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boutons, I am not against any of these things, but all mens' policies should not be covering this stuff - that's what drives UP the price - unnecessary coverage that cannot possibly be used.
The 85/15 rule is an attempt to keep clients' premium money paying for health care rather than for excess profits, luxurious "overheads" executive kingly salaries, and payouts to investors.
"birth control pills, pap smears, pediatric dental and vision" all preventative and/or humanitarian, which of course you are, probably as Ayn Randian asshole, no doubt firmly against.
boutons, I am not against any of these things, but all mens' policies should not be covering this stuff - that's what drives UP the price - unnecessary coverage that cannot possibly be used.
Hiltzik trashing the NYT
No, Marco Rubio didn't score a blow against Obamacare -- he merely hurt patients
Rubio's provision, which indeed was slipped onto page 892 of the 1,603-page spending bill last December, dealt with the risk corridor provisions of the Affordable Care Act. (By the way, when a newspaper states that something was "little-noticed," it means unnoticed by itself. But we noticed it, and we weren't alone.)
Risk corridors were designed to stabilize insurance premiums in the first few years of the ACA. The drafters understood that health insurers would have difficulty pricing their plans in the individual market in those first years. Not only would some insurers be entering that market in volume for the first time, but the market itself would be dramatically altered by the flood of new customers, as well as the law's prohibition on exclusions for preexisting conditions. Some insurers would set their premiums too low, and therefore pay out benefits higher than they anticipated; others would set their rates too high, and capture a windfall.
That's exactly what has happened. Without a safety valve, these miscalculations could have an impact on premiums the following year, as insurers tried to adjust.
Under the risk corridor provision, insurers that set prices more than 3% below a set target would get a reimbursement from the government, and those that overpriced by the same margin would pay some of the windfall to the government. The arrangement expires after next year, when it's assumed that insurers will know what they're doing.
Rubio started grousing about the risk corridors in 2013, when he called the arrangement a "bailout" of insurers. We labeled that claim the most cynical attack on the ACA up to that point, because as
Rubio well knew the provision's purpose was consumer protection, not corporate protection.
"a serious flaw: the ACA didn’t appropriate any money to fund it." The administration's workaround was that the Department of Health and Human Services would use the money that came from profitable plans to make payments to cover the losses of unprofitable plans.
Rubio's rider prohibits the use of any other federal funds to cover the shortfall.
the plans owed money that they'll get only 12.6 cents on the dollar of what they're owed -- $362 million to cover claims of $2.87 billion.
health plans owed money have the right to sue the government in the U.S. Court of Claims, which can order them to be repaid; the position of Health and Human Services is that the claims are valid as an obligation of the U.S. government. If the court upholds them, the taxpayer hasn't saved a dime.
Rubio's provision has undeniably produced pain, especially among nonprofit co-op health plans that were created under the ACA to provide compe ion in some state marketplaces. In terms of enrollment, some of these plans were immensely successful -- the co-op serving Iowa and Nebraska had 80,000 customers last year, nearly eight times what it expected. But they tended to be financially shaky, as was expected at first.
They've been devastated by the shortfall in risk corridor funds. As healthcare expert Timothy Jost reported, the Colorado co-op got only $184,000 on its nearly $16 million in risk corridor claims; Kentucky's recovered only $9.7 million of $77 million in claims. The Iowa-Nebraska co-op got $16 million to cover $140 million in claims. The New York Freelancers CO-OP received about $19 million on $150 million in claims. So they've shut down, leaving their patients high and dry.
As Bagley states, "Marco Rubio hasn’t killed Obamacare and he hasn’t saved taxpayers any money. All he’s done is throw a wrench in the works."
, the Rubio rider is worse than an innocuous complication for the ACA; it actually will cost taxpayers money.
