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In State Health Care Markets, Results May Vary

States are readying their rollout of Obamacare. We’ll check in across the country.

The state of Oregon is one state putting its full resources behind their health care exchange. The Cover Oregon campaign will have spent $2.9 million in outreach efforts. (CoverOregon)

The state of Oregon is one state putting its full resources behind their health care exchange. The Cover Oregon campaign will have spent $2.9 million in outreach efforts by the Oct. 1 roll out of the state exchange. (CoverOregon)

With day one of Obamacare fast approaching and the debt ceiling hanging in the balance, states are facing choices. Oregon is using folksy music to promote its new health insurance exchange. Washington state has ads about snowboarding. In Florida and Missouri, lawmakers are regulating who can and cannot answer questions about signing up for new coverage. This hour, On Point: States and Obamacare’s implementation.

Guests

Noam Levey, national healthcare reporter at the Los Angeles Times‘ Washington Bureau. (@NoamLevey)

Jenny Gold, health care reporter for Kaiser Health News in Washington. (@JennyAGold)

Ryan Barker, Vice President of health policy at the Missouri Foundation for Health. (@CoverMissouri)

Michael Marchand, director of communications at the Washington (State) Health Benefit Exchange. (@MMNextSteps)

From The Reading List

Kaiser Health News: Navigators Say GOP Lawmakers’ Information Requests are ‘Shocking’ — “Organizations that received the latest round of health law navigator grants say last week’s letter from House Republicans could have a chilling effect on efforts to hire and train outreach workers to sign up Americans for health insurance by Oct. 1the opening day for  new online insurance marketplaces. The letters were signed by 15 Republican members of the House Energy and Commerce Committee and requested that the organizations provide extensive new documents about their participation in the program and schedule a congressional briefing by Sept. 13.  The letters went out to 51 organizations–including hospitals, universities, Indian tribes, patient advocacy groups and food banks—out of 104 that shared $67 million in grants.”

Los Angeles Times: As Healthcare Law Rolls Out, Its Effects Will Depend on Your State — “As President Obama’s healthcare law rolls out next month, even supporters acknowledge there will be problems. But Americans who live in states backing the Affordable Care Actwill receive substantial protections and assistance unavailable to residents in states still fighting the 2010 law. That could mean confusion and higher insurance premiums for millions of consumers in states resisting the law. Leaders in these resistant states have not set up consumer hot lines. Several state insurance regulators are refusing to make sure health plans offer new protections required by the law, such as guaranteed coverage for people who are ill. In response to the law, Florida suspended its authority to review how much insurance companies charge consumers.”

The Atlantic: No, Obamacare Isn’t The Reason Emory is Laying Off 101 Staffers – “What’s happening? Reports about 101 layoffs at Emory are circulating widely in conservative media, including the Drudge Report and The Weekly Standard. A local Atlanta TV station, WSB, confirmed the layoffs with an Emory Healthcare spokesman. “Emory Healthcare to cut 100 jobs partly because of Obamacare,” the station reported Friday, tipped off by a disgruntled employee who described a presentation where employees heard the news. ‘The saddest part,’ the employee wrote the station, ‘is when during the announcement we were told our job loss is due to the new affordable healthcare plan.’ But the real story behind Emory’s layoffs is more complex than what WSB reported, and doesn’t really fit into the Obamacare debate. It’s really about the changing practice of psychiatry.”

 

 

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  • Matt MC

    I hope you talk a little about what happens when states like mine (Wisconsin), who didn’t set-up their own exchanges, have to use the federal healthcare site instead. Does it have all of the same features? How does it compare to say, California or New York’s sites? If they can just do it on the federal site, why even have the states do their own?

    • Shag_Wevera

      I’m glad our bone-head governor didn’t set one up. I’m sure it would have been a joke meant to sabotage the Affordable Care Act.

      • TFRX

        (Which bonehead governor is yours? I sorta forget.)

        • Matt MC

          Scott Walker

  • Shag_Wevera

    Letting the states set up their own markets was a mistake. Imagine the differences between states run by redneck hillbilly governors and those run by pinko lefty governors. A mish-mosh quilt of inconsistency at best. We’re idiots in this country.

    • jefe68

      I would use the term cut off our noses to spite our faces.

      We can’t get anything done in this country due to the political extremism on the right. Of course the tea party would say it’s the left, but lets get real here.

      They are very extreme and the nation as a whole is more center right/left. When you have the Chamber of Commerce asking the tea party caucus to reconsider shutting down the government as a threat to the Democrats and President Obama you know that they are extremist.

      Lets be clear here, the extremist in the GOP held congress are holding the nation hostage for their regressive agenda. They are a minority and yet they have taken over the GOP. House Speaker John Boehner can’t control them. So the result is dysfunctional government.

      Which is what the tea party wants. You can’t govern with out compromise and horse trading. The tea party congressional caucus is not interested in compromise, just anarchy.

      • John Cedar

        Using every metric you use to mislabel today’s Tea Party and GOP members as extremists, to be consistent, you would need to label JFK as the same.

        Extremism is borrowing 17 trillion dollars in order to give free no co-pay birth control pills to 30 yo perpetual ivy league college students.

        The government does not “shut down” if the borrowing stops. There is still several trillion in revenue coming in every year without the foolish borrowing.

        Our founding fathers purposely made it difficult for your mob rule party to mob rule us and you lament that fact and point fingers at the vocal slightly less than majority.. Be careful what you wish for.

