The very name of the law was a calculated lie:
Gruber said that Obamacare had no cost controls in it and would not be affordable in an October 2009 policy brief, presented here exclusively by TheDC. At the time, Gruber had already personally counseled Obama in the Oval Office and served on Obama’s presidential transition team. Obama, meanwhile, told the American people that their premiums would go down dramatically.
“The problem is it starts to go hand in hand with the mandate; you can’t mandate insurance that’s not affordable. This is going to be a major issue,” Gruber admitted in an October 2, 2009 lecture, the transcript of which comprised the policy brief.
“So what’s different this time? Why are we closer than we’ve ever been before? Because there are no cost controls in these proposals. Because this bill’s about coverage. Which is good! Why should we hold 48 million uninsured people hostage to the fact that we don’t yet know how to control costs in a politically acceptable way? Let’s get the people covered and then let’s do cost control.”
So, they were consistent.
The very name of the law was a calculated lie
I assume the “Affordable” in the law’s name refers to the way the law uses subsidies and Medicaid expansion to put a ceiling on the fraction of income that any citizen has to spend to buy coverage. Before the ACA coverage was literally unaffordable (i.e. would cost most or all of a person’s income) for millions.
It’s good of The Daily Caller to link to Gruber’s policy brief; it’s a good survey of the issues and tradeoffs that were at the forefront of the health care reform debate in 2009. As they say, read the whole thing. For example:
From the perspective of 2014 Gruber seems unreasonably optimistic about the prospects of post-ACA federal legislation aimed at cost control (Congress seems more interested in neutering the ACA cost-control provisions that currently exist), and unreasonably pessimistic about the need for such legislation (as it turned out the period 2010-2014 has seen the slowest health care cost growth in decades).
“I assume the “Affordable” in the law’s name refers to the way the law uses subsidies and Medicaid expansion to put a ceiling on the fraction of income that any citizen has to spend to buy coverage.”
Wouldn’t you want a floor? I don’t care what the ceiling is on how people choose to spend their money. Rich people buying Teslas may cause the price to drop if innovation occurs. The same is true for expensive medical care. But don’t you want a floor for the poor people to stand on? Cause right now under Obamacare, the ceiling is the floor. When Obama put the out of pocket cap at $6450 (or whatever it is) a lot of plans had their deductibles jacked up to it.
Obamacare gave us craptastic plans with high deductibles and little if any coverage but it also outlawed good plans by taxing them and increasing the taxes on them with the goal of eliminating them.
“Before the ACA coverage was literally unaffordable (i.e. would cost most or all of a person’s income) for millions”
Its unaffordable now for millions and for millions more is only personally affordable to an individual if it is subsidized by the government, the plans themselves are not affordable. I have health insurance but it doesn’t help me treat any illness. I still have to pay for treatment and while my old deductible was something I could hit in a bad year, my new deductible is something that I will only hit in the event of a catastrophe. I just pay in and pay in and pay in and never get anything back but I guess that was the intention wasn’t it?
I don’t care what the ceiling is on how people choose to spend their money.
Me neither. But there should be a ceiling on the income fraction any citizen has to spend to have health coverage. Pre-ACA there wasn’t.
outlawed good plans by taxing them
Low deductible plans haven’t been outlawed, there are lots on the exchanges. The tax on expensive tax-deductible employer plans goes into effect in 2018.
Its unaffordable now for millions
By what definition of unaffordable? What % of gross income?
I have health insurance but it doesn’t help me treat any illness.
It will help plenty if you have major expenses, which is the point of insurance, right?
“But there should be a ceiling on the income fraction any citizen has to spend to have health coverage. Pre-ACA there wasn’t.’
Why?
What Marxist dogma suggests this?
It’s basic humanity. The alternative is to accept that some people won’t have health coverage, or necessary health care, simply due to accidents of birth and circumstance. That’s a more cold-hearted model than most voters will accept, which is why there is a long history of trying to provide health care to those (the poor, unlucky, elderly, disabled, etc.) who could not afford it on a free market.
Health coverage is not health care. Only in a progressive’s mind is insurance the same thing as a humanity, regardless of basic or not. As for providing health care for the poor, there is a long history of charity to provide such things. Indeed many hospitals in the US started as charity hospitals. This was a fact long before Obama was born, much less a politician, and well established prior to ACA. All of that has nothing to do with the statement Jim made previously nor does it answer the question asked by myself or Gregg.
So Jim, why do you claim there should be a ceiling that is a fraction of someone’s income? You made that assertion, but you haven’t explained it. Not one part of your response has a connection to income.
As for providing health care for the poor, there is a long history of charity to provide such things.
Right, there’s a consensus that people shouldn’t die or suffer because they can’t afford health care. Nonetheless, they did and still do. The ACA is an attempt to narrow the gap between our aspirations and reality.
So Jim, why do you claim there should be a ceiling that is a fraction of someone’s income? You made that assertion, but you haven’t explained it.
If there’s no ceiling — if coverage might cost 50%, or 100%, or 1,000% of a person’s income — then coverage will be unaffordable for some people. Making coverage available for no more than 10% of income (and less than that for very low incomes) makes it affordable to everyone. Does that explain it?
Right, there’s a consensus that people shouldn’t die or suffer because they can’t afford health care. Nonetheless, they did and still do.
So you thought if Obama passed ACA, people would be immortal? Is that why it means so much to you? He may be your messiah, but he doesn’t have enough money in the world to save you.
But there should be a ceiling on the income fraction any citizen has to spend to have health coverage.
Why?
