How To Spot A Fake Obamacare Horror Story (very useful!)

[geek tragedy]

Last edited Thu Oct 31, 2013, 06:17 PM - Edit history (1)

http://thinkprogress.org/health/2013/10/31/2868631/essential-guide-debunking-obamacare-cost-myth/

So before you buy into the sticker shock hysteria, here are four questions you should ask:

1. What does the old plan actually cover? Most of the policies in the existing individual health care market — which are currently issuing notices — offer low premiums, but also come with skimpy benefits and high out-of-pocket costs. These plans often have low limits for outpatient treatment, hospitalization or don’t offer any benefits for procedures like colonoscopy, chemotherapy or mental health treatment. Insurers market these policies to young and healthy people who don’t use their coverage — and never know the true extent of their benefits. (The market is also fairly mobile, with just 17 percent of individual subscribers purchasing the same plan for two years or longer.)

Under the Affordable Care Act, insurers cover 10 essential categories of benefits, offering far more comprehensive coverage than what’s available in most individual insurance plans.

2. Did this person go to the exchanges? Insurers informing policy holders that their health care costs will go up, often direct beneficiaries to their other brand products without telling them about competitive options and prices available through the exchanges. Cavallaro, for instance, got a quote from a broker, but did not explore the available options on her own.

Prices are lowest in areas with the most insurer competition. An analysis from the McKinsey Center for U.S. Health System Reform found that “new entrants into the market make up 26 percent of all insurers,” and “tend to price their plans lower than the median premiums in their market.” The average premium in the exchanges is 16 percent lower than previously projected.

3. Yes, the premium is low, but what are the co-pays and deductibles? This coverage often forces individuals who do use care to meet high deductibles — the amount you pay out-of-pocket before your insurance kicks in — pay high co-pays and co-insurance or limit the number of doctor visits that are allowed. Cavallaro, for instance, must meet a deductible of $5,000 a year and has an out-of-pocket cap of $8,500 a year. The plan covers just two doctors’ visits and each include a $40 co-pay.

As the LA Times’ Michael Hiltzik points out in California, Cavallaro could sign-up for a Silver level plan with a $2,000 deductible, maximum out-of-pocket cost of $6,350, pay $45 for a primary care visit and $65 for a specialty visit — “but all visits would be covered, not just two.”

The health law sets exchange enrollees’ maximum annual out-of-pocket costs at $6,350, and silver plans have deductibles ranging from $1,500 to $5,000.

4. Does this person qualify for subsidies? Americans between 100 and 400 percent of the federal poverty line ($46,000 for an individual, or about $78,000 for a family of three) qualify for tax credits under the law. Six of the 7 million individuals who are expected to sign up for insurance through the exchange will receive an average tax credit of $5,290 per year.

Bonus visual aid:

http://talkingpointsmemo.com/livewire/chart-winners-and-losers-from-obamacare

[NYC_SKP]

1. Thank you geek and thinkprogress for helping america sort this out.

That's all, thank you!

[NoOneMan]

2. Does the story conflict with Obamacare being the most awesome system any nation has ever developed?

Fake

[geek tragedy]

3. Sorry the story had too many words for you to read and understand. Here's a picture for you.

http://talkingpointsmemo.com/livewire/chart-winners-and-losers-from-obamacare

[enlightenment]

4. Interesting chart.

Interesting link that you pulled it from, too . . .

http://www.businessinsider.com/heres-whats-wrong-with-this-obamacare-winners-and-losers-chart-2013-10

Unfortunately, except the 80% largely unaffected, these numbers are garbage.

[geek tragedy]

5. "except for the 80% largely unaffected"

Other than that, how was the play Ms Lincoln.

Also:

Finally, about 3% will have to buy more comprehensive plans than they now get through the individual market. Lizza labels this group as "potential losers," but some of these people are actually winners: They'll get better coverage than they used to have, and it may be at a lower cost after federal subsidies. But some of these people will pay more for a costlier insurance plan they didn't want.

It's clear that Obamacare creates more winners than losers, but this chart and the analysis behind it don't shed much light on the ratios

[enlightenment]

6. Parse it how you want it -

I was just curious where you found the chart, checked the properties, and discovered it was part of an article that was criticizing the data used to create the chart.

Spin it how ever you want to, geek.

[geek tragedy]

7. It's spin on spin

The person's basic quibble comes down to whether it's:

80% the same (employer based and those who stay uninsured)
14% clear winner--former uninsured
3% no real effect--currently insured keep policy
3% potential loser--change in policy

or:

86% stay the same (employer based and those who stay uninsured)
8% clear winner--currently uninsured
1.5% winner--currently insured keep policy
1.5% loser--currently insured keep policy
1.5% winner--change in policy
1.5% loser--change in policy

[enlightenment]

8. Okay.

What ever makes you happy.

[7962]

40. I'll know on Monday, when my employer's benefit plan comes out.

Then I can see what my premiums are going to be

[Mass]

11. Barro's willfully misrepresent what the graph says.

[Purveyor]

105. OOPSIE!

[JoePhilly]

15. I don't think I've heard anyone claim that ... I have heard some claim ...

that it will LITERALLY kill you grandmother and your kids.

But claim that its perfect, no.

No one claims that, except builders of straw-men. And that industry group seems to be BOOMING.

[Hekate]

101. The strawman industry certainly has some adherents ...

... here.

Amazing, isn't it?

