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Obamacare: Obama just straight up lied to you, in your face (2 Viewers)

Did I miss anything directed at me? I don't think so but I'm a bit tired and jumping back and firth a page or two might have resulted in ignoring something. Oh well, your loss. :P

The one major piece of the ACA that needs to get fixed that I don't think you mentioned is when the employee has available affordable care offered by their employer, but their family does not. The Kaiser data that mattyl linked suggest that this impacted around 5 million people. These are the working poor that we need to find a source to pay for extra subsidies if we are looking for such things.
Great, lets just tack on a few more billion on the cost of this thing.

 
Argue against the ACA all you want, but the healthcare and insurance systems in this country are a complete wreck. That a certain percentage of the country doesn't want to face that reality is the main reason we are stuck with #### half-measures. Obviously you have stronger incentive to deny that than most.
Why do you say that? They could use some fixing, but they aren't a complete wreck by any means. We have 85% of the population covered, with another 7.5% able to afford coverage now and choose not to, or who already qualify for existing public assistance to obtain coverage. That's ~92% of the population, which is a figure that even the CBO doesn't think the ACA will achieve. In 47 of the 50 states there is already a "guaranteed issue" policy available to all.

It could use some work, sure - nearly every sector in our economy and society could, but it's not a complete wreck by any means.
Argue against the ACA all you want, but the healthcare and insurance systems in this country are a complete wreck. That a certain percentage of the country doesn't want to face that reality is the main reason we are stuck with #### half-measures. Obviously you have stronger incentive to deny that than most.
Why do you say that? They could use some fixing, but they aren't a complete wreck by any means. We have 85% of the population covered, with another 7.5% able to afford coverage now and choose not to, or who already qualify for existing public assistance to obtain coverage. That's ~92% of the population, which is a figure that even the CBO doesn't think the ACA will achieve. In 47 of the 50 states there is already a "guaranteed issue" policy available to all.

It could use some work, sure - nearly every sector in our economy and society could, but it's not a complete wreck by any means.
Nearly every sector in the economy isn't going to bankrupt the nation on its current path.

 
So the almost $400 I'll receive off my premiums in 2014 just for filling out a survey in the next few weeks isn't real? Then there is the subsidies for joining a gym, etc. Maybe they don't exists in your individual market world, but they exists for an ever increasing number of the rest of us. And it is only going to get bigger as we all get care coordinators assigned to nanny us.
The ACA is built around the individual market.
No it is not. A key component sure, but not the point of the legislation.

 
So the almost $400 I'll receive off my premiums in 2014 just for filling out a survey in the next few weeks isn't real? Then there is the subsidies for joining a gym, etc. Maybe they don't exists in your individual market world, but they exists for an ever increasing number of the rest of us. And it is only going to get bigger as we all get care coordinators assigned to nanny us.
The ACA is built around the individual market.
No it is not. A key component sure, but not the point of the legislation.
My point was to get these discounts and rebates and such into the individual market the ACA is creating.

 
Nearly every sector in the economy isn't going to bankrupt the nation on its current path.
And I'm not sure the ACA is going to prevent that the way it's currently constructed.
Maybe, maybe not. But a few minor tweaks isn't going to do it either.
Why not? Pretty much everything on the cost side of this can be done without canceling millions of policies. As much as I hate to admit it, the individual mandate is really a good tool to get people to enroll - as many of the currently uninsured (like half) can already afford coverage currently or can already qualify for CHIP or Medicaid. And before you say you can't do that without guaranteed issue, the mandate penalty wouldn't apply to anyone who's declined from an individual policy from 2 or more carriers.

Expand guaranteed issue to all states, and more options in each state. For those who's only option is a GI policy, give government assistance to those who need it.

 
You are kidding correct? How is your analogy serious? A more correct analogy is that everyone in New Orleans is required to have hurricane coverage just like everyone in places that has never seen a hurricane. Hurricanes still cost the same. More people share the cost, but the pool is so big it is relatively small cost. And no one is any longer left devastated financially. Both those who would have foolishly went without such coverage without this "hurricane essential benefit" for some mandated insurance, and those that were paying all along into policies that just didn't cover anything.

Now for those that are devastated along with their suffering children who picks up the tab for that misfortune?
Ok, so maybe it was a poor analogy. How about buying auto coverage knowing you'll have a wreck next month. Actually knowing you will wreck the car in a month. Why should "insurance" pay for that known and expected expense?
The question isn't whether insurance should cover such expenses as opposed to the individual, but whether all of us should pay for it in hidden cost or out front cost.

 
Did I miss anything directed at me? I don't think so but I'm a bit tired and jumping back and firth a page or two might have resulted in ignoring something. Oh well, your loss. :P

The one major piece of the ACA that needs to get fixed that I don't think you mentioned is when the employee has available affordable care offered by their employer, but their family does not. The Kaiser data that mattyl linked suggest that this impacted around 5 million people. These are the working poor that we need to find a source to pay for extra subsidies if we are looking for such things.
Great, lets just tack on a few more billion on the cost of this thing.
Says the person who last night suggested we get rid of the employer mandate. Spa owners who let go of employees to avoid the employer mandate can pay a penalty to fund this.

 
You are kidding correct? How is your analogy serious? A more correct analogy is that everyone in New Orleans is required to have hurricane coverage just like everyone in places that has never seen a hurricane. Hurricanes still cost the same. More people share the cost, but the pool is so big it is relatively small cost. And no one is any longer left devastated financially. Both those who would have foolishly went without such coverage without this "hurricane essential benefit" for some mandated insurance, and those that were paying all along into policies that just didn't cover anything.

