Homer D’Uberville Florida
I am one of the people with a supposedly “substandard” plan for I and my family that will be dropped by my insurance company because of Obamacare. How substandard s it? $35 co pay for doctor visits in a PPO, $1500 deductible per person, pays 80% in network, prescriptions are $10. Cost for me, the spouse, three college kids, $1375 a month. I thought that was horrendous until I finally got a quote on what the same coverage will cost come next June under AHCA: $1900 a month. Why is my current policy substandard? it does not provide maternity coverage for we parents (in our 50s) or newborn care (kids are in college). My options are a bronze plan that covers NOTHING until expenses exceed $6000 a piece (but if my 58 year old wife gets pregnant, we will be in good hands after that), OR, tell the college kids go ask Obama for their own policy, I am booting one of them off. There is no way I can afford to spend almost $24,000 a year insuring the entire family under Obamacare., who on earth can? the UnAffordable Health Care Act is deeply, deeply flawed, and I say that as someone who voted for Obama. I am thrilled Dems in congress are sensible enough to recognize that.
Nov. 13, 2013 at 6:32 p.m.
Bill Belle Harbour, New York
The health exchange in NY has let me buy a policy with Empire Blue Cross/Blue Shield as part of a group. My monthly insurance premium will drop from $1,534 to only $620 for what is essentially the same plan sponsored by the same insurance company. I don’t need nor am I seeking any kind of help to pay my premium. Americans at large need to learn about the quality of the plans that are being offered, the premiums that will be charged, and the subsidies that are available.
Nov. 13, 2013 at 6:35 p.m.
one of the few states in America where prices will drop. Of course NY had one of the most highly regulated insurance markets in the first place. It also had some of the highest prices. The average premium cost for the majority of Americans will continue to rise.
According to the CMS analysis, the ACA bends the cost curve up, not down.
This was an ill conceived and poorly drafted law.
Nov. 13, 2013 at 7:06 p.m.
jon greene brooklyn, ny
This is very serious. I have Chron’s disease. Before I got it under control, I was bed-ridden. I burned through my savings and lost 30 pounds in the year-and-a-half it took for the symptoms to reveal themselves in a way that could be profiled as Chron’s.
Today I am stable, thanks to a prominent specialist at Beth Israel and the drug Remicade, which is administered by infusion every 6 weeks. I’m self-employed, and for 15 years I have bought my insurance as an indivdual. I currently apay $700/mo for my policy, and it covers all my needs. Unlimited in-network treatment (and the Oxford network is huge), $50 co-pays, plus full coverage of the infusions which are obscenely expensive. Thanks to my ongoing treatment, I can live, work, contribute to society, and pay taxes.
But last month I got a letter from Oxford saying my policy is cancelled! I am terrified. I called the broker who set me up with the policy in the first place, but he’s got nothing. He says I may not be able to continue my current level of care.
How could this have happened!? Obama promised over and over that we could keep our policies if we wanted. He lied. He looked into the cameras and lied for political expediency. I have always voted Democrat. I can’t even believe this!
In the meantime, I can not get the .gov website to work. If I miss my infusion or am late receiving it even once, my body will overcome the drug and it will cease to work for me. I will be crippled.
Americans deserve better than this.
Nov. 13, 2013 at 11:21 p.m.
Health Law Rollout’s Stumbles Draw Parallels to Bush’s Hurricane Response
Republicans readily made the Hurricane Katrina comparison. “The echoes to the fall of 2005 are really eerie,” said Peter D. Feaver, a top national security official in Mr. Bush’s second term. “Katrina, which is shorthand for bungled administration policy, matches to the rollout of the website.” Looking back, he said, “we can see that some of the things that we hoped were temporary or just blips turned out to be more systemic from a political sense. It’s a fair question of whether that’s happening to President Obama.”
The number of people, by state, who selected a health insurance plan offered through the Affordable Care Act from Oct. 1 to Nov. 2.
The memo that could have saved Obamacare
In Obamacare speech, Obama makes a desperate sales pitch
Problem solving: The three 20-year-old programmers developed a site in matter of days that does things the expensive and faltering healthcare.gov just can’t do.