[Scurrilous]

9. Thanks!

K & R

[leftstreet]

10. I'm tripling your rent. But I insulated

I also added storm windows. Changed out the old fusebox for safer circuit breakers, put in a downstairs egress window and demolished the outside carport for a 2car garage with an extra bathroom.

These are awesome changes - more convenient, you'll be safer, and your heat bill will go down a few bucks in the winter. It's for your own good.

If you can't handle the tripled rent, you may qualify for subsidies being given to landlords like myself to help you meet your obligations. Or you may not.

[Mass]

12. I sell you a cheap car, but its brakes do not work, its direction is not very good, and it has not

direction lights, but it is cheap.

[leftstreet]

13. If I could afford a better one, I'd have gotten it

[Mass]

16. So, you are against regular tests on cars to make sure they are safe?

and you prefer to pay tons of money after you cause an accident (or in the case of healthcare if you get really sick).

[leftstreet]

21. That doesn't make any sense

People buy what they can afford

If cars and insurance and lawn darts are being sold 'unsafe' it's not the fault of the people who purchased them

Where was this great wringing of hands and concern™ over junk insurance before the ACA?

[geek tragedy]

23. "Where was this great wringing of hands and concern™ over junk insurance before the ACA? "

Apparently you didn't pay attention to the healthcare reform lobbying that occurred pre-ACA passage.

[leftstreet]

24. I remember when they arrested single payer advocates

[geek tragedy]

26. Do you seriously think that the term "junk insurance" post-dates the ACA? nt

[leftstreet]

27. It pre-dates "You can keep your insurance"

That's what this is about

How the administration could let this happen is beyond me. But it did, and they need to apologize and offer a way to fix it. They DON'T need to beat up on people as losers or suckers for purchasing shitty insurance. And they DON'T need to send out the nanny-state talking points about how this is for your own good!!!!111

[Mass]

31. "nanny-state". The only people I know using this expression are from the GOP.

Progressives understand the importance of the role of government. Our should be better, not smaller.

Repeating GOP talking points may be fun, but bye bye.

[leftstreet]

32. And Democrats would be wise to avoid it

Not HAND the GOP the ammunition they need

[geek tragedy]

36. Fuck Ron Paul nt

[Dr Hobbitstein]

90. Watch it...

You remember what happened last time...

[geek tragedy]

35. fanatically anti-mandate, opposes basic regulations on health insurance policy

by defending them as 'free choice' and uses language like "nanny state"

Yep, paulbot

[geek tragedy]

34. "Nanny state talking points" Uh oh, someone let their Libertarian slip show.

Oops.

[leftstreet]

37. :eyes:

You must be very young, or politically naive

The GOPers have SLAMMED Democrats for decades by using that pejorative

I'd like to see it end

[geek tragedy]

42. Hardy fucking har. A single payer advocate who complains about "nanny state

talking points"--that's pretty rich.

Almost as rich as someone who complains about people losing private junk insurance policies but claims to want to take away everyone's private insurance policy.

[leftstreet]

53. You don't support single payer

That's fine. Your choice

Some of us are strong advocates

[geek tragedy]

54. No single payer advocate I've ever known would object to getting rid

of private junk insurance policies using language like "nanny state talking points that this is for their own good."

[leftstreet]

61. No working class advocate would blame workers

Junk insurance isn't the issue

Blaming working class people for buying junk insurance sux

[geek tragedy]

62. No one is blaming them. Stop making shit up. nt

[dbackjon]

55. The only way that will end

Is if we select Paul and other Libertarians as our overlords



Newsflash - anything that a government does that these "rugged Individualists" don't like is a "nanny-state". Excepting the items that make them a profit.

[JoePhilly]

43. See sub thread with me, and your friend, below.

Apparently, bad insurance policies never lead to bankruptcy.

[geek tragedy]

44. "people buy what they can afford" is another libertarian talking point nt

[leftstreet]

51. LOL n/t

[moriah]

50. Junk insurance can still be sold in my state.

There are several plans listed for 2014 on Arkansas's BCBS website that don't meet the ACA guidelines to avoid having to pay a penalty, it's clearly stated why they don't meet the minimum qualifications. I think that's a great compromise. So if the plans are being cancelled, it's not by federal law.

If a person can't afford real insurance they probably won't be charged a penalty, they might be able to buy one of these plans instead if they really couldn't afford full insurance to have some coverage. Or, for some, paying the penalty and buying the junk insurance might be cheaper.

[VanillaRhapsody]

56. did you have to sign a new policy last year?

I did...as I have every year I had insurance. Have they changed insurance companies without my input? They sure as hell have....did they change what they were charging...yep! This happened Pre ACA as far back as I remember.

[JaneyVee]

65. LOL. Single payer advocate talking about nanny state.

[ProSense]

70. OK,

"They DON'T need to beat up on people as losers or suckers for purchasing shitty insurance. And they DON'T need to send out the nanny-state talking points about how this is for your own good!!!!111"

...that's weird.

[leftstreet]

74. That's what's happening

People are in the news claiming Obama lied about keeping their plans.

Rather than parse the details and have an actual discussion, ACA advocates ™and Obama's Ardent Supporters™ are screeching that people who bought shit insurance should be thrilled that even though their premiums may triple or quadruple - the plans will be better for them!!

That's classic GOP fodder for claiming "liberals are nanny-staters!" and it's been very harmful for Democrats for decades

But you already understand that

[ProSense]

76. No, that's not "what's happening." You seem to be upset that people are attacking shitty plans.

"That's classic GOP fodder for claiming "liberals are nanny-staters!" and it's been very harmful for Democrats for decades"

You are the one throwing around the phrase "nanny state."

