It's official, folks - your for-profit health insurance company is now part of the government

[derby378]

Big Insurance has won. The mandate survives as a tax - a tax that you pay not to the government itself, but to corporations such as UnitedHealthcare, Blue Cross Blue Shield, and others who have succeeded in making American healthcare the mess that it is.

We are slouching towards corporatism.

[Poll_Blind]

1. And 20 cents of every dollar goes not to your health care, but to them. The middlemen. nt

PB

[Romulox]

2. Don't worry! The Insurers are *only* guaranteed a 20% profit margin! That's not much...

is it? :fuck:

[Swede Atlanta]

78. You are not stating that figure correctly....

The insurers must spend 80% of their revenues on patient care. The remaining 20% may be used as the insurer sees fit to cover employee salaries and benefits, administrative costs, bonuses for employees and executives and profit.

While they will try to squeeze as much profit as possible out of that 20%, they are in no way guaranteed 20% profit.

[Romulox]

79. My bad--the government now guarantees a 20% GROSS margin for insurers.

Still a better deal than essentially any other business.

[Zalatix]

84. And that'll change (read: go upwards) with the help of the GOP in Congress.

[Hoyt]

81. Exactly. Plus, each insurer must set its premiums competitively or get eaten alive in the Exchanges.

There is a lot to keep the cap on what goes to admin and profits.

ACA isn't perfect, but it's a whole lot better than what we had before. Not to mention, those who will get coverage for the first time or who were stuck in jobs or with crummy private coverage because of a pre-existing conditions.

[rurallib]

3. good, now our foot is in the door

Elect good dems to change it to medicare for all!

[Romulox]

4. Right after we renegotiate NAFTA! nt

[rurallib]

9. whatever - it is still better than teabagger care

[Romulox]

10. Um, the plan was drafted by the Heritage Foundation and first implement by Mitt Romney...

[rurallib]

24. yes, we know, we know

[Zalatix]

65. You fought for the Heritage Foundation's master plan and the Heritage Foundation won. Happy?

[rurallib]

66. can you understand that it is a foot in the door

can you understand that millions of people who did not have a prayer of any health care are now covered?
SS was not what it is today when it was passed. I believe ACA can be morphed.

I am a devout single payer advocate, but ACA is definitely better than nothing.

Are you wanting to go back to the old system where insurance companies call all the shots, where there are caps, where payments are denied, where pre-existing conditions are cause for no coverage etc., etc? Because that's what it sounds like.
If that's the system you want until you get single-payer, I doubt you'll get many wanting to go backwards with you.

Would you hold out for the CEO job as your entry job and starve rather than work your way up?

[Zalatix]

67. I never once said that I oppose the entire ACA.

99.99% of the ACA is good stuff for America. It's that one tiny festering cancerous boil called RomneyCare/Heritage Foundationcare that I want carved out of its otherwise shapely backside.

[rurallib]

68. sorry - it was sure as hell implied by your response

[Zalatix]

69. I don't see how that could be interpreted from my remarks but far stranger things have happened.

[rurallib]

75. ok - my last post

your post was something to the effect that i supported the Heritage Foundation's health care plan (yes I know it was their plan originally)
Thus you took a shot at my supporting the ACA thus implying that you did not support it - my interpretation is that you therefore would want nothing to do with this flawed bill because it wasn't enough and it was Republican.
As I said i have worked my ass off for single-payer. i have the check stubs and the hate mail to show for it.
If it is a Republican bill that finally moves us off the schnied and starts the trek toward real health care then so be it. It is also saving Americans who may otherwise die.

I have lived a long time. I have seen programs start and slowly morph into good programs. But in health care I have seen decades go by without even a start. i believe it will move us forward. If it doesn't we are still much better off than yesterday.
And in this day when Republicans are actually making a run at ending SS and Medicare, this is also an affirmation that the US can indeed go forward even if only in baby steps.

Now I have work to do.
BTW, I was frankly insulted by your original response. You have no idea how hard I have worked for single payer.
And Monday I give the pint that will give me 51 gallons of blood donations because I put my money where my mouth is.

[dionysus]

71. "I never once said that I oppose the entire ACA."

well, from most of your posts, no one would be able to tell that!

