Minding Ag's Business
Marcia Zarley Taylor DTN Executive Editor

Tuesday 11/12/13

Over 65? Turn Off Noise on Obamacare

David and Anne (not their real names) are Nebraska farmers in their 70s, still active in the business. With health coverage under Medicare, a supplemental health insurance policy to cover prescription drugs and other non-Medicare costs, and a long-term care policy if they need a nursing home, they tell me they are spending $18,000 to $19,000 a year for health expenses. Dropping their long-term care insurance would only save $6,000/year. Is there anything in the new health care program for them?

That's a good question, since rural America is graying and already spends a good chunk of their incomes on health care. According the last Census, Nebraska's rural counties are home to two-thirds of the state's elders over 65, even though rural counties represent only 41% of the state's population, according to the Center for Rural Affairs. What's more, the Kaiser Family Foundation estimates that Medicare recipients spend an average of 15% of their incomes on health costs. Without a supplemental policy, seniors will find Medicare offers relatively high deductibles and no ceilings on their share of payments, a frightening thought at any age.

But the short answer is, most of the Obamacare provisions affecting senior citizens were implemented beginning in 2010, according to a new report from the Center for Rural Affairs in Lyons, Neb.

For starters, Medicare fulfills the mandatory insurance requirement starting Jan. 1. Anyone over 65 with Medicare Part A coverage (for inpatient care in skilled nursing facilities, hospitals, hospice care and home health care) fulfills the mandate that all U.S. citizens and legal residents acquire health insurance or face a fine. Those with Medicare are ineligible to purchase supplemental health or dental insurance on the state or federal exchanges, so David and Anne can't shop for better deals there.

“There has been so much media attention to the difficulties surrounding implementation of the new health insurance marketplaces. Seniors, however, do not have to worry about the ‘issues’ with the exchanges impacting them directly. They can tune out some of that noise and consider the positive benefits that the Affordable Care Act has to offer them,” says Jon Bailey, director of research for the Center for Rural Affairs.

Bailey points out that seniors are beginning to get relief from the "donut hole"--the gap between prescription drug costs and Medicare coverage. Beginning in 2010, ACA provided relief for seniors and will close the "donut hole" by 2020. They already receive an automatic 50% discount on Part-D covered brand name prescription drugs and that deductible will be reduced in 2014.

In 2011, the Affordable Care Act eliminated co-pays and other cost sharing for preventative services such as mammograms.

"Rural seniors should not be apprehensive about the Affordable Care Act," Bailey says. "They do not have to concern themselves with the health insurance marketplaces, the largest and, so far, most complicated piece of the law. And the ACA provisions from which seniors can benefit are becoming systemized in their day-to-day Medicare health care."

To read the Center for Rural Affairs report, go to http://files.cfra.org/…

For a summary of Medicare see http://kff.org/…

Follow me on Twitter@MarciaZTaylor

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Posted at 3:45PM CST 11/12/13 by Marcia Zarley Taylor
Comments (23)
I'm four years away from turning off the noise, but doing so would be like sticking my head in the ground. I'm part of a group that will soon be the largest retirement population ever. At the same time, the people paying for government expenditures will become disproportionately small. In addition, 47% (and growing) of our population doesn't pay any taxes. Who will pay for all my "freebies" when the till runs dry?! Will I be able to choose my doctor - reports now indicate that freedom will be lost. I also worry that if I'm to benefit from ACA I will have to enter all my personal information on an unsecure web site. Better stop here while I can still be civil!
Posted by Curt Zingula at 6:29AM CST 11/14/13
The 47% you refer to are net Federal taxes. State, property, sales, fuel, airport, assessments, and FICA are still paid by all who are obligated. We'll cover your and my "freebies'" but it require a little adjustment such as raising the top end limits on SSN taxes. Curt, in all seriousness, when are we going to raise Federal income taxes to pay for the decade + of warfare after 911? I want to make sure I get my mil retirement check as well as USDA insurance.
