Obamacare Status Report

We'll never have lawlessness; is that what you are proposing? I don't think so.

The issue is, and always will be, WHERE DO WE DRAW THE LINE?

 

Obamacare was never designed to provide subsidies for people who choose not to have insurance. I am not sure why you would insert that red herring into the discussion. Previously, before giving up on trying to calculate cost, the CBO estimated 10 to 20 billion dollars just to implement the program. Certainly that would go a long way toward providing some kind of care to those who cannot afford insurance.

Refgal 's daughter is 24 (independent for virtually every purpose -ie financial aid). She makes $15,000 a year and has loans for her tuition. Seems like she would have some kind of subsidy. It took them 4 months to tell her that she was out of luck. The "solution" they gave her was "you are under 26. You can still be put on your mother's plan." Of course, covering kids on her plan costs $450 a month.

This discussion has not touched the relative low number of people who have signed up through the ACA that could not afford insurance before (low enough in OR to discontinue the exchange) compared to the costs to implement. That should be a metric that is important.

 

No, people were dying from lack of health insurance. The uninsured rate has dropped, which will likely result in deaths from lack on insurance dropping as well. The logic train is undeniable.

 

No one dies from not having insurance, insurance isn't the same as health care. One could die from not having health care, but when they have no insurance at all or insurance they can't afford to use there really is no difference when it comes to health care.

 

Except when it does.

"New study finds 45,000 deaths annually linked to lack of health coverage"

Nearly 45,000 annual deaths are associated with lack of health insurance, according to a new study published online today by the American Journal of Public Health. That figure is about two and a half times higher than an estimate from the Institute of Medicine (IOM) in 2002.

The study, conducted at Harvard Medical School and Cambridge Health Alliance, found that uninsured, working-age Americans have a 40 percent higher risk of death than their privately insured counterparts, up from a 25 percent excess death rate found in 1993.

“The uninsured have a higher risk of death when compared to the privately insured, even after taking into account socioeconomics, health behaviors, and baseline health,” said lead author Andrew Wilper, M.D., who currently teaches at the University of Washington School of Medicine. “We doctors have many new ways to prevent deaths from hypertension, diabetes, and heart disease — but only if patients can get into our offices and afford their medications.”

The study, which analyzed data from national surveys carried out by the Centers for Disease Control and Prevention (CDC), assessed death rates after taking into account education, income, and many other factors, including smoking, drinking, and obesity. It estimated that lack of health insurance causes 44,789 excess deaths annually.

Previous estimates from the IOM and others had put that figure near 18,000. The methods used in the current study were similar to those employed by the IOM in 2002, which in turn were based on a pioneering 1993 study of health insurance and mortality.

Deaths associated with lack of health insurance now exceed those caused by many common killers such as kidney disease. An increase in the number of uninsured and an eroding medical safety net for the disadvantaged likely explain the substantial increase in the number of deaths, as the uninsured are more likely to go without needed care. Another factor contributing to the widening gap in the risk of death between those who have insurance and those who do not is the improved quality of care for those who can get it.

The researchers analyzed U.S. adults under age 65 who participated in the annual National Health and Nutrition Examination Surveys (NHANES) between 1986 and 1994. Respondents first answered detailed questions about their socioeconomic status and health and were then examined by physicians. The CDC tracked study participants to see who died by 2000.

The study found a 40 percent increased risk of death among the uninsured. As expected, death rates were also higher for males (37 percent increase), current or former smokers (102 percent and 42 percent increases), people who said that their health was fair or poor (126 percent increase), and those who examining physicians said were in fair or poor health (222 percent increase).

Steffie Woolhandler, study co-author, professor of medicine at Harvard Medical School, and a primary care physician at Cambridge Health Alliance, noted: “Historically, every other developed nation has achieved universal health care through some form of nonprofit national health insurance. Our failure to do so means that all Americans pay higher health care costs, and 45,000 pay with their lives.”

“The Institute of Medicine, using older studies, estimated that one American dies every 30 minutes from lack of health insurance,” remarked David Himmelstein, study co-author, associate professor of medicine at Harvard Medical School, and a primary care physician at Cambridge Health Alliance.
“Even this grim figure is an underestimate — now one dies every 12 minutes.”