[Zalatix]

76. Because I am vehemently dissing exactly and only one aspect of the ACA...

this somehow means I am attacking the WHOLE law?

Really?

[girl gone mad]

29. It is teabagger care.

The 99% getting teabagged. The 1% getting richer.

[joshcryer]

37. It's certainly thanks to the Teabaggers that we didn't get a public option.

That much is sure.

[Dr Fate]

89. And the DEM centrists who either agree with them, or were too frightened to fight them.

nt

[SomeGuyInEagan]

93. + 1.

Wish I could rec your reply. Spot on.

[Harmony Blue]

14. Exactly

The conversation can start now that this is a real possibility.

[joshcryer]

36. Oh no, stay home, pointless voting now. Clearly we have lost to the corporations.

[Harmony Blue]

5. I don't view it this way

as it is a small victory for what is to come (universal health care) down the road. The path has been opened up that is for sure.

[GObamaGO]

7. This is how I view it also

It also stops insurance companies from denying coverage for pre-existing conditions, etc.

[hifiguy]

12. Correct. nt

[sufrommich]

16. I agree. Once people see a benefit to government

getting involved in health care as a good thing as opposed to "the end of America" as it's been painted by the teabaggers, they'll be open ti more intervention on their behalf.

[Harmony Blue]

21. The conversation of universal health care can start

once people see that it does make a difference in real life practice. Most Americans have never traveled outside of the U.S. so they don't know at all?!

[HappyMe]

83. Exactly.

It's a foot in the door.

[HereSince1628]

6. I understand the anxiety about being mandated to assume another financial obligation

I appreciate the anxiety that accompanies the thoughts that there is really nothing anyone can promise about 'protections' from insurance gouging that cannot be overturned by a corporate controlled Congress.

[cynatnite]

8. I see it as laws for insurance companies...

They can't deny anyone for pre-existing conditions. No caps.

This is also the start of getting more comprehensive health care for all.

[girl gone mad]

31. They can both deny claims and impose caps.

Last edited Fri Jun 29, 2012, 01:05 AM - Edit history (1)

Strange that so many people who support this bill don't seem to have read it very thoroughly.

The ACA actually makes it easier for insurance companies to drop patients who get sick, deny claims, or refuse coverage for pre-existing conditions since the insurance companies will be allowed to cancel policies or refuse payment if the insured “made an intentional misrepresentation of material fact as prohibited by the policy” according to the fraud provisions.

Insurers can easily design their policies to in a way that makes it virtually impossible for customers to avoid committing what the insurers label fraud. In terms of the caps, the insurance companies will be allowed to pay for the least expensive treatment available, not the most appropriate according to your treating physician.

[PoliticAverse]

51. "The devil is in the details". n/t

[a kennedy]

91. and, THIS IS HUGE!!!

no denying ANYONE for pre-existing conditions....and NO CAPS!!! sorry for the caps.... but just these two things are HUGE.

[DainBramaged]

11. And my beautiful daughter can stay on my healthcare for three more years

You say tomato, I say tomatoe

[Harmony Blue]

17. That is wonderful

as young adults that age still have a lot of bills to deal with (eg school).

[girl gone mad]

32. That's good, but that could have easily passed as a stand alone bill.

There was no reason to throw millions of people under the bus so that a small fraction of people could get this benefit, which costs the insurers absolutely nothing.

[RBInMaine]

13. Please, stop the NONSENSE ! This law was the best we could PASS. You really need to find reality.

[GarroHorus]

15. WRONG, you pay the tax to the government, not to a corporation

You only pay the corporations if you do not wnat to pay the tax.

This is the BACK DOOR to single payer. If the government is going to tax you for not paying an insurance company, then the government is going to have to COVER YOU if you pay the tax.

[Harmony Blue]

18. It will start with the poor

but will eventually extend to a general coverage for all.

This is how most western democracies do it.

[Egalitarian Thug]

63. Sorry, but no. Most western Democracies do not allow what we think of as insurance companies

to exist anywhere near health care. From the Germans to the Japanese, what they call health insurance companies are nothing like the giant parasites that we have. So saying this is how it worked anywhere else is mistaken, if not disingenuous. This nation's cancerous blight is why we pay more than twice as much for much worse results.

