibusters, solyndra, college transcripts, staged bin laden killings, secret muslimismism, and benghazi!!!!!!, the right finally has something on BOB. it's almost cute how gleeful they are (after shutting down the government!) but (big) if the dems hold strong nobody's gonna remember this next november

a growing meme? seen in comment boxes, twitter responses: that the Ocare rollout was botched on purpose, that maximum chaos and wrecking indiv market is all to pave the way for single payer

seeing this from (apparent) conservatives, i should say. ha.

Tensions escalate between Democrats, White House

oh lord Politico. Seriously, don?

Politico runs "Tensions escalate between ________ and _________" twice an hour.

obama could veto any of these proposals that have been popping up over the last few days. hopefully he'll keep his spine.

the oregon exchange still doesn't have an online application system at all. however a few weeks ago they put up a PDF of the application that can be filled out and submitted electronically, so I did that yesterday. when they talking about "fixing the website," do they mean just healthcare.gov, leaving the individual markets to work out their issues themselves? or are all the different exchanges using the same system behind the scenes?

everyone in Washington reads Politico and you know it, Alfred. You could always make an argument that tension wasn't rising.

well, everyone in Cokie's beauty parlor thinks Obama is a cold man and that Michelle should stop attacking Georgetown's fat kids.

lolz. I hear ya.

But 27,000 people signed up for Obamacare isn't quieting anyone down.

no one is ever going to quiet down, because no one knows the exact number that would constitute 100%. the number of people who could benefit from using Healthcare.gov to purchase new insurance is a relatively small percentage of the U.S. population, because so many others are already covered by their employer or by medicare/medicaid, or they live in a state where the healthcare.gov platform isn't being used because the state decided to exert the option to build its own exchange.

anyway, no one knows what the exact figure is that would constitute "success", although there are the administration's own stated goals, i suppose.

so yeah, when 489,000 people have signed up using healthcare.gov will people shut up? no, they won't, because no one knows what the fuck they're talking about in the first place

Isn't the number of uncovered citizens projected to be at 9million or more even with Obamacare at full implementation?

also, won't the real test come in 2014 when employer plans are held to the fire?

Looks like Politico got it right, Alfred.

NYTimes: Democrats Threaten to Abandon Obama on Health Provision

In a closed-door meeting Wednesday of House Democrats and White House officials, tensions flared as several lawmakers upbraided the administration, saying that the president had put Democrats in a tough political position by wrongly promising consumers that they could keep their existing health care plans. In fact, hundreds of thousands of Americans have received cancellation notices from their insurers because their health care coverage does not meet the minimum standards dictated by the new law.

The overall message of the meeting, said several attendees, was that the White House and the House Democratic leadership have until Friday to come up with a satisfactory alternative, or House Democrats may be forced to support Mr. Upton’s bill, which already has two Democratic co-sponsors: Representatives John Barrow of Georgia and Mike McIntyre of North Carolina, who represent more conservative districts.

It's not a matter of getting it right -- Tiger Beat on the Potomac, as Charles Pierce on the Potomac is the Beltway hack's bible -- it's a matter of who gives a shit, especially with unnamed sources.

whoa: I meant "as Charles Pierce calls it, is the Beltway hack's bible

yes it's a hack gossip rag but shooting the messenger kind of sidesteps the issue.

Are you questioning the gray lady's unnamed sources right now?

And really, if you think no one gives a shit about Democrats throwing out threats to the President about his signature achievement--or that a closed door meeting that is being completely misreported, then I guess we disagree.

if the Dems yield and allow people to keep existing insurance plans, the ACA fails. There's no shading it. And Dems will be destroyed in 2014.

Dems do best when they stop mewling and stop acting like "me too!" crypto-Republicans.

Basically, they fucked this roll-out up so badly that all bets are off in terms of support. Those numbers yesterday were disheartening, not just because they were even worse than expected, but because they show how far this still has to go, how much work they have to do on the fucking website weeks after it debuted, which is a travesty. The unintended consequence of all that Tea Party tomfoolery is that the timing was such that the gov was basically forced to go live rather than delay the ACA even a day. Which was the right thing to do, but still, surely dozens of people knew what kind of mess to expect when it launched and just basically watched as it went kablooey.

And I still think the average American has no idea about the very basic ins and outs of the ACA, which is strictly a communication problem, no tech necessary.

I think the average American has no idea about the ins and outs of most government services unless they actually need them. Easy to point to the waste in the safety net unless you rely on it. Easy to get off on the political shit for a function you've never even had to deal with on any level--that goes for the people who think it's just and those who think it's not.

I fully expected a clusterfuck of this magnitude but not because I think the Obamas are incompetent. Obamacare is a very complicated solution to a very complicated problem and thus, very difficult to implement on every level. It's important to hold these guys' feet to the raging fire and demand transparency, but I think that ACA is gonna survive and even expand over the years.

the Obamas

What does this even mean?

the Obama admin

I think the average American has no idea about the ins and outs of most government services unless they actually need them.

Probably true enough. But the fact that the whole point of the ACA is that it is something every American needs to get, or at least be aware of, makes the shoddy communication that much more glaring. Maybe I've missed these press conferences (probably), but massive tech screw up and Obama's "keep what you have" gaffe aside, the administration might have done a better job explaining the lack of cooperation among certain states, the confusion fostered by anti-ACA folks, basically, better explain the aforementioned ins and outs of the ACA in simple, easy to understand terms. Which maybe the website does! But, well, you know ... the website.

Like, the ACA is something I don't have to deal with right now. So I was surprised to hear that enrollment entailed making the first payment months in advance, before service even began. If I were on a budget, like I imagine many of the folks most in need of the ACA, I'd be wary of shelling out cash in advance of a scheme whose entire reputation is prematurely in shambles. Granted, a lot of this will work itself out when slacker healthy young folks start buying in, or those signing up actually make their first payment, but that's a lot of time left to pass while people stir and shit in various pots.

This whole situation is shameful and the way Democrats are eagerly lining up to gut ACA is some of the worst cowardice I've seen from these people. I'm extremely pessimistic that ACA is going to remain in any kind of functional state for very long.

LOL "functional." It's off to a great start!

Eh, it'll all work out in the end. Just depressing to see such a major achievement fucked up so easily. I hate that lizard Issa, but he was sort of OTM comparing the roll-out to a rocket that blows up on the launch pad. But eventually, we'll get our Tang.

true, it is barely functioning now. My fear is that the Dems are ready to completely neuter it, causing a situation where it will never be any better even if the website improves.

Medicaid has signed up 444,000 people in 10 states in the six weeks since open enrollment began.
http://abcnews.go.com/Health/wireStory/medicaid-health-overhauls-early-success-story-20859281

Kentucky, which built its own marketplace, signed up more people (5,586) than Texas (2,991), which relied on HealthCare.gov, even though it has a fraction of the latter's population. California has enrolled more people (35,364) on its own than the 36 HealthCare.gov states combined.
http://talkingpointsmemo.com/dc/here-s-where-people-have-signed-up-for-obamacare

anyone know what massachusetts enrollment looked like two and a half months into romneycare?

Less than 200 people, according to Chris Hayes last night. Guess what triggered massive enrollment by the young? Fear of penalties.

and deadlines. Deadlines work.

Maybe in this case it's good that the young people are waiting. If iPhones all crashed non-stop their first few weeks, people would wait a few months for them, too.

just to make sure i'm right on this: even if dems cave on this and pass legislation to let people keep their existing (shitty) insurance, obama still has to sign it, right? and he can veto, right?

Yes.

i guess i'll worry about one thing at a time, but then at least there will be a last opportunity for him to prevent a terrible calamity if a shitty bill comes his way.

hopefully he'll keep his spine.

ohhh, et tu?

heh. well, it's nothing to count on, that's for sure. but at least he'll have the opportunity.

His spine is IMMATERIAL. People surrender their spine, if any, before they raise a billion dollars to be Executive Puppet.

He may or may not veto. If both parties are intent on gutting the law, then a veto can be overridden.

and then we revolt.

Dems do best when they stop mewling and stop acting like "me too!" crypto-Republicans.

but that's what they aaaaaare, Blanche

thanks, Sofia.

tsk tsk, Baby Jane, not GG

Morbsbait, not trollbait

RIP

In a bid to quell a growing political crisis, the Obama administration announced Thursday that it will give health insurers new flexibility to renew existing individual health insurance policies that do not comply with the Affordable Care Act.

...The new guidance would allow insurance companies to "offer the option" of renewing non-Obamacare compliant plans to their existing customers, according to senior White House officials. The policies could be renewed for an additional year at any time through 2014. According to the White House, non-compliant plans could currently only be renewed before Dec. 31, 2013.

The administration will be "suspending enforcement of market provisions" for those existing plans, the officials said. Several million individual health insurance policy holders were expected to have their existing plans canceled because they didn't meet the minimum coverage requirements of Obamacare.

"The bottom line, insurers can extend current plans that would otherwise be canceled into 2014 and Americans whose plans had been canceled can choose to reenroll in the same kind of plan," Obama said in a statement announcing the change.

http://talkingpointsmemo.com/dc/here-s-how-the-white-house-wants-to-fix-obamacare

wow, so, uh, yeah

JESUS FUCKING CHRIST I HATE THIS COUNTRY

oof. well, if it's any consolation, i (and others) will still be able to get an affordable plan soon. did some more research into my available plans and it's a lot better than I originally thought, with federal subsidies included. of course, this is because I'm both ineligible for medicaid and my employer offers no insurance. so, i'm still glad this law has some effect, for now

Despite the president’s reversal, Speaker John A. Boehner said Thursday that he intended to push ahead with a House vote Friday on a measure that would allow consumers to keep their canceled plans without penalty and allow others to sign up for them. Mr. Boehner said he was skeptical of the president’s proposal and that the new law needed to be overturned.

“The only way to fully protect the American people is to scrap this law once and for all,” Mr. Boehner told reporters.

Representative Nancy Pelosi, the Democratic leader in the House, said her members were clamoring for a fix on top of what the president was offering. Many of them, she said, were those who fought hard for the law’s passage and want to see it saved.

“Nobody is as unhappy as I am,” she said, adding, “Maybe the president of the United States.”

“But the fact is we’re all of the same mind in our caucus,” she added. “We have to have a fix.”

http://www.nytimes.com/2013/11/15/us/politics/obama-to-offer-health-care-fix-to-keep-plans-democrat-says.html?hp&_r=0

spoiler alert

at the end of 2014, there will once again be millions of people - many of them young and healthy - who receive letters informing them that their terrible insurance is being canceled, and they will need to find better insurance.

I assume the insurance companies will try to find a way to lock people into these super turd policies for as long as they possibly can now that they have an opportunity.

At least it's better than the Senate bill and the way worse Upton house bill

The administration's guidance does not allow insurers to sell non-compliant plans to new customers. In addition, insurers must provide two pieces of information to their customers: what benefits these non-compliant plans do not offer and what options the health reform law, such as the insurance marketplaces and financial assistance, makes available to them.