Now for those that are devastated along with their suffering children who picks up the tab for that misfortune?
Ok, so maybe it was a poor analogy. How about buying auto coverage knowing you'll have a wreck next month. Actually knowing you will wreck the car in a month. Why should "insurance" pay for that known and expected expense?
The question isn't whether insurance should cover such expenses as opposed to the individual, but whether all of us should pay for it in hidden cost or out front cost.
Why are you just accepting that all of "us" pay for it? Why can't the individual pay for their known expense? What's wrong with a $5k or even a $10k maternity deductible? It can be covered just like any other OOP cost so that if your income is low enough you'd still get cost sharing subsidies to assist you with it.

Again, if you can't handle a $5k or a $10k maternity deductible, you can't handle the cost of raising a child.

 
Did I miss anything directed at me? I don't think so but I'm a bit tired and jumping back and firth a page or two might have resulted in ignoring something. Oh well, your loss. :P

The one major piece of the ACA that needs to get fixed that I don't think you mentioned is when the employee has available affordable care offered by their employer, but their family does not. The Kaiser data that mattyl linked suggest that this impacted around 5 million people. These are the working poor that we need to find a source to pay for extra subsidies if we are looking for such things.
Great, lets just tack on a few more billion on the cost of this thing.
Says the person who last night suggested we get rid of the employer mandate. Spa owners who let go of employees to avoid the employer mandate can pay a penalty to fund this.
In all honesty, I do agree with your point. Lets say I'm a single guy making $30k without employer offered care. Well I can get a subsidy. Now if I get married, and my wife's employer sponsored coverage is available to me (no matter what it costs), I'm no longer subsidy eligible. I think that's kinda dumb....but at the same time why should my wife's employer subsidize my health insurance? I don't work for them, she does.

 
You are kidding correct? How is your analogy serious? A more correct analogy is that everyone in New Orleans is required to have hurricane coverage just like everyone in places that has never seen a hurricane. Hurricanes still cost the same. More people share the cost, but the pool is so big it is relatively small cost. And no one is any longer left devastated financially. Both those who would have foolishly went without such coverage without this "hurricane essential benefit" for some mandated insurance, and those that were paying all along into policies that just didn't cover anything.

Now for those that are devastated along with their suffering children who picks up the tab for that misfortune?
Ok, so maybe it was a poor analogy. How about buying auto coverage knowing you'll have a wreck next month. Actually knowing you will wreck the car in a month. Why should "insurance" pay for that known and expected expense?
The question isn't whether insurance should cover such expenses as opposed to the individual, but whether all of us should pay for it in hidden cost or out front cost.
Why are you just accepting that all of "us" pay for it? Why can't the individual pay for their known expense? What's wrong with a $5k or even a $10k maternity deductible? It can be covered just like any other OOP cost so that if your income is low enough you'd still get cost sharing subsidies to assist you with it. Again, if you can't handle a $5k or a $10k maternity deductible, you can't handle the cost of raising a child.
So what we need is a law banning people making under 30 grand a year from having children.
 
Why are you just accepting that all of "us" pay for it?
Because I live in the real world.
... Why can't the individual pay for their known expense? What's wrong with a $5k or even a $10k maternity deductible? It can be covered just like any other OOP cost so that if your income is low enough you'd still get cost sharing subsidies to assist you with it.
It is not can they, but will they? And what do we do when they don't?

Oh, and should they? That is should women who work for small businesses, or own them and the others in the individual markets be subjected to such cost that those working for larger companies that compete for labor on benefits don't face? Why? What policy goal is achieved? Should we remove the higher quality women of child bearing age from the smaller business labor market?

.Again, if you can't handle a $5k or a $10k maternity deductible, you can't handle the cost of raising a child.
I'd venture to guess that this describes the norm, or at least the very common.

 
I have been surprised by a couple of friends that I know who have been long time Obama supporters who have totally jumped ship over Obamacare.

Also, another observation... I find it interesting how we had seen Democrats, allies and Obama himself starting to co-opt the term Obamacare leading up the launch. Suddenly they have reverted back to calling it ACA or Affordable Care Act.

 
Bottomfeeder Sports said:
matttyl said:
.Again, if you can't handle a $5k or a $10k maternity deductible, you can't handle the cost of raising a child.
I'd venture to guess that this describes the norm, or at least the very common.
A significant percentage of babies are born with Medicaid coverage (something like 35%). So, yeah, pretty much.

---

Also, I happened upon this article in USA Today that talks about how young people signing up isn't a panacea due to the rising cost and numbers of folks seeking treatment for depression. According to the article it takes an average of $7k per year to treat. :shock:

 
"I'm sorry you all believed my lies."

Obamacare: After Obama's apology, talk of solutions and -- still -- the websiteBy David Simpson, CNN
updated 4:05 AM EST, Fri November 8, 2013
(CNN) -- President Barack Obama's apology to Americans whose health insurance plans are being canceled because of the Affordable Care Act opens the door to the question of how the problem will be fixed -- even as his administration tries to overcome the dysfunctional rollout of the website where people are supposed to be able to choose new coverage.

As the president's apology was being aired in an exclusive interview with NBC News on Tuesday, talk was in the air of new legislation in Congress and unspecified steps the president might take on his own.

Meanwhile, Secretary of Health and Human Services Kathleen Sebelius' office promised "an important announcement related to the Affordable Care Act" during a visit to Atlanta on Friday.

