Showing posts with label affordable care act. Show all posts
Showing posts with label affordable care act. Show all posts

Saturday, July 27, 2019

Health Care

It should be fairly obvious that every person should be entitled to good health care.

We have however developed into a country where that is not true.

Some people simply cannot afford to get adequate care, and that is a shameful thing.

Some argue that ultimately everyone can get treated, if they are persistent, but of course in some cases they will have to lose everything first.

It may or may not be something you care about if you feel you are covered, but it should be.

Especially if the parts of the Affordable Care Act that mandated that pre-existing conditions be covered and the expansion of Medicaid are eliminated.

Most Americans are aware of this but there are still some conservatives trying to eliminate the law.

They don't like Medicare or social security either.

It should be a clear goal that everyone is entitled to good health care, no matter their individual status.

Some may be able to afford extras, but all of us should be covered.


Wednesday, March 27, 2019

Health Insurance

We see the attacks on the Affordable Care Act continue as the administration has decided to support the ruling that it is unconstitutional.

Almost no one thinks that is a good legal argument, it is based on some convoluted logic concerning the last decision, that the individual mandate was constitutional under the congress' ability t tax.

Since subsequently they reduced the penalty (tax) to zero, it is no longer a real tax, meaning the individual mandate is unconstitutional.  The argument goes on to say that the mandate is intertwined so deeply that if it is unconstitutional, the whole thing is.

Now this flies in the face of the act passed by congress that reduced the tax.

However, as odd as the argument actually is, the question arises why would the administration attack the rest of the law?

It has become very popular with most people, at least the provisions related to the pre-existing conditions, the dependent age increase, and the increase in coverage to so many.

It is almost as if the administration, who got hurt in the last mid-terms over health care, want to give their incumbents a handicap.

Still it is something to watch and in the very unlikely scenario where the entire law is invalidated, we will have to see what is offered up instead.

Maybe millions of uninsured, the Republican goal.

Saturday, December 15, 2018

Bipartisan Solution?

On pretty shaky grounds a judge in Texas has ruled that the Tax law of 2017 made the affordable care act of 2010 unconstitutional because it eliminated the penalty for the individual mandate.

What will happen with this is anybody's guess and the logic is very tenuous, but in this country if you find the right judge you can get almost any nonsense.

Now that we see more conservative judges being appointed we may have reason to think this might be upheld, although it is certainly not certain and the law will remain in effect until it winds its way through all the appeals.

It would of course be ideal to simply pass a new law that includes all the things we like but the problem with that is, some conservatives view any interference in the health marketplace as a type of socialism.

Certainly the affordable care act wasn't perfect but it greatly increased coverage, has covered pre-existing conditions and has allowed dependents to stay on coverage longer.

It also mandates that certain preventive services be offered at no additional cost in order to increase the overall health of Americans.

If of course you simply believe that he Government has no role to play here, the good things it does becomes irrelevant.

That is not the view of the great majority of Americans and its time our representatives actually represented us.

This will take a number of years to get to the Supreme Court, its ultimate destination and in two years the American people will have the opportunity to make their voices heard on how they feel.

Its time to have a bipartisan solution.

Unfortunately the odds of that happening are pretty slim.

Sunday, December 2, 2018

Health Care, Still Under Attack

You may or may not have noticed that this is the time to enroll in a health plan under the Affordable Care Act if you are eligible.

There is virtually no outreach going on for the Federal Exchange if you live in one of the states without their own exchange.

The current administration was unable to repeal it and instead is doing everything it can to destroy it by other means.

Attempts to repeal it outright are probably over, at least for the next two years if not forever, but attempts to undercut it continue.

As predicted with more experience and with a more stable outlook, premiums have generally stabilized and more providers are joining in since they see opportunities to make profits.

Current attempts to destabilize it include the introduction of low cost do little plans designed to appeal to low risk customers.  If you can get them out of the plans, it will increase costs.

However for many of those, the full coverage plans in the exchange end up being more affordable when you get the income based subsidy that's part of the act.

Now the administration is trying to allow states to apply those subsidies to non qualifying plans outside of the exchanges.

This is of doubtful legality since the coverages and the subsidies are both pretty clearly spelled out, but when you predict it will collapse and try to undermine it without success, well try harder.

Most Americans have come to, if not love, at least accept the plan and most love some of its best provisions like covering pre-existing conditions or allowing dependents to stay covered longer.

We are now going to see some attempts at expanding it even further as many progressives are pushing the concept of Medicare for All.

It will be interesting to watch.


Saturday, October 13, 2018

Health Care

Health care as an issue has become form the polls something that benefits the Democrats.

The Republicans are trying to paint the proposals by Bernie Sanders about universal Medicare as a expensive socialist Democratic proposal but it remains to be seen how successful that is.

What voters discovered after the Republicans tried to repeal the Affordable Care Act is that they like an awful lot of it.

This just shows how poorly it was explained to them when it was first passed.

