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[Health Care Threads merged - please stop creating new threads]

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ace2000

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The problem with the OLD STYLE health insurance, YES ... prior medical issues would cause a NEW POLICY to be rated as AT A HIGHER RISK FACTOR (higher rate). As I did NOT change policies in the past 2 years, I did not change my risk factor rating. And think if your were in a large group, it was the large "group's" combined Risk Factor. Individual, small or family policy holders got zap.

For ACH, there is NOT PRIOR risk factor or future risk factor -- you pay for WHAT you can afford in a policy as for options. You can not be denied - I did the applications and it DID NOT ask me for my prior health history or prior (or if I even had a) health insurance policy in effect now.

Good to know... thanks to you, Ken, and geekette for the quick response.
 

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Possibly. I'll have time to look at it more this evening. I seem to recall some data or a chart that showed how the future deficits will increase in the next 7 or 8 years, and the primary cause was the Medicaid expansion (I'm estimating the timeframe). I did a brief search and can't find anything like that now. Could I have seen it on Fox News? :)

I've heard the President say that "Obamacare will not add one dime to the deficits", and I've seen similar quotes in other sources. I'll be honest with you, I always thought they were referring to the exchanges or a partial view of the ACA. It really is big deal to me to know the answers about this question.

I had always heard the conservative pundits making the claim of increased budget deficits, and every time, the answer, not only from the dems but also from the mainstream press, was "but the CBO's own estimates show that ACA will actually reduce the deficits." So when I saw your graph from the CBO, something didn't click. That's why I looked it up and read carefully. It's all a matter of presenting the full picture rather than cherry-picking parts.

Blues, how do you come to the conclusion that it covers "one of many provisions"? I'm just curious if you read something and know for sure.

From exactly the quote that I provided. The CBO presents that graph as part of the estimate of the coverage provisions, then goes on to state that "those amounts do not reflect the total budgetary impact of the ACA. That legislation includes many other provisions that, on net, will reduce budget deficits."

I believe I'm reading that right, that just the coverage provisions cost money, but the sum-total of all provisions result in a net deficit reduction. But if you read it differently, I'd love to know a different interpretation.

Also, I'm taking it on faith that that statement includes all provisions, including Medicaid expansion. But truthfully I don't know; would love a confirmation one way or the other.

-Bob
 

Blues

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Follow-up:
The quote I provided came from the CBO publication on this web page:
http://www.cbo.gov/publication/44176

By following the link referencing the letter to John Boehner, you get here:
http://www.cbo.gov/publication/43471

The first bulletted point on that page states:
"The ACA contains a set of provisions designed to expand health insurance coverage, which, on net, are projected to cost the government money. The costs of those coverage expansions—which include the cost of the subsidies to be provided through the exchanges, increased outlays for Medicaid and the Children’s Health Insurance Program (CHIP), and tax credits for certain small employers—will be partially offset by penalty payments from employers and uninsured individuals, revenues from the excise tax on high-premium insurance plans, and net savings from other coverage-related effects."
[emphasis mine]

So, as I read it, they are taking into account increased costs, including Medicaid expansion, and still come to the conclusion that the new revenues and cost reductions more than make up for it, resulting in a net reduction in the deficit.

That's my interpretation. I'd love to hear other interpretations.

-Bob
 

ace2000

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I had always heard the conservative pundits making the claim of increased budget deficits, and every time, the answer, not only from the dems but also from the mainstream press, was "but the CBO's own estimates show that ACA will actually reduce the deficits." So when I saw your graph from the CBO, something didn't click. That's why I looked it up and read carefully. It's all a matter of presenting the full picture rather than cherry-picking parts.



From exactly the quote that I provided. The CBO presents that graph as part of the estimate of the coverage provisions, then goes on to state that "those amounts do not reflect the total budgetary impact of the ACA. That legislation includes many other provisions that, on net, will reduce budget deficits."

I believe I'm reading that right, that just the coverage provisions cost money, but the sum-total of all provisions result in a net deficit reduction. But if you read it differently, I'd love to know a different interpretation.

Also, I'm taking it on faith that that statement includes all provisions, including Medicaid expansion. But truthfully I don't know; would love a confirmation one way or the other.

-Bob

Thanks Bob. That does help and hopefully it'll save me some time this evening.