Here's what you need to know to get up to speed:

The problem

Insurers are sending cancellation notices to some of the 12 million Americans whose individual policies don't meet Obamacare requirements for more comprehensive care.

The law does not require cancellation of policies that were issued before the new law passed Congress in 2010. But people whose policies have changed since then must get polices that conform to the new requirements. In 2010, the Health and Human Services Department estimated that 40% to 67% of individual plans would eventually lose their "grandfathered" status.

Some insurance companies also appear to be canceling policies for other reasons, such as withdrawing from states where they have fewer subscribers.

The president contends many of the people who have received cancellation notices actually will wind up with better coverage at lower cost. But he acknowledged that's a hard sell when people are still having trouble logging onto the Obamacare website to enroll.

The apology

"Even though it's a small percentage of folks who may be disadvantaged, you know, it means a lot to them," Obama told NBC. "And it's scary to them. And I am sorry that they, you know, are finding themselves in this situation, based on assurances they got from me. We've got to work hard to make sure that they know we hear them and that we're going to do everything we can to deal with folks who find themselves in a tough position as a consequence of this. ... Obviously, we didn't do a good enough job in terms of how we crafted the law. And, you know, that's something that I regret. That's something that we're going to do everything we can to get fixed."

The change

The president's previous comments on whether people could keep their insurance plans under Obamacare:

Before passage in 2012: "If you like your plan, keep your plan."

Last week: "If you had one of these substandard plans before the Affordable Care Act became law, and you really like that plan, you are able to keep it."

Monday: "If you have or had one of these plans before the Affordable Care Act came into law, and you really like that plan, what we said was you could keep it if it hasn't changed since the law passed."

The solution

Senior administration officials told CNN the president is seeking administrative solutions that can be implemented without approval of House Republicans who are steadfastly opposed to the entire law.

Some experts suggest one possible approach would be to ask insurers to delay the cancellation of plans and extend them into 2014 so that people are not left without insurance. That has been done in California.

House Speaker John Boehner said "the House will vote next week to allow anyone with a health care plan they like to keep it. If the President is sincerely sorry that he misled the American people, the very least he can do is support this bipartisan effort. Otherwise, this apology doesn't amount to anything."

And Senators Joe Manchin, a West Virginia Democrat, and Mark Kirk, an Illinois Republican, introduced legislation to delay by a year the tax penalty for people who choose to go without insurance and are not covered by Medicaid or other government insurance program.

The penalty in 2014 for an individual is scheduled to be $95 or 1 percent of income above $10,000, whichever is greater. Penalties for families without coverage can reach $285 or 1 percent of income above $20,000, whichever is greater. Penalties will increase sharply in 2015 and 2016 under current law.

The Manchin-Kirk bill would prevent any penalty before Jan. 1, 2015.

The website

In the NBC interview, Obama reiterated the administration's line that he's "confident" a "majority of people" will be able to use the website and apply for insurance by November 30.

But he added, "Given that I've been burned already with a website -- well, more importantly, the American people have been burned by a website -- that has been dysfunctional, what we've also been doing is creating a whole other set of tracks. Making sure that people can apply by phone effectively. Making sure that people can apply in person effectively. So what I'm confident about is that anybody who wants to buy health insurance through the marketplace, they are going to be able to buy it."

He did not say whether he would push back the March 31 deadline to enroll or the penalty for those who do not purchase insurance.
 
Bottomfeeder Sports said:
matttyl said:
.Again, if you can't handle a $5k or a $10k maternity deductible, you can't handle the cost of raising a child.
I'd venture to guess that this describes the norm, or at least the very common.
A significant percentage of babies are born with Medicaid coverage (something like 35%). So, yeah, pretty much.

---

Also, I happened upon this article in USA Today that talks about how young people signing up isn't a panacea due to the rising cost and numbers of folks seeking treatment for depression. According to the article it takes an average of $7k per year to treat. :shock:
I don't believe the real point of getting young adults insured is to offset the costs of older folks. It may be the stated reason, but I think the real point is to get younger people - especially younger males into the health care system where their care is managed earlier. It is the "preventive care" is cheaper than "treatment" argument that is ruling the thinking behind just about everything. Is the thinking correct :shrug: ?

Rayderr posted earlier that he opposes "coddling the stupid and lazy" but that is exactly where health care is moving.

 
Bottomfeeder Sports said:
Did I miss anything directed at me? I don't think so but I'm a bit tired and jumping back and firth a page or two might have resulted in ignoring something. Oh well, your loss. :P

The one major piece of the ACA that needs to get fixed that I don't think you mentioned is when the employee has available affordable care offered by their employer, but their family does not. The Kaiser data that mattyl linked suggest that this impacted around 5 million people. These are the working poor that we need to find a source to pay for extra subsidies if we are looking for such things.
There's also a gap between medicaid and ACA where people are too "rich" for medicaid but can't afford ACA. People are hesitating on giving specifics on how many people that actually is, but I think it's safe to say it's going to be more than a handful.

 
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Dr Oadi said:
matttyl said:
Bottomfeeder Sports said:
matttyl said:
Bottomfeeder Sports said:
You are kidding correct? How is your analogy serious? A more correct analogy is that everyone in New Orleans is required to have hurricane coverage just like everyone in places that has never seen a hurricane. Hurricanes still cost the same. More people share the cost, but the pool is so big it is relatively small cost. And no one is any longer left devastated financially. Both those who would have foolishly went without such coverage without this "hurricane essential benefit" for some mandated insurance, and those that were paying all along into policies that just didn't cover anything.

