Initial attempts to sign up for ObamaCare go about as well as expected

[Capt Bringdown]

Tax filing problems could jeopardize 1.8 million Household's Obamacare aid

About 1.8 million households that got financial help for health insurance under President Barack Obama's law now have issues with their tax returns that could jeopardize their subsidies next year.

The 1.8 million households with tax issues represent 40 percent of 4.5 million households that had tax credits provided on their behalf and must account for them. Consumers who got health care tax credits are required to file tax returns that properly account for them, even if they are unaccustomed to filing because their incomes are low. Unless they follow through, "they will not be able to receive tax credits to help lower the cost of their health insurance for 2016," Lodes explained.

[boutons_deux]

Medicaid expansion isn't bankrupting states—it's saving them money and will continue to

The Center on Budget and Policy Priorities has an update on how Medicaid expansion has been working out for states. We've seen plenty of reports about how states aren't only able to cover more of their uninsured, but how they're saving money by not having to spend it on other programs. That's confirmed, again by CBPP.

Kentucky, for example, has saved $109 million and Washington has saved $465 million through June, according to a recent report from the State Health Reform Assistance Network. By the end of 2015, Colorado expects its expansion to save $308 million while Oregon projects $275 million in savings. Medicaid expansion has had similar impacts in other states, as we’ve shown.These savings come in two main forms, both due to strong enrollment.

First, by expanding Medicaid, states have been able to move people who received health services through targeted Medicaid programs, such as family planning services and care for certain women with breast and cervical cancers, at the state’s regular matching rate of sharing the costs with the federal government into the new eligibility group for which the federal government is now paying the entire cost.

Second, as more people have gained health coverage, demand for health services for uninsured low-income people that states fund entirely, such as funding for hospitals to offset their uncompensated care costs and behavioral health services, has fallen. States that experience greater-than-expected expansion enrollment may therefore experience a larger-than-projected drop in demand for these services. That in turn could mean even greater state savings in these programs.

So here's what's becoming clearer through these results: states are saving enough to outweigh those costs they'll incur when they have to start chipping in to pay for the expansion.

Beginning in 2017, states will start paying a modest percentage of the tab, eventually reaching—but not exceeding—10 percent. With the kinds of returns the expansion states are seeing now, the expansion will still more than pay for itself.

That's the main argument the 10 or so holdout Republican governors and legislatures have been using—that it'll end up bankrupting their states once federal support starts shrinking. That's clearly a bogus argument. If moral concerns aren't enough to bring these Republicans around—and clearly they are not—then maybe fiscal concerns eventually will.

http://www.dailykos.com/story/2015/0...28Daily+Kos%29

[boutons_deux]

More good jobs and economy news from Obamacare


Economist Dean Baker has noticed something about Obamacare and jobs that is pretty significant: it's giving people who want the flexibility to work part time the opportunity to do so. The growth in part-time employment has been a persistent and troubling aspect of the economic recovering from the great recession. But Baker says it doesn't have to be so troubling.

"[This has] in my mind been incredibly underreported, because this is one of the really good aspects of the Affordable Care Act. I mean, it's important that people get health insurance, that's a really big deal, but one of the problems that we had in the market before we had the Affordable Care Act was that people felt tied to their jobs. Most people pre-Medicare age get insurance through their employer, so what that means is that, particularly if they are in bad health ... they are very worried that if they leave their job or if they lose their job, they're going to lose insurance for themselves and/or their family. Well, now that you can get insurance through the exchanges we see there's a big increase in voluntary part-time employment. ... These are people who choose to work part-time. It's particularly [apparent] among young parents and what we also see among people pre-Medicare age. ... To me, that is a great story, so they can spend time with their families, their kids."





The largest increases in people choosing to work part-time are among younger people with children, a 10.2 percentage point increase in the share of workers under 35 who have 1 or 2 kids and a 15.4 percent increase for those younger workers with three of more kids.