Unlike a proposal from some Senate Democrats, the White House's plan would not require insurers to continue offering non-compliant coverage. The officials said it would be at the "discretion of insurers." As for people whose plans have already been canceled, they said insurers "would have the ability to reach back out to these individuals."

and as fucking usual you make what looks like a concession to the right and they just move the posts.

how about just enrolling people whose "insurance" has been "cancelled" straight into medicare or VA insurance, and saying "fuck you" to the republicans?

Digby ain't freakin' 'out, surprisingly:

Honestly, I understand why people are freaking out. You get one of these letters, as I have, and the numbers are scary. Unless you understand this new system you're going to be unnerved to say the least --- especially if you can't get the information you need from the web-site to see what the new plans are going to cost. But in my view, most people will eventually figure out what they need to do simply because the insurance bill is such a big one, even if you only have to use it for a short time.

I don't happen to think that the President's proposal to allow insurance companies to extend the shit plans for a year is the end of the world. They already "grandfathered" shit plans from before 2010 so it's not a huge deal to do the same thing for the bad plans the insurance companies wrote between then and now. Most people aren't going to keep paying for crappy coverage once they see they can do better. The problem now is that they have no way of seeing that and don't have a clear understanding of how the plan works. With a little time, they will be able to do that.

And keep in mind that nearly 50% of the people who are buying insurance on the private market are only doing it temporarily anyway. When new people come into the market they will simply go to the (hopefully working) exchange website and buy new policies without any of these concerns about these cancellations.

Most people aren't going to keep paying for crappy coverage once they see they can do better.

hope she's right, but i think in the real world short-term thinking is too powerful an influence. if you're young and not making money and you are lucky enough to not have to go the hospital too often, the temptation to spend less money per month on insurance is very strong, even if you know you could spend $40 more per month and get better coverage.

I'd like to show those ppl my insurance numbers, and how I've has probly over $500,000 covered since my lil surprise happened.

And we probably wouldn't be here if they hadn't fucked something this important up so severely. I think the shitty rollout of the ACA will go down as one of the biggest fuck ups in US history, though again, I think we'll end up in the right place eventually. So close yet so far. A travesty.

So with the reversal - does that negate stuff like a compulsion to cover people with pre-existing conditions and the like, kids on their parents' plan, all those changes made? And is there an expiration to this extension of old plans?

depressed about this mostly because you could just tell the GOP and Tea Partiers were just ready to pounce on any little problem that showed up when the ACA went live, and we gifted them this albatross.

undoing the law at this point would have more detriment than good, but the GOP is pretty much dedicated to acting like the Stupid Police Chief from 80's action films right now, so I won't be surprised if even after ACA gets to a workable state, we don't keep seeing symbolic "Repeal ACA" votes annually.

I wish I could turn Boehner's head into a tetherball

you know, from the point when the ACA was passed, in the back of mind I kind of imagined something like this happening, and that feeling nagged me more and more as the months then years went by and I realized that the administration was doing no better a job preparing people for the bill's implementation/getting them to understand what would be happening than it did as they were trying to pass the bill. but I always figured it couldn't really be that bad, that surely there would be a big sigh of relief once the new markets became accessible and people started signing up. turns out that little nagging thought was completely OTM. so depressing.

from the insurance industry:

“Changing the rules after health plans have already met the requirements of the law could destabilize the market and result in higher premiums for consumers. Premiums have already been set for next year based on an assumption of when consumers will be transitioning to the new marketplace. If now fewer younger and healthier people choose to purchase coverage in the exchange, premiums will increase and there will be fewer choices for consumers. Additional steps must be taken to stabilize the marketplace and mitigate the adverse impact on consumers.”

and they have a point. it seems like the obama administration's political attempt to soothe the concerns of those whose shitty insurance no longer meets the bare minimum requirements for coverage under the new law could have financial ramifications for those who have already purchased insurance on the exchanges.

Anyone who's ever done a widespread implementation across multiple systems with competitive constituencies knew that this shitshow was going to happen. Nobody does this well--not Amazon, not Facebook, not Snapchat, not Obama, not anyone. Anyone remember this? And yet the planes keep flying.

The only thing that matters in the short term is that the ACA passed and is being implemented. It's not going anywhere. It's going to take years for people to fall in love with it or become consciously dependent on it. I'm trying to think of a government program with this kind of scope that's ever been scrapped.

Digby's right.

xp

and the state insurance regulators, singing the same song:

"This decision continues different rules for different policies and threatens to undermine the new market, and may lead to higher premiums and market disruptions in 2014 and beyond."

god, what an unforced fuckup.

clearly the Democrats don't have the stomach to wait it out until this thing is running smoothly, that's why I tend to think the whole thing is doomed

Tried to apply for assistance and shop for healthcare plans this week, since my open enrollment period at work ends tomorrow. Went through the whole assistance application, but apparently none of it applied to me and my family. But when I was finished with that, I was unable to shop for plans. I kept pressing all the buttons, signing out and back in again, refreshing pages. Nothing worked. It sucked. I tried. Oh well.

See? How can anyone ultimately complain about CYA compromises and retrofits when that is the reality people are dealing with? It's just a total, how you say? Cock up.

i assume the contractors will reimburse the federal government for their "work" on this (he says, laughing)

So with the reversal - does that negate stuff like a compulsion to cover people with pre-existing conditions and the like, kids on their parents' plan, all those changes made? And is there an expiration to this extension of old plans?

No. Yes, 1 year.
There's already been A LOT of migrating people to new plans from their current nonACA plans. Would've been nice if Obama didn't wait til nearly December to announce this shit, christ.

i know talking about messaging is an eyeroll inducer, but seriously, what's up with everyone being totally cool with calling this latest thing "the Obamacare FIX"? first, the thing that the "fix" is supposedly addressing - the fact that some people with shitty insurance have to change insurance plans to something that's not an insult - is not something that is broken or unanticipated. lawmakers knew this was coming, presumably, although i can see why they weren't jumping out of their boots to trumpet the fact to constituents. but calling it a "fix" implies that it was broken, and that's not the case. the aspect of obamacare that is broken, in the meantime - HealthCare.gov - isn't impacted by this "fix" at all.

I guess it sort of fixes the problem that these people who are losing their crappy plans can't start up a new plan. I don't know how well it fixes this problem and surely it will have other negative consequences as well, but presumably it will alleviate the fear that they will be left without insurance.

BOB's ACA vs. junk insurance. oh well

http://talkingpointsmemo.com/muckraker/insurance-company-using-obamacare-scare-tactics-to-sell-crappy-insurance

After yesterday's fit I'm not gonna worry about it. It's possible the bungling will whittle the president's "capital" but that's not our problem, is it? Every day more people enroll. When the website is fixed, more will enroll. If ACA works I don't give a shit how low Obama sinks in polls.

plus there'll be the fun of HRC "distancing" herself from him

http://www.theatlantic.com/past/docs/issues/2001/02/curtis.htm

I entered the Kahiki, said to be modeled after a New Guinea men's meetinghouse, between a pair of twenty-foot-high Easter Island idols with flames spouting from their heads. Inside, after crossing a low bridge and passing through a damp grotto, I wandered into a series of dining rooms filled with thatched "dining huts." The main room, a conical structure with a towering ceiling, was presided over by an eighty-foot-high tiki goddess with glowing red eyes and a fireplace for a mouth.

rip

haha wrong thread

i'd like to see hillary run on medicare for all, but who knows

medicare for all AND Tiki Bars for all

and electric car chargers to replace a gallonagas

and student loan debt jubilee!

whoa the website works for me now

let The Corner know!

i feel like i should ask you the sort of questions near death experience people get asked

when you got into the website, was there a warm feeling of glowing light? were all your old friends there waiting for you?

tbh it did feel kind of magical

pages even load fast

this is Obama's gotcha moment - HAHA IT WORKED ALL ALONG, FOOLED UUUUUUU

http://www.salon.com/2013/11/16/can_we_trade_obama_for_nixon/

what a stupid article

well it's by the film critic who wrote that The Counselor was the worst ever.

it was just a month ago that the GOP had fatally wounded itself for the '14 elections, amirite?

The circus cycle is neverending and nothing has changed since the Clintonistas destroyed the last progressive vestige of the Dem party.

ouch, oregon hasn't enrolled a single user . . . but "has received about 18,000 paper applications, at 19 pages each, and is scrambling to manually file and clear them"

http://finance.yahoo.com/news/once-leader-oregon-exchange-struggles-132443462.html

the headline is stupid, the article makes some good points.

xp - i am one of those 18,000 paper applications! and i felt so accomplished even getting to the point where i could even turn it in, agh

Officials Were Warned About Health Site Woes

The McKinsey report found that the effort was at risk because of issues including “significant dependency on external parties/contractors,” as well as “insufficient time and scope of end-to-end testing,” and “parallel stacking of all phases,” all predictions that have turned out to be accurate. Briefings on the report were held in the spring at the White House and at the headquarters of the Health and Human Services Department and for leaders at the Centers for Medicare and Medicaid, congressional investigators said.

...

House Republicans have latched on to a final report by the Mitre Corporation, one of the main firms hired to assess the security of the site, which said on Oct. 11, 11 days after the site went live, that it was “unable to adequately test the confidentiality and integrity” of the health exchange. Mitre went on to say that a “complete end-to-end testing” of the site “never occurred.”

Important:

...And it is unclear how many fixes remain to be made, because the list keeps changing.

This issue (which is very common in software development) is going to make things complicated for the near term.

walkercare: "a plan that allows Walker to reject Obamacare and turn down federal money offered to help states pay for expansion of Medicaid [but] also may make it possible for Wisconsin to still provide health coverage to many of the state's poor and working poor residents"

http://www.npr.org/blogs/health/2013/11/19/246003602/wisconsin-chooses-its-own-path-to-overhaul-medicaid

"will cost state taxpayers an additional $460 million through 2020..."

Yeah, but that's $460 million of their money, not taken from the stupid tax-and-spend government! Oh wait, I mean, look over there ... !

(runs away)

the funny part about that quote is the idea that walker gives half a shit about wisconsin's "poor and working poor residents"

"will cost state taxpayers an additional $460 million through 2020..."

― reggie (qualmsley), Tuesday, November 19, 2013 2:28 PM (5 hours ago) Bookmark Flag Post Permalink

the price tag of self-reliance

So, uh, no surprise: health care site works where states allow exchanges to happen.

the state sites work, not the fed one, right?

Federalism rearing its beautiful head.

federalism > feudalism

$174MM for the fed's broken website. I wonder what California paid.

Less contractors involved, less options needed

The backend theoretically would be way less complicated for sure.

So if every state built their own, would the fed one even be needed?

yeah I don't think so.

maybe it says in the FAQ

http://obamacarefacts.com/insurance-exchange/california-health-insurance-exchange.php

yeah the oregon article posted above indicates that the states with their own websites are running them independently of the federal version. oregon is working with oracle on its (non-functioning) website, and in the past week they've taken down their claim that online registration should be working by the end of the month. instead they're pointing people to PDF applications and local "application fairs."