        • jefe68

          Oh please. The birth control meme.
          JKF is an extremist? The tea party is a kin to the John Birch Society and Barry Goldwater. By your definitions here I guess Eisenhower is a liberal and Nixon is just shy of being one. Neither of them could be nominated with the litmus test the regressive tea party holds to candidates.

          • Don_B1

            Actually, Senator Jesse Helms (NC, R) is the role model for the modern Republican Party used the motto, “Senator No.” His adamant refusal to fund the State Department has led to its chronic underfunding (which Sec. of State Madeline Albright had to coax him to partially relent on) has led to an inflated presence of the military (DoD) at embassies and in diplomatic missions everywhere. How much that has cost in the lack of preparedness at various embassies may never be known.

            And then there is the blatant racism of the Senator, as written about by David Broder in 2001 after Senator Helms announced his retirement from the Senate:

            http://articles.washingtonpost.com/2008-07-07/opinions/36889443_1_jesse-helms-conservatives-massachusetts-governor-william-weld

            all of which Republicans such as Senator Ted Cruz (TX,R) are bringing out as their dominate values. Has anyone noticed a lot of even “moderate” Republicans, even one, denounce this?

          • jefe68

            The thing is Helms would play ball if his arm was twisted enough. Cruz is more right wing than Helms in this regard.
            Are there any moderates left in the GOP?
            I heard an interview with Bob Dole and he was going on about this issue. I never considered Bob Dole a moderate, but by the standards of todays GOP he is.

          • Don_B1

            I agree with each point you make. It is possible that Senator Helms would allow his goal to be “adjusted” by an earmark or two, whereas Senator Cruz certainly would not, even if they were still available.

    • John Cedar

      While I cannot argue with your closing self assessment, you might be interested in how Canada does healthcare…by the province rather than with one massive centralized dictator.

      • jefe68

        Dictator? So when Bush was president was he a dictator too?

        • Ray in VT

          Of course not. He was a Republican.

      • Don_B1

        When each state sets up its own exchanges, with the only requirement from the Federal government that the policies should provide certain minimum coverages, so that insureds will not be led to purchase worthless policies, I don’t see any “massive centralized dictator.”

  • Leonard Bast

    Thank God I live in Vermont.

    • northeaster17

      I moved just over the western border 11 years ago. I may be back

      • Ray in VT

        To New York? Blech!

        • thequietkid10

          What’s so wrong with New York?

          • Ray in VT

            It blows.

          • thequietkid10

            It does, especially outside of New York City. Oddly enough it’s also one of the most solidly liberal states in the nation.

          • TFRX

            It’s not so odd if one considers where the bulk of the people live, is it?

            The upstate people who come from where the NYC resentment lives are outsizedly represented in Albany.

          • Ray in VT

            Yeah, but the red states are even worse toilets. I have my issues with New York, but I’d take it any day over some place where they’re trying to outlaw abortion, put religion in the science class or shift the tax burden onto the poor.

          • sickofthechit

            What’s science class?

          • Ray in VT

            It’s where you go to get the liberal propaganda that contradicts the real facts of natural history as revealed in the Bible.

          • northeaster17

            Its about the mountain lakes and rivers for me.

          • Ray in VT

            You can have ‘em. I’m a land lubber myself. I saw a good sized moose in the road as I rode my bike into work today. I just had to wait for it to wander off before I could continue along.

          • northeaster17

            Slowly they are returning to the ADK’s

          • hennorama

            Champlain’s pretty nice, too.

          • Ray in VT

            Yeah, but that’s Vermont’s lake.

          • hennorama

            More than a few Empire Staters and Québécois disagree.

          • Ray in VT

            My position has always been that the islands, at least the principal ones are Vermont’s so so is the Lake. I’m mostly joking on this one in case you didn’t know.

          • hennorama

            Ray in VT — yes, the “flavor” came through.

            Mostly. ;-)

          • http://neilblanchard.blogspot.com/ Neil Blanchard

            It doesn’t have single payer!

          • Don_B1

            Governor Shumlin and the state legislature are working on just that as you post!

            I believe that a form of single payer is scheduled to begin in a year or two.

          • sickofthechit

            New Yorkers think everyone should love it?

    • Don_B1

      My understanding is that you will be able to have a public option within a year or so. It should work nicely and I hope things work out.

  • northeaster17

    Slowly we move towards single payer and away from the rigged uncompetitive system that strangles business and so many who need care. The fight is not over.

    • Don_B1

      I listened to “Innovation Hub” on WGBH (driving and out of range of WBUR) and had a good introduction to what will be necessary to complete the transition of the current health care system to one which will remain affordable. You can listen to the program this Saturday 21 September at 10 a.m.:

      http://wgbhnews.org/programs/innovation-hub

      It is also available as a podcast which would make it available at your convenience.

  • thequietkid10

    The way I see it we have four endgame options

    1. The GOP successfully defunds Obamacare. The Democrats run on a platform of “of course Obamacare isn’t working the Republicans aren’t funding it.” The republicans get crushed and the size and scope of government continues to expand, and we face more budget problems down the road (especially in 50-75 years when our populations totals start declining. (aka Nightmare Scenario A)

    2. The GOP doesn’t defund Obamacare, the voters still reject it because of some combination of their premiums go up/Health care spending as a percentage of GDP goes up/they don’t like the product they are paying for.

    3. The GOP doesn’t defund Obamacare, cost of health care goes down, we all live happily ever after, at least for a little until it is inevitably expanded into or becomes a boondoggle.