Other authors include Karen E. Lasser, Danny McCormick, David H. Bor, and David U. Himmelstein. The study was supported by a National Service Research Award.

http://news.harvard.edu/gazette/sto...s-annually-linked-to-lack-of-health-coverage/

 

Again, it has nothing to do with insurance, you don't rub your policy paperwork on a broken arm to fix it. When you have insurance that you can afford to use, you see the doctor more, meaning better health care than someone without insurance or with insurance they can't afford to use, that's the dots you are connecting.

Having a health insurance policy that you can't afford to use is next to worthless day to day and I know people that have new policies as a result of ACA that went from having a good policy to one with a deductible so high they can't afford to ever use it. Those people are worse off now than they were to begin with and if you went from being uninsured to having one of those types of policies, you are worse off as well because you don't have any more access to healthcare now than before, but you have a monthly bill.

That's what makes this issue so tricky, it's not as simple as forcing everyone to pay for health insurance.

 

Got to agree with you on this one. Before Obamacare more and more people could not afford to use their health insurance with all the copays etc. Obamacare doesn't solve that.

Sooner or later we will get national health care with little or no copayments. Sadly there will have to be a lot more suffering before enough of the American people wise up.

Just talked to a client this morning. 26 years old; horrible health problems and too old to be on dad's insurance. At least Obamacare allowed her dad to buy her insurance under the no pre-existing rule. Old dad is paying about a thousand a month for daughter's healthcare and that is prior to another surgery she might need.

"America is beautiful but it has an ugly side." Neil Young lyrics.

 

Thanks again to Perry and his supporters in Texas.

***********
Arkansas accepted the Medicaid expansion in the Affordable Care Act. Texas did not.

JUNE 8, 2014
That makes Texarkana perhaps the starkest example of how President Obama’s health care law is altering the economic geography of the country. The poor living in the Arkansas half of town won access to a government benefit worth thousands of dollars annually, yet nothing changed for those on the Texas side of the state line.

Photo

Ed Miller lives in a shelter in Texarkana, Tex. On the Arkansas side he might be insured by Medicaid.
After the Supreme Court decided in 2012 that states could not be compelled to expand Medicaid to cover more of their low-income residents, many politicians voiced fears that the poor in states that opted out of the expansion might flood into states that opted in.

nyt. june 08

 

Bahahaha... funny stuff.

 

I don't really find it funny that I should have to point out the obvious like that. Thinking that insurance is the important factor is like thinking that ice cream is the important factor when you hear that there are more murders in the summer. Sure there is a correlation, but you have to go beyond that.

 

Holy ****. Obamacare is doing way better than I expected.

Obamacare
No Rate Increase? Can It Be?

By CAROL GENTRY

Something unprecedented may be unfolding in Florida's individual health-insurance market: None of the nine companies that have filed their 2015 rate requests so far wants an increase.

In fact, two of the companies -- Molina Healthcare of Florida and Sunshine Health -- actually requested a price cut.

None of the companies will talk about their filings until they are approved; and a spoiler could still pop up in the four days that remain before the deadline for plans to compete in the 2015 enrollment.

But consumer advocates are cautiously optimistic that this is evidence that the Affordable Care Act is restraining prices for individuals who don't get coverage through a group.

"The fact is, an overall pattern of insurers not seeking rate increases -- and even seeking rate decreases -- is unheard of," said Greg Mellowe, policy director for the consumer advocacy group Florida CHAIN.

The filings apply only to plans in which individuals will enroll for next year, the federal marketplace that has the online address www.Healthcare.gov. (Some enrolled on their own; others received help through a toll-free line and still others got help from insurance agents.)

The inaugural enrollment took place Oct. 1 through mid-April, with most of the sign-ups occurring after Jan. 1 because of early kinks in the computer system. Enrollment for 2014 plans is closed except for those who have a change in circumstances, such as losing a job or getting divorced.

Total enrollment in Florida for 2014 has not yet been released, but likely exceeded 1 million. Almost 1 million in Florida had enrolled by mid-March, the last time Health and Human Services officials released data. It's unknown how many who enrolled paid the first monthly premiums.

Florida officials decided not to try to create a state-run enrollment exchange, which is an option under the health law. In fact, the Legislature told the Office of Insurance Regulation to leave rate regulation to HHS until 2016.