Posted by Don Thompson at 8:32AM CST 11/14/13
typical baby boomers
Posted by Mark Knobloch at 10:35AM CST 11/15/13
While the grasshopper parties to the tune of "Don't Worry, Be Happy", the ant, painfully aware of higher taxes (what the Supremes call the ACA), must work even harder to pay for their own needs and the needs of the soon to be dependent grasshoppers. No self-respecting senior should expect their kids to pay for their health care so the seniors can spend their retirement accounts on cruises around the world! And Don, get a clue, the freebies I referred to earlier are in regard to the ACA which isn't funded by property taxes, so take that arguement where it applies.
Posted by Curt Zingula at 6:31AM CST 11/16/13
Anyone thinking Obama is concerned about healthcare for the elderly think again. See http://news.yahoo.com/unitedhealth-drops-thousands-doctors-insurance-plans-wsj-030014903--finance.html
Posted by Sally Benson at 7:50AM CST 11/16/13
More evidence that Obama is a fraud. See http://www.nationalreview.com/article/364117/lawlessness-fix-andrew-c-mccarthy
Posted by Sally Benson at 8:04AM CST 11/16/13
November 17, 2013 'Racist' President Says Now You can Keep Your 'Substandard Insurance' By Clarice Feldman In ancient times were a ruler to have mismanaged everything as badly as has Obama, stonemasons would start gathering near the palace in anticipation of being hired to chisel the ruler's name and visage off all public buildings and temples, funerary garb purveyors would be spreading their wares out in the public square, and the top viziers would be stirring a special concoction for him to drink to bring his disastrous reign to a quick end. We don't do things that way, so Obama, his party, and the country if not the world, will watch his power dissolve and the chaos he used to thrive on now overwhelm us all. We have, however, the -- to me -- happy pleasure of watching the arrogant press's favorite party face humiliating and ruinous exposure as know-nothings who lied, covered up, ignored normal legislative procedures, constitutional law, public sentiment, math, technology, and common sense. Just a few days ago the president's defenders were calling his critics "racists" and claiming ObamaCare was merely allowing us to get rid of our "substandard health insurance" for better plans our betters, the Democrat leadership, thought we should have. Thursday he offered up a purported rollback fix announcing, incredibly "we are discovering that insurance is complicated to buy...." His right-hand gal, the party's own Norma Desmond, Nancy Pelosi, about whom Joshua Sharf says: "I *am* big. It's my caucus that got small," is standing firm, though her caucus is running for the hills as waves of angry voters strike out. The purported "fix" to allow voters to keep the insurance that the administration ordered them to cancel is so unworkable, the insurance commissioners of South Carolina and Washington State both turned the proposition down almost as soon as the president made it. Even Howard Dean questioned whether the president can legally do this, though I don't recall him saying a word when this train wreck started down the track through procedures which ignored decades of Congressional practice and procedure and when the president tossed off waivers to his friends and allowed HHS to draft regulations that were directly in conflict with the promises he was repeatedly making to voters and even the clear language of the Act. (This, as his spokesmen were arguing that ObamaCare was "settled law" which could not be altered or repealed.) More weighty than Dean's second thoughts, however, were those of legal scholars like Professor Eugene Kontorovich, a real constitutional law professor from Northwestern University (as opposed to Obama, the part-time lecturer at the University of Chicago). President Obama in his speech on "fixing" the Affordable Care Act today did not specify what statutory authority, if any, he thinks authorizes him to make such dictats. Given the gargantuan length of the ObamaCare statute, he might still be looking. Press reports say the President is claiming a broad "enforcement discretion." It is true that the Chief Executive has some room to decide how strongly to enforce a law, and the timing of enforcement. But here, Obama is apparently suspending the enforcement of a law for a year -- simply to head off actual legislation not to his liking. Congress is working on legislation quite similar to the president's fix, but with differences he considers objectionable. This further demonstrates the primarily legislative nature of the fix. Indeed, the fix goes far beyond "non-enforcement" because it requires insurers to certain new action to enjoy the delay. This is thus not simply a