Now for those that are devastated along with their suffering children who picks up the tab for that misfortune?
Ok, so maybe it was a poor analogy. How about buying auto coverage knowing you'll have a wreck next month. Actually knowing you will wreck the car in a month. Why should "insurance" pay for that known and expected expense?
The question isn't whether insurance should cover such expenses as opposed to the individual, but whether all of us should pay for it in hidden cost or out front cost.
Why are you just accepting that all of "us" pay for it? Why can't the individual pay for their known expense? What's wrong with a $5k or even a $10k maternity deductible? It can be covered just like any other OOP cost so that if your income is low enough you'd still get cost sharing subsidies to assist you with it. Again, if you can't handle a $5k or a $10k maternity deductible, you can't handle the cost of raising a child.
So what we need is a law banning people making under 30 grand a year from having children.
Where did I say that? Again, if they financially qualify they can receive not only premium subsidies but also cost sharing subsidies to offset the maternity deductible. Those who don't qualify financially for those will have a maternity deductible.

People knowing they will have a baby in the following year (with a $10k+ single claim) will simply pick the plan with the lowest deductible (typically either $500 or $750) where the increase in premium is more than justified. That's just tip of the iceberg as well. Anyone with a known large claim coming up (joint replacement, heart surgery, etc.) will do the same.

 
Looks like Obama is looking to make some changes to ACA.
Obama;s legacy is in making ACA work. In avoiding a replacement system, including single payer in the near future. It is not in his interest to fight against changes that would give it a chance to work. But politically is he already too much of a lame duck to do much positive? Not knowing that answer is what makes this so interesting.

 
matttyl said:
Again, if you can't handle a $5k or a $10k maternity deductible, you can't handle the cost of raising a child.
How is this relevant when making policy?
It's relevant to reduce cost, so that more will enroll (which is one of the main points of the ACA). Tim asked to come up with some ideas that can make the ACA more palatable to all. This is one of mine. I'd love to see your ideas, or do you think the ACA is perfect just the way it is?

 
By the way - How does a high deductible plan (or really any deductible plan) work in a non FFS healthcare world? What triggers a payment and for how much?

(This is not a political/policy point but a question I don't know the answer to. ETA: Though the answer may lead to one.)

 
Last edited by a moderator:
Looks like Obama is looking to make some changes to ACA.
How's he going to do that? Isn't it like a law or something?
http://www.realclearpolitics.com/articles/2013/11/08/obama_seeking_fix_for_canceled_policy_holders_120613.html

President Obama, reversing course Thursday, said he is exploring whether executive, administrative changes could allow millions of Americans to keep health insurance temporarily, even if their plans don’t comply with new standards that begin Jan. 1 under the Affordable Care Act.

For weeks, the president has defended the government’s aim to move Americans who buy their own insurance into more comprehensive plans that cover hospitalizations, preventative health screenings and other benefits required by the 2010 law.

But his confident assurances that millions of Americans impacted by the change could shop for better replacement coverage on HealthCare.gov were undermined by the federal website’s troubles, and the anxious demands from Democratic lawmakers that if he couldn’t fix the mess, they would act legislatively to alter the law.

A band of 15 Senate Democrats facing re-election next year met with the president at the White House Wednesday to make their displeasure crystal clear. Obama and his advisers agreed with the group that advocates of the law had a messaging problem, but a plan to repair the damage remained unsettled.

Republicans have marveled at the turn of events, chortling that the flawed implementation of the Affordable Care Act did more to bring the law to the brink of a rewrite than any of the 46 House votes that failed to repeal it.

Democrats have said they are torn between the urgency of launching a state-based system meant to benefit 15 million uninsured Americans, and responding to protests from many middle-class people notified in recent weeks by insurers that Obamacare would make their policies extinct.

Chastened by the public and political backlash, and boxed in by his own words, Obama switched gears to empathize with those impacted by a confusing law, its imminent deadlines, the botched website and, in many cases, the portent of higher costs.

“I am sorry that they are finding themselves in this situation based on assurances they got from me,” Obama told NBC News Chief White House Correspondent Chuck Todd during a brief interview. “We’ve got to work hard to make sure that they know we hear them, and we’re going to do everything we can to deal with folks who find themselves in a tough position as a consequence of this.”

It is unclear if the Health and Human Services Department has the legal authority to re-interpret the law’s definition of insurance plans that are “grandfathered” and could continue to exist, perhaps temporarily, under certain circumstances, even if those plans don’t meet the law’s basic benefits standards. The president has resisted suggestions on both sides of the aisle in Congress to extend the law’s open enrollment period beyond March 31.

Those who received cancellation notices from their insurance companies could choose another plan, or shop in the new exchanges, but their insurance will expire Dec. 31. To remain insured on Jan. 1, they would need to find and buy new coverage by Dec. 15.

When the ACA was written, advocates sought to limit the number of consumers who could retain insurance plans the government deemed substandard -- plans sold by insurance companies to individuals who lacked the collective clout to bargain for better benefits at lower premiums and deductibles.

Obama said Thursday he wants to address, without legislation, what he now terms “a loophole” in his signature legislative achievement.

“Even though it only affects a small amount of the population, it means a lot to them, obviously, when they get this letter canceled,” he said. “I am deeply concerned about it, and I’ve assigned my team to see what can we do to close some of the holes and gaps in the law, because my intention is to lift up and make sure the insurance people buy is effective.”

