Mandatory Health Insurance part 3

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Irvine511 said:
Do you see ANY other politician acting this way?

It generally takes an egomaniac to run for office, but what Cruz is doing is of a different order altogether.
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Honestly - they all seem to take a turn at this - especially when the opposing Party has the Oval Office. There's nothing new or shocking here.
 
INDY500 said:
Big business got their exemption... Funny how political allies of the White house always get their waivers and exemptions in the end. It too will be illegal.
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I thought Obama was always anti-business? Someday you should get your talking points straight.

INDY500 said:
Large companies are dropping coverage, cutting hours and hiring part-time only.

Rates are skyrocketing.
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These are both highly exaggerated, and many have turned out to be complete fabricated bs that Drudge just made up.
 
INDY500 said:
Large companies are dropping coverage, cutting hours and hiring part-time only.
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This was the argument heard in Canada when the government legislated a 52-week maternity leave. That companies would respond by not hiring women in their 20s and 30s. Maybe at the margin there were a few that behaved this way, but guess what? As people accepted this to be the norm, it simply did not bear out the way you would think.
 
bye, Ted. i hope your 21-hours of self-aggrandizement in the small minds of a few was worth it:


Shortly after Sen. Ted Cruz's (R-TX) 21-hour talkathon, the Senate voted overwhelmingly on Wednesday to advance a continuing resolution to keep the federal government open beyond Sept. 30.

The final vote was a unanimous 100-0 and even Cruz voted to begin debate. His lengthy speech was a call for a filibuster to end debate unless Senate Majority Leader Harry Reid (D-NV) agreed to make it easier for the GOP to block funding for Obamacare.

"The next vote we take will occur on Friday or Saturday and it will be on what is called cloture on the bill," Cruz said during his speech. "That is the vote that matters."
It was a conscious strategy by Republican leaders to steer clear of threatening a government shutdown over the unachievable goal of gutting President Barack Obama's signature legislative achievement. Procedurally they had an escape hatch: they were merely agreeing to debate the House-passed bill, which keeps the federal government running until Dec. 15 but denies funding to implement the Affordable Care Act.

"Invoking cloture on a bill that defunds Obamacare, doesn't raise taxes and respects the Budget Control Act strikes me as a no-brainer," said Senate Minority Leader Mitch McConnell (R-KY).

Democratic leaders intend to restore the Obamacare funds when debate ends with a simple majority vote, as Senate rules permit them to do. Cruz and other conservatives wanted Republicans to block cloture until Reid agreed to a 60-vote threshold for amendments.

"I know how this movie ends. I don't know all the scenes, but I know that at the end, we don't defund Obamacare," Sen. John McCain (R-AZ) told reporters in the Capitol. "It'll be a cold day in Gila Bend, Arizona" -- a desert town known for its scorching heat -- "before we defund Obamacare. Very cold day. In fact, there might be a snowstorm."

Senate Democrats' substitute bill would move funding to extend to Nov. 15, instead of the House's version which funds the government until Dec. 15. Reid said Democrats will also eliminate a House-passed provision to prioritize debt payments to foreign creditors and Social Security recipients in the event that the country's borrowing authority expires.

Both the House and Senate bills fund the government at $986.3 billion, roughly what the government is spending now after the automatic cuts ordered by the sequester. It's a victory for conservatives who lock in a lower spending level than most Democrats want. Senior Democratic aides insist the move was tactical and they'll still push to replace sequestration.

Cruz's vote for cloture after his call for a filibuster caused plenty of confusion. But there are multiple cloture votes. Wednesday's vote was about *beginning* debate. What Cruz wants is for 41 senators to vote against *ending* debate and moving toward final passage unless Democrats allow a 60-vote threshold to fund Obamacare.

"Cloture on the bill, the vote Friday or Saturday, is the vote that matters," he said.

If Republicans don't filibuster the cloture motion to end debate, and if both sides avail of their debate time, the Senate will likely wrap up the bill late this week or during the weekend. Then it'll be send to the House, where Speaker John Boehner (R-OH) will have little time to pass the Senate version or face a government shutdown.

The lights go out when the clock strikes midnight on Monday night.