delay, but a new law. The "fix" amounts to new legislation -- but enacted without Congress. The President has no constitutional authority to rewrite statutes, especially in ways that impose new obligations on people, and that is what the fix seems to entail. And of course, this is not the first such extra-statutory suspension of key ObamaCare provisions. UPDATE: Here is the text of the administration's letter describing the fix. The legal problems are no bigger than the practical and political problems of Obamacare and the man who viewed this as his signature achievement: Normally insurance companies take months to set up plans, negotiate with network providers, get state insurance commissioners to sign off on the proposed rates, and then do a bit of marketing. Now they have until December 15 for customers whose plans are cancelled as of Jan 1. But hey, don't blame Obamacare! It has only been the law for three years now; if insurance companies really thought it would go into effect and acted accordingly, well, psych! Experts indicate even the mechanical issue of the website will not -- cannot -- be fixed by Obama's latest promised date, December 1. See: The well-documented critiques of the front-end and back-end software on HealthCare.gov beg the question of whether this critical site was properly designed -- or, even worse, designed at all. It has been reported that the front end was designed with an agile process; unfortunately, most agile processes reject and discourage "big design up front." In a nutshell, many agile processes -- and especially extreme programming -- reject the big design phase as part and parcel of rejecting the waterfall methodology. Agile processes follow more of an "organic" software development, where developers start coding the smallest increment possible and "grow" the working software up, little by little, with constant customer feedback. These agile methodologies call for "user stories" to design each small increment of the system being developed. To be fair, agile can work for some software projects, but I assert that it is the kiss of death for projects with many moving parts, multiple organizations and complex interactions. And then there are the political issues, Pelosi's continued optimistic predictions aside. Kimberley Strassel lays out the devastating political wreckage facing the Democrats: The primary purpose of the White House "fix" was to get out ahead of the planned Friday vote on Michigan Republican Fred Upton's "Keep Your Health Plan Act." The stage was set for dozens of Democrats to join with the GOP for passage --potentially creating a veto-proof majority, and putting enormous pressure on Senate Majority Leader Harry Reid to follow suit. The White House couldn't risk such a bipartisan rebuke. Moreover, the Upton bill -- while it lacks those GOP joy words of "delay" or "repeal" -- poses a threat, since it would allow insurers to continue providing non-ObamaCare policies to any American who wants one. Democratic Sen. Mary Landrieu's version of the bill would in fact (unconstitutionally) order insurers to offer the plans in perpetuity. Both bills undermine the law's central goal of forcing healthy people into costly ObamaCare exchange plans that subsidize the sick. The president's "fix" is designed to limit such grandfathering, but that's why it is of dubious political help to Democrats. Within minutes of Mr. Obama's announcement, several Democratic senators, including North Carolina's Kay Hagan -- whose poll numbers have plummeted in advance of her 2014 re-election bid -- announced that they remain in favor of Landrieu-style legislation. And the White House "fix" doesn't save Democrats from having to take a vote on the Upton bill. A yes vote is a strike at the president and an admission that the law Democrats passed is failing. A no vote is tailor-made for political attack ads and requires a nuanced explanation of why the president's "fix" is better than Upton's. Which it isn't. There remain some diehard believers in the efficacy of an even larger federal role in our lives and health care even if they lightly acknowledge the president just might have "misspoke" or failed to act as a competent executive. For example, the New York Times, whom Professor Althouse flays here. But I believe the president's tardy apology for creating chaos in at least one-sixth of the U.S. economy is about as effective as the Syrian Al-Qaeda members who videoed an apology for beheading the wrong guy. The poor man is dead. The apology is useless, and in that same way, the persons who lost their jobs, whose incomes were reduced, who face periods of time with no health insurance coverage of their choosing, who will face a larger tax burden, or who are committed to pay much