BUCKNACKT'S SORDID TAWDRY BLOG
We should not be a journey to the grave with the intention of arriving safely in an attractive & well preserved body, but rather to skid in sideways, chocolate, bier or wein in hand, body thoroughly used up, totally worn out and screaming "WHOO-HOO, WHAT A RIDE!!!!!!"
NORTON META TAG
Showing posts with label health care exchanges. Show all posts
Showing posts with label health care exchanges. Show all posts
verse of the day
You will know the truth, and the truth will make you free.
- John 8:32
voice of the day
You shall know the truth, and the truth shall make you odd.
-Flannery O'Connor
prayer of the day
Lord, may your truth make us both free and odd in a world that breeds bondage and demands conformity. Amen.
OBAMACARE. The very mention of the ACA / Affordable Care Act can set repiglicans and tea-baggers off on a foaming at the mouth, spit flying rampage. While that is all some of their supporters need to justify their voluntary ignorance and racist hatred, others need lies, deception and manipulation to make their voluntary ignorance and racist hatred more acceptable to themselves and those like them. Here are two examples of the continuing lies, manipulation, deception and fear started by greedy fascist pig koch brother's american action forum being spread on the internet by anonymous cowards and the blatantly fascist, racist and hateful karl rove's & ed (lost the VA Senate race) gillespie's american crossroads organization. From +PolitiFact .....
As a result of Obamacare, "California seniors face benefit cuts of over $1,700."
By Lauren Carroll on Friday, October 31st, 2014 at 9:30 a.m.
A recent American Crossroads ad attacks Rep. Ami Bera, D-Calif., for supporting Obamacare.
Even though Rep. Ami Bera, D-Calif., wasn’t in office when
Obamacare passed, a pro-Republican ad in California’s seventh
congressional district is using the law to attack him.
Bera is running against Republican Doug Ose for a second term, and
it’s a tight race. Less than six months into his first term, Bera voted against
repealing the Affordable Care Act, and American Crossroads, Karl Rove’s
conservative political action committee, used this fact to appeal to
California seniors in a recent ad.
"Bera voted to keep Obamacare, which cut $716 billion from Medicare,
slashing Medicare Advantage," the ad’s narrator says. "Now California
seniors face benefit cuts of over $1,700."
Many times, we’ve rated the claim that there are $716 billion in Medicare cuts as Half True. But we hadn’t heard claims about specific benefit cuts by state before, so we decided to check it out.
We found that the claim that California seniors will see $1,700 in
benefit cuts as a result of the Affordable Care Act is misleading. The
statistic comes from a report that ignores critical context and evidence
that the law has expanded Medicare’s benefits packages. Advantages
We should first note that the statistic comes from an April 2014 report by the American Action Forum,
and they have a stake in the election. The American Action Forum is an
arm of the American Action Network, which is a conservative political
nonprofit with financial ties to the Koch brothers. According to the Center for Responsive Politics, the group shares office space with American Crossroads -- the group that produced the very ad we’re checking.
Now to the claim. The ad makes it sound like all California
seniors will face cuts to this degree. However, the report only
addresses Medicare Advantage. About one-third of seniors use Medicare
Advantage, which is a private coverage option.
Medicare Advantage plans are required to provide at minimum the same
array of benefits as traditional Medicare. Many Advantage plans offer
extra benefits -- things like gym memberships, vision exams or generous
cost-sharing -- that have contributed to escalating program costs.
The creators of Medicare Advantage thought that letting seniors
choose plans from private insurance providers would be more
cost-effective than traditional Medicare. But Advantage has turned out
to be more expensive. Medicare paid insurers about 114 percent more for
Advantage plans than for traditional plans, as of 2009 before enactment of the federal health care law.
The law attempted to close that gap in part by gradually reducing how
much Medicare pays Advantage plan providers. It was estimated that its
changes would slow down spending
on Medicare by about $716 billion over 10 years, and Medicare Advantage
cost-saving measures accounted for about one-third of that. (Though the
Obama administration has reversed these cuts for the past two years -- facing pressure from insurance providers, Republicans and some Democrats, including Bera.)
Critics argue that the cuts will force insurance providers to reduce
the benefits they offer to Medicare Advantage enrollees. However,
Medicare Advantage plans are still required to offer, at minimum, the
same level of benefits as traditional plans. And Obamacare includes language protecting that set of guaranteed benefits from shrinking.
In fact, the law expanded Medicare’s required benefits to include
certain preventative services, annual visits, closing a gap in
prescription coverage and more.
Additionally, the law rewards Medicare Advantage providers
with financial bonuses to encourage quality and cost-efficiency.
Providers are required to use the bonuses to offer extra benefits,
attracting more enrollees. Nearly all Medicare Advantage plan providers received these bonuses in 2012, according to the Kaiser Family Foundation. A matter of speculation
It’s possible that Medicare Advantage providers could respond to
their pay cut by reducing benefits, but the only benefits they could cut
would be those extra benefits that go beyond Medicare plan
requirements.
"It's not automatic and won't affect every (Advantage) enrollee or
any of the (traditional Medicare) enrollees," said Dylan Roby, an expert
in health economics at the University of California Los Angeles Center
for Health Policy Research.
Insurance providers could also respond to lower payments by offering
the same benefits while operating more efficiently. They could cut
administrative costs, adjust cost-sharing plans, take in less profit or
drop out of the market altogether.
But, according to the Kaiser Family Foundation, the Department of Health and Human Services
and more, insurance providers’ response to the cuts has been less
dramatic than was expected when Obama signed the legislation in 2010. In
fact, Medicare Advantage enrollment is at an all-time high, and the
percentage of plans with four or more stars in the program’s five-star
rating system is increasing.
"When Congress debated the payment reductions in 2010, forecasters
and analysts also projected that reductions would drive insurers to
raise premiums, cut extra benefits and even pull out of the Medicare
Advantage market," Kaiser experts wrote in May. "Thus far, however, the
response by insurers to the (Affordable Care Act) cuts has been more
muted."