Why would anyone want to keep a shitty plan?

Reminder for people getting those letters from their insurers: You're not their captive anymore
http://www.democraticunderground.com/10023956700

[leftstreet]

78. Yes it is

Sorry to disappoint you, but I didn't invent the term 'nanny staters'

It's a powerful concept used by GOPers in everything from gun control to seatbelts - but I know you know this

Do you understand how crucial the healthcare debate is right now?

The first major, massive legislative intervention into social programs in decades. Screeching at people with complaints - 'well it's for your own good' is political suicide

I'm assuming we're all here to support the Democratic party's efforts at social reform, so I am flummoxed at the efforts of some to shut down necessary conversation

Hmm

[ProSense]

79. Wait,

"It's a powerful concept used by GOPers in everything from gun control to seatbelts - but I know you know this "

...is that why you're using it here: http://www.democraticunderground.com/10023956884#post27

[leftstreet]

82. Yes, exactly!

When people complain about legislative actions and you pound on them that it's 'for your own good!' - that's a GOP pejorative talking point known as 'oh those nanny-state liberals'

'Tax and spend liberals' is another

I can't believe you don't know these things

[ProSense]

83. You seem to be attempting to blame others for your use of a GOP talking point. n/t

[leftstreet]

85. LOL

Sorry, I don't understand

I used an example of a GOP talking point that's been deadly for Democrats for decades, and I stressed that we must avoid it at all costs. I just assumed, based on your posting history, that you understood

LOL maybe DU needs a terminology dictionary

[ProSense]

86. LOL! No, that's not how you used it.

Still, I can see why you'd want to deny using it.

[leftstreet]

87. Well, that's how I meant it

Sorry if you're confused

My statement is here somewhere...try reading it again and you'll see

[ProSense]

89. Again, with the attempted blame. "Nanny state" is a GOP phrase.

"They DON'T need to beat up on people as losers or suckers for purchasing shitty insurance. And they DON'T need to send out the nanny-state talking points about how this is for your own good!!!!111"

http://www.democraticunderground.com/10023956884#post27

The intent is there, and no I'm not "confused."

[leftstreet]

91. I blame no one

For anything

Sigh. I can't see where you're confused

OH WAIT!

"They DON'T need to beat up on people as losers or suckers for purchasing shitty insurance. And they DON'T need to send out the nanny-state talking points about how this is for your own good!!!!111"

Uh..is it because I said 'send out?' Would it have been more comfortable for you if I'd said 'send the GOP out with'...the talking points? To me it's the same thing

[ProSense]

94. You can't spin that.

What you're trying to claim would make no sense to use the phrase "nanny state."

The context of the statement is clear.

[leftstreet]

96. That makes no sense

I'm sorry, I don't get that

Whatever

This thread is a reminder to me of the incredible sensitivity of Obama's Ardent Supporters - scanning the worldwidewebz for the slightest hint of an intrusive anti-Obama transmission with a vigor and dedication that puts NASA's SETI program to shame

I assure you everything is fine. This has nothing to do with Obama. It's about policy. It's about not bashing working class people. It's about not giving the GOP an advantage politically by claiming what looks like a shit sandwich is actually good for you because it's fortified with vitamins and minerals. It's about wanting government to work for people, and wanting people to like it

Can I go now?

[ProSense]

98. You used the phrase "nanny state," which you admit is a RW talking point, and

you attempted to assign a context to it unsupported by the statement.

Here is the appropriate context: "Nanny state" is a RW talking point.

The rest of your comment is throwing around insults because it was pointed out that you used a RW talking point.

"It's about not giving the GOP an advantage politically by claiming what looks like a shit sandwich is actually good for you because it's fortified with vitamins and minerals. "

I suppose that's why, including with the "nanny state" comment, you're all over the place. Why would you want a "shit sandwich" to "succeed"?

[leftstreet]

100. ??

LOL I can't understand why you're beating this dead horse, you're not very good at it and you're going to get upside down on this

YES I USED THE TERM NANNY STATE

YES I KNOW IT'S A RIGHTWING PEJORATIVE TERM

YES I WANT DEMOCRATS TO AVOID LETTING THE GOP CLAIM THEY'RE NANNY-STATERS BECAUSE WHEN THEY DO DEMOCRATS LOSE THE CONFIDENCE OF THE VOTERS




I must say it's intriguing to me how many, many times you've used and re-used and regurgitated and reposted that term in this thread. Hmm

[ProSense]

103. Well,

LOL I can't understand why you're beating this dead horse, you're not very good at it and you're going to get upside down on this

YES I USED THE TERM NANNY STATE

YES I KNOW IT'S A RIGHTWING PEJORATIVE TERM

YES I WANT DEMOCRATS TO AVOID LETTING THE GOP CLAIM THEY'RE NANNY-STATERS BECAUSE WHEN THEY DO DEMOCRATS LOSE THE CONFIDENCE OF THE VOTERS

...that's spin. This is the statement:

"They DON'T need to beat up on people as losers or suckers for purchasing shitty insurance. And they DON'T need to send out the nanny-state talking points about how this is for your own good!!!!111"

http://www.democraticunderground.com/10023956884#post27

The fact is that you really aren't concerned about the people who will be helped by the law. You seem more concerned that people are criticizing shitty insurance policies.