higher premiums now, have suffered irretrievable losses. Some may even die as their treatment for serious health issues -- like cancer -- were suspended with the loss of their coverage. Fouad Ajami compares Obama's rise and fall to those of a number of Middle Eastern rulers. He's seen this play about charismatic but incompetent leaders before: Five years on, we can still recall how the Obama coalition was formed. There were the African-Americans justifiably proud of one of their own. There were upper-class white professionals who were drawn to the candidate's "cool." There were Latinos swayed by the promise of immigration reform. The white working class in the Rust Belt was the last bloc to embrace Mr. Obama -- he wasn't one of them, but they put their reservations aside during an economic storm and voted for the redistributive state and its protections. There were no economic or cultural bonds among this coalition. There was the new leader, all things to all people. A nemesis awaited the promise of this new presidency: Mr. Obama would turn out to be among the most polarizing of American leaders. No, it wasn't his race, as Harry Reid would contend, that stirred up the opposition to him. It was his exalted views of himself, and his mission. The sharp lines were sharp between those who raised his banners and those who objected to his policies. America holds presidential elections, we know. But Mr. Obama took his victory as a plebiscite on his reading of the American social contract. A president who constantly reminded his critics that he had won at the ballot box was bound to deepen the opposition of his critics. A leader who set out to remake the health-care system in the country, a sixth of the national economy, on a razor-thin majority with no support whatsoever from the opposition party, misunderstood the nature of democratic politics. An election victory is the beginning of things, not the culmination. With Air Force One and the other prerogatives of office come the need for compromise, and for the disputations of democracy. A president who sought consensus would have never left his agenda on Capitol Hill in the hands of Harry Reid and Nancy Pelosi. [snip] If Barack Obama seems like a man alone, with nervous Democrats up for re-election next year running for cover, and away from him, this was the world he made. No advisers of stature can question his policies; the price of access in the Obama court is quiescence before the leader's will. The imperial presidency is in full bloom. There are no stars in the Obama cabinet today, men and women of independent stature and outlook. I resist amateur psychological analyses but it is hard to ignore the President's narcissistic pathology, and, if this is the case, as he is cornered he is only more dangerous than ever. Iowahawk's nailed it I think: David Burge �@iowahawkblog "Let's not argue whose idea it was to bring the Jarts and tequila. We need to all work together to fix the hole in this guy's head." Read more: http://www.americanthinker.com/2013/11/racist_president_says_now_you_can_keep_your_substandard_insurance.html#ixzz2l02kARDL Follow us: @AmericanThinker on Twitter | AmericanThinker on Facebook
Posted by Wesley Kuster at 6:32AM CST 11/18/13
Say Don how does terrorizing Americans by denying their doctors and hospitals of choice, taking away the policies they were promised they could keep, and continually lying to them constitute health care? At least Nixon had the decency to resign. All Obama has done is create chaos.
Posted by Sally Benson at 6:24AM CST 11/19/13
Sally, you do know that if Don replies he will probably say that he cares about the needy - like you don't. I think the worst aspect of the ACA is that legislators exempted themselves from this miracle of health care and not enough people wonder why.
Posted by Curt Zingula at 7:07AM CST 11/19/13
Curt, With all due respect, I don not believe you are completely familiar with the ACA regarding "legislators" participation in the exchanges. This issue was in the news last week. Please study up and report back. For Sally Benson, Wesley W, John Olsen, or whatever you are calling yourself this time around, the ACA will allow private insurance companies to provide medical and mental health coverage. I encourage you to take advantage of these features since any individual's illness or lack of mental stability has proven to be a threat to all of society. Remember your chosen insurance company will contract with individual providers for your health care. The insurer will provide you with a list of their preferred providers. You are free to go to a provider of your choice, however. Your private insurer may cover that cost or may not. That is the decision of your private insurer. Simple enough?