Health and Human Services reported in fall 2013
that "The average number of plan choices will remain about the same in
2014 and access to supplemental benefits remains stable. Since passage
of the Affordable Care Act, average MA premiums are down by 9.8
percent."
Experts also told us that they haven’t seen evidence of reduced Medicare Advantage cuts.
"The evidence is that plan participation has been stable, premiums
have been stable or even a little bit lower, and there are no overall
changes in the benefits provided," said Jack Hoadley, a research
professor at Georgetown University and a member of the nonpartisan Medicare Payment Advisory Commission.
"In my view, the claims in this advertisement are misleading,"
Hoadley added. "Seniors have not faced benefit cuts in Medicare
Advantage, even though the plans (and providers) have to manage with
somewhat lower payments."
So how did the American Action forum report come up with their estimated benefit cut figures?
The American Action Forum report breaks down the reduction in
Medicare payments to Advantage plan providers by state and county. It
says, compared to pre-Obamacare, Medicare Advantage benefits in
California are down $1,718 per beneficiary.
We asked several experts to take a look at the report, and they told
us that it is misleading because it assumes that Obamacare’s spending
reductions directly results in reduced benefits.
Yes, Obamacare reduces Medicare’s spending per Advantage beneficiary,
but this does not necessarily mean fewer benefits for seniors with
Advantage plans. Like we said before, there are multiple ways that an
insurance provider can deal with the spending cuts other than slimming
down its offerings.
"To immediately treat it as a cut to benefits is an exaggeration,"
said Judith Feder, a professor of health policy at Georgetown
University. Our ruling
American Crossroads said that as a result of Obamacare, "California seniors face benefit cuts of over $1,700."
First of all, this claim is misleading because it makes it seem like
all seniors will face these cuts, when the statistic actually refers to
Medicare Advantage enrollees -- only about one-third of seniors.
The statistic comes from a report that assumes all reductions in
Medicare Advantage spending results in fewer benefits for enrollees.
While insurance providers feel the cuts, there are multiple ways for
them to respond other than reducing benefits, such as trimming
administrative costs. We heard from multiple experts and researchers who
said Medicare Advantage benefits have remained stable.
The ad also leaves out the fact that the federal health care law
expanded Medicare’s minimum required benefits and established incentives
for Advantage plans to provide extra benefits.
It’s possible that some Medicare Advantage enrollees could see their
benefits shrink, but this ad blows that possibility out of proportion
and ignores important context. We rate this claim False.
By Steve Contorno on Thursday, November 6th, 2014 at 4:11 p.m.
A chain email
claims more than 200,000 doctors aren't accepting patients with coverage
bought on Affordable Care Act marketplaces.
Are doctors en masse refusing patients who gained health care coverage due to the Affordable Care Act?
That’s the claim in a chain email a reader asked us to check. "More,
truly scary Obamacare news," said the email, sent just before Halloween.
The accompanying story was from CNSnews.com, a site operated by the conservative Media Research Center.
"Over 214,000 Doctors Opt Out of Obamacare Exchanges," read a headline on CNSnews.com.
We found the source of the claim. It was coming from American Action
Forum, a self-described "center-right policy institute." The
organization put out an analysis on Oct. 27 titled: "Health Care
Providers are Opting-Out of Obamacare Exchange Plans."
How many? According to the post, "as many as 214,524 American
physicians will not be participating in any (Affordable Care Act)
exchange products." It went on to list some reasons "doctors are opting
out of the exchange plans."
That’s a lot of doctors. Have that many decided to turn away patients with insurance purchased on the marketplaces?
Let’s take a look. Can doctors opt out of Obamacare exchanges?
The Affordable Care Act requires essentially everyone to have
insurance. To make it easier for people to buy insurance, the government
created federal and state insurance marketplaces, sometimes called
exchanges. The biggest one is HealthCare.gov, but some states elected to operate their own as well.
These marketplace policies are private plans sold by insurance
companies. In some states, just one or two companies are providing
plans; in others, it’s many. Consumers typically have dozens of choices
ranging from bronze policies, which pay 60 percent of health costs on
average, to platinum, which pay 90 percent of costs. (For comparison, a typical employer-based plan covers about 80 percent of costs.)
Can doctors choose not to participate in the networks of policies
purchased on exchanges? Sure. While some states require doctors to
accept any plan for an insurance provider they do business with, in most
cases insurance companies are constantly negotiating with physiciansand hospitals to determine which policy networks they will participate in, experts and industry officials told us.
Some doctors might decide they don’t want to be in the network of
plans purchased on federal or state marketplaces. In other instances,
insurance providers might choose not to include certain doctors or
health groups in policies they created for the marketplaces.
It’s a two-way street, and marketplace policies are just the latest
twist to a contracting process that has always existed between doctors
and insurance companies. 200,000 doctors?
We asked American Action Forum to explain their analysis to us. The
organization based its findings on an April survey from the Medical
Group Management Association, a trade organization for physician groups.
"The survey found that 23.5 percent of doctors said they would not
participate in (Affordable Care Act) exchange plans," said Marisol
Garibay, spokeswoman for American Action Forum.
That percentage was multiplied by the total number of professional
active physicians, which Kaiser Family Foundation estimates is 893,851.
That equals 210,054 doctors, close to the American Action Forum number.
Garibay called it an "upper bound" estimate.
But when we looked at the survey ourselves, we found this to be a pretty dubious figure.
Here’s the rub, from the research: "The survey includes responses
from more than 700 medical groups in which more than 40,000 physicians
practice nationwide."
While there’s a lot of interesting information gleaned from this
survey, the results cannot be extrapolated to represent all the doctors
in the country. Why not? Because the Medical Group Management
Association only represents doctors who are part of medical groups. This
does not include physicians who run independent practices, for example,
and there’s no reason that a poll of 700 medical groups is
representative of all 900,000 physicians in the country.