But there should be a ceiling on the income fraction any citizen has to spend to have health coverage. Pre-ACA there wasn’t.
There’s that faux outrage again. Who says what the percentage is? 1 percent? 30 percent? Who gets to decide? You? Anytime a decision is decided on a mass level, distortions appear. The fact that you ignore this lesson while massive historical evidence stares you straight in the face leads to the conclusion that you are either naive or have a socialist agenda.
Why? Because Baghdad Jim wants it! And what “liberals” (and by “liberals” I mean of course “tax-happy, coercion-addicted, power-tripping State-fellators”) want everyone must submit to!
The ACA has two percentages. If insurance would cost you more than 8% of income, you’re exempt from the mandate. The subsidies are designed to keep you from having to spend more than 9.5% of income on coverage.
Who gets to decide? You?
All of us, through our elected representatives.
From the perspective of 2014 Gruber seems unreasonably optimistic about the prospects of post-ACA federal legislation aimed at cost control (Congress seems more interested in neutering the ACA cost-control provisions that currently exist), and unreasonably pessimistic about the need for such legislation (as it turned out the period 2010-2014 has seen the slowest health care cost growth in decades).
The point of a source like Gruber or the CBO is to provide instant propaganda not to be accurate. That’s why he can brag about his role in lying about the consequences of Obamacare and still continue to get business.
Moving on, I read through your subsequent posts and I still don’t see any acknowledgement that a) Obamacare didn’t make health care more affordable – even your weak argument that health care costs have slowed (which is not the same thing as becoming more affordable!) is just an expected consequence of having the slowest economic recovery since the Great Depression, and b) who’s going to pay for the health care of people on Medicaid?
a) Obamacare didn’t make health care more affordable
Of course it did. Before the ACA if you were poor, or near-poor, or had a bad health history, health coverage could easily cost you more than 20-30% of your income, if it was available at all. Now every citizen in a Medicaid-expanding state should be able to get comprehensive coverage for 0-10% of income.
just an expected consequence of having the slowest economic recovery
It isn’t that simple — health care inflation increased during the previous recession, and was last this low during the mid-90s expansion.
b) who’s going to pay for the health care of people on Medicaid?
Taxpayers, particularly high-income taxpayers.
Before the ACA if you were poor, or near-poor, or had a bad health history, health coverage could easily cost you more than 20-30% of your income, if it was available at all.
There are two problems with this assertion. First, that health coverage costs even more now than it did before the ACA. The costs are passed on to other taxpayers and health providers. Second, health coverage is not health care. Medicaid is a great example of this. Medicaid recipients are transforming into a new class of uninsured. And as a number of people have noted, health insurance for a number of people has simultaneously grown more expensive with less coverage.
Taxpayers, particularly high-income taxpayers.
And where are these taxpayers going to get the money from to pay for Medicaid? And don’t forget those growing subsidies too.
It isn’t that simple — health care inflation increased during the previous recession, and was last this low during the mid-90s expansion.
I think it is that simple. The real estate crisis of 2007-2008 caused the worst global (and US) recession since the Second World War. And the US has since had the worst recovery from that recession. Further, we still have the problem of growing health care costs in a country which already has the highest health care costs by a host of measures.
I think we’ll see a resumption of health cost increases as the cost inflating measures of Obamacare take effect.
Second, health coverage is not health care. Medicaid is a great example of this. Medicaid recipients are transforming into a new class of uninsured.
Medicaid recipients don’t have the same selection of care providers as someone with Medicare or private insurance, but it’s a gross distortion to consider them uninsured. They have much better options than the uninsured (just ask them).
health insurance for a number of people has simultaneously grown more expensive with less coverage.
True. It’s hard to imagine a policy change that would make things better for millions, without making things worse for anyone.
The real estate crisis of 2007-2008 caused the worst global (and US) recession since the Second World War. And the US has since had the worst recovery from that recession.
The US recovery has been better than that of any other major country.
I think we’ll see a resumption of health cost increases as the cost inflating measures of Obamacare take effect.
Anything’s possible, but the cost inflating measures of Obamacare have been in effect for a year now, and so far cost growth is down. Meanwhile, some of the law’s cost-control measures (the cadillac tax, IPAB) haven’t kicked in yet.
The US recovery has been better than that of any other major country.
So you agree that the US recovery has been the worst since the end of the Second World War.
Anything’s possible, but the cost inflating measures of Obamacare have been in effect for a year now
And they’ll be in effect for more than a year. The problem here is that Obamacare is not a one year thing.
I assume the “Affordable” in the law’s name refers to the way the law uses subsidies and Medicaid expansion to put a ceiling on the fraction of income that any citizen has to spend to buy coverage. Before the ACA coverage was literally unaffordable (i.e. would cost most or all of a person’s income) for millions.
You assumed wrong. It’s still unaffordable. The word affordable was merely put there as spin.
http://www.the-american-interest.com/2014/12/11/the-medicaid-expansions-other-shoe-drops/
Then there is this:
http://www.the-american-interest.com/2014/12/10/expanding-medicaid-in-name-only/
And this:
http://www.the-american-interest.com/2014/12/10/health-care-to-suppress-wages-even-more/
It’s still unaffordable.
Compared to what? Under the ACA, if you’re poor (and live in a state that expanded Medicaid) then you can afford healthcare coverage. That wasn’t the case pre-ACA. If you earn up to 400% of the poverty level you are eligible for subsidies that bring your premium costs down to an affordable level. That wasn’t the case pre-ACA. If you earn more than 400% of the poverty level you have enough income to pay for coverage, even if you have a poor health history, because your premiums won’t be be affected by that health history. That wasn’t the case pre-ACA.
