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Affordable Health Care
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bieramar



Joined: 19 Nov 2010
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Location: Taylor Ranch, NM

PostPosted: Sun Jan 02, 2011 4:18 pm    Post subject: Affordable Health Care  Reply with quote

Effective yesterday, 01/01/11 the second phase of the Affordable Health Care law kicked in.


The first phase, implemented in September last year for private sector insurance as policies are renewed, or new ones written, included.

- federal tax credits for small businesses offering insurance for their employees.

- coverage for individuals with pre-existing conditions.

- choice for adults through age 25 to remain on their parents' plans.

- requirement to offer free preventative care for specified procedures.

- ban from rescinding coverage based on technicalities when an enrollee became ill.

- eliminate lifetime limits on insurance coverage.


Effective as of Jan. 1, 2011.

- health savings accounts and similar drug accounts used by workers in employer-offered plans must have doctor's Rx for the items.

- insurance companies must spend at least 85% of collected premiums for providing health care (80% percent for individual and small business plans).


- Medicare (for ages 65 up) provides specified preventative services free.

- Medicare recipients' "donut hole" (about 3 million retirees) out-of-pocket Rx expenditures reduced by providing a 50% discount for covered brand-name Rx drugs, and 7% discount for covered generics. ?


- Medicare recipients earning more than $85,000 annually have subsidy for Rx drugs reduced (Medicare Part D only).

- Medicare Advantage (the name is misleading as these are private sector plans which retirees can choose to enroll in to pay for the co-pays and other items which the federal Medicare does not pay) enrollees will no longer get free gym memberships and eyeglasses.

- reduces the double federal subsidies currently being paid to the private sector insurance companies who provide supplemental insurance under the optional Medicare Advantage plans for seniors.

- provides new home/hospice services to Medicare recipients after release from hospital care.

- initiates a sales tax on Rx manufacturers.*


In October this year, states can begin using federal Medicaid money for offer home- and community-based services for the disabled.

Next year in 2012, the use of electronic medical records is mandated, and Medicare payments will be linked to the quality of health care actually provided.

Not until 2014 (unless the ongoing federal lawsuits are successful) is the requirement for most individuals to obtain insurance, with federal subsidies for the poor, to go into effect.

--- end summary of changes ---

*The drug manufacturers in behind the scenes negotiations signed on to this industry-wide $5+ billion annual tax because and quietly supported the Affordable Care Bill because of the millions of new customers with their Rx insurance-paid programs as the new rules are implemented.

Likewise the reform Bill would never have been passed without the backroom support of the major private sector health insurance companies, who also are now guaranteed customers from birth to death in the U.S. (only a small percentage of old folks do NOT have some type of private supplemental insurance like Medicare Advantage.


I also note the political rhetoric by many incoming Republicans to Congress that they will block Appropriations (funding) Bills to implement the changes, in lieu of trying to repeal the entire law.

Most of the changes do NOT require separate Appropriation legislation as they are simply rule/regulation changes to current laws.
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bieramar



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PostPosted: Mon Feb 28, 2011 10:03 pm    Post subject: Reply with quote

Obama Supports Relaxing ACA Requirements for States

By Emily P. Walker, Washington Correspondent, MedPage Today
February 28, 2011

WASHINGTON -- President Obama has announced that he'd support a bill that would let states opt out of requirements of the Affordable Care Act (ACA) three years earlier than currently allowed, as long as states could cover as many people and at the same cost....

Specifically, the president said he supports a bipartisan bill sponsored by Sen. Ron Wyden (D-Ore.) and Sen. Scott Brown (R-Mass.) that would allow states to request permission from the Department of Health and Human Services (HHS) to set up their own healthcare systems starting in 2014 as long as they meet minimum standards established by the federal government.

Under the ACA, states can receive a waiver to opt out of some federal requirements in the ACA starting in 2017 if they successfully enact a state-specific plan to cover as many people as the ACA would cover, at a similar cost.

"Now, some folks have said, well, that's not soon enough," Obama said, referring to the 2017 date. The Wyden/Brown bill would give states the opt-out option three years earlier, in 2014, which is when many of the ACA's main provisions -- including the requirement that every one have health insurance -- take effect.