"That’s a significant difference," said Anders Gilberg, a senior vice
president of government affairs for Medical Group Management
Association. "I wouldn’t generally suggest using it as a proxy for all
physicians."
Let’s put that aside for a second and dig further. The survey found
that as of April, 76.5 percent of respondents were accepting health
insurance sold on a state or federal marketplace.
Of those not participating in marketplace policies, 42 percent said
it was because insurance companies in their area didn’t ask them to
participate in the networks of plans sold on marketplaces.
Meaning, even if this limited survey could be extrapolated to
represent all doctors, not all of them are "opting out" of Obamacare.
Many — almost half — weren’t asked to participate in ACA marketplace
policies.
Why weren’t they asked? One reason is that the insurance companies
want to limit which doctors will serve their customers by creating
narrow networks.Narrow networks are a way for insurance providers to keep costs lower for insurers.
How? If you create a narrow network, it guarantees a doctor will get a
bigger share of your patients, and a doctor would be willing to accept
lower reimbursement rates in exchange for more business.
Narrow networks are also more common on the exchanges because
consumers can pick the plan with the doctors that fit their needs, said
Paul Ginsburg, a professor of the practice of health policy and
management at University of Southern California.
"Employer plans tend to have a broad network because they’re trying
to satisfy everyone (at the company)," Ginsburg said. "On an exchange,
you don’t have to satisfy everyone with one policy, you can offer many,
so you can have narrower plans."
There are plenty of broad plans on the exchanges, they just tend to
be more expensive. According to a May survey of individuals likely to
use the marketplace, 54 percent said they would accept more limited
networks to get a cheaper sticker price. As it is, 85 percent of plans
bought on federal and state marketplaces were the less expensive bronze
or silver plans, according to the Department of Health and Human
Services.
To be sure, it appears some doctors want nothing to do with these cheaper marketplace plans or the customers who buy them.
Among other things, doctors worry that many of the plans on the
marketplace, particularly bronze and silver plans, have high
deductibles. Some patients won’t be able to meet their obligations for
cost-sharing, potentially forcing physicians to eat those costs or shake
down customers.
These are legitimate concerns, and there is reason to believe that
some doctors are choosing not to contract with marketplace insurance
plans. But there is no evidence to suggest the number is anywhere near
214,000. Our ruling
A chain email claimed that more than 214,000 American doctors are
"opting-out of Obamacare exchange plans." That is based on a survey of a
select group of doctors and even the makers of the survey said it can’t
be extrapolated for the entire country. Further, of the doctors
responding to the survey, 42 percent said they weren’t participating in
marketplace plans because they were never asked to, not because they
were "opting out."
The estimate is the result of a flawed methodology and a misreading of survey data. We rate the claim False.
HOUSE majority leader +john boehner r OH (yes, he signed up for and is covered under +Obamacare, see AMAZING: Speaker Boehner just signed
up for Obamacare & Whoops! Obamacare turns out to be great deal
personally for Boehner 22NOV13
http://bucknacktssordidtawdryblog.blogspot.com/2013/11/amazing-speaker-boehner-just-signed-up.html ) he has joined the propaganda campaign against +Obamacare to boost the chances of a gop/tea-bagger controlled congress. This from +PolitiFact dispelling his lies about the number if people who now have health insurance.....
The Truth-O-Meter Says:
The United States has seen "a net loss of people with health insurance" because of Obamacare.
John Boehner on Thursday, March 13th, 2014 in a press conference
John Boehner says more people are uninsured since Obamacare took effect
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House Speaker John Boehner, R-Ohio, discusses the Affordable Care Act at his weekly press conference on March 13, 2014 (video available at the bottom of this page)
For a law that will be judged, in part, by how many
uninsured Americans gain coverage, it’s a pretty bold statement when the
most powerful Republican in Washington claims the Affordable Care Act
is leading to more people without coverage.
In a press conference on March 13, 2014,House
Speaker John Boehner, R-Ohio, claimed "there are less people today with
health insurance than there were before this law went into effect."
A reporter later asked him if he really meant that. Boehner doubled down.
"I believe that to be the case," Boehner said. "When you look at the 6
million Americans who've lost their policies, and (government
officials) claim 4.2 million who've signed up — I don't know how many
have actually paid for it — that would indicate to me a net loss of
people with health insurance. And I actually do believe that to be the
case."
There are a lot of holes in the administration’s data for new signups. Further clouding the stats arefluctuations
in the existing insurance market caused when insurance companies
canceled plans that didn’t meet Obamacare’s coverage standards.
But to say that has resulted in a net loss is a stretch.
The Washington Post Fact Checker beat us to the punch on this. He gave Boehner’s comment Four Pinocchios, his worst rating.
We have looked at similar claims
before. We mostly heard it late last year, when several million
Americans received notices from their insurance provider that their
current policies would no longer be offered.
Since it came from Boehner, though, we decided it was worth looking into again. Polls and projections
We took the issue first to Boehner spokesman Brendan Buck. He offered
this explanation: "The speaker explained the statement at the presser:
More people have had plans canceled than signed up, especially when
considering how inflated the enrollment numbers appear to be."
But that's not what Boehner said. He twice claimed that the number of
people with insurance overall is down since the health care law went
into effect, a considerably more audacious statement.
While there isn't a final tally that looks at those numbers yet,
Boehner's assertion goes against a recent Gallup poll, which said the
number of uninsured Americans declined from 17.1 percent at the end of
last year to 15.9 percent in the first quarter of 2014, the lowest level
since 2008. Also, the Congressional Budget Office, the nonpartisan
policy scorekeeper, estimates over time that the percentage of insured Americans will rise as a result of the health care law.