Oh yes, it was much worse before Obamacare. Poor people had no chance. None whatsoever. Except for medicaid. But besides that, it was much worse. And those awful, affordable catastrophic plans, those were terrible. That’s why you got rid of them.
If we had let the free market do more than what was allowed, we would have affordable health care.
Many states only allow a few companies to compete so that the state bureaucrats can micro-manage them to death in the state capitol. There was never a true market for health care (at least after FDR). So don’t tell me that the situation before Obamacare was worse.
You keep forgetting that many people have lost their health insurance. In fact, several commenters have pointed it out. Funny how you forget that.
Why Jim do you mess up an entire economic sector, and, when you make it worse, you need to control it further?
You keep forgetting that many people have lost their health insurance.
They all have the option of getting new insurance, and it won’t cost more than an affordable fraction of their income. That wasn’t the case before the ACA.
“They all have the option of getting new insurance, and it won’t cost more than an affordable fraction of their income. ”
Lie.
We all know that is definitely NOT the case.
And that new more expensive insurance is far worse than the one they were happy with.
As Gregg says, a total lie.
What Jim must have meant, unless he is a liar, is that people may have lost their preferred insurance, but those people have an option to get new insurance with a higher premium and deductible. It’s a price to pay to cover about 10 million more people with insurance (not healthcare, because insurance isn’t care), while nearly 40 million people are still uninsured.
We all know that is definitely NOT the case.
In what way? There’s some fine print — you have to be a citizen, if you’re poor you have to live in a state that expanded Medicaid — but basically everyone can get affordable insurance now, where affordable means that it shouldn’t cost more than 9.5% of an individual’s income for coverage for that individual.
I used to be able to, but I can’t anymore.
Regardless of which option I choose (the coverage offered in my cancellation letter, through healthcare.gov, or through my employer), I will now be spending 20% of my net income in coverage for my family. I have yet to find any other options.
I don’t think my situation is terribly unique.
You didn’t even bother reading the links, did you?
I read them.
“It’s still unaffordable.
Compared to what?”
Compared to what? My old insurance plan for one.
“Under the ACA, if you’re poor (and live in a state that expanded Medicaid) then you can afford healthcare coverage. ”
Hold on there Gruber, the “you” in your sentence still can’t afford it. The costs of health care and the price of insurance did not drop allowing people to afford insurance. You want to hide the way things are paid for in order to gruber people into thinking that something is affordable.
This is the same type of dishonesty Obama fanatics have been using since Obamacare was passed. The very name, Affordable Care Ace is dishonest.
ace act whatever.
My old insurance plan for one.
Your old insurance may have been available and affordable to you, but it wasn’t available and affordable to everyone.
the “you” in your sentence still can’t afford it
What’s the cheapest Silver plan in your state, as a fraction of your gross income?
It is 16%. I am ineligible for the tax-credit/subsidy since my employer offers health insurance. During the last 7 years I have purchased my health insurance on the individual market, and the premiums have nearly tripled. Because of that, as well as the cancellation letter (Grandfather must have died) I received in October which offered an ACA compliant policy at a 40% increase, I was beginning to think that I would be compelled to resume purchasing insurance through my employer. However, the new 2015 employer premiums are such that an entire day’s pay of every week would go to pay the premium, so I am no longer certain of this. It appears that regardless of which option I choose, my premiums will now be no less than 15% of gross income, 20% of net income.
“Your old insurance may have been available and affordable to you, but it wasn’t available and affordable to everyone.”
He isn’t paying for everyone, he’s paying for himself! How can you even breathe, with you head shoved so far up an uncomfortable place?
And again you reveal your true intention. “You had a better plan than me, so I’m going to make you pay.”
That’s the philosophy of the left.
I am ineligible for the tax-credit/subsidy since my employer offers health insurance.
If the employer’s coverage for you as an individual costs you more than 9.5% of your income, it shouldn’t affect your eligibility for subsidies. Unfortunately that doesn’t help if you need coverage for an entire family, and the employer coverage is only affordable (under 9.5% of income) for the employee alone.
Which is precisely the situation in which I find myself. The individual plan through my employer is well under 9.5% of income, whereas the family plan is not. <sarc>I’m sure that my situation is unique though, and very few other people obtain coverage for a entire family through their employer.</sarc:> So, once again, in 2007, I had affordable coverage for my family, and in 2015, I do not. At what point will I see the annual savings of $2,500? Is it a $2,500 savings from what I paid pre-ACA, or from some point in the future? The correct answer, more likely, it that is just like the plan that I was (not) able to keep.
That definitely is an unfortunate situation. My preference would be to let employees with families be eligible for exchange subsidies whenever the employer family plan costs more than 9.5% of income. It would cost more to do that, but it would be in keeping with the law’s goals. Sadly, I think there’s very little chance of a GOP Congress making that change.
Perhaps they could make a change that will permit me to purchase the same plan I purchased in 2008 or 2009, at 1/3 the cost( 5% of my income, rather than 16%) of my current one?? That sounds like a reasonable solution to me. I realize that President Obama would never sign such a law, but I bet President Jindal would
Perhaps they could make a change that will permit me to purchase the same plan I purchased in 2008 or 2009, at 1/3 the cost( 5% of my income, rather than 16%) of my current one??