Posted by Don Thompson at 5:54PM CST 11/19/13
Don you still are believing in fairy tales. Check out this- Obamacare�s Death Spiral by Richard A. Epstein (Peter and Kirsten Bedford Senior Fellow and member of hoover ip squared working group steering committee) Striking the law down will be an act of mercy for the American people. It has been a tumultuous two weeks since I last wrote about Obamacare�s moral blindness. The President�s dismal performance since that date has only confirmed my initial impression. He has refused to take full responsibility for the key policies embedded in that legislation. He has also endorsed naïve short-term fixes that do nothing to correct the fundamental design flaws of the Affordable Care Act. epstein Illustration by Barbara Kelley Those two errors will give way to two larger public debates, one constitutional and one social. First, should the President�s new proposals be subject to attacks under the oft-discredited doctrine of substantive due process? Second, will the failures of Obamacare require a massive leap to a single-payer system to avert a return to some status quo ante that is morally and socially intolerable? It�s clear that we need to kill Obamacare and avoid a single-payer system at all costs. The President�s Listless Apology The President�s November 14 press conference reveals that he is unable to come to grips with the fatal flaws of his healthcare program. He claims that �in the first month, nearly a million people successfully completed an application for themselves or their families.� Deconstructed, what that really means is a paltry 27,000 people have been able to get coverage on the federal exchanges and some 79,000 others through the state exchanges. The million-person figure includes the 975,000 people deemed �determined eligible� for coverage that they have not purchased but, he assumes, they soon will. The President thinks this shows the pent-up demand for his program. But he hasn�t addressed the composition of the applicant pool, which clearly attracts individuals with known healthcare conditions who will receive extensive public subsidies to join the ranks of the insured. There is no way that the government exchanges can remain viable without attracting large numbers of healthy young persons, all of whom are well-advised to stay away in droves, until they become sick and can sign up with the plan of their choice, no questions asked. Obamacare can only remain solvent with an enormous public subsidy. But the President compares apples to oranges when he disparages the private plans he considers substandard while he praises the efficiency of the public plan, even though it will require public subsidies. To him, taxpayer costs don�t matter. The President fared no better when he claimed he misspoke in saying, repeatedly, that �if you like your current healthcare plan, you can keep it.� His tortured explanation had two parts. First, he did not focus enough on the individual market; second, the grandfather protection built into the ACA turned out to be �insufficient.� One key difficulty with the individual plan is that its ten categories of Essential Health Benefits are not met by the policies offered in the individual healthcare market. But as the HealthCare.gov website makes clear, �The Affordable Care Act ensures health plans offered in the individual and small group markets, both inside and outside of the Health Insurance Marketplace, offer a comprehensive package of items and services, known as essential health benefits.� The small group market covers firms with under 50 or 100 workers depending on the state. But the President never once discusses how Obamacare undermines both markets. Millions now find themselves in a similar bind with group plans. The President is also flatly wrong to assume that the defects in plan structure are confined to the individual market. Nor can he claim that the grandfather provision just turned out to be �insufficient.� They were that way by design. From start to finish, the entire exception was a sham. The President has no patience for the �substandard� policies rolled out by the voluntary market, which may lose, or in many cases have lost, their grandfathered status the moment they introduced any material change in their coverage formulas or rate, which they routinely do. In addition, �most PPACA requirements apply to grandfathered plans,� including limitations on waiting periods and essential healthcare benefits, which lie at the root of the problem. The tragedy remains that it is far easier to force people out of healthcare plans that they want than it is to enroll them in healthcare plans that they don�t. Possible Legislative Fixes Public outrage and Democratic uneasiness has forced the President to back down from his hard-line position that would force millions of individuals with canceled polices to seek coverage on the dysfunctional government website. But once again, the President�s unyielding opposition to substandard coverage has made it impossible for him to beat a graceful retreat from his flawed program. The House just passed (with 39 Democratic votes) a Republican legislative plan from Michigan Congressman Fred Upton that would allow all insurers one more year to offer policies identical to those now in effect, without running afoul of the ACA. The logistical difficulties that stand in the path of the implementation of this simple fix are serious. It�s not easy to close the floodgates after the water has raced downstream. The situation is made still worse because the President has vowed to veto this bill on the basis that, gasp, it lets insurance companies sell their �substandard� policies to new customers, who in his view should have their options limited solely to products offered for sale on the dysfunctional exchanges. The President�s position raises yet again the thorny legal question of whether any president can suspend the operation of a law that he is supposed to execute. His legal position is ever so tenuous, because his fix doesn�t just suspend the law. It also requires insurers to inform consumers ��what protections these renewed plans don�t include� and alert customers to potentially better and more affordable insurance in the new federal and state marketplaces.