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Healthcare Bill Part III; Obamacare
Topic Started: Mar 3 2014, 02:20 PM (48,612 Views)
kbp

Thanks Chatham!
Edited by kbp, Dec 13 2014, 11:42 AM.
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Baldo
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From ProPublica which is supposed to be non-partisan but IMHO they are more to the left.

Big Changes in Fine Print of Some 2015 Obamacare Plans

A ProPublica analysis found that many health insurance plans offered in the federal Affordable Care Act marketplace are changing their benefits heading into 2015. Consumers have until Dec. 15 to switch plans before they are automatically re-enrolled.

...They have until Dec. 15 to select a new plan or they'll be re-enrolled automatically in the one they currently have. Or, if that plan no longer exists, they'll be enrolled in another product offered by the same insurer, when available. But even if they get the same plan — of the nearly 2,800 health plans offered in 2014, about 1,700 of them will exist in the same form next year — their benefits may not stay the same.

"You're getting re-enrolled in the same carrier, but there's basically no guarantees that your product looks anywhere near the same as it did last year," said Caroline Pearson, vice president of Avalere Health, a consulting firm.

Much attention has focused on changes to plans' monthly premiums, but changes to other kinds of benefits — affecting the cost of things like doctors' visits and prescriptions — can be trickier to understand and make a huge difference in annual health care costs....snipped

http://www.propublica.org/article/big-changes-in-fine-print-of-some-2015-obamacare-plans?utm_campaign=sprout&utm_medium=social&utm_source=twitter&utm_content=1418336504


The writers of Obamacare knew modt people don't study their plans because they are too "Gruber Stupid".

Personally as one who had to make a decision on our company's policy it really is that easy, and a big pain in the butt.
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LTC8K6
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Assistant to The Devil Himself
http://twitchy.com/2014/12/14/im-sure-its-in-the-constitution-somewhere-latest-obamacare-spin-from-hhs-testimonial-is-beyond-delusional/

Quote:
 
nothing says freedom like being compelled by law to buy insurance or face fines
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Baldo
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I don't know if this is true, but from anecdotal data I have about local hospitals, it is true.We will find out in the next two years

Obamacare blamed for killing hospitals
Closures by the multitude seen as danger to patients, harbinger of future


http://www.wnd.com/2014/12/obamacare-blamed-for-killing-hospitals/


I also know how well the Feds run VA Hospitals :sarc2:
Edited by Baldo, Dec 14 2014, 10:42 PM.
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2close2durham

The predictions are that 20% of hospitals will close. This was reported last year and most people are thinking there will be many more.
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kbp

LTC8K6
Dec 14 2014, 10:37 PM
:biggrin:
Quote:
 
Oh yes, the freedom to force someone else to pay for your health insurance. I'm sure it's in the Constitution somewhere.
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Baldo
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However i do remember hearing "Thou shall not covet" somewhere
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kbp

Baldo
Dec 14 2014, 10:41 PM
I don't know if this is true, but from anecdotal data I have about local hospitals, it is true.We will find out in the next two years

Obamacare blamed for killing hospitals
Closures by the multitude seen as danger to patients, harbinger of future


http://www.wnd.com/2014/12/obamacare-blamed-for-killing-hospitals/


I also know how well the Feds run VA Hospitals :sarc2:
Has been posted a few times. Think "Medicare savings" to pay for Obamacare. Another hit not mentioned at your link is the private networking.

The new regulations increased costs, so to help offset it the out-of-pocket went up and the network prices got tighter. As prices go for the Walmart type traffic, the smaller shop prices suffer also.
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kbp

DEADLINE...

Midnight today is the end of open enrollment for 1/1/15 coverage to avoid the tax penalty or replace an existing policy.... unless they change the rules!

Quote:
 
http://online.wsj.com/article/AP1c760b4605e449078d82b807d091b18b.html
NY health exchange extends registration deadline

New York's health exchange is extending its registration deadline for the coming year by five days until Dec. 20.

The state Health Department says the extension applies to enrolling or renewing health insurance coverage for the second year of the state-run marketplace.

Officials say they're doing it because of the snowstorms that hit parts of the state last month, causing power outages and road closings in western New York.

Since the open enrollment period began Nov. 15, they say more than 154,562 people have enrolled through the marketplace for the first time.

New York's exchange enrolled 370,604 people with commercial and nonprofit insurers in the first year.