If states receive a waiver, they wouldn't be required to follow some of the law's mandates, such as adhering to rules on minimum benefits insurance plans must offer, the requirement that most individuals obtain coverage, and the requirement that almost all employers provide it.

States that want to create their own system would receive the federal money that would have otherwise been spent there to provide insurance subsidies to residents who can't afford to buy insurance on their own....

In his State of the Union speech in January, he backed doing away with a tax provision in the ACA that requires all businesses to fill out a 1099 form when they spend $600 or more. Earlier this month, the Senate passed a bill that would eliminate that part of the law. The House is expected to follow suit.

The American College of Physicians (ACP) applauded Obama for endorsing the earlier option for states to create their own approach to insurance coverage.
"It could provide a basis for much-needed bipartisanship by giving states more options, sooner, as advocated by many governors, Republicans and Democrats alike, while preserving the ACA's promise of providing coverage to all Americans. It recognizes that states differ greatly in their cultures and traditions and should be encouraged to try what works best for them -- as long as their residents would get the comparable coverage and consumer protections" ~ ACP president J. Fred Ralston Jr., MD....
===

Nice piece of fine-tuning.  

Obama will be forever in the history books as the president who finally obtained universal health care in the United States, after attempts beginning with Truman,  decades after the rest of the modern industrial world did so.

If the ongoing rapprochement with the changing Muslim world which began with his first speech in Egypt continues he will be ranked in the top ten presidents.

And if the Jews, Muslims and Christians in Israel come to their senses as the Arabs, Persians, Copts and others surrounding them continue to make radical changes in their alliances and political philosophies, he'll be in the top ten of world-changers.
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bieramar



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PostPosted: Sun Apr 17, 2011 3:29 pm    Post subject: Reply with quote

Rep. Paul D. Ryan's proposals would relieve the government of much of the responsibility for paying for healthcare, but if the result is that individuals carry a heavier burden, is that really a 'path to prosperity'?

By Michael Hiltzik
April 17, 2011

If consensus-building is a hallmark of effective governing, a rule you can probably find in a civics textbook or two, then I suppose it's an achievement that everyone agrees that unending federal deficits will lead us to perdition.

But the unresolved question is what to do about it.

That question is bound to be hashed out among the contestants for the 2012 presidential sweepstakes, whether they represent the Democratic Party, the Republican Party or the You-Gotta-Be-Kidding-Me Party (chairman of the board: Donald Trump).

The two political bookends of the deficit debate were established over the last two weeks, first in a long-term budget road map issued April 5 by Rep. Paul D. Ryan (R-Wis.), chairman of the House Budget Committee, and passed by the Republican majority of the House on Friday, and then by President Obama in his budget speech Wednesday.

If there was any doubt that the debate over deficits is not about numbers but philosophies of government - it just exploits the vocabulary of fiscal policy - these two events should lay it to rest.

The principal target of Ryan's plan is government healthcare spending - Medicare, Medicaid and the healthcare reform plan. That's a reasonable place to aim any deficit-reduction plan, because that's the area where costs are rising most sharply.

But his solutions are the antithesis of reasonable. They involve almost entirely throwing the neediest and sickest Americans out from under the government umbrella to fend for themselves. Medicare as we know it would be eradicated, the cost of Medicaid shifted largely to already hard-pressed state government, and a reform program designed to give tens of millions more Americans the protection of health insurance canceled outright.

Is this really the only path to deficit reduction?

Obama, to his credit, drew a philosophical line in the sand that his progressive supporters have been waiting to see for two years. Ryan's vision, he said last week, "says America can't afford to keep the promise we've made to care for our seniors?. It's a vision that says up to 50 million Americans have to lose their health insurance in order for us to reduce the deficit."

Obama connected the dots between the House Republican majority's proposed spending cuts and its determination to preserve tax cuts for the wealthiest taxpayers - proposals to cut out not only government healthcare but a host of programs that directly benefit the middle and working class while indirectly helping to build the American economy for the future.