 
Bottomfeeder Sports said:
matttyl said:
.Again, if you can't handle a $5k or a $10k maternity deductible, you can't handle the cost of raising a child.
I'd venture to guess that this describes the norm, or at least the very common.
A significant percentage of babies are born with Medicaid coverage (something like 35%). So, yeah, pretty much.

---

Also, I happened upon this article in USA Today that talks about how young people signing up isn't a panacea due to the rising cost and numbers of folks seeking treatment for depression. According to the article it takes an average of $7k per year to treat. :shock:
So how would changing ACA policies change anything for any of them? The ACA is constructed to have those who can afford to pay more, correct? If they can't afford a seperate maternity deductible, they would be covered by Medicaid or already in place cost sharing subsidies for those under a certain income threshold.

If on the other hand you have a family making $80k+, or a 3+ person family making $100k+ a year, they can afford this separate deductible, which would then lower costs for all (except obviously for them). These people are already getting "penalized" for making too much money and thus not qualifying for a subsidy. How is a maternity deductible any different?

 
Looks like Obama is looking to make some changes to ACA.
How's he going to do that? Isn't it like a law or something?
http://www.realclearpolitics.com/articles/2013/11/08/obama_seeking_fix_for_canceled_policy_holders_120613.html

President Obama, reversing course Thursday, said he is exploring whether executive, administrative changes could allow millions of Americans to keep health insurance temporarily, even if their plans don’t comply with new standards that begin Jan. 1 under the Affordable Care Act.

For weeks, the president has defended the government’s aim to move Americans who buy their own insurance into more comprehensive plans that cover hospitalizations, preventative health screenings and other benefits required by the 2010 law.

But his confident assurances that millions of Americans impacted by the change could shop for better replacement coverage on HealthCare.gov were undermined by the federal website’s troubles, and the anxious demands from Democratic lawmakers that if he couldn’t fix the mess, they would act legislatively to alter the law.

A band of 15 Senate Democrats facing re-election next year met with the president at the White House Wednesday to make their displeasure crystal clear. Obama and his advisers agreed with the group that advocates of the law had a messaging problem, but a plan to repair the damage remained unsettled.

Republicans have marveled at the turn of events, chortling that the flawed implementation of the Affordable Care Act did more to bring the law to the brink of a rewrite than any of the 46 House votes that failed to repeal it.

Democrats have said they are torn between the urgency of launching a state-based system meant to benefit 15 million uninsured Americans, and responding to protests from many middle-class people notified in recent weeks by insurers that Obamacare would make their policies extinct.

Chastened by the public and political backlash, and boxed in by his own words, Obama switched gears to empathize with those impacted by a confusing law, its imminent deadlines, the botched website and, in many cases, the portent of higher costs.

“I am sorry that they are finding themselves in this situation based on assurances they got from me,” Obama told NBC News Chief White House Correspondent Chuck Todd during a brief interview. “We’ve got to work hard to make sure that they know we hear them, and we’re going to do everything we can to deal with folks who find themselves in a tough position as a consequence of this.”

It is unclear if the Health and Human Services Department has the legal authority to re-interpret the law’s definition of insurance plans that are “grandfathered” and could continue to exist, perhaps temporarily, under certain circumstances, even if those plans don’t meet the law’s basic benefits standards. The president has resisted suggestions on both sides of the aisle in Congress to extend the law’s open enrollment period beyond March 31.

Those who received cancellation notices from their insurance companies could choose another plan, or shop in the new exchanges, but their insurance will expire Dec. 31. To remain insured on Jan. 1, they would need to find and buy new coverage by Dec. 15.

When the ACA was written, advocates sought to limit the number of consumers who could retain insurance plans the government deemed substandard -- plans sold by insurance companies to individuals who lacked the collective clout to bargain for better benefits at lower premiums and deductibles.

Obama said Thursday he wants to address, without legislation, what he now terms “a loophole” in his signature legislative achievement.

“Even though it only affects a small amount of the population, it means a lot to them, obviously, when they get this letter canceled,” he said. “I am deeply concerned about it, and I’ve assigned my team to see what can we do to close some of the holes and gaps in the law, because my intention is to lift up and make sure the insurance people buy is effective.”
Administrative changes? What the hell does that even mean? Can the POTUS just change any law he doesn't like now?

 
By the way - How does a high deductible plan (or really any deductible plan) work in a non FFS healthcare world? What triggers a payment and for how much?

(This is not a political/policy point but a question I don't know the answer to. ETA: Though the answer may lead to one.)
I'm not fully sure I understand your question. Would you mind rephrasing it? I mean, your "payment" is triggered when your OOP is more than your deductible.

 
Looks like Obama is looking to make some changes to ACA.
How's he going to do that? Isn't it like a law or something?
http://www.realclearpolitics.com/articles/2013/11/08/obama_seeking_fix_for_canceled_policy_holders_120613.html

President Obama, reversing course Thursday, said he is exploring whether executive, administrative changes could allow millions of Americans to keep health insurance temporarily, even if their plans don’t comply with new standards that begin Jan. 1 under the Affordable Care Act.

For weeks, the president has defended the government’s aim to move Americans who buy their own insurance into more comprehensive plans that cover hospitalizations, preventative health screenings and other benefits required by the 2010 law.

But his confident assurances that millions of Americans impacted by the change could shop for better replacement coverage on HealthCare.gov were undermined by the federal website’s troubles, and the anxious demands from Democratic lawmakers that if he couldn’t fix the mess, they would act legislatively to alter the law.

