Category Archives: Affordable Health Care Act

The Republican Lies About the ACA (Obamacare)

 
 
Everyday each Republican who is on tap for any interview on any TV show tells America that Americans do not want the Affordable Care Act (aka Obamacare). They have been quoting this exact same bogus fact for years now and have geared up the repetitions exponentially in recent days. Just saying something again and again does not make it so. Honest.

Why would Americans hate this bill? It makes no sense. Americans like so many things about this bill.

Your children can be covered by your health insurance until they are 26 years old, if necessary. (What is hateful about this?)

We won’t have to continue to pay higher fees because some people use the emergency room as their doctor. (Perhaps you don’t mind paying higher fees.)

The private for-profit health insurance providers will have some competition from the public part of the plan and from the exchanges which will lower costs and stop these companies from riding roughshod over their customers. (Are you sure that you want to be a purist about stopping all public programs?)

You will be covered even if you have a pre-existing condition. (You have to be crazy to not want that, and you will never get this concession in a totally private for-profit world.)

I will not have to go bankrupt if I get really sick. (Oh did you want to go bankrupt?)

The health insurance industry has agreed not to put a cap on expenditures over a lifetime. (They only agreed to this because so many new customers will be buying insurance.)

Why would we want to defund this law, to starve it out? It does not make sense. It makes sense that the health care insurance people and others in the health care industry might want to undo this law, but not the average citizen. This might make some sense if you are a hard line Republican who wants to defund everything, but do you want the everything that is defunded to include Social Security? Do you want to include that disability money for your disabled child or young adult? Republicans somehow think they are being asked to pay for more poor people when actually they have already been paying more for poor people’s medical care and under the ACA will pay less.

We will probably find many flaws with “Obamacare” and once we find out what they are we will be able to fix these flaws. Maybe there will be doctors who will refuse to see Medicare or Medicaid patients because the payments are set to low. We will have to see what happens to drug costs. We will have to see how the taxes on those who manufacture medical devices will affect costs. Can they pass the fees on to the consumer? Will treatment choices be too limited? Will it destroy the 40 hour work week? (We’ll see.)

This is a very complicated law, thousands of pages, but most of those pages contain technical information about how to implement the law. We probably don’t really need to understand all these instructional pages. It would be nice if someone boiled the whole thing down to just the points that affect the insured (us) but this type of summary is available on the web and I got my information from listening to presentations in the media. Forget the thousand pages, just focus on what affects you.

If we no longer are able to get good and timely health care because of the ACA I believe that we will then make a big stink and we can then try to write a new plan, perhaps the single payer plan that seems to work so well in other nations and that seems so appealing to some of us.

As for the Republican plan which now calls for subsidies paid by the government (how is this different from vouchers) and the same private for-profit insurance plans for our health care that we are trying to get away from, except they will be able to offer insurance across state lines (how much will that improve cost cuts from competition when insurance companies in the past all have colluded to offer the same choices at nearly the same prices.) While this (Republican) plan will get our employers out of our healthcare, in every other way it will represent a return to what we had, except for those subsidies (vouchers) that may or may not cover the newly skyrocketing health care costs we will probably encounter.

Why didn’t we just fix health insurance for those who didn’t have it and leave the rest of us alone? I think that the answer to this is statistical; since the insurance industry runs on calculating risks, they could not offer the advantages built into the ACA without large numbers of insured so that meant the whole system had to change. I believe they tried to change as little as possible for people who were happy with their insurance (was anyone really happy), and, once again, if the product we get is unsatisfactory I don’t think we will be silent about it. It’s the law; we’re trying it. If you are one of those people trying to defund it or delay it then please stop. Just cut it out!

 This blog post is also available at www.brissioni.com


 

The IRS and the ACA – OMG


 
 

What role will the IRS play in the Affordable Care Act? Apparently the IRS is expected to play a very big role in implementing and governing the Affordable Care Act and apparently the reason so much of this will be done by the IRS is that the Supreme Court decision about Health Care made it so. (Health and Human Services will play a role and so will the Labor Department.)

1.  47 tax provisions will go into effect (including small business health care credit and the medical device tax.

2.  The IRS will determine whether people qualify for a health insurance premium tax credit as part of the minimum coverage requirement.

3.  Americans will have to report their insurance status on their taxes each year – the agency will review that and collect a $95 penalty on those not carrying insurance.

4.  The IRS will set these rules and collect the penalties when businesses aren’t in compliance.

This information is from an article published in the NationalJournal.com

Here’s another interesting part of what they had to say:

Republicans rushed to connect Obama’s health care law to the IRS scandal, especially after the news that Ingram would oversee the health law’s implementation at the IRS. “The recent deplorable actions at the IRS have shattered our trust that they can responsibly handle the people’s sensitive medical information,” said Rep. Phil Gingrey of Georgia. Rep. Michele Bachmann of Minnesota asked: “Does this means that some government plutocrat can look at my personal healthcare data? Could I be denied healthcare? Could it be delayed?” she asked. The law does not require the IRS to collect or view information about individuals’ health.”

I have always thought that we should go with a single payer system similar to England or Canada, but Obama’s plan does manage to cover almost everyone without completely scraping America’s dedication to capitalism. His plan not only allows millions of health care and insurance workers to keep their jobs, it adds jobs, especially in the ranks of the IRS (apparently about 2000 jobs). This gives it the advantage of being both a health care program and a jobs program. Criticisms that call the plan out for its complexity may prove to have some validity, but since we are almost geared up to implement the Affordable Care Act it seems best to go with it and see how it works. Of course, with so many Republican governors determined to sabotage the plan we may not get a true picture of whether the plan would work or not.