That's "a vision that says even though Americans can't afford to invest in education at current levels, or clean energy, even though we can't afford to maintain our commitment on Medicare or Medicaid, we can somehow afford more than $1 trillion in new tax breaks for the wealthy," he said.

Indeed, as the bipartisan Congressional Budget Office found in its analysis of the plan (done at Ryan's request), until the Medicare and Medicaid cuts kick in starting in 2022, the red ink of its tax cuts overwhelms the savings from other program reductions. Ryan's plan actually increases federal public debt compared with what it would be under current law: to 70% of gross domestic product under the Ryan plan compared with 67% under current law. Nevertheless, it passed by a party-line vote Friday, just before the nation's lawmakers high-tailed it out of Washington for a two-week vacation.

As for the health programs, the House passed Ryan's proposal to extinguish Medicare as a guaranteed coverage program and substitute healthcare vouchers, allowing seniors to buy private health insurance with a government subsidy.

The vouchers would rise in value with the consumer price index, but as medical expenses have been rising much faster than general inflation, the value of the government subsidy would erode over time. The CBO calculated that the share of standardized medical expenses paid out-of-pocket by the typical 65-year-old in 2030 would be 68% under Ryan's plan, compared with 25% under current law.

The delivery of health benefits would be much less cost-effective under this giveaway to the private insurance industry than it is under Medicare, as seniors would be paying for the private insurers' much higher administrative costs, including profits. And don't forget that the elderly are sicker than the general population, so the premiums charged for this standard plan may well rise faster than overall medical inflation, putting the seniors further behind the curve.

There are other flaws in this arrangement. For example, because traditional Medicare would remain in place for today's retirees and near-retired, the difference between their health program and that of younger retirees after 2022 could generate political pressure for Congress to increase the latter's benefits.

The proposal assumes that raising patients' out-of-pocket costs leads to more cost-efficient care, a notion that is unproven at best and has been questioned by some experts.

The proposal overlooks the fact that the cost of healthcare for the elderly can't easily be wished away. The CBO observes that some elders unable to pay for their care might end up in the government's disability or Supplemental Security Income (SSI) programs, both of which are already overstressed.

Others may require help from their children, which would only cut into the next generation's economic resources; alleviating exactly such an intrafamilial burden was a founding principle of both Medicare and Social Security.

Ryan is right when he suggests that his plan would "fix" Medicare; it's the same way that the Mafia "fixes" an informer. In both cases the solution guarantees that the target won't be around to create trouble anymore, and as long as you don't feel remorse about collateral damage you're home free.

As for Medicaid, Ryan proposes to shift much of the federal burden of this program for the poor and infirm to the states, while reducing its overall scope and eliminating some federal mandates.

This is plainly a threat to the well-being of our most unfortunate citizens. Can you think of any states that, confronted with fiscal problems and relieved of the federal mandate and federal dollars, might decide to take a hatchet to their Medicaid budgets?
I can think of about 50.

Finally, repealing healthcare reform simply reinstates the system of coverage dominated by private profit-seeking companies that has failed to stem rising medical costs for decades, while leaving some 47 million American residents uninsured.

There's no reason to believe that Ryan's proposals will do anything to reduce healthcare costs in the U.S., and reason to believe they would do the opposite.

They would relieve the government of responsibility for paying much of the price of care, but if the result is that individuals carry a heavier burden - and the neediest individuals the heaviest - is that really a "path to prosperity," as the Ryan plan was titled?

As always, it's instructive to summon up the words of the dean of progressive social policy, Franklin Roosevelt. In 1935 he was asked his opinion of the platform of the American Liberty League, which, like the Ryan cabal, aimed to dismantle the New Deal under the guise of preserving individual rights and free enterprise. (Its principal backers were the Du Pont family, conservative Democrats who might be thought of as the Koch brothers of that era.)

"The two particular tenets of this new organization," FDR told reporters, "say you shall love God and then forget your neighbor. For people who want to keep themselves free from starvation, keep a roof over their heads, lead decent lives, have proper educational standards, those are the concerns of government besides these two points." He threw in "the protection of the life and the liberty of the individual against elements in the community that seek to enrich and advance themselves at the expense of their fellow-citizens."

