2-Year Anniversary of Affordable Care Act: Why it Works, How Republicans Will Smear It, And Why The GOP's War on Health Care May Backfire in November

[one...two...tree 2,762]

As the Affordable Care Act turns two today, the Serious Village Types are contractually obligated to inform us that it was the worst piece of legislation ever conceived and that President Obama is the worst politician of all time for wasting time trying to get GOP votes for the bill, and then going it alone without them, assuring they would vow to destroy the law. We are assured that everyone hates the bill, left, right, and center, despite the fact that elements of the bill are popular (particularly the parts involving coverage for pre-existing conditions and keeping kids on insurance plans to age 26.) But at this point I think Republicans have vastly overplayed their hand on it for three reasons.

One is MetamorphoMitt. The one thing from his past that he can't shake away is MassCare. Two, the GOPreally can't stop themselves from twirling their collective evil mustaches when doing things like voting to kill the Medicare cost review board while complaining that Medicare costs too much. The other is the GOPassault on women's rights, which is seriously driving away voters of both sexes.

All of these are going to seriously put a dent in the amount of damage the Republicans can do in November. And call me crazy, but I think the Supreme Court may punt on the law until 2014 because the mandate isn't in effect yet, and precisely because the GOP has done zero to replace the law should it be struck down, there's a fair argument that nuking the law would be a massive burden for the states and for individuals. Indeed, the government's argument is that without a replacement set of laws, the entire health care system itself could be at risk if the mandate is severed.

Meanwhile, the parts of the law that are going into effect are working slowly and surely behind the scenes, and the law is rolling inexorably forward. I think we're going to be okay here.

http://www.alternet....re_in_november/

[SMR 368]

That's a nice puff piece but it is really short on facts. Honestly, I'm not sure if there is really much of the Affordable Care Act that is yet in effect. Can anyone explain how it has affected them or someone they know? Two years later, and with the 10 year cost now estimated to exceed $1.7 trillion (if I remember the latest CBO estimate correctly), I would expect to be seeing results. So where are they?

As far as the OP's allusion to the fact that the healthcare system may fall apart, people may be burdened, etc. if Obamacare is repealed, I call total BS. Healthcare will return to what it was before. That wasn't fantastic, but I don't see how it's gotten any better.

[luckytxn 2,263]

That's a nice puff piece but it is really short on facts. Honestly, I'm not sure if there is really much of the Affordable Care Act that is yet in effect. Can anyone explain how it has affected them or someone they know? Two years later, and with the 10 year cost now estimated to exceed $1.7 trillion (if I remember the latest CBO estimate correctly), I would expect to be seeing results. So where are they?

As far as the OP's allusion to the fact that the healthcare system may fall apart, people may be burdened, etc. if Obamacare is repealed, I call total BS. Healthcare will return to what it was before. That wasn't fantastic, but I don't see how it's gotten any better.

Well my premiums jumped 40% in the first year. The industry made out like a bandit. See the huge inflow of cash to the Socialist party members. Obama the Socialist will be a wealthy man when he leaves office just from this act. The other giveaways this president gave will be icing on the cake in the money he will rake in.

[Obama 2012 1,714]

Yes, stomping on liberty is "working" - Only a socialist pig would think that.

[james&olya 1,121]

The opposition to 'Obamacare' centers on the individual mandate.The reason the mandate is needed is that without it the un-insured go to the ER and get care, then don't pay and stick everyone else with the bill! Many hospitals are lucky to collect 50%!!

Perhaps it would be more acceptable to the right wing if instead of a mandate we had something more in keeping with their philosophy. An alternative approach would be to change policy from requiring hospitals to provide emergency care regardless of a patients insurance status to FORBIDDING them to provide care to anyone who has no insurance and cannot pay in advance! This policy would be coupled with the other provisions of Obamacare making insurance available and affordable to everyone. I dare say very few people would choose to go without insurance knowing that if they were injured or had a sudden severe medical emergency that they would first have to find the cash up-front to pay for any needed care! This seems to me like an idea that the tea party could really get behind! It might seem cruel but it accomplishes the same goal without the 'bleeding heart' liberal kind of approach.

[Gary and Alla 3,694]

Vermont has avoided it by passing single payer.

Obamacare will likely be a non-issue by November. SCOTUS will kill it in June.

[Obama 2012 1,714]

The opposition to 'Obamacare' centers on the individual mandate.The reason the mandate is needed is that without it the un-insured go to the ER and get care, then don't pay and stick everyone else with the bill! Many hospitals are lucky to collect 50%!!