Also, I didn't "forget" or "cherry-pick" the information I provided. When I posted the original chart to Ken's general question about budget impact, that was a graph that I had remembered seeing previously and so I posted that and mentioned it as a starting point for the discussion. It looked pretty complete to me. I expected a lot more overall discussion and feedback on Ken's question than what was given. I believe if you go back to the post, hopefully you can see that point.

For some reason, it's pretty customary for people to not post their entire articles into their posts on TUG. :rolleyes: I posted the graph because I thought it was pertinent. I appreciate the clarification if you're right about what you're saying.
 

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Thanks Bob. That does help and hopefully it'll save me some time this evening.

Also, I didn't "forget" or "cherry-pick" the information I provided.

You're welcome. I've learned a lot from this discussion.

And I'm sorry that my poor wording made it appear that I was accusing you of cherry picking. I had no such intention. I meant to say that the conservative pundits and Fox News tend to cherry pick what they present. Many apologies if my poor wording left a wrong impression.

And BTW, the latter page that I referenced, the letter from CBO to John Boehner, quantifies the deficit reduction they expect. It says that the repub's bill to repeal the ACA would add $109 billion to the deficit between 2013 and 2022. IOW, that's the amount that the enacting of ACA is expected to save over that period.

Thanks for the spirited discussion.

-Bob
 
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Ken555

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It says that the repub's bill to repeal the ACA would add $109 billion to the deficit between 2013 and 2022. IOW, that's the amount that the enacting of ACA is expected to save over that period.


Wow. If accurate, how could any politician anywhere even think of advocating repeal, or drastically change, the ACA without a new plan ready to go on day one to prevent our deficit from increasing?


Sent from my iPad
 

ace2000

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I believe I'm reading that right, that just the coverage provisions cost money, but the sum-total of all provisions result in a net deficit reduction. But if you read it differently, I'd love to know a different interpretation.

Blues (Bob), I believe you're reading it right also. I've spent 2 hours researching the Internet for the real impact of ACA on the budget and I've seen nothing that has firmly convinced me otherwise.

I am even ready to concede further that I cannot even find any definite evidence that suggests that the ACA will end up adding to the deficits at all. I did see some opinions and some credible possible negative scenarios that might happen, but it's speculative.

Bottom line for me: the graph I presented is very misleading and I apologize to everyone for submitting it to the thread.
 

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Bob, you've caused me re-evaluate some things here and I really appreciate that aspect. I hope you choose to contribute even more to the thread in the future.

Thanks!
 

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I am even ready to concede further that I cannot even find any definite evidence that suggests that the ACA will end up adding to the deficits at all. I did see some opinions and some credible possible negative scenarios that might happen, but it's speculative.

One last comment about the subject of the ACA's impact on the budget. I do still believe that the overall financial impact will be negative in the end, but unless I firmly believe that I have some facts to back up that opinion, you won't be hearing those words from me again on this thread. :)
 

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Bottom line for me: the graph I presented is very misleading and I apologize to everyone for submitting it to the thread.

Glad Bob read the rest of the article from CBO and posted his findings here. Sometimes the taste of crow kinda puts it all in perspective. We've all had our share. It tastes like chicken. :)
 

Conan

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We're [Not] Number One

https://www.youtube.com/watch?v=UsQkAjR4P_0#t=233

In the Social Progress Index, the United States excels in access to advanced education but ranks 70th in health, 69th in ecosystem sustainability, 39th in basic education, 34th in access to water and sanitation and 31st in personal safety. Even in access to cellphones and the Internet, the United States ranks a disappointing 23rd, partly because one American in five lacks Internet access.
....
This Social Progress Index ranks New Zealand No. 1, followed by Switzerland, Iceland and the Netherlands. All are somewhat poorer than America per capita, yet they appear to do a better job of meeting the needs of their people.
....
Many who back proposed Republican cuts in Medicaid, food stamps and public services believe that such trims would boost America’s competitiveness. Looking at this report, it seems that the opposite is true.

Ireland, from which so many people fled in the 19th century to find opportunity in the United States, now ranks 15th. That’s a notch ahead of the United States, and Ireland is also ahead of America in the category of “opportunity.”

Canada came in seventh, the best among the nations in the G-7. Germany is 12th, Britain 13th and Japan 14th.

http://www.nytimes.com/2014/04/03/opinion/were-not-no-1-were-not-no-1.html?smid=tw-share&_r=0
 
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geekette

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...