There are a number of reasons why your options today are more expensive as a percentage of income:
1) Inflation — if you’re like most people health insurance premiums have risen faster than income since 2008
2) Coverage — the ACA mandates more comprehensive coverage than many individual policies had (e.g. no annual or lifetime benefit caps), which costs more
3) Selectivity — before the ACA insurers could offer a lower premium to people who posed a lower risk of health costs, and higher premiums to people who posed a higher risk. Now they have to offer the same premium to everyone of a certain age, and there are limits to how much more they can charge older customers. If you were previously in the lower-risk category, this change increased your costs; if you were in the higher-risk category it reduced them.
A President Jindal (and an amenable Congress) couldn’t do much about 1), at least not in the short run. They could reverse the ACA changes in 2) and 3). Reversing 2) would give you the option of spending less money to get less coverage. Reversing 3) would give you cheaper options if you are in a low-risk category, and make your options even more expensive if you are in a high-risk category. Such a change would benefit those blessed with relatively good health, and punish those who are unlucky in their health risks.
You mean like those of us without a genetic predisposition for promiscuity, drinking or eating to excess, or those able to tolerate moderate amounts exercise? Not all health factors are out of my control, and some lifestyle choices (like eating salads) are ones I would rather not pursue, all things being equal. Now they are equal as I cannot be penalized for making unhealthy lifestyle choices, smoking being the sole exception. BBQ, cheeseburgers, tacos, and pizza, damn the carbohydrates, full speed ahead!!
If you earn up to 400% of the poverty level you are eligible for subsidies that bring your premium costs down to an affordable level.
So what?
ACA plans are already cutting back compensations to doctors and hospitals. Yeah, you pay for coverage, but your coverage is not paying your provider, so the providers won’t treat you. According to Matt Yglesias, it is because doctor’s in the US make too much money, and should get paid less. I wonder if reducing Doctor’s pay actually will encourage more people to become healthcare professionals. That seems to be the bet played.
But even if you take Matt Yglesias out of the equation, you can’t eliminate the obvious: Paying your premium is not the same as paying your doctor.
ACA plans are already cutting back compensations to doctors and hospitals.
So if you self-insure, and bargain-hunt your way to paying less for healthcare, that’s a triumph of the free market’s ability to control costs. But if your ACA insurer bargains for lower payments to doctors and hospitals, that’s bad news?
ACA doesn’t allow you to bargain hunt. And when the ACA denies you coverage based on age, which it does, then the government has developed a means to decide when a person has outlived its usefulness to society. This is called tyranny, and that seems to be the triumph progressives are excited to have made.
ACA doesn’t allow you to bargain hunt.
What do you mean? I have coverage through an ACA exchange and I’m allowed to comparison-shop between providers and bargain for lower prices.
And when the ACA denies you coverage based on age, which it does, then the government has developed a means to decide when a person has outlived its usefulness to society.
The ACA exchanges only deny you coverage based on age in the sense that once you’re 65 you have to get Medicare (which is free) instead. Where does this myth come from?
I have to agree with Jim, “The enemy of the good” would have been a much better name for this law. That was your point, right Jim? Because everything else was state shtuper B.S.
The only way to get costs down is consumer choices in real competition.
Actually, enemy, is the correct name for this new dem party.
The only way to get costs down is consumer choices in real competition.
Can you offer an example of a heath care system that does so? There are numerous counter-examples; basically every developed country other than the U.S. “gets costs down” by restricting choice and competition in health care insurance, delivery and/or pricing.
Sure. American dentistry, orthodonture, and vision care have all been pay for service, and have all (as opposed to all other subsidized medical care in the entire world) constantly decreased in cost.
As demonstrated by British teeth.
Rand, there’s nothing wrong with British teeth. I was in the UK recently, and saw plenty of teeth. The white ones looked just fine (perhaps due to spending so much time in a glass by the bed) and the natural (and thus multicolored) ones looked fine too (those are usually kept in jars rather than glasses) though they do need dusting on occasion.
🙂
You could add breast implants and nose jobs to that list. Markets are great at restraining the cost of elective products and services. But health care in general isn’t elective.
“Markets are great at restraining the cost of elective products and services. But health care in general isn’t elective.”
Lie.
We now know that people are putting off going to get health care because of the forced high deductibles of the Obama-cide, UnAffordable Care Act. That’s “elective”.
Why do you lie?
In Canada, dentistry and optometry are not covered by the Canada Health Act. There is no shortage of quality dental or optical care here. The wait time for emergency dental care is measured in minutes.
Car insurance.
Do you think that over regulation of the software industry will make you a better company? Do you think that only allowing your company to offer bronze, silver and gold programs will make you a better company? Do you think that forcing small tech companies to start working for larger companies because they can no longer afford to deal with the regulations good for the industry?
Nobody has to buy my software. People have to buy health care. Kenneth Arrow’s 1963 Uncertainty and the Welfare Economics of Medical Care is the place to start to understand why health care isn’t like most products.
Nobody has to buy health care, except in tyrannical governments.
And, you dodged the question.
“People have to buy health care.”
They didn’t HAVE to until the law was changed to FORCE them to do so. LIAR.
Actually, people are not buying health care. They are buying insurance that may or may not cover their health care. The government is forcing people to buy insurance.
” basically every developed country other than the U.S. “gets costs down” by restricting choice and competition in health care insurance, delivery and/or pricing.”
So, you are saying the critics of Obamacare were correct when they said Obamacare would lead to rationing, restricting choice, destroying the private health insurance market, reducing access, and price controls?
Places like the UK don’t lower costs by getting rid of competition among health insurers, they don’t have any to compete. They are not particularly good at lowering costs. The costs keep going up but services and access keep getting cut.
So, you are saying…
No, I’m saying that other countries control costs by restricting choice and competition. The ACA tries to use choice and competition between insurers to control costs.
