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  • Obama Care

    The Greatness of Obamacare

    By Froma Harrop
    - November 26, 2013







    During the botched rollout of the Affordable Care Act, it's been hard to defend the law, much less to call it "great." But great it is -- for the American economy and for the American people, rich ones included.

    The program has already succeeded in one of its key backbreaking missions: to curb the exploding costs of health care. The president's Council of Economic Advisers issued a report this month containing lots of good news on that front.

    Since Obamacare was passed in 2010, the growth in health care spending has slowed to the lowest rate on record for any three-year period since 1965. "If half the recent slowdown in spending can be sustained," the report says, "health care spending a decade from now will be about $1,400 per person lower than if growth returned to its 2000-2007 trend."

    The authors further note that the benefit will go to workers in the form of fatter paychecks and to taxpayers as federal and state governments cut projected spending on health care. Another plus would be more jobs as employers feel less burdened by the cost of covering their workers.

    What about the recession? One may reasonably ask whether the economic downturn was responsible for cutting the growth rates of medical spending. Yes, but not by much, the authors respond.

    They note that the slowdown has persisted well beyond the end of the recession. Very importantly, it also applied to Medicare, a government program whose elderly beneficiaries are more insulated from a weak job market. And the growth in prices for health services (different from total spending) has eased significantly.

    Here's how the health care reforms did it:
    --They reduced the overpayments to private insurers' Medicare Advantage plans and the price increases for providers.

    --They're promoting new payment models, whereby medical providers are being financially rewarded for giving good care in an efficient manner. Under the old setup, providers could enhance their incomes by pumping up the volume of visits, tests and other services.

    The reforms encourage the growth of "accountable care organizations." The more efficiently these groups of medical providers operate the more money they get to keep.
    --Hospitals with high readmission rates are penalized. This is also a quality issue for Medicare beneficiaries, who are often discharged with inadequate planning for post-hospital care. Under a perverse set of incentives, hospitals were making more money when elderly patients returned. The taxpayers, of course, picked up the bills.

    --Changes in Medicare should spill over into the private sector, generating even more savings. Medicare's payment structure is often the starting point in negotiations between private insurers and medical providers.

    What about the rich? All this conservative talk about Obamacare's "redistributing" wealth to the less well-off ignores this reality: Every time medical spending rises, so do the taxes (of those who pay income tax) and the premiums for those who buy their own coverage.

    I mean, who do you think has been paying for all those uninsured people showing up at expensive hospital emergency rooms for free care?
    For those worried about federal deficits, here are some encouraging numbers, courtesy of the Affordable Care Act: The Congressional Budget Office recently cut its projected Medicare and Medicaid spending in 2020 by $147 billion. It expects the reforms overall to reduce the deficit by more than $100 billion from 2013 to 2022.

    All this great stuff has been obscured by the bungled launch of the federal government's HealthCare.gov website. Once it is up and running, the conversation should turn in a more positive direction. Those who read the advisers' report won't have to wait that long. Google "Council of Economic Advisers" for a copy.


    fharrop@gmail.com

    COPYRIGHT 2013 CREATORS.COM



    Read more: http://www.realclearpolitics.com/art...#ixzz2ljYL76pa
    Follow us: @RCP_Articles on Twitter
    "Never doubt that a small group of thoughtful, committed citizens can change the world. Indeed, it is the only thing that ever has."

  • #2
    Soon, Obamacare Will Become Benghazi


    November 25, 2013, 4:42 pm
    Soon, Obamacare Will Become Benghazi

    OK, I just created an Obamacare account for myself (if I broke any laws, please, it was just investigative journalism). I went all the way through the process at healthcare.gov, stopping before the final step of actually applying (I don’t qualify, of course, because Princeton provides insurance), just to see how hard it was. And the answer is that it was no problem at all, with no delays.

    I also used the information only feature to get a listing of plans in my area. Again, no problem. And healthcare.gov directs you to Kaiser for an estimate of subsidies and final cost.

    Now, I know that this is only part of the story, and we’re still not getting clear answers on how well the 834 transmissions — which send the information to insurers — are working. But the visible parts of the process bear no resemblance to the horror stories of a few weeks ago.

    Why did I carry out this little exercise? Well, I scanned the comments on today’s column and noticed a lot of people reporting having successfully enrolled in Obamacare — not at one of the well-functioning state exchanges, but at the supposedly disastrous healthcare.gov. Just anecdotes, I know — but anecdotes suggesting that the system is no longer the black hole of yore.
    In short, it’s looking increasingly likely that the story from here on is going to be one of steadily better news — of growing enrollment in the federal as well as state exchanges, of people discovering either that their insurance has gotten better and cheaper or that they can afford insurance for the first time. Bit by bit these stories will percolate into the news media, replacing the sob stories about cancelled policies.

    And I find myself wondering what Republicans will do. Or actually, not so much. As Martin Longman noted over the weekend, Obamacare already looks like one of those Republican obsessions — like Benghazi — where the party has convinced itself that there must be a pony winning issue hidden in there somewhere, and that if only it keeps flogging the thing, long after the public has moved on, it will eventually score big.

    I’m not saying that the botched rollout is irrelevant: it has badly hurt Obama, and may do damage that lasts into the midterms. But the facts on the ground are changing, and my very strong guess is that the GOP will undo a lot of its gains by refusing to acknowledge that change.

    http://krugman.blogs.nytimes.com/
    "Never doubt that a small group of thoughtful, committed citizens can change the world. Indeed, it is the only thing that ever has."