[leftstreet]

106. I want single payer

As shitty as it is if Obamacare fails, there's a good chance the US will never, ever, ever NEVER get it

This is the first legislative action on a major public concern in decades. It's huge. And if it fails, single payer is at high risk not because the political parties will block it, or the insurers and big pharma will fight it. It will be because Americans are convinced government is incompetent and incapable of enacting social programs. Then say goodbye to Medicare...SS...public schools...

There's a long game here that has nothing to do with who's in office. It's about policy

[ProSense]

107. So

"This is the first legislative action on a major public concern in decades. It's huge. And if it fails, single payer is at high risk not because the political parties will block it, or the insurers and big pharma will fight it. It will be because Americans are convinced government is incompetent and incapable of enacting social programs. Then say goodbye to Medicare...SS...public schools... "

...in order to ensure that it doesn't "fail," you think the best thing to do is characterize it as a "shit sandwich" that's trying to separate people from existing shitty insurance plans?

Nearly 12 million Americans are about to get Medicaid (the other 5 milion are being blocked by Republicans). Those are the people, including millions more who will qualify for subsidies that this will help.

Single payer is inevitable.

Single Payer movement in the era of Obamacare

by Shockwave

If you believe that healthcare is a basic human right and understand why Single Payer IS the final destination of healthcare reform and you want to get it done as soon as possible, read on.

<...>

If you are involved in the Single Payer movement in California this diary may help you understand what we face and whet we can do to get things done.

I am one of those Single Payer activists who understands that Obamacare will benefit many and it is truly amazing that this effort, that President Obama should get full credit for, is the best that could come from a dysfunctional and extremely polarized DC.

And I support those who keep up the fight to prevent its sabotage by all the Republicans in red states and in DC.

I consider the ACA a giant first step towards an America where healthcare is recognized as a basic human right and there is a system that allows ALL who live here to have access to affordable medical attention without the fear of going bankrupt.

And I understand that California is leading the country in the implementation of Obamacare. But it's not about being better than other states like Texas and Georgia where Obamacare is being sabotaged or ignored. It's about joining Vermont to help lead the country to a place where ALL are covered, where the private insurance blood suckers are gone, where medical results and costs are in line with other developed nations, where if you need to see a doctor (or a dentist) you make an appointment and you don't worry whether you will be able to pay the rent (given that 76% of all Americans live paycheck to paycheck).

So how do we get it done? <...>

Bill Zimmerman has just published an article that sets the tone;

Why California can lead the way to Single Payer in the U.S.

Recently Public Citizen, a member of California’s AllCare Alliance, released a report entitled, “A Roadmap to Single-Payer: How States Can Escape the Clutches of the Private Health Insurance Industry.” “We’re looking for a few pioneering states with the courage and fortitude to let common sense prevail over the insanity of our current patchwork system, “said Lisa Gilbert, director of Public Citizen’s Congress Watch division. “Once they succeed, we expect most opposition to single-payer and our reliance on privately insured health care to become historical relics.”

By the time California votes to move to a single payer system – the earliest date possible is 2017 when the Affordable Care Act allows states to set up their own systems – Congress will have gone through two more election cycles. Voters will be less white, and probably less conservative, and the changing composition of the House of Representatives may allow for passage of single-payer waiver legislation for states, perhaps even with “state’s rights” support from a few Republicans.

California, Vermont and possibly other states moving to single-payer will put increasing pressure on Congress to grant other state waivers. Once subject to such pressure, Congress could theoretically pass a federal bill to give (improved) Medicare to all, but it is politically far more likely that they will simply let the states set up their own systems, which can then become models for a larger federal program. California, once again, could be the engine driving national change.

One of the features of Obamacare is the "waiver". The idea is that states can apply for this "waiver" and implement their own plan starting 2017 if this new plan covers more people and is affordable.

So lets take a look at what the ACA says about the "innovation waiver";

SEC. 1332 ø42 U.S.C. 18052¿. WAIVER FOR STATE INNOVATION.
(a) APPLICATION.—
(1) IN GENERAL.—A State may apply to the Secretary for the waiver of all or any requirements described in paragraph
(2) with respect to health insurance coverage within that State for plan years beginning on or after January 1, 2017. Such application shall—
(A) be filed at such time and in such manner as the Secretary may require;
(B) contain such information as the Secretary may require, including—
(i) a comprehensive description of the State legislation and program to implement a plan meeting the requirements for a waiver under this section; and
(ii) a 10-year budget plan for such plan that is budget neutral for the Federal Government; and
(C) provide an assurance that the State has enacted the law described in
subsection (b)(2).

So this is the milestone that any state has to go through. The Vermont single payer activists lead the way. Even Vermont will apply for the "innivation waiver" to get federal funds starting in 2017 to help pay for their Single Payer system.

Here in California the Single Payer organizations (linked logos below) will announce soon the plan to achieve the "waiver" milestone by January 1st 2017. The Single Payer plan that will be proposed will be based mostly on SB 810, which was approved by SEnate and Assembly twice and vetoed twice by Arnold Schwarzenegger and in 2012 it was stopped by 6 blue dogs in the Senate before it could get to Jerry Brown's desk.

In California, one of the key issues is that Obamacare will leave out over 3,000,000 undocumented workers. These 3,000,000 are an integral part of our society and mostly but not all are Latinos. And as Joan McCarter pointed out, Latino organizations worry about funding for Obamacare outreach efforts;

Hispanic health centers and community organizations say they don’t have the funding or resources to carry out the complicated sign up process for the 10 million Latinos who will be eligible for new public and subsidized health coverage options.