A band of 15 Senate Democrats facing re-election next year met with the president at the White House Wednesday to make their displeasure crystal clear. Obama and his advisers agreed with the group that advocates of the law had a messaging problem, but a plan to repair the damage remained unsettled.

Republicans have marveled at the turn of events, chortling that the flawed implementation of the Affordable Care Act did more to bring the law to the brink of a rewrite than any of the 46 House votes that failed to repeal it.

Democrats have said they are torn between the urgency of launching a state-based system meant to benefit 15 million uninsured Americans, and responding to protests from many middle-class people notified in recent weeks by insurers that Obamacare would make their policies extinct.

Chastened by the public and political backlash, and boxed in by his own words, Obama switched gears to empathize with those impacted by a confusing law, its imminent deadlines, the botched website and, in many cases, the portent of higher costs.

“I am sorry that they are finding themselves in this situation based on assurances they got from me,” Obama told NBC News Chief White House Correspondent Chuck Todd during a brief interview. “We’ve got to work hard to make sure that they know we hear them, and we’re going to do everything we can to deal with folks who find themselves in a tough position as a consequence of this.”

It is unclear if the Health and Human Services Department has the legal authority to re-interpret the law’s definition of insurance plans that are “grandfathered” and could continue to exist, perhaps temporarily, under certain circumstances, even if those plans don’t meet the law’s basic benefits standards. The president has resisted suggestions on both sides of the aisle in Congress to extend the law’s open enrollment period beyond March 31.

Those who received cancellation notices from their insurance companies could choose another plan, or shop in the new exchanges, but their insurance will expire Dec. 31. To remain insured on Jan. 1, they would need to find and buy new coverage by Dec. 15.

When the ACA was written, advocates sought to limit the number of consumers who could retain insurance plans the government deemed substandard -- plans sold by insurance companies to individuals who lacked the collective clout to bargain for better benefits at lower premiums and deductibles.

Obama said Thursday he wants to address, without legislation, what he now terms “a loophole” in his signature legislative achievement.

“Even though it only affects a small amount of the population, it means a lot to them, obviously, when they get this letter canceled,” he said. “I am deeply concerned about it, and I’ve assigned my team to see what can we do to close some of the holes and gaps in the law, because my intention is to lift up and make sure the insurance people buy is effective.”
He is going to force insurance companies to provide the grandfathered coverages now? What if insurance companies don't want to offer them because they want to focus on the future where they won't be allowed to?

 
Looks like Obama is looking to make some changes to ACA.
How's he going to do that? Isn't it like a law or something?
http://www.realclearpolitics.com/articles/2013/11/08/obama_seeking_fix_for_canceled_policy_holders_120613.html

President Obama, reversing course Thursday, said he is exploring whether executive, administrative changes could allow millions of Americans to keep health insurance temporarily, even if their plans don’t comply with new standards that begin Jan. 1 under the Affordable Care Act.

For weeks, the president has defended the government’s aim to move Americans who buy their own insurance into more comprehensive plans that cover hospitalizations, preventative health screenings and other benefits required by the 2010 law.

But his confident assurances that millions of Americans impacted by the change could shop for better replacement coverage on HealthCare.gov were undermined by the federal website’s troubles, and the anxious demands from Democratic lawmakers that if he couldn’t fix the mess, they would act legislatively to alter the law.

A band of 15 Senate Democrats facing re-election next year met with the president at the White House Wednesday to make their displeasure crystal clear. Obama and his advisers agreed with the group that advocates of the law had a messaging problem, but a plan to repair the damage remained unsettled.

Republicans have marveled at the turn of events, chortling that the flawed implementation of the Affordable Care Act did more to bring the law to the brink of a rewrite than any of the 46 House votes that failed to repeal it.

Democrats have said they are torn between the urgency of launching a state-based system meant to benefit 15 million uninsured Americans, and responding to protests from many middle-class people notified in recent weeks by insurers that Obamacare would make their policies extinct.

Chastened by the public and political backlash, and boxed in by his own words, Obama switched gears to empathize with those impacted by a confusing law, its imminent deadlines, the botched website and, in many cases, the portent of higher costs.

“I am sorry that they are finding themselves in this situation based on assurances they got from me,” Obama told NBC News Chief White House Correspondent Chuck Todd during a brief interview. “We’ve got to work hard to make sure that they know we hear them, and we’re going to do everything we can to deal with folks who find themselves in a tough position as a consequence of this.”

It is unclear if the Health and Human Services Department has the legal authority to re-interpret the law’s definition of insurance plans that are “grandfathered” and could continue to exist, perhaps temporarily, under certain circumstances, even if those plans don’t meet the law’s basic benefits standards. The president has resisted suggestions on both sides of the aisle in Congress to extend the law’s open enrollment period beyond March 31.

Those who received cancellation notices from their insurance companies could choose another plan, or shop in the new exchanges, but their insurance will expire Dec. 31. To remain insured on Jan. 1, they would need to find and buy new coverage by Dec. 15.

When the ACA was written, advocates sought to limit the number of consumers who could retain insurance plans the government deemed substandard -- plans sold by insurance companies to individuals who lacked the collective clout to bargain for better benefits at lower premiums and deductibles.

Obama said Thursday he wants to address, without legislation, what he now terms “a loophole” in his signature legislative achievement.