    Comment


    • #3
      he Obamacare success stories you haven't been hearing about

      The Obamacare success stories you haven't been hearing about




      Delaware artist David Shevlino will get better health coverage at lower cost next year, thanks to Obamacare. Why aren't we hearing more about him? (David Shevlino / November 25, 2013)


      By Michael Hiltzik November 25, 2013, 3:45 p.m.


      Last summer Ellen Holzman and Meredith Vezina, a married gay couple in San Diego County, got kicked off their long-term Kaiser health plan, for which they'd been paying more than $1,300 a month. The cause wasn't the Affordable Care Act, as far as they knew. They'd been living outside Kaiser's service area, and the health plan had decided to tighten its rules.

      That's when they discovered the chilly hazards of dependence on the individual health insurance market. When they applied for a replacement policy with Anthem Blue Cross of California, Ellen, 59, disclosed that she might have carpal tunnel syndrome. She wasn't sure--her condition was still being diagnosed by Kaiser when her coverage ended. But the possibility was enough to scare Anthem. "They said, 'We will not insure you because you have a pre-existing condition,'" Holzman recalls.

      But they were lucky, thanks to Obamacare. Through Covered California, the state's individual insurance marketplace, they've found a plan through Sharp Healthcare that will cover them both for a total premium of $142 a month, after a government subsidy based on their income. They'll have a higher deductible than Kaiser's but lower co-pays. But their possible savings will be impressive.

      More important than that was knowing that they couldn't be turned down for coverage come Jan. 1. "We felt we didn't have to panic, or worry," Holzman says. "If not for the Affordable Care Act, our ability to get insurance would be very limited, if we could get it at all."

      Holzman and Vezina are exactly the type of people Obamacare is designed to help--indeed, rescue from the cold, hard world of individual health insurance of the past. That was a world where even an undiagnosed condition might render you uninsurable. Where your insurance could be canceled after you got sick or had an accident. Where your financial health was at risk as much as your physical well-being.

      These are the stories you're not hearing amid the pumped-up panic over canceled individual policies and premium shocks--many of which stories are certainly true, but the noise being made about them leads people to think they're more common than they are.

      We've compiled several alternative examples for this post. They're anecdotes, sure, just like the anecdotes you've been seeing and reading about people learning they'll be paying more for coverage next year.

      The difference is that Americans learning that they'll be eligible for coverage perhaps for the first time, or at sharply lower cost, are far more typical of the individual insurance market. Two-thirds of the 30 million Americans who will be eligible for individual coverage next year are uninsured today, whether because they can't afford it now or because they're barred by pre-existing condition limitations, which will no longer be legal. And more than three-quarters will be eligible for subsidies that will cut their premium costs and even co-pays and deductibles substantially.

      Let's hear from a few more of them.

      David Shevlino, 51, is an artist in Delaware. Between the COBRA policy that extends the coverage his wife, Kathy, received at a former job and the bare-bones policy that covers himself and their 15-year-old son, they've been laying out $1,000 a month in premiums. Next year they'll pay $650 a month, after the government subsidy, for a plan through Blue Cross of Delaware that covers the entire family and provides many services that have been excluded up to now.

      That makes a big difference, especially for Kathy, who is still dealing with injuries she suffered in a cycling accident and that would have made her uninsurable once her COBRA ran out less than a year from now. "She had already been turned down by Aetna and Blue Cross, the very company that will now insure her," Shevlino says. "This is a really significant thing--to me, the fact that insurance companies could turn you down didn't make sense in terms of what healthcare is supposed to be for."

      And Judith Silverstein, 49, a Californian who was diagnosed with multiple sclerosis in 2007. Her family helps her pay the $750 monthly cost of her existing plan--which she only had because of federal law requiring that insurers who provide employer-based insurance continue to offer coverage if the employer goes out of business, as hers did. Next year she'll get a subsidy that will get her a good "silver" level plan for $50.

      For Silverstein that coverage is indispensable. Her case is relatively mild, but MS is a progressive condition that typically has made its sufferers pariahs of the individual insurance market in the past. "I researched the options," she says. "Nobody's going to sell you insurance in the individual market if you have MS." But these customers can't be excluded or saddled with big premium markups any more.

      It's not only recipients of subsidies who are benefiting. Jason Noble, 44, who has his own property management firm in Southern California, found a gold plan that will cover his wife and their three children--a daughter, 9, and 5-year-old twins--for a little less than $1,300 a month. That's slightly more than they'd be paying next year for their existing Blue Shield plan, but the benefits are much greater, including pediatric dental coverage. Their family deductible will fall from $3,400 to zero. Last year, the family had a health scare that ran them $1,800 in out-of-pocket expenses; a similar event next year would cost them nothing. "It's definitely a good deal," Noble says.

      it's fair to observe that not all these people are enamored with their enrollment experience. Ellen Holzman found Covered California's website "definitely clunky," and she and Vezina are still awaiting enrollment documents from Sharp that they say are well overdue.

      Brian Sheppard, 58, a self-employed Southern California attorney, says he spent five to seven hours on the website before determining that he could upgrade from the existing Kaiser plan covering him and his wife for an additional $100 a month, but with lower deductibles and prescription costs. He's still waiting to hear whether he'll be eligible for a subsidy that would slash his expenses significantly.