Another 525,283 enrolled in Medicaid and 64,875 in the state's Child Health Plus coverage
Exceptions due to global warming climate change, as they've lost out on the issue of technology blips to blame this year (failure and incompetence in completing the tasks assigned for setup of the web site is merely called "a technology blip" now!).
.
Edited by kbp, Dec 15 2014, 07:56 AM.
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kbp

kbp
Dec 15 2014, 12:37 AM
Baldo
Dec 14 2014, 10:41 PM
I don't know if this is true, but from anecdotal data I have about local hospitals, it is true.We will find out in the next two years

Obamacare blamed for killing hospitals
Closures by the multitude seen as danger to patients, harbinger of future


http://www.wnd.com/2014/12/obamacare-blamed-for-killing-hospitals/


I also know how well the Feds run VA Hospitals :sarc2:
Has been posted a few times. Think "Medicare savings" to pay for Obamacare. Another hit not mentioned at your link is the private networking.

The new regulations increased costs, so to help offset it the out-of-pocket went up and the network prices got tighter. As prices go for the Walmart type traffic, the smaller shop prices suffer also.
I just remembered something...

The Obamacare crew was so certain that more people being insured through the amazing enrollment drive would mean hospitals and care providers would be earning a larger profit (fewer non-paying customers), so they scheduled 1/1/15 as the date for funding reductions through the Medicaid program. Facilities that served a larger share of uninsured would get some help offsetting the costs. Barry was spending the savings before they were in his pocket, actually redistributing the anticipated hospital profits!

Some hospitals got higher Medicaid rates because they disproportionately served the low rate Medicaid patients AND the uninsured, so there was not a lot of private coverage fees to redistribute within those hospitals.
Edited by kbp, Dec 15 2014, 08:18 AM.
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kbp

Quote:
 
http://blogs.wsj.com/washwire/2014/12/12/rep-issas-committee-subpoenas-gruber-over-obamacare-work/
Rep. Issa’s Committee Subpoenas Gruber Over Obamacare Work

...The subpoena seeks all documents and communications referring or relating to funding — for research or otherwise — from any federal, state, or local government agency, including any contracts with federal, state, or local government agencies. It also seeks work products that Mr. Gruber created, as well as communications with government officials related to the ACA, and federal and state exchanges.vMr. Gruber, who provided computer modeling on the impact of the Affordable Care Act for the administration....

:)

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Baldo
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Uninsured Under the ACA: Millions of Americans Can't Afford Coverage

Rocky Rush, a 37-year-old single father from Nebraska, has gone without health insurance for years due to the cost, and the Affordable Care Act hasn't changed that.

"I can go without medical coverage, but my children need it," Rush says.

Affordable health insurance for all Americans was one of the cornerstones and selling points of the ACA. And while the law has helped reduce the proportion of uninsured Americans from 20 to 15 percent, according to The Commonwealth Fund, it has left millions without coverage.

These uninsured Americans, falling into a gap created by the ACA, are too poor to receive assistance on their health insurance premiums, but make too much to qualify for Medicaid, putting them in a difficult predicament when costly medical bills come due.

When Rush last shopped for coverage -- while working full time at a local events center that didn't offer benefits he could afford -- he says he didn't qualify for subsidies under the ACA. But because Nebraska didn't expand Medicaid, he didn't qualify for that either.

"Both of my kids are on Medicaid," says Rush, who has a daughter, 5, and a son, 3. Rush lost that job and briefly had access to Medicaid, but once his unemployment benefits kicked in, he made too much money and again had to go without coverage.

Court Ruling Creates Gap

In 2012, the Supreme Court determined Medicaid expansion as written in the ACA couldn't be forced on states. Each state can decide whether to expand coverage. Twenty-seven states and the District of Columbia have expanded Medicaid, 21 have not and two are debating the issue.

"The way that the law was originally intended was that there would be a continuum of coverage for people across the income spectrum," says Rachel Garfield, senior researcher for the Kaiser Family Foundation and associate director for the Kaiser Commission on Medicaid and the Uninsured. The poorest Americans would be eligible for Medicaid; those in the middle would get their coverage through an employer or the ACA marketplace; and those with the highest incomes could purchase their insurance where they saw fit.

With the Supreme Court's ruling, this continuum was interrupted.

"Because the intention was that there would be this continuum, the way the law was written was so that those at the lowest income levels are not eligible for tax credits to purchase coverage in the marketplace," Garfield explains. "So, if they're in a state that doesn't expand Medicaid, they are left with no financial assistance for coverage under the ACA."

This tear in the continuum created a gap -- one that Rush fell into.