    4. Nightmare scenario #2, Voters accept Obamacare, but the cost of health care keeps going up and up, now the Democrats can milk the rich for as much as they can get. And we never get back to Pre-Obama levels of employment and maybe even growth.

    • northeaster17

      Your silent premise that the Republicans actually would shrink government has been proved wrong many times

      • Ray in VT

        But look how they cut spending and shrank government in the early 2000s when they ran the whole show.

        • sickofthechit

          huh? oh, sarcasm! nice.

        • thequietkid10

          True…..but consider the alternative.

          • Ray in VT

            I’ve often dreamed of what we could have maybe avoided if we had made better decisions.

      • thequietkid10

        Your right, the GOP has a few true believers and a lot of lip service, still better then what the Democrats are offering. At least I can dream that say President Paul might actually do something. Short of that, our condition is terminal, it’s only a matter of time.

    • Jasoturner

      I think the ideal solution is that we accept a class of Americans who can go bankrupt if they get sick because healthcare is unaffordable to them. That also keeps my premiums down and results in less crowded communities. America! We were number one before the crazy liberals showed up, and we will be again!

      • Don_B1

        When a large portion of Walmart workers and even soldiers are at or below the poverty line, so that they qualify for food stamps, how do you expect a disaster in the family to not make bankruptcy the result?

        Less crowded communities? Do you really think that unnecessary deaths and the resulting family disaster something average Americans will allow?

        That level or mean-spiritedness and greed is usually only expressed by the wealthy.

        • Jasoturner

          I was being sarcastic…

  • John Cedar

    “With day one of Obamacare fast approaching”? What planet do you live on? We’ve been getting screwed by Obamcare for a few years now.

    LA Times…”resistance is futile”. “as Obama’s healthcare law rolls out next month”.

    Another writer hitting the crack pipe.

    The Atlantic…”these layoffs are just a co-wink-a-dink and have nothing to do with Obamcare”

  • MadMarkTheCodeWarrior

    As this society unravels and life becomes more challenging for everyone as a whole except the 1%, the right bemoans our economic malaise while defending low taxes on the wealthy and drives towards a smaller government; neither of which were present with our economic rise in the last history. Even Mitt Romney argued that some of universal healthcare was necessary to reduce overall costs. The right has only themselves to blame for this messy compromise as they opposed anything proposed, even when it originally came out of their thought leadership.

    • thequietkid10

      Government spending as a percentage of GDP has only been higher once in our history, WW2 and we are coming up fast on that amount. Not sure were you are getting this “small government” idea from.

      • MadMarkTheCodeWarrior

        Hmmmm lemme see. Here are three three letter acronyms: TSA, NSA and DoD. The increase in gov by the TSA is huge in number of employees. Who was behind that growth? So we payed off a whole bunch of people who fight crime, tax evasion, safety violations… to be replaced by TSA employees. Then there’s the black hole of NSA funding, then there’s our massive DOD budget… All to protect people do they can live as long as they don’t need life saving healthcare.

      • Don_B1

        The “percentage” term you are considering has both a numerator and denominator. The numerator is higher than it might be if, the economy had recovered rapidly as it might have given that the government had spent a bit more so that more of the lost consumer spending and consequent lost business spending had been temporarily replaced to create the necessary aggregate demand for a stronger recovery.

        The denominator is nearly $1 trillion below what it would be if that recovery had been stronger as it could have been with a bit more government spending, which would have meant more revenue for the government and a smaller deficit even with the added spending.

  • Markus6

    Let’s remember a bit of history. This was a monstrous piece of legislation of thousands of pages with almost no mechanisms in place to reduce costs and a bunch of sweetheart deals for senators who refused to sign up without gifts to their state. It will cost a gazillion extra dollars as the CBO pointed out in the details (that surprisingly few read), because we’re paying for it years before the implementation costs are incurred. Although some were surprisingly bright to see that when the government has to support tens of millions (40 mill sticks in my mine) of people with health care insurance that they didn’t have to before, there might be an additional cost. And finally, it will give an inept government bureaucracy greater control over what care you get.

    So, it will be an expensive mess with degraded service. Of course, the existing system is a mess too and getting unsupportable.

    Single payer will also be a mess, but my guess it’s the smallest mess of all.

    Not to take us too much off point, but it’s a little like people who put Obama stickers on their cars last election. I can see voting for him, as incompetent as he has been, cause you don’t like the other guy. I just don’t understand advertising this on your car. So, I can see being for ACA or single payer. It’s just hard to understand people who do it so enthusiastically.

    • thequietkid10

      I think you are assuming that the old system was some kind of a free market wild west situation and ergo capitalism won’t work here. (like it works for everything else)

      • northeaster17

        The old system was in no way capitalism

        • Kathy

          Well it was capitalism, what it wasn’t was a free market. It’s easy to have a free market when the choice is between no tv, a 30″ tv or a 60″ tv. It’s not possible to have a free market when the option to not pay the price is to die.

          • thequietkid10

            You mean like food?

          • Don_B1

            She more likely means going to the emergency room when you have a medical emergency.

            The patient has no choice in going or not going when there is a fixed price and there are no alternatives.

            This situation in healthcare is not unique to going to the emergency room either. Many insurance plans and/or doctors work only with certain hospitals, etc., limiting the choices, usually to just one.

          • northeaster17

            Or when your choices for insurance are pretty much limited to what your employer offers you.