      "I'm persistent, I'm a lawyer, and I found it very difficult to work through that system," he says. But for him it was worth the effort. "In 2010, when people were being canceled because they got sick, there was all this outrage," he observes. "People have forgotten that."

      The difficulties of the federal government's healthcare.gov and some state enrollment websites are real, and have kept hundreds of thousands of Americans, even millions, from enrolling. But many of those who understand the benefits of the Affordable Care Act know that obsessing about the technical glitches is like mistaking the scoreboard for the game.

      Political opportunists (like House Speaker John Boehner), exploit near-term difficulties to obscure the tangible benefits the Affordable Care Act will bring to tens of millions of their constituents. When they say "this law has to go," as Boehner's spokesman did this weekend, they're talking about returning people to the era of exclusions for pre-existing conditions. To people learning they're uninsurable because of injuries from accidents, or chronic diseases, or the sheer bloody-mindedness of insurance company bureaucrats.

      Let's hear Boehner and his people explain to Holzman and Vezina, the Shevlinos, the Nobles, the Sheppards, and Silverstein--and to 20-30 million other Americans like them who might be locked out of the individual insurance market without the law they ridicule as "Obamacare"--how they'd be better off that way.





      http://www.latimes.com/business/hilt...#ixzz2ljev2gNO
      "Never doubt that a small group of thoughtful, committed citizens can change the world. Indeed, it is the only thing that ever has."

      Comment


      • #4
        My take - Redest of State may turn Blue? -

        Mitch McConnell's big ObamaCare conundrum
        The Senate minority leader faces a tough re-election fight — and the health-care law might make it harder

        By Jon Terbush | November 20, 2013
        .st_fblike { z-index:4 !important; }.fb-like { float: right; }.linkedin { float: right; margin-left: 6px; margin-right: 3px;}.cB {vertical-align: top;margin-right: -3px;}#TB_window .linkedin { float:none; margin-left:0px;}




        Mitch McConnell may have to rein in his ObamaCare-bashing. (Alex Wong/Getty Images)



        S
        enate Minority Leader Mitch McConnell (R-Ky.) hates ObamaCare, which isn't too surprising, given that he's an elected Republican politician. And considering the health-care law's miserable rollout and the Obama administration's painfully laborious attempts to patch up the problems, unapologetic opposition to the Affordable Care Act would seem to be a political no-brainer in the run-up to McConnell's 2014 re-election bid.
        Yet Kentucky may be one of the few places where support for ObamaCare is actually a winning argument come next year.

        The state's exchange marketplace has been one of ObamaCare's early bright spots. And continued success, coupled with a turnaround for the law at the federal level, could make ObamaCare relatively popular there over the coming months.

        That would put McConnell, facing challengers on both his right and left, in a tricky bind.

        Before ObamaCare, 640,000 Kentucky residents — or one-sixth of the state's population — didn't have health insurance. So Democratic Gov. Steve Beshear made it his biggest priority to ensure the law was in place and working properly.

        "My state needs ObamaCare," he wrote in a New York Times op-ed. "Now."
        The early results have been quite positive.

        Despite its relatively small population, the Bluegrass State has enrolled more people in new health plans than almost any other in the nation, primarily because Kentucky is one of the 14 states that built its own health exchange marketplace. The state-run marketplaces have proven far more effective than the feds' mothership, with roughly three-quarters of all October ObamaCare enrollees signing up via state exchanges.

        Kentucky also accepted the federal government's expansion of Medicaid under ObamaCare, and nearly 40,000 residents have already taken advantage of their new eligibility to sign up for it. And with a November surge, Kentucky is already beating its estimated enrollment pace, according to the Los Angeles Times.

        At the national level, too, there is reason to believe ObamaCare could be in for a big turnaround.

        The federal exchange marketplace is finally starting to gain steam after a dismal first month, and the Obama administration has said it will have Healthcare.gov fully operational for the "vast majority" of Americans by the end of the month. Even if the administration misses that deadline, there is still plenty of time for people to sign up for insurance before the individual mandate's penalty kicks in next April.

        "Most people don't sign up for something until the deadline," Jonathan Miller, a Democratic former Kentucky state treasurer, told Newsweek. "If that is true in Kentucky, then the positive success the program's been having is only the tip of the iceberg."

        McConnell has blasted ObamaCare in the past month as "beyond repair," saying that "anything short of full repeal leaves us with this monstrosity." If ObamaCare continues to improve, though, that talking point "will dry up," wrote Salon's Brian Beutler, and McConnell's job will "come into exquisite tension with his responsibility to his own constituents."

        Beshear declared in a joint Washingotn Post op-ed this week that ObamaCare was already working in Kentucky. Even if McConnell were to concede some ground to that argument — though there's little reason to believe he would — he could only do so at the risk of handing more ammunition to his GOP primary challenger, Matt Bevin, and all the conservative groups attacking him as a "turncoat" and Obama sympathizer.

        Polls have already shown McConnell in a dead heat with the presumed Democrat in the race, state Secretary of State Alison Lundergan Grimes, and found that a majority of voters disapprove of his job performance. If he holds the anti-ObamaCare line, he may have to find other ways to link Grimes to Obama himself, who lost Kentucky in 2012 by an abysmal 23 points.