"I really couldn't find anything under $140 per month, the last time I looked, and as a single father raising two small children on a limited income, even that was something I felt like I couldn't afford," Rush says. He estimates he would need to bring in $40,000 to comfortably afford health insurance. But at that level, he's worried his children wouldn't be eligible for Medicaid.

The Kaiser Family Foundation estimates the average bronze Marketplace plan to cost $224 a month in 2014. This may not seem like much for many Americans, but represents 25 to 50 percent of the monthly income of people who fall into the gap.

"We estimate about 4 million people fall into this situation," Garfield says. "[These people] would have been eligible for Medicaid had their state been expanded, but are not eligible for anything because their state decided not to." ...snipped

http://news.yahoo.com/uninsured-under-aca-millions-americans-cant-afford-coverage-201854260.html


and pray tell where would the money come for states to expand Medicaid?
Edited by Baldo, Dec 15 2014, 11:43 PM.
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kbp

Baldo
Dec 15 2014, 11:40 PM
Uninsured Under the ACA: Millions of Americans Can't Afford Coverage

Rocky Rush, a 37-year-old single father from Nebraska, has gone without health insurance for years due to the cost, and the Affordable Care Act hasn't changed that.

"I can go without medical coverage, but my children need it," Rush says.

Affordable health insurance for all Americans was one of the cornerstones and selling points of the ACA. And while the law has helped reduce the proportion of uninsured Americans from 20 to 15 percent, according to The Commonwealth Fund, it has left millions without coverage.

These uninsured Americans, falling into a gap created by the ACA, are too poor to receive assistance on their health insurance premiums, but make too much to qualify for Medicaid, putting them in a difficult predicament when costly medical bills come due.

When Rush last shopped for coverage -- while working full time at a local events center that didn't offer benefits he could afford -- he says he didn't qualify for subsidies under the ACA. But because Nebraska didn't expand Medicaid, he didn't qualify for that either.

"Both of my kids are on Medicaid," says Rush, who has a daughter, 5, and a son, 3. Rush lost that job and briefly had access to Medicaid, but once his unemployment benefits kicked in, he made too much money and again had to go without coverage.

Court Ruling Creates Gap

In 2012, the Supreme Court determined Medicaid expansion as written in the ACA couldn't be forced on states. Each state can decide whether to expand coverage. Twenty-seven states and the District of Columbia have expanded Medicaid, 21 have not and two are debating the issue.

"The way that the law was originally intended was that there would be a continuum of coverage for people across the income spectrum," says Rachel Garfield, senior researcher for the Kaiser Family Foundation and associate director for the Kaiser Commission on Medicaid and the Uninsured. The poorest Americans would be eligible for Medicaid; those in the middle would get their coverage through an employer or the ACA marketplace; and those with the highest incomes could purchase their insurance where they saw fit.

With the Supreme Court's ruling, this continuum was interrupted.

"Because the intention was that there would be this continuum, the way the law was written was so that those at the lowest income levels are not eligible for tax credits to purchase coverage in the marketplace," Garfield explains. "So, if they're in a state that doesn't expand Medicaid, they are left with no financial assistance for coverage under the ACA."

This tear in the continuum created a gap -- one that Rush fell into.

"I really couldn't find anything under $140 per month, the last time I looked, and as a single father raising two small children on a limited income, even that was something I felt like I couldn't afford," Rush says. He estimates he would need to bring in $40,000 to comfortably afford health insurance. But at that level, he's worried his children wouldn't be eligible for Medicaid.

The Kaiser Family Foundation estimates the average bronze Marketplace plan to cost $224 a month in 2014. This may not seem like much for many Americans, but represents 25 to 50 percent of the monthly income of people who fall into the gap.

"We estimate about 4 million people fall into this situation," Garfield says. "[These people] would have been eligible for Medicaid had their state been expanded, but are not eligible for anything because their state decided not to." ...snipped

http://news.yahoo.com/uninsured-under-aca-millions-americans-cant-afford-coverage-201854260.html


and pray tell where would the money come for states to expand Medicaid?
On the Medicaid expansion, it's all federal funds until the states will be responsible for 10%.

As for this article, it is full of inaccuracies.

...the law has helped reduce the proportion of uninsured Americans from 20 to 15 percent

The number of uninsured varies, depending on whether or not you count illegal immigrants. Even if you count the estimated number of illegals, the uninsured stood at about 17% of the US population and the HHS has NOT given us an accurate number for the reduction. They count ALL the new Medicaid signups in their amazing head count, but a percentage of them would have signed up with the Medicaid expansion. Even if you count all of them and the Obamacare enrollees, the reduction in the percentage of our uninsured population is close to 3%.