Latino organization outreach is a key to success.

And we should coordinate the efforts around the country.

So here in California we need to work with Sacramento at all levels. It will be a lot of hard work but there are thousands of committed activists.

One way you can help is by joining one of the Single Payer organizations and help us organize and direct the grassroots movement that will be instrumental in convincing Sacramento to go along.

And this week on Thursday August 1st you can join other activists to watch The Healthcare Movie in Santa Monica at 7:30PM and celebrate the 48th anniversary of Medicare. You can buy tickets here.

- more -

http://www.dailykos.com/story/2013/07/30/1226609/-Single-Payer-movement-in-the-era-of-Obamacare

Note:

Kos Media, LLC Site content may be used for any purpose without explicit permission unless otherwise specified

Remember Section 1332 of the health care law?

State single payer waiver provisions in the Senate healthcare bill - legislative language and fact sheet from Vermont Sen. Bernie Sanders

Why the 1332 Waiver in the Senate Health Reform Bill is the Only Opportunity for State Single Payer Systems Under the Bill

The health care reform bill passed by the Senate requires that all states set up Exchanges through which private insurance companies could sell their plans. Because federal laws preempt state laws, the federal health care reform bill would supplant any state attempt to set up a single payer system in lieu of an Exchange, which by its nature calls for multiple payers to compete. If the Senate bill is enacted, the only opportunity for states to move toward a single payer system is found in Section 1332. This section would allow a state with a plan that meets certain coverage and affordability requirements to waive out of the requirement to set up an Exchange for private insurance companies. Only with such a waiver could a state move in the direction of a single payer system.

- more -

http://www.pnhp.org/news/2010/march/state-single-payer-waiver-provisions-in-the-senate-healthcare-bill-legislative-langu

Release: President Endorses State Waiver Proposal

Vermont Delegation and Gov. Shumlin Hail Obama Endorsement of State Health Reform Waiver Legislation

WASHINGTON, Feb. 28 - The Vermont congressional delegation and Gov. Peter Shumlin today hailed President Obama's endorsement of legislation allowing states to provide better health care at a lower cost starting in 2014.

At a meeting of the National Governors Association Monday morning, Obama announced his support for amending the Affordable Care Act to allow states like Vermont to seek a federal waiver to the new law three years earlier than currently allowed. States would be required to design plans that are at least as comprehensive and affordable as the federal model and cover at least as many people

Last month Sens. Bernie Sanders (I-Vt.) and Patrick Leahy (D-Vt.) introduced in the Senate and Rep. Peter Welch (D-Vt.) introduced in the House legislation that would advance the date waivers would be accepted from 2017 to 2014. The three joined Gov. Shumlin at a Montpelier press conference to announce the legislation, which would provide Vermont the flexibility it needs to adopt reforms Shumlin is pursuing.

Leahy said, "This is a wise decision that keeps in focus the goal of continually improving health care in America. I applaud President Obama and Secretary Sebelius for supporting efforts by Vermont and other states to go above and beyond what the Affordable Care Act requires. They know that the federal government does not have a monopoly on good ideas, and innovations by the states will prove - and improve --- the benefits of health insurance reform, on the ground, and in practice. While some in Washington want to turn the clock back and repeal the new health reform law, Vermont and other states want to move ahead. Vermont has already been working hard to improve the state's system of health care, and passage of the delegation's waiver bill will move our state one step closer to that goal."

Sanders said, "At a time when 50 million Americans lack health insurance and when the cost of health care continues to soar, it is my strong hope that Vermont will lead the nation in a new direction through a Medicare-for-all, single-payer approach. I am delighted that President Obama announced today that he will, in fact, support allowing states to innovate with health coverage models sooner rather than later. I worked hard to draft and secure the waiver provision in the health reform law and I am very pleased the president now agrees that we should make it available in 2014 as originally intended. While there is a lot of work to be done, I look forward to working with Sens. Leahy, Wyden, Inouye, Brown and others in the Senate and Rep. Welch and others in the House to get this done as soon as possible."

Welch said, "President Obama's support for allowing states to innovate sooner is a good news for Vermont and all states looking to tailor health care reform to individual states' circumstances. This legislation will give Vermont a green light to lead the nation in providing quality health care at a lower cost. I'm hopeful that Democrats and Republicans alike will support this practical step to give states flexibility to achieve progress their own way."

Shumlin said, "I was excited to learn about this today during a visit to the White House. All along officials from Health and Human Services have expressed a willingness to work with us, as long as we don't compromise standards under the law. I think this is an excellent example of how we can work together to control skyrocketing health care costs and implement meaningful health care reform as soon as possible."

A fact sheet on the delegation's "State Leadership in Healthcare Act" is available here.

http://www.sanders.senate.gov/newsroom/news/?id=44a664de-8e92-43f4-a871-d26e0b5a252d

FACT SHEET

"State Leadership in Healthcare Act‟

Section 1332 of the Patient Protection and Affordable Care Act – the “Waiver for State Innovation” – allows states to waiver out of some of the requirement of federal health reform if they meet certain standards. The provision in the new law was authored by Sens. Bernie Sanders (I-Vt.) and strongly supported by Sen. Patrick Leahy (D-Vt.) and Rep. Peter Welch (D-Vt.).

The Sanders-Leahy-Welch “State Leadership in Healthcare Act” moves the availability of state waivers from 2017 to 2014. This would allow a state to avoid the expense of setting up an exchange – which is otherwise required in every state in 2014 – only to dismantle it later.