Those are still the concerns of government, and to say we can't afford them is an affront to the working people who build America today. But let's give the House GOP majority the last word. In the introduction to the GOP budget resolution passed by the House, Ryan declared: "Americans face a monumental choice about the future of their country."

No kidding.

---
Michael Hiltzik's column appears Sundays and Wednesdays. Reach him at mhiltzik@latimes.com, read past columns at latimes.com/hiltzik, check out facebook.com/hiltzik and follow @latimeshiltzik on Twitter.
====

There are already 117 comments on this column at http://www.latimes.com/health/la-fi-hiltzik-20110417,0,1181721.column
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bieramar



Joined: 19 Nov 2010
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PostPosted: Fri May 06, 2011 5:24 pm    Post subject: Reply with quote

National Survey of 1,000 Likely Voters
Conducted April 29-30, 2011
By Rasmussen Reports
 
1. Will the health care plan passed by Congress and signed into law by President Obama be good for the country or bad for the country?
 
45% say it will be bad for the country.
37% say it will be good.
5% say it will have no impact.

2. A proposal has been made to repeal the health care bill and stop it from going into effect. Do you strongly favor, somewhat favor, somewhat oppose or strongly oppose a proposal to repeal the health care bill?

47% somewhat favor repeal, including 38% who strongly favor repeal. 

42% somewhat oppose repeal, including 33% who strongly oppose repeal. 
 
NOTE: Margin of Sampling Error, +/- 3 percentage points with a 95% level of confidence
======

The opposition to the Affordable Health Care law has been gradually diminishing as more people understand it along each step of implementation.
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coebul



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PostPosted: Fri May 06, 2011 6:20 pm    Post subject: Reply with quote

bieramar wrote:


The opposition to the Affordable Health Care law has been gradually diminishing as more people understand it along each step of implementation.
Understand or misunderstand?
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coebul



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PostPosted: Fri Aug 12, 2011 5:39 pm    Post subject: Reply with quote

U.S. Appeals Court Rules Against Obama's Health Care Law


A federal appeals court ruled Friday that the individual mandate in President Obama's health care law is unconstitutional.

Read more: http://www.foxnews.com/politics/2...as-health-care-law/#ixzz1Upyw8lO5

More

A federal appeals court ruled Friday that a provision in President Obama's health care law requiring citizens to buy health insurance is unconstitutional, but didn't strike down the rest of the law.

The decision is a major setback for the White House, which had appealed a ruling by a federal district judge who struck down the entire law in January. But the case is clearly headed to the Supreme Court, which will have the final say.

On Friday, the divided three-judge panel of the 11th Circuit Court of Appeals sided with 26 states that filed a lawsuit to block Obama's signature domestic initiative.The panel said that Congress exceeded its constitutional authority by requiring Americans to buy insurance or face penalties.

"This economic mandate represents a wholly novel and potentially unbounded assertion of congressional authority," the panel said in the majority opinion.

In other cases, two federal judges have upheld the law and one judge ruled the individual mandate is unconstitutional but left the rest of the law intact.

Read more: http://www.foxnews.com/politics/2...as-health-care-law/#ixzz1Uq3OKN8K
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bieramar



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PostPosted: Fri Aug 12, 2011 9:42 pm    Post subject: Reply with quote

A FoxNews.com writer wrote:
A federal appeals court ruled Friday that a provision in President Obama's health care law requiring citizens to buy health insurance is unconstitutional, but didn't strike down the rest of the law.

The decision is a major setback for the White House,...


The writer may consider this ruling a major setback for the White House, but it definitely isn't a setback for Obama personally.

As I've noted before, including links to Obama's campaign platform and his subsequent speechs, Obama did NOT include mandatory enrollment as an essential part of the health care reform Bill - that provision was added by Democratic members of the Progressive Caucus in Congress.

The essential portions of the health care reform law are the mandatory offered availabilities of coverage to everyone and the extensions of coverage, and no judge so far has ruled those mandatory provisions unconstitutional.
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coebul



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PostPosted: Fri Aug 12, 2011 10:24 pm    Post subject: Reply with quote

bieramar wrote:
A FoxNews.com writer wrote:
A federal appeals court ruled Friday that a provision in President Obama's health care law requiring citizens to buy health insurance is unconstitutional, but didn't strike down the rest of the law.