        ObamaCare will factor heavily into the 2014 midterms, but in Kentucky, it may not be a four-letter word.

        http://theweek.com/article/index/253...care-conundrum
        "Never doubt that a small group of thoughtful, committed citizens can change the world. Indeed, it is the only thing that ever has."

        Comment


        • #5
          My take - Redest of State may turn Blue? -

          Mitch McConnell's big ObamaCare conundrum
          The Senate minority leader faces a tough re-election fight — and the health-care law might make it harder

          By Jon Terbush | November 20, 2013
          .st_fblike { z-index:4 !important; }.fb-like { float: right; }.linkedin { float: right; margin-left: 6px; margin-right: 3px;}.cB {vertical-align: top;margin-right: -3px;}#TB_window .linkedin { float:none; margin-left:0px;}




          Mitch McConnell may have to rein in his ObamaCare-bashing. (Alex Wong/Getty Images)



          S
          enate Minority Leader Mitch McConnell (R-Ky.) hates ObamaCare, which isn't too surprising, given that he's an elected Republican politician. And considering the health-care law's miserable rollout and the Obama administration's painfully laborious attempts to patch up the problems, unapologetic opposition to the Affordable Care Act would seem to be a political no-brainer in the run-up to McConnell's 2014 re-election bid.
          Yet Kentucky may be one of the few places where support for ObamaCare is actually a winning argument come next year.

          The state's exchange marketplace has been one of ObamaCare's early bright spots. And continued success, coupled with a turnaround for the law at the federal level, could make ObamaCare relatively popular there over the coming months.

          That would put McConnell, facing challengers on both his right and left, in a tricky bind.

          Before ObamaCare, 640,000 Kentucky residents — or one-sixth of the state's population — didn't have health insurance. So Democratic Gov. Steve Beshear made it his biggest priority to ensure the law was in place and working properly.

          "My state needs ObamaCare," he wrote in a New York Times op-ed. "Now."
          The early results have been quite positive.

          Despite its relatively small population, the Bluegrass State has enrolled more people in new health plans than almost any other in the nation, primarily because Kentucky is one of the 14 states that built its own health exchange marketplace. The state-run marketplaces have proven far more effective than the feds' mothership, with roughly three-quarters of all October ObamaCare enrollees signing up via state exchanges.

          Kentucky also accepted the federal government's expansion of Medicaid under ObamaCare, and nearly 40,000 residents have already taken advantage of their new eligibility to sign up for it. And with a November surge, Kentucky is already beating its estimated enrollment pace, according to the Los Angeles Times.

          At the national level, too, there is reason to believe ObamaCare could be in for a big turnaround.

          The federal exchange marketplace is finally starting to gain steam after a dismal first month, and the Obama administration has said it will have Healthcare.gov fully operational for the "vast majority" of Americans by the end of the month. Even if the administration misses that deadline, there is still plenty of time for people to sign up for insurance before the individual mandate's penalty kicks in next April.

          "Most people don't sign up for something until the deadline," Jonathan Miller, a Democratic former Kentucky state treasurer, told Newsweek. "If that is true in Kentucky, then the positive success the program's been having is only the tip of the iceberg."

          McConnell has blasted ObamaCare in the past month as "beyond repair," saying that "anything short of full repeal leaves us with this monstrosity." If ObamaCare continues to improve, though, that talking point "will dry up," wrote Salon's Brian Beutler, and McConnell's job will "come into exquisite tension with his responsibility to his own constituents."

          Beshear declared in a joint Washingotn Post op-ed this week that ObamaCare was already working in Kentucky. Even if McConnell were to concede some ground to that argument — though there's little reason to believe he would — he could only do so at the risk of handing more ammunition to his GOP primary challenger, Matt Bevin, and all the conservative groups attacking him as a "turncoat" and Obama sympathizer.

          Polls have already shown McConnell in a dead heat with the presumed Democrat in the race, state Secretary of State Alison Lundergan Grimes, and found that a majority of voters disapprove of his job performance. If he holds the anti-ObamaCare line, he may have to find other ways to link Grimes to Obama himself, who lost Kentucky in 2012 by an abysmal 23 points.

          ObamaCare will factor heavily into the 2014 midterms, but in Kentucky, it may not be a four-letter word.

          http://theweek.com/article/index/253...care-conundrum
          "Never doubt that a small group of thoughtful, committed citizens can change the world. Indeed, it is the only thing that ever has."

          Comment


          • #6
            Obama Care Facts - Obama Care regulates Health INSURANCE not

            Health Care. It reforms the Health Care System.

            ----

            Our 'Affordable Care Act' Summary breaks down ObamaCare section by section. The 'Affordable Care Act' summary will give the most factual representation of the law by summarizing each of the Act's 10 titles. Every title and every section of the 'Affordable Care Act' is packed with details (even the condensed version of the law is about 1000 pages long).

            Keeping in mind the length of the Patient Protection and Affordable Care Act we have separated our section-by-section analysis of the law from our basic summary of each title. If you keep reading this page you will get a basic overview of the law and of each title contained within.

            You can also check out our section-by-section Summary of Provisions of the Patient Protection and Affordable Care Act, or even read the full text of the Patient Protection and Affordable Care Act.

            What is the Affordable Care Act?