Boehner claimed the math, though, is simple. According to him, there
were 6 million people told their policies were canceled because they
didn't meet the health law's minimum benefits and coverage. And the
administration announced that through February, 4.2 million had
purchased insurance through the state and federal marketplaces. (A few
days after Boehner spoke, the administration announced enrollment
through the marketplace surpassed 5 million.)
By that logic, 1.8 million people must have lost insurance.
But Boehner misses a lot of important factors. We'll go through them one by one. What happened to canceled plans
There were many Americans notified that their insurance plans were
canceled because they did not meet Obamacare's standards of coverage,
despite promises that wouldn't happen. Boehner puts this at 6 million.
It's a hard figure to pin down exactly.
Through an extensive reporting project, the Associated Press found at least 4.7 million Americans received notices about canceled policies; it could be higher.
Some of those policies, about half, were restored when Obama
administratively allowed canceled plans to continue for another year and
later through 2016.
Many others were moved to new plans, either through their insurance
company or by purchasing a new policy on the marketplaces set up for
Obamacare. The administration estimated that of the people with canceled
plans, just 500,000 were left without coverage, and catastrophic coverage was extended to those individuals.
That's not to say this wasn't a difficult ordeal for people who lost
their plans, especially if they thought the law would allow them to keep
their coverage. But most of them were able to find new plans, meaning
Boehner's 6 million uninsured people basically vanishes.
We could probably stop there, but let's dissect the rest of the
numbers, since this is a debate that won't subside any time soon. Marketplace signups
Boehner also casts doubt that the administration's figures for new
insurance purchases is inflated, which they put at 4.2 million (now 5
million).
He does have a point there.
First, many of the people who lost coverage due to Obamacare were
shifted to the marketplace to buy coverage. Just as those individuals
shouldn't be included in Boehner's figure of people without insurance,
they also don't count as a net gain, since they previously had
insurance.
It's ultimately difficult to tell how many people who bought insurance didn’t have coverage last year. A survey by McKinsey & Company found that 27 percent of the people who reported buying a new policy in February for 2014 were previously uninsured.
It's equally difficult to know how many of the people who bought plans actually paid their premiums. The New York Timesreported
that 20 percent of people buying insurance on the exchanges never made
their first payment. The McKinsey & Company survey reported similar
results for the previously uninsured.
So Boehner's skepticism toward that 4.2 million figure is not
misguided. But even if it includes a lot of people who didn't pay their
premiums or people who were previously insured, there were some
previously uninsured people who found and paid for policies. That alone
makes it a net gain.
It also doesn't include the people who are buying insurance directly
from insurance companies or through other Obamacare approved third-party
sites. In Washington state, for example, 184,000 of the 300,000 projected new enrollees bought coverage outside the marketplace. Medicaid
Boehner also completely ignores individuals who gained coverage
through the expansion of Medicaid, the federal-state health care
program.
The administration says 4.4 million people were deemed eligible for
Medicaid when signing up for coverage through the marketplace.
That doesn't count all of the people who signed up through local
state offices, not through an exchange. But it also includes those who
were assessed as eligible but didn’t complete the sign up. There could
be duplication in the process as well.
But whatever the actual number is, it still points toward a net gain in insured Americans. Kids up to 26
One of the earliest provisions of the law to take affect allowed children to stay on their parents' insurance until age 26.
The administration has estimated 3.1 million young adults took advantage of this change. The Washington Post Fact Checker noted the number hasn't been updated for a number of years and questioned whether it was that high.
Not all of those children were previously uninsured. And presumably
some of those initial sign ups could have aged out of their parents
insurance by now. It's possible many were included among the previously
insured who transitioned to the marketplace.
But like the Medicaid number, for the purpose of this check the
actual number isn't as significant as knowing there are a lot of young
adults that gained insurance through this provision. Our ruling
Boehner said the Affordable Care Act so far has caused "a net loss of
people with health insurance." Boehner's logic is based on reports that
about 5 million had their insurance policies canceled while 4.2 million
signed up for policies on the state and federal marketplaces. It's bad
math for two reasons.
First, most of the people who lost their insurance have seen those
policies extended to them through an administrative fix, or they
received new coverage through their previous insurer or they bought a
new plan.
Second, he ignores the millions of people who bought coverage off the
exchange, those who gained coverage through Medicaid and the under-26
crowd able to remain on their parents' insurance.
We don't yet know how many new Americans will ultimately gain coverage. But every indicator right now suggests itwill be a net gain. We rate Boehner's statement False.
I haven't posted anything about the problems Obamacare has been facing since the program opened for enrollment on 1 OKT 13. I found the attacks from the repiglicans and tea-baggers to be hypocritical because they still have not been able to offer a comprehensive national plan to reform the "best health care system (if you can afford it) in the world". I found the lack of support, and the attacks from some Democrats disappointing, since these people, many of whom actually voted for the Affordable Care Act, also voted to accept compromises on the bill to satisfy conservatives in the party and the gop (who in turn failed to deliver any votes in the House for Obamacare) rather than pass Universal Health Care, which would have eliminated the need for all these different plans. But what I found most disturbing was the short term memory loss among all the critics on Capital Hill of the other federal programs that faced serious problems when they were opened to the public. (AND for those of you who are Progressives and support Universal Health Care, a petition from Credo calling on Congress not to weaken Obamacare and to expand Medicare for ALL follows the PolitiFact article.) This from PolitiFact shedding some light on this issue...
The Truth-O-Meter Says:
"Things went wrong with the Medicare prescription D plan that George Bush rolled out."
Steve Israel on Wednesday, November 6th, 2013 in an interview on MSNBC
Did Medicare Part D have the same rollout problems as the Obamacare online marketplaces?
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Democrats are pleading for patience as they try to reassure
the country that the online insurance marketplaces critical to
President Barack Obama’s health care overhaul can be fixed.
Big programs have seen rocky rollouts only to achieve success later, they say. Their top example:the 2005 launch of Medicare Part D, President George W. Bush’s prescription drug benefit plan.