That's because (among other things) the disappearance of the co-ops willreduce compe ion in their old markets, raising premiums and requiring the government to spend more in premium subsidies for the buyers eligible for them--more than 80% of the buyers.
http://www.latimes.com/business/hilt...10-column.html
Thanks, Repugs. You're ideological, -everything- -everybody MISgovernance is always welcomed by Americans.
Marco Rubio enrolled under Obamacare — benefits from taxpayer-funded subsidy
Rubio campaign staffers confirmed to NBC late Thursday that he continues to accept a $10,000 federal subsidy reserved for congressional members under an Affordable Care Act exchange program.
Rubio first received criticism for accepting the subsidy back in 2013, when he attached a provision to a spending bill seeking to prevent insurance companies from receiving reimbursement owed under the law. Rubio has used the provision as a campaign tactic, arguing that he has done the most to “hurt” Obamacare of any of the presidential candidates. His critics contend that blocking reimbursement for insurance plans only hurts patients who qualify for federal assistance, but Rubio says he saved taxpayers billions of dollars.
To receive health insurance from their employer (the U.S. government), federal lawmakers must enroll under Obamacare. All lawmakers were required to sign up through an exchange, under a law that Republicans introduced in 2009 to try to embarrass Democrats for supporting the program. Since then, many critics of the program, including presidential candidate Lindsey Graham, have refused to accept the $10,000 subsidy, in order to demonstrate their opposition.
Rubio argued back in 2013 that he was merely accepting an employer contribution like anyone else who receives health insurance at work. This is correct, but it doesn’t exactly look good on the debate stage to rail against your employer’s policies, then reap all the benefits of those policies when opting out is a perfectly acceptable option.
http://www.rawstory.com/2015/12/marc...e+Raw+Story%29
Rubio puts his mouth and actions where other people's money is, not his own.
Haven't Congress critters had 5-star, gold-plated health insurance for many years? who put their $10K subsidy into ACA?
Ummm...it's an employer subsidy, not an ACA subsidy. His employer......the Fed.
PS....he's not alone.
Kentucky Gov. Matt Bevin says Obamacarenot working—70 percent of Kentuckians disagree
A new poll from the Kaiser Family Foundation finds that 72 percent of all Kentuckians want to keep Medicaid the same, opposing Gov. Matt Bevin’s calls to repeal or change the program in Kentucky. Kentucky is rare among southern states in that leadership under Democratic former Gov. Steve Beshear chose to expand Medicaid to cover low-income healthy adults and run the state health insurance marketplace. The innovative program used re-branding (changing its state marketplace name to Kynect) to market to citizens who demonstrated an aversion to “Obamacare,” but less so to its central policies.
Bevin ran on a platform to dismantle Kynect and roll back the Medicaid expansion and won handilyin November’s election. However, his cons uents now oppose some of these core policy points. According to the Kaiser Family Foundation survey:
The poll finds that Kentuckians are divided, leaning negative in their views of the ACA in general (41 percent favorable, 49 percent unfavorable), but they feel more positively about the two biggest ways the law has played out in their state.
Over six in ten (63 percent) have a favorable view of the Medicaid expansion, and more have a favorable than an unfavorable view of Kynect (42 percent versus 28 percent, with 29 percent saying they don’t know enough to say).
Asked about next steps, more than seven in ten residents (72 percent) say they would prefer to keep the state’s Medicaid program as it is today rather than change it to cover fewer people.
One in five (20 percent) would prefer to scale back the program so that fewer people are covered.
When it comes to the health insurance marketplace, about half (52 percent) want the new governor to keep Kynect, while roughly a quarter (26 percent) would prefer to switch to the federal marketplace and 18 percent aren’t sure.
As in the nation as a whole, Kentuckians’ views on the ACA and its provisions divide sharply along party lines.
However, when it comes to Medicaid, even 54 percent of Republicans and 43 percent of those who say they voted for Governor Bevin would prefer to keep Medicaid as it is today rather than scale it back to cover fewer people.