            The Patient Protection and Affordable Care Act (PPACA) 2010 HR3590, or Affordable Care Act (ACA) for short, is the new health care reform law in America and is often called by its nick-name Obamacare. The Patient Protection and Affordable Care Act is made up of the Affordable Health Care for America Act, the Patient Protection Act, and the health care related sections of the the Health Care and Education Reconciliation Act and the Student Aid and Fiscal Responsibility Act. It also includes amendments to other laws like the Food, Drug and Cosmetics Act and the Health and Public Services Act. Since being singed into law additional rules and regulations have expanded upon the law, we have attempted to update our summaries with those changes.

            What Does the Affordable Care Act Do?

            The Affordable Care Act is a long, complex piece of legislation that attempts to reform the healthcare system by providing more Americans with affordable quality health insurance and by curbing the growth in healthcare spending in the U.S.. Reforms include new benefits, rights and protections, rules for insurance companies, taxes, tax breaks, funding, spending, the creation of committees, education, new job creation and more.

            Please note that the law, in many cases, gives power to ongoing efforts by Health and Human Services and other Government programs to reform health care. So healthcare reform doesn't start and end with the Act itself. Make sure to check out the official HHS site for more information on healthcare reform outside of the ACA.

            Titles of the Affordable Care Act

            The Affordable Care Act addresses the following topics in detail. Each topic is a title, which contains sections of provisions that reform our health care system.
            Title I Quality, affordable health care for all Americans
            Title II The role of public programs
            Title III Improving the quality and efficiency of health care
            Title IV Preventing chronic disease and improving public health
            Title V Health care workforce
            Title VI Transparency and program integrity
            Title VII Improving access to innovative medical therapies
            Title VIII Community living assistance services and supports
            Title VIIII Revenue provisions
            Title X Reauthorization of the Indian Health Care Improvement Act
            Affordable Care Act Overview

            This Summary of the ACA will help you get a quick idea of what exactly is in The Affordable Care Act (ObamaCare) and how it applies to you. Having a basic understanding of the law will help you to digest the details below.
            • The Affordable Care Act helps to reform the healthcare system by giving more Americans access to quality, affordable health insurance and helps to curb the growth of healthcare spending in the U.S.
              • All Americans with health insurance will have access to a number of new benefits, rights, and protections which ensure that they can get treatment when they need it, protecting consumers from some of the worse abuses of the health care and insurance industries.
              • It makes insurance more affordable by reducing premium and out-of-pocket costs for tens of millions of families and small business owners who had been priced out of coverage in the past. This helps over 32 million Americans afford health care who could not get it before – and makes coverage more affordable for many more. Under the plan, 95% of Americans will be insured. In 2013 over 15% of Americans are without insurance.
              • The law spreads risk equally to all insured to end discrimination. In the past you could be discriminated based on gender or health status, or costs could differ wildly due to factors like age. The ACA limits discrepancies in what you can be charged and in order to do this requires all Americans who can afford to maintain Minimum Essential Coverage starting in 2014. Many who can't afford coverage will be exempt from the requirement to maintain coverage.
              • It sets up a new competitive health insurance marketplace (healthcare.gov) giving tens of millions of Americans access to group buying power and allowing them to compare plans and receive cost assistance.
              • It puts our budget and economy on a more stable path by reducing the deficit by more than $100 billion over the next ten years – and more than $1 trillion over the second decade – by cutting government overspending and reining in waste, fraud and abuse.
            Understanding the ACA Isn't As Hard As You Think

            While the law itself is a difficult read, most of what the average person thinks of as "ObamaCare" is contained within the first title. The first title, Quality Affordable Health Care For All Americans, contains most of the new benefits, rights, and protections, new rules for insurance companies, insurance exchanges, mandates, rules for tax credits and cost-sharing reduction subsidies, new rules for businesses, and just about everything else will hear about with the exception of Medicare, Medicaid, new taxes, and a "few" other details.

            The first title spans about 140 pages and contains mostly white space, with around 450 characters a page. Luckily our Summary of Provisions of the Patient Protection and Affordable Care Act breaks down those 150 pages into about 5 pages of text.

            Want to skip the Affordable Care Act Summary and just read the bill? Download the Full Affordable Care Act Bill.

            Or check out this detailed ObamaCare Facts Health Care Reform Timeline of every protection, benefit, and tax laid out by the Affordable Care Act from 2010 to 2022.
            Affordable Care Act Summary of Titles and Provisions

            The Affordable Care Act is it is broken down into titles, each title is broken down into subtitles, and subtitles are broken down into sections that contain provisions or amendments to other laws. Provisions are the parts of the law that affect Americans. Our goal will be to break down each title, subtitle, section and provision to give you a complete, yet simplified, understanding of exactly what the Affordable Care Act does.

            TITLE I - QUALITY, AFFORDABLE HEALTH CARE FOR ALL AMERICANS

            Subtitle A—Immediate Improvements in Health Care Coverage for All Americans
            Subtitle B—Immediate Actions to Preserve and Expand Coverage
            Subtitle C—Quality Health Insurance Coverage for All Americans
            Subtitle D—Available Coverage Choices for All Americans
            Subtitle E—Affordable Coverage Choices for All Americans
            Subtitle G—Miscellaneous Provisions
            The first two sub-titles of the law contain immediate improvements to the healthcare system. Many of these provisions worked as temporary fixes until the provisions could be fully implemented. The next four subtitles deal with the insurance exchanges, cost assistance, rules for businesses, mandates, and some misc. provisions. Below we discuss where the related provisions stand today.