"Things went wrong with the Medicare prescription D plan that George
Bush rolled out," Rep. Steve Israel, D-N.Y., told MSNBC on Nov. 6. "When
things go wrong, there are two things we can do as a country. We can
spend all our time figuring out who to blame, or we can spend all our
time figuring out how to fix it."
Eight years after it went live, Medicare Part D is now widely popular among the seniors who use it.
Were there major problems with the rollout of Medicare Part D? And
were they comparable to the challenges facing Obamacare? We decided to
take a more a detailed look at its implementation. Strangely similar
Let’s play a quick game: who made this statement?
"This is a huge undertaking and there are going to be glitches. My goal is the same as yours: Get rid of the glitches."
A Democrat in 2013? Wrong!Actually, it wasRep. Joe Barton, a Texas Republican who chaired the House Energy and Commerce Committee, about Medicare Part D in 2006.
The similarities between the two health care programs, both heralded
as the signature domestic achievements of the presidents who signed them
into law, are at times eerie. Supporters of the laws asked for time and
promised a quick fix. Critics did not mince their words. Even the lingo
-- words like "glitches" -- has been recycled.
A report documenting the history of Medicare Part D was released earlier this year bya
group of health policy experts at the Center on Health Insurance Reform
at Georgetown University. It highlighted several areas where Medicare
Part D struggled in its implementation that sound extremely familiar.
For one thing, the Bush administration faced a difficult political
battle to get the bill passed in 2003. That damaged public opinion of
the law, making it a challenge to educate 43 million seniors on its
nuances.
Enrollment in the law was set to begin in late 2005. In April of that
year, a Kaiser Family Foundation poll found that only 27 percent of
respondents understood the law, while only 21 percent favored it. (In a
comparable Kaiser poll in April 2013, 35 percent viewed the Affordable
Care Act favorably and less than half felt they were well-informed of
its details.)
The Medicare site, meant to help seniors pick benefit plans, was supposed to debut Oct. 13, 2005, but it didn’tgo live until weeks later in November. Even then, "the tool itself appeared to be in need of fixing," the Washington Postreported at the time.
"Visitors to the site could not access it for most of the first two
hours. When it finally did come up around 5 p.m., it operated awfully
slowly," the Post reported. (Sensing a pattern?)
Once seniors began to enroll, problems persisted. According to the
report, the online tools had "accuracy problems," and local
organizations designated with assisting seniors "reported problems
getting necessary and accurate information." Call centers provided by
the Center for Medicare and Medicaid Services underestimated "the needed
capacity to ensure that reliable answers could be provided" and
"service representatives were not knowledgeable or failed to provide
accurate information."
The Georgetown experts anticipated similar hiccups with the
Affordable Care Act, noting that the country’s experience with Medicare
Part D suggested "the experience will be far from perfect" and "problems
were not always addressed as quickly or as thoroughly as critics would
have liked, but fixes were usually found."
These days,nine in 10 seniors who utilize the program report they are satisfied with it.
"There’s really a striking amount of similarity even though this time
it’s a far larger and daunting task. It’s a fair comparison," said Jack
Hoadley at the Georgetown University's Health Policy Institute and one
of the authors of the study. "Once something works its way through the
problems, you forget the problems." Still different
But there are important differences between Medicare Part D and the
Affordable Care Act that make the challenges facing the exchanges
different.
Because it was aimed at seniors and e-commerce was still relatively
young, Medicare.gov was not intended to be the main hub for people to
purchase and review plans, said David Brailer, the first National
Coordinator for Health Information Technology under Bush.
"The issue with Medicare Part D is there were choices of 70 to 100
plans," Brailer said. "People were overwhelmed with the choices, with
the options available and didn't know how to navigate and pick one. I
don’t remember a conversation at all blaming any IT people. This was
about how do you really navigate through all these choices."
Meanwhile, most people who logged on to healthcare.gov in the opening
weeks couldn’t even get far enough to review what options were
available.
Also, prescription drugs are a relatively small and
easy-to-understand part of health care. Shopping for an insurance plan
is more complicated.
"For those who did choose to enroll (in Medicare Part D) online, they
checked out their options by typing in drugs they used, and once you
did, you got an estimated out-of-pocket cost to make your comparisons.
In the exchange world you have a full health care benefit to buy,"
Hoadley said. "The drug cost is relatively predictable, certainly a lot
more predictable than overall health costs. The challenge for this
website is a lot greater, probably by a significant amount of
magnitude."
And there’s the political climate as well. When Medicare Part D
passed, Democrats were not happy with the final bill and were critical
of its botched rollout. But even then, they were generally supportive of
its intended outcome and worked with constituents who had difficulty
signing up or utilizing their new benefits.
When Medicare Part D faced early troubles, many blue states came to its rescue. The New York Timesreported in
2006 that "about 20 states, including California, Illinois, Ohio,
Pennsylvania and all of New England, have announced that they will help
low-income people by paying drug claims that should have been paid by
the federal Medicare program."
By contrast, not a single Republican voted for the Affordable Care
Act, and in the years since it passed, the party has made its repeal a
top priority. In the states, many Republican governors have bucked the
Medicaid expansion and rejected offers to build their own insurance
marketplaces, putting greater pressure on the federal government.
Henry Aaron, a health policy expert at the Brookings Institute, said
the opposition from Republicans has forced the Obama administration into
a "two-front war" Bush did not have to fight.
"On the one hand, one must and should address the administrative
problems that no one denies is plaguing the problem," he said. "But
you’re also waging a war of public opinion against the hysterics of its
critics." Our ruling
Israel said, "Things went wrong with the Medicare prescription D plan
that George Bush rolled out." There definitely were problems, and in
some cases, the parallels between the prescription benefit program’s
introduction and the Obamacare marketplaces are strikingly similar.
While we also found some serious differences in the laws, we can’t find
fault with Israel’s fairly general statement.