Three 20-year-old programmers build a working Obamacare website in just days (which is more than the government can do)
Easy: The site, designed by Ning Liang, George Kalogeropoulos and Michael Wasser, allows a user to simply input their zip code and view all the health plans available to them
HealthCare.gov, built by 55 contractors, is one of the most complex pieces of software ever created for the federal government. It communicates in real time with at least 112 different computer systems across the country. In the first 10 days, it received 14.6 million unique visits, according to the Obama administration.
11/12/2013 10:43 PM EST
At least the Titanic made it out of port before it sank..
11/12/2013 10:44 PM EST
Former CBO Director: Obamacare Will Bankrupt Us
Wednesday, 24 Mar 2010 10:01 AM
While the Congressional Budget Office reported that President Barack Obama’s healthcare bill would lower federal deficits by $138 billion, the budget office “is required to take written legislation at face value and not second-guess the plausibility of what it is handed,” says former CBO director Douglas Holtz-Eakin.
“So fantasy in, fantasy out.”
Strip out all the gimmicks and budgetary games and rework the calculus, a wholly different picture emerges: The healthcare reform legislation would raise, not lower, federal deficits, Holtz-Eakin writes in The New York Times.
“Removing the unrealistic annual Medicare savings ($463 billion) and the stolen annual revenues from Social Security and long-term care insurance ($123 billion), and adding in the annual spending that so far is not accounted for ($114 billion) quickly generates additional deficits of $562 billion in the first 10 years,” Holtz-Eakin points out.
“And the nation would be on the hook for two more entitlement programs rapidly expanding as far as the eye can see.”
The federal deficit, he notes, is expected to exceed at least $700 billion every year over the next decade, doubling the national debt to more than $20 trillion.
“By 2020, the federal deficit — the amount the government must borrow to meet its expenses — is projected to be $1.2 trillion, $900 billion of which represents interest on previous debt,” Holtz-Eakin says — and Obamacare will only increase this crushing debt.
An especially vivid example of how the legislation manipulates revenues, Holtz-Eakin says, is the provision to have corporations deposit $8 billion in higher estimated tax payments in 2014, thereby meeting fiscal targets for the first five years.
“Since the corporations’ actual taxes would be unchanged, the money would need to be refunded the next year,” he says.
“The net effect is simply to shift dollars from 2015 to 2014.”
The House of Representatives narrowly approved the Obama administration’s healthcare legislation Sunday night, voting 219-212 for passage.
The good news, if you want to call it that, is that roughly 1.6 million Americans have enrolled in ObamaCare so far.
The not-so-good news is that 1.46 million of them actually signed up for Medicaid. If that trend continues, it could bankrupt both federal and state governments.
Medicaid is already America’s third-largest government program, trailing only Social Security and Medicare, as a proportion of the federal budget. Almost 8 cents out of every dollar that the federal government spends goes to Medicaid. That’s more than $265 billion per year.
Indeed, already Social Security, Medicare and Medicaid account for 48% of federal spending. Within the next few years, those three programs will eat up more than half of federal expenditures.
And it’s going to get worse. Congress has shown no ability to reform Social Security or Medicare. With ObamaCare adding to Medicare spending, we are picking up speed on the road to insolvency.
All those accusations about how “Obama knew there would be cancellations and still lied about it”? Yes, the administration knew. But so did any reporter that read the press releases put out be the Department of Health and Human Services. To be sure, that language favored the interpretation the administration still prefers: that policy holders would have to “transition” to “ACA-compliant” plans. But there was no subterfuge about the fact of change.
Cash for Clunkers lasted 55 days and ended with confusion that was a preview of things to come. The New York Times explained in August 2009 the final surge of demand for clunker funds:
“Around the country, dealers had put off the laborious task of applying for the rebates . . . which requires entering the 17-character identification numbers of each vehicle to be scrapped, scanning images of proof of insurance and filling out other paperwork. The computer system was overloaded, according to the dealers. They said they would finish one page in the application, hit enter and nothing would happen. Eventually a message would appear notifying the dealer that the page had ‘timed out.’ Tom Frew, the business manager at Galpin Motors in Los Angeles, said that he needed 35 tries to register just one of the company’s 11 dealerships on the day that the program opened because of problems with the government Web site. On Friday, he spent an hour processing just one rebate application, he said.”
