MUCH More Obamacare TRUTH

Medicaid is privatized, it has been for years. If that's all you want, it's already been achieved: most states have handed off risk and management of Medicaid to private insurers at this point. The state pays a monthly premium to private insurers for those enrollees. It's called Medicaid managed care and 77% of the Medicaid population nationwide is in it.

But those private insurers still pay below-market prices for services for the Medicaid population, which is why the program remains the cheapest way to insure someone. If you want to put people in the regular commercial market, then their services won't be reimbursed at below-market prices and the costs of insuring those people will go up.

Sure, they could improve access if they increased per person spending in Medicaid. But you said they're going to cover more people and not spend any more. Obviously paying providers more means spending more.

 

That's not real privatization. The insurance companies act as public utilities in implementing the rules of Medicaid.

 

As I said, "real" privatization (i.e., paying commercial prices for the enrolled population) would be substantially more expensive than the way it's already been privatized.

If you think that's the way to go, get ready to spend a lot more on Medicaid.

 

One word - Indiana (plus more states). By placing the health care consumer as the direct health care payer costs go down.

https://www.i2i.org/files/2012/03/IP_2_2012.pdf

 

Indiana has Medicaid managed care (like almost every state). Which I thought you just said you don't consider "real" privatization.

Three private insurers in the state receive a monthly premium from the state to insure Medicaid enrollees. But those premiums are cheaper than for regular commercial coverage because the insurers pay health care providers lower prices than commercial plans do. Under Indiana's plan they reimburse at Medicare payment rates.

 

You must have missed the reforms that Indiana has implemented ??

Ryan's roadmap is another good source for Medicaid reform. The numbers may be outdated.

http://www.deseretnews.com/media/pdf/349985.pdf

 

You're talking about the Healthy Indiana Plan. Yes, it uses HSAs to encourage individual contributions toward cost-sharing. But the actual insurance is still provided by private Medicaid managed care plans that reimburse providers at Medicare rates. It's relatively low cost for the same reason all of Medicaid is relatively low cost: it doesn't pay as much as other insurance.

If Indiana were to "really" privatize (in your words), it would be more expensive than what they do today.

Refer to everything I've already said: moving everyone from low-cost Medicaid plans to higher-cost commercial plans will raise spending on that population, not lower it.

 

It will not. High deductible catastrophic plans coupled with some type of health savings account will be less expensive and insure more people plus get the economic losses off the national debt summation.

 

You'll have to explain how spending ~50% higher prices for every single service purchased is less expensive.

 

Health care consumers in control of their health savings accounts can figure out where to spend their health care funds.

 

Prove it. Never worked that way before ACA. How will this mythic miracle suddenly come about?

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Obamacare Repeal: How Many People Could Lose Coverage in YOUR State?









Sadly, many will die in a Republican created holocaust upon repeal of ACA.

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link for above chart:


http://www.dailykos.com/stories/2016/12/6/1608146/-Obamacare-Repeal-How-Many-People-Could-Lose-Coverage-in-YOUR-State

 

GOP Obamacare repeal will be an annual death sentence for thousands








The ink from President Obama's signature on the Affordable Care Act wasn't even dry when then-Senate Minority Leader Mitch McConnell unveiled the Republican mantra for the upcoming midterm elections. As he put it on March 23, 2010, "I think the slogan will be 'repeal and replace', 'repeal and replace.'"

Now, almost seven years later, McConnell and his Republican allies are finding out just how difficult their simplistic Obamacare proposition will really be. With Donald Trump weeks away from defiling the Oval Office, congressional Republicans are no closer to a replacement plan for the roughly 25 million people they will soon add to the ranks of the uninsured. "Repeal and replace" has become "repeal and delay."

Meanwhile, worried House and Senate Republicans are getting an earful from almost every corner of the American health care industry. Having already asked a federal judge to postpone action on the House GOP lawsuit challenging cost-sharing payments for 7 million Americans, Republicans have received dire warnings from health insurers about the death spiral their individual market will experience if no Obamacare replacement is immediately forthcoming. Hospitals have also alerted President-elect Trump and Congress that many of them will face financial ruin as millions of newly uninsured Americans once again require uncompensated care. While American Medical Association (AMA) President Andrew Gorman declared "a core principle is that any new reform proposal should not cause individuals currently covered to become uninsured," new assessments this week from ACASignups.net and the Urban Institute forecast that will be the fate for up to 29 million people who obtained coverage thanks to Obamacare. It's no wonder even Republican voters are losing their appetite for repeal.

Oh, and one other thing: Recent research suggests that the Republican repeal of President Obama's landmark health care law will result in tens of thousands of Americans needlessly dying every year.