Senate Unanimously Moves Toward Averting A Government Shutdown
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anitram said:
This was the argument heard in Canada when the government legislated a 52-week maternity leave. That companies would respond by not hiring women in their 20s and 30s. Maybe at the margin there were a few that behaved this way, but guess what? As people accepted this to be the norm, it simply did not bear out the way you would think.
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from an article I posted in another thread.

#2 Since Obama has been president, seven out of every eight jobs that have been "created" in the U.S. economy have been part-time jobs.

I'm afraid this is "the norm" under this president's policies which Obamacare.
 
It is the norm over here in the UK to. It's cheaper for businesses to have part time workers, better for profits, just you know the brilliance of capitalism...unless you think we should maybe introduce more protection for workers? Maybe even allow them to collectively bargain, but ah tis but a fairy tale.
 
yep, still can't sign up. i've tried creating an account every day since the site opened. at least now i can create an account, but when i get the confirmation email, i click on the link to confirm my email address (really? how pointless) within seconds of receiving it, and i get told i waited too long to click it. gawrsh, i didn't realise there was only a two second window to click on it.

i know i still have months to sign up and given where i live will probably get told i can get next to nothing for $300/month even though i don't work (thanks, tennessee!), so i really don't want to find out now. chances are i'll probably just pay that minimum fee they've been talking about to not have any coverage or whatever.
 
I think it is a travesty that the federal site has been a bomb so far, and while I'm certain it will improve, Seibelius has a lot to answer for. This is the most ambitious, complex website in history, but still, it should be better.

What is also disappointing is that in the states that have set up their own exchanges, their websites are going reasonably well (Kentucky seems a particularly notable success). It was always intended to be a state marketplace, not a national one. It's too bad that red states, with the largest amount of people most in need, are further harming their citizens. I wish you the best of luck, because you deserve more than your state and federal government are giving you.

i found this article interesting:

WASHINGTON — Robyn J. Skrebes of Minneapolis said she was able to sign up for health insurance in about two hours on Monday using the Web site of the state-run insurance exchange in Minnesota, known as MNsure. Ms. Skrebes, who is 32 and uninsured, said she had selected a policy costing $179 a month, before tax credit subsidies, and also had obtained Medicaid coverage for her 2-year-old daughter, Emma.

“I am thrilled,” Ms. Skrebes said, referring to her policy. “It’s affordable, good coverage. And the Web site of the Minnesota exchange was pretty simple to use, pretty straightforward. The language was really clear.”

The experience described by Ms. Skrebes is in stark contrast to reports of widespread technical problems that have hampered enrollment in the online health insurance marketplace run by the federal government since it opened on Oct. 1. While many people have been frustrated in their efforts to obtain coverage through the federal exchange, which is used by more than 30 states, consumers have had more success signing up for health insurance through many of the state-run exchanges, federal and state officials and outside experts say.

Alan R. Weil, the executive director of the National Academy for State Health Policy, an independent nonpartisan group, credited the relative early success of some state exchanges to the fact that they could leap on problems more quickly than the sprawling, complex federal marketplace.

“Individual state operations are more adaptable,” Mr. Weil said. “That does not mean that states get everything right. But they can respond more quickly to solve problems as they arise.”

In addition, some states allow consumers to shop for insurance, comparing costs and benefits of different policies, without first creating an online account — a barrier for many people trying to use the federal exchange.

The state-run exchange in New York announced Tuesday that it had signed up more than 40,000 people who applied for insurance and were found eligible.

“This fast pace of sign-ups shows that New York State’s exchange is working smoothly with an overwhelming response from New Yorkers eager to get access to low-cost health insurance,” said Donna Frescatore, the executive director of the state exchange.

In Washington State, the state-run exchange had a rocky start on Oct. 1, but managed to turn things around quickly by adjusting certain parameters on its Web site to alleviate bottlenecks. By Monday, more than 9,400 people had signed up for coverage. The Washington Health Benefit Exchange does not require users to create an account before browsing plans.

“The site is up and running smoothly,” said Michael Marchand, a spokesman for the Washington exchange. “We’re seeing a lot of use, a lot of people coming to the Web site. If anything, I think it’s increasing.”

Other states reporting a steady stream of enrollments in recent days include California, Connecticut, Kentucky and Rhode Island.

In Connecticut, a spokesman for the state-run exchange, Access Health CT, said users have generally had a smooth experience with the Web site other than “a couple of bumps and hiccups on the first day.”