            Provisions from the first title of the Affordable Care Act:
            • Eliminate lifetime and unreasonable annual limits on benefits - The law does away with annual and lifetime dollar limits completely by 2014. In the past over 60% of bankruptcies were medical related and 3/4 of these bankruptcies happened to those with health insurance, many due to reaching coverage limits.

            • Essential Health Benefits must be included on all new plans. Learn about the benefits of Obamacare.

            • Prohibit rescissions of health insurance policies - You can no longer be dropped from coverage for any reason aside from fraud. Before the ACA it was common practice to find a reason (such as an honest mistake on an application) to drop patients when the cost of care got too great.


            • Provide assistance for those who are uninsured because of a pre-existing condition - temporary high risk pools were established for people with pre-existing conditions. As of 2014 no one can be charged more or dropped from coverage due to being a pre-existing condition. You can't be charged more due to health status either.


            • Require coverage of preventive services and immunizations - All health plans starting after 2014 and all non-grandfathered health plans will have to provide many A and B rated preventative services at no out-of-pocket cost on all insurance plans starting in 2014.


            • Extend dependent coverage up to age 26 - Dependents can stay on their parent's plan until 26.

            • Develop uniform coverage documents so consumers can make apples-to-apples comparisons when shopping for health insurance - In the past there was no uniform system for showing benefits included in insurance plans. Today a simple standardized document makes comparing insurance options easy.


            • Cap insurance company non-medical, administrative expenditures - Insurance companies can't spend more than 80% of premium dollars on non-medical costs. If they do, you get a rebate. (85% in large group markets).

            • Ensure consumers have access to an effective appeals process and provide consumer a place to turn for assistance navigating the appeals process and accessing their coverage - In the past if you were denied treatment or had to make an appeal to your insurance company you had little rights. Today you have the right to a rapid appeal.


            • Create a temporary re-insurance program to support coverage for early retirees - Starting 2014 all Americans can use the health insurance marketplace to purchase coverage.


            • Establish an Internet portal to assist Americans in identifying coverage options - healthcare.gov was established to provide accurate information on the law and to provide a portal to the State-based health insurance marketplaces.


            • Facilitate administrative simplification to lower health system costs - all medical data is now collected on centralized databases making coordinating care more effective.

            • Require individuals maintain Minimum Essential Coverage (most types of health insurance) starting in 2014.

            • Starting 2015 small businesses have to insure full-time workers.

            • Many new rules for businesses improve equality in the workplace in regards to healthcare.

            • You can no longer be charged more money based on health status, gender, or salary.

            The first title states that the Affordable Care Act puts individuals, families and small business owners in control of their own healthcare.

            The Affordable Care Act also reduces what most people will pay for healthcare by capping out of pocket expenses and requiring all preventative care to be fully-covered and without cost to the individual.
            Nothing in the Bill forces any American to have healthcare or to drop their current healthcare plan, assuming that plan complies with the ACA or retains a grandfathered status if signed before the bill became law.

            There will be a competitive insurance market (now known as the health insurance marketplace) and all Americans will be able to choose their insurance out of these plans. Since everyone will have access to the same care through the Affordable Care Act it helps to ensure that all Americans receive quality healthcare. Those wishing to purchase private health insurance will be able to do so and receive the same care available today.

            All participants in the exchanges will be paying into the Affordable Care Act, the insurance exchange will then pool buying power allowing individuals to afford private insurance plans. These plans will have to compete for your business, thus helping to regulate cost and quality.

            Small business owners will be able to purchase their own coverage, and will receive tax credits for up to 50% of the cost of their employees health insurance making it easier to give their employees benefits.

            It keeps insurance companies honest by setting clear rules that rein in the worst insurance industry abuses. And it bans insurance companies from denying insurance coverage because of a person’s pre-existing medical conditions while giving consumers new power to appeal insurance company decisions that deny doctor ordered treatments covered by insurance.

            This year, American families and small business owners will begin to experience the benefits of this common-sense reform:
            • New Affordable Choices:
              • Uninsured Americans with pre-existing conditions will finally have the choice of quality, affordable insurance through a new insurance pool;
              • Small business owners will be eligible for billions in tax credits to help offer insurance coverage to employees;
              • New plans will have to offer preventive care and immunizations at no cost;
              • New plans and certain existing plans that offer dependent coverage will have to cover an enrollee’s dependent children until age 26;
              • A re-insurance program for employers that offer health insurance to their early retirees will save as much as $1,200 for every family enrolled.
            • More Power for Consumers:
              • A new website to help consumers compare different insurance coverage options along with state-by-state health care consumer assistance and ombudsman for any of their health insurance questions;
              • A new independent appeals process for new plans so consumers and patients can appeal insurance company decisions.
            • Insurance Company Accountability:
              • Prohibits new plans and existing group health plans from denying coverage for children because of a pre-existing medical condition;
              • Review of requested insurance premium increases; health insurers with a pattern of excessive rate increases can be blocked from selling through new insurance exchanges;
              • Remove arbitrary lifetime limits on coverage in all plans, and remove restrictive annual limits on benefits in all new plans and existing group health plans so people know that all of the care they need will be paid for;
              • Prevent insurance companies from dropping insurance coverage when a person gets sick and needs it most.
            These common-sense reforms will be implemented step by step so that families and small business owners have the information they need to make the choices that work best for them.