Factored into this has to be the high cost of child care—parents might still feel that they don't have much choice about one of them working part-time because they can't afford day care. At the same time though, now they have that option because they can get health insurance.

http://www.dailykos.com/story/2015/0...8Daily+Kos%29#

[boutons_deux]

Alaska Republicans ready to spend upward of $1 million in taxpayer money to stop Medicaid expansion



Alaska's independent Gov. Bill Walker, fed up with a Republican legislature which refused to even debate a Medicaid expansion proposal, decided last month to act unilaterally and take the expansion. Alaska's attorney general and the legislature's legal department agree that the state cons ution gives him authority to do so. Nonetheless, the Republican-led legislature hascommitted to spending a minimum of $450,000 in taxpayer funds to sue. The governor is likely to spend an equal amount in defending the action.Who did the Alaska Republicans get to be their lawyer? Who else, Paul Clement.

Clement, who has urged courts to adopt conservative positions on issues as diverse as immigration, health care, voter suppression, […] and gay rights, is the de facto Solicitor General of the Republican Party—an experienced Supreme Court advocate frequently hired by Republican lawmakers and interest groups to argue landmark cases.If past is prologue, it is likely that the total bill for this legal team will exceed $450,000. In 2011, for example, U.S. House Republicans hired Clement to defend the anti-gay Defense of Marriage Act for “a sum not to exceed $500,000.00.” This contract was amended several times to raise this cap, however. In the end, the American people paid Clement’s legal team $2.3 million to unsuccessfully defend the proposition that same-sex couples are not en led to the same federal marriage rights as opposite-sex couples.

Now Alaskans are going to have to s out again to pay Clement to fight against their interests, this time with their state taxes. State Rep. Sam Kito III notes that the expansion would "save the state over $6 million in the first year, bring over $140 million in federal funding to the state, and provide healthcare coverage for up to 40,000 hardworking, low-income Alaskans." What the Republican legislature is doing, in contrast, will cost the state maybe as much as $1 million.


http://www.dailykos.com/story/2015/0...28Daily+Kos%29

[Winehole23]

Cadillac tax to crapify your insurance?

http://www.nakedcapitalism.com/2015/...illac-tax.html

[Winehole23]

The governor of Texas was angry about a health plan leader's demand that he expand Medicaid to low-income, uninsured adults under the Affordable Care Act because he hates Obamacare.

But behind the scenes, he and his aides were trying to convince the Obama administration to keep sending Texas billions of dollars in supplemental Medicaid funding to finance care for low-income, uninsured Texans—while continuing to insist he didn't want or need a Medicaid expansion that would extend coverage to more than 1 million Texans.

If that sounds like a contradiction, welcome to the continuing political battle over the ACA and Medicaid expansion that has hospitals caught squarely in the middle.

According e-mails obtained by the Texas Tribune, Republican Gov. Greg Abbott asked aides to investigate a health plan whose leader urged Medicaid expansion. Meanwhile, Abbott and his advisers were pursuing negotiations with the Obama administration about extending Texas' five-year Medicaid waiver program, which ends next September.

http://www.modernhealthcare.com/arti...BLOG/150909969

https://www.texastribune.org/2015/08...re-safety-net/

[boutons_deux]

Americans are so ed by health insurance and confiscatory, exorbitant health prices, and so un able.

Anybody have a number on the cost of people OVER-consuming health care because they have Cadillac insurance? Is this really a huge problem in the $3T health racket?

[boutons_deux]

Kentucky Is Obamacare’s Undeniable Success Story. This Man Is Trying To Burn It All Down.





Though it has been largely ignored by national media and pollsters, Kentucky’s November gubernatorial election could mean striking changes for the Bluegrass State. The nation’s most unlikely Obamacare success story — a state system that has provided more than 500,000 Kentuckians with affordable health insurance — might well be ransacked by a Tea Party candidate named Matt Bevin.

From the earliest days, Kentucky’s efforts to implement Obamacare have earned national acclaim. As the troubled roll out of the national health care exchange website was ruthlessly mocked bylate night television, Fortune praised “one health exchange success story“: Kentucky’s new state-level marketplace.