Protecting the existence and profitability of insurance corporations, more accurately nonproductive extortionists, has nothing to do with health care.

[HereSince1628]

20. I'm not so sure...is that really more than faith-based?

This same reality we live in includes local, state and federal elected officials that want no obligations to healthcare because its costs are out of control.

I think all that has happened is that a great Waring blender has been turned on, and it will chop then blend all of this into an unrecognizable mush of federal regulations and court rulings.

[Lionessa]

27. That would only be true if you get health care with the tax, you don't.

All you get is a penalty tax, it doesn't not provide one with access to health care. Nor is it seemingly re-distributed to Emergency Rooms which will still be the only recourse for the poor and working poor. Still no access to regular health care at all.

[davekriss]

35. Not correct

A single person earning less than around $15000 a year is covered 100% by the extension of Medicaid in the ACA. (Albeit Roberts gave the states some wiggle room in his decision.). Out of pocket expenses are very minimal.

A single person earning $18000 per year pays less than $64 a month in premiums and a maximum of $2000 in deductibles and copays once medical expenses exceed $10000+. I understand that in the latter case that $2000 is a burden and will be difficult to pay, but it is better than going without care when an illness is serious enough to rack up 5 figures or greater in fees.

The ACA is a big plus to many Americans struggling at the bottom and even into the middle class. I'll take it while still advocating for single payer, which cuts the inefficient middle man out of the picture.

[joshcryer]

38. Yep, almost 50 million Americans covered by 2014. But who gives a fuck about them.

[Lionessa]

47. Okay, perhaps, I have indeed misunderstood something, then,

last I knew Medicaid, and the extension therein, were still under state rules, and the states I've been in, only disabled get medicaid. Are you saying that (barring Roberts optout for the states) this will be forcibly changed to include all those in poverty below $15K, regardless of disability?

If that's so, then we still have the issue of Robert's killing the Medicaid hammer to be used against states, which means I think that the states I've been in mostly, ID, AZ, and TX will still not offer Medicaid to the masses in poverty.

If I'm still misunderstanding please inform me.

[davekriss]

49. The Medicaid issue

My understanding: The result of Roberts' decision is that if a state refuses to match the Medicaid requirements of ACA, the federal government cannot withdraw existing funding for that state. So, in effect, compliance (on Medicaid changes) is optional.

Will some Paleolithic states opt out? Certainly (even though Washington pays for the Medicaid increases for 3 years before cost sharing kicks in). But those people will still be ables to buy subsidized insurance at a low percentage of their pay.

If income is zero, will one be able to "buy" insurance on a state exchange for zero dollars (the federal government paying 100% of the premiums)? Honestly I don't know. But, since the ACA anticipated non-compliance (thus the Medicaid penalty for non-compliant states), it may have codified remedy for the poor in those states. It is an interesting question to explore.

Also, under current law, if a state accepts federal Medicaid funds, the state Medicaid program must comply to basic federal standards. I believe one of those standards is to provide healthcare for the very poor regardless of whether a disability is present or not. Are you sure that Medicaid is only available for the disabled in the states you mention?

[eridani]

61. SCOTUS just said that states could refuse to expand Medicaid n/t

[girl gone mad]

60. Regressive taxation seems an unlikely back door to single payer.

It looks more like a front door to privatized medicare/medicaid.

[mvd]

19. I don"t like it and would have still pushed for the public option, instead of..

saying it wasn't important. Hard to say whether we would have gotten it with enough pressure, but need to stick with stressing how we need. Obama also should never have been against single payer. It is still better than nothing until we can improve it, so I am happy with the decision.

[datasuspect]

22. if this means an insurance executive's son can get a lotus on his 16th b-day, i will do my patriotic

duty to make damn sure he can put premium fuel in it too!

god bless the corporate states of uhhhhhmerica!

[ieoeja]

23. So if you don't get insurance and pay the government a tax penalty instead, are you saying ...

... that they give that tax to the insurance companies? Because what you wrote is otherwise untrue.

[Lionessa]

25. Slouching towards? Obama is making a mad dash to give them global corporatism/oligarchy.

Didn't you know about this?

