“When In Doubt, Go Shopping”: The Affordable Care Act Puts People, Not Insurers, First
It’s pretty straightforward: A major reason we have 50 million uninsured people in the United States is that insurance companies do not see individuals as a profitable market.
The recent uproar over canceled health insurance plans not only highlights the insurance industry’s out-of-hand dismissal of this market, but also reinforces why there is a need for the new health reforms under the Affordable Care Act .
Consumers have reason to be angry but they should be angry at the insurers, not the health care law. Connecticut’s Insurance Commissioner, Thomas B. Leonardi, announced Monday that of the approximate 27,000 insurance policy cancellation notices which have gone out only 9,000 of them were because plans were not in compliance with the health care law. The new law forbids insurers to deny or drop coverage when people get sick or have a pre-existing condition such as hypertension, diabetes or obesity. Consumers will gain those protections in 2014 whether they buy through the insurance exchange called Access Health CT or on their own.
Mr. Leonardi’s comments highlight the fact that it has been a customary practice of insurers to send their policyholders notifications that a particular plan will no longer be available or there’s been a change in benefits. Only one-third of the policies being canceled in Connecticut were plans that did not have protection under the law’s grandfather clause and did not meet the benefit standards or the consumer protections required by the law. The other two-thirds were discontinued as part of the insurance companies’ business-as-usual practices.
Historically, the health insurance industry has made its fortune by denying coverage to sick people, decreasing benefits and jacking up prices. Insurers do not see the individual market as profitable unless they continue to shift risk onto consumers through high deductible plans and unless they can raise rates on their customers as they age and develop health problems to the point they can no longer afford health insurance. That’s why they’re getting out. The Affordable Care Act is stopping this bait and switch approach.
Understandably, the cancellation notices came as a jolt for policyholders, especially because the reasons behind them were not made clear. Furthermore, insurers failed to do the right thing and inform their policyholders that other coverage options are now available to them under the new health care law.
Fortunately for consumers though, President Barack Obama‘s decision to give insurance companies another year to continue their substandard health plans carried the proviso that they must inform their customers of the new coverage opportunities under the health care law.
It’s too bad the commotion over the cancellations happened to coincide with the rocky rollout of the new health insurance exchange website. But consumers would do well to keep their eyes on the big picture, beyond the political grandstanding and partisan bickering. Websites can be fixed. Health care reform is about improving the quality of coverage benefits and offering more choice and affordability through the health insurance exchanges. That’s what Connecticut is trying to do.
Friday’s announcement by Gov. Dannel P. Malloy that the state would not extend poor quality policies through 2014 re-emphasizes Connecticut’s commitment to making sure its residents have access to plans that will provide quality comprehensive care. The state also announced that it was pushing back the date people had to sign up by for coverage that begins Jan. 1. Now residents have until Dec. 22, giving them an additional week to weigh the options on Access Health CT, the state’s health insurance exchange, and to find a plan that fits their families’ needs.
According to Access Health CT, in the first month, more than 300,000 Connecticut consumers checked out their options on the Website, almost 40,000 calls have been answered through the call center and more than 13,000 Connecticut residents are now enrolled.
Clearly, consumers here are getting the message: When in doubt, go shopping.
By: Frances G. Padilla, President of Universal Health Care Foundation of Connecticut, Op-Ed Columnist, The Hartford Courant, November 22, 2013
“Obscuring The Bigger Picture”: The Republican Tempest Over The Affordable Care Act Diverts Attention From Three Large Truths
Having failed to defeat the Affordable Care Act in Congress, to beat it back in the last election, to repeal it despite more than eighty votes in the House, to stop it in the federal courts, to get enough votes in the Supreme Court to overrule it, and to gut it with outright extortion (closing the government and threatening to default on the nation’s debts unless it was repealed), Republicans are now down to their last ploy.
They are hell-bent on destroying the Affordable Care Act in Americans’ minds.