Unlike most southern states, Kentucky opted to both set up its own state exchange (the Kentcuky Health Benefit Exchange, commonly known as “Kynect”) and to expand Medicaid under the Affordable Care Act. These efforts, ordered by Gov. Steve Beshear (D) and overseen by Governing magazine’s 2014 Public Official of the Year Carrie Banahan, helped get 521,000 Kentuckians insurance coverage in the first year alone. According to a Gallup poll, by the first half of 2015, Kentucky’s uninsured rate had fallen from 20.4 percent in 2013 to just 9 percent, the second largest drop of any state. Governing fêted Kentucky as “one of the few states that got everything right.”

In testimonials provided to ThinkProgress by Kentucky Voices for Health, a coalition of health advocacy groups, many Kentuckians agreed. “Thank God for Kynect,” said Eddie Alvis, who after years of struggling financially was able to get health insurance, and discovered he had severe asthma. “It has really empowered me,” said Lynn Young, a Louisville resident who got insured despite her recent unemployment. And Helen Spalding, who lost her job and benefits after a serious car accident, was also able to purchase insurance. “Kynect has been here for me,” she said. “It’s a blessing.”

There’s over 300,000 [Kentuckians that are on expanded Medicaid], and Matt Bevin is just going to take it from every single one of them.But with Beshear term-limited, Bevin, the GOP nominee, has made it clear he wants to reverse course. The Tea Party-backedcandidate vows he’ll do away with both the successful state exchange and the Medicaid expansion that has helped hundreds of thousands get affordable health care — moves that the governor could likely make unilaterally.

It’s a prospect that worries many state-based health experts, business groups, and public officials who spoke to ThinkProgress about the upcoming election and the state of Kentucky’s health care system. One of those officials was Beshear himself, who accused Bevin of playing politics with the hundreds of thousands of Kentuckians who now have insurance for the first time.

“It terrifies me,” Beshear said. “There’s over 300,000 [Kentuckians that are on expanded Medicaid], and Matt Bevin is just going to take it from every single one of them — just because he doesn’t like the fact that President Obama was the one that got it passed.”

Despite Kynect’s popularity and growing support among conservatives for the system, the most recent polls show Bevin locked in a tight race with current Attorney General Jack Conway (D), who has indicated he would continue the state’s current health care regime. So the questions are surely worth asking — who is Matt Bevin? And what would happen to Kentucky’s health care system if he won?

A Long-Time Obamacare Hater

If Bevin’s name sounds familiar, it’s probably because last year he mounted a primary challenge to Kentucky Sen. Mitch McConnell, the current Republican leader.

Among Bevin’s top priorities was a full repeal of Obamacare. Calling the law “already a disaster,” the manufacturing millionaire vowed to use any means necessary to stop the law, even if it meant voting for a government shutdown.

“Washington politicians say they oppose Obamacare, but they continue to vote for spending bills that fund it,” Bevin wrote on his campaign website at the time. “This has to stop. Matt will not vote for any spending bills that fund Obamacare. None.”

http://thinkprogress.org/health/2015...e-health-care/

[ducks]

http://finance.yahoo.com/news/obamac...QDBHNlYwNzYw--

[ducks]

Obamacare enrollees must double to make budget projections work

http://www.washingtontimes.com/news/...utm_medium=RSS

[ducks]

Obamacare May Miss Enrollment Mark by 11 Million
http://www.newsmax.com/Newsfront/Oba.../14/id/691480/

[Winehole23]

bipartisan opposition to the ACA "cadillac tax":

A new bipartisan effort to cancel Obamacare’s so-called Cadillac tax, the 40 percent levy on high-cost health insurance plans, adds a wrinkle to an impending fight in Congress.


The repeal bill unveiled Thursday in the U.S. Senate by Nevada Republican Dean er and New Mexico Democrat Martin Heinrich stands little chance of becoming law soon, especially with Barack Obama in the White House. Yet it demonstrates lawmakers’ frustration with the tax, which takes effect in 2018.


“I have not seen a piece of legislation that brings more sides together,” er said at a news conference in the Capitol on Thursday, invoking a coalition of business groups and unions opposed to the tax, including those that represent casino workers in Las Vegas. “I think we’re going to see a breakthrough.”