Since google is giving the government all of our emails and stuff you'd think we could ask them to set up our health care website.

http://www.texasobserver.org/a-galveston-med-student-describes-life-and-death-in-the-safety-net

New Tech Worries Loom for Health Law

...He said people are working around the clock, "fixing the functional defects" of the site. "There's still a lot of moving parts. It wouldn't be prudent to give 100% guarantees about where we are going to be, but I think we are on the right track," he said.

...But Mr. Swedish said it was too soon to write off the Affordable Care Act. "I'd say the potential is there for a significant uptake" in consumers wanting to sign up for coverage, he said. Then "we will be communicating with the young. We will be communicating with the Hispanic community."

Connecticut, Kentucky, Minnesota, and Washington [are] on track to exceed their enrollment targets. [. . .] Last week, [New York] officials reported that close to fifty thousand people had signed up for health insurance through the state’s new Web site, NY State of Health, with about half of them taking out private plans and half enrolling in Medicaid. “I would say we are seeing great interest in New York, and we are very pleased with our enrollment numbers,” Danielle Holahan, the deputy director for NY State of Health, said.

http://www.newyorker.com/online/blogs/johncassidy/2013/11/americans-like-obamacare-where-they-can-get-it.html?currentPage=all

California Won't Let Insurers Reinstate Policies, Pitting Backers Against Each Other

Meeting Thursday, the board of California's health-insurance exchange unanimously decided to stick to its stance blocking older policies that don't meet the law's coverage requirements. It won swift praise from some state lawmakers.

...

Among states with Democratic governors, nine including California have said they won't allow carriers to renew the plans in 2014, seven have said they will and four were still deciding as of Thursday.

good. those plans were bullshit

Re: sign-up rates, isn't it still pretty nebulous how many people have signed up vs. how many people have signed up and, as required, paid the first month's fee?

Obamacare signup delayed -- for 2015

After the many bumps, ruts and roadblocks the Affordable Care Act has run into, health officials in Washington have decided to delay open enrollment in Obamacare -- not this year, but a year down the road.

The Department of Health and Human Services wants to give insurers, consumers and engineers more time to avoid the first go-round's site crashes, coverage train wrecks and cost surprises.
It has moved the start of next year's open enrollment from October 15 to November 15 and extended the sign-up period from roughly seven weeks to eight, an HHS official, who spoke on condition of anonymity, told CNN.

Nothing to do with an election. Nope.

Don't know if it's been discussed here but...

http://www.liveleak.com/view?i=086_1385148641

Four in Ten Uninsured Americans Still Haven't Heard Anything About the Obamacare Exchanges
http://www.thewire.com/politics/2013/11/four-out-ten-uninsured-american-havent-heard-anything-about-obamacare-exchanges/355422

What, don't they go on the internet?

my gf the unicorn

http://www.pressdisplay.com/pressdisplay/viewer.aspx

secretary kerry and all the ayatollahs covering for healthcare.gov's glitches?

CNN analysis: No Obamacare subsidy for some low-income Americans

One of the basic tenets of Obamacare is that the government will help lower-income Americans -- anyone making less than about $45,900 a year -- pay for the health insurance everyone is now mandated to have.
But a CNN analysis shows that in the largest city in nearly every state, many low-income younger Americans won't get any subsidy at all. Administration officials said the reason so many Americans won't receive a subsidy is that the cost of insurance is lower than the government initially expected. Subsidies are calculated using a complicated formula based on the cost of insurance premiums, which can vary drastically from state to state, and even county to county.

http://www.washingtonpost.com/national/in-rural-kentucky-health-care-debate-takes-back-seat-as-people-sign-up-for-insurance/2013/11/23/449dc6e0-5465-11e3-9e2c-e1d01116fd98_print.html

If the health-care law is having a troubled rollout across the country, Kentucky — and Breathitt County in particular — shows what can happen in a place where things are working as the law’s supporters envisioned.

One reason is that the state set up its own health-insurance exchange, sidestepping the troubled federal one. Also, Gov. Steve Beshear (D) is the only Southern governor to sign on to expanded eligibility parameters for Medicaid, the federal health-insurance program for the poor.

duelling links!!

i bet the poor won't be able to afford romneycare, and the old will be subject to death panels

http://www.washingtonpost.com/blogs/wonkblog/wp/2013/11/26/wonkbook-is-obamacare-turning-the-corner/

This guy is so horrible:

One of the Beltway's best-known pundits gave credence this week to perhaps the fringiest of all Obamacare conspiracy theories.

In an interview on Monday with the conservative Newsmax, Time's Mark Halperin said that so-called "death panels" are enshrined in the Affordable Care Act.

"It's going to be a huge issue," Halperin said. "And that's something else about which the President was not fully forthcoming or straight-forward."

"So, you believe there will be rationing, a.k.a 'death panels'?" host Steve Malzberg asked Halperin, the co-author of the 2012 election chronicle "Double Down."

"It's built into the plan. It's not like a guess or like a judgment. That's going to be part of how costs are controlled," Halperin said.

Anyone who's ever done a widespread implementation across multiple systems with competitive constituencies knew that this shitshow was going to happen. Nobody does this well--not Amazon, not Facebook, not Snapchat, not Obama, not anyone. Anyone remember this? And yet the planes keep flying.

The failure rate of big government IT projects is mind-croggingly huge. Just off the top of my head there's:
http://en.wikipedia.org/wiki/Virtual_Case_File
http://arstechnica.com/information-technology/2012/06/how-to-blow-6-billion-on-a-tech-project/
http://arstechnica.com/information-technology/2013/10/why-us-government-it-fails-so-hard-so-often/

Shocked that any of this works...

To be clear: the ACA website was created by a private company.

Most of these sites are created by a private corp.

they're talking about death panels again so I guess the website is almost fixed

can't wait to be put to death by a death panel frankly

take heart. the audit will end someday.

been reading a lot of gleeful columns by byron york lately, heavily slanted and piling-on about the aca's inherent, fatal failures, and how it will doom not only the act, but poison the public against the notion of big gov't programs overall. so it was good to go back and re-read this exchange, in 2008, between york and matt taibbi.

Got three e-mails this morning from the "Health Insurance Marketplace." They've got a logo and everything. My account has been created, they've confirmed my subscription change, I've apparently signed up for e-mail updates, and I can join the conversation on Twitter and Facebook.

Either the real ACA outreach is in even more disarray than advertised, or the grifters are doing just fine.

so now too many people are signing up?

http://in.reuters.com/article/2013/12/03/us-usa-healthcare-idINBRE9AR05M20131203

uh oh, we'd better cut taxes, and eliminate long term unemployment insurance

I checked out the plans and punched in our income and discovered that I don't qualify for any kind of subsidy, so whether or not I sign up this december or sign up maybe next fall seemed less urgent. The tax penalty in year one of ACA is low, so it isn't a big incentive, yet.

Margaret Talbot's experiences.

haha somehow amongst all the migrating of old plans to new plans, my company incorrectly changed the addresses of 2.3 million customers, nice work applause all around

hey play fair ALEC!

http://blogs.laweekly.com/informer/2013/12/obamacare_california_gop_website.php

ratfucking!

Gallup: Majority of Americans Want Major Changes to Health Law

social security for all

i should probably stop dragging my feet on this

commie!

http://www.tampabay.com/news/politics/stateroundup/rubio-enrolls-in-obamacare-takes-federal-subsidy/2156529

Lie of the Year non-shockah

Oh dear

uh oh: "industry groups give up on lobbying for medicaid expansion"

http://talkingpointsmemo.com/dc/obamacare-medicaid-expansion-lobbying-2015

"What I'm really struggling with is -- I don't even know how to talk about expanding Medicaid without just pissing Republicans the hell off and making them think I'm part of the problem," said a top official for one of the industry groups, who spoke on the condition of anonymity to talk frankly about the political reality in their state and avoid upsetting the chances of expansion in the long term.

I think these expansions will eventually happen because the amount of free money being left on the table is just too huge to ignore forever, but it may end up taking years.

I don't even know how to talk about expanding Medicaid without just pissing Republicans the hell off and making them think I'm part of the problem," said a top official for one of the industry groups, who spoke on the condition of anonymity to talk frankly about the political reality in their state and avoid upsetting the chances of expansion in the long term.

profile in courage

One of the basic tenets of Obamacare is that the government will help lower-income Americans -- anyone making less than about $45,900 a year -- pay for the health insurance everyone is now mandated to have.
But a CNN analysis shows that in the largest city in nearly every state, many low-income younger Americans won't get any subsidy at all. Administration officials said the reason so many Americans won't receive a subsidy is that the cost of insurance is lower than the government initially expected. Subsidies are calculated using a complicated formula based on the cost of insurance premiums, which can vary drastically from state to state, and even county to county.

this is now me, because I make a bit more money but well under that limit. No subsidy and the cheapest silver plan is $244 (cheapest bronze $180).

I'd continue to say fuck it rather than pay 10% of my income to insurance I likely won't use but I really want to take up Brazilian jiu-jitsu and I can't be comfortable doing that without insurance.

straining my empathy to feel bad for someone complaining about health ins costs but can do cool stuff like jiu-jitsu and gun buying.

that legendary american empathy

straining my empathy to feel bad for someone complaining about health ins costs but can do cool stuff like jiu-jitsu and gun buying.

― A True White Kid that can Jump (Granny Dainger), Thursday, December 26, 2013 6:25 PM (19 minutes ago) Bookmark Flag Post Permalink

yeah this is right on everyone should have to pour money into bullshit instead of spending their time doing stuff

totally with you on the ilx.xls mandatory background check for gun owners but otherwise i mean

i could be deluding myself, but i feel like the hysterical reaction about obamacare's rollout and early impact has died-down some, at least judging from the twitter feeds of some conservative "advocacy-journalists" i follow (e.g., byron york, who's begun to find time for other topics).

xxp I know, right? If your hobbies are playing with firearms and getting kicked in the face, who has time for nonsense like health insurance? Someone else will pay for that if it comes up.

I mean, I get the vibe that Milo's the ilxor most likely to own nunchuks but begrudging jiu jitsu is basically the same as all those bullshit "I saw a POOR PERSON WITH AN IPHONE" Facebook things ppl repost

Someone else will pay for that if it comes up.

someone else paying for it is awesome; everybody else paying for the healthcare of people who need it is how healthcare can work

i am reared on socialised medicine so i can just leave if it's gonna make people awkward

i could be deluding myself, but i feel like the hysterical reaction about obamacare's rollout and early impact has died-down some, at least judging from the twitter feeds of some conservative "advocacy-journalists" i follow (e.g., byron york, who's begun to find time for other topics).

― Daniel, Esq 2, Thursday, December 26, 2013 10:51 PM (1 hour ago) Bookmark Flag Post Permalink

It's kind of strange, no one really talks about it at all anymore in the MSM. I'm sure there's all sorts of speculation about FEMA camps or something on the Blaze tho.