...The Kaiser Family Foundation estimates the average bronze Marketplace plan to cost $224 a month in 2014. This may not seem like much for many Americans, but represents 25 to 50 percent of the monthly income of people who fall into the gap

That ignores how income percentage is used to limit the maximum a premium may be for an enrollee. I'm not sure where they are getting this information.
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kbp

Quote:
 
http://www.weeklystandard.com/articles/architect-obamacare-speaks_821209.html?page=1#.VI4FKt9fMY4.twitter

The Architect of Obamacare Speaks
The government’s defense in King v. Burwell is not open and shut


Jonathan Gruber’s testimony before Congress last week was a series of apologies, evasions, denials, and outright lies. The MIT professor widely acknowledged to be the “architect of Obama-care” before it was known that he attributed passage of the law to legislative deception and the “stupidity of the American voter” began his opening remarks by declaring: “I was not the ‘architect’ of President Obama’s health care plan.” He later refused to say how much money he’d made from his consulting and speeches on Obama-care. But the most staggering and consequential falsehood spoken by Gruber came when he tried to explain away his previous claim that states do not qualify for subsidies under Obamacare if they do not set up their own exchanges (the subject of a Supreme Court case, King v. Burwell, that could destroy the law).

Gruber said during his opening prepared remarks:

  • The point I believe I was making was about the possibility that the federal government, for whatever reason, might not create a federal exchange. If that were to occur, and only in that context, then the only way that states could guarantee that their citizens would receive tax credits would be to set up their own exchanges.
    [That is so weak. He and his team must have been frustrated seeing that was the best they could come up with!]
During follow-up questioning, Rep. Justin Amash of Michigan pointed out that Gruber’s explanation doesn’t make sense. “The law requires the federal government to create Obamacare exchanges in states that refuse to create the exchanges for themselves,” Amash said. He was right: The law clearly states the secretary of health and human services “shall” establish an exchange in states that fail to do so. So, Amash continued, “What did you mean when you repeatedly said that the citizens of some states may not qualify for Obamacare tax credits?”

“When I made those comments, I believe what I was saying was reflecting uncertainty about the implementation of the federal exchange,” Gruber insisted. “I don’t recall exactly what the law says.”

Gruber was clearly not telling the truth to Congress. At the very same 2012 speaking engagement in which he said states don’t get subsidies if they don’t set up their own exchanges, he acknowledged that the federal government is directed to set up exchanges in states that decline to do so:

  • Audience Member: You mentioned the health information exchanges for the states. And it’s my understanding that if states don’t provide them then the federal government will provide them for the states.

  • Gruber: Yeah. So these health insurance exchanges—you can go on MAHealthConnector and see ours in Massachusetts—will be these new shopping places, and they’ll be the place that people go to get their subsidies for health insurance. In the law it says if the states don’t provide them, the federal backstop will. The federal government has been sort of slow in putting in this backstop, I think, partly because they want to, sort of, squeeze the states to do it. I think what’s important to remember politically about this is that if you’re a state and you don’t set up an exchange, that means your citizens don’t get their tax credits [emphasis added].
Gruber’s 2012 remarks—and his failure at the December 9 congressional hearing to plausibly walk them back—have dealt a great blow to the government’s defense in King v. Burwell. Before he became a controversial figure, it would have been entirely uncontroversial to state that Gruber knew more about how the law actually works than Nancy Pelosi, Barack Obama, or Max Baucus. “I was involved in writing the legislation,” Gruber said in a 2010 lecture. “I know more about this law than any other economist,” Gruber told the New York Times in 2012.

Gruber’s remarks are consequential not because the Supreme Court will look to them to determine legislative intent, but because they will significantly affect the legal and political debate surrounding King v. Burwell. Democrats and their allies in the media have tried to create a political environment in which the pressure on the Supreme Court would be simply too great for the Court to rule against the government. When cases challenging the legality of Obamacare subsidies began making their way through the courts, liberals roundly mocked and ridiculed the idea that the federal government had broken the law.