            TITLE II - The Role of Public Programs

            The Affordable Care Act extends Medicaid, preserves CHIP (Successful children's insurance plan) and simplifies enrollment.

            Improves community-based care for disabled Americans and provides States the opportunity to expand home care services for people with long term care needs.

            The Act treats all States equally and gives them flexibility to adopt strategies to improve care in coordination with Medicare and Medicaid beneficiaries.

            The Affordable Care Act TITLE II states that it saves the taxpayer money by reducing prescription drug costs and payments to subsidize care for uninsured Americans.

            The Act also gives more Americans access to health insurance greatly increasing the number of Americans who have healthcare.

            Title III. Improving the Quality and Efficiency of Health Care

            The Affordable Care Act preserves, protects and reforms Medicare.

            The ACT closes the coverage gap "donut hole" for drug costs for seniors. Seniors will save thousands of dollars in drug costs due to closing the "donut hole".

            Healthcare institutions and professionals will be incentivized to improve care.
            The Affordable Care Act provides additional health services to rural America.
            The Act ends the overpayment of tens of billions of dollars to insurance companies in order to help protect Medicare.

            Taxpayer dollars are saved by keeping people healthier before joining Medicare, reducing Medicare's need to pay hospitals to care for uninsured patents.

            A team of healthcare experts and not members of congress, will work together to come up with the best ideas to keep Medicare running by figuring out how to improve the quality of coverage and reduce costs for Medicare.

            Medicare is a sacred trust with America’s seniors, and this Act preserves it.



            Title IV. Prevention of Chronic Disease and Improving Public Health

            Title IV promotes prevention, wellness and public health via unprecedented funding.

            The Act uses national prevention and health promotion strategies to work to improve the health of Americans and reduce preventable illness and disability in an effort to keep Americans healthy and health care costs down.

            Nutritional information will be more prevalent.

            Co-payments will be waved for preventative measures for seniors.

            The law adds many preventative services for women.

            The law as a whole will save taxpayers by ensuring that people have access to the preventative measures saving millions of lives and astronomical hospital bills that go unpaid and drive up the cost of healthcare.

            If we want to truly reform health care to benefit American families, we need to transition from a system focused primarily on treating the sick to one that helps keep people well throughout their lives.

            The Act will promote prevention, wellness, and the public health and provides an unprecedented funding commitment to these areas. It directs the creation of a national prevention and health promotion strategy that incorporates the most effective and achievable methods to improve the health status of Americans and reduce the incidence of preventable illness and disability in the United States.

            The Act relies on the innovation of small businesses and state and local governments to find the best ways to improve wellness in the workplace and in our communities. And it strengthens America’s capacity to respond to public health emergencies.

            The Act empowers families by giving them tools to find the best science-based nutrition information, and it makes prevention and screenings a priority by waiving co-payments for America’s seniors on Medicare.

            By attacking disease before it hits, the Act helps to improve health, save lives, and avoid more costly complications down the road.

            Title V Health Care Workforce

            Affordable Health Care Act funds scholarships and loan repayment programs to assist young people with going to school for health care related professions.

            The act promotes much needed jobs in the healthcare industry to prepare for our future thus creating jobs for American workers.

            The Act gives states power to recruit healthcare workers.

            Helps fund and expand community health centers.

            Because doctors, nurses, and other health care providers are the backbone of the health care system, the Act supports and expands our Nation’s health care workforce.

            Title VI. Transparency and Program Integrity

            The Affordable Care Act focuses on keeping Americans informed about healthcare.

            Doctor-patient relationships are strengthened via cutting edge medical research and access to more data to allow doctors and patients to make the decisions that work best for them.

            Greater transparency in nursing homes by placing regulations and incentive programs to help improve quality control.

            The Act reins in waste, fraud and abuse by imposing disclosure requirements to identify high-risk providers who have defrauded the American taxpayer.

            States now have the authority to prevent providers who have been penalized in one state from setting up in another.

            Gives states flexibility to propose and test tort reforms that affect patient safety, encourage resolution of disputes and improve liability insurance.

            Title VII. Improving Access to Innovative Medical Therapies

            Extending Discounts on Drugs

            Promoting Biologics Price Competition and Innovation

            The Act promotes innovation and saves consumers money. It ends anti-competitive behavior by drug companies that keep effective and affordable generic drugs off the market. It extends drug discounts to hospitals and communities that serve low-income patients. And it creates a pathway for the creation of generic versions of biological drugs so that doctors and patients have access to effective and lower cost alternatives.

            Title VIII. Community Living Assistance Services and Supports Act (CLASS Act)

            Title VIII establishes a Voluntary, Self-Funding Long-Term Insurance Choice for American Families

            The Act provides Americans with a new option to finance long-term services and care in the event of a disability.

            It is a self-funded and voluntary long-term care insurance choice. Workers will pay in premiums in order to receive a daily cash benefit if they develop a disability. Need will be based on difficulty in performing basic activities such as bathing or dressing. The benefit is flexible: it could be used for a range of community support services, from respite care to home care.

            No taxpayer funds will be used to pay benefits under this provision. The program will actually reduce Medicaid spending, as people are able to continue working and living in their homes and not enter nursing homes. Safeguards will be put in place to ensure its premiums are enough to cover its costs.
            The CLASS Act was repealed January 1, 2013.