Confronted with this anecdotal assault, Democrats defended Obamacare in kind, with Richard from Oregon, Karl and Bonnie from Wisconsin, Kathleen from Iowa, Gary from Montana and far too many more.
“While it’s always risky to legislate by anecdote, we’re telling stories here today,” Sen. Chris Murphy (D-Conn.) had said Tuesday at the first of two Senate hearings this week on Obamacare. “And so, let me just add one to the mix, and that’s Betty Berger from Meriden, Connecticut. . . . Betty’s story became one that can be repeated 2 million times every single year across this country.”
Republicans are right to hammer President Obama for his dishonest — and now debunked — claim that those who like their insurance plans can keep their coverage. Millions who buy their own health insurance will not have that option. The White House knew this during the health-care debate and didn’t tell the truth.
But what Republicans are doing now is dishonest, too, because their constituents’ tales of woe, even if true, aren’t representative. Suppose the worst forecast proves to be true, and 12 million people cannot renew their coverage and must find new policies on the exchanges. In a country of 317 million people, that group would still be dwarfed by the number of people now able to get health insurance for the first time — and by the overwhelming majority of Americans who are largely unaffected by Obamacare.
Using props to make policy may be unreliable, but it’s apparently irresistible.
Beyond HealthCare.gov, Obamacare’s other challenges
Andrew Harrer/Bloomberg News – The failure of HealthCare.gov website to process millions of applications has drawn fire from contractors who say more time was needed for final testing.
By Jon Kingsdale, Published: November 8
Jon Kingsdale, who oversaw the Massachusetts health insurance exchange from 2006 to 2010, is a managing director of the Wakely Consulting Group. Wakely has provided actuarial and other technical assistance for the Obama administration’s Affordable Care Act.
“The Affordable Care Act is not just a Web site. It’s much more,” President Obama said last month. This focus beyond short-term technical problems is meant to bolster the faith of those, like me, who support the Affordable Care Act. However, it will succeed only if the administration does much more than fix the Web site.
As HealthCare.gov — the main door to insurance shopping for 13 million of the 17 million uninsured who are eligible for subsidies — gets patched up in the coming weeks, the government must also prepare the world’s largest insurance store to meet two equally daunting challenges.
Here’s why: Enrollees are not covered until their first month’s premium is received. In the individual insurance market, premium billing and collection is difficult to track. Folks frequently pay late or in weekly installments, or send too little or even too much. And when they stop paying, they often do not notify the insurer; the company must determine whether it is an intentional termination, an oversight, or a lost or late payment. Unlike most of today’s 15 million direct enrollees, who pay premiums on their own, an estimated 27 percent of those who will be eligible for tax credits under the ACA do not have checking accounts. So they must use cash, money orders or prepaid debit cards to pay their share of monthly premiums.
Under the health-care law, premium billing and tracking will be even tougher. There are hundreds of prices across each of the thousands of plans in the federal marketplace. Having enrollees pay partial premiums, and the IRS issue tax credits for the rest, means twice as much billing. Calculating subsidies based on personal income tax filings also creates security issues: In addition to the problems with verifying consumers’ identities online, which have created delays on HealthCare.gov, tens of thousands of unlicensed “navigators” are fanning out across the country to help folks enroll. Many of these people don’t have to submit to thorough background checks, although they will gain access to personal financial information. And consumer protections for low-income enrollees who miss payments require complex notifications over 90 days before an insurer can end coverage.
Even when the Web site is fixed, these challenges will remain.
In Massachusetts, we received about 100 visits to the site for every one enrollment. If the tens of millions of hits for the federal exchange in October eventually translate into millions of customers, the accuracy of the enrollment data — and insurers’ ability to correctly split premium billing between millions of enrollees and the IRS; track premium remittances; and chase, reconcile and report on accounts receivable — will be tested under the pressure of high volume. If insurers cannot track and collect premium dollars each month, the extra work of doubling back with customers and insurers will frustrate consumers and delay coverage. And a mounting backlog could eventually compromise the fiscal integrity of the exchange.