A document circulating among House Republicans (reported by the New York Times) instructs them to repeat the following themes and stories continuously: “Because of Obamacare, I Lost My Insurance.” “Obamacare Increases Health Care Costs.” “The Exchanges May Not Be Secure, Putting Personal Information at Risk.”
Every Republican in Washington has been programmed to use the word “disaster” whenever mentioning the Act, always refer to it as Obamacare, and demand its repeal.
Republican wordsmiths know they can count on Fox News and right-wing yell radio to amplify and intensify all of this in continuous loops of elaboration and outrage, repeated so often as to infect peoples’ minds like purulent pustules.
The idea is to make the Act so detestable it becomes the fearsome centerpiece of the midterm elections of 2014 — putting enough Democrats on the defensive they join in seeking its repeal or at least in amending it in ways that gut it (such as allowing insurers to sell whatever policies they want as long as they want, or delaying it further).
Admittedly, the President provided Republicans ammunition by botching the Act’s roll-out. Why wasn’t HealthCare.gov up and running smoothly October 1? Partly because the Administration didn’t anticipate that almost every Republican governor would refuse to set up a state exchange, thereby loading even more responsibility on an already over-worked and underfunded Department of Health and Human Services.
Why didn’t Obama’s advisors anticipate that some policies would be cancelled (after all, the Act sets higher standards than many policies offered) and therefore his “you can keep their old insurance” promise would become a target? Likely because they knew all policies were “grandfathered” for a year, didn’t anticipate how many insurers would cancel right away, and understood that only 5 percent of policyholders received insurance independent of an employer anyway.
But there’s really no good excuse. The White House should have anticipated the Republican attack machine.
The real problem is now. The President and other Democrats aren’t meeting the Republican barrage with three larger truths that show the pettiness of the attack:
The wreck of private insurance. Ours has been the only healthcare system in the world designed to avoid sick people. For-profit insurers have spent billions finding and marketing their policies to healthy people – young adults, people at low risk of expensive diseases, groups of professionals – while rejecting people with preexisting conditions, otherwise debilitated, or at high risk of heart disease, diabetes, and cancer. And have routinely dropped coverage of policy holders who become seriously sick or disabled. What else would you expect from corporations seeking to maximize profits?
But the social consequences have been devastating. We have ended up with the most expensive healthcare system in the world (finding and marketing to healthy people is expensive, corporate executives are expensive, profits adequate to satisfy shareholders are expensive), combined with the worst health outcomes of all rich countries — highest rates of infant mortality, shortest life spans, largest portions of populations never seeing a doctor and receiving no preventive care, most expensive uses of emergency rooms.
We could not and cannot continue with this travesty of a healthcare system.
The Affordable Care Act is a modest solution. It still relies on private insurers — merely setting minimum standards and “exchanges” where customers can compare policies, requiring insurers to take people with preexisting conditions and not abandon those who get seriously sick, and helping low-income people afford coverage.
A single-payer system would have been preferable. Most other rich countries do it this way. It could have been grafted on to Social Security and Medicare, paid for through payroll taxes, expanded to lower-income families through Medicaid. It would have been simple and efficient. (It’s no coincidence that the Act’s Medicaid expansion has been easy and rapid in states that chose to accept it.)
But Republicans were dead set against this. They wouldn’t even abide a “public option” to buy into something resembling Medicare. In the end, they wouldn’t even go along with the Affordable Care Act, which was based on Republican ideas in the first place. (From Richard Nixon’s healthcare plan through the musings of the Heritage Foundation, Republicans for years urged that everything be kept in the hands of private insurers but the government set minimum standards, create state-based insurance exchanges, and require everyone to sign up).
The moral imperative. Even a clunky compromise like the ACA between a national system of health insurance and a for-profit insurance market depends, fundamentally, on a social compact in which those who are healthier and richer are willing to help those who are sicker and poorer. Such a social compact defines a society.