However, the companies still have to file their rate requests with OIR, and that agency has put the requests online. The requests do not include the rationale behind them, as that is considered a trade secret and not open to the public.

Of the nine health-insurance filings for ACA-compliant plans "qualified health plans" so far, five are HMOs and four are other products. Here is the list as of Tuesday morning:

--United Healthcare of Florida Inc., HMO, zero increase.

--Sunshine State Health Plan Inc., a rate decrease of 7.9 percent. (Sunshine Health is marketed as Ambetter.)

--Health First Health Plans Inc., an HMO, zero increase.

--Health First Insurance Inc., zero increase.

--Cigna Health and Life Insurance Co., zero increase.

--Blue Cross & Blue Shield of Florida Inc., zero increase. Blue Cross & Blue Shield of Florida has rebranded itself as Florida Blue and is the largest insurer in the state.

--Health Options Inc., an HMO affiliated with Florida Blue, zero increase.

--Molina Healthcare of Florida, a rate decrease that averages 11.6 percent. Each county in Florida is a different rate zone, and Molina has requested premium cuts from 10.79 to 16.05 percent.

--Time Insurance Co. -- not applicable, because this is a new applicant.

The details on which counties will have which plans and at what price will not become available until after HHS completes its review, which is not expected before August or September. Open enrollment for 2015 is scheduled for Nov. 15 to Feb. 15.

To be sure, the majority of Florida enrollees -- 91 percent, in fact -- did not pay full price on premiums this year and the same could be true for 2015. The ACA provides tax credits upfront to those who have incomes between 100 and 400 percent of the federal poverty level.

Those who do not have health coverage, except for those with very low incomes and a few other groups, are subject to a penalty. The penalty for 2014 is $95 or 1 percent of income, whichever is higher, for adults; in 2015 it will be $325 or 2 percent of income. It will go up again in 2016.

http://health.wusf.usf.edu/post/no-rate-increase-can-it-be#.U6miaadwweR.twitter




Report: No O-Care rate increases coming in Fla.

By Elise Viebeck - 06/24/14 12:41 PM EDT
Not a single health insurance company on Florida's ObamaCare exchange has asked to increase its rates for next year, according to a report.

Of the nine companies that have filed their proposals so far, seven are asking for zero increase in price and two are asking to lower their premiums by 7.9 and 11.16 percent on average.


The rates deal a blow to ObamaCare critics who predicted insurers would have to hike premiums substantially in states like Florida, where older, sicker patients were expected to outnumber younger, healthier ones.

"The fact is, an overall pattern of insurers not seeking rate increases — and even seeking rate decreases — is unheard of," Greg Mellowe, policy director for the consumer advocacy group Florida CHAIN, told Health News Florida, which broke the story Tuesday.

The nine companies that have filed rates so far include five health maintenance organizations, or HMOs, and four other insurers.

It is rare for larger firms like Cigna, United Healthcare and Blue Cross Blue Shield not to request higher rates, but that is the situation for next year on the exchange.

At least one new carrier, Time Insurance, is applying to sell plans through the system for the first time.

The news is part of a trend as states publish their proposed premium rates for next year. None of the drastic predictions about rate hikes have materialized, and more insurers are seeking to join the marketplaces.


Read more: http://thehill.com/policy/healthcar...ate-increases-coming-in-florida#ixzz35aKoaxaX

 

Are you saying hyper-inflated rate increases before O-care would lead to no rate increases or lower rates now?

I don't know what the situation was in Florida pre-Obamacare. The first article does say this is unprecedented.

 

What does COBRA eligibility have to do with buying from the exchange? Is it just about the subsidies? A friend told me the other day that she faced some restrictions in buying through the ACA because she was "COBRA-eligible."

Anyone know what would specifically apply?

 

No she lives in NC. She is under her current plan through August 17th but her comment to me was that the restriction was due to her COBRA-eligibility...

 

Her regular coverage ends on AUG 17 and she becomes eligible for COBRA. She is being cut back to part-time.

She told me that she was told by BCBS or one of its agents that her eligibility for COBRA would have some kind of impact on how or what she can buy.

Sorry but I don't know more specifics... but the takeaway is that she was told that her simple eligibility for COBRA would somehow limit her.

Ever heard of such a thing or did she just misunderstand?