In 2013, Gruber himself told Mother Jones that the lawsuits were “screwy .  .  . nutty .  .  . stupid”:


  • Jonathan Gruber, who helped write former presidential candidate Mitt Romney’s Massachusetts health care law as well as the Affordable Care Act, calls the theory behind the legal challenges a “screwy interpretation” of the law. “It’s nutty. It’s stupid,” he says. And beyond that, “it’s essentially unprecedented in our democracy. This was law democratically enacted, challenged in the Supreme Court, and passed the test, and now [Republicans] are trying again. They’re desperate.”
After the 2012 video of Gruber saying the opposite was unearthed by Rich Weinstein :toast: , a private citizen and investment adviser, and circulated by the Competitive Enterprise Institute, no intellectually honest person could argue that the interpretation that states don’t get Obamacare subsidies if they don’t set up exchanges is absurd. As federal judge Ronald A. White wrote in another case challenging Obamacare’s subsidies in states without their own exchanges, “The court takes [Gruber’s] statement for the limited relevance of words of interpretation, not intent. That is to say, the statement cuts against any argument that the plaintiff’s interpretation is absurd on its face, or that plaintiff’s argument that the statutory language might support a reading of ‘incentivizing’ states to set up exchanges is ‘nonsense, made up out of whole cloth.’ ”

...“I know more about this law than any other economist,” Gruber told the New York Times in 2012.

I wish I knew what data was entered in his magic program as it relates with what he did with the costs of tax credits for all the exchanges... State and federal.

......federal judge Ronald A. White wrote in another case challenging Obamacare’s subsidies in states without their own exchanges, “The court takes [Gruber’s] statement for the limited relevance of words of interpretation, not intent. That is to say, the statement cuts against any argument that the plaintiff’s interpretation is absurd on its face, or that plaintiff’s argument that the statutory language might support a reading of ‘incentivizing’ states to set up exchanges is ‘nonsense, made up out of whole cloth.’ ”

Evidently the judge did not give consideration to any "intent" that Gruber's program data might show. Was it because nobody entered it in to evidence or because it does not show any intent?

What was in Gruber's data??? :bump:

Gruber's job was to predetermine what the CBO would determine in their reports. The guy was on a panel at the CBO at the time, one that was influencing how the CBO determined what to count as costs, the price tag the taxpayers were subject to. So what are the possibilities for how Gruber determined the costs associated with State and federal exchanges giving out tax credits?

ALL STATES SET UP EXCHANGES
If the data entered in his program was that ALL exchanges would be set up by States, who told him to do that and what was the basis for selecting that number? The idea that ALL the States would cooperate is just about insane, certainly looking like an unprofessional and biased guesstimate. The only reason one could come up with that idea is if they set the law up with INCENTIVES that would really force the States to cooperate.

NOT ALL STATES SET UP EXCHANGES

To quote Gruber: In the law it says if the states don’t provide them, the federal backstop will. There was sound reasoning used to include that in the law; there was no chance in the world ALL the States would cooperate and the Dem's knew the Rep's would NOT vote for the law. Nobody in their right mind could have truly believed all States would set up their own exchanges. That all said, WHAT did Gruber do with the cost numbers for HHS exchanges? The record clearly indicates that he was 110% certain "if you’re a state and you don’t set up an exchange, that means your citizens don’t get their tax credits," so where he got the data to show that in the numbers should show the INTENT of Congress.

I suppose it is possible that the Ocare team had planned all along to twist the law after it had passed (as Barry has done often), knowing full well the they would be violating the law and using the idea that the courts would NEVER take the FREE MONEY away from the po' folks ....after all, it's a tax! Of course I'd think the Gruber that knew about hidden tax on the people by way of calling it a tax on the insurance companies (meeting with Barry and Kerry at the WH) would not go out a half a dozen times or more and preach to his select audiences that the law would squeeze the states to do it...[or the States] don’t get their tax credits."

The federal government's strategy has been to squeeze INTENT of the entirety of the law into their argument to support the idea that their interpretation of a few portions of the law is correct, they are ambiguous, therefore the plaintiff's interpretation MUST be absurd, so they then can move back to INTENT provided by the IRS to clear up the issue... so UNread the plain text.

An alternative argument for the plaintiff may be to also start with the INTENT first, if the cost data Gruber used would remove any ambiguity about what Congress asked him to use in determining costs from the tax credits.
Edited by kbp, Dec 16 2014, 10:16 AM.
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kbp

http://www.usatoday.com/story/news/nation/2014/12/15/healthcaregov-call-center-waits-five-day-delay/20450269/
Call center wait won't stop Jan. 1 insurance coverage


I'm not sure why they even established a cutoff date!


ADD: another...
http://www.latimes.com/business/la-fi-exchange-enrollment-20141216-story.html
Covered California extends deadline to sign up for Obamacare
Edited by kbp, Dec 16 2014, 10:26 AM.
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