The other day I heard a young man say he’d rather pay a penalty than buy health insurance under the Act because, in his words, “why should I pay for the sick and the old?” The answer is he has a responsibility to do so, as a member the same society they inhabit.
The Act also depends on richer people paying higher taxes to finance health insurance for lower-income people. Starting this year, a healthcare surtax of 3.8 percent is applied to capital gains and dividend income of individuals earning more than $200,000 and a nine-tenths of 1 percent healthcare tax to wages over $200,000 or couples over $250,000. Together, the two taxes will raise an estimated $317.7 billion over 10 years, according to the Joint Committee on Taxation.
Here again, the justification is plain: We are becoming a vastly unequal society in which most of the economic gains are going to the top. It’s only just that those with higher incomes bear some responsibility for maintaining the health of Americans who are less fortunate.
This is a profoundly moral argument about who we are and what we owe each other as Americans. But Democrats have failed to make it, perhaps because they’re reluctant to admit that the Act involves any redistribution at all.
Redistribution has become so unfashionable it’s easier to say everyone comes out ahead. And everyone does come out ahead in the long term: Even the best-off will gain from a healthier and more productive workforce, and will save money from preventive care that reduces the number of destitute people using emergency rooms when they become seriously ill.
But there would be no reason to reform and extend health insurance to begin with if we did not have moral obligations to one another as members of the same society.
The initial problems with the website and the President’s ill-advised remark about everyone being able to keep their old policies are real. But they’re trifling compared to the wreckage of the current system, the modest but important step toward reform embodied in the Act, and the moral imperative at the core of the Act and of our society.
The Republicans have created a tempest out of trivialities. It is incumbent on Democrats — from the President on down — to show Americans the larger picture, and do so again and again.
By: Robert Reich, The Robert Reich Blog, November 22, 2013
“About Those Canceled Plans”: When “Victims” Become Beneficiaries
When pressed for specifics, the Affordable Care Act’s detractors tend to focus on two main areas of concern: the website and the cancelation notices. The website is obviously important and administration officials are doing what they can. Maybe it’ll be fixed quickly, maybe it won’t – we’ll find out soon enough.
But the cancelation notices are a different kind of concern. As we’ve discussed, we’re talking about a very small percentage of the population that has coverage through the individual, non-group market and are now finding that their plans are being scrapped. When the House Republican “playbook” looks for people saying, “Because of Obamacare, I lost my insurance,” these are the folks they’re talking about.
But the story about these “victims” of reform is coming into sharper focus all the time.
Only a small sliver of the Americans who buy their own health insurance plans and may be seeing them canceled under Obamacare will pay higher premiums, according to an analysis released Thursday.
More than seven in 10 Americans who purchase health plans directly will get subsidies to help pay for coverage under the Affordable Care Act, according to the report by Families USA, a Washington-based organization that supports the health care reform law.
“It is important to keep a perspective about the small portion of the population that might be adversely affected,” said Ron Pollack, executive director of Families USA. “That number is a tiny fraction of the 65 million non-elderly people with pre-existing health conditions who will gain new protections through the Affordable Care Act. It is also a small fraction of the tens of millions of uninsured Americans who can also get help.”
Let’s put this another way. A tiny percentage of consumers will receive cancelation notices, and of them, more than 70% will get new, more secure coverage that ends up costing them less.
They’re not, in other words, victims. They’re beneficiaries.
In fairness, many of them won’t know this for a while because they can’t yet go to healthcare.gov and see how much they’ll benefit, but we’re talking about the health care system itself – for all the talk about the cancelations, by a 2-to-1 margin, these folks are going to be better off, including receiving subsidies through the Affordable Care Act.
In reference to the remaining folks who’ll pay more, Pollack told the Huffington Post, “That’s approximately 1.5 million people, and that’s not trivial and I don’t in any way suggest that we shouldn’t be concerned about that group. But … the number of people at risk of this becoming a problem is considerably smaller than the tens of millions of people who are going to get substantial help.”