They are not particularly good at lowering costs.
The UK spends half what we do, while covering everyone; by our standards their costs are very low.
“No, I’m saying that other countries control costs by restricting choice and competition. The ACA tries to use choice and competition between insurers to control costs.”
Lie.
As Gruber points out several times and as any sensible person can see if they use their heads, and as we have seen, there are NO cost controls other than death panels
And that’s a cost control we can live without.
. The Obama-cide Unaffordible Care Act raises prices, reduces care overall and generates nothing but misery.
The ACA is not affordable by any possible measure. It’s not affordable to the individuals; to taxpayers; to the economy, to the government.
But it was never meant to be.
It doesn’t improve health care for anyone. Poor people could always go to the emergency room (and did and are STILL doing in record numbers) . It destroys a great level of health care; research, development, incentive. People who work hard and pay their taxes now have worse health care at higher prices. Poor people get worse health care too because the system is generally worse, and is going to continue to degrade because hoospitals are closing, because doctors are rejecting taking medicaid patients, because free clinics are being forced to close, because those doctors who do take medicaid are now being flooded with patients, because poor people now have to drive farther to get their health care, and because, as we have amply seen, people are PUTTING OFF treatment because of the cost. That will only have a further cascading negative effect.
But it was never intended to improve health care for anyone.
ACA’s sole purpose was to drive us to single payer, socialized, government health care; to aggrandize government power and control; to massage the gargantuan egos of people like Polosi and Gruber and Obama and all the others who voted for it enthusiastically or took the bribes; people who think that the government could actually run something so complex and impossible to run. People who forgot that human beings don’t march in line.
It would have been cheaper, more effective, less destructive to the economy and CERTAINLY FAR less destructive to the 85% of people who had good plans and wanted them to just buy health insurance in some large risk pool set up by the government.
Of course that would have been the smart sensible thing to do. So of course the Democrat-Socialists and idiotic, onsie-wearing, cocoa sipping, bespeckled, State bum-kissers supporters of that monstrosity vehemently oppose it.
Wouldn’t do to be smart.
“ACA’s sole purpose was to drive us to single payer, socialized, government health care; to aggrandize government power and control”
That is true but it is also about getting them and their friends rich.
“It would have been cheaper, more effective, less destructive to the economy and CERTAINLY FAR less destructive to the 85% of people who had good plans and wanted them to just buy health insurance in some large risk pool set up by the government.”
When I wrote this, I should have added:
“……to just buy health insurance for people below the poverty line…”
“……to just buy health insurance for people below the poverty line…”
That’s one thing that the ACA does, in the form of Medicaid expansion, and the Supreme Court ruled that each state gets a veto on that provision. About half of the states have blocked it. Do you think they should allow it?
“That’s one thing that the ACA does, in the form of Medicaid expansion”
They why not just expans medicaid – which didn’t really need expansion – and be done with it. Why destroy a health care system that 85% of the people liked?
Why cause deterioration of the health care systems so that everyone – even the poor – get worse health care than they did before?
Why? Because the Obama-cide Unaffordable Uncaring Act isn’t about helping the poor, or making health care better or lowering costs.
It’s about power and control.
They why not just expans medicaid – which didn’t really need expansion – and be done with it.
In some states childless adults who are not disabled can not qualify for Medicaid, no matter how poor they are. Medicaid expansion was definitely necessary.
If you think that Medicaid expansion by itself would have better than all of the ACA, then ask your Congressman to repeal all of ACA except for the Medicaid expansion. I will be surprised if you find much GOP support for that position. The core of GOP opposition to Obamacare is opposition to taking money from relatively well-off people to pay for health coverage for people who are less well-off, and Medicaid expansion is a pure example of that.
It doesn’t improve health care for anyone. Poor people could always go to the emergency room
Having Medicaid is better than having to rely on the emergency room. The ACA definitely improved health care for poor people who now qualify for Medicaid.
“Having Medicaid is better than having to rely on the emergency room. The ACA definitely improved health care for poor people who now qualify for Medicaid.”
Lie.
People are delaying health care due to deductibles; free clinics are closing; people have to travel farther to get to health care because hospitals are closing – which is a bigger burden on the poor – doctirs are refusing medicaid patients causing massive overload on those that still do…
all because of the Obama-cide Unaffordable Uncare Act.
Why do you lie?
“Why do you lie?”
I have come to the conclusion that he has to lie. He HAS to. He has to keep saying the emperor’s clothes are exquisite. If any truth slips through there, his whole worldview will collapse like a house of cards. He’s chiefly lying to himself.
People are delaying health care due to deductibles
FYI, Medicaid typically does not have any deductibles.
people have to travel farther to get to health care because hospitals are closing – which is a bigger burden on the poor
Also FYI, Medicaid covers transportation to medical appointments.
Obamacare is so affordable that you need the federal government to pay for it.
Exactly — it’s affordable to the poor and near-poor precisely because the government makes up the difference. Saying that it’s only affordable because of the government’s role is missing the the point entirely.
Now as for whether it’s affordable for the country as a whole, that’s a separate question. The evidence so far is that it has, as it’s helped keep health care inflation to its lowest level in decades, and reduced projected future government medical spending by trillions.
” Saying that it’s only affordable because of the government’s role is missing the the point entirely.”
Saying it’s affordable is simply a lie.
“Exactly — it’s affordable to the poor and near-poor precisely because the government makes up the difference.”
And by “the government” Baghdad Jim means of course “the taxpayer.” Whom he has the right to force to financially support Obamacare because . . . ?