The decision is a major setback for the White House,...


The writer may consider this ruling a major setback for the White House, but it definitely isn't a setback for Obama personally.

As I've noted before, including links to Obama's campaign platform and his subsequent speechs, Obama did NOT include mandatory enrollment as an essential part of the health care reform Bill - that provision was added by Democratic members of the Progressive Caucus in Congress.

The essential portions of the health care reform law are the mandatory offered availabilities of coverage to everyone and the extensions of coverage, and no judge so far has ruled those mandatory provisions unconstitutional.
If I thought is was a major setback for 0bama personally I probably would have posted this in the President 0bama thread.  The economy is doing that on it's own.  

The gist of the piece is the decision dealt a major blow to the Health care legislation and that is why it was posted here in the health care thread.  

And while it did not end the mandatory coverage (and the piece never said it did) offered, it did shoot down having to buy that coverage which with out that provision there is a significant short fall in "paying" for the health and keeping rates low.   Most agree that this decision guts the finances of the Affordable Health care act.  

That "is" a major blow to the AHC act.
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bieramar



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PostPosted: Fri Aug 12, 2011 11:54 pm    Post subject: Reply with quote

coebul wrote:
And while it [the federal Appeals Court decision being discussed] did not end the mandatory coverage offered, it did shoot down having to buy that coverage which with out that provision there is a significant short fall in "paying" for the health and keeping rates low.   Most agree that this decision guts the finances of the Affordable Health care act.


Most who?  Most conservative bloggers,  Most liberal bloggers?  
Most Republican politicos?  Democratic ones?  Economists?  CBO?
Super Committee members?  

The mandatory enrollment (or pay a penalty) provision isn't scheduled to kick in until 2017 - and so far the Appeals Court decisions go both ways as to constitutionality.  

If SCOTUS tosses it prior to 2017, the Super Committee and the rest of Congress will just have some more deficit to cut - or borrow some more money.

The amount of penalty fees lost - if that comes to pass - is a very small portion of the overall projected deficit over the next 30 years.

Nothing is "gutted" as nothing is even projected to be paid into the Treasury for six years.  All that would be changed are guesses with dollar signs in plus/minus columns.
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coebul



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PostPosted: Sat Aug 13, 2011 12:58 am    Post subject: Reply with quote

bieramar wrote:
coebul wrote:
And while it [the federal Appeals Court decision being discussed] did not end the mandatory coverage offered, it did shoot down having to buy that coverage which with out that provision there is a significant short fall in "paying" for the health and keeping rates low.   Most agree that this decision guts the finances of the Affordable Health care act.


Most who?  Most conservative bloggers,  Most liberal bloggers?  
Most Republican politicos?  Democratic ones?  Economists?  CBO?
Super Committee members?  
Pick one.  With out mandatory participation it won't matter whether or not the insurance companies are required to provide coverage.  It will not be affordable with out that group exempted by the 11th Circuit Courts decision today.

bieramar wrote:
The mandatory enrollment (or pay a penalty) provision isn't scheduled to kick in until 2017 - and so far the Appeals Court decisions go both ways as to constitutionality.  
Won't matter if it stands the cost of insurance will sky rocket mandatory participation.  

bieramar wrote:
If SCOTUS tosses it prior to 2017, the Super Committee and the rest of Congress will just have some more deficit to cut - or borrow some more money.
SCOTUS doesn't have to do a thing.  They don't have to hear the case.  

The amount of penalty fees lost - if that comes to pass - is a very small portion of the overall projected deficit over the next 30 years.

bieramar wrote:
Nothing is "gutted" as nothing is even projected to be paid into the Treasury for six years.  All that would be changed are guesses with dollar signs in plus/minus columns.
Nothing but the pool that needs to pay for it.  You may not think it a big deal but there are those that do.  Yet another talking points to repeal the legislation...  They need 13 Senators to have a filibuster proof Senate and as we have seen there are ways around that filibuster.  

Which is exactly how through Congress in the first place.


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