We rate his statement True.
We won’t go back.
Republicans are opening new fronts in the war on healthcare, and
rewriting their battle plans for the 2014 elections with a focus on
opposition to the president’s reforms.
But we won’t go back to letting insurance companies deny coverage to
people with pre-existing conditions. We won’t let them kick young adults
in their early twenties off their parents’ plan. We won’t let them take
away free birth control as preventative medicine with no co-pay.
Democratic unity on health care reform is cracking as some vulnerable
Democrats are joining Republicans in an attempt to pass a bill that
would require insurance companies to continue offering policies that
were recently cancelled because they don't meet the tougher requirements
of the Affordable Care Act.
Meanwhile, even the president is responding to pressure from
Republicans and Democrats alike by attempting to defuse the situation
with new rules that will allow insurance companies to continue offering
some policies disallowed under the Affordable Care Act. We cannot afford to go backwards. Neither the House, nor the
Senate (or even the White House) should be allowed to chip away at the
hard-won advances of the health care reform fight. Tell Democrats and Republicans in Congress: We won’t go back. In fact, we’re ready to go further and expand Medicare to all Americans. Click here to sign the petition automatically.
The real problem isn’t the modest but still life-changing reforms of
the Affordable Care Act (despite its botched rollout). Millions of
people have already been helped -- people with pre-existing conditions,
young adults who get to stay on their parents' plan and beneficiaries of
the Medicaid expansion.
When it comes down to it, this most recent fight is about the power
of predatory insurance corporations. Insurers sold to a small percentage
of Americans junk plans that were so bad they fall below the threshold
of what’s acceptable under the Affordable Care Act. The fact that greedy
insurers are confusing customers for profits is exactly why we need a
real solution like Medicare for All.
But with Republicans on the attack, and some Democrats and even the White House on the retreat, what can progressives do? It’s time to stop playing defense and build power for the only reform that would get us out of this mess: Medicare for All. Tell Congress: Not only will we not let you take down health care reform, we want you on the record with an up-or-down vote on Medicare for All. Click here to automatically sign the petition automatically.
The Affordable Care Act, also called ObamaCare, has brought some
positive reforms, but we all know it only represents the very first few
steps down the path to fixing our broken health care system. In fact, it
was really a health insurance reform bill, not a health care reform
bill.
Now, as right-wing extremists work methodically to dismantle the
law's modest improvements in how health insurance is bought and sold, we
need not only to stop them in their tracks, but also to counter their
demands with a real progressive vision that has the power to deliver the
change this country needs. We have to form a strong progressive flank in this fight so
if a deal gets cut we don’t end up with a compromise on the compromise
that moves us further to the right.
Every other industrialized country in the world provides quality,
universal health care at a fraction of the cost of the U.S. system.
Private insurance companies are a big part of our problem. And while
President Obama's health care law will expand coverage to millions of
Americans, it guarantees customers and profits for insurance companies
that put profits before people.
The point of the newly launched exchanges is to funnel insurance
customers into these companies’ plans. The latest controversy concerning
Americans supposedly losing their current private coverage is largely a
mess created by insurers shutting down short term, high cost plans so
customers can be shifted onto lower cost, long term coverage offered by
the clumsily launched federal (or in some instances, state) exchange.
From the beginning, these companies opposed a "public option" -- a
government-run health insurance program that would compete with private
insurers -- because they wanted to maximize profits and minimize care. But
we don’t need health care exchanges to cover Americans. We could solve
today’s problems by expanding a program that is already up and running
-- and working.
Medicare already covers 40 million Americans over the age of 65,
providing quality care at prices that are much lower than the private
market. We may not have the votes to win this fight, but the current
mess provides a strategic opportunity to get Congress on the record when
it comes to universal health care and build momentum not just to
preserve the status quo but to win the real change we need. Tell Congress: We won’t go back. Now more than ever, it’s clear that what we need more, not less, reform and that means Medicare for All. Click here to sign the petition automatically.
Time and time again we see the right go on offense. After the
murderer of Trayvon Martin mounted a “Stand Your Ground” defense in
Florida, Republicans didn’t agree to modest reforms to the law to
protect citizens from vigilante violence. Instead, they pushed for
changes to the “Stand Your Ground” law to expand the rights of gun
owners and make it harder to hold murderers accountable. They didn’t win
their bid to expand the law, but they successfully defended the current
law and didn’t lose any ground to reformers. By staking out a position
far to the right they made maintaining the status quo look like a
compromise.
The current debate in Washington DC lacks any kind of forceful push
for the policy that will actually solve our nation’s health care crisis.
It’s clear that Democrats, some of whom are now joining Republicans to
turn against key portions of the law, may not even hold the line, let
alone fight for even better coverage for Americans. So that push needs
to come from us. By staking out a progressive flank and generating a
groundswell of public support for expanding Medicare so that it covers
everybody, we can create space for a better outcome in potential
negotiations and can help prevent the debate on health care reform from
shifting even further to the right. Tell Congress: Get your hands off the Affordable Care Act, and get-on-record with an up-or-down vote on Medicare for All. Click here to sign the petition automatically.
Let's remember, when health care reform went through Congress, a
single-payer system like Medicare for All wasn't even on the table.
The implementation of the modest -- but still life-changing --
reforms of the Affordable Care Act and the battle over a deficit deal
that cuts Medicare benefits (instead of closing corporate tax loopholes
or reining in Pentagon spending) are sure to be among the top issues in
the 2014 election.
America's health care system is in crisis. If Democrats fight for
half-measures and Republicans continue on their rampage trying to
destroy what few reforms we’ve been able to achieve, 2014 could
conceivably give the Republicans the wins they need to take the Senate
and repeal the entire Affordable Care Act. We know Medicare already works. Let’s fight to expand Medicare to all Americans, and find out who in Congress is with us. Tell Congress: Support Medicare for All. Click the link below to automatically sign the petition: http://act.credoaction.com/sign/medicare_for_all?sp_ref=19446663.4.1239.e.5291.2&referring_akid=9466.179403.RCNim3&source=mailto_sp Thank you for fighting for the change we need.