And here’s the larger question: if the evidence had pointed in the other direction, and 71% of these folks were poised to pay more, not less, would the story have gotten more attention? Would the coverage be dominated by “More bad news for Obamacare”?
This week, after years in which Obamacare critics said the law would fail to control costs, we saw remarkable evidence that the law is succeeding in controlling costs. Didn’t hear much about that? Neither did I.
I’m starting to get the sense that there’s an approved narrative – the Affordable Care Act is failing and is in deep trouble – and developments that point in the opposite direction are filtered out, while developments that reinforce the thesis are trumpeted.
The debate is often confusing enough, but this isn’t helping.
By: Steve Benen, The Maddow Blog, November 22, 2013
“It’s Not All Doom And Gloom On Obamacare”: Just A Matter Of Time Before Republicans Start Criticizing Something New
Condemning the Affordable Care Act and its problem-plagued rollout is easy, but when the White House insists things are getting better, that’s not just spin. Brett Norman reports this afternoon:
Tech surge czar Jeff Zients said that HealthCare.gov will be able to handle 50,000 users at a time by the end of this month – up from 25,000 now, thanks to hardware additions and software additions the team is putting in this weekend and next week.
He said that will enable the site to handle 800,000 people a day – “a conservative estimate,” he said in a conference call with reporters.
It’s important to note that handling increased traffic, while clearly important, is not the resolution to all of the website’s troubles. Accurately connecting consumers to insurers and providing reliable data on subsidies is just as important, and to date, these are areas with which healthcare.gov has also struggled.
That said, Zients told reporters all of these issues are being addressed, and the increased website capacity should – should – keep the larger enrollment system on track towards its 2014 goals.
Indeed, even before Zients’s media briefing, Sarah Kliff highlighted reports of a “November surge” in enrollments.
By the end of October, the federal government had counted 106,000 people enrolled into private coverage through the new health insurance marketplaces, a small percentage of the projected half-million sign-ups.
By mid-November, though, with the 14 state-based marketplaces reporting fresh data, that number had just about doubled to more than 200,000…. State officials say they are seeing an uptick in sign-ups this month. California, which has had about 80,000 sign-ups, is now reporting about 2,000 enrollments per day. New York and Washington reported double-digit enrollment numbers as of this week.
Kaiser Family Foundation President Drew Altman told Kliff, “It’s not all doom and gloom.”
Reports from several states where officials want the system to work are reporting impressive numbers for the first half of November. California, in particular, appears to be leading the way – and given that the Golden State is the nation’s largest, that’s good news for the overall totals.
The law’s proponents shouldn’t be Pollyannaish about any of this, and we have not reached the point at which the system can fairly be described as “adequate.” It’s just not there yet.
But the administration can credibly say they’re putting out the fires; they’re making steady progress; and they’ve moving closer to their goals. The panic is subsiding. The recent chatter that “Obamacare” is going to destroy the president, Democrats, the health care system, and the idea of progressive governance on a conceptual level hasn’t quite gone away, but it’s looking increasingly silly.
And while I’m reluctant to look too far ahead with so much uncertainty still surrounding the system’s functionality, I can’t help but wonder about what the political world’s conversation will look like if, in the near future, healthcare.gov is working as it should, enrollment is strong, costs are contained, millions are gaining coverage they previously lacked, and millions more enjoy health care security that previously didn’t exist.
I have a very strong hunch we would, under this scenario, see very few headlines that say “Obama fixes problems, brings health care security to nation.” Rather, folks would just move past the hysteria of the last month, start criticizing something new, and Republicans could return to saying, “Now, about Benghazi….”
By: Steve Benen, The Maddow Blog, November 22, 2013
“Revisionist History”: Chris Christie Shows Why The GOP Is Hopeless On Health Care Reform
With the rollout of the health care exchanges created by Obamacare hitting some bumps, to put it mildly, and President Obama’s approval rating falling to new lows, it seems like now would be the perfect time for Republicans to take control of the health care issue. Yet they haven’t.