“Even though it only affects a small amount of the population, it means a lot to them, obviously, when they get this letter canceled,” he said. “I am deeply concerned about it, and I’ve assigned my team to see what can we do to close some of the holes and gaps in the law, because my intention is to lift up and make sure the insurance people buy is effective.”
Administrative changes? What the hell does that even mean? Can the POTUS just change any law he doesn't like now?
The key word is "temporary" I think. Executive orders can make any kind of temporary change I assume.

 
Looks like Obama is looking to make some changes to ACA.
How's he going to do that? Isn't it like a law or something?
http://www.realclearpolitics.com/articles/2013/11/08/obama_seeking_fix_for_canceled_policy_holders_120613.html

President Obama, reversing course Thursday, said he is exploring whether executive, administrative changes could allow millions of Americans to keep health insurance temporarily, even if their plans don’t comply with new standards that begin Jan. 1 under the Affordable Care Act.
Doing so would be devastating to the insurance industry, unfortunately - as well as the ACA itself.

New plans have been priced assuming that not just the millions of currently uninsured people, but also the millions who currently have coverage (and by in large are healthy as most had to medically meet requirements to obtain it) would have to pay them (or share the cost with government subsidies). If "millions" of Americans are able to keep their current "crappy" plans at an average cost of $215 (national average for an individual plan pre-ACA) a month instead of the ~$303 a month (which assumes the report earlier this week is correct that the national average increase is 41%) the insurance companies will be losing an average of $88 per person per month for as long as this "temporary" measure is extended.

Meaning that if insurance companies had known this whole time that the only people buying the new plans would be currently uninsured (and only those currently insured who would be paying less for an ACA plan), they would have priced them much, much higher.

With all the lost premiums that the insurance companies won't be receiving, this will likely lead to a situation where the new "pool" being created will be an extremely expensive one for carriers, and thus they will have to severely increase the rates of them next year, which will prevent additional people from wanting to jump in.

 
...Tim asked to come up with some ideas that can make the ACA more palatable to all. This is one of mine. ....
Do you really believe any of these eight still on the table as both being a change ("wellness programs") and not counter productive (industry preferred age bands, removing essential benefits, removing employer mandate more complicated assistance eligibility requirements, expanded high deductible plans)?

 
...Tim asked to come up with some ideas that can make the ACA more palatable to all. This is one of mine. ....
Do you really believe any of these eight still on the table as both being a change ("wellness programs") and not counter productive (industry preferred age bands, removing essential benefits, removing employer mandate more complicated assistance eligibility requirements, expanded high deductible plans)?
I'm just coming up with some ideas. I seem to be the only one doing so. I still fail to see how expanding age bands would have a detrimental effect on enrollment, and would likely lead to less cost (less subsidies) for the public.

 
By the way - How does a high deductible plan (or really any deductible plan) work in a non FFS healthcare world? What triggers a payment and for how much?

(This is not a political/policy point but a question I don't know the answer to. ETA: Though the answer may lead to one.)
I'm not fully sure I understand your question. Would you mind rephrasing it? I mean, your "payment" is triggered when your OOP is more than your deductible.
Payment for what? You do know what "FFS" means - correct? As someone in the industry what triggers a bill to the patient for a deductible in a "global capitated" environment?

 
...Tim asked to come up with some ideas that can make the ACA more palatable to all. This is one of mine. ....
Do you really believe any of these eight still on the table as both being a change ("wellness programs") and not counter productive (industry preferred age bands, removing essential benefits, removing employer mandate more complicated assistance eligibility requirements, expanded high deductible plans)?
I'm just coming up with some ideas. I seem to be the only one doing so. I still fail to see how expanding age bands would have a detrimental effect on enrollment, and would likely lead to less cost (less subsidies) for the public.
That is because there aren't really many ideas to be made right now other than postponing some things (which is not all that unusual in health care - when was ICD10 supposed to be in place originally?)

Listing the problems such as the two "gap" issues mentioned since last night, the web issues, states opting out of Medicaid expansion, etc. is pretty easy. Solving them is more complicated. And sure you offered some ideas from your industry's perspective, and I think they were fairly evaluated before being rejected as counter to the more far reaching global concerns of health care reform.

And the reason for rejecting the age band is that 5:1 isn't reflective of the actual relative cost of populations today, but reflective of the market's demand. Older people are willing to pay more because they value coverage more and thus there is higher demand. That with the included "essential benefits" is likely to change and while I don't know that 3:1 is going to be correct, 5:1 is already not correct and will never be correct.

 
Payment for what? You do know what "FFS" means - correct? As someone in the industry what triggers a bill to the patient for a deductible in a "global capitated" environment?
Yes, fee for service. Typically the patient is just billed their deductible, and the provider gets the balance directly from the carrier.

 
And the reason for rejecting the age band is that 5:1 isn't reflective of the actual relative cost of populations today, but reflective of the market's demand. Older people are willing to pay more because they value coverage more and thus there is higher demand. That with the included "essential benefits" is likely to change and while I don't know that 3:1 is going to be correct, 5:1 is already not correct and will never be correct.
We see as high as 8:1 in the industry today. I think going 3:1 is too much of a swing all at once. 5:1 is right in the middle, and could be adjusted later if needed.

 
Calling it now, Obama will say that the policies can't be extended, even temporarily, because the insurance companies are unwilling/unable to do so. That will be the 2nd time in a month he'll throw the insurance companies under the bus.

 
"I'm sorry you all believed my lies."