Yes, the taxpayer. Congress has the same right to force taxpayers to financially support Obamacare as it had to force 18th century taxpayers to pay whiskey taxes to reduce the national debt, and to force those taxpayers to pay taxes to financially support the army George Washington used to forcibly put down resistance to the whiskey tax.
In other wo0rds, BJ, (translating from the Statist), no right at all.
Your generosity with other people’s money has been well-established, along with your contempt for other people’s liberty,
So what you’re saying (and I know you cultists have trouble with the whole logic thing, BJ, but see if you can stay with me on this one) is that because Congress imposed a tax on A for one reason, centuries ago, that gives you the right to take money from B (by proxy, through the thieves you elect using their goon squad in the IRS) for whatever reason you want, centures later? Even for you that’s pretty thin reasoning.
Either Congress has the right to levy taxes, and force citizens to pay them, or it doesn’t. If Congress had the right to levy taxes in the 1790s, it has that right today — the Constitution that governs Congress’s powers hasn’t been amended to remove that power.
Either Congress has the right to levy taxes, and force citizens to pay them, or it doesn’t.
Congress doesn’t have the right to levy taxes because it doesn’t have any rights. Rights are things that individuals have as protection from the federal and state governments. Please learn the distinction between “rights” and “powers”.
Second, the power of Congress to levy taxes and force citizens to pay them is substantially limited. My view is that Obamacare’s individual mandate remains unconstitutional in this respect.
Uh Oh…new lies will have to be generated. Clearly the old claims about expanding coverage for the poor vi aMedicaid have been exposed as viscious lies – and by the New York Times. Notice the very first sentence:
“……to get even worse”
That means they suck to start with. Which explodes the lies we’ve been hearing:
The Grey Lady Deflates the Medicaid Expansion
Even the New York Times has started to notice that Medicaid’s access problems are about to get even worse. Robert Pear reports on the imminent expiration of the Affordable Care Act’s temporary Medicaid payment increase. Though the ACA provided federal money to reimburse for Medicaid patients at the same rate as Medicare, that provision stops on Thursday. In may states, that expiration is going to be extremely disruptive:
The impact will vary by state, but a study by the Urban Institute, a nonpartisan research organization, estimates that doctors who have been receiving the enhanced payments will see their fees for primary care cut by 43 percent, on average.
Stephen Zuckerman, a health economist at the Urban Institute and co-author of the report, said Medicaid payments for primary care services could drop by 50 percent or more in California, Florida, New York and Pennsylvania, among other states.
What this means is that Medicaid reimbursement rates will plummet just as the program is adding many new people to its rolls—9.7 million, as a matter of fact. Doctors will close their doors to Medicaid patients in favor of people with better insurance, and the Medicaid expansion, a center-piece of the ACA, will in practice mean little to those patients who face serious access problems. With even the New York Times noting this, the Obama administration and ACA supporters should no longer be able to get away with sweeping the access question under the rug.
http://www.the-american-interest.com/2014/12/31/the-grey-lady-deflates-the-medicaid-expansion/
Let me repeat for the lying liars:
“…Medicaid expansion, a center-piece of the ACA, will in practice mean little to those patients who face serious access problems.”
Notice the states mentioned that will be affected:
“…………..California, Florida, New York and Pennsylvania,.”
California- the bluest of the blue……..and holder of massive amounts of electoral votes….
Ditto New York……..
Ditto Florida……..
And while Pennsylvania isn’t totally blue, it’s a key state in any national election.
Obamacare temporarily increased Medicaid provider reimbursements, and that temporary increase is ending. A permanent increase would be good for the poor who rely on Medicaid, but a temporary increase was better than nothing.
Note that thanks to the GOP, poor citizens in half the country got no benefit from the temporary reimbursement bump because their states refused to accept Medicaid expansion. And now Republicans cry crocodile tears over the expiration of a small part of a benefit that they blocked — and continue to block — their constituents from ever receiving.
Note that thanks to the GOP, poor citizens in half the country got no benefit from the temporary reimbursement bump because their states refused to accept Medicaid expansion.
Those states realized that the federal government subsidies were only temporary, and they are. As for not getting the federal subsidies at all, that was the carrot that the Democrats put into the ACA to get both their Representatives to vote for it and later some states to accept it at all. Otherwise, the majority then, and particularly now, realized that ACA was just a shifting of the money, and as stated in the OP was never affordable at all.
“Those states realized that the federal government subsidies were only temporary, and they are.”
Exactly. Not only that the States themselves woudl be FORCED to make up the difference.
Smart not to take that money.
Stupid for Jim to bring that up.
Those states realized that the federal government subsidies were only temporary, and they are.
It’s true that the federal contribution to Medicaid expansion starts at 100% and eventually drops to 90%. That will still be a great deal for states (i.e. a lot of federal money flowing to doctors and clinics and hospitals, generating tax revenue and paying for some care that otherwise wouldn’t be compensated), even aside from the fact that it’s a compassionate thing to do for their poor, uninsured citizens.
As for not getting the federal subsidies at all, that was the carrot that the Democrats put into the ACA
No, the ACA as written said that states had to accept Medicaid expansion as a condition of participating in Medicaid at all (i.e. states that did not want to expand Medicaid would have to opt out of Medicaid entirely). The Supreme Court intervened to sever Medicaid expansion from “Medicaid Classic”, giving states the option of turning down Medicaid expansion (where the feds pay 90+% of the cost) but keeping traditional Medicaid (where the feds pay about half the cost). About half of the states have taken that option, basically as a reflex action against all things Obama.