By Monday afternoon, the Connecticut exchange had processed 1,175 applications, said the spokesman, Jason Madrak.

Daniel N. Mendelson, the chief executive of Avalere Health, a research and consulting company, said: “On balance, the state exchanges are doing better than the federal exchange. The federal exchange has, for all practical purposes, been impenetrable. Systems problems are preventing any sort of meaningful engagement.”

“By contrast,” said Mr. Mendelson, who was a White House budget official under President Bill Clinton, “in most states, we can get information about what is being offered and the prices, and some states are allowing full enrollment. All the state exchanges that we have visited are doing better than the federal exchange at this point.”

In California, Peter V. Lee, the executive director of the state-run exchange, said that more than 16,000 applications had been completed in the first five days of open enrollment. Mr. Lee said that while the consumer experience “hasn’t been perfect,” it has been “pretty darn good.”

Some state-run exchanges have run into difficulties because they rely on the federal marketplace for parts of the application process, like verifying an applicant’s identity. Minnesota, Nevada and Rhode Island are among the states that have reported problems with the “identity-proofing” process, which requires state-run exchanges to communicate with the federal data hub.

Brandon Hardy, 31, of Louisville, Ky., was one of the first to sign up for health insurance through Kentucky’s state-run exchange, working with an application counselor who guided him through the process last Wednesday. Mr. Hardy, who is uninsured and has epileptic seizures that land him in the hospital every few months, spent about 45 minutes filling out the online application, and learned that he would be eligible for Medicaid under the health care law.

“It was pretty easy,” Mr. Hardy said of the process. “What I really need is a neurologist, and now hopefully that will happen. This is like a huge relief.”

Attempts to sign up for coverage through the federal marketplace have often proved more frustrating.

Bruce A. Charette, 60, of Tulsa, Okla., said he had been trying to log onto the Web site for the federal exchange since last Wednesday, but had not been able to see the available plans or their rates.

Mr. Charette said he was asked verification questions that did not appear to match his identity. One question, he said, asked about the name of a pet for which he had purchased health insurance two years ago. “I don’t have any pets,” he said.

“It’s obvious that the site is overloaded,” said Mr. Charette, an electrician who works in the aviation industry and said he did not have health insurance. “I am not going to stare at a computer screen for 45 minutes, waiting for a response. It looks as if the Web site is freezing up.”

Still, some groups helping people sign up for insurance through the federal marketplace said they were finally able to complete applications on Tuesday, a week into open enrollment.

“This was the first day that I have been able to get onto the Web site and sign people up,” said Laura Line, corporate assistant director for Resources for Human Development in Philadelphia, which has a contract to help people in Southeastern Pennsylvania enroll in health plans through the federal exchange. “We have been setting appointments and answering a ton of phone calls now that we are able to do something.”

http://www.nytimes.com/2013/10/09/us/politics/uninsured-find-more-success-via-health-exchanges-run-by-states.html?_r=0
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Wow....that was....incredibly stupid. I went through the whole thing and then at the end, got a PDF document, basically telling me to call Hoosier Healthwise....why make me go through all of that if you were just going to send me to the Indiana Medicaid office?
 
The-System-is-Down-at-the-Moment.jpg


15 days and counting...
 
From the same folks that run Amtrak and the USPS.

Perhaps the non-functioning web site was actually part of the ACA - the bill no one ever read.
 
food for thought:

The Truth About the Obamacare Rollout

The feds botched the website. But the states are doing much better.

by Jonathan Cohn | October 18, 2013

The federal government is open and paying its bills, which means you can start looking at the other big story from the past few weeks: The startup of Obamacare’s marketplaces. But to fully appreciate what’s happening, you need a split screen.

On one side is the story you’ve heard so much about. In 36 states, the Department of Health and Human Services (HHS) is operating the new insurance marketplaces, where non-elderly people without employer benefits can buy coverage on their own. This part of the rollout has gone … really badly. Two weeks after the sites went online, people are still have trouble setting up accounts and logging onto the system.