The federal waiver would allow a state to:

a) Collect all the federal funding and use for financing coverage for individuals through a plan designed by and for that state.
b) Coordinates this waiver process with Medicare, Medicaid and CHIP waiver processes that may be required depending on the design of the system. The state

The federal waiver would not allow a state to:

a) Offer lower quality or less affordable care to their residents than would be available in the exchange.
b) Obtain waivers from the health insurance market reforms implemented under the law such as those benefiting ending the use of pre-existing conditions to exclude individuals from coverage or those allowing young adults to stay on their parents’ plans longer.

How does the waiver provision of the law work?
Step 1: The state passes a law to provide health insurance to its citizens.
Step 2: The Secretary of Health and Human Services and Secretary of the Treasury review the state law and determine that the plan is:

a) At least as comprehensive as its residents would receive in the exchange;
b) At least as affordable;
c) Deficit neutral to the federal government; and,
d) Covers at least as many people.

Step 3: If the federal government finds that the alternative state system meets these requirements without certain federal rules, states can get a waiver. The state plan could receive waivers from:

a) The section requiring establishment of the exchange
b) The designs for how federal subsidies would have to reduce premiums and co-pays.
c) The employer penalty for providing coverage
d) The individual mandate.

http://www.sanders.senate.gov/graphics/011411state_waiver_fact_sheet.pdf

The Affordable Care Act: Supporting State Innovation
http://www.healthcare.gov/news/factsheets/2012/02/state-innovation02222012a.html

[leftstreet]

108. I thought my characterization was polite

FFS - people are on tv calling Obama a liar over this.

Get serious - stop worrying about how the conversation happens. Stop thinking you've scored a reawwy, reawwy, big point !!!111 by finger-wagging someone on the internet for improper form

Good grief

[ProSense]

109. Well,

"FFS - people are on tv calling Obama a liar over this."

...people there are "on tv calling" him a Muslim.

"Get serious - stop worrying about how the conversation happens. Stop thinking you've scored a reawwy, reawwy, big point !!!111 by finger-wagging someone on the internet for improper form"

You should take your own advice instead of "worrying about" what people on "tv" are saying.

[leftstreet]

111. Sigh n/t

[Mass]

25. I was part of those very concerned. Many people were in fact. We wanted single payer. We did not get

it. You may have been asleep.

So, what do you propose? That we stay as before the law (please do not say single payer. Not going to happen at this point of time). I am a breast cancer survivor. I am lucky enough to live in MA. In many other states, I would not be able to find a decent insurance. So, I am sorry if I see the reality and the urgency of the problem. We cannot wait until the country wakes up and see the light.

[JoePhilly]

17. It also won't pass inspection.

[Mass]

18. Just like the old contracts do not pass Obamacare standard. My point.

[JoePhilly]

20. Yup ... agreeing with you completely.

[geek tragedy]

14. More like they added rooms, a roof and indoor plumbing. nt

[JoePhilly]

19. Or, they replaced your cardboard box, with a subsidied room, with a bed if you get sick.

Hey ... that's IS actually much like what they did!!!!

Insurers can't bankrupt you and force you out onto the street, when you get sick. You still get treated, and you are protected by an ot of pocket max, and no life time limits.

[leftstreet]

22. Wow! Medical debt is being waived under the ACA?

I didn't know that

So you can exclude medical debt from bankruptcy?

[JoePhilly]

29. The amount of out of pocket debt you can accrue is limited.

And you get no life time cap.

If you can't figure out how that helps people NOT lose their homes, you may need to take a math class.

But hey ... I'm a helper ... so here's an example.

Today ... you get an illness for which the cost blows through your cap. You lose everything. Then die.

Under ACA ... same illness, you have a max out of pocket (let's say 10k), and no CAP.

You can work with people on a way to pay off 10k, or 20k. But you don't have to lose your home, or die.

AND ... as I am sure you know ... Hospitals are able and willing to FORGIVE debt and write it off. But not if its millions. But 10k, yes, they WILL write that off.

[leftstreet]

33. Oh. You said insurers couldn't bankrupt you

Thanks for clarifying

[JoePhilly]

38. Sure, because no one goes bankrupt because their insurance sucks.

Most liberals know that MANY people have gone bankrupt for exactly that reason.

I understand that being a member of the disgruntled left is your "thing" ... but in this case, you have joined the RW in claiming that no one goes bankrupt because their insurance sucks.

Well done.

[leftstreet]

41. That's nonsensical n/t

[JoePhilly]

45. Sure, because no one goes bankrupt because their policy sucks.

[Politicub]

48. You are purposefully obscuring the issue

It's a big deal for some of us that our max bill will be under $7,000 on the lowest tier.

Many can come up or finance $7k and won't be left with a $200k bill for heart surgery.

I lived through this growing up. My parents almost lost everything when my dad needed emergency surgery. He worked hard his whole life and would be able to afford or finance $7k. His condition was one that an annual physical may have caught.

So don't cluck about bankruptcy to me. It's an insult that you throw around like it's nothing.

If there's a common thread between Obama's priorities it's the dignity of the individual.

This will give people that. My father would not have needed to be declared indignant with the ACA.

Yes, single payer would have been great, but the ACA is damn better than the status quo. If you don't believe that you probably have insurance through work, on a parent's or spouse's policy, or too well off to care about the people this will help.

No federal program is perfect. None. But they can be improved over time and the ACA is a good foundation to build on.