I do not like having health care tied to employment and I really don’t like having health care participation tied to the IRS, but single-payer insurance looks highly unlikely to happen since every time someone suggests it others start calling them “socialists”. I wish we could just stop being so contentious about this, since it is happening anyways, and try it on for size to see if it works. Stop the obstructionism in Congress. Elect Democrats in 2014.

This is the view from the cheap seats.

 

 

Four Fathers

Here they are. Meet our new Forefathers, Thomas Cantor, James Ryan, Ben Boehner, and George McConnell. I do think these guys believe they are channeling our Forefathers. They are so unyielding and so sure they are right. Any one of us could have predicted how they would react to yesterday’s Supreme Court Decision. Of course the election is adding drama to their extreme reactions, but that does not explain everything. The Affordable Care Act is not that different as health plans go. It does not get rid of the private sector. Everything stays essentially the same except more people are served.  So why so much vituperation. It all has to do, I believe, with the way Obama got the law passed. Seeing the opposition he faced he made a sort of end run around Congress and got his bill. Republicans were so angry they wanted to spit and they have not been able to put their anger aside. They have been “poor sports”. They have been worse than that; they have been vengeful. They just found Eric Holder, Obama’s Attorney General in Contempt of Congress, a thing which has never happened before. They are out of control. They are so angry they can’t think straight. They need to go sit on the bench for a while until they get a civil bone in their bodies. What Congress needs is a really good Coach.

The GOP symbol is the elephant. Elephants are wonderful critters, but are probably on the edge of extinction in the wild because they need so much human-free territory. The Democratic symbol on the other hand is the donkey, a wily little creature that can survive in the Grand  Canyon, can climb mountains, can carry burdens, can be tough and adapt to our crowded future. Which one promises to be around in the long run and which will be visiting in a wildlife preserve?

Waiting With Obama

It’s not like The Affordable Care Act was my ideal plan for health care. I wanted health care to be separated from employment. I wanted National Health Care (Medicare for everyone). I realized that in a national system we might have to wait longer for elective care and we might lose some access to services. Yet we seem to be losing access to some services anyway. There is a campaign to convince us that too many tests can have negative outcomes in the form of unnecessary biopsies or procedures, besides being expensive and sometimes exposing us to harmful rays or chemicals. We are told we should have fewer mammograms, fewer colonoscopies, fewer ultrasounds, fewer pap smears, fewer CT scans, fewer PSA’s. C’est la vie. We can’t have less expensive health insurance without losing a few services (although someone recently pointed out that even with fewer services costs are still rising). However, private insurers have no motivation without government regulation to insure people with pre-existing conditions or to insure people who can’t afford health insurance.
Anyway, National insurance was not what we got, except, in a way we did get most of what I wanted. We didn’t get to separate health insurance from employment but we did get insurance for those with pre-existing conditions and for the uninsured and young people got to stay on their parent’s insurance until the age of 26. Obama also found a way to leave plenty of room for private insurers which I felt was a real mistake, but which one would think would be seen as a plus by private insurers.
So now Obama and I are waiting with butterflies in our stomachs to see what the Supreme Court will say about The Affordable Care Act. Of course, Obama doesn’t know me and my butterflies can’t comfort him, but maybe it will help him to know there are some of us out here in America who are with him on this.
I would guess there is no such thing as a perfect health care plan for America (or any large nation), still, we will both survive, Obama and I, regardless of what the court has to say, but the repercussions will probably be much greater for Obama in the short run, and much greater for the rest of us in the long run.

Suspense

What will the Supreme Court decide about The Affordable Health Care Act? This is the week that the court will deliberate, hear evidence, etc about this issue which has been at the center of debates for the past two years. Will they decide that there are no really serious constitutional problems with the health care mandate or will they declare it unconstitutional?
The mandate is only part of the Health Care Act but it is a very key part. Making sure people who were using expensive emergency room treatment because they had no health care provider will be covered by health insurance so their care will not be as huge a burden for taxpayers, was the raison d’etre for the entire plan. Will there be enough value left in the plan without the mandate?
How much does the Conservative agenda inform the Supreme Court? Here is the breakdown

Conservative        John Roberts              G. W. Bush Appt.           Chief Justice
Conservative        Antonin Scalia             Ronald Reagan
Cons/Swing          Anthony Kennedy        Ronald Reagan
Conservative        Clarence Thomas         George HW Bush  
Liberal                   Ruth Bader Ginsburg   Bill Clinton
Liberal                   Stephen Breyer             Bill Clinton
Conservative        Samuel Alito                  George W. Bush
Liberal                    Sonia Sotomayor           Barack Obama
Liberal                   Elena Kagan                    Barack Obama    

There are 6 male justices and 3 female justices; there are 6 Roman Catholics justices and 3 Jewish justices. In light of these demographics it will be interesting to see the results. The Court is not dominated by Conservatives in the way it is dominated by Roman Catholics but as “court followers” try to decide which way each justice will decide there are certain justices who seem to be unpredictable and none are perfectly predictable. Justice Kagan has recused herself from most decisions since she was confirmed because her questioners were worried that she had dealt with some of these cases outside of the Supreme Court or some such conflict-of-interest concern. It sounds like we will remain in suspense until the opinions are handed down in June.
I have butterflies in my stomach; how crazy is that? Whatever decision is made life will go on. Will the Obama presidency go on? I don’t know and it does mean a lot to me to reelect Obama so he can save us from the extreme revisions the GOP wishes to impose on America. I don’t think most of us will fare at all well if the Supreme Court decides against the mandate and therefore against Obama and the dominoes start to fall like those well-planned displays, until America belongs to the wealthy and the rest of us are left to shift for ourselves in the muck at the bottom of the empty pond.