      • jefe68

        You think what we now have for a health care system is working? We a have fee for service system that is broken. We have(had) an insurance market that denied people with pre-existing conditions, that in some cases meant allergies, or getting cancer from getting coverage. We have insurance policies that are absurd in that they use high deductibles. Which is useless really.

        The market based fee for service health system is broken. It’s a mess that should have been done away with decades ago.

        The ACA is nothing short of a ban-aid on being put on a gaping wound that we call health care in this country. It’s shameful that the richest nation on the planet cannot or outright refuses to have decent not-for profit single payer based system.

        • thequietkid10

          You think what we have for a health care system is free market capitalism? (before or after Obamacare)

        • sickofthechit

          My idea is to lower the eligibility age for Medicare by one, two or three years each year until everyone is covered at birth. Be a nice level of transition and in the meantime cover everyone with “Wellness Care”. charles a. bowsher

          • jefe68

            I think it would be easer to implement a single payer system for all with the option to buy supplemental insurance that is regulated and not for profit. Which is what they have in Switzerland.

          • TFRX

            And there’s a slogan too: “Medicare for all.”

            The policy part sounds good. The politics part? I’d love to see the right thread the needle between the Medicare that its DDSers (Demographic Death Spiralers) enjoy and depend on, and the idea that everyone would benefit from it.

          • jefe68

            The extremist on the right need to be marginalized if they don’t want to help solve this mess we call a health care system. Sorry, but I’ve had it up to my ear lobes with the rhetoric and scare memes.
            Enough is enough. We need to have an adult conversation about how to fix our dysfunctional health care system or it’s going to we are going to start seeing some real serious financial and health problems that will dwarf what we have now.

            Even Nixon was interested in the idea of a single payer system.

      • Kathy

        There is no “old system” really. It’s the exact same system, just with some common sense limits and exchanges to make it easier to compare costs and benefits.

    • northeaster17

      If the other party had offered any kind of vision for health care in this country other than the staus quo and death panels, things may have been different. By abdicating any and all responsibilty to fix what is widely seen as a problem they are left on the outside looking in. As they try for the 43rd time to over turn a flawed law that is actually moving in the right direction.

      • jimino

        The ACA is essentially what that party supported until the other party did.

        • TFRX

          Did you hear Bill Maher’s latest term for that GOP reaction?

          • http://neilblanchard.blogspot.com/ Neil Blanchard

            No, I’ve not heard it – do tell!

          • TFRX

            It’s here.

          • hennorama

            Voila:

    • sickofthechit

      At least acknowledge that the inclusion of the 20% overhead limit on insurance company expenses
      was a good thing.

  • J__o__h__n

    Please rotate the guest hosts.

    • hennorama

      But won’t that result in weird Doppler effects on the microphone?

      (Plus the guest host(s) might fall off the chair due to equilibrioception issues.)

      • TFRX

        Let’s just rotate the microphone, then.

        • hennorama

          TFRX — I suppose they could overcome the “windage” noise with a filter/baffle.

          But doesn’t rotating guest hosts also result in circular reasoning? We have enough of that in here already, methinks.

      • Shag_Wevera

        Bwa ha ha ha!!!

  • AC

    who cares what the US chamber of commerce says? they’re not a government office, they’re a lobby group – why do people think otherwise?

  • TFRX

    “There should be no conversation about shutting the government down.”

    That’s true, but in exactly the opposite way Boehner said it.

    I’m just imagining the absolute media crapstorm we’d have been subjected to if a Tip ONeill tried this fake crisis crap. (And the media respected ONeill. Imagine a Jim Wright doing that.)

  • Michiganjf

    Why not OUT all these Republican HYPOCRITES in Red State Governerships and Congresses, who want all the money and coverage from the AFA in their private machinations, but denounce the AFA publicly to appease their fanatical base?

    • Ray in VT

      What? Hypocritical? Like the small government red states that take way more from the big guv’ment that they hate than they contribute?

      • jimino

        So the obvious answer to a Congressional refusal to honor already incurred obligations is to stop payments of those obligations in those districts whose members advocate and vote for this result. They owe the rest of us anyway, as you point out.

        Give the teabaggers and their representatives what they want and see how happy they are with the results. That’s how a true market would deal with it.

      • toc1234

        so taxpayers that contribute more than others (and receive less back) are in the right when they oppose the redistribution tactics (ie vote buying) of todays democrats?

        • northeaster17

          In the face of vast rethug gerrymandering for the house I’m not sure what you are talking about

        • Ray in VT

          I just think that people should walk the walk if they are going to talk the talk. Red states don’t like big government and all of its spending. So why not just stop taking?

          • toc1234

            sure and liberals like Obama should stop talking about ‘fair share’ when he won’t define who is ‘rich’ and what ‘fair’ means. or more to your point – why don’t liberals pay more than what they owe in taxes? (ie.I think the optional tax in MA nets about $15k each yr. Or in the case of the Obama administration, why don’t they at least pay what they owe…) the answer is, and same for your question, that its the law. so yes, both are full of bs.

          • Ray in VT

            Why pay more than what one owes? Didn’t someone say that only a sucker or something would do that?

          • toc1234

            then why wouldn’t the red states take what’s coming to them under the current law? same thing.

          • Ray in VT

            Because it makes them miserable hypocrites, and all them Gawd fearin’ folk aught to live up to their words and professed beliefs.

  • TFRX

    I’m getting a “Portlandia” vibe from that jingle. Heehee.