What Obama points to with justifiable pride are good prices for good coverage. But there lies the second potential pitfall, with even greater political peril for the ACA. Comparing prices in 2014 to those in 2013 is an “apples to oranges” exercise because the health plans on the exchange are new, and many of them differ considerably from older ones. The president is correct in pointing to the substandard quality of much of the individual coverage that is being phased out. We did that in Massachusetts as well, replacing an estimated 150,000 individual and group insurance policies that lacked prescription drug coverage and other basic elements.
Because the exchange makes it easy for consumers to compare premiums and other features of one health plan against those of another, by next autumn they will be able to see premium increases, state by state and congressional district by district. The insurance shopping season is scheduled to open on Oct. 15, 2014 — 20 days before the midterm elections.
Why is this an immediate challenge? Because the hundreds of insurers offering plans on the federal exchange will begin pricing for 2015 in just a few months. Their chief financial officers should be sweating bullets about the obstacles that HealthCare.gov’s glitches have put in the path of enrollees. Fortunately, October was an early shopping month, mainly for browsing and for those who are sick and highly motivated to get coverage. It wasn’t an important month for enrolling the “young invincibles” — uninsured young people who don’t think they need health care — who will subsidize older, sicker enrollees. But the longer HealthCare.gov remains clogged, the more young invincibles will be discouraged from joining. If that happens, enrollment in the 36 states using the federal exchange will resemble small, high-risk insurance pools composed mainly of the sick — potentially causing premiums to soar in 2015.
Insurers must set rates for 2015 in some states by the end of February, and in most states before June. They can’t raise their rates on plans in the federal exchange now; their prices are locked in for next year. Nor can most carriers recoup any 2014 losses by raising premiums for 2015: Unless most competitors do the same, hiking premiums will chase away any healthy customers they have. But that is the imminent danger — a general rise in rates among health plans on the federal exchange.
The administration can try to head off the problem, or it can blame insurers after the fact. To convince skeptical CFOs that October 2014 will be very different from today, first the Web site and the information systems behind it must work. Additionally, the administration has to prove that it can effectively manage the world’s largest commercial health insurance store. And the president has only a few months to do so.
Health reform is a marathon, not a sprint. The Congressional Budget Office projects that public exchanges will build enrollment gradually — to 7 million in 2014, 13 million in 2015 and 22 million in 2016. A shortfall in 2014 can be made up in 2015.
Except that 2015 is essentially here already. In Massachusetts, we begin planning for open enrollment nine months ahead — and that’s just one state. Even while it struggles with its start-up, Covered California is already planning for 2015.
A health insurance exchange is more than a Web site. It is an insurance store, and to manage it well requires insurance experience, technical know-how, and savvy marketing and sales tactics. The administration has a few months to put together a management team with these skills, dedicated exclusively to running the world’s largest store for private insurance. The Centers for Medicare and Medicaid Services have talented staff, and Jeffrey Zients, a former budget official who’s been called up to help fix the federal exchange’s online enrollment, may be just the guy to corral wayward technology vendors. But selling insurance is not what policy analysts and turnaround specialists do. I had 45 employees dedicated to operating the Massachusetts Health Connector; California has budgeted more than 300. Who’s minding the federal store?
If the administration fails to convince hundreds of insurers that the federal exchange will do a superb job marketing their products next fall, what then?
Premiums will jump, Democrats will blame “greedy” insurers, regulators will review rates and push for price controls. And Republicans can credibly crow: “We told you so.”
SOCIAL PROGRAMS RUN DEEP St.-Étienne, a midsize French city, has deep working-class roots and a population that depends on government benefits.
ST.-ÉTIENNE, France — Patrick Jouve, the owner of a game store on the Rue Louis Braille here, assails the government regulations that limit the size of the bright chess set and bouncing balls he has painted on his storefront. If the painting covers more than 36 feet, it constitutes advertising and he has to pay a fee of $1,350….The pervasive presence of government in French life, from workplace rules to health and education benefits, is now the subject of a great debate as the nation grapples with whether it can sustain the post-World War II model of social democracy….“You cannot take away guns from Americans, and in the same way you cannot take away social benefits from French people,” said Louis Paris, the 25-year-old son of a couple who live on the Rue Louis Braille, a typical neighborhood in St.-Étienne, which has deep working-class roots and historically has leaned Socialist….“There are too many government functionaries,” Mr. Jouve said as he demonstrated magic tricks to a customer. Referring to the city officials who come to measure the dimensions of his storefront painting, he said, “They make up jobs for themselves.” …“The state has put in place a system,” said Salvatore Garaffa-Botta, a butcher and the deputy secretary of the largest union in St.-Étienne, the C.G.T. “But we are also slaves to this system.”