No wonder why the GOP is afraid of it.

[VanillaRhapsody]

58. There are no caps now!

[XRubicon]

110. No...

I have this shitty insurance policy. It's real cheap. I hardly pay anything, its my right to choose. But when I get sick and the shitty insurance drops me and I don't pay- you the tax payer pick the cost of my emergency room care and after I declare bankruptcy you pay my Medicaid and welfare costs... It's my choice as an murican.

[ProSense]

28. This Halloween, Obamacare Critics Are Trying Their Best To Scare You About Health Reform

This Halloween, Obamacare Critics Are Trying Their Best To Scare You About Health Reform
http://thinkprogress.org/health/2013/10/31/2867251/obamacare-critics-scare-halloween/

[Mass]

30. A few Republicans are revealing themselves on this forum as well,.

repeating GOP talking points.

[geek tragedy]

39. I was onto that one a long time ago. They came here within 1-2

minutes of the announcement that the GOP C.R. on 9-30 would include a delay to the individual mandate.

Guess what they did?

Posted a thread pushing a delay in the indvidual mandate, repeating the talking points of the RNC.

[leftstreet]

46. I worry more about people who try to shut down discussions

I think to myself...

In order for Americans to ever get single payer healthcare, the ACA - clusterfuck that it is - MUST SUCCEED. This is the most important legislation addressing social concerns in decades. Nothing would be more deadly than Americans believing 'gubmint fucks everything!' The ACA needs discussion, it needs tinkering, the WH and legislators need feedback from Americans

Yet some are very anxious to halt those conversations

Oh wait...maybe they weren't single payer advocates to begin with

[geek tragedy]

47. So says someone who wants to gut it by removing the individual mandate.

Which would then keep the young and healthy out, which would then in turn increase premiums, which would then drive more people out, which would then drive premiums up even further.

Allow me to quote Paul Krugman from 2007, blasting candidate Obama:

Finally, Mr. Obama is storing up trouble for health reformers by suggesting that there is something nasty about plans that “force every American to buy health care.”

Look, the point of a mandate isn’t to dictate how people should live their lives — it’s to prevent some people from gaming the system. Under the Obama plan, healthy people could choose not to buy insurance, then sign up for it if they developed health problems later. This would lead to higher premiums for everyone else. It would reward the irresponsible, while punishing those who did the right thing and bought insurance while they were healthy.

Here’s an analogy. Suppose someone proposed making the Medicare payroll tax optional: you could choose not to pay the tax during your working years if you didn’t think you’d actually need Medicare when you got older — except that you could change your mind and opt back in if you started to develop health problems.

Can we all agree that this would fatally undermine Medicare’s finances? Yet Mr. Obama is proposing basically the same rules for his allegedly universal health care plan.

[leftstreet]

49. Not gut. Improve

The Administration felt delaying the employer mandate and caps-on-costs would improve the legislation by extending the time for working out...bugs.

[geek tragedy]

52. Yes, those are the RNC talking points on why the individual mandate should be delayed.

The individual mandate is there to get people to join the insurance pools to keep premiums down.

Thanks for playing.

[leftstreet]

57. What are the DNC talking points?

Americans are losers if they refuse to eat catfood and dirt while they give all their money to insurance companies? I seriously doubt it



Give me a break

[geek tragedy]

59. You're objecting to the ACA banning private

insurance that rips people off. Spare us the objection to people getting decent private insurance.

[leftstreet]

64. They haven't banned private insurance

I wish!

This may come as a shock to you, but some of the plans will see working class people struggling to make high monthly premiums, high deductibles and cover 40% of the costs of care themselves. And some of those people will not get help from the exchanges

You started this thread to cast blame and suspicion on people in the news complaining that Obama lied when he said people could keep their plans

Then you attack people who think this is a problem and should be discussed

[geek tragedy]

88. As opposed to paying 100% out of pocket

because their junk insurance won't cover anything.

[VanillaRhapsody]

63. removing the mandate IS gutting it...for the reasons noted above.

[leftstreet]

66. Uh..the employer mandate, or the individual mandate?

Which elements are key in making this work?

Given that 80% of people currently have medical coverage and insurers seem to be able to manage risk without their CEOs and stockholders going hungry, I'm assuming you don't mean the 20% who aren't currently covered

[VanillaRhapsody]

67. take your pick.

[Cali_Democrat]

73. Your slip is showing. n/t

[tblue37]

93. The employer mandate was NOT ESSENTIAL to the

functioning of the ACA. The idividual mandate IS.

[VanillaRhapsody]

60. I think you guys are onto somthing...its not like it's beneath Wingers to do something like that.

Wolf in sheeps clothing....trojan horses...etc.

[leftstreet]

68. Single payer advocates are troublemakers

That's for sure

In spite of the massive clusterfuck the ACA is, we seriously need it to not fail

When the nightly news is screeching that Obama lied about the ACA, when late night comedians are ridiculing the debacle - single payer advocates worry that Americans will end up believing the government can't be responsible for social programs

It's serious

[VanillaRhapsody]

69. Single Payer Advocates that don't know when enough is enough....

and to stop joining the fray to ensure its failure!

[leftstreet]

71. Obamacare sucks - but it must succeed

I don't expect those of you who don't support single payer national plans to understand that

You can learn a lot if you're careful not to shut down conversations about the ACA - even when there are complaints.

[VanillaRhapsody]

72. No YOU don't get it...we DID want Single Payer. But we are realists...

It is what it is...