Why? To figure that out, look no further than the GOP’s darling of the moment, New Jersey Gov. Chris Christie.
Fresh off a re-election rout, plenty of conservatives are pointing to Christie as the hope for a new, modern and revitalized GOP. And at the Wall Street Journal’s CEO Council 2013 yesterday, Christie knew his cue, saying, “Obamacare is a failure, it’s always been a failure and it will not succeed. It just won’t.”
But when asked what he would replace it with, Christie first demurred, saying he didn’t have enough time to flesh out a solution, but then added:
Obamacare is wrong, it’s a failure, it’s the most extraordinary overreach of government power in the history of our country. And it’s being run by people who have never run anything. So why are we surprised it’s failing?
What do we need to replace it? We need a robust debate among both sides. Unlike last time, where the president jammed this down everybody’s throat and got not one Republican vote because he was unwilling to make any compromise, including tort reform, for god’s sake. Well, then this time we need a robust conversation between both sides where everybody brings skin to the table and everybody compromises. And if we do that we can craft a solution.
This is just red meat, not a constructive discussion of the nation’s health care problems. And it’s emblematic of the mainstream GOP’s fact-free approach to health care reform and the problems it’s having landing punches against Obamacare.
For starters, it’s simply incorrect that the Obamacare exchanges are “being run by people who have never run anything.” Secretary of Health and Human Services Kathleen Sebelius, after all, ran a state (she was the governor of Kansas, not exactly a socialist utopia), which I imagine Christie counts as executive experience. And President Obama, like it or not, has been at the helm of the world’s largest economy and military since 2009.
But far more importantly, Christie’s only solution to the health care conundrum is more “debate.” He seems to believe that health care reform would have gone just fine if mean old Obama hadn’t “jammed this down everybody’s throat” without making any compromises. That’s revisionist history, to say the least.
Back here in reality, Senate Finance Committee Chairman Max Baucus, D-Mont., spent months fruitlessly trying to get Republicans to sign onto a health care bill, which was also endlessly debated in committee, in each chamber of Congress and on the airwaves. There are a slew of provisions in the law that come from various proposals Republicans have put forth over the years, including some lifted from their Obamacare alternative, but they earned Obama not one Republican vote.
Obama also ditched the public option – a government run plan in the health care exchange – as a concession, for which he got nothing in return except accusations that he was engineering a “government takeover” of health care. Oh, and Christie’s magical tort reform, the GOP silver bullet? Obama has offered it to Republicans multiple times, and in response, they did nothing. (Tort reform, in the end, would result in scant savings anyway.)
This is not to deny that Obamacare has its problems, but simply to highlight that the GOP had the opportunity to be constructive during the health care debate, and instead chose across-the-board opposition and obstruction as an explicit political strategy to bring about Obama’s “Waterloo.”
Now, years later and with Obamacare faltering, the best the GOP’s newest star can muster is to tell the same old tales in the same old way. Complicating the matter is the fact that the few ideas conservatives do have for health care reform would result in many of the same things which Republicans are now criticizing. Reforms favored by the GOP would cause people to lose their insurance plans, even if they like them. And they would cut Medicare. Gasp!
Christie either knows this and can’t say it, because he would then be vilified by the conservative base, or he is just another Republican who doesn’t understand the tradeoffs involved in reforming America’s inefficient, wasteful and oftentimes completely backward health care system. And his refusal to even try to formulate a coherent health care alternative shows why, even after 40-something repeal votes and a disastrous rollout of the exchanges, Obamacare is still very much the law of the land.
By: Pat Garofalo, U. S. News and World Report, November 19, 2013
Share This Blog
Unknown Feed- An error has occurred; the feed is probably down. Try again later.
mykeystrokes.com 