This discussion of the American health care system's body count isn't a new one. In a 2002 study, the Institute of Medicine estimated that 18,000 Americans died in 2000 because they lacked health insurance. In January 2008, a study by the Urban Institute ("Uninsured and Dying Because of It") didn't just conclude that "the absence of health insurance creates a range of consequences, including lower quality of life, increased morbidity and mortality, and higher financial burdens." The national death toll, it found, was rising: "137,000 people died from 2000 through 2006 because they lacked health insurance, including 22,000 people in 2006." By 2012, Families USA ("Dying for Coverage: The Deadly Consequences of Being Uninsured") concluded that "uninsured adults are at least 25 percent more likely to die prematurely than adults who have private insurance" and found that "26,100 people between the ages of 25 and 64 who died prematurely due to a lack of health insurance in 2010." A 2009 analysis by Harvard Medical School and Cambridge Medical Alliance was gloomier still, warning "uninsured, working-age Americans have 40 percent higher death risk than privately insured counterparts." All told, the Harvard study lamented, each year "nearly 45,000 annual deaths are associated with lack of health insurance." That kind of horrifying data, along with a dramatic shift of health costs to individuals and families as employers curtailed or dropped coverage, helped propel the passage of the Patient Protection and Affordable Care Act in 2010. (Nevertheless, that didn't stop Republicans from George W. Bush, Tom Delay, and Mitch McConnell to Mitt Romney and Phil Bryant to complain before and after Obamacare became law that "no one goes without health care" because "you just go to an emergency room.")

But with the Supreme Court ruling in the 2012 case of NFIB v. Sebelius, the issue of death by lack of insurance resurfaced. States, the Roberts Court declared, could refuse to expand Medicaid coverage as Obamacare originally required. Without the mandate to extend the joint federal/state insurance program to those earning up to 138 percent of the federal poverty level (FPL), 19 states decided to opt out. The predictable result, beginning in 2014, was a "coverage gap" which left millions of people uninsured. As the New York Times reminded readers again this week, those stuck in the gap in the non-expanding states earned too much to qualify for free Medicaid and too little to qualify for subsidies to purchase private insurance on the Obamacare exchanges. As Janet Foy, a Missouri resident caught in the GOP coverage gap put it this week:

"I'll take my chances with dying, if that's what it comes down to. We have no money."
In 2014, another team of researchers from Harvard Medical School warned in Health Affairs that a lot of Americans—almost 7.8 million—would find themselves in Ms. Foy's situation. The authors of "Opting Out Of Medicaid Expansion: The Health And Financial Impacts" tallied up the coming body count in the Republican states that rejected the ACA's extension of Medicaid to millions of their residents:

Nationwide, 47,950,687 people were uninsured in 2012; the number of uninsured is expected to decrease by about 16 million after implementation of the ACA, leaving 32,202,633 uninsured. Nearly 8 million of these remaining uninsured would have gotten coverage had their state opted in. States opting in to Medicaid expansion will experience a decrease of 48.9 percent in their uninsured population versus an 18.1 percent decrease in opt-out states...
We estimate the number of deaths attributable to the lack of Medicaid expansion in opt-out states at between 7,115 and 17,104. Medicaid expansion in opt-out states would have resulted in 712,037 fewer persons screening positive for depression and 240,700 fewer individuals suffering catastrophic medical expenditures. Medicaid expansion in these states would have resulted in 422,553 more diabetics receiving medication for their illness, 195,492 more mammograms among women age 50-64 years and 443,677 more pap smears among women age 21-64. Expansion would have resulted in an additional 658,888 women in need of mammograms gaining insurance, as well as 3.1 million women who should receive regular pap smears.
The Republicans' killer math netted out this way: of the 7,781,829 left uninsured, the authors estimated between 7,115 (0.091 percent) and 17,104 (0.220 percent)) would die for no reason other than political spite.




more ...




Republican death panels to come back if ACA is ended.

 

It worked better prior to PPACA except health ins companies were not covered under the Sherman act and other insurance regulating laws, they were legally free to do what they wanted. HMo, PPOs and managed care started the mess and then medicare low payments put the nail in the coffin as private insurance started to reduce reimbursements inline with medicare while patients were paying for other coverage. Therefore private insurance was and still is charging higher premiums and deductibles while only paying slightly more for care than medicare. Keep the Protection portion of obamacare that regulates the health insurance industry, regulate deductibles based on set premiums, do away with out of pocket. Then expand medicare by adding another Part that will insure those that can't afford insurance or have pre existing conditions with a premium based on income. The remainder on medicaid.

 

We had 45,000 die every year from lack of health care. Not so any more thanks to ACA.

 

How's this for 'fake news' 20 million more insured under barrycare.
http://dailysignal.com/2016/12/09/i...vTGNEd3E1MEFsZ29kVXB1Zm54SW11QklERVdEYVAifQ==

 

"Fake" news? So why hasn't the Government Accountability Office (GAO) refuted the Obama administration's report?

 

Because they report to the Executive Branch ??

 

They report to the Republican controlled Congress.