Becky Bond, Political Director CREDO Action from Working Assets
IT isn't concern about access to afforable health care for the American people, it is that THEY have to pay for their health insurance! Consider these two statements from the article below, from PolitiFact......
"Hensarling was referring to a provision of President Barack Obama’s health care law that was originally intended as a political maneuver by critics of the law. We asked his office for evidence to support his statement, but we didn't hear back.
When the health care law was being written in 2009 and 2010, Republicans proposed requiring that lawmakers and their staffers obtain insurance through the exchanges, arguing that if the law was good enough for ordinary Americans, then it was good enough for Congress.
Presumably fearing a public backlash if they refused, Democrats accepted the language, and it became part of the law."
"Will Members of Congress even get "subsidies"? Not really. All lawmakers and many staffers won’t qualify for the subsidies we discussed above because their income is too high. Instead, what lawmakers and staff will qualify for is better described as employer cost-sharing -- an allotment of money that works exactly the same way as it does for the majority of Americans who get employer-based health care, and that long predated the beginning of the Obamacare exchanges. For Americans who have employer-sponsored health insurance, the employer pays a share of the premiums. In this case, that "employer" is the federal government."
HERE'S the entire article from PolitiFact...
The Truth-O-Meter Says:
In a "sweetheart deal … members of Congress, thanks to the Obama administration, are going to be the only people in America to get subsidies in the Obamacare exchanges."
Jeb Hensarling on Tuesday, October 1st, 2013 in a House floor speech
GOP Rep. Jeb Hensarling assails "sweetheart" deal for lawmakers, staff under Obamacare
Share this story:
We fact-checked a portion of a House floor speech given by Rep. Jeb Hensarling, R-Texas.
In the wee hours of the morning of Oct. 1, 2013, as the House was engaged in a futile ping-pong match over averting the federal government shutdown, Rep. Jeb Hensarling, R-Texas, took to the floor to decry a "sweetheart deal" on health insurance for members of Congress.
"Mr. Speaker," Hensarling said, "we are debating should members of Congress get a better deal than every other American in Obamacare? House Republicans say, ‘No, that’s not fair. That’s not equal protection under the law.’ Yet, our friends on the other side of the aisle (Democrats) are now saying, ‘No, no, no.’ They’re going to protect this sweetheart deal. ...
"Now members of Congress, thanks to the Obama administration, are going to be the only people in America to get subsidies in the Obamacare exchanges. Is this fair, Mr. Speaker? I think not. Clearly, the other side of the aisle wants to preserve this special deal for Members of Congress granted by the President of the United States."
Hensarling was referring to a provision of President Barack Obama’s health care law that was originally intended as a political maneuver by critics of the law. We asked his office for evidence to support his statement, but we didn't hear back.
When the health care law was being written in 2009 and 2010, Republicans proposed requiring that lawmakers and their staffers obtain insurance through the exchanges, arguing that if the law was good enough for ordinary Americans, then it was good enough for Congress.
Presumably fearing a public backlash if they refused, Democrats accepted the language, and it became part of the law.
The problem arose in the drafting of the law. For most Americans who have employer-based insurance, the employer pays a majority of the cost of insurance. But the version of the health care bill signed into law doesn’t include an explicit mechanism to allow the federal government to pay its employer share of congressional employees’ health insurance if they use the exchanges, now called marketplaces. (Here’s a rundown of how this drafting error occurred.)
Without a fix, congressional employees would have to foot the entire cost of their health insurance when buying insurance on the exchange -- a financial hit that could go well into the thousands of dollars. To fix this problem, the Office of Personnel Management, which serves as the federal government’s human resources office, issued a ruling that allowed the same money that would have been spent on the employer’s old health insurance to instead be spent on whatever they purchased on the Obamacare marketplaces.
Obamacare critics have portrayed this as a special exemption to protect politically connected lawmakers and staff, one that was unavailable to the public at large. So some lawmakers backed an effort by Sen. David Vitter, R-La., to revoke the employer’s premium cost-sharing for members of Congress, aides and other political appointees. As the House and Senate debated how to proceed to end the shutdown, passage of a funding bill with the Vitter Amendment attached was floated as a possibility.
So that’s the background. Getting back to Hensarling’s statement, we see four claims embedded in it:
Will members of Congress be "the only people in America to get subsidies in the Obamacare exchanges"? Hardly -- the tax credits commonly known as subsidies under Obamacare were being put into place starting Oct. 1, the same day the shutdown began. Anyone within a specified income range who purchases insurance on the Obamacare marketplace will be eligible for subsidies in the form of tax credits. The Congressional Budget Office has estimated that by 2017, about 24 million Americans will be buying insurance on the Obamacare marketplaces, many of them with federal subsidies. Only time will tell how many Americans eventually sign up, but it’s almost certainly going to be more than the roughly 30,000 people who work in the legislative branch.
Will Members of Congress even get "subsidies"? Not really. All lawmakers and many staffers won’t qualify for the subsidies we discussed above because their income is too high. Instead, what lawmakers and staff will qualify for is better described as employer cost-sharing -- an allotment of money that works exactly the same way as it does for the majority of Americans who get employer-based health care, and that long predated the beginning of the Obamacare exchanges. For Americans who have employer-sponsored health insurance, the employer pays a share of the premiums. In this case, that "employer" is the federal government.
Is this a "sweetheart deal"? Quite the opposite. Under the law as enacted, lawmakers and congressional aides are actually treated more harshly than any other American.
Obama and his allies created a system in which most Americans --at least three quarters -- who have insurance will remain on their existing plans and see few if any disruptions. The marketplaces were createdfor Americans who lacked insurance entirely or had to buy insurance on their own, without employer assistance.