The survey also shows the general effectiveness of the re-brand,
noting disapproval for policies known as “Obamacare” or the “Affordable Care Act”
approval for Kynect and the Medicaid expansion,
two policies that are a part of the ACA.
http://www.dailykos.com/stories/2015/12/11/1459192/-Kentucky-Governor-Matt-Bevin-says-Obamacare-not-working-70-of-Kentuckians-disagree?detail=email
goddam, you red staters, slave staters are ing stupid, ignorant.
TX Repug DEATH PANEL news
Gains in health insurance across Texas fall behind rest of US, new report shows
Low-income Texans see lowest decrease in uninsured rate from 2013 to 2015
The rate of adults without health insurance across the US dropped nearly twice as much as in Texas from 2013 to 2015, according to a new report. The report found that since enrollment began in the Affordable Care Act (ACA) in September 2013, the adult uninsured rate in the U.S. fell by 41 percent. Researchers found Texas' uninsured rate dropped just 21 percent during the same time.
The rate of adults without health insurance across the U.S. dropped nearly twice as much as in Texas from 2013 to 2015, according to a new report released today by Rice University's Baker Ins ute for Public Policy and the Episcopal Health Foundation (EHF).
The report found that since enrollment began in the Affordable Care Act (ACA) in September 2013, the adult uninsured rate in the U.S. fell by 41 percent. Researchers found Texas' uninsured rate dropped just 21 percent during the same time.
"The good news is that Texans, like all Americans, saw meaningful drops in the rates of uninsured since the ACA began," said Elena Marks, president and CEO of the EHF and a nonresident health policy fellow at the Baker Ins ute. "However, Texas still has the most uninsured adults in the nation, and Texans with the lowest incomes continue to get health-insurance coverage at a rate far below anyone else."
http://www.sciencedaily.com/releases...1217143522.htm
then add in 1000s of additional unwanted pregnances and 20K more abortions/year because of TX Repugs closing health clinics, what's not to love?
premiums rising in MA. Obamacare's achilles heel is that it doesn't control costs.
http://www.bostonglobe.com/business/...b6L/story.html
ACA was only an attempt to "bend the curve" of costs down. There certainly savings in poor people getting preventative, early detection care before they get much more expensively sick, but not enough to offset BigMedicine looting America.
so much for affordability
They need to expand the insurance commissions of the 50 states. They already have actuarial control over P&C and life so it's not like they are reinventing the wheel. Until corporate lobbying becomes illegal or otherwise severely curtailed it will never happen.
... was NEVER the primary goal of ACA. If ACA had drug price regulation limits (like allowing govt to negotiate as single buyer), or anything that touched BigMed's looting, BigMed would have killed ACA like it killed Hillary's health plan. BigCorp runs the USA, not the govt.
Uh, isn't it called The Affordable Care Act?
ACA made insurance (subsidized) affordable for poor people so they could get timely medical care without being bankrupted. ACA didn't target the price of medical CARE, only insurance for poor people.
Uh, isn't Repugs' (black, brown) Voter Suppression called Voter Fraud Suppression?
Last edited by boutons_deux; 01-04-2016 at 02:26 PM.
Repug death panels report
A wretched example of American exceptionalism: Our poor showing on maternal mortality
A United Nations report released in November had some very good news for most of the world in terms of maternal mortality in the past 25 years:
“Over the past 25 years, a woman’s risk of dying from pregnancy-related causes has nearly halved,” said Dr. Flavia Bustreo, WHO Assistant Director-General, Family, Women’s and Children’s Health. “That’s real progress, although it is not enough. We know that we can virtually end these deaths by 2030 and this is what we are committing to work towards.”