HHS is working feverishly to make improvements and the system's performance has improved incrementally. But people are still getting hung up at the initial stages, which means they never get the chance to apply for financial assistance and shop for plans. A study following web traffic showed a sharp drop-off in users at each successive stage of the online application process, which suggests the system was stopping a lot of people from moving forward. And that’s just the part of the system visible to consumers. Insurers say that the system is producing some incorrect information about the few people who make it through the process—a fixable problem, for sure, but a warning that other flaws may yet lurk undetected.

Administration officials have said they never expected so many initial visitors and that the high demand is a good sign. Both claims are true. But the system quite obviously suffers from serious design flaws. I’ve spoken to about a half-dozen developers in the week and they pointed to some of the same problems that experts in the Wall Street Journal, Washington Post, Kaiser Health News, and Slate identified previously. It's hard to know how much of the second-guessing is accurate. But there's a broad consensus about one early source of trouble. As a story in the Journal explained, the site initially required visitors to create accounts before shopping, because a tool to allow anonymous browsing wasn't ready on time. Establishing an account is among the more complicated tasks the website must perform—it requires sending information back and forth between multiple systems, all through secure channels. The result was a bottleneck.

In fairness, federal officials operated under tremendous political and logistical constraints, the kind few outsiders can grasp. Private developers don't have the same stringent standards for privacy and security, for instance. And given the enormous challenges of trying to integrate so many systems—some new, some old—nobody seriously expected the launch of Obamacare’s federal websites to take place without glitches. But few expected this many problems. And nobody seems quite sure when things will get better.

You can get a sense of what real people visiting the sites are seeing by reading dispatches from Sarah Kliff and Phil Galewitz, two reporters who have spent the last two weeks trying to apply. (Kliff finally succeeded; Galewitz got only as far as the account creation process, and that was after 63 tries.) You could also listen to some of the law’s “navigators”—the official counselors, most of whom work for non-profits, who are advising people on coverage options and how to enroll. Here’s, Vicki Tucci, who works with the Legal Aid Society of Palm Beach County, Florida, and who spoke recently to TNR reporter Mimi Dwyer:

People trying to get insurance have been remarkably patient, which tells you something important about how dysfunctional and frustrating the old insurance market was. In fact, one of the most insightful analyses of Obamacare’s federal site came from John Green, co-producer of Vlogbrothers—who tried applying for insurance via an Obamacare exchange (one the federal government is running for Indiana) and then compared the experience to applying for insurance the old way, via an insurance company website. Even with the delays and server errors, he found, Obamacare was quicker and easier—mostly because, under the old system, he had to reconstruct several years of his medical history down to every exam and test.

But at some point patience will run out—and delays will start to affect who’s signing up for insurance.

So that’s the part of the story you’ve heard. But it’s not the whole story—not by a longshot.

Obamacare’s architects assumed that most states would opt to run their own marketplaces, with federal officials running only a few. The assumption proved wrong:

Pretty much any state with a Republican governor or Republican legislative control said no, adding to the administrative burden on HHS. But 14 states plus the District of Columbia are managing their own markets. Mostly it’s places you would expect—progressive outposts like California, Washington, and New York—where Obama and his policies are most popular. But Kentucky, where a Democratic governor and group of dedicated officials have worked diligently to deliver the law’s benefits, is also on the list.

Some of these states are still having major problems: Hawaii, which relied on the same contractor as HHS, seems to be in the worst shape. But the websites in other states are now running and, while it's difficult to get a precise sense of how each one is operating, most appear to be functioning well. They may have more traditional glitches, like random error messages or delays in certain features. (California had to hold off introducing a tool that allows people to check provider networks online.) And most had trouble on the first day or two. But since that time they've been running more smoothly.

One of those states is Connecticut, where Kevin Counihan, chief executive of Connecticut’s health marketplace, told me last week that

As a result, Obamacare in these places seems to be working more or less like it's supposed to work. Consumers are getting opportunities they never had before—to shop for insurance plans, each one with clearly defined benefits that make true comparisons possible, and to receive substantial financial assistance that provides many with thousands of dollars a year in assistance. And, from the looks of things, people are taking advantage of it. The Advisory Board, which is tracking state figures, says that about 180,000 have completed applications for insurance and, of those, 50,000 have enrolled.