By contrast, the law revokes the longstanding congressional health insurance arrangement and forces them into a new system, something not done for any other class of employee.
Even the National Review, the conservative magazine that is none too fond of Obamacare,recently wrote that the provision treats lawmakers and staff "particularly badly." The situation "isn’t a ‘special handout’ for congressional employees. … People who happen to be paid by the federal treasury don’t deserve to have the entire value of their existing coverage stripped away, as almost no Americans will experience."
An added irony is that the Federal Employees Health Benefits Program is widely considered a key model for the exchanges themselves. Under the program, federal employees under the age of 65 can choose among a variety of health insurance offerings, just as people will be able to do under the exchanges. In 2003, the conservative Heritage Foundationpublished a papertouting the program as a model for market-based health care reform.
In short, the ability for congressional employees to keep their employer cost-share merely returns them to the already harsh provision that severs them from their existing health care plan. All the fix does is stop that provision from making even more trouble by forcing them to pay thousands of dollars more. We don’t think this qualifies as a "sweetheart deal."
Is this "thanks to the Obama administration"? The Obama administration isn’t entirely blameless -- in the rush to sign Obamacare into law, the president overlooked or ignored the problem looming in the legislative language, and his administration did approve the "fix."
Still, this controversy has been kept alive largely by Republicans, from the original Republican proposal to the Vitter amendment. So it’s at best a stretch to blame Obama.
Our ruling
Hensarling said that in a "sweetheart deal … members of Congress, thanks to the Obama administration, are going to be the only people in America to get subsidies in the Obamacare exchanges."
This statement is wrong in almost every regard. Millions of ordinary Americans who currently lack health coverage are expected to get Obamacare subsidies in the years ahead. Congressional employees who purchase insurance on the marketplaces won’t be getting subsidies so much as they will be benefiting from a traditional employer cost-share, as many other Americans do. Far from getting a "sweetheart deal," congressional employees would otherwise findthemselves forced off their existing insurance plan, something the law itself does to no other employment group. And the issue has been largely driven by Republicans, not by the Obama administration.
That’s a lot to get wrong in the space of a sentence or two. We rate Hensarling’s comment Pants on Fire.
About this statement:
Published: Tuesday, October 1st, 2013 at 5:45 p.m.
GOP Staffer on Vitter Amendment: "Congress Literally Threw Staff Under The Bus"
The latest Republican assault on Obamacare involves jacking up health insurance costs for members of Congress and their staffers. That has some GOP aides upset.
There's a new front in the battle over Obamacare: Republican congressional staffers are angry at their bosses for trying to deprive them of affordable insurance.
Like many Americans, most Congressional staffers receive health insurance through their employer, the federal government. And like most employers, the government covers a big portion of the cost: 75 percent. The Affordable Care Act changed this, requiring members of Congress and their staff to obtain coverage via the the health insurance exchanges created by the law. But the language in the law was unclear as to whether lawmakers and their aides would be able to keep using government money to purchase heath insurance. To clear this up, the Obama administration issued a proposed rule in August stating that the government would continue to cover 75 percent of congressional health benefits. The GOP latched onto this new regulation as an "outrageous exemption for Congress" and a "big fat taxpayer funded subsidy." Sen. David Vitter (R-La.) and Rep. Michael McCaul (R-Tex.), introducedbills that would strip out those employer contributions.
Yanking taxpayer subsidies for lawmakers makes sense politically for GOPers; it would be dangerous for Democratic lawmakers to reject a spending bill that slashes their benefits. But the proposed move has Congressional staffers—including Republicans—indignant.
"I understand it politically, and as a talking point," one rank-and-file Republican staffer says of the Vitter and McCaul measures. "But Congress literally threw staff under the bus on this…You're hurting staff assistants who are sorting your mail."
Staffers don't make as much money as you may think, he adds. "When I started on the Hill answering phone calls, I'd hear people saying, 'You're a rich congressional staffer,' and I'm like, 'you must be out of your mind.'" Some low-level congressional employees make as little as about $28,000 a year; House staff salaries are the lowest they've been since 2007. "We have folks in our office who don't make a lot of money," the GOP aide says, "and losing an employer contribution will make it hard on them."
Some Republican lawmakers agree: Rep. Peter King (R-NY), said Monday that junior staff members were being "sacrificed" for a political game. Sen. Rand Paul (R-Ky.) told ABC that bumping up health care costs for staffers was "probably not a good idea," adding that low-paid staffers will "suffer."
Julian Zelizer, a professor of history and public affairs at Princeton University, thinks the GOP has picked a losing strategy. "You never want your staffers unhappy," he says.
Rep. Alan Grayson (D-Florida), is of the same mind: "If you're going to stick pins in a voodoo doll, the doll shouldn't be people who work for you."
Vitter's office did not respond to a request for comment. Nor did McCaul's.
Jacking up health care costs for low-paid aides is not only mean; it could cause brain drain on the Hill. Staffers "are not living large," Zelizer says. "If you take away essentials and make basic things like health care much harder for them, it will lead them to go into the private sector."
The GOP staffer agrees. "You need to make X number of dollars," he says. A recent survey found that 63 percent of Hill staffers want to leave their jobs because of the low pay and long hours. And that's before losing health insurance benefits.
The GOP, in its all-out-effort to undermine Obamacare, could end up harming its own people. "I'm a perfectly healthy guy," the staffer says, "but there are people [in my office] who use [insurance] and need it and depend on it."
Reporting Fellow
Erika Eichelberger is a reporting fellow in Mother Jones' Washington bureau. She has also written for The Nation, The Brooklyn Rail, and TomDispatch. Email her at eeichelberger [at] motherjones [dot] com. RSS | TWITTER
The latest Republican assault on Obamacare involves jacking up health insurance costs for members of Congress and their staffers. That has some GOP aides upset.