            Title IX. Revenue Provisions

            Improved Enforcement and Closing Tax Loopholes

            Broadened Medicare Hospital Insurance (HI) Tax Base for High-Income Taxpayers

            Reformed Excise Tax on Insurance Companies


            Health Industry Fees

            Additional Health Savings

            Additional Tax Benefits for Healthcare

            The Affordable Care Act not only makes health care more affordable for families and small business owners and raises taxes on high earners, large businesses, and the health care industry. It also limits medical deductions which is something that some Americans may be affected by. Tens of millions of families will benefit from new tax credits which will help them reduce their premium costs and purchase insurance. Families making less than $250,000 will see their taxes cut by hundreds of billions of dollars.

            When enacted, health reform is completely paid for and will reduce the deficit by more than one hundred billion dollars in the next ten years.

            Title X. Reauthorization of the Indian Health Care Improvement Act

            The Act reauthorizes the Indian Health Care Improvement Act (ICHIA) which provides health care services to American Indians and Alaskan Natives. It will modernize the Indian health care system and improve health care for 1.9 million American Indians and Alaska Natives.

            Summary of Provisions of the Patient Protection and Affordable Care Act.

            http://obamacarefacts.com/affordablecareact-summary.php
            Last edited by Karl; November 26, 2013, 04:27 AM.
            "Never doubt that a small group of thoughtful, committed citizens can change the world. Indeed, it is the only thing that ever has."

            Comment


            • #7
              Some encouraging information here. The cost control in particular would be a major achievement if it can hold up over time. However I would wait to see some data from an independent source, the presidents economic council is hardly that.

              The bad news of course is that the White House and the Dems in general have a mountain to climb to turn around the public sentiment once they finally get the website and overall technology infrastructure fixed. Fortunately Obama will have veto power to block any attempt to dismantle the law in the short term even if the Dems lose the Senate in 2014. Longer term...the reality on the ground will be the ultimate decider.
              Last edited by Islandman; November 26, 2013, 08:18 AM.
              "‎It is easier to build strong children than to repair broken men" - Frederick Douglass

              Comment


              • #8
                Still can't understand why so many of us have allowed ourselves to be dumbed down by the Repugs and an ignorant media. How is it that a screwed up website, that cannot remain screwed up for ever, is the chief indicator of whether the program itself is good or not?!?!

                The JFF had a phuqed up website for years. Did the JFF stop working?

                Ok, I'll think of a better analogy soon!


                BLACK LIVES MATTER

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                • #9
                  I am confused about this Obamacare thing...it's more expensive than the previous plans...so the US now has Universal Healthcare...but you have to pay out your ass for it...

                  Comment


                  • #10
                    Yes, please do.

                    Seriously though Mo, it really is an oversimplification to say it is "just" the website and all will be fine when fixed. It does not work that way in the world we live in today. The perception that develops is that crappy website = crappy product/service and even when the website is fixed the window of opportunity to turn that viewpoint around may have closed.

                    We still do not know if Obamacare will ultimately be a success or failure. What we do know is that Obama and his administration have been on the defensive from day 1 since it passed and its support among the general public has been mixed at best.

                    That is not the fault of the media, that is the fault of the people responsible for selling and implementing it.
                    "‎It is easier to build strong children than to repair broken men" - Frederick Douglass

                    Comment


                    • #11
                      But the way things are going there are some who believe the program itself is not working and so have not signed up for it when they need it! Because the website is crappy! When there are other ways to do so, if I'm not terribly mistaken. Dat nuh mek nuh sense!

                      And as for those who just hate Obama and will cut off their nose to spite their face and not sign up for it. They are going to need health insurance to reattach that nose!


                      BLACK LIVES MATTER

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                      • #12
                        Well I think once the call goes out by the White House that the website is now functional, many people will go back on and check it out. If you do not have or cannot afford insurance and have health problems that will be enough motivation to sign up and get the subsidies if you qualify. Well, unless you are a Tea party nut. The call to try again to sign up will have to be very soon of they plan to enforce the mandate in 2014.

                        The more difficult group to convince/force to sign up will be the young people who don't think they need health care and don't want to pay for it. Those people need to sign up for the economics to work, otherwise taxpayers will probably end up paying a lot of high insurance premiums for a high risk pool of people. Now maybe that still is worth doing, but that would mean the model did not work and the US would have to move closer to government controlled health care than the ACA had designed.
                        "‎It is easier to build strong children than to repair broken men" - Frederick Douglass

                        Comment


                        • #13
                          Better plans though, or that is the argument. Also eventually when (if?) the young people get on board the prices will go down.
                          "‎It is easier to build strong children than to repair broken men" - Frederick Douglass

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                          • #14
                            The implementation was **** poor. The website was crappy. How can you have 25,000 people sign up in the first month on the web??? That was a disaster, and to add to that some of promises were never kept and insurance were sending out cancelation letters to people. There is also a small percentage of people who had to pay higher premium.


                            One of the lady they used to sell it saying how she got a deal, then insurance company send back to say she can't get that deal after review.

                            I supported Obama care but the implementation was VERY CRAPPY at best.
                            • Don't let negative things break you, instead let it be your strength, your reason for growth. Life is for living and I won't spend my life feeling cheated and downtrodden.

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                            • #15
                              More expensive for some. It also means better health plans for some as well.
                              • Don't let negative things break you, instead let it be your strength, your reason for growth. Life is for living and I won't spend my life feeling cheated and downtrodden.

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