“I have not seen a piece of legislation that brings more sides together.”


Businesses have already begun planning for the tax and are considering trimming health benefits while closely monitoring rules from the Internal Revenue Service. About one-third of employers are at risk of paying the Cadillac tax in 2018 if they don’t adjust their insurance plans, according to Mercer, the benefits consulting unit of Marsh & McLennan Cos. The proportion is projected to quickly rise to over 50 percent.


The tax applies to family health-care coverage exceeding $27,500 and individual coverage exceeding $10,200, with low inflation adjustments intended to capture more people over time.


The tax was designed to put pressure on health costs and reduce the benefit of the largest tax break for individuals, which allows the value of employer-provided health insurance to escape income and payroll taxation.
It has faced bipartisan opposition since first being proposed. Republicans dislike it as they have almost every piece of the Affordable Care Act. Democrats aligned with labor unions also object, as unions have often negotiated generous, untaxed benefit packages in lieu of taxable wage increases.


er and Heinrich said the tax has stymied labor negotiations and would hurt middle-income workers it wasn’t intended to affect.


“This is not a Cadillac tax,” Heinrich said. “This is not a Lexus tax. This is going to be a Ford Focus tax.”

http://www.bloomberg.com/politics/ar...e-cadillac-tax

[Winehole23]

deductibles outpace wage gains. mandated health insurance makes Americans poorer:

It may not seem like much — just an extra hundred dollars or so a year.


But the steady upward creep in health insurance deductibles has easily outpaced the average increase in a worker’s wages over the last five years, according to a new analysis released on Tuesday by the Kaiser Family Foundation.
Kaiser, a health policy research group that conducts a yearly survey of employer health benefits, calculates that deductibles have risen more than six times faster than workers’ earnings since 2010.

http://www.nytimes.com/2015/09/23/bu...udy-finds.html

[TeyshaBlue]

Shocking.
Not.

[boutons_deux]

BigHealthCare rapes ALL Americans, has been for DECADES, and you rightwingnutters blame Obama and Obamacare.

[ducks]

I know several who had insurance and do not know thanks to Obamacare and several that cost them 10% of their income
that is a BAD

[boutons_deux]

I know several who had insurance and do not know thanks to Obamacare and several that cost them 10% of their income
that is a BAD

Avg annual cost of health insurance for a family of 4 is approaching $20K/year. That's not Obamacare's fault. Insurance costs have been on the upward trajectory, way above inflation, for many years before Obamacare (which doesn't set prices)

[TeyshaBlue]

Which is the central failure of ACA.

[boutons_deux]

Which is the central failure of ACA.

... ACA doesn't set prices, but it has had some effect in moderating increases. It's still early, only a couple years so far. Central objective of ACA was to get more people insured and therefore get them health care. That has been a huge success, even with the Repugs screwing their own poor people by refusing to expand Medicaid

[TeyshaBlue]

The escalation of deductibles would seem to counter the notion of moderating increases.

[boutons_deux]

Martin Shkreli Is Just a Tiny Part of a Huge Problem

Americans were outraged over his 5,000 percent price hike of a life-saving drug. They should see what Big Pharma has in store.

The United States pays the highest drug prices in the world. According to Valerie Paris, an economist with the Organization for Economic Co-operation and Development (OECD), we spend about $1,000 per person per year on drugs, which is about 30 percent higher than Canada. We spend over 50 percent more than what European countries like France and Germany spend per person. These inflated costs are passed on to consumers, in the form of co-pays and healthcare premiums, and to taxpayers, who subsidize healthcare through public programs like Medicaid and Medicare, the Veterans Administration, and the Indian Health Service.

The justification for these high prices is always that this is the cost of innovation, something Shkreli also cited in defense of his 5,000 percent price hike. New drugs tomorrow require private investment today. However, this claim is almost entirely unverified.

Most companies refuse to disclose their research-and-development costs to the public and ask that we take it on faith that the massive profits they receive (between 10 and 43 percent for the largest pharmaceutical companies) are being plowed back into generating new medicines.