 

Obamacare demand so high, administration extends the deadline to meet it



http://www.dailykos.com/stories/201...dministration-extends-the-deadline-to-meet-it



Suck on this, Republicans. An “extraordinary volume of consumers” contacting call centers and logging on to Healthcare.gov has prompted the government to extend the enrollment deadline until midnight Monday, Dec. 19 for coverage starting Jan. 1.

Healthcare.gov CEO Kevin Counihan said that many consumers were asked to wait before signing up for health insurance both online and over the phone. “Nearly a million consumers have left their contact information to hold their place in line,” he said in a statement late Thursday night. “Our goal is to provide affordable coverage to everyone seeking it before the deadline, and these two additional business days will give consumers an opportunity to come back and complete their enrollment for January 1 coverage.”
That covers people in the 39 states that use the federal exchange, Healthcare.gov. And three of the states that operate their own—California, Connecticut, and New York—also have extended deadlines, but just to Saturday, Dec. 17. Three states—Massachusetts, Rhode Island, and Washington State—are keeping enrollments open until Friday, Dec. 23.

And if you can't meet those deadlines, you still have 46 days to sign up. The final deadline for 2017 coverage is Jan. 31.

So guess what, Republicans? There's huge demand for health insurance out there. You're now completely in charge of having to figure out how to meet it. Good luck with that.







It is a good bet that the current right wing euphoria over Trump's "victory" will crash downwards once all who voted form him are left without health care and die from lack of coverage.

 

"Slightly more than Medicare" is relative, I suppose.

 

Republican Congresswoman Marsha Blackburn's Obamacare Twitter Poll Backfires


http://www.nbcnews.com/politics/pol...rn-s-obamacare-twitter-poll-backfires-n703271




A Twitter poll by ardent Obamacare foe Rep. Marsha Blackburn, R-Tenn., on whether the health-care law should be repealed backfired big-time Wednesday as lots more people — a whole lot more people — tweeted "No," rather than "Yes."

Blackburn posted the poll Tuesday, asking people their views on repeal, and requesting that they retweet their support for killing Obamacare if they favored repeal.

Follow
Marsha Blackburn ✔ [MENTION=23552]Mars[/MENTION]haBlackburn
Do you support the repeal of Obamacare? RT if you do, and share what you want to see as the replacement.
9:47 AM - 3 Jan 2017
16%Yes
84%No
7,968 votes • Final results
2,637 2,637 Retweets 2,503 2,503 likes
She also asked in that tweet what people want to see as a replacement for the Affordable Care Act.

The Hill.com noted that Blackburn's cause probably wasn't helped by the fact that White House Deputy Press Secretary Eric Schultz retweeted the poll Tuesday to his more than 23,000 Twitter followers.

Schultz's boss, President Barack Obama, lists the ACA as his signature legislative achievement, and on Wednesday visited Capitol Hill to encourage his fellow Democrats to defend it against Republican repeal-and-replace efforts.

Also Wednesday, President-elect Donald Trump, who has repeatedly called for the repeal of the ACA, warned his fellow Republicans in several tweets to "be careful" how they handle the issue. Trump's tweets said Democrats "own" the "mess" and "disaster" of Obamacare, implying that if Republicans repeal-and-replace efforts lead to spikes in uninsured rates and premium prices, they too could suffer political fallout.

Follow
Donald J. Trump ✔ [MENTION=3512]real[/MENTION]DonaldTrump
massive increases of ObamaCare will take place this year and Dems are to blame for the mess. It will fall of its own weight - be careful!
8:26 AM - 4 Jan 2017












Obamacare saves money and lives.



If it is repealed, then prepare for REPUBLICAN DEATH PANELS to kill off the poor.

 

People who oppose Obamacare would continue to oppose it until they really really really need it.

Sure the ACA has problems. Some reforms that would fix some of the problems would conflict with other needed reforms without complex strategies to make it all work.

Wanna know how to fix it all fast, simply, and with least cost? Declare healthcare a human right. Make it a right like voting is a right. Then we would get price controls on drugs, non-profit drugs and supplies (no more $10 bandaids in hospitals), and national healthcare Medicare-for-All and the tax structure to do it.

No more quibbling over mandates. No more issues with pre-existing conditions. And no more poring over pages and pages of plans and schemes for deductions, copays, annual maximums, PPO vs HMO vs XYZ plans.

(It's funny how some pro-highway robbery insurance proponents think a nice buzz word to sell their schemes is "choice".)

 

Yup, price controls on drugs, non-profit drugs and supplies (no more $10 bandaids in hospitals), and one more little item: simplify tort reform so that those who cause harm can be more easily sued for the harm they cause. Drug manufacturers, medical device manufacturers and other big corporations want to pass on the health costs for their damage to insurance companies and Medicare. If they were sure they would be successfully sued for negligence and fraud they would clean up their act and the costs for healthcare coverage would decline.