I guess the Duck Dynasty thing really sucked up a lot of the oxygen

Man, Granny, the gun control threads were all over a year ago, you can let it go.

fyi, I want to try jiu jitsu because I'm getting older and want to remember what it was like being even a little bit athletic. No depth perception so rec league basketball lost out.

if only obamacare covered vision

Someone else will pay for that if it comes up.

someone else paying for it is awesome; everybody else paying for the healthcare of people who need it is how healthcare can work

― mustread guy (schlump), Thursday, December 26, 2013 6:18 PM (3 hours ago) Bookmark Flag Post Permalink

Yes, well, until we have that, that is most emphatically not how it works.

yeah this is right on everyone should have to pour money into bullshit instead of spending their time doing stuff

I mean, I get the vibe that Milo's the ilxor most likely to own nunchuks but begrudging jiu jitsu is basically the same as all those bullshit "I saw a POOR PERSON WITH AN IPHONE" Facebook things ppl repost

This is not where I was coming from but, being ILX, I knew people would assume it was.
If you think buying health insurance is pouring money into bullshit then I really don't know what to tell ya.
If you're complaining about having to spend 10% of your income to guard yourself from possible financial and physical ruin then I really don't know what to tell ya. Being an adult has financial responsibilities - rent, food, healthcare being the big 3 - and whining about having to meet those (non-fun) responsibilities is what Milo and many others seem to be doing wrt Obamacare.

I enjoy (intense sarcasm) listening to people explain how they have lifestyles that make them not really need insurance, making it a rip-off for them.

that legendary american empathy

― ogmor, Thursday, December 26, 2013 3:33 PM (Yesterday) Bookmark Flag Post Permalink

The main issue is that my empathy lies with people who desperately needed coverage but couldn't get it pre-ACA, not with people who have to buy coverage (something they should do anyway) so it's feasible that those uninsured can obtain coverage. Everyone makes this about them, how they're affected by the law.

Everyone makes this about them, how they're affected by the law.

Nah, for real?

yep you're not alone in your self-centeredness

I mean, yeah, as someone who doesn't use medical care on anything resembling a regular basis (pretty sure I haven't been to a doctor in 8 months), it is kind of a big deal that the government wants to push me into writing a check for 10% of my real-world money every month to a for-profit corporation. Well, I guess I could just shovel 8% of my money into a plan that's utterly useless outside of a major tragedy (which would, of course, fuck me anyway).

I'm not sure why you'd be surprised that people like me are hesistant to cheer for Obamacare. No one likes tithing a large percentage of income to something where they perceive little benefit, particularly when other options (single-payer) exist and work in the rest of the civilized world.

This is separate from my current process of looking - if I start engaging in a contact sport, yes, I'm a moron if I don't have insurance. That's why I'm looking. Doesn't make the costs - which are, for the record, significantly higher plan-to-plan vs what I was looking at 18 months ago - more palatable.

Then just pay the fine and stfu

I'm glad my grandma was never so whiny.

I'm not sure why you'd be surprised that people like me are hesistant to cheer for Obamacare.

Nice phrasing. They are outright against it, many based purely on the financial consequence it has for them personally. (I can guarantee you ACA has a more severe--financial and otherwise--on me than it does on you)

I'm with you that their are better options in rest of the world. This "fix" is shit.

you're saying that *I'm* the one whining here? Good grief

xp -
So, basically, you're being a twat because some other people are libertarians, even though I'm not.

Coo'.

as someone who doesn't use medical care on anything resembling a regular basis (pretty sure I haven't been to a doctor in 8 months)

this is why it's called "insurance"

it is kind of a big deal that the government wants to push me into writing a check for 10% of my real-world money every month to a for-profit corporation.

... No one likes tithing a large percentage of income to something where they perceive little benefit, particularly when other options (single-payer) exist and work in the rest of the civilized world.

but...people in countries with single-payer also pay a significant amount of their income toward healthcare...it's just that they pay it to the govt in the form of taxes rather than directly to the hospital/insurance companies. i'm no pro, but look at canada. in 2013, , the average 'unattached person' (someone paying only for themselves, not for their family or any dependents) in Canada paid $3,780 with an average income of $39,039. in other words, in canada the average person like you (i'm assuming you're only looking for coverage for yourself) paid 9.6% of their income in taxes for healthcare.

not trying to gang up on you, and not trying to trash single payer (which would be much better than ACA, i agree) just saying that if you're thinking that single payer would save the day in terms of you having to pay for health insurance, i don't think you're correct.

I'm a pretty healthy dude in my early 30s, and among my friends who I consider healthier than myself, one had to have his gall bladder removed and another was diagnosed with multiple sclerosis in the last couple years. Shit's random.

Health care is expensive, there's no way around it. 10% of my income towards it seems totally reasonable to me. The "I don't use health care regularly" argument...one day you're one of those people, the next you're in urgent need of really expensive health care services (I've been there myself, tho thank god it didn't arise during those years when I was uninsured). Rolling the dice when it comes to my health is something I'm no longer willing to do (having a health scare def changed my outlook on that).

xp yup. nearly everyone has something go wrong with their health at some point.

come the fuck on with that libertarian think tank piece attacking socialized healthcare - I'm comfortable assuming that a Canadian at my income level doesn't pay $3500 more in federal tax just to fund healthcare.

xp - right, but if I get diagnosed with MS I'm fucked regardless. Neither of my jobs can be performed with advancing MS, so eventually I'm turning to Medicaid anyway. If I have to get gall bladder surgery for $12k and I'm stuck with the $6500 out of pocket cap, there's really not that much difference to me. In either case I'm setting up a payment plan that won't be paid off for a very, very long time.

As discussed above, I think that people who tout catastrophic plans and the like don't take into account that many people who buy the cheapest plan can't afford the portion assigned to them under a catastrophic plan in the first place.

Y'all don't need to pretend that I'm opposed to ACA - it's shitty policy but less shitty than what came before. That doesn't mean that as a lower-middle class person I don't feel the pinch, and from a political perspective it's pretty stupid to run with "suck it up."

xpost

here's another take on it from the Canadian Institute for Health Information: https://secure.cihi.ca/free_products/Lifetime_distEffects_overview_EN.pdf

they put the average costs at 6% (for lowest earning people) to 8% (for highest earners) of total income.

idk, if I had a disease that'd be exacerbated by my job I might consider a new trade

if the cheapest bronze plan is more than 8% of your income (actually modified AGI), then you are exempt from the penalty

<q>they put the average costs at 6% (for lowest earning people) to 8% (for highest earners) of total income.

― Karl Malone, Friday, 27 December 2013 21:44 (6 days ago) Bookmark Flag Post Permalink</q>

Interestingly most developed economies spend about 8% of GDP on healthcare (US runs at about 16%)

apparently that "prayer as preventative care if you're poor" thing isn't working so well

if you don't raise the price of health care, you kenyan you, we're going to force the country to default!

http://talkingpointsmemo.com/dc/paul-ryan-debt-limit-obamacare-insurer-bailout

i get that the gop wants to create conditions that will cause obamacare to fail or justify a repeal (and that's the intent behind eliminating the risk-corridor). but what's the gop's articulated policy rationale for proposing the elimination of the risk-corridor, e.g., that it's a tax on insurance companies or that it's an encroachment into business freedom?

socialism!

benghazi?

rationale?

It's not a wholesale conversion. But it's major movement given conservatives' unyielding anti-Obamacare doctrine of the last few years.

http://talkingpointsmemo.com/dc/2014-gop-candidates-medicaid-expansion

over/under on when the GOP starts going "we thought of it first, in 1994!"?

APPLICANT STATES USES ZUMBA EVERY WEEK AND WANTS
TO KNOW IF INSURANCE WILL COVER THAT.

HHS Reports $380M in Obamacare Savings

http://www.nationaljournal.com/health-care/hhs-reports-380m-in-obamacare-savings-20140130

not good enough! tax cuts!

Obamacare enrollees hit snags at doctor's offices.

http://www.nytimes.com/2014/02/06/business/cvs-plans-to-end-sales-of-tobacco-products-by-october.html?hp&_r=0

A shortage of primary care doctors and expanding access to health care coverage under the Affordable Care Act is turning drugstore chains into big players in the nation’s health care system. Consumers routinely get flu shots in drugstores, for instance, and clinics staffed by nurse practitioners or physician assistants and offering basic care for common ailments like strep throat or pink eye are popping up everywhere from Walgreens to Walmart.

A report last year by Accenture predicted such so-called retail clinics were poised to grow at a rate of 25 to 30 percent over the next few years, which would swell the number to 2,800 in 2015, from 1,400 in 2012.

CVS’s 800 MinuteClinics already account for most of such outlets, and Mr. Merlo said the company hoped to add another 700 for a total of 1,500 by 2017. For that reason, he said, the decision to stop selling tobacco products “was really more of a discussion about how to position the company for future growth.”

Heard it on the teevee this morning. Bummer - CVS and Walgreens sold the cheapest packs.

Good. Fuck smokers.

I do.

Yeah, CVS sells cartons for $10-$12 less than gas stations or specialty shops. I keep saying I'm going to move to e-cigs, and now I guess it will be sooner rather than later.

CVS didn't carry American Spirits anyway, fuck 'em.

lol

friends of mine who didn't grow up in the u.s. would always marvel at the fact that drugstores sold cigarettes

when you think about it, it's... JUUUUUST A LITTLE BIT STRANGE

it's cool, we have hard liquor at gas stations/convenience stores now B)

they should sell cigs everywhere: big-box convenience stores, gas stations, churches, children's daycare centers.

this is america. we do what we want.

NYT editorial.

this is ridiculous. the report says there will be 2.5 million fewer full-time workers by 2024, right? so obamacare is a job-killer. period.

as usual, everyone's assumption is that in the future the # of jobs in the U.S. will just happen to exactly equal the number of adults in the U.S. in reality machines are going to do more and more of the work, the number of full-time jobs will continue to decrease as a % of the population, and we better figure out how to provide a decent safety net for people that used to work in Amazon warehouses moving boxes around but were replaced by Move-a-Tron 4000s

I'm thinking while it was off on the population density, Soylent Green was only a decade or two off in other respects.

http://jama.jamanetwork.com/article.aspx?articleID=1828530&utm_source=Silverchair%20Information%20Systems&utm_medium=email&utm_campaign=JAMA%3AOnlineFirst02%2F05%2F2014

this was just e-published today, and i think it's free. i think there are some ethical problems with companies refusing to hire smokers -- about which rahm emanuel's brother, ezekiel, has written well iirc -- but i am generally strongly in favor of the rest of the antismoking public health measures. as a pharmacist (though i don't work at a CVS) i have always been strongly opposed to selling tobacco products in pharmacies (actually they're sold up in the front of the store, imo invalidating the least-unconcinving claim by advocates who say that selling them in pharmacies offers them a chance to discuss the issue with a health professional) and i think what CVS is doing is necessary and has been a long time coming

and we better figure out how to provide a decent safety net for people that used to work in Amazon warehouses moving boxes around but were replaced

lol that sure seems like an issue that's keeping your legislators and mine up all night

k3vin, is it true they're looking at getting rid of smoking cessation products, too? not that I have any idea how effective nicotine gum and patches are....

i haven't heard that, and like i said i don't work for CVS, but that wouldn't make any sense

in south florida, "vapor" cigarettes (or "e-cigarettes," or whatever they call them) are a huge thing now. they're everywhere.

are you all futuristic bounty hunters?

yes. wait, no.

i saw a commercial last night for e-cigs and the general message was 'friends don't let friends smoke cigarettes'
that seemed like a very different message than steven dorff on the beach being like "basically i just love to smoke and now i smoke this weird little blue thing"

oh god, I listened to a pop radio station last week and they kept having commercials that sounded like they were about the dangers of smoking and, yup, e-cig advertisement

f u e-cig companies

I mean, e-cigs seem like a safer option health-wise than cigarettes, but there's really been no research to tell how much safer or to confirm that fact

Opens up new marketing ideas, though:
"Eww, beer makes you all fat. Even that so-called light beer!"
"Here, try this. It doesn't have all the empty calories that beer has. It's called.... vodka"

When filtered cigs came out they were heavily marketed as a 'safer' alternative, which we now know was bollocks, but it made a lot of nervous smokers less anxious about the risk of cancer.

not much is known about their long-term health risks, and their rise (and the embrace of them by some clinicians) has provoked fierce controversy in public health circles

http://www.nejm.org/doi/full/10.1056/NEJMp1313940

CVS didn't carry American Spirits anyway, fuck 'em.

