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Browsing Posts tagged Affordable Care Act

The Hill has this report as Obamacare Sprints Across The Finish Line...Obamacare

The end to this year’s ObamaCare signup season at midnight on Sunday is expected to add more than 11 million people to its rolls, putting the administration ahead of its own expectations.

While the second year of ObamaCare has been just as high-stakes as last year, the enrollment drive has been met with far less fanfare.

Healthcare advocates say the quieter enrollment period – largely devoid of politics  – has been good news for ObamaCare.


Wendell Potter explains how Making Insurers Do The Right Thing Saves Billions

The chairman of the committee, Sen. Jay Rockefeller, (D-W.Va.), then decided to explore the issue further. After examining years of reports filed by insurance companies, the committee found that, as Rockefeller said Wednesday, “many of the policies health insurance companies were selling to families and businesses were just not a good value” because of their low medical loss ratios.

At Rockefeller’s insistence, the Affordable Care Act included a provision that requires insurance companies to spend at least 80 percent of our premiums on medical care and no more than 20 percent on overhead, including executive salaries and profits. That single provision — which went into effect in 2011 — has saved consumers billions of dollars in just two years.

As I explained to the committee last Wednesday, consumers benefit from the minimum MLR requirement in two significant ways. First, insurers are now operating more cost-efficiently to stay in compliance with the law. As a result, many policyholders are paying lower premiums than they would have been charged otherwise. Second, if an insurer fails to comply and spends less than 80 percent on medical care — or 85 percent in the large group market — it has to issue rebates to its policyholders.

Please help promote this public service event. Contact Lloyd Klinedinst (email: cell phone:  (314)-609-5571 ) for more information or for a flyer version of this post for printing and distribution.


Pacific City Hall – 300 Hoven Drive

Wednesday December 11, 2013

7:00 pm


Health Care Reform: 

What’s Here? What’s Coming? What’s Missing?


Dr Ed Weisbart will speak to us about healthcare issues in the US including:

- what is currently available in Affordable Care Act

- the current and future state of US healthcare

- how our present system does address many vital improvements such as expanding coverage to millions.

- many problems still unaddressed, costing us unnecessary expense

- the myths and facts of US healthcare

- how America’s healthcare compares to other industrialized nations.


You will leave with a greater understanding of the healthcare we have now and what the future holds.


Dr. Weisbart practiced family medicine at Rush Medical Center in Chicago for twenty years before moving to St. Louis in 2003 to become chief medical officer at Express Scripts. He retired from that position in 2010.

Dr. Weisbart chairs the St. Louis chapter of Physicians for a National Health Program, part of the 26 year-old 18,000 member group that advocates for improving Medicare and providing it to all Americans. He also volunteers as a physician in a variety of safety net clinics and other non-profits across the St. Louis area.

Dean Baker takes a look at all the hyperbole surrounding a few folks having their current insurance cancelled because it does not meet the minimum standards of the Affordable Care Act.  Just how few have lost the insurance they had since the enactment of the ACA?

Glenn Kessler, the Washington Post fact checker, again took a swipe at the Obama administration over its claim that under the ACA people would be able to keep their insurance if they liked their plan. (He earlier had given Obama the maximum of four Pinocchios over the issue.) The proximate cause is the administration’s efforts to blame insurers for cancelling plans, pointing out that the plans that were in place at the time the ACA was passed would be grandfathered and therefore would not be eliminated due to the requirements of the ACA.

Kessler responds by noting that the vast majority of plans in the individual market are for short periods of time. He presents evidence showing that 48.2 percent of individual plans are in effect less than 6 months and 64.5 percent are in effect less than year. Extrapolating from this evidence on the rate at which individuals leave plans, Kessler calculates that less than 4.8 percent of the people in the individual market have a plan that would be protected by this grandfather provision. Based on this assessment, he awards the Obama administration three Pinocchios for trying to blame the insurers for dropping plans.

While Kessler is undoubtedly correct in noting that few people would be protected by the grandfather provision, there are two important points worth pointing out. First, the vast majority of people hearing President Obama’s pledge would be covered by insurance through their employer. For these people it is absolutely true that the ACA allows them to keep their insurance.

As far as the minority in the individual market, while Kessler is correct that the grandfathering protects relatively few people because policies tend to be short-lived, this data also raises an issue about the pain caused by earlier than expected cancellations. Kessler’s data show that almost half of the plans will be held by people for less than six months and almost two-thirds will be held for less than a year. This means that most of the people being told that their plans are being cancelled probably would have left their plans in the first half of 2014 anyhow. While no one wants to buy insurance more than necessary, it hardly seems like a calamity if someone expected to leave their policy in March and will now have to arrange insurance through the exchange for two months.

Furthermore one has to ask about the role of insurers in this process. Kessler’s data imply that more than three quarters of the people in the individual market signed up for their policies for the first time in the last year. Didn’t insurers tell people at the time they sold the policies that these plans would only be in effect through the end of December because they did not comply with provisions in the ACA? If the insurers did inform their clients at the time they purchased their policies then they would not be surprised to find out now that they will need new insurance. If the insurance companies did not inform clients that their plans would soon be terminated then it seems that the insurers are the main culprits in this story, not the Obama administration.


Yikes!  Paul Ryan got booed at the AARP Convention when he mentioned repealing Obamacare.  Looks like Senior Citizens are on to the fact that Ryan included the same cuts to providers in both his budgets, the same ones Blaine Luetkemeyer voted for, as the Affordable Care Act. 

They are also on to the fact that the Ryan plan, with Luetkemeyer’s support, would turn Medicare into a coupon entitlement while President Obama would continue Medicare as a program of guaranteed coverage – without coupons.