    (And I see I’m not alone.)

  • toc1234

    Results may vary from ‘this is a nightmare’ to ‘holy crap, what have we done??’

  • creaker

    Romney actually left a pretty nice legacy here in MA – we’re done already. 7 years – it’s not perfect (what is?) – but it’s still working well.

  • TFRX

    “Anyone in a state-funded agency cannot even say the word Obamacare“?

    I guess it’s a worse word than “birth control”, let alone “abortion”.

    Jill, please don’t bury the lead: This is Run-it to Ruin it Rightwingery.

    Remember when the right in this country tried to actually do that whole governance thing?

    • hennorama

      The nose/face conundrum has been resolved, with both the nose and face hacked away.

      Wait until THAT [reconstructive surgery] bill comes due.

    • sickofthechit

      Maybe they can’t say Obamacare because it is called The Affordable Health Care Act?

  • AC

    i’m ok with obamacare. it’s already 3 yrs old, let it go – ugh!

    • creaker

      I know folks would scream bloody murder if they lost what they’ve already gotten under Obamacare.

      • TFRX

        Oh, it’s even better: Liberals are already joking that in 20 years the descendants of the Tea Party are going to carry signs saying “Get the Government out of my Obamacare!”

        (That’s the direct descent from the low-information voters who wanted to “Get government out of my Medicare”.)

        • Kathy

          Well, there really isn’t very much government in Obamacare.

        • Ray in VT

          Hey. They just didn’t want a government takeover of their government health care.

  • creaker

    Has anyone brought up that for almost everyone with employer provided healthcare (which is most of the folks currently with health insurance), there will basically be no change at all other than filing an extra form with their taxes?

    • TFRX

      I dunno, Creaker. I saw some TV ads the other day and, they weren’t specific, but now I have the gnawing fear that Obama’s gonna insert Reverend Wright between me and my doctor.

      • creaker

        MA has been doing it for 7 years – I have employer provided insurance and I just file an extra 1099 proving I had health insurance. And that was the only difference.

        • TFRX

          (You know I’m full on deadpanning here, right? In some fiscally responsible states, the regular crowd–Kochs, C of C, Americans for Proseperity– ads are horrendous and full of lies.)

          That you and I live in a state that actually does the governing thing spares us this brunt.)

  • Fiscally_Responsible

    As Ronald Reagan accurately said, “national health insurance will combine the efficiency of the post office with the compassion of the IRS”.

    • Ray in VT

      He also fear-mongered about Medicare leading to socialism and the destruction of freedom. How did that work out?

    • Kathy

      Yet every other developed country has single payer of some kind and they live longer and spend less money on health care. Funny that.

    • http://www.openeyesvideo.com/ Glenn C. Koenig

      The USA is not similar enough to those other countries to have single payer. It’s never going to happen here. We are the third most populous country on the planet! We are not really one nation anymore, we’re just pretending to be one. There is no way we’ll ever reach agreement in Washington on a single payer plan.
      Add to that that this is all about medicine and medical services and not really about health! The current system makes more money the more services it provides, not the healthier we are! It’s based on medical doctors and leaves out other kinds of care that are evolving outside of traditional medical practice that have to do with nutrition, emotional health, and so on.
      So, single payer is still limited to medical doctors prescribing medicines and doing procedures and tests.

    • sickofthechit

      Before you wrongly malign the Postal Service again might I suggest you get some facts first? Try boxing up two or three different size packages for mailing and take them to the local Post Office, the nearest UPS store and the FedEx facility, wherever it is. If you do that kind of price comparison there is no way either beats the Post Office. Get one day pricing, two day, three day and standard. The postal service wins every day all day. The Repugnicans in CONgress are hell bent on Privatizing (Profitizing) the Postal Service for their wealthy CONtrollers. The postal service is only operating at a loss because about 6 or 7 years ago CONgress passed a law that said the Postal Service had to pre-fund all its future retiree health care costs over an arbitrarily shortened period. Just another of their under-handed “If we can’t win we will destroy” tactics. charles a. bowsher

    • MsAbila

      Reagan didn’t have to worry about where his monthly health insurance payments came from in addition to his health care treatments and end-of-life treatments.

      The majority of Americans have to worry about their health care!

    • Shag_Wevera

      Reagan’s writers sure were good with the one liners!

    • Isernia

      Reagan was wrong….Both the US Post Office and the IRS are excellent government agencies serving the public. They implement laws passed by Congress. If you have a beef with either agency, you should complain to your Congressman, but you will have to wait in a long line filled with lobbyists influencing the voting and decision-making involved in mail delivery and tax collection policies.

  • Bigtruck

    Is it lack of information or an abundance of misinformation?

    • hennorama

      Yes.

  • http://www.openeyesvideo.com/ Glenn C. Koenig

    It’s very hard for me to listen to this program. Here in Massachusetts, I’ve lived under a similar law for the last 5 years and it’s been less than useless to me. I’m self employed in late middle age. My income is too high for Medicaid, yet way too low to afford the astronomical insurance rates (close to my mortgage monthly payment!).
    Now, because of an unexpected temporary dip in income, the state is trying to fine me for not applying to Medicaid. Problem is, my income varies so widely, I would qualify some months and not others! Now I’m in the middle of a byzantine appeal process where they want me to report all my personal expenses, month by month, for a year that’s already gone by.
    This is crazy.