[treestar]

26. You have tried to use this to get us to go against our own interests and opinions

We can fool those left wingers with their hatred of business into being against what they and their party really are for. But it's not working. Or it's only working on this with a rabid hatred of business forms.

[derby378]

28. Speaking of our own interests...

Within two years, I'll be forced to either purchase for-profit health insurance or pay an annual tax, which also means the IRS is getting into the healthcare industry. Just what we need.

The kicker is that Texas, where I live, currently has no mechanism for regulating or overseeing premium rate increases by health insurance companies. That means if Blue Cross Blue Shield or Wellpoint or UnitedHealthcare wants to increase premiums on their Texas customers by an obscene amount, there's no way to stop them. And if they all jack up their rates to where nobody can afford them, in two years it will be illegal to tell the insurance companies "No." Because all they have to do is call the IRS, and despite all of the assurances to the contrary, the IRS is not the least bit hesitant to bring criminal charges against those who don't have the money to purchase insurance.

Now, if I still had a job where I made $35,000 a year, maybe I wouldn't complain quite so much. But right now, I'm living from paycheck to paycheck. And competition for whatever good jobs are out there has just gotten a lot more fierce.

[pimpbot]

30. You are wrong, they need to spend at leastr 80% on member healthcare

If they jack up the premium rates, they need to jack up how much they spend on members. Most people will be getting a rebate in a couple months.

See:
http://www.marketwatch.com/story/most-consumers-unaware-of-health-insurance-premium-rebates-ehealthinsurance-survey-finds-2012-06-13

[treestar]

33. So how much would it cost if you had no insurance but then

happened to get sick enough to need a hospital stay? A few days in the hospital would overwhelm the 35K per year and make the premiums look like chump change.

You have to be dragged kicking and screaming to pay those premiums? And they are subsidized, too, if you don't make that much.

[derby378]

34. Subsidies can be whittled away

We've got a bunch of jackals in Congress who are geniuses at the "death by a thousand cuts" approach.

[joshcryer]

39. Just put your money in a Health Savings Account.

It's even tax free.

PS the HSA is Bush's idea and it is regressive and not leftist.

[joshcryer]

40. Wait, living paycheck to paycheck? In 2 years if you make under 14k you meet the 100% Medicare...

...expansion.

[derby378]

41. Nope, doesn't cover me

Nice try, though.

[joshcryer]

42. Must not be in 133% poverty.

[AnotherMcIntosh]

52. They will use civil penalties, not criminal charges.

They will not be able to incarcerate you, nor collect money through liens or levies.

But the money will be collected by the IRS.

[woo me with science]

43. Deeper and deeper, every day.

We are sold now. Help is not coming from within the system.

[Texasgal]

44. It's small step.

I'd love to have a better bill. I'd love to have everyone insured with no problems. I'd love to take a vacation to Hawaii too.

Baby steps... Look how long it has taken us to get to this!

[fascisthunter]

45. you are correct... this is a double-edged sword

however I am pleased because we actually have a better chance of getting to universal healthcare. Now we fight for it! It's "CONSTITUTIONAL"... the private health insurance industry will cease to exist.

[JoePhilly]

46. Bullshit.

I paid a corporation for insurance before, and I still do. The only folks who will pay a tax will be those who decide to not carry insurance when the can afford it.

Meanwhile ... my Niece who had cancer at 2 (now 16) is now fully covered. Her brother, 22, can stay on my sister's plan.

Personally, I've had many illnesses that could be called pre-existing conditions ... and given the surgeries I've needed, I'm sure I'd CAP OUT at some point in the future.

This Bill was not perfect, but it moves in the right direction ... unless you think NOTHING was a better alternative. My Niece would disagree.

[lonestarnot]

48. Why should anyone give a crap about the tax? $90.00 and it doesn't even have to be paid.

[morningfog]

50. It is a tax if you choose not to be covered. Otherwise it is just you using a useful product.

Try having a baby uninsured, the tax would be a drop in the bucket.

[CleanLucre]

56. if it were that simple, the U.S. would have universal health care

[morningfog]

57. It is that simple, and that is the way we could have universal health care.

It may very well be the way we get there. Broken politics and lack of political will is all that is holding us a back.