Hey Paul and Blaine,  it looks like if you are going to spread the BS you better find a pasture that isn’t filled with knowledgeable senior citizens.

You have to watch this video to see what a difference the Affordable Care Act/Obamacares made in the lives of Travis and his family.

Millions of Americans don’t know that their insurance has limits that could leave them on the hook for literally millions of dollars or cost a loved their life.  While at Integram we experienced a Franklin County resident that worked there have to face the prospect of exceeding their insurance coverage due to a child’s health condition.  Luckily, we were near negotiations and the local union was successsful in raising the lifetime limit from $1 million to $2 million and resolved the problem.

Watch this video and then decide if repealing Obamacare with vague statements about replacment are worthy of a great nation like the United States of America.

DailyKos features a review of the initial reaction of Florida papers to Mitt “Job Cremator” Romney selecting Paul “Medicare Destroyer” Ryan as his VP.  Look like both current and future seniors are upset by the Ryan coupon for Medicare plan.

Ryan’s plan to make cuts to Medicare have been very unpopular when they’ve been tested with focus groups.

Adding to the despair and dread felt among those paid to elect Republicans, Todd continued:

… when you look at older voters, this issue is a big, big problem for Romney, that he’s going to have to figure out how to deal with.

In contrast to the Ronmey/Ryan plan which forces seniors into the private health insurance market armed with just a coupon the Obama plan actually increases benefits for seniors.  Obama also maintains the guarantee of coverage and extends the life of Medicare by eight years.

Obama’s cuts add eight years on the life of Medicare, according to the Congressional Budget Office, largely by reducing reimbursement rates to hospitals, prescription drugs under Medicaid and private insurance plans in Medicare Advantage. The AARP, as well as hospital and drug industries, endorsed the Affordable Care Act despite the cuts.

The cuts to Medicare Advantage plans have resulted in higher enrollment and lower average premiums in 2011 and 2012, according to official figures. Reforms closing the “doughnut hole,” which were partly funded by the cuts, have also saved seniors money on prescription drugs.

In addition, the Affordable Care Act’s Medicaid expansion offers seniors greater access to long-term care and other services that Medicare does not provide.

The Department of Health and Human Services projects that beneficiaries of traditional Medicare will save roughly $4,200 over 10 years as a result of the Affordable Care Act. HHS expects that the law will also save seniors between $3,000 and $16,000 on average on prescription drugs, depending on their costs.


Back in May this blog featured a post regarding refunds that may be available to Missourians thanks to the Medical Loss Ratio provisions of the Affordable Care Act/Obamacares. 

 Over 20 percent of consumers who purchase coverage in the individual market today are in plans that spend more than 30 cents of every premium dollar on administrative costs.  An additional 25 percent of consumers in this market are in plans that spend between 25 and 30 cents of every premium dollar on administrative costs.  And in some extreme cases, insurance plans spend more than 50 percent of every premium dollar on administrative costs.  This regulation will help consumers get good value for their health insurance premium dollar.

In 2011, the new rules will protect up to 74.8 million insured Americans, and estimates indicate that up to 9 million Americans could be eligible for rebates starting in 2012 worth up to $1.4 billion.  Average rebates per person could total $164 in the individual market. 

Our previous post asked you to contact Representative Blaine Luetkemeyer and ask him not to vote for repeal of the ACA/Obamacare as many will be receiving refunds from their insurance company if that company spent more than 20% on items other than health insurance for clients.  I contacted Rep. Luetkemeyer and recently received his response – a weakly reasoned theory that insurance companies being required to provide at least 80% of premiums on actual health care might lead to fewer anti-fraud efforts.  They can easily find fraud by looking in the mirror.   He failed to mention the compensation of health insurance CEO’s such as Stephen Hemsley of United Healthcare who has over $744 million in unexercised stock options!  How many anti-fraud efforts would that buy?

Much to Luetkemeyer’s chagrin, I just received my refund for over $250 thanks to Obamacares.  Sorry Blaine but most of us expect a fair deal from our insurer and it feels great getting some of it back when they shortchange us.

If anyone is still trying to find an issue that Republican Presidential candidate Mitt Romney will state consistently, wrap your mind around this.  During his just concluded trip to Isreal Mitt actually praised government-run, socialized medicine.

During a trip to Israel, Mitt Romney hailed the nation’s health care system for holding down costs and broadening coverage more effectively than the U.S.

The irony: Israel contains costs by adopting a very centralized, government-run health care system — anathema to Romney’s Republican Party.

“Do you realize what health care spending is as a percentage of the GDP in Israel? Eight percent. You spend eight percent of GDP on health care. You’re a pretty healthy nation,” he said Monday at a breakfast fundraiser, according to the New York Times. “We spend 18 percent of our GDP on health care, 10 percentage points more. That gap, that 10 percent cost, compare that with the size of our military — our military which is 4 percent, 4 percent. Our gap with Israel is 10 points of GDP. We have to find ways — not just to provide health care to more people, but to find ways to fund and manage our health care costs.”

This statement is correct but when did GOP voters want to hear the truth?  High health care costs are driving up the budget deficit, pressuring businesses to leave or drop coverage, and threatening our social safety net.  All reasons President Obama proposed the Affordable Care Act/Obamacare. 

The proven way to reduce costs is a more centered approach like every other industrialised nation has except the United States.  Since that wouldn’t pass Romney/Obamacare is what emerged.  Evidently, Mitt won’t take credit for this plan in Massachussetts, says it is too much when in America , and says it isn’t enough when overseas. 

Talk about saying what he thinks people want to hear.  This is embarassing.


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