President Obama apologizes to Americans who are losing their health insurance
11/7/2013 10:52 PM EST
15 Lib Senators up for re-election and Barry call an emergency meeting in a panic on the day following the VA elections.
The Libs must have spanked Barry REAL BAD.
11/7/2013 10:42 PM EST
I dont get it. Why is Obama apologizing for people losing their insurance? Last week he said they were all junk policies. Was he lying then?
11/7/2013 11:14 PM EST
He said it was a “gap” because the people with rejected policies did not qualify for subsidies. He’s admitting to negligence.
3:22 AM EST
Only an obsequious toady would continue to defend Obamacare after realizing they were lied to to get it passed.
3:20 AM EST
Look out below, the RW Trolls are out from under their bridges and spreading fear, angst and misinformation from the founts of spew.
3:19 AM EST
Owning up to a shortcoming is a strength and not a weakness. The problem will be fixed. That I am sure.
3:21 AM EST
do u think it will be fixed before Dec 15 because that is when my insurance goes up 20%
3:22 AM EST
Mine is going up 30% from a great policy to a much worse one. Will that be fixed?
Concierge doctors a growing practice
By Tom Kisken, Ventura County Star
Published 5:30 pm, Tuesday, September 17, 2013
Dr. Jack Padour was burning out.
The Ventura internal medicine doctor faced falling reimbursement rates and rising overhead. The only way to maintain his earnings was to see more patients.
“I knew I was being compromised by seeing patients every eight to 10 minutes just to keep the doors open,” he said.
Two years ago, Padour changed his practice to a model attracting doctors and debate across the nation.
Patients now pay him an $1,800 membership fee that allows him to see fewer people and spend more time with each of them. A roster that once hovered at 2,000 patients is now at 300.
The annual fee guarantees an extensive physical, including tests on lung function, vision, heart, anxiety, diet and other aspects of wellness. Patients get Padour’s cell phone number. They are guaranteed immediate access and, perhaps most important, more time with the doctor.
If they end up in the hospital or a nursing home, he follows them there for treatment.
Some doctors call it a concierge practice. Others, frustrated over what they say is a misperception that the service attracts only wealthy patients, prefer direct primary care or personalized care.
The forms vary. But in most cases, doctors charge membership fees to provide certain services and specialized care. Many of the doctors, including Padour, continue to accept insurance payment for care not covered by the membership, although some doctors accept only direct payment.
A leader of the American Academy of Private Physicians estimates as many as 5,000 doctors nationwide have direct primary care practices, charging fees of $600 to several thousand dollars. A leader of MDVIP, a Florida company that runs a national network of membership fee practices, suggested the national number is closer to 2,500 doctors but increasing.
No patients are abandoned when doctors join MDVIP, said Dan Hecht, CEO of the 12-year-old company that is a division of Procter & Gamble. Before doctors join, they must find a new home for patients who choose not to pay membership fees.
Hecht says MDVIP helps combat the primary care doctor shortage by extending the career of physicians so frustrated with traditional practice that they leave medicine.
Dr. Paul Block of Thousand Oaks (Ventura County) joined MDVIP in 2004. He said the membership-fee format allows him to better avoid what he sees as the problems created by the power of insurance companies, pressure to see more patients and federal health care overhaul.
“I became aware I couldn’t change the system, but I could dramatically change it for myself and a few people,” Block said.
Bristling at the notion of upper-crust care for an affluent few, Block said his $1,800 annual fee is less than some people spend on cable and Internet services.
MDVIP officials say their practices have brought a 79 percent reduction in hospitalizations for Medicare patients.
‘$5 a day’
Tony Plaia is a 79-year-old retired insurance agent who had knee replacement surgery. A spine injury means he has 10 screws, two bars and four wires in his neck.
He comes to Block because he doesn’t have to wait for appointments and the care is focused on keeping him going to the gym, healthy and out of the hospital. He receives a comprehensive physical, a wellness plan and a copy of his health record.