Which brings me onto the thought that I regularly share, if you take my city, state, federal taxes, medical premiums, copays and deductibles and add it all up it pretty much comes to the 40% higher marginal rate tax band that I paid in England (income over £31,866 ~ $50k)
...
Medical should be free at the point of use. It does not mean that you are not paying for it, just not paying for it when you may not have the means to pay.

What's bothersome to me is that poverty levels, etc., are federal, but cost of living is local. What might afford living in a studio apt in a bad part of town here at poverty level might get a van down by the river in a larger city or a 2 bd apt in a small town.

400% of poverty to qualify for subsidy is either ridiculously generous or screwing folks over. I forget the figure beneath which it's Medicaid, but the gap between medicaid and subsidy is pretty large in some areas. Those folks are the big question marks for me, as to whether they can actually afford to be insured (let alone be sick and actually use the insurance), and whether or not their penalty is waived because they truly cannot afford it.

While we may now have lifetime caps lifted, I don't think we'll see the end of personal bk over med bills yet. Some of the annual out of pocket amounts could indeed wreck a persons financial life. Coming up with thousands, even if the provider will float payments for a year, could be devastating to someone barely making ends meet before getting sick and becoming unemployed.

I agree with you completely - point of service should be free, everyone should pay something (but there will always be folks that really Cannot and also some Cheats).

I also can afford my med stuff (you know, so far) but like Linda, have had to finance bills before. What alarms me is when I hear about 'prepay' before ever going for treatment. I'm not sure how prevalent this is, but it is very troubling to me.
 

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Blues (Bob), I believe you're reading it right also. I've spent 2 hours researching the Internet for the real impact of ACA on the budget and I've seen nothing that has firmly convinced me otherwise.

I am even ready to concede further that I cannot even find any definite evidence that suggests that the ACA will end up adding to the deficits at all. I did see some opinions and some credible possible negative scenarios that might happen, but it's speculative.
I think that since Medicaid is not expanding as far as originally expected, there is even less to 'pay for'.

I don't know if your latest analysis went by original estimate or revised, and what the difference is.

Just curious. but not curious enough to go look it up myself :eek:
 

Conan

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A useful illustration from the Wall Street Journal
(But it would be good to see a similar illustration for a married couple age 35 with a couple of young children.)

Edited to add:
I checked and the young family's premium is about 2/3 (per adult) of what the 55 year old pays: $722/month combined before subsidies.
Of course the children are also included at that price.

OG-AA948_SUBSID_G_20140311121508.jpg

ig_viewer.php
 
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ace2000

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I think that since Medicaid is not expanding as far as originally expected, there is even less to 'pay for'.

I don't know if your latest analysis went by original estimate or revised, and what the difference is.

Just curious. but not curious enough to go look it up myself :eek:

After researching the question, I just don't see how anyone else can provide a better budget impact analysis than the CBO right now. Definitely not a guarantee that they'll be right in their predictions, but who has the resources to do a better job? There are going to be so many variables though. One of the keys is going to be enforcement of the ACA provisions. There is no way to figure that out right now.

I got lost because the title of the chart had the words "Net Budgetary Impact", and I was very confident it meant the real net impact to the budget. Plus I had actually seen that chart in a few other news articles, so I felt good about it. After Bob referenced the paragraph in the source, I'm convinced he's right.

The impact on my beliefs is significant because the budgetary issues are my number one concern. The rest of my concerns are relatively minor, and I've always supported helping the ones that need it, even if I have to pay more.

On your specific question about original or revised, if you look at the chart there are several lines each offering a different revision date. The analysis that contained the chart was published in May 2013, so I don't know.

Additional Edit: A lot of the numbers are labeled as "original". I assume they're almost always referring to the point in time when the ACA was enacted into law. I ran into a few articles that mentioned the "30 million" uninsured that George referenced yesterday. I have no idea where they came up with that number.
 
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ace2000

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Sometimes the taste of crow kinda puts it all in perspective. We've all had our share. It tastes like chicken. :)

Ha! Yea maybe so, but next time can you all serve it with some ketchup or something ??? It tasted kinda lousy. :)
 

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Wow. If accurate, how could any politician anywhere even think of advocating repeal, or drastically change, the ACA without a new plan ready to go on day one to prevent our deficit from increasing?

Yes, it's a good question. One side was completely shut out of the original negotiations though, so that may have something to do with it. Plus the fact that the current law happens to have the President's name labeled on it.

In the past week, there was a budget submitted for debate by one side. Of course, it called for repeal of the ACA with no suggested plan to take its place. Do I really believe they actually want to repeal it? No, but it feeds their base.
 