Those figures don't say much about whether Obamacare in these states will meet goals for enrollment. It's way, way too early to make that judgment. But the figures suggest that the technology in these places works. And people using the sites say the same thing. “The system is working well—we can’t complain,” Licelot Miguel, a navigator in New York, told Dwyer. (Miguel emphasized that she was speaking for herself, not on behalf of her organization.) The first day was tough, Miguel said: It seems some browsers weren’t working. But now the slowdowns tend to be human rather than technological, Miguel said, because people need 15 or 20 minutes to choose the right plan. “When you get through to the end, it’s like oooooh. People get excited.”

The success of some (not all) states shouldn’t spare the federal sites from scrutiny. It’s possible, for example, that federal procurement and contracting policies limited HHS to a universe of information technology developers that were good at delivering winning bids—but not so good at making modern websites. It’s also possible that cabinet agencies are not set up to run these kinds of operations well, at least not on such a large scale and under such a strict timeline. In the future, conservatives will cite the early problems of Obamacare's federal websites when they express skepticism of large federal programs. They might be right when they do.

The Obama Administration also has questions to answer. Implementation did not appear to suffer from neglect or indifference. Countless officials, staff, and contractors put in long weeks and long hours. Chief of Staff Denis McDonough told people he spending two hours a day on it. (Presumably he still is.) But a recent New York Times story painted a devastating picture of project management, with officials ignoring internal warnings or refusing to heed them. And it sounds like things got worse in the weeks leading up to October 1, as the likelihood of a severely flawed launch grew. Here’s what I heard from somebody direct knowledge of what was happening behind the scenes:

But if these past two weeks appear to reflect poorly on the federal bureaucracy and the Administration managing it, they shouldn’t reflect poorly on health care reform itself—which, after all, has worked in Massachusetts and seems to be working in the states running their own operations. The success of states like Kentucky and New York and Connecticut and California are important for their own sake: By my count, they constitute about a fourth of the national population. But they are also important for what they show about how the law can work, once the technology piece is in place.

Larry Levitt, a senior vice president of the Kaiser Family Foundation, puts it this way:

One reason it's too early to draw judgments is that the administration still has time. Open enrollment lasts until March 31. To get coverage that will start by January 1, consumers must enroll by the middle of December. The best evidence we have about enrollment patterns comes from a New England Journal of Medicine paper written by economists Amitabh Chandra, Jonathan Gruber, and Robin McKnight. They examined the Massachusetts reforms, during the first year, to see who signed up and when. Most people waited until the last minute—the point at which delay meant incurring financial penalties under the mandate. Relatively speaking, the latecomers were more likely to be young and healthy people, the ones whose support the system needs to function properly. That’s good news, because it suggests the most tentative consumers—the ones least likely to wait out website delays—haven’t started shopping yet.

Massachusetts provides another lesson: Early logistical and technological problems aren’t the end of the world. Stephanie Mencimer recalled the history recently in Mother Jones:

Medicare Part D, the prescription drug benefit that the Bush Administration introduced in 2006, had its own problems at the start. Now the program works seamlessly. “We saw the same kind of challenges in Part D and they sorted themselves out,” Karen Ignagni, the head of America’s Health Insurance Plans (AHIP), told me recently. She would know. One reason the Bush Administration was able to correct the problems of Part D is that groups with a stake in success, like the insurers, lent a hand. Insurers are doing the same thing now—in no small part because the high web traffic suggests a large market of new and enthusiastic buyers. “I can tell you, based on calls and emails and other kinds of contacts, like through brokers, the interest is very high,” Ignagni says. “And we’re seeing enrollment coming through and that’s growing.”

Obamacare is a more ambitious enterprise and, as such, its problems appear to be more significant. And Ignagni, like administration officials, has a rooting interest in the new system's success. (Her members want and need the customers.) But she is absolutely right to make a big deal about the apparent enthusiasm. The architects of Obamacare weren't simply trying to build websites, after all. They were trying to build a whole new health care system. And, up until now, they've been mostly successful. A few million young adults have gotten health insurance through their parents' policies. Hospitals are reducing readmissions, apparently in reaction to the law's new incentives. Setting up insurance marketplaces was always bound to be more complicated, just because it requires reinventing the existing market. But that effort has also achieved more than most people seem to realize. Insurers are offering competitive premiums, lower even than projections had suggested. And it's for a product—comprehensive insurance, available to anybody at uniform prices—that in most places insurers never offered before.