Nearly halved, as in reduced by 44 percent. To be more exact, maternal deaths—those that occur during pregnancy or within 42 days of the end of pregnancy—globally fell from about 532,000 in 1990 to some 303,000 in 2015, according to the report. Sierra Leone is estimated to have the highest rate at 1,360. Some other examples: There were 1,340 maternal deaths per 100,000 live births in Afghanistan in 1990; this year that number is 396. In Guatemala, the rate of maternal deaths was 205 in 1990 vs. 88 in 2015. In France, the rate was 15 in 1990 and 8 in 2015. Measured across all countries, the rate worldwide is 216 deaths per 100,000 births. While that is still a huge number, progress has been remarkable. Still, 99 percent of the world’s maternal deaths occur in developing nations.
A dozen of those developing nations—including Zimbabwe, Venezuela and North Korea—showed an increase in maternal deaths during the period measured by the report, whose research was led by the World Health Organization. Only one developed nation did, the United States.
That’s right, the nation with the biggest economy, and that spends the most money per capita on health care of any other nation except Switzerland and Norway, saw maternal deaths rise from 12 per 100,000 in 1990 to 14 in 2015, twice the rate of Canada.
That puts the United States behind 45 other nations, including all but three of the 34 nations of the Organization for Economic Cooperation and Development. In 24 nations, the rate is half that of the United States.
http://www.dailykos.com/stories/2016/1/2/1459961/-A-wretched-example-of-American-exceptionalism-Our-poor-showing-on-maternal-mortality?detail=email
So it's only affordable for poor people (even this is doubtful with deductibles and copays) but not the rest of us? Paying for UNNECESSARY mandated benefits that people will never use is mostly what's driving up the price. Sooner or later, it'll be too expensive, people will stop buying and insurance companies will exit the market. Can't happen soon enough.
BigMed Looting Americans
Lost Jobs, Houses, Savings: Even Insured Often Face Crushing Medical Debt
Here is the surest way to enjoy the peace of mind that comes with havinghealth insurance: Don’t get sick.
The number of uninsured Americans has fallen by an estimated 15 millionsince 2013, thanks largely to the Affordable Care Act. But a new survey, the first detailed study of Americans struggling with medical bills, shows that insurance often fails as a safety net. Health plans often require hundreds or thousands of dollars in out-of-pocket payments — sums that can create a cascade of financial troubles for the many households living paycheck to paycheck.
roughly 20 percent of people under age 65 with health insurance nonetheless reported having problems paying their medical bills over the last year. By comparison, 53 percent of people without insurance said the same.
“We’re at a point where there’s been slow growth in health care costs and huge improvements in the numbers of people who have health insurance,” said Sara Collins, a vice president at the Commonwealth Fund, a health research group. “But there is this underlying trend towards higher cost sharing that could put increasing numbers of people at risk for being underinsured.”
Among those who reported having problems paying their bills despite having insurance, 63 percent said they used up all or most of their savings; 42 percent took on an extra job or more work hours; 14 percent moved or took in roommates; and 11 percent turned to charity.
The health law has led to a decline in the number of Americans suffering financial stress from health problems, thanks to the new options for receiving coverage, especially for the poor. But the problem is still widespread, touching roughly a quarter of Americans under 65, when the insured and uninsured are looked at together. Americans older than 65 are covered by Medicare, which more frequently protects people from major financial trouble.
Unlike other polls, which have focused on the ways that insurance affects health care, the new Times-Kaiser survey explored the effects of medical bills on people’s daily lives well beyond the medical system. We found that medical bills don’t just keep people from filling prescriptions and scheduling doctors’ visits. They can also prompt deep financial and personal sacrifices, affecting their housing, employment, credit and daily lives. Kaiser has released a report today, detailing the survey’s main findings about this population.
“The major impact is actually a pocketbook or economic impact: their ability to pay the rent or the mortgage or buy food,” said Drew Altman, president of the Kaiser Family Foundation.
The rates at which people with medical bill problems sought charity or borrowed money from friends was similar among people earning less than $25,000 and those earning more than $100,000.