― Orson Wellies (in orbit), Wednesday, February 5, 2014 6:56 AM (Yesterday)

Walgreen's does. It's hilarious because the auto-generated "spending statement" my bank provides categorizes all Walgreens purchases as "health" -- I love America.

http://www.washingtonpost.com/national/health-science/white-house-delays-health-insurance-mandate-for-medium-sized-employers-until-2016/2014/02/10/ade6b344-9279-11e3-84e1-27626c5ef5fb_story.html?hpid=z1

As word of the delays spread Monday, many across the ideological spectrum viewed them as an effort by the White House to defuse another health-care controversy before the fall midterm elections. The new postponements won over part, but not all, of the business community. And they caught consumer advocates, usually reliable White House allies, by surprise, particularly because administration officials had already announced in July that the employer requirements would be postponed from this year until 2015.

Congressional Republicans seized on the announcement as the latest justification for scrapping the health-care law. In particular, they renewed their opposition to the law’s requirement that most Americans have insurance, saying it is unfair to delay rules for businesses and not for individuals.

not an onion headline

http://www.chicagotribune.com/business/breaking/chi-illinois-onion-obamacare-partnership-20140210,0,4949538.story

unexpected demand causes another Florida Health Choices delay. aca at work, and working.

obamacare horror stories: "at some point it’s worth asking whether the apparent difficulty conservatives have finding them suggests that maybe the law isn’t wreaking all the devastation they want you to believe it is"

http://www.salon.com/2014/02/21/are_republicans_even_trying_another_obamacare_horror_story_bites_the_dust/

my job-tied health insurer has turned down my one-year-cancer-anniversary PET scan TWICE now; ACA not really relevant to me w/ this shit.

The letter i got says "you have not been undergoing treatment" (balls).

Do you have a friend or family member who can help fight for you on that stuff? When my mom was being treated for leukemia, her insurance tried to deny her coverage for a CAT scan during treatment by claiming for some crazy reason that it was nondiagnostic in nature. Luckily my sister worked at the time in a doctor's office and was able to harangue the insurer over the coding on the bill.

ACOOOOOOOOOORN!!!!

http://talkingpointsmemo.com/news/obamacare-enrollment-hits-4-million

Shit so I am trying to finish enrollment but I forgot my password and every time I try to login and change it, it fails and says I either got the security questions wrong (which I didn't) or that I was unable to come up with a new password. Does anyone have advice?

it's OK, the insurer OK'd my scan on the THIRD try

Ok so i called the number and talked w a very helpful person over the phone pretty much instantly. I have to start a new account w a new email address.

Thank god they added IT hassles to our fucked up health care system eh

Apparently my credit history is too light to do the normal verification, so I have to go through some extra hoops and call an extra number. If I was a good American, I would have credit cards and car loans.

"The only good American is an indebted American."

-- Bob Marley --

Ended up just having a nice helper fill in my form for me over the phone, and yay I'm eligible for stuff! Time to do research!

happy to hear it dr. m

very glad to hear that, dr. m.

this is my shocked face -- florida "restaurant" chain charging "obamacare" fee isn't paying for "obamacare"

http://www.orlandosentinel.com/features/blogs/gone-viral/os-gators-dockside-obamacare-fee,0,7464589.post

I was on the phone the other day w two more people, the first was the official service that verifies your identity before you can sign up. They were unable to do so and asked me if I had a car loan or a house loan or a credit card or SOMETHING because they were looking at my credit history and there was nothing there. I guess years of paying utility bills means nada because I'm not actively incurring debt.

So they told me to call _this_ number, which turned out to be the regular Healthcare.gov help number. I talked to a helpful lady, probably a volunteer, who was really nice but had no idea why the verification company sent me back to her. So she filled out my form over the phone and it went really well and eventually she got to where my options for the different plans were, etc. so I asked her if I could now login and check these out for myself, and she said yes. She was really nice.

Of course, later, I login, and get the same "You must verify your identity" crap. WTF? If I can call this third person up over the phone, and they can just enter the info in themselves, why can't I just do it myself? Again, WTF?

latest way ACA is ruining america is by increasing americans' disposable income. socialism!

http://blogs.wsj.com/economics/2014/03/03/obamacare-effects-account-for-most-of-income-spending-increases/

Has anyone on this board successfully signed up? I know one person who signed up, but she signed up in December and was able to go through the whole process in one go.

*raises hand* I still have to actually go out and use it, though.

there was a glitch in my application to oregon's expanded medicaid program, so i didn't receive my introductory packet for a long time. however, whoever runs the twitter account for the oregon exchange was basically telling people "email me if you're having problems and i'll figure it out," so i did and they did! they also sent me a copy of the entire email chain generated by my request, like four different people all in communication with each other trying to pinpoint the source of the error. it was pretty cool.

Cool i hope they send me a packet i have given them my address three time now.

Apparently you can now keep your insurance for another two years if you want.

In other words, Obama is afeared that there will be blowback in the midterms.

Another proud moment in US politics.

All of the voters that were angry about Obamacare will now vote for democrats because of the extension. Brilliant political move, at least a dozen dimensions of chess right there, these guys are in charge for a good reason!

btw I haven't actually read any conformation on this so I'm trusting that dandydonweiner's account is 100% accurate

I signed up via the exchange but didn't have any kind of subsidy.

ah, here we go: http://www.nytimes.com/2014/03/06/us/politics/obama-extends-renewal-period-for-noncompliant-insurance-policies.html?hp&_r=0

WASHINGTON — The Obama administration said Wednesday that it would allow consumers to renew health insurance policies that do not comply with the Affordable Care Act for two more years.

The action helps Democrats in tight midterm election races because it avoids the cancellation of insurance policies that would otherwise have occurred at the height of the political campaign season this fall.

it's really weird that the second sentence is stated as a fact

so the masterfully executed strategy was

1. have obama repeatedly say "if you like your policy, you can keep it"
2. get absolutely destroyed in the media for many months because it turned out that in many cases, no, you couldn't keep your policy if it was non-compliant, no matter how much you liked it.
3. wait patiently until the firestorm of criticism over 1 and 2 has successfully angered every single voter who would ever hear about it and care one way or another
4. go ahead and let people keep their policy if they like it

can I start a get-rich quick scheme by making new policies that don't conform, or is it only ones that are grandfathered in?

I think a bunch of them are of the format: "send us $20 per month, and if you have a catastrophic injury, we'll pay up to $10,000 after you satisfy the $9500 deductible"

tbh I'm surprised anyone is surprised by this latest laffer

it's all over now, baby soetero

http://news.investors.com/ibd-editorials-obama-care/031214-693001-latest-obama-mandate-exemption-change-guarantees-obamacare-failure.htm

I think weakening the mandate is a bad thing, but

Another easy out: Just fail to pay a utility bill until a shut-off notice arrives. Send that in and — poof! — hardship exemption.

wtf dude

"I'll just have my power shut off! It'll be fun! Easy peasy!"

That's something you do after deciding to have more children to scam extra food stamps.

i've seen today apoplectic stories that the white-house has fatally undermined obamacare by compromising on the individual-mandate, and stories from aca-focused journalists saying it's no big deal. anyone know what's happening here, in a sentence?

i prefer to be apoplectic, honestly. c'est cathartique !

It continues to boggle my mind that people who work in and around health care blame every new change on "Obamacare." I worked with a transport person today who was convinced that the "government" is behind the (often absurd) pilot projects and studies at my place of employment. How does anyone who knows anything not realize that it's about insurance exchanges, not about doctors and administrators doing studies that (while sometimes absurd) do impact medical and nursing practices?

can I start a get-rich quick scheme by making new policies that don't conform, or is it only ones that are grandfathered in?

only grandfathered policies

;_;

so what if i claim that my grandfather created the new non-conforming policies?

Ok so I got the address of where to mail my proof to (just a copy of my driver's license) and it will take 2 weeks but if you have been trying and unsuccessful they are lenient on time so March 31st isn't the end-all-be-all date.

Still, it's silly, and hasn't made me feel like my account is any safer, in fact, now I have given out my personal info to 4 people over the phone. The mind boggles trying to imagine exactly how someone would steal my identity and use it to sign up for health insurance. Pretty sure the 'insurance fraud' scare tactics are just another chip in the massive giveaway to private industry that this is. Going through this process, I have had multiple people tell me I should get a credit card, get loans, etc., - not just these companies I have to talk to on the phone to access my stuff - but friends that are genuinely trying to help.

I pay for everything in cash, whether it is buying a car or going to college. If I can't afford it, I don't want it.

Clearly the insurance industry and credit industry are hand-in-hand, and no doubt had as much of a say in writing the ACA.

Still, I'm going to finally get health insurance! I am so excited.

That is awesome.

congrats, man.

https://www.youtube.com/watch?v=OUJLSopIWnc

lebron is proud of you.

bron constantly hawking products he doesnt use like staying in school and govt healthcare

that'll end now that he is past his prime and unlikely to get future endorsement deals.

haha

http://www.nbcnews.com/storyline/obamacare-deadline/obamacare-website-fails-deadline-arrives-n67666

http://www.washingtonpost.com/blogs/plum-line/wp/2014/03/31/obamacare-fails-to-collapse-time-to-move-on-folks/

http://www.washingtonmonthly.com/political-animal-a/2014_03/waiting_for_the_obamacare_alte049701.php

there's no secret to what the gop will offer as an aca "alternative," right? they will impose caps on med/mal suits; emphasize, as a bipartisan measure, new steps to further prevent and prosecute health-care fraud; propose "high-risk" pools; and propose allowing insurers of one state to sell policies to citizens of another state (on the theory that competition reduces prices and increases consumer-choice).

these are humdrum or totally regressive ideas. and they're all stale, across the board (except for further fraud-busting measures, which should be bipartisan and should be applauded).

A friend was trying to go online yesterday to make sure they had an extended deadline and it was too busy all day.