[CleanLucre]

58. Understand and Disagree

It may very well be the way we don't get there; further empowers corporate insurance industry power; further delays what we've been promised for decades; corporate rule and lobbyists running Congress is what is holding us back

[shcrane71]

53. If Health Insurance premiums are 8% of your earnings, you're not liable for the 1-2.5% tax

if you chose to go without insurance. I believe the bill provides more funding for states to provide expanded Medicaid services to help ensure low-income earners.

So, I have a single friend who makes 18,000 a year, and he was up in arms about the mandate tax. Eight percent of 18,000 is 1440.00, and most health insurance premiums for an individual are around 2000. If the state where he resides takes the Medicaid money, he'll most likely pay nothing and finally have health insurance after over a decade.

And don't forget Vermont.

[derby378]

85. I make about $18K a year, and I don't even get health insurance

I certainly can't afford $2,000 for insurance, yet I make too much money to qualify for subsidies. That means the IRS steps in with a tax, if I understand correctly.

[shcrane71]

87. If you make +400% of the poverty level, you'll receive subsidies to pay for healthcare.

Putting that aside, because I don't know what the poverty level is for a single person, the worst case scenario is that you would be required to pay for an insurance premium at 8% of 18,000 which is 1440.00 a year. The other $540.00 would be subsidized. Or you could pay a tax of 1% of your income 180.00.

My bet is that you'd be eligible for far more than an $540.00 subsidy as it is needs based.

[derby378]

88. Good to know; thanks for sharing that

Now to hunker down and see what else develops...

[shcrane71]

92. Here's more information. It seems you'll be getting quite a bit of help paying for health insurance

http://www.healthcare.gov/blog/2011/01/saving-money.html

[Warren DeMontague]

54. And because of that, they can no longer deny coverge for pre existing conditions.

It is a Good day.

[Jack Sprat]

55. And your preference would be

to wait on the republican house or a future republican president to scrap Medicare for a for-profit private insurance with no government interference, free to deny coverage to pre-existing conditions of children and the elderly? Or maybe you like the lifetime limits on coverage by a private plan?

No thanks. I cannot afford to wait on something else. I can live with the guarantees that I can get health insurance regardless of my condition or age and can still qualify for Medicare when I become of age.

[The Midway Rebel]

59. No.

We are slouching toward socialism and its a big fucking deal.

[JDPriestly]

62. Sorry, but I disagree. I would say: It's official, folks -- your for-profit health

insurance company is now operating under government regulation.

Big Insurance has to behave itself. You still have to pay for your insurance, but the government is going to see to it that more of your money is spent on health care, and less on CEO salaries.

We are progressing toward single payer.

[kenny blankenship]

73. You poor poor delusional creature.

Insurance will behave itself under "regulation" exactly the way its cousin the BANKING industry behaves itself. By ordering the government around and doling out welfare checks to Senators.

[JDPriestly]

94. In California, we have an independently elected insurance commissioner.

We elect a lot of Democrats to represent us. They aren't perfect by any means, but our insurance coverage has improved a lot since we elect our insurance commissioner and our insurance companies are regulated.

[spanone]

64. one man's ceiling is another man's floor

[snooper2]

70. You going to respond to posts 15, 30 and 53

or just continue listening to AM radio?

[kenny blankenship]

72. And the countdown to Social Security Privatization has begun.

Medicare and Medicaid are already doomed. Their demise will be assumed, the Social Security "problem" will be the only question going forward.

[meaculpa2011]

74. My son just enrolled in a not-for-profit...

medical cost sharing program. Low cost, plenty of providers in our county and zero dollars to the insurance cartel. Plus, it qualifies under the mandate rules. It's basically a healthcare co-op. Maybe this an idea whose time has come.

[ithinkmyliverhurts]

80. It's only fair.

I mean, they spend all that time helping to write the laws and all.

[Tierra_y_Libertad]

82. It's a protection racket with the government as the enforcers.

[StarryNight]

90. bingo. why else would the SC support it? nt

[sinkingfeeling]

86. Wrong on so many levels. The 'tax' which is only for those who refuse

to buy health insurance coverage, goes to the IRS.