Um Jim, the Gruber tape already came out stating exactly what I wrote, that the subsidies were only a carrot.
The Gruber tape you are referring to was about state exchanges, not Medicaid expansion. And Gruber was wrong — the record does not include a single instance of a state legislator or governor arguing for or against establishing a state exchange due to a perceived linkage to eligibility for subsidies. A “carrot” that is completely unknown to both the drafters of the law and the state governments who were supposedly to be lured by it, is no carrot at all.
“Obamacare temporarily increased Medicaid provider reimbursements, and that temporary increase is ending. A permanent increase would be good for the poor who rely on Medicaid, but a temporary increase was better than nothing.”
A more accurate way to put that woudl be:
First you suck people in and then you F%#K them over
” That will still be a great deal for states”
it is not a great deal for the States, for the poor, for the people who used to have insurance…
not for anyone.
For all the reasons listed and more.
To bray on how wonderful it is, is to display an utter lack of connection to reality.
GOP has not one fingerprint on this monstrosity and rightly so. So every time you write about how the GOP gets in the way of it, avoids it, blocks it, you are celebrating right thinking.
Of course the GOP tries to block and undermine the Obama-cide Unaffordable Uncaring Act – in the same way, and for the same reasons, they would block and undermine shooting 5 billion people to solve world hunger.
“Either Congress has the right to levy taxes, and force citizens to pay them, or it doesn’t. If Congress had the right to levy taxes in the 1790s, it has that right today — the Constitution that governs Congress’s powers hasn’t been amended to remove that power.”
One more time (and as I said before I know you cultists have trouble with logic but stay with me): because Congress has the [legal] right to levy taxes, that gives you and your gang (via the thieves you elect and your IRS goons) to plunder at will?
because Congress has the [legal] right to levy taxes, that gives you and your gang (via the thieves you elect and your IRS goons) to plunder at will?
The ACA (including its taxes) wasn’t passed by me, it was passed by Congress. It doesn’t “plunder at will” any more than the 1791 tax on distilled spirits did. If Congress didn’t have the right to pass the ACA, it didn’t have the right to pass the 1791 tax, and every other federal tax since then. Your view seems to be that Congress doesn’t have the right to levy taxes that you oppose. That was the opinion of the Whiskey Rebellion leaders as well.
The ACA (including its taxes) wasn’t passed by me, it was passed by Congress.
No previous such sweeping legislation in the history of the Republic has ever been passed by such a combination of chicanery and a single party. Which is one of the objections that many have to it. It’s barely legitimate as a law.
No previous such sweeping legislation in the history of the Republic has ever been passed by such a combination of chicanery and a single party.
As for chicanery, you must be joking. Lincoln wasn’t an exaggeration — for much of the history of the Republic major legislation was routinely passed with generous helpings of explicit bribery. The ACA political process was if anything cleaner than, say, the passage of Medicare Part D.
As for a single party, there is nothing in the Constitution that requires bipartisan support for legislation. If the GOP passed a law that you liked without any Democratic votes there is no way you would question its legitimacy.
It’s barely legitimate as a law.
The ACA is legitimate, period.
Its repeal will be more so.
So you already know that a law that might hypothetically be passed at some point in the future, in some manner that we can’t yet predict, will be more legitimate than the ACA? I think you just proved that your opinion on the legitimacy of the legislative process that produces a law is merely a reflection of your opinion on the law’s content. Laws that you are like are, by definition, more legitimate than laws that you don’t like. Cynicism about representative government doesn’t get much purer than that.
So you already know that a law that might hypothetically be passed at some point in the future, in some manner that we can’t yet predict, will be more legitimate than the ACA?
Yes, because unlike the ACA, it will almost certainly be bipartisan.
There is nothing illegitimate about a party-line vote. I predict that if repeal (or any other law) passes without any Democratic votes you’ll consider it 100% legitimate.
I’ll consider it much more legitimate, since (unlike when it passed) it’s what polls indicate the people actually want to happen.
Polling does not show majority support for repeal. But it doesn’t matter — you would never consider a law that you support to be illegitimate simply because of polls. That’d be like you considering George W. Bush illegitimate simply because he lost the popular vote.
Presidents are not supposed to be elected by popular vote.
Another example of how government knuckleheads have neither the brains nor enough information to make rational decisions about something as large as Health Care.
What’s more this was predicted and has come to pass:
Article Number one:
Since Obamacare, L.A. County ER visits show hospitals in ‘state of flux’
“Data hospitals report to the state show that as insurance coverage was extended to hundreds of thousands of residents, ER visits for ailments not serious enough to require an admission grew 3.9% in the county in the first half of 2014, compared with the same period the previous year. The growth is in line with annual increases of 3% to 5% in the three years prior to the federal healthcare overhaul.”
Who could have imagined?!?!?!?!
Article Number Two:
Dilemma over deductibles: Costs crippling middle class
“Patients with job-based plans, he says, will say: ” ‘My deductible is so high. I’m trying to come to the doctor as little as possible. … What is the minimum I can get done?’ They’re really worried about cost.”
It’s a deep and common concern across the USA, where employer plans cover 60% of working-age Americans, or about 150 million people. Coverage long considered the gold standard of health insurance now often requires workers to pay so much out-of-pocket that many feel they must skip doctor visits, put off medical procedures, avoid filling prescriptions and ration pills — much as the uninsured have done.”
The portion of workers with annual deductibles — what consumers must pay before insurance kicks in — rose from 55% eight years ago to 80% today, according to research by the Kaiser Family Foundation. And a Mercer study showed that 2014 saw the largest one-year increase in enrollment in “high-deductible plans” — from 18% to 23% of all covered employees.