I'm still waiting on snail mail from the regional center...

nice article talking about how enrollment will continue during non-open enrollment parts of the year: http://talkingpointsmemo.com/cafe/obamacare-enrollment-is-far-from-over

http://talkingpointsmemo.com/livewire/obamacare-cuts-kentucky-uninsured-rate-by-40-percent

Impressive

The governor was on Chris Hayes' show last night touting this phenomenon.

LOL @ POTUS-BO for sending this out on April Fool's Day. suck it "conservatives"

Hello everyone,

Last night, the first open enrollment period under the Affordable Care Act came to an end.

And this afternoon, we announced that 7.1 million Americans have now signed up for private insurance plans through the new Health Insurance Marketplaces.

7.1 million.

That doesn't count the more than 3 million young adults who have gained insurance under this law by staying on their families' plans. It doesn't count the millions more who have gotten covered through the expansion of Medicaid and the Children's Health Insurance Program. It doesn't include the more than 100 million folks who now have better care -- who are receiving additional benefits, like mammograms and contraceptive care, at no extra cost.

Now, millions of our fellow Americans have the comfort and peace of mind that comes with knowing they're no longer leaving their health and well-being to chance. For many of them, quality health insurance wasn't an option until this year -- maybe because they couldn't afford it, or because a pre-existing condition kept them locked out of a discriminatory system.

Today, that's changed. And while our long-broken health care system may not be completely fixed, it's without question a lot better. That's something to be proud of -- and there's no good reason to go back.

Regardless of your politics, or your feelings about the Affordable Care Act, millions more Americans with health coverage is something that's good for our economy and our country.

At the end of the day, that is what this law -- and the other reforms we're fighting for, from a 21st-century immigration system to a fairer wage for every American who's willing to work for it -- are all about:

Making sure our country lives up to our highest ideals.

I am thankful to be your President today, and every day. And I am proud that this law will continue to make life better for millions of Americans in the years to come.

Thank you.

President Barack Obama

Great responses to Ted Cruz's FB poll about Obamacare:

https://www.facebook.com/SenatorTedCruz/posts/517779935000978

ahahahaha

According to Byron York, if you are getting Medicaid benefits or you are 26 years or younger and getting coverage on your parents’ health insurance plan, you simply do not exist. There are an estimated seven and a half million people in this country that fall into one of those two categories and now have access to health care that they would not have enjoyed if John McCain had won the 2008 election, but they don’t count.

http://www.washingtonmonthly.com/ten-miles-square/2014/04/if_obamacare_helps_you_you_don049707.php#

am i wrong in thinking that there are millions still without coverage because they 1) can't afford even the most basic plans & 2) their states have rejected medicaid expansion? so they fall into a doughnut hole of sorts, where they're too "rich" for classic medicaid but too poor to afford a plan?

That sounds about right. Heard someone suggest that the White House should allow in the long-term more basic cheaper plans, but it concerns me that they could get caught in a Republican race to the bottom bind that way with insurance plans that don't really provide anything. Not sure where the happy medium is. There is also so much variance between states-- with so many Republican southern states opting out of the Medicaid expansion. Plus the cost iof insurance plans are varying widely across the country. I heard a cynic say US healthcare costs will remain higher than those of Canada and Germany, no matter what (even if Obamacare changes do limit the rate of increased costs here somewhat).

that "doughnut hole" points to the fact that ACA didn't really address the root issue plaguing US healthcare: the exorbitant and often times arbitrary costs involved relative to what the rest of the world pays. Yes, more people can now have access to outrageously price-gouged healthcare, super.

Theoretically, getting more more folks with insurance and medicaid who are not just showing up in the ER will help push down healthcare costs a bit. But it will take more.

yep. they tackled the one problem which can be addressed in a pro-business way, and ingorned all the rest. Shocking.

so the most recent conservative talking points re: ACA seem to be

1. The bulk of the 7 MIL sign ups had been kicked off their previous plans in 2013 and forced to sign up for new plans under ACA, so the net gains are minimal.

2. No one who's signed up for ACA has actually paid for their plans yet, so those numbers aren't even real.

My assumption is that both points are complete BS, not even sure what #2 is supposed to mean really. Has anyone seen these addressed anywhere or do they only exist in the fevered minds of republicans?

the latter. no one's paid yet because premiums aren't due yet. grasping at straws, Repubs are.

re: #1, people didn't get kicked off old plan and then just told to go sign up at healthcare.gov. They were mapped onto new ACA-compliant plans, which didn't happen via the exchanges (though some could've decided on their own they wanted to actively shop for their new plan rather than be passively placed on one)

I mean my employer represents 1 company working in 5 states and we have 9 million members. Roughly 75% of those 9 million had non-grandfathered plans and so had to be mapped onto ACA ones. That's 6.75 mil right there who "had to sign up for Obamacare cause got kicked off old policy". ie the 7 mil figure mostly doesn't include these people.

Mapped on to a new ACA-compliant plan, or had to seek out a new plan from the marketplace? I think the numbers are marketplace-only.

My numbers there are out of date, just checked and we have 14 mil members. So that's 10.5 mil that got "kicked off" their old policy.

that "doughnut hole" points to the fact that ACA didn't really address the root issue plaguing US healthcare: the exorbitant and often times arbitrary costs involved relative to what the rest of the world pays. Yes, more people can now have access to outrageously price-gouged healthcare, super.

― A True White Kid that can Jump (Granny Dainger), Wednesday, April 2, 2014

i think the admin knows this. it has used the aca to begin creating an atmosphere less friendly to fee-for-service reimbursements (which is what keeps health care costs, and utilization, so high) and more friendly to alternative approaches (which reward efforts to keep patients healthier and with less utilization (like "ACOs")).

I'm more worried about the high deductibles I keep reading about (and a relative who's not an Obama hater told me about).

No one with an existing plan had to seek out a new plan from the marketplace

Good to know

Without a fundamental reconfiguration, you can either have a system that allows insurance companies to avoid risk via declining to offer coverage to certain people, in turn allowing for lower premiums or deductibles... or you can have a system that forces insurance companies to offer coverage to all and take on all that risk, which gets transferred to the consumer in the form of higher premiums or deductibles. Can't have both.

eh, not sure that's true. prohibiting insurers from rejecting applicants because of pre-existing conditions won't raise premiums and deductibles, if everyone's forced to buy insurance (the pool of money from premiums swells, allowing insurers to cover the increased costs from high-risk insureds). but your broader point was true; the current incentive system in healthcare is all screwed up. it rewards constant, duplicative utilization. it should be moved to a system in which groups of physicians are rewarded, with bonuses, for keeping patients healthier, and using less medical resources. that's the idea behind these ACOs, if they can ever really get off the ground.

true, forcing everyone to get health insurance is a way around some of that transferrence of risk from insurer to consumer. I don't know the numbers (and not sure I would 100% trust any "expert" "estimate" anyway), but as ACA is being and most likely will be practiced, not enough healthy people will sign up to fully defray those costs of insuring higher risk people. What would do the trick is single payor system, ie "fundamental reconfiguration".

obv the more healthy people that do sign up, the better it will be as far as premiums/deductibles go. Which is why the efforts to sabotage that aspect of ACA rollout specifically is so heinous.

those efforts will fail, tho, especially as the law begins to just be part of the netting of the state's support systems. plus the admin built protections into the law, to prevent a cost "death-spiral" in the event that fewer-than-needed "healthies" signed-up early in the process.

anyway, i agree: a single-payor system (or, absent that, a public-option) is better than the ACA. but the ACA is better than what we had before. it's a big, big deal.

oh for sure, I agree. It's laughable that a) ACA is being painted as a "government takeover" of healthcare and b) that an "employer takeover" of healthcare (which, if you want to stretch things characterizations in the same way conservatives are so fond of doing, the prior system was) is preferable!!

the ACA is also having the effect that a number (not sure how significant overall) of people are actually filing income tax returns in order to qualify for subsidized care who previously just did not file.

is it helping your business? I hope so!

when i took my continuing education last fall, one of the main units was about the ACA and taxes and the opening infographic said "congratulations, you are now part of the health care industry!"

ballpark dollar figure on all the effort wasted trying to discredit the ACA? hundred$ of million$? billion$? ten$ of billion$? hundred$ of billion$? good thing we have fiscal conservatives around to keep costs down

Hey, without spending that kind of money, where would we get the kind of top talent we have now?

with so many Republican southern states opting out of the Medicaid expansion.

well this is the crux of it, isn't it? the ACA was counting on this not being an option. but the Supreme Court said states could opt out. so suddenly there's no provision for people between the cut-off for existing Medicaid means-testing and the lowest rung of the bronze plans.

in tennessee there was a bill that would have made it against the law for schools to provide information to parents about the ACA. it almost passed.

i love how states have the right to ensure that more of their own citizens needlessly suffer and die

if there was a dude with a giant gun roaming the state killing thousands of people he'd be a legendary mass murderer, but when it's politicians refusing to pass legislation their adoring fans beg them to run for president

Hey, let's not bring the fossil fuel companies into this.

jesus hated the sick and the poor. vote GOP

So, I sent off my ID to the local processing center a month ago. I was told I should expect to hear back from them in 2 weeks.

Still haven't heard a peep.

how all the bastards let their healthcare industry overlords write it

In one TV ad, Obama blistered Tauzin for the kind of inside corruption that's made Washington famous.

"The chairman of the committee, who pushed the law through, went to work for the pharmaceutical industry, making $2 million a year," Obama announced to the camera, his sleeves rolled up for action. "That's an example of the same old game-playing in Washington. You know, I don't want to learn how to play the game better; I want to put an end to the game-playing."

A year later, he would find that game not so unpleasant after all.

After he became president, Obama would indulge Tauzin in the same closed-door dealings he once lambasted. The drug industry agreed to taxes and rebates involving $80 billion in savings over 10 years. In exchange, Obama reneged on three crucial promises: to speed generics to market, to allow the importation of cheaper drugs, and to retain the right to negotiate Medicare drug prices.

http://blogs.villagevoice.com/runninscared/2014/04/obamacare-sabotage.php?page=all

maybe when we elect hilary, she'll enact single-payer, right guys?

fuck presidents and forget em

Bill did!

My girlfriend (soon to be graduate student, just completed community college supplemental ed for said grad school, works at a restaurant) was able to get a solid plan for 20$ / month since she makes $10-12K per year. I spent several years in my earlier 20s uninsured (in a similar situation as she is now) with no decent healthcare options available for less than 150-200/ month. I wasn't pleased with the limitations of the ACA (would have preferred a public option to compete with private healthcare) but I am really happy that she doesn't have to live without a healthcare safety net. It really is a scary way to be, uninsured

So has anyone else sent in hard proof and never heard back? I sent in my driver's license months ago and haven't gotten a single thing in the mail. Each time I call the number, I end up getting someone new, who seems to have never encountered a case like mine before. WTF? I just want to buy health insurance! On top of that, I just got sick, and instead of going to the doctor I'm just going to have to sit around at home and hope I don't get my roommates and friends sick as well. :(

I'm pretty sure credit companies were in the room w the drug & insurance industries when writing this bill.

Got a letter in the mail saying my identity has been verified! Yay! I am on the site right now trying to log in.