� A major new disclosure program will need to be built from scratch over the Christmas holidays, on top of a reinstatement process that has to overcome huge hurdles within individual companies who have to reprice their revised policies before gaining regulatory approval on a state-by-state basis. No wonder their executives are up in arms. Constitutional Complications The President�s adamant position in the face of an industry-wide insurance meltdown ought to force a serious reconsideration of the constitutional issues at play over Obamacare. As everyone recalls, the constitutional challenges raised in the Supreme Court case over Obamacare, National Federation of Independent Business v. Sebelius,were over issues of Congressional power, not of individual rights. Chief Justice Roberts walked an implausible line when he held that Congress did not have the power to enact the legislation under its commerce power, but could do so under its power to tax and spend for the general welfare of the United States. From the outset, no one took seriously the view that the individual mandate posed any threat to the individual liberty protected under the Due Process Clause of the Fifth Amendment. Our New Deal legacy has left economic liberties to the tender mercies of the national and state governments. The individuals who are bound by minimum wage and mandatory collective bargaining laws have grounds to attack a statute that proclaims it protects patients and supplies them with affordable health care. One real price of the first generation challenges under the tax and commerce powers is that they focused exclusively on a small slice of the overall legislation, thereby ignoring its most coercive and corrosive effects. But the extraordinary claims for government domination over individual rights comes front and center when the President announces that he will protect the fundamental right to healthcare by barring ordinary folks from acquiring coverage in the voluntary market, in order to force them to seek coverage they don�t want�like treating maternity care for men as an essential minimum benefit�in a nonfunctional government market that serves none of their personal needs. The Obamacare fiasco now flunks Justice Holmes� extreme rational basis test in the 1905 decision of Lochner v. New York: �I think that the word liberty in the Fourteenth Amendment is perverted when it is held to prevent the natural outcome of a dominant opinion, unless it can be said that a rational and fair man necessarily would admit that the statute proposed would infringe fundamental principles as they have been understood by the traditions of our people and our law.� In the light of day, Obamacare is that bad, even if the minimum wage law is not. Even the most ardent defender of government power must concede that it is sickening when a president tells people without healthcare insurance that they must navigate his government websites or go without. If �the right to healthcare� is fundamental, Obamacare violates it. Delay here is no option. If left in place, every single structural problem that besets Obamacare today will continue to wreck innocent lives a year from now. Striking it down is an act of mercy for the American people. Single Payer: From the Frying Pan into the Fire Ironically, the incorrigible supporters of Obamacare have learned the wrong lesson from this debacle. Both Harry Reid and Nancy Pelosi run up the progressive flag and fault Obamacare for not going far enough in its refusal to adopt a �Single-Payer� healthcare system that would get rid of all those pesky remnants of individual choice that are now sinking Obamacare. But this proposal is sheer delusion. No sane person who has watched the government bollix its effort to implement Obamacare could tolerate the prospect of the government displacing the existing system of private healthcare insurance subject to state regulation. What would that solve? It would not fix the expanded website that would function as the only portal into the healthcare system. It would not trim the outsized package of essential minimum benefits that have now turned the system upside down. It would not eliminate the immense network of cross-subsidies that has driven private plans to insolvency. And most certainly�with both Medicare and Medicaid in place�it could never implement the Canadian system in which national government makes block grants to the provinces who then have to allocate those dollars to various medical services consistent with budget caps on federal support. Politically, it seems clear that the American public will not tolerate yet another round of healthcare reforms that cannot shoot straight. The real question is whether the Democrats in Congress will come to their senses and realize that Obamacare is DOA. It is possible to think of all sorts of mid-level fixes that might moderate the damages, but none has a prayer of success so long as this president remains in office. Deregulation and tax cuts are dirty words to Obama, but they are the only source of relief to a nation. The ACA has already done enough harm. The time to start over is now. Richard A. Epstein, Peter and Kirsten Bedford Senior Fellow at the Hoover Institution, Laurence A. Tisch Professor of Law at New York University, and senior lecturer at the University of Chicago, researches and writes on a broad range of constitutional, economic, historical, and philosophical subjects. He has taught administrative law, antitrust law, communications law, constitutional law, corporate law, criminal law, employment discrimination law, environmental law, food and drug law, health law, labor law, Roman law, real estate development and finance, and individual and corporate taxation. His publications cover an equally broad range of topics. His most recent book, published in 2013, is The Classical Liberal Constitution: The Uncertain Quest for Limited Government (2013). He is a past editor of the Journal of Legal Studies (1981�91) and the Journal of Law and Economics (1991�2001).