It’s high time to call the companies’ bluff—let them show us the data on the investments in all their drugs on the market and let us make a judgment based on the evidence. In fact, one California state assemblyman, David Chiu, tried to pass a bill to require this kind of transparency. The industry killed the bill in Sacramento.

 The simple fact is, we do not lack policy proposals to bring down the price of high drugs. My short list would include:

• Expand utilization of existing generics by further incentivizing their use or further penalizing the use of brand-name versions.
• Expedite the entrance of generic versions of expensive medications to the market by shortening the lifetime of patents on brand-name drugs, or by buying out patents from the originator companies, as Harvard’s Michael Kremer suggested back in the late 1990s.
• Set thresholds for the cost paid by public and/or private payers for classes of drugs that are bioequivalent or therapeutically equivalent—that is, they are either the same chemical en ies produced by different drug-makers or drugs that act in the same way for the same condition—based on the lowest price in a given class.
• Use cost-effectiveness analysis to look at the bang-for-the-buck, the increase in quality adjusted life years (QALYs) offered by a drug at a given cost, and set a threshold above which the cost for a QALY is too expensive to justify. The National Ins ute for Health and Care Excellence in the UK has been around since 1999 and has made recommendations to the National Health Service there on which drugs to cover as part of its formulary using this approach.

Despite these and other proposals, many of which are already implemented in other countries, the drug lobby has killed every attempt to address the exorbitant price of drugs in the United States over the past few decades, including in the negotiations over the Affordable Care Act and Medicare Part D. In the partisan world of Washington, DC, there is one thing both parties rely on and cherish—the largesse of the pharmaceutical industry. Until we address this political reality, we won’t see these mechanisms being championed in any serious way anytime soon.

In fact, drug companies are pushing ahead with aggressive measures to further deregulate the industry and neuter the Food and Drug Administration, which approves new medical products. Since the thalidomide tragedy of the 1960s, the FDA has been able to require that companies show that their drugs are both safe and effective before putting them on the market. That’s hardly too much to ask for from clinical and public-health perspectives, and from the consumer’s point of view as well: We pay a lot of money for these medicines, they should work as advertised and be safe to use. However, even though the FDA approves 96 percent of the drugs that come before it nowadays, the industry is pushing legislation to water down the requirements for drug approval to make it even easier to get on the market with less and less data.

The 21st Century Cures Act just sped through the House of Representatives this summer, and a similar bill is likely to make it through the Senate within the next few months. The legislation is touted as being about innovation—there’s that word again—but two former FDA commissioners, David A. Kessler and Margaret Hamburg, along with leading academic experts on the FDA, have criticized the bill as being a Trojan horse and a threat to the FDA’s core mandate to keep unsafe and ineffective drugs off of pharmacy shelves.

Meanwhile, in the courts, conservative think tanks like the Washington Legal Foundation and their Pharma allies are pushing the free-speech rights of drug companies, which would allow them to make claims about their products without sufficient evidence to prove that they are true, as long as the claims are not proven false or misleading. Two of these cases have been successful this far, and should the Supreme Court take up a similar case and rule as the lower courts have, the 1st Amendment may give drug companies the right to get a drug approved on the narrowest of indications by the FDA and then market the out of the drug for everything else as long as the claims aren’t shown to be patently untrue.

With less and less evidence being required for FDA approval, and with wider and wider la ude in what companies can claim about the drugs they market, we may be returning to the pre-thalidomide days, when opening one’s medicine cabinet was akin to a game of Russian roulette. In a few years, we’ll be living, and dying, with greater uncertainty about whether the drugs we put in our bodies are actually safe and actually do any damn good.

When you think about Martin Shkreli is this light, you realize he is small fry. Was what he did stupid and greedy? Yes. But the bigger threat is still out there, and with no significant opposition to stop Big Pharma’s march forward. We all may have been mad at Martin Shkreli, but what drug companies have in store for us scares me to death.

http://www.thenation.com/article/mar...-huge-problem/

BigCorp corrupts govt, makes the laws, regulations, which aren't enforced.

America is ed and un able.

A few years ago, BigPharma was spending $30B/year on innovation, development and $60B/year on marketing.