FUUUUUUCK I'm getting the same "Your identity wasn't verified." page =(

So yeah spent a nice hour and a half on the phone w Experian, who told me to call a health care hotline, like they did several times before. I call that hotline and they say there is no documentation on me at all. I tell them I have a letter, in my hand, saying the southeast center received my driver's license and that I am OK to go. They don't see anything! They ask me why I think I should still be good for open enrollment and I search my mailbox for the first mail I got from Healthcare.gov. My Marketplace account was created 10/8/2013. They ask me when I mailed in my proof of ID and I tell them mid-March, weeks before the March 31st cutoff.

None of this matters. I do not qualify for enrollment, none of my documentation is in the system, etc. They have entered all my information (for the 4th or 5th time now) and sent it to their superior, whose department will contact me. "So the department will contact me? There is no number I can reach them at?" "No sir, the department will contact you. Please be advised it usually takes 30 days to process this information.

This is the same waiting period they gave me in March, when I mailed in my driver's license. I got the letter saying it was accepted IN MAY.

Fuuuuuuuuuuuu

I don't understand what is wrong. I WANT TO GIVE YOU MY MONEY.

mad sympathy for you, my experience wasn't nearly as bad but, unsurprisingly, Experian seems super confused by a dude who's changed his last name and it lead to some headaches

obviously I know the real answer, but as a rhetorical rage against the void, why in the holy fuck is Experian involved in a government agency confirming our identities?

signed up before the deadline, paid up the first month. never got a second bill. got my coverage canceled. found out about it 4 months later. thanks Empire Blue Cross/Blue Shield!

http://www.washingtonpost.com/national/health-science/federal-appeals-court-panel-deals-major-blow-to-health-law/2014/07/22/c86dd2ce-06a5-11e4-bbf1-cc51275e7f8f_story.html?hpid=z1

http://www.washingtonpost.com/blogs/wonkblog/wp/2014/07/22/the-potentially-huge-cost-of-todays-obamacare-decision/?hpid=z1

D.C. Circuit opinion written by Thomas Griffith, Bush appointee from Brigham Young U in Utah

Two federal appellate courts handed down contradictory rulings Tuesday on the legality of a central part of the Affordable Care Act that provides insurance subsidies to millions of Americans in three dozen states that rely on the new federal health insurance marketplace.

The D.C. Circuit Court of Appeals ruled that the tax credits available under the 2010 health-care law may be provided only to residents of states that set up their own marketplaces. Less than two hours later, the Richmond-based 4th Circuit Court of Appeals ruled in a separate case that the law’s language was ambiguous so that the Obama administration was free to allow the subsidies nationwide.

The ruling by the D.C. Circuit affects 27 states, most with Republican leaders who oppose the law,and another nine states that partially opted out.

The government immediately announced it was seeking an “en banc” hearing in the D.C. case, requesting that it be heard before the entire appeals court. The question ultimately may end up at the Supreme Court. But if subsidies for half the states are barred, it represents a potentially crippling blow to the health-care law, which relies on the subsidies to make insurance affordable for millions of low- and middle-income Americans.

“We feel very strong about the sound legal reasoning of the argument that the administration is making,” White House spokesman Josh Earnest said. “... there’s a clear, commonsense case to be made here which is that intent of Congress was to be sure that every eligible American who applied for tax credits to make their health insurance more affordable would have access to those tax credits whether or not the marketplace was operated by federal officials or state officials.”

Hours later, another circuit court came to the opposite decision

Sloppiness aside, there's no ambiguity about the law's "overall statutory scheme." Other parts of the law make clear that its drafters contemplated subsidies in every state. This lower court judge agrees. You could make an argument that it's ambiguous, but that wouldn't doom the ACA either. Courts are obliged to apply a two-part test known as the Chevron test in cases like these.

http://www.newrepublic.com/article/118803/halbig-v-burwell-ruling-anti-obamacare-lawsuit-could-backfire-gop

the GOP's still gonna run on this in 2016 aren't they

what else are they going to run on? "we hate anyone who isn't a WASP!" "we hate gay people!" "...ronald reagan!"

http://www.washingtonpost.com/blogs/plum-line/wp/2014/07/23/morning-plum-republicans-certain-obamcare-hasnt-helped-anyone-in-america/?hpid=z3

No shocka poll results

aaaand Dave Weigel on how the GOP hopes to hang this flaming tire around Dems' necks. I don't think it's gonna work this time.

http://www.slate.com/blogs/weigel/2014/07/22/here_s_how_republicans_are_blaming_the_damage_from_the_obamacare_lawsuit.html

who would jesus heal?

Richard Posner turns anti-ABA lawyers to mincemeat:

http://www.courthousenews.com/2014/09/16/71454.htm

"You're suggesting a breathtaking expansion of jurisdiction, aren't you?" he asked. "You're suggesting that anyone with a potential economic injury from a law can bring a suit. Where would you stop?"
"The stopping point is if someone is not being regulated by a particular statute," plaintiff's attorney Andrew Schlafly replied. "This is a regulation of the medical field, not some remote tax."
He then argued that people forced to buy insurance will never seek out cash practices in order to avoid paying for healthcare twice.
This did not satisfy Posner. "That's like saying people who get food stamps don't pay as much for groceries."
"We don't try to trace through all levels of the economy," Judge Frank Easterbook added.
Schlafly tried again: "In a concurring opinion by Justice Potter Stewart ..."
"Concurring opinions and $2.50 will get you a cup of coffee at Starbucks," Easterbook laughed. "I'm asking if you know of the Supreme Court ever allowing someone to sue for someone else's tax!"
As Schlafly floundered, Posner seemed skeptical: "The Act has had substantial economic consequences. Many people are better off, many are worse off. There are millions affected by this law. How do you have standing to sue? Is your proposition that anyone adversely affected has standing to sue?"
Schlafly began to cite another case, but Posner cut him off: "Yes or no?"
"Depending on the issue ..."
"No!" Posner shouted. "It doesn't depend on the issue. It depends whether they're hurt."

THAT andrew schlafly? lol

Got to see what's available in MS for 2015 -- Blue Cross just increased my premium by 25% for the 2nd year in a row, the fuckers.

based on my new job duties, highly urge everyone to scrutinize their bills from insurance comp. Esp if they qualify for a subsidy and esp esp if they ever make ANY sort of plan change during the year (eg add dependent...even address change). Shit gets all fucked up, it's a mess.

got my official letter last week saying that I can no longer keep my plan, and that my new "comparable" plan offered by Aetna would be almost 3x higher in monthly premiums.

if you don't mind me asking, what are the specifics of your current plan? I'm curious about real world examples of plans that don't meet ACA imposed standards.

the monthly premiums on my bare bones plan w/ BCBS TN creep up ~$15 every year. this happened before ACA, too.

I'm not really sure what wouldn't meet ACA standards but Aetna has been warning me about my plan likely not going to survive ACA for a couple of years now. And my premiums have been rising steadily for seven years on Aetna (despite no changes in coverage) by 5-10% each year. And I just did the math again and luckily the new Aetna alternative plan is only 177% more expensive (not 3x).

I'm sure that the alternative plan is "better" on some levels, but it's still very basic ($12.5k deductible, no dental, etc.) I need to decide before the end of the year if I'm going to stay with Aetna or find an alternative.

so long, romneycare!

http://talkingpointsmemo.com/dc/mitch-mcconnell-obamacare-repeal-reconciliation

like, unless yr paying 100 bux a month for insurance (and looking @ a 1.77x increase) then your current Aetna plan seems absurdly over-priced by what you're getting? I went platinum in NYS and pay 480-something (absurd) but no deductable + dental. It's supposed to go up to 570 next year so I'ma tier-down to the next level (prob around my same current price; mas o menos) which is something like a 2500 deductable but still dental etc.

‘People Are Going To Be In For A Shock': Penalty For Uninsured Not Signing Up For Obamacare To More Than Triple

i guess i better try to sign up again, sigh

americans are too stupid to understand? go get 'em, megyn!

https://www.youtube.com/watch?v=8Hcu1S2GKf0

well, the NYS site's better than last year, but still really slow and complicated as hell

...and at 1 am in the morning, the website goes down for maintenance until 8am. this has happened to me at least a half dozen times over the last month. Also everytime this happens, you have to start the whole damn application over again, though it at least saves most of the information you put in. Sigh.

What's everybody doing? I've been on Freelancers Union w/ Freelancer Medical since the beginning of both but am NOT down with zero coverage for specialists until deductible is met. Is there another thread for this? We all need to decide RIGHT NOW.

in NYS; use the exchange/nystateofhealth. just downgraded my play from 480-something no deductable to 430 something w 2K deductable now that my previous plan significantly broke the 500.00 barrier. there's something morally wrong to me about having to freelance one day a month just for insurance. will chime back in if I'm reminded w/ who I changed to. Did the whole thing in about 45 min the other day at 8 PM

freelancers' union always seemed like garbage to me btw

i went with the cheapest possible plan I could get from Health Republic NY through the exchange site, mostly because Empire Blue Cross/Blue Shield totally burned me last year

it'll be kind of annoying to pay the ~$150 per month but that's better than nothing in the case of catastrophe. pretty good chunk of my income though - it's kind of unfortunate to be not eligible for medicare but not easily afford decent insurance. lots of others in much worse situations than me, though; at least i don't have currently have any crazy medical bills.

jimmy-which plan did you choose? that is the question.

I have trouble with the exchange/subsidies because my income varies wildly from year to year. If I got subsidized based on my income from last year, I would definitely have to pay that money back based on my income in the upcoming year.

When I joined freelancers union, it was the only option for freelancers to get their own insurance that didn't cost 800+. There was like one other thing, Fractured Atlas, which wasn't ideal either.

I'm used to paying 350+/mo for healthcare and have no expectation of not paying that much or more, I have enough doctors that I need normal healthcare and not a catastrophic plan.

how tf is 480 dollars a month "affordable"

or 350 for that matter

Even with good health insurance, we were sort of forced to make all sorts of decisions this year in terms of coverage. Same with my mother in law, who is a lifetime government employee with great insurance whose options often nonetheless made so little sense. For example, one of her options covered gender reassignment surgery, but not foot surgery to remove bunions. Just perplexing nickel and diming.

NEW: Metro Plus: GoldPlus-G2, NS, INN, Dep25, Pediatric and Adult Dental, Adult and Pediatric Vision. deductable is something like 2K, which is manageable

Previous was metroplus platinum w/ the works; no deductable

See, the thing is that afaict you can't get a comprehensive adult plan (w/ both dental; vision) w/o getting one that also offers pediatric, which seems like a pretty obvious attempt to assfuck a consumer. I was looking @ oscar bc they seem competitive and nimble (i may have fallen victim to advertising) but they offer neither dental nor vision. NYSHealth offers a la carte dental/vis plans but that sums to more than an all in one pkg.

also hi tracer 480 isn't affordable but here we are

we can't all be living your life w your beautiful family in a foreign land :D

you're all invited btw

here's how much the entire NHS costs per capita per year
http://www.nuffieldtrust.org.uk/data-and-charts/health-care-spending-person-uk

that's about 260 dollars a month, everything included (no vision) (bad dental, naturally) and no deductible.

just in case anyone thinks it's "free"

well we will all be dead soon here so it doesn't really matter and u cant take it w u

Things are relative. A few years ago if you were self-employed and needed healthcare, most options cost more than 800 dollars a month. Thus options that cost 400 or less are affordable. And when you need insurance and you factor that expense into your cost of living in america, you quickly become accustomed to the fact that you're going to be spending 3 or 400 a month on insurance. Now there's lots of options in that range. There used to be two. All the options suck, but I have no choice.