Medical Problems Lead to Financial Sacrifices
People who reported problems paying medical bills in the last year told pollsters they’d done the following:
http://www.nytimes.com/2016/01/06/up...ushpmg00000003
Just more DATA that America is ed and un able.
For working-age cancer survivors, debt and bankruptcy are common
One third of working-age cancer survivors go into debt, and 3 percent file for bankruptcy, according to a new study.
Cancer care costs have increased two to three times faster than other healthcare expenses in recent years in the U.S., the authors wrote. The average monthly cost of a new cancer therapy agent is now $10,000 and can be as high as $60,000.
Using 2012 survey data from 4,719 cancer survivors ages 18 to 64, Dr. Matthew P. Banegas at the Kaiser Permanente Center for Health Research in Portland, Oregon and colleagues found that one-third had gone into debt because of cancer, and in more than half of those cases, the debt was above $10,000. Three percent had filed for bankruptcy.
Younger age, lower income and public health insurance increased the risk of debt or bankruptcy, the researchers reported in Health Affairs.
A previous study found that bankruptcy rates are more than two times higher for people with a history of cancer than for others.
http://www.reuters.com/article/us-he...ame=healthNews
Actelion sees Uptravi price of $160,000-170,000/patient
Swiss drug company Actelion expects an average annual per-patient price for its new pulmonary arterial hypertension medicine in the United States of $160,000 to $170,000, before rebates, Chief Operating Officer Otto Schwarz told analysts on Tuesday.
The drug, Uptravi, won approval from the U.S. Food and Drug Administration last month and went on sale this week, giving doctors another option to treat the deadly disease that kills victims within a few years.
Actelion declined to give forecasts for Uptravi's average price after rebates or say how many patients could be eligible annually for the treatment to open pulmonary arteries, easing pressure on the heart.
However, Schwarz said Uptravi will likely compete for treating a group of intermediate-stage disease sufferers who number around 3,800 people in the United States and now get inhaled treatments.
"There is an influx of new patients in this segment," Schwarz said, predicting physicians will prescribe Uptravi for them before progressing to an inhaled treatment.
http://www.reuters.com/article/us-ac...ame=healthNews
I can't find a price in Europe, but it will certainly be lower than in USA, as all drugs are.
Study: ObamaCare not shifting workers to part-time jobs
ObamaCare has not caused employers to shift workers into part-time work, according to a new study.
The study, released Tuesday in the journal Health Affairs, examines the claim made by critics of the law that employers will make more people work part-time in order to avoid having to give them health insurance.The law mandates that employers provide health insurance for people working 30 hours or more per week. This had sparked reports that some employers would cut hours to avoid paying out insurance.
However, the study, which looks at data from the Current Population Survey, does not find evidence to support suggestions the law would have such an effect.
The authors write that their study finds “no evidence consistent with the thesis that the ACA caused an overall increase in part-time employment in the United States.”
The probability of working 25-29 hours a week has stayed essentially flat over the last few years, even after the employer mandate went into effect in 2015. The probability of working 30-34 hours also did not decrease.
http://thehill.com/policy/healthcare...part-time-jobs
Of course, you left out this part.
"The employer mandate, which was delayed from its original start in 2014, went into effect for employers with 100 or more workers in 2015. It only just went into effect, at the start of 2016, for employers with 50-99 workers, so it is possible more effects will emerge over time."
we'll see
Congress will pass destruction of ACA soon, Obama will veto. Repugs wasted their time, taxpayer $Ms with symbolic bull . Vote Repug, America will always regret it.
Yes. We'll see. Keep the touchdown dances in your pants for now.
Barry's beloved ACA made 'em do it!It's all Obamacare's fault!
Pfizer hikes U.S. prices for over 100 drugs on January 1
http://www.reuters.com/article/us-pf...ame=healthNews
The GOP’s Obamacare alternative?
http://www.msnbc.com/rachel-maddow-s...d=sm_fb_maddow
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