  • sickofthechit

    Your caller was not talking about confusion, nor was he confused. He was talking about Obfuscation by his State’s Insurance Commissioner as regards the implementation of the Affordable Healthcare Act. The REPUGNICANS have figured out that they can seriously hobble the Affordable Health Care by delaying its implementation. Typical Spoiled Brat Behavior by them. They didn’t get their way, so rather than hold their breath, shut up and turn blue, they instead will do every under-handed thing to destroy an advance on health care for all. Which I would consider falls under the Constitutional phrase “….promote the General Welfare”. Living without healthcare for the last 10+ years sucks! I for one look forward to being covered again. Charles A. Bowsher

  • http://www.openeyesvideo.com/ Glenn C. Koenig

    This law was what the medical industry wanted, not what will really benefit individuals. It’s ultimate purpose is to suck as much money out of the pockets of individuals and gather it for the benefit of the drug companies, mega hospital consortia, device makers, insurance companies, and the greedier doctors.
    I guess I should just calm down and wait. I don’t fault the president for trying, but in the long run, this mess is going to become the train wreck I’ve been predicting for years by now, alas.
    Eventually, we will transition to some kind of extremely decentralized community based medical cost sharing, with salaried doctors and a little money to cover the extreme medical crisis.

    • creaker

      single payer would make so much more sense – but profits trump healthcare in Washington.

  • creaker

    Opponents of Obamacare (and/or Obama) have an opportunity here to make Obamacare/Obama fail by making you fail. And they are pulling out all the stops to insure that you do indeed fail.

  • Community Mapper

    The big question asked, is the asset question…medicaid takes your assets after the age of 55, if you own your own house, has that changed????

    • hennorama

      Different programs, different qualification standards.

    • Cristina

      I think that’s dependent on each individual state’s laws.

    • Community Mapper

      don’t think so, its a federal program, but the answer should have been given or discussed.

    • jefe68

      It depends on the state. In Massachusetts you can’t own a home and be on medicaid. In fact you have to make less than 15k a year as a single person. Basically you have to homeless or on welfare to get medicaid in Massachusetts.

      • Community Mapper

        I know so why do you think the world thinks medicaid is living big???? So in NY you have to sign it over, so the asset question was not answered on the show correctly, which was my original point.

        • jefe68

          The world? If your on medicaid your not doing so well.

          • Community Mapper

            I had a child almost die of a weird unknown disorder that came on suddenly, in 6 weeks racked up almost a half million in medical debt…Medicaid was a godsend because of medical debt laws, and medicaid goes backward. As a single mom I hedged my bets against disaster….I had never had to live on a medicaid diet, but when I did…it was an eye-opener…and I have learned a great deal….more than my very expensive and unused MBA ever taught me. Am not tied to it now, but the first chance I get I am moving to Vermont.

          • jefe68

            Sorry to hear about that, I hope your child is fine now. So did getting on Medicaid unease the financial burden?

            $500,000 is a huge amount of debt.

            Yeah, Vermont is nice. I use to live in Scotland, my daughter was born there.

            No extra costs as it was NH and my ex was able to stay in the maternity ward for almost a week. Plus they gave her a pint of Guinness. After that we had a midwife visit us once a week for the first two months and then every two weeks for one month after. One night my daughter was very ill and we called our doctor who happened to live near by and she came right over. If I remember it right it was after 9 PM. The British NH system is not perfect but my experience with it and those who I knew with serious illnesses, was miles better than what we have.

          • Community Mapper

            Absolutely and yes she is much better, and having never suffered a day of sickness prior to that point, we are very grateful to our experience to Burlington VT and their progressive politics. She is now in her 3rd year in college, in France, talk about a country who is way ahead. Thank you for asking.

  • http://www.openeyesvideo.com/ Glenn C. Koenig

    What an incredibly biased program this has been for the last hour! It’s all boosters of this law and very little of a real critique of what’s wrong with it, and what’s wrong with the Medical industry that this law does nothing to fix. I say this regardless of what political party you’re affiliated with. This is not a Republican versus Democrat problem. It’s a nation wide cultural issue related to how we think of our health, use medical services, and our entire economic system.

    • jefe68

      I agree 100%. The entire system needs to be rebuilt from the ground up. It’s a huge mess but the ACA does fix the pre-existing condition issue and some other things. But I don’t see the Obama administration doing anything to get this thing rolling smoothly.

      I hate to say this but I don’t think we will ever fix health care in this country. We are just to big a nation with a huge portion of the population and very intrenched special interest groups who will do everything in their power to prevent the kind of change we really need.

    • Kathy

      The problem is there’s nobody talking about the real problems of the system. We have democrats defending the law and Republicans spinning nighmarish fantasies completely out of touch with reality.

      There are issues with the ACA as we’ve seen in Massachusetts. People can still go bankrupt due to medical costs even though they have insurance. Also, there’s been very little change in the cost curve.

      • jefe68

        The ACA is going to cause a huge mess in Massachusetts. Commonwealth care is stopping on October 1st and I’ve yet to get one bit of information about this and when I go online it’s very vague as to what’s going to happen.
        I buy my own insurance using Commonwealth care, which is not the best by the way.

        The cost is going up, that’s for sure. We shall see.
        It’s a mess.

        Single payer is the only way to go.