Posted by Sally Benson at 6:54PM CST 11/19/13
Sorry "Sally", I do not read your stuff - too long and delirious.
Posted by Don Thompson at 7:07PM CST 11/19/13
Say Don is your real name Nancy Pelosi?
Posted by Sally Benson at 7:14PM CST 11/19/13
No. She is a wonderful Lady I must say. She can teach us all a thing or two about having class. Thanks for the question.
Posted by Don Thompson at 8:23PM CST 11/19/13
I want what Mass. has, ROMNEYCARE!!!
Posted by Jay Mcginnis at 5:45AM CST 11/20/13
Its obvious to the honest that obamacare is not about healthcare but all about government control. See http://www.nationalreview.com/corner/364362/some-dc-exchange-plans-cover-elective-abortion-not-hearing-aids-betsy-woodruff
Posted by Sally Benson at 5:53AM CST 11/20/13
I want what Don is smoking! Who in their right mind would use the exchanges after the testimony from several hacking experts that the web site isn't remotely safe and may not be safe for a long, long time?! And it was obvious to the Supreme Court that the ACA is a tax first, healthcare second (wolf in sheep's clothing). Regarding the legislator's participation; Why did I hear a legislator report a month ago about exempting themselves because they have a good plan and want to keep it? Because of classy Nancy's advice to pass it so we can learn what's in it?
Posted by Curt Zingula at 7:18AM CST 11/20/13
Curt, Sorry I can't help you with the smoke. You will have to see the mayor of Toronto or the new Congressman from SW Florida for that! The ACA law is aimed at those not covered or individual buyers. That is a relative small amount of the population. Folks such as myself can keep our insurance with improved coverage afforded by ACA and in some cases, some folks are not eligible to use the federal exchange as directed by the law. The rollout of the website was extremely disappointing to me and other supporters for obvious reasons. However, that does not change the fact that healthcare in the USA is flawed and needs improvement. I believe that we now have an opportunity to work on it. Even if our efforts fall short in some areas it still contributes to the learning process and puts us ahead overall. Farmers certainly learn from failure and we may be in for another round soon. If you are accustom to everything coming out flawless and have an answer for our situation, then your role in life is not in the fields but putting your life and reputation on the line to help the USA and mankind to follow. I encourage you to put forth your well thought out and guaranteed to perform solution. Thanks.
Posted by Don Thompson at 11:14AM CST 11/20/13
I appreciate your sense of humor Don. I also appreciate the idea of learning from mistakes and coming up with a better solution. My concept of "change" involves limited influence from the government - the same government that mismanaged the Postal Service, stole from Social Security and lies. Perhaps we can make improvements that aren't wealth transfers such as the one Marcia describes in her "don't worry, be happy" article about seniors sponging off their kids. There are an immense number of problems in the ACA and at the risk of being labeled as a "half empty glass of water" those problems shouldn't be ignored!!