That leaves just one, final challenge: Making sure people can actually buy the insurance, and apply for the federal subsidies, so they can get the security they've craved for so long. It's no minor thing: Given the depth of problems at the federal sites, there's obviously a lot of work to do. And if it's months, rather than weeks, before the federal sites are working, the administration will need to consider other actions—whether it's quickly developing alternative methods of enrollment, extending the open enrollment period beyond March 31, or even offering short-term extensions and exemptions from the mandate in those states where people can't enroll easily. (Dan Diamond and Jonathan Chait discussed those possibilities recently.) But the administration still has plenty of time to get this right, just as some states have already.

Source URL: Obamacare Implementation: What the Feds Got Wrong, States Got Right | New Republic
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Drudge leads with this and I am sure Fox News will be all over it


Jacksonville-based Florida Blue, the state’s largest health insurer, will be canceling 300,000 individual policies, according to Kaiser Health News.

The company cites costs associated with the new health care law’s requirement that things like maternity and newborn care, mental health, substance abuse services, and emergency services be covered by individual and small market plans.
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the headlines should read 300,000 people that were paying premiums for a shit health care policy will no longer be paying too much for an inferior product
 
I really don't understand American healthcare...I am assuming every aspect of your health you want covered adds more to your insurance? So you want to have babies, so you get maternity cover, but oh maybe you can't afford any mental health cover now, so fuck you and your post-partum depression? or you've got a long term psychiatric illness like schizophrenia so you get mental health cover, but can't afford a lot of other cover, so screw you and any other of the many co-morbidities people have with mental illness?

Btw does this mean you guys don't get maternity pay etc?
 
LJT said:
Btw does this mean you guys don't get maternity pay etc?
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From what I remember when I lived there, the feds guarantee 12 weeks of unpaid leave and some states provide a few more weeks than that. But there is no mandated pay, though employers are free to provide that as an employment benefit.

In Canada you get 52 weeks of paid leave (paid out from employment insurance, which comes in at 55% of your current pay up to a maximum of something like $1700/month) and then you typically get an employer top up added to that which varies from as little as 6 weeks to as long as 6 months in my experience.
 
LJT said:
I really don't understand American healthcare...I am assuming every aspect of your health you want covered adds more to your insurance? So you want to have babies, so you get maternity cover, but oh maybe you can't afford any mental health cover now, so fuck you and your post-partum depression? or you've got a long term psychiatric illness like schizophrenia so you get mental health cover, but can't afford a lot of other cover, so screw you and any other of the many co-morbidities people have with mental illness?

Btw does this mean you guys don't get maternity pay etc?
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Regarding maternity leave, I've never heard anything different from what anitram described. As for mental health, some insurances have limits on how often you can visit a therapist. Its not like you can go every week, depending on your insurance. And I think at one point, you will have to pay in full, probably for the first two or three visits before insurance kicks in. This is based on my experience.
 
You would think proper maternity leave and pay would be a strong conservative principle as it would make the choice of having a baby easier for a woman to make rather than to have financial matters dictate whether you can or not.

I mean it's an easy thing to spin as being for the family and what not.

On the mental health side of things, if you have a mental health problem that requires you to be in a facility for a period of time, is that covered by the state or does that come from health insurance? I imagine people with severe and enduring mental illness are unlikely to be on any kind of insurance plan? Do they then accrue debt while being treated or does it work some other way?
 
HealthCare.gov pricing feature can be off the mark - CBS News

Industry analysts, such as Jonathan Wu, point to how the website lumps people only into two broad categories: “49 or under” and “50 or older.”

Wu said it’s “incredibly misleading for people that are trying to get a sense of what they’re paying.”

Prices for everyone in the 49-or-under group are based on what a 27-year-old would pay. In the 50-or-older group, prices are based on what a 50-year-old would pay.

CBS News ran the numbers for a 48-year-old in Charlotte, N.C., ineligible for subsidies. According to HealthCare.gov, she would pay $231 a month, but the actual plan on Blue Cross and Blue Shield of North Carolina’s website costs $360, more than 50 percent higher. The difference: Blue Cross and Blue Shield requests your birthday before providing more accurate estimates.

The numbers for older Americans are even more striking. A 62-year-old in Charlotte looking for the same basic plan would get a price estimate on the government website of $394. The actual price is $634.
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