[boutons_deux]

How Big Pharma Is Price Gouging You

We pay roughly twice as much for our drugs as the average for other wealthy countries.

The United States stands out among wealthy countries in that we give drug companies patent monopolies on drugs that are essential for people’s health or lives and then allows them to charge whatever they want. Every other wealthy country has some system of price controls or negotiated prices where the government limits the extent to which drug companies can exploit the monopoly it has given them. The result is that we pay roughly twice as much for our drugs as the average for other wealthy countries. This additional cost is not associated with better care; we are just paying more for the same drugs.

This is not an issue about the free market. The free market doesn’t have patent monopolies. The monopoly power provided by a patent is a government policy to promote innovation. There are problems with patent monopolies in many areas, but nowhere is the issue worse than with prescription drugs.

A monopoly that allows drug companies to sell their drugs at prices that can be hundreds of times the free market price has all the problems economics predicts when governments interfere with the market. Drug companies routinely mislead doctors and the public about the safety and effectiveness of their drugs to increase sales. The cost in terms of bad health outcomes and avoidable deaths runs into the tens of billions of dollars every year.

Drug companies also spend tens of millions on campaign contributions and lobbying to get every longer and stronger patent protection.

The pharmaceutical industry is one of the main forces behind the Trans-Pacific Partnership, and its demands for stronger patent protections is one of the main obstacles to reaching an agreement with the other countries.

http://www.alternet.org/economy/how-...er1042974&t=20

[boutons_deux]

Insurance Loopholes & Master Pricing: How Surprise Medical Bills Knock Consumers Down

Most of us know which local hospitals and doctors are covered by our insurance providers, but even when we make sure that we only see an in-network physician or surgeon, nearly one-third of privately insured Americans are still hit with higher-than-expected medical bills, often because their in-network hospital brought in or contracted out to an out-of-network service provider.

How did we get to the point where so many consumers have so little information about what to expect when their hospital bill arrives?

According to consumer advocates and a medical billing specialist who spoke to Consumerist, the problem of surprise medical bills isn’t exactly new, but healthcare providers appear to be taking greater advantage of long-existing loopholes in the insurance system, leaving more patients feeling blindsided when they finally get their bills.

“It’s a tremendous problem that seems to be getting worse and worse,” Chi Chi Wu, an attorney with the National Consumer Law Center, tells Consumerist. “The big picture is that it’s due to peculiarities and problems and how healthcare is priced in the U.S.”

At the core of the issue is the distinction between in-network and out-of-network health insurance coverage and how each is priced and passed on to consumers.

In-network providers are those who have agreed to charge lower fees to customers of a particular insurer, with the expectation that being listed as a covered provider will bring in more patients.

Julie, a long-time medical billing specialist, provided Consumerist with an example of how in-network billing works:

You have a procedure done for which an in-network doctor normally charges $1,000, but your insurance company has negotiated a maximum fee of $600 for that procedure with that doctor, so that’s the most the physician can charge.

The doctor must write off the remaining $400 and is prohibited from “balance-billing” you for the difference between the $1,000 list price and what your insurance’s “maximum allowable amount” or “negotiated fee” is for that service.

On the other hand, an out-of-network doctor is, basically, not bound by any rules of your insurance company because he or she has not agreed to any of maximum.

That doctor, therefore, can charge you the full $1,000 for that procedure, or the difference between $1,000 and whatever your insurance pays, with no discount.

http://consumerist.com/2015/09/24/a-...onsumers-down/

America is SO ED and SO UN ABLE.

[ducks]

when are you moving since america is so ed and so un able?

[Winehole23]

Texas Hospital Ass'n launches an ACA related website:

The Texas Hospital Association launched a website Thursday to help educate Texans about enrolling in health care coverage under the Affordable Care Act.


The site includes links to information and enrollment, as well as a way to calculate costs. It is designed to promote enrollment and make the process easier to understand, officials said.
The Insure Health Insure Texas site can be found at insurehealthtx.org.


Open enrollment starts Nov. 1 and ends Jan. 31, 2016.

http://www.mystatesman.com/news/news...aunches/nnsSQ/