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One side was completely shut out of the original negotiations though, so that may have something to do with it. Plus the fact that the current law happens to have the President's name labeled on it.

Do I really believe they actually want to repeal it? No, but it feeds their base.

Let's not re-write history here. If you'll recall, The President and congressional leaders asked, no, begged the Republicans for their plans that would accomplish the following: Lower costs, insure the uninsured, end pre-existing condition exclusions (you know the rest of the minimum standards) and no plan was brought forth. There STILL is no competing plan.

Then to address the 'name of the President' on it. Again, that name was put on it by the Republicans as a 'dig'. It was only after he embraced the name by saying "Obama DOES Care!" that the name stuck. Do I wish it was still known as Affordable Care? Sure. But after a new administration takes over, and 30-40 million are signed up for it, a new name will surface.

Can it still be repealed? Maybe. I don't find it likely, especially with this President still sitting through 3 more open enrollment periods. Americans got a taste of what 'insurance for all' might look like, and the major tenets won't go away.
 

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Let's not re-write history here.

Let's not re-write my "post" here.

I mentioned negotiations. This was not a bi-partisan solution and it was not a compromised solution, nor one attempted. I think I understand where you're coming from though. The last two presidential candidates both had solutions to health care, though nowhere near the scope of the ACA.

Again, I am strongly suggesting that this will not be repealed and rolled back to square one. There's absolutely no way. Repealed, or replaced, or enhanced, or whatever all become a matter of semantics.
 

Ken555

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This was not a bi-partisan solution and it was not a compromised solution, nor one attempted. I think I understand where you're coming from though.

Ace, you're slipping into no mans land for TUG. And some of us won't be able to hold back and not respond when we see partisan statements that are, perhaps, heavily influenced by biased "news" sources (which are themselves heavily influenced by those with a cause). History should not be rewritten, so be careful what you post here.

The last two presidential candidates both had solutions to health care, though nowhere near the scope of the ACA.


Really? Something more than a campaign promise without details? The kind we have had for decades that turn out to be meaningless? I wonder which candidates you have in mind...as "last two" would strictly be defined as Obama and Romney, and Romney only had campaign promises...

FWIW, I humbly suggest you not bother responding to this post, or else we may likely finally have this thread locked.


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Ken555

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Yes, it's a good question. One side was completely shut out of the original negotiations though, so that may have something to do with it.

Oh, please. Utter nonsense. "One side" removed themselves unilaterally from discussions. That's not the same as being "shut out".

In the past week, there was a budget submitted for debate by one side. Of course, it called for repeal of the ACA with no suggested plan to take its place. Do I really believe they actually want to repeal it? No, but it feeds their base.


I really wish we could have a civil debate here on this topic, as I think it would be interesting. I think we need competing ideas for our national budget and direction as it keeps everyone continually pushing for the best solution (as it should in commerce, etc). I define it like this: one side wants those who earn the vast majority of money to pay the vast majority of taxes, and the other side doesn't. Guess which side is going to benefit most from this weeks Supreme Court decision on removing campaign donation limits and how influential that will be on twisting the election? No, don't answer... ;)


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FWIW, I humbly suggest you not bother responding to this post, or else we may likely finally have this thread locked.

This is hilarious. You make your initial political post and then suggest to me not to respond to your political post.

There's two sides to the story, if you can't handle hearing an opposing view, don't make the first political post in the first place. Because right now, you've given your "opinion" and I gave mine. I'm willing to leave it alone, but please stop your "games".
 

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Guess which side is going to benefit most from this weeks Supreme Court decision on removing campaign donation limits and how influential that will be on twisting the election? No, don't answer... ;)

More of the same...
 

Ken555

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This is hilarious. You make your initial political post and then suggest to me not to respond to your political post.

There's two sides to the story, if you can't handle hearing an opposing view, don't make the first political post in the first place. Because right now, you've given your "opinion" and I gave mine. I'm willing to leave it alone, but please stop your "games".


Ace, I'm done letting you have the last word when you slip in political statements - it was you who just referenced the last "two" candidates first, not me. Then you think it's hilarious that I'm making a political post first. I think we all get the picture here - you really don't want to discuss this issue, as you know it's not allowed here, but still you want to slip in your own biased viewpoint of history...well, some of us won't allow that anymore, and if it requires locking this thread to stop it, so be it.


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