Perhaps it would be more acceptable to the right wing if instead of a mandate we had something more in keeping with their philosophy. An alternative approach would be to change policy from requiring hospitals to provide emergency care regardless of a patients insurance status to FORBIDDING them to provide care to anyone who has no insurance and cannot pay in advance! This policy would be coupled with the other provisions of Obamacare making insurance available and affordable to everyone. I dare say very few people would choose to go without insurance knowing that if they were injured or had a sudden severe medical emergency that they would first have to find the cash up-front to pay for any needed care! This seems to me like an idea that the tea party could really get behind! It might seem cruel but it accomplishes the same goal without the 'bleeding heart' liberal kind of approach.

You only get stuck with the bill of others if you pay cash instead of using insurance, or if you're one of those kind souls who donates money to hospitals.

If you have insurance, you nor the insurance company pay for those who do not pay. That's a HUGE falsehood. Anyone who knows a fraction about medical billing knows this.

[Neonred 3,444]

You only get stuck with the bill of others if you pay cash instead of using insurance, or if you're one of those kind souls who donates money to hospitals.

If you have insurance, you nor the insurance company pay for those who do not pay. That's a HUGE falsehood. Anyone who knows a fraction about medical billing knows this.

So who is paying the bill then???

[james&olya 1,121]

You only get stuck with the bill of others if you pay cash instead of using insurance, or if you're one of those kind souls who donates money to hospitals.

If you have insurance, you nor the insurance company pay for those who do not pay. That's a HUGE falsehood. Anyone who knows a fraction about medical billing knows this.

No, you are the one who does not know! It is true that some insurance plans negotiate down what they will pay but it still, by necessity, helps subsidize the dead-beats! Otherwise the hospitals would all go bankrupt!! What winds up happening a lot is that the insurance pays what they feel like and you have to pay the rest yourself!

[Obama 2012 1,714]

So who is paying the bill then???

Your literacy is astounding. Your English teachers would be proud!

Edited March 24, 2012 by ♫

[Obama 2012 1,714]

No, you are the one who does not know! It is true that some insurance plans negotiate down what they will pay but it still, by necessity, helps subsidize the dead-beats! Otherwise the hospitals would all go bankrupt!! What winds up happening a lot is that the insurance pays what they feel like and you have to pay the rest yourself!

you mean the medicaid and medicare deadbeats? You want to talk about real deadbeats, look no further than the Feds who "pay what they will pay."

Each individual circumstance isn't "negotiated down" - It's really simple. Hospitals take certain plans because those are the ones they have PRE-negotiated with where they know how much they'll be getting, which is usually a fair rate over the actual "cost" of the health care. Where medicare and medicaid "negotiate" it as they go and choose to pay what the government schmuck says the program will pay which is usually significantly less than the actual "cost" of delivering the care and why many doctors keep dropping the programs.

[james&olya 1,121]

you mean the medicaid and medicare deadbeats? You want to talk about real deadbeats, look no further than the Feds who "pay what they will pay."

Each individual circumstance isn't "negotiated down" - It's really simple. Hospitals take certain plans because those are the ones they have PRE-negotiated with where they know how much they'll be getting, which is usually a fair rate over the actual "cost" of the health care. Where medicare and medicaid "negotiate" it as they go and choose to pay what the government schmuck says the program will pay which is usually significantly less than the actual "cost" of delivering the care and why many doctors keep dropping the programs.

Medicaid varies greatly from state to state. Sometimes it is less than the cost of providing care. Medicare pays much better but still less than what many hospitals and doctors would like. But you cannot say that just because it is less than what is billed that it is less than the cost of providing the care. Much of the short-fall between what is billed and paid in these programs is what doctors and hospitals must get from the paying customers to subsidize the NON-INSURED dead-beats. As a result many hospitals are facing severe financial problems. If they were paid by 100% or near that of their patients, the rates billed could be substantially less. That is why the Affordable Care Act is actually projected to save money for the federal government vs going back to the previous status quo.

[Neonred 3,444]

Your literacy is astounding. Your English teachers would be proud!

Just making the point that you are wrong.

[one...two...tree 2,762]

I work in Critical Care and it is astonishing how many really sick people there are without insurance or any reasonable means to pay. These are people who are in the ICU for a month or sometimes longer, where they constant care, multiple IV poles, each with 6 pumps and tubing, they are ventilated (on a breathing machine), getting dialysis, etc. An RN tossed an IV bag to me and asked me if I've ever had $10,000 in my hand before. All of this loss that hospitals have (because they cannot turn anyone away) is passed on to those with insurance. But there is a far more efficient and cheaper way - have everyone covered, especially with preventative care, check-ups, maintenance drugs. You wanna see the cost of untreated diabetes because someone can't afford to see a doctor, let alone get insulin, come visit your local hospital's ICU.

Of course, we could do things they way do it in my wife's country - if you can't pay, you just die on the street.

Edited March 24, 2012 by Mister Fancypants

[Obama 2012 1,714]

Just making the point that you are wrong.

So you try and recover by ignoring the fact you didn't read the original post and by saying now magically I'm wrong?

Learn a bit about medical billing and get back to me. Kthx.