  • Dan Shramo

    There’s a few things that are being overlooked here. My understanding is most of the insurance offered under this new law has deductables around $5000. How can anyone that can’t afford health insurance now. afford that kind of up front expense? And second, since when is health insurance health care? The American public made their preference known back when this law was being conceived that we wanted a single payer option and our government allowed the insurance companies to take that off the table. I tried to get on the air with my questions but was told we didn’t have time. Also it is my understanding that the Obama administration is spending a great deal of energy and money in the next year sending auditors around the country making sure every business is compliant with this new law. So instead of educating us about it, they’re just enforcing it. I’d appreciate any clarification anyone has to offer on these matters.

    • Cristina

      Where did you hear the $5000 deductible factoid? The plans all have different deductibles depending on what size premium you want to pay (this is nothing new for insurance). Also, most preventative health screenings and visits are free now, so the deductible would kick in for other kinds of treatment. Say, if you have cancer. And relatively speaking, $5,000 is nothing if you are receiving cancer treatment. If you have a preexisting condition you can’t be denied anymore (this is huge!). For anyone who has a preexisting condition and tried to acquire private health insurance before, it was a NIGHTMARE. This process, through the marketplace, will be a breeze compared to that. Anyway, just a couple of reasons I think that this is healthcare related and not just insurance related.

      • Dan Shramo

        My girlfriend recently went to a meeting about the implementation of ACA and being compliant as a business and the representative was describing different plans that were available and for most the deductible’s were all $5000.

        • Cristina

          Thanks so much for responding. That’s interesting to me. I wonder who the presentation was being given by – if they were non-partisan – and where they got their facts. The reason why it seems incorrect to me is that, by their nature, different plans all have different deductibles depending on how high your premiums are. So, to say that all the deductibles for all the plans are the same amount doesn’t make any sense. See what I mean?

    • MsAbila

      The devil is in the details again! And we don’t really know the details.
      I’m in Calif and Obamacare is projected to be a huge mess. Many doctors will not accept certain insurance plans but individuals and companies are required to purchase ‘something’ of a plan. It’s absolutely ridiculous, because we (individuals and companies) have to come up with huge monthly payments for insurance plans that are essentially useless.

      • hennorama

        MsAbila – under the “Covered California” State Health Benefit Exchange, according to coveredca.com, there are twelve insurance companies offering plans for individuals, and six participating with plans for small businesses:

        “The following companies will offer plans in Covered California’s individual market:

        Alameda Alliance for Health
        Anthem Blue Cross of California
        Blue Shield of California
        Chinese Community Health Plan
        Contra Costa Health Plan
        Health Net
        Kaiser Permanente
        L.A. Care Health Plan
        Molina Healthcare
        Sharp Health Plan
        Valley Health Plan
        Western Health Advantage

        “Covered California selected the following health plans to participate in SHOP:

        Blue Shield of California
        Chinese Community Health Plan
        Health Net
        Kaiser Permanente
        Sharp Health Plan
        Western Health Advantage

        That seems like a reasonable amount of choice, although the number of options vary by Rating Region within the state. If you have a specific health care provider that you want to work with, simply ask in advance if they prefer a particular insurer, or if they will accept the insurer you prefer.

        Source:
        http://www.coveredca.com/news/press-releases/pr-08-07-13.html

        See also:
        http://www.coveredca.com/news/PDFs/CC-health-plans-booklet-rev2.pdf (Booklet that discusses Plans, Pricing Regions, and Profiles of the insurers involved in the marketplace)

        http://www.coveredca.com/coverage_basics.html

      • Isernia

        Doctors have a long history of refusing Medicare and Medicaid patients. Reason given…the government does not repay the docs sufficiently for their costs (overhead, equipment, staff) of the physician’s office. Until EVERYBODY is on a NATIONAL health plan with doctors working on salary, not fee for service. and until the government can bargain with pharmaceuticals on pricing (competitive)..i.e. Americans will continue to be one of the least healthy citizens of the Western World.

        • mozartman

          Amen to that. Well said.

    • hennorama

      Dan Shramo — start here:

      https://www.healthcare.gov/

      The Kaiser Family Foundation also has looked at the insurers offering plans in the exchanges, and premiums and costs before and after tax credits, for 17 states and DC, titled “An Early Look at Premiums and Insurer Participation in Health Insurance Marketplaces, 2014.”

      “This report presents an early look at insurer participation and exchange premiums – both before and after tax credits – for enrollees in the 17 states plus the District of Columbia that have publicly released comprehensive data on rates or the rate filings submitted by insurers. These include eleven states operating their own exchanges and seven defaulting to a federally-facilitated exchange. Plan availability and premiums for all states are expected to be available by October 1.”

      “While premiums will vary significantly across the country, they are generally lower than expected.”

      See:

      http://kaiserfamilyfoundation.files.wordpress.com/2013/09/early-look-at-premiums-and-participation-in-marketplaces.pdf

      These sites give you an “at a glance” comparison of the various coverage plans in the health insurance marketplace/exchanges:

      http://www.webmd.com/health-insurance/insurance-marketplace/marketplace-insurance-choices

      http://www.medicoverage.com/health-insurance-blog/news/comparing-exchange-plans-bronze-silver-gold-platinum

      Keep in mind that these are commercial websites.

      Hope that helps.

  • dawoada

    Isn’t Obamacare going to be more expensive for young people who don’t qualify for subsidies? This comes about because that they have to make up the difference for older people that get sick more often.
    Let’s face it: Healthcare is NOT affordable for anyone unless someone else is paying for it (through taxes)!