Obamacare: After Obama's apology, talk of solutions and -- still -- the websiteBy David Simpson, CNN
updated 4:05 AM EST, Fri November 8, 2013
(CNN) -- President Barack Obama's apology to Americans whose health insurance plans are being canceled because of the Affordable Care Act opens the door to the question of how the problem will be fixed -- even as his administration tries to overcome the dysfunctional rollout of the website where people are supposed to be able to choose new coverage.
Wait a sec, if Obama now acknowledges that the opponents of ACA were correct with their criticisms, going back to 2009 when these flaws were pointed out the first time, does that mean that those opponents were not, in fact, racists and terrorists? Can we confirm that now? I'd like to know.

 
"I'm sorry you all believed my lies."

Obamacare: After Obama's apology, talk of solutions and -- still -- the websiteBy David Simpson, CNN
updated 4:05 AM EST, Fri November 8, 2013
(CNN) -- President Barack Obama's apology to Americans whose health insurance plans are being canceled because of the Affordable Care Act opens the door to the question of how the problem will be fixed -- even as his administration tries to overcome the dysfunctional rollout of the website where people are supposed to be able to choose new coverage.
Wait a sec, if Obama now acknowledges that the opponents of ACA were correct with their criticisms, going back to 2009 when these flaws were pointed out the first time, does that mean that those opponents were not, in fact, racists and terrorists? Can we confirm that now? I'd like to know.
Leave a little straw for the horses, please

 
Calling it now, Obama will say that the policies can't be extended, even temporarily, because the insurance companies are unwilling/unable to do so. That will be the 2nd time in a month he'll throw the insurance companies under the bus.
:violin:
As I pointed out above, though, this will be the best thing for the law itself and it's ability to be self supporting. If all of the "healthy" people are able to remain on their current lower costing plans, the new pool being created will not be self supporting.

 
matttyl said:
Bottomfeeder Sports said:
matttyl said:
Bottomfeeder Sports said:
You are kidding correct? How is your analogy serious? A more correct analogy is that everyone in New Orleans is required to have hurricane coverage just like everyone in places that has never seen a hurricane. Hurricanes still cost the same. More people share the cost, but the pool is so big it is relatively small cost. And no one is any longer left devastated financially. Both those who would have foolishly went without such coverage without this "hurricane essential benefit" for some mandated insurance, and those that were paying all along into policies that just didn't cover anything.

Now for those that are devastated along with their suffering children who picks up the tab for that misfortune?
Ok, so maybe it was a poor analogy. How about buying auto coverage knowing you'll have a wreck next month. Actually knowing you will wreck the car in a month. Why should "insurance" pay for that known and expected expense?
The question isn't whether insurance should cover such expenses as opposed to the individual, but whether all of us should pay for it in hidden cost or out front cost.
Why are you just accepting that all of "us" pay for it? Why can't the individual pay for their known expense? What's wrong with a $5k or even a $10k maternity deductible? It can be covered just like any other OOP cost so that if your income is low enough you'd still get cost sharing subsidies to assist you with it.

Again, if you can't handle a $5k or a $10k maternity deductible, you can't handle the cost of raising a child.
So only the wealthy can have kids?

 
So only the wealthy can have kids?
Only people that can afford to raise them should have kids.

I would think that's an axiom.
Only the people that can afford to raise them and WANT them should have kids.

That's where I've never understood the Right's position on contraception. Most of the people who have an "oops" are too stupid, selfish, or poor to use a condom or other forms of birth control. But the Right holds firm to the idea that abstinence is the (only) way to prevent a train-wreck. Only NON-SINFUL way, I suppose. At any rate, how many ~15-25 year-olds do you know who possess even 30% of the willpower to not insert object A into warm, moist hole B when they're feeling all tingly? How many millions of selfish morons do you know who might be rational before they've had their first 5-6 beers...who have the maturity of a six-year old after they're drunk/baked?

Condoms and other forms of birth control aren't the end-all, be all. But if folks want to greatly-reduce the drain of social services on our country/economy, it would be a great place to start. Yet the Party/group(s) that are railing the hardest against social services are the ones railing the hardest against contraception. I understand why. But maybe they could also, then, understand why people think that their answers/solutions are the wrong answers/solutions. Or at least about as likely to happen and work as us seeing flying rainbow-colored unicorns during our daily commutes.

 
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So only the wealthy can have kids?
Only people that can afford to raise them should have kids.

I would think that's an axiom.
Only the people that can afford to raise them and WANT them should have kids.

That's where I've never understood the Right's position on contraception. Most of the people who have an "oops" are too stupid, selfish, or poor to use a condom or other forms of birth control. But the Right holds firm to the idea that abstinence is the (only) way to prevent a train-wreck. Only NON-SINFUL way, I suppose. At any rate, how many ~15-25 year-olds do you know who possess even 30% of the willpower to not insert object A into warm, moist hole B when they're feeling all tingly? How many millions of selfish morons do you know who might be rational before they've had their first 5-6 beers...who have the maturity of a six-year old after they're drunk/baked?

Condoms and other forms of birth control aren't the end-all, be all. But if folks want to greatly-reduce the drain of social services on our country/economy, it would be a great place to start. Yet the Party/group(s) that are railing the hardest against social services are the ones railing the hardest against contraception. I understand why. But maybe they could also, then, understand why people think that their answers/solutions are the wrong answers/solutions. Or at least about as likely to happen and work as us seeing flying rainbow-colored unicorns during our daily commutes.
I think you're painting with pretty broad strokes here.

And it's also a little bit of a straw man argument as 89% of all Americans (which includes 82% of Catholics - the category normally associated with contraception opposition) say birth control is morally okay. Link

 

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