Many Americans were sold on it being a Government takeover of health care with 'death panel", loss of choice, terrible coverage and restrictions on treatment when it was none of those things.

The benefits it provided have become clear to the public over time and the disasters predicted never happened.

This isn't going to stop the lies and propaganda from the republicans and the faux fox network but the public has seen it in action and likes what they see, in general.

The party of the few is forced to use lies and deception to convince the many that it cares about them.

It simply doesn't, except for their votes.
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Saturday, June 9, 2018

Pre-Existing Conditions

By this time, most of the country has accepted that the Affordable Care Act added some good things to health care.

Not allowing insurers to charge more for pre-existing conditions, allowing children to stay on their parents coverage until 26, expanding health coverage to millions of previously uninsured Americans.

Despite this and even having no replacement plan, the dontard and his cohorts continue to attack it.

The elimination of the personal mandate and certain subsidies to health insurers only served to increase some premiums and since most premiums get subsidized increase the cost to the Government and therefore us.

They have reduced the sign up periods and advertising for the plans being offered.

Despite some dour predictions, we see more states incorporating the Medicaid expansion and the public still trying to get health insurance.

Now the administration has decided to stop defending the benefits of the plan in court as certain states continue to attack it.

The legal arguments are pretty weak, they argue that with the individual mandate tax advantage gone the other provisions such as pre-existing conditions are now unconstitutional.

The administration has decided not to defend the act, so it is now states attacking and other states defending.

The opposition to the law is based mostly on a philosophical opposition to Government health care and a general dislike of some rich people paying taxes.

All Americans have benefited from these provisions and no politician would try to eliminate them, except of course the dontard, who has a twisted sense of reality.

He opposes the act because it was passed under his predecessor.

That's enough to try to strip these benefits from all of us.

Monday, May 7, 2018

Afordable Care Act

Don't hear much about the Affordable Care Act right now.

It is still under assault as a group of states have filed suit calling it unconstitutional, oddly because congress repealed the individual mandate which they argue invalidates the rest of the law.

I think this is more of a stunt but of course we would need to see if it progresses in the courts.

Generally the law continues and while a lot of it cold be improved, the odds of that are slim indeed.

So it will probably just continue in its current form until at least 2020 when w will see if a new administration wants to tackle it.

American all want affordable, available health care if they think about it.

Young people often don't think much about it until they start a family.

If of course you end up needing expensive treatment and have no coverage, it will bankrupt you or leave you in heavy debt.

We are one of the few, if not the only, industrialized countries that treats our citizens that way.

The cost of treatment and medicines is often obscene.

We could certainly benefit from a single payer system, but that seems pretty far off at this point

In addition to being expensive, it also manages to be extremely complex with coverages uncertain, as well as deductibles and co-pays.

Just something else our useless congress isn't going to address.

Monday, April 24, 2017

Wall or Healthcare?

It seems that the major sticking points in funding the Government right now come down to build a wall or at least fund a study or we will cut funds off for the Affordable Care Act.

Now the wall is an unnecessary project but in the scheme of unnecessary government projects it isn't the worst idea ever.

In fact, there is an old adage about giving someone enough rope to make their own noose.

Republicans need democrats to pass a spending bill because many in their own party oppose the spending increases.  The wall qualifies to some extent as an infrastructure project that will give some people jobs.  The fact that it won't work and will if ever completed stand as a monument to the stupidity of this promise is possibly the best thing about it.

On the other hand, guaranteeing the subsidies for the Affordable Care Act will allow insurance companies to project more reasonable premiums for the next year and could go a long way to institutionalizing health care for many Americans.  Further progress on universal health care can proceed but keeping the gains we already have is essential.

Considering that the republicans can't come up with a workable replacement this might even lead to some bi-partisan efforts to improve what we already have. 

The wall as a glaring example of the idiocy of this administration will continue to be debated among republicans every year going forward.  It might be the gift that keeps on giving for admittedly a few billion dollars, but it will create some jobs.

With the bonus of funding the Government for the rest of this fiscal year.

Seems easy enough if you think it through.

Tuesday, October 25, 2016

Affprdable Care Act Increases

There are going to be some fairly large rate increases on some of the affordable care plans as the market adjusts to the actual experience of the first few years.

What happened was that the people who signed up were in general sicker than predicted and used more services than projected.  Not sure if this is a result of the projections or the fact that many young people didn't sign up because they could continue coverage under their parents plans or felt it was cheaper to pay the penalty.

Now what was easily projected and what happened is that all the people with pre-existing conditions and chronic health conditions did sing up and getting them coverage is a very worthwhile objective.

It should be noted that increases in the first couple of years were very low due to some provisions inn the affordable care act so to some extent this increase is partly a result of that.

Couple of points.

First, the people who use the most health care are already signed up so the demographics going forward should improve as others decide to sign up.

Second, because of subsidies, the enrolled will not see these increases if they are eligible for the subsidies.  More people will become eligible so the increases are not as bad as advertised.