    • tbphkm33

      Lets face it, as long as there is a string of middle men profiting off healthcare, then healthcare is NOT affordable for anyone. There is too much subsidy of private industry built into the U.S. healthcare industry. Since when it is morally acceptable for profits to be gained on the backs of dying people? U.S. healthcare is the more repugnant side of U.S. crony capitalism.

      • dawoada

        In this part of the country (western New York), the major insurance companies are all non-profit, as are the hospitals, so profit is not the problem.

    • Cristina

      Young people whose income is below 400% of the poverty line ($45,000 for a family of 1, $62,000 for a family of 2, and $78,000 for a family of 3) will qualify for subsidies. If you make more than this, than it would seem likely to me that you have a job that is “good” enough to provide health benefits. And if not, than you can elect to get a catastrophic plan (very low premiums, very high deductibles) if you are under 30. Lots of options. But yes, young people do qualify for subsidies up to 400% of the poverty line under the Affordable Care Act.

  • MsAbila

    We need a SINGLE PAYER health care system in the US!

    Obamacare could be the first step towards a single payer nat’l healthcare but it’s a long way away. Under Obamacare people will still go bankrupt because of the costs or they will not receive proper healthcare.

    In this system there is no cost control for healthcare in addition to the monthly high insurance costs, the quality of healthcare given to patients is questionable and most likely healthcare will be severely restricted for those who cannot afford the more expensive plans.

    I’m in California, and now the word is out from many doctors: they will not take the gov’t provided healthcare plans because doctors don’t receive proper payments for their services, or if they do they receive them late and the administration of healthcare rules is extremely difficult and cumbersome.

    • NrthOfTheBorder

      Right on. The problem with the ACA, in a 1960′s approach to governance, is it gave something to everyone resulting in the cumbersome easy to criticize mess that it is…even though it is better than the alternative.

      A single payer – a disciplined single payer system – is very efficient and is the best bang for the buck.

      For this to happen, many Americans will have to forgo the notion that the rules of capitalism don’t work so well when it comes to healthcare.

      • MsAbila

        Right. The mindset of people is a big part of the problem. Many cannot fathom that a single-payer system could work because it is viewed to be a
        ‘socialist’ backward gov’t run healthcare system where gov’t officials would decided who dies and who receives treatment.

        In the meantime, the transfer of wealth from the average Americans to the wealthy continues with full throttle.

        • tbphkm33

          Unfortunately, even with the ACA, the reality for millions is that a serious diagnosis requires not a medical treatment choice, but a financial choice. Do they spend all their money and available credit on trying to treat the illness, in the process guaranteeing financial strain for their families. Or do the accept the diagnosis as terminal and hopefully spare their families from becoming destitute.

      • jefe68

        As much as I don’t want to say this, but I doubt we as a nation will get this together until the entire systems is really failing. Which it will in about 5 to 10 years.

  • NrthOfTheBorder

    One day, maybe, Americans will wake up and realize that equitable and universal health care and capitalism don’t mix.

    • tbphkm33

      Especially not with the corrupt crony capitalism of the U.S.

  • NrthOfTheBorder

    Watching this fight from afar I’ve not heard anyone wanting to defund Obamacare what they would replace it with if they were successful. Not many calling the detractors on this point as far as I can tell.

  • Sy2502

    The only thing I need to know about Obamacare is that the legislators went above and beyond to exempt themselves from it.

  • myblusky

    There are so many problems with the healthcare system – oh where to begin! Obamacare is probably a temporary fix to an enormous problem.

    We live longer and get more complicated illnesses than we used to. Now the dreaded Alzheimer’s is staring us down and going to drown us in debt not to mention the absolute gut wrenching emotional misery it brings. How is the world at large going to fund this one?

    Drugs cost a lot to research and make and they often don’t really cure anything, but rather keep the disease at bay. Then there are all the problems on the administrative side of medicine that could be debated over a lifetime.

    Medical bills are now the number one cause of bankruptcy for Americans.

    Lesson here: don’t get sick. Ever.

    • tbphkm33

      Don’t lament… we have over population as it is. Sooner or later some super bug will come along and our “problems” of today will seem irrelevant.

  • Bluejay2fly

    We cannot have it both ways. We have a system where healthcare is guaranteed but still dispensed on a for profit system. Either it should be pure capitalism and those who have no insurance pay will either have to pay upfront, go to debtors prison when they don’t pay, or be denied the service and die. Or we have a single payor system where the government controls costs by taking the enormous profits away from: the pharmaceutical industry, medical supply companies, colleges, student loan providers, lawyers, and all the other middlemen whose profiting off healthcare causes it to be inconceivably expensive.

    • John Cedar

      We CAN have it both ways and do have it both ways in about every industry in our economy.

      • Bluejay2fly

        My state is 140 Billion in debt and that has a lot to do with our 30-40 Billion dollar a year medical budget.

  • John Cedar

    What does an appendectomy cost:
    http://www.zerohedge.com/news/2013-07-13/what-does-appendectomy-cost

    I cannot wait until Obamcare drives the cost of an appendectomy in our country down from $14k to a couple thousand dollars like it is in Germany/ France/ Spain and those other third world countries.

  • http://www.facebook.com/people/Cacimbo-Smith/1142235495 Cacimbo Smith

    Kaiser Health is a democrat funded heavily partisan organization.

    • mozartman

      The Heritage Foundation is a republican funded heavily partisan organization.

  • hdesignr

    No guests, nor callers opposed to this healthcare policy. So I assume this show is part of the advertising.

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