Meanwhile the size of the average deductible more than doubled in eight years, from $584 to $1,217 for individual coverage. Add to this co-pays, co-insurance and the price of drugs or procedures not covered by plans — and it’s all too much for many Americans.
The growth is in line with annual increases of 3% to 5% in the three years prior to the federal healthcare overhaul.
So the ACA hasn’t changed the growth rate of ER visits in one county. That’s something that “was predicted and has come to pass”?
the size of the average deductible more than doubled in eight years
Yes, it’s a trend that predates Obamacare. You’d think that Republicans, who want health care consumers to have more “skin in the game” to discourage frivolous health care consumption, and incentivize bargain-hunting and comparison shopping, spurring the market to deliver more cost-effective health care products and services, would be thrilled by this.
“So the ACA hasn’t changed the growth rate of ER visits in one county. That’s something that “was predicted and has come to pass”?”
YOU predicted that OUUA was going to reduce ER visits. You said it was a major goal of the bill (along with Obama, Pelosi, Reid and the rest of the imbeciles.
YOU were (and continue to be) wrong.
WE predicted rising rates/deductibles: True
WE predicted worsening health care: True
And this is just one of the ways it got worse.
“You’d think that Republicans, who want health care consumers to have more “skin in the game” to discourage frivolous health care consumption, and incentivize bargain-hunting and comparison shopping, spurring the market to deliver more cost-effective health care products and services, would be thrilled by this.”
If that’s what you think Conservatives (Republican != Conservaitve necessarily) want you are hallucinating.
YOU predicted that OUUA was going to reduce ER visits. You said it was a major goal of the bill (along with Obama, Pelosi, Reid and the rest of the imbeciles.
The ACA wasn’t meant to reduce overall ER utilization, it was meant to reduce the use of the ER by the uninsured as the uncompensated healthcare provider of only resort. Given that the ACA has already reduced the number of uninsured by 10 million or so, it seems to be making good progress in that direction. If you have statistics that ERs are providing as much uncompensated care as before the ACA, particularly in states like CA where Medicaid was expanded, by all means share it.
“You’d think that Republicans, who want health care consumers to have more “skin in the game” to discourage frivolous health care consumption, and incentivize bargain-hunting and comparison shopping, spurring the market to deliver more cost-effective health care products and services, would be thrilled by this.”
You seem to have REAL trouble with the simplest of concepts. I’ll try to help you out one more time:
It is not a good idea to solve world hunger by shooting 5 billion people in the head.
So in the “We Told You Government Cannot Run Something This Complex” category we now have:
Millions of Obamacare subsidy recipients may need to pay back-taxes.
The problem for Democrats is not exactly this: “As many as 3.4 million people who received Obamacare subsidies may owe refunds to the federal government, according to an estimate by a tax preparation firm… H&R Block is estimating that as many as half of the 6.8 million people who received insurance premium subsidies under the Affordable Care Act benefited from subsidies that were too large, the Wall Street Journal reported Thursday.” Although it’s definitely going to be a problem: ‘several million people suddenly discovering that they now owe back taxes to the government over Obamacare’ is not exactly a good scenario, especially if you belong to the political party that set that scenario up in the first place. But it’s still not the worst thing for Democrats.
No, the problem for Democrats here is that this is going to happen every year. The system is more or less designed to assume that people would twiddle with their coverage on a regular basis: as plans changed, improved, or degraded the consumer would be obligated to follow suit, in order to keep the subsidy. This sounds perfectly reasonable… if you’re not the one doing it. But out in the real world? Well, I’ve written about this before:
April, 2014: “The uncertainty is really the killer. And, bizarrely, it’s about the only thing that’s reliable about Obamacare. There’s no way to plan around this monstrosity of a health care rationing system. Nobody is really certain that they’re not going to end up being smacked around by the new rules. And it would be better in a lot of ways if the law was even worse, as long as it was consistently worse. An inconsistent, unpredictable law is more or less guaranteed to become an object of fear.”
May, 2014: “The administration, in its boundless wisdom, decided to handle [the government’s inability to calculate subsidies in real-time] by simply estimating the subsidy in problem cases. If it’s too low, they’ll probably cut the applicant a check or give a tax credit. Eventually. Probably before the end of the decade. But if the subsidy is too high… well, the government is going to need that tax money immediately… This is where you distinguish the wonks from the politicos, by the way. The former won’t understand why the latter are wincing at the situation, and the latter will wonder how on earth the former manage to go through life without a keeper.”
November, 2014: “Health insurance is scary because being sick is scary, and people do not like to think about scary things. So when they have a policy that they like, they want to keep it because then they can stop thinking about the scary thing. This is, by the way, not a silly or unreasonable desire to have, much to the disgust of Obamacare’s more sociopathic boosters: people should be allowed quiet enjoyment of their lives whenever possible. Unfortunately, nobody told the Democratic party leadership that.”
Nothing about any of this has changed since then. The basic problem still remains: the way that health care subsidies are calculated and implemented is as fundamentally messed up as the rest of Obamacare is*. Possibly the Democrats should hope that Halbig v. Burwell gets decided against the administration. It’d represent the Left’s last chance to get the law back into Congress for any kind of repair. That ‘repair’ would also involve substantial ‘gutting’ is… a reminder that actions have consequences. Think of it as a teachable moment! My kids love to hear that one**.
the Constitution that governs Congress’s powers hasn’t been amended to remove that power.
Remove? No. Expand? Yes.
Repeal the 16th.