Posted by Curt Zingula at 1:16PM CST 11/20/13
Curt, I fully believe that the government is "we the people" so when we say the problem is the government I agree. We people are the problem in that we have discouraged sanity in our governing. You and I may disagree on who the problem children are but our best and brightest are not willing to serve in elective office today. Regarding ACA, I fully want whatever healthcare law we arrive at to be refined to the best of our ability to formulate without the political need to make sure someone loses and someone perceives himself as a winner. Throughout my varied career enterprises I have sensed an increasing creep of regulation and it concerns me. That concern is only exceeded by the realization of the overwhelming willingness for our fellow citizens to purposefully muck things up, private and public, for personal gain.
Posted by Don Thompson at 2:20PM CST 11/20/13
Check out http://youngcons.com/the-best-video-deconstruction-obamacare-you-will-ever-see/
Posted by Alvin Obert at 11:51PM CST 11/21/13
Getting back to the topic of your article, Marcia. Over 65 might only be wishfull thinking. With the interpretations of Obamacare, from various decision makers, the end resusult is still in LaLa Land. I wonder if Rep. Pelosi has yet read this mess.
Posted by Bonnie Dukowitz at 5:56PM CST 11/23/13
Physician says Obamacare is causing 'chaos' for doctors Text Size Published: Tuesday, 3 Dec 2013 | 12:00 AM ET By: Ben Thompson | Senior segment producer for the Kudlow Report Poor situation for Obamacare: Pro Monday, 2 Dec 2013 | 7:25 PM ET Paul Howard, senior fellow at the Manhattan Institute, and Dr. William Grace, assistant professor at New York Medical College and a physician at Lenox Hill Hospital, discuss problems on the Obamacare exchanges. The administration is furiously trying to rectify another Obamacare issue: faulty enrollment data that could soon become a significant headache for consumers and insurers. The latter say much of the information they have received is practically useless, which means some consumers might not be able to get access to benefits on Jan. 1, the date their coverage is scheduled to take effect. Dr. Bill Grace, founder of Grace Oncology in NYC and an assistant professor of clinical medicine at New York Medical College, told CNBC Monday night that the enrollment problems also are causing significant problems for doctors. "Right now that back end is in chaos. â?¦ We don't even know if we should sign up for these plans, because we have a suspicion that many of [them] offer very little reimbursement or offer a loss to the physicians who are going to see these patients," Grace told Larry Kudlow on CNBC's "Kudlow Report". "No physician wants to take money out of his pocket and put it in the government's." (Read more: Obamacare enrollment error rate still secret as more sign up) The Centers for Medicaid & Medicare Services, which is responsible for running the federal Obamacare website, has refused to reveal how many sign-ups have software-related errors that could delay enrollees' coverage. The administration released a 50-state report Tuesday morning saying that nearly 1.5 million people had been found eligible for Medicaid during October, far outpacing enrollment eligibility in subsidized private coverage. But as Obamacare puts more people in the Medicaid system, Grace said fewer doctors are treating Medicaid patients. "The problem is, who's going to care for you when you have Medicaid?" he said. "For an hour-and-15-minute evaluation of a cancer patient, I get $6.50. That won't even pay for the electricity. What kind of physician will you get ... what kind of specialist will you get?" Doctors are "already leaving in droves from accepting Medicare," he said. "They're going to concierge practices. They're limiting the number of Medicare patients they take. They're taking only commercial insurance plans, and the premier physicians are taking no insurance at all." (Read more: Insurers claim health website is still flawed) Obamacare's website troubles have resulted in enrollment numbers significantly lower than administration officials had hoped. It's questionable whether the program will reach the 7 million sign-ups the Congressional Budget Office predicted. The sign-up period runs through March. Grace told CNBC that the biggest problem with Obamacare is that patients don't have skin in the game. He offered this health-care fix as an alternative. "I'd give everybody at birth a health savings account, because it makes everybody a capitalist. People make poor health care choices and want somebody else to bail them out. When they own the plan, they begin to make healthy ... choices. " â?”By CNBC's Ben Thompson. Follow him on Twitter @BenThompson00.
Posted by W Kuster at 6:21AM CST 12/05/13
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