For what its worth, when you get it as a benefit through a company, you're putting money in and they're putting money in. You just don't feel it the same.

anyway I hope I was useful 4 u dan. nb I also went to the dr one time in my first year under obama's doctrine so that dr visit cost me 5.7K dollars

That's insurance, no big deal.

I feel like people are spoiled if they're coming from jobs...or have never had insurance before. I will repeat, before ACA, getting decent healthcare in New York cost 800 bucks and did not include dental or eyes or any of that shit.

Paying 480/mo for a 2000 deductible and getting dental and optical is a GOOD DEAL. It sucks, but that's AMERICA. Not to be captain obvious, but that 5.7k was for insurance, not just 1 dr visit, and if you go to the doctor once a year, pay the fine and pay the doctor out of your pocket. If you want insurance, it's gonna cost.

guys do be careful when enrolling for obamacare, i read recently that more than 700 fake websites have been created to defraud folks. apparently you can tell which sites are a bunch of baloney because they are easy to log on to!

make sure that you start out at healthcare.gov instead of healthfraud.xxx

lol on hold for an hour and as soon as i hear a dial tone the call ends. waited twice as long a couple nights ago only to connect to someone who seemed to have no idea what he was doing

how is this worse than before

For what its worth, when you get it as a benefit through a company, you're putting money in and they're putting money in. You just don't feel it the same.

I have never had health insurance through a job. At one point, when I was in my early 30s, I was paying like $700/mo. Now I'm at a "manageable" $470/mo. I was afraid I was gonna start getting reamed this year, having turned 40, but no.

I have trouble with the exchange/subsidies because my income varies wildly from year to year. If I got subsidized based on my income from last year, I would definitely have to pay that money back based on my income in the upcoming year.

Are you mostly/entirely self-employed?

I hassled my daughter into finally checking the ACA website and it looks like she's eligible for huge tax credits that will completely cover the cost of her coverage.

I am sometimes/mostly/entirely self-employed but occasionally hourly w4 employee and sometimes 1099 contractor and sometimes not making any money and sometimes making a normal amount of money.

I do have some family members that are in this middle class suck hole, where the cheapest thing they can get are plans with shit deductables and $800/month premiums for the three of them, which is allegedly three times what they were paying a few years ago. i feel for them but still.

I am sometimes/mostly/entirely self-employed but occasionally hourly w4 employee and sometimes 1099 contractor and sometimes not making any money and sometimes making a normal amount of money.

It makes it really convoluted -- because they base the subsidy/credit on some modified AGI, so it would be your net profit from self-employment/1099s, so in addition to timing expenses to reduce self-employment tax, you would also be doing it for the ACA subsidy/credit.

classic url here:

http://talkingpointsmemo.com/dc/scotus-king-obamacare-workarounds-doomed

"We're quite pessimistic. The operational, legal and political challenges here are immense," Nicholas Bagley, a University of Michigan law professor who co-authored the article, told TPM in a phone interview on Thursday. "The more I've looked at this, the more alarmed I've grown."

The problem is three-pronged: Legal, because the Affordable Care Act sets some very specific requirements for state-based exchanges; practical, because states might not have time or authority to act after the Court ruling comes down in June, as expected; and political, because Republican intransigence against Obamacare is currently one of the defining elements of American politics.

An adverse Court ruling in the King vs. Burwell case would invalidate the law's tax credits, received by nearly 90 percent of Obamacare enrollees in 2014, in at least 34 states that are using the federal website. Health coverage would likely then become unaffordable for many enrollees, and those who choose to keep paying the higher price are more likely to be sick and more costly, potentially sending the law into a dreaded death spiral.

praise jesus

http://www.washingtonpost.com/opinions/republicans-cut-and-pasted-their-new-obamacare-alternative/2015/02/06/def0d0a0-ae57-11e4-9c91-e9d2f9fde644_story.html

let it be easier once again for a camel to fit through the eye of a needle than it is for a poor american to afford health care, the lazy bums!

Still stuck in "verify identity" hell. =( I think I have tried signing up 10+ times now.

I can now fully apply and then get to the "Sign & Verify" page and then it says "We will get back to you when we verify your identity". On the front page there is a little "Identity Verified" thing next to my name, yet it will not let me complete an application =(

My daughter makes so little in her shitty dollar-store job that she'll qualify for subsidies that pretty much cover her entire policy, if she'll only finish the fucking signup procedure. I don't believe she's finished yet, and I've reminded and nagged her all I'm going to. If she lets this deadline pass and pays a couple grand unnecessarily out of pure willful stubbornness, I'm going to be pissed. But it's her money.

If you fail to sign up for medical insurance it's not just a matter of going uncovered now. There is a minimum tax penalty of (iirc) several hundred dollars that you'll pay for the privilege of having no insurance.

Yeah that is like a nice kick in the nuts. Not only can I not get signed up for reasons nobody I talk to seems to know, I am going to have to pay a penalty because this shit still doesn't work.

The fee in 2015

If you don’t have coverage in 2015, you’ll pay the higher of these two amounts:

2% of your yearly household income. (Only the amount of income above the tax filing threshold, about $10,000 for an individual, is used to calculate the penalty.) The maximum penalty is the national average premium for a bronze plan.
$325 per person for the year ($162.50 per child under 18). The maximum penalty per family using this method is $975.
The fee for not having coverage in 2014

If you didn’t have coverage in 2014, you’ll pay the higher of these two amounts when you file your 2014 federal tax return:

1% of your yearly household income. (Only the amount of income above the tax filing threshold, about $10,000 for an individual, is used to calculate the penalty.) The maximum penalty is the national average premium for a bronze plan.

$95 per person for the year ($47.50 per child under 18). The maximum penalty per family using this method is $285.

The fee after 2015

The penalty increases every year. In 2016 it’s 2.5% of income or $695 per person. After that it's adjusted for inflation.

Looks like I need to just move to another damn country.

Is there anyone on this board who has successfully signed up and never owned a credit card? Cos I feel like that is the main thing holding me back and I refuse to participate in the credit card system.

Use a human insurance agent who is certified to assist people in signing up through healthcare.gov and let them wrestle with the shitty software for you. I'm guessing they should be able to use a paperwork back door of some sort.

Hah yeah I've been through 3 people via that route. Acted surprised and bewildered, then told me I should really just go on the site cos they logged in as me and see all these cool plans.

I guess I could give it another shot.

yes. shooting them might help.

If you fail to sign up for medical insurance it's not just a matter of going uncovered now. There is a minimum tax penalty of (iirc) several hundred dollars that you'll pay for the privilege of having no insurance.

― Aimless, Saturday, February 14, 2015 9:23 AM (3 hours ago)

in the case of William's daughter, she might qualify for a low income/affordability exemption

Also, I believe you could add her to your plan, (depending on her age) and there would just be a few extra forms to fill out at tax time if she files her own tax return and is not your dependent.

She's 26, past the cutoff for being added to my insurance. She has health insurance and pays for it herself so she won't get hit with the tax penalty, I'm just cranky at her for not taking advantage of the ACA. She definitely qualifies for the low-income subsidy. She's done all the math, I just don't think she's finished the signup procedure. Maybe she's psychic and knows King vs. Burwell is going to go badly.

I was irritated that this year, the tax credit only applies to people that purchased insurance through the marketplace, as opposed to people that got policies by other means, which means I lose out.

Ok gonna give it ONE MORE TRY.

"Almost Finished...."

FUUUUUUUUUUUUUUUU

Can anyone recommend healthcare in other countries? Can I fly to a country with real socialized healthcare and get help as a foreigner?

On the front page in green letters next to my name it says "Identity Verified". And yet it will not let me finish my application because "My identity has not been verified"

My bf tried it (self-employed) and got, "You can't choose a health plan until we verify these two documents. Please send or fax them to (xxxxx) before 5-31-2015" or something. So if the deadline for turning in his proof of citizenship is MAY, he can't be held liable for not having a plan by 2-15. Surely? We hope.

Hoping one place or the other hires me soon bc I didn't sign up and don't have the info to hand, but there's a 90-day grace period for getting health insurance by other means. C'mon full time job!

I don't think you need to go through the exchange website. When I was looking to switch from freelancers to Health First, I just called up Health First and was about to sign up. Maybe that's only if you're not going for subsidies? But you should be able to do that through the insurance company directly no? I ended up taking a job at the same time so it's a moot point, but I'm still fighting Freelancers over money.

Maybe that's only if you're not going for subsidies?

Yep.

http://www.esquire.com/news-politics/politics/news/a33865/diabetes-is-a-reason-to-repeal-obamacare/

"obamacare" has already contributed to saving an estimated 50,000 lives

http://www.washingtonpost.com/blogs/fact-checker/wp/2015/04/01/obamas-claim-the-affordable-care-act-was-a-major-reason-in-preventing-50000-patient-deaths/?tid=hybrid_experimentrandom_1_na

time to repeal this evil!

Two years ago I didn't have health care and the health care cooperative I now belong to did not exist, yet. Now I can afford to buy insurance and it was easy to compare policies and make a choice. Pure evil.

I just want to know if Adam Bruneau's 1 1/2 year odyssey to signing up for health care has met with success?!

Hah. No. I checked my trash to see if I missed anything and it was full of emails from Healthcare.gov, saying "It is almost your last chance to sign up!" "Hurry up!" and NONE of them were responding to my requests for help or any of the document uploads I had done or anything. Really looking forward to paying that fee, they are doing a bang-up job in Washington and deserve my money /s

So I lost my contract job that dictates my income level, leaving me with a rather high income level and no substantial current income (I still have plenty of work but it's not nearly at the level it was last year). I could buy private insurance but it seems like they would base my payments on what I made last year, and I couldn't afford it at the moment.

But hold on I am going to try again.

Ok the MY PROFILE page has a green "Identity Verified" with a green checkmark right under my name. At the top it says "You have messages".

In MESSAGES it says "You have a notice available about your identity verification. Download". I download the PDF.

The PDF is dated Nov 28, 2014. It asks for two proofs of ID, which I sent in and received a piece of paper in response to. The paper told me that my identity had been verified, which is what the website currently tells me and has told me ever since Dec of last year.

it seems like they would base my payments on what I made last year

I think you are misconceiving this.

Insurance premiums are set according to underwriting standards, such as your age, smoking habits, and a few other broad criteria. The only income-based adjustments are done by the federal government via tax credits, and the only way to qualify for tax credits is to sign up using a health care exchange such as healthcare.gov or your state exchange. If you buy insurance through the private market, you won't get any subsidy, and your premium will not be related to your income at all.