We win with ACA or you will NEVER see Single Payer in your or your children's lifetime.

It's THAT simple!

[leftstreet]

75. Then you do want it to succeed

Then you welcome each opportunity to discuss its problems, its potential, possible legislative changes, and help people understand the whole thing

Great!

[VanillaRhapsody]

77. Not right now I don't...

Let's let it run its course first....there will be plenty of time for improvement

Or do you always jump on GOP bandwagons as a rule?

Or unless killing it in utero is your true goal

[leftstreet]

80. I wish you did support it

Eventually you might

In the meantime, just think about the significance of everyday people - not necessarily as well versed as yourself in the ACA, etc. Their complaints are serious and should be treated as an opportunity to guarantee the ACA succeeds and moves everyone to embrace the idea of government tax-based responsibility in healthcare

[VanillaRhapsody]

95. I AM thinking about "everyday people"

I AM one!

The ACA hasn't even gone into effect yet. Can't we stand behind it until it actually does? Because even YOU admit how important it is that it succeeds!

The first thing this needs to succeed. Is for that website to succeed. The SECOND most important thing it needs to succeed...is for YOUNG HEALTHY people to sign up for it....if they don't it is doomed!

Do you get my drift? Or have you never heard of marketing? But to nitpick it at a time like this.....at the precipice of it even beginning???? Do you think your little criticisms are going to help or hinder that?

Cause after all what we really want is Single Payer....our only path to that is THROUGH the ACA! Failure is not an option!

[leftstreet]

97. That's good! n/t

[VanillaRhapsody]

104. What it needs from us right now....considering the circumstances...

is a little support. Yes there are going to be issues galore that have to be addressed. But like the website...they have to logically and methodically be worked through. It will receive lots of criticism from the Right!

But ACA is just a stepping stone...we have to hold that stepping stone however...we have to give "everyday people" just a little taste of what could be....that's where ACA comes in....once they understand the benefits far outweigh the drawbacks...they will be down for Single Payer.

But the ACA is what we have right now....and it is far from perfect. There will likely be some collateral damage. But as Joe Biden said...this IS a BFD! Nothing this big doesn't come with some challenges. But this thing is designed to increase competitiveness among insurance companies. What they are eventually NOT going to want to happen...is for them to try cancelling your policy...thus giving you a chance to test your buying power on the market...which when they try to cancel a policy...you have every right to do! They will NOT want to see lots of people leave them and get a policy on The Exchange. They are definitely overcharging right now....guess what happens at the end of 2014 if they over charge and paid out less than 80% of their customers money? MORE checks go out to the policy holders....in ***2014*** There is some significance to that date don't you think?

Right now one of the things I have heard people doing is to threaten to leave the Insurance company for a policy on the exchange.... whereby they dropped one guys payments $75 a week as a result!

[Pretzel_Warrior]

81. Great! Same things we've been asking at DU

Ha!

[Tarheel_Dem]

84. K&R

[PasadenaTrudy]

92. I make

$45,000, single person, and didn't qualify for a subsidy. I called and asked.

[tiredtoo]

99. Thsnks for the post.

I just looked at an email addressed to some friends from an irate right wing radical. he is complaining of his insurance going up 350 percent. He closed his email by calling Obama a turd and told NSA to screw themselves. I could not respond as it would just be disregarded as bs. But i did send it to some of the others on the list. Hopefully they will be able to calm this guy down and explain some of this to him.

[liberal N proud]

102. They sure have them lined up and rolling them out

[BKH70041]

112. It's up to the plan owner to determine if it is (was) good or not.

Someone else telling them their plan was less than adequate means ZERO.

Some individuals prefer to learn the hard way they don't get to decide for others. So be it.

[TexasBushwhacker]

113. Except when they find out their crappy insurance doesn't cover anything

the costs associated with the non-coverage are passed on to others. For example, the woman who complained that she used to pay just $54 for her insurance and would now have to pay $590. The thing is, her $54 insurance only paid the first $50 of a medical bill. If she's in a car wreck and goes to the ER, her insurance would pay $50 and she would be stuck with a bill for thousands (maybe tens of thousands). When she can't pay, those costs are absorbed in the form of higher medical bills for EVERYONE. I have no problem with personal responsibility, IF the irresponsible person is the only one who suffers the consequences.

[SoCalDem]

115. Except when they show up at an ER, unable to afford to pay afterward

and then "we" all end up paying for their care...as if they had NO insurance at all...and then of course their credit is ruined too.

[BKH70041]

116. No Exceptions

They decide if their plan was (is) adequate. It's their plan and it's not up to anyone else. If people don't like that it's up to the individual to decide if their plan is adequate, they can shove it. They'll just learn the hard way to mind their own business.

[XRubicon]

117. Yes they can pay in emergencies with their holdings in Beenie Babies

I think you are on to something, we should let people opt out and go it alone. Choose coverage that is below ACA standards or no insurance at all, after all it's their right and those busy bodies should mind their own business.

I would only ask one thing though, that they sign a legal document like a living will that states they are not eligible for emergency room treatment without proof they can pay in advance or Medicaid/Medicare. It's my right not to pay for them if they don't want to pool risk with the rest of us.

Later, when they show up to the emergency room their name would show up in a database, they would have to prove ability to pay before any care is given (it's their right) - then the emergency room staff could roll them out to the sidewalk.

I'm good with that.

[upi402]

114. IF it's in the Mainstream Media - it's horse fertilizer

CNN and Fox are the moist steam on top of the pile