Third, in some states the number of providers is going to decrease and reduce competition.  This should be self correcting as insurers find out how to market profitable plans.  One solution would be to have some nationwide plans in the exchanges similar to the federal employees plans.

Fourth, This impacts a very small percentage of those getting health insurance and is going to look worse in headlines than it actually is.  The impact on any individual has to be determined and certainly it will be a hardship for some, but not most.

Fifth, The plan is structured this way to maintain market forces.  If we went to a single payer system it would not be an issue.  However, fixing a system that provides coverage to those who need it the most is still a worthy outcome.

This is how market forces work and the proposed rates may very well be a bit too high as we see the typical pendulum movement in the year to year predictions.  The gains from the affordable care act are not gone, millions have coverage, and the cost will find its level ultimately.

Monday, October 10, 2016

Is the Afforable Care Act failing

During the debate last night we heard the ACA called the worst disaster ever and it needs to be repealed.  Now we also heard that it needs some fixes.

What actually is the state of the ACA at this point.


  • It has achieved one of its major goals which was to reduce the number of unemployed Americans who didn't have health insurance.
  • It has eliminated the ability of insurers to refuse coverage because of pre-existing conditions.
  • It has allowed young adults to stay on their parents coverage until the age of 26.
  • It has required certain preventive care to be provided at no additional out of pocket expense.


Now it has some issues.


  • Some areas are seeing less competition as companies drop out because they are unprofitable
  • Some plans have limited network providers.

Now, the general idea of these exchanges and the idea of insurance in general is that there is shared risk.  So everyone pays the average cost even though some use a lot more of the services as others.  It was fairly predictable that when people who had been denied health insurance because of pre-existing conditions got insurance they would use a of of services.

The idea to offset this was to get younger healthier people enrolled so the average cost would decrease.  There were penalties associated with not having insurance.  The penalties were however too low apparently since the low risk pools have not signed up to the extent expected.

So in our market based economy, the cost will adjust until the companies make enough profit to continue.

So is this the worst disaster imaginable?  Hardly.  A program that achieves its major goals while working through some market forces is hardly a disaster.
Sounds more like a success.










Saturday, August 6, 2016

Promises

Making promises is easy, delivering on those promises can be hard.

Politicians make promises, its what they do to quote a current commercial.  Being able to deliver is quite another thing.  This is true for all politicians and while you clearly want to elect the one that promises the things you want as opposed to one who promises things you don't want, its also important to understand if they are real or empty promises.

In politics two things are required to deliver on a promise in this country.  The desire and power to do it.  One of the things that has led to the current distrust of Government are all the promises made by candidates that they couldn't deliver on, mostly because they didn't have the power, but sometimes they didn't have the desire either.

It is an infrequent event when one party has enough support in both houses of Congress to make fundamental changes One such scenario was after the election of 2008 when the Democrats were able to pass the Affordable Care Act.  An act that is attacked so very much but which has done so much good.

But that is a rare event since the senate rules require a majority of 60 to push through legislation.  Few remember that because we lost a senate sear the only way to pass the Affordable Care Act in the Senate was to accept the latest House version without revisions since the Democrats had only 59 votes.  A few known issues had to be left in.

However, making promises you can't keep is a time honored political tradition and one that shows no sign of ending.  Media coverage really tends to fail here since they repeat the promises without the proper analysis.  To the extent the promises simply represent goals to be pursued that's fine, but certain people actually believe these promises.  When the promises aren't delivered its because the Government is corrupt or untrustworthy.

I don't know if its always been this way.  It seems to me that we used to understand that campaign promises were goals and not guaranteed.  I think a lot of us still do understand that but sadly, it seems that when I talk to people, or see what they post on social media, they buy in to the idea that politicians are corrupt and untrustworthy.  Of course some are, but the vast majority on both sides aren't.  Maybe its the fact that everything is now instantaneous.  Further, we live in an age where irresponsible reporting is rampant.  Look at how much media was spent on where Obama was born when it wasn't even really an issue.  Partisan politics is actually tame compared to the partisan media we now have, but that is another topic.

I wish we could see more facts and less empty promises in our elections, but I'd also like to win the lottery.


Wednesday, October 2, 2013

Silly Shutdown

When you play poker, you have to "know when to hold them and know when to fold them"  and if you don't you will get taken to the cleaners. 

Certain Republicans thought that the cards they held, shutting down the government, were worth holding and that they could get concessions.  Well they didn't and I think they will get taken to the cleaners.

The scary part is that they are simply too ignorant to realize that the Affordable Care Act is not going away and to shut down the government or too create a default will end up causing a lot of unnecessary grief.

I think they are terrified by the fact that the dire predictions they made about the law are not going to come true.  The exchanges are up and the premiums are actually reasonably affordable.  There are some glitches, but mainly because of the tremendous amount of interest.

There is a lot of misunderstanding about the law, but it is going to become better understood now that it is going live and the Republicans are terrified by that.  It really is a pretty good law once you get to know it, not perfect, but still pretty good.