“It boils down to $5 a day,” he said. “I could spend that on a super latte or spend it on MDVIP.”
If patients need care outside the wellness program covered by the membership fee, Block bills the insurance company or Medicare.
All but a few of Block’s patients carry insurance. Outside observers say people need a high-deductible plan, because the membership fees don’t cover all health care needs.
That means patients pay insurance premiums and membership fees. If they’re not insured, they will face fines of at least $95 next year, said Dylan Roby, a UCLA health policy professor. The penalty is part of the federal health care overhaul’s mandate that people obtain insurance overage.
The law guarantees that insurance companies provide free coverage of care labeled “preventive.” But doctors in concierge practices say many of the wellness tests and treatments covered by membership fees are not covered by the law.
Raising the Medicare Age: A Popular Idea With Shockingly Few Benefits
Deficit hawks want to increase the Medicare age to 67, but that would only save $19 billion over 10 years — or 0.01 percent of cumulative GDP.
MATTHEW O’BRIEN OCT 25 2013, 2:00 PM ET
Increasing the Medicare age would barely save the government any money, and, to make matters worse, would increase overall healthcare spending . Other than that, Mrs. Lincoln, the policy is fine.
It may seem obvious that raising the Medicare age should save money. After all, the projected rise of the long-term debt is mostly about the projected rise of federal health-care spending. If we raise the Medicare age, Washington can wait longer to pay for seniors’ health care, which means they’ll pay less, overall.
Any time there’s any chance for any kind of budget bargain, “grand” or otherwise, the discussion inside the Beltway inevitably turns to hiking the Medicare age. (Call it Peterson’s Law: As a fiscal debate grows longer, the probability of a CEO proposing a higher Social Security and Medicare age approaches one). Right on cue, this got trial-ballooned during the debt ceiling talks in 2011, and then again during the fiscal cliff talks in 2012. Professional deficit hawks think of raising the Medicare age as a sign of seriousness. It’s not so much about the money it saves as the message it supposedly sends markets: that the debt will be fixed.
Not that there’s much money to be saved. The nonpartisan Congressional Budget Office (CBO) now estimates that gradually increasing the Medicare age from 65 to 67 would only save the government $19 billion between 2016 and 2023 — or 0.01 percent of GDP over that time. Nor would it save much more over the longer term; just 0.07 percent of GDP by 2038.
These estimates are actually much lower than the CBO’s already-low ones from last year. Back then, it thought gradually increasing the Medicare age to 67 would save $113 billion by 2023. That’s not a lot in the grand scheme of a $16 trillion economy that will be even bigger 10 years from now, but it’s a whole lot more than what the CBO thinks now. So what changed?
The CBO realized that it overestimated how much Medicare spends on typical 65 and 66 year-olds. Its old estimates looked at average Medicare spending for all65 and 66 year-olds. But some disabled and terminally ill patients get Medicare before they turn 65, and that wouldn’t change if we raised the age to 67. So increasing the Medicare age eliminates Medicare benefits for the healthiest 65 and 66 year-olds, but not the sickest ones.
And even cutting Medicare benefits isn’t the same as cutting government benefits. With Obamacare kicking in, some 65 and 66 year-olds would get Medicaid or exchange subsidies if they couldn’t get Medicare. This other federal healthcare spending would offset a big chunk of whatever Medicare savings there were. It’s federal cost-shifting, not cost-saving.
Now, it is true that Social Security spending would fall a bit too. If they couldn’t get Medicare, some 65 and 66 year-olds would postpone retirement to keep their employer-provided healthcare. But not very many. As the CBO points out, most people retire when they want to, not when they can get Medicare. That means increasing the Medicare age wouldn’t increase the labor force all that much.
Raising Medicare age seems like an obvious idea, because it’s mentioned so often. But what exactly is so obvious about its benefits? Before Obamacare, it would have just shifted healthcare costs from the government to the healthiest seniors. That’s not just morally questionable. It’s also bad economically, since their private insurers would cost more than Medicare. After Obamacare, it would just shift healthcare costs from one part of the government to another — and some seniors would lose coverage altogether. That’s worth $19 billion over ten years?