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

[TSA]

http://www.pacificlegal.org/do ent.doc?id=1038

[boutons_deux]

After two months of barely functioning, the federal online health care exchanges delivered, racking up 975,000 enrollments in the month of December.

That brings the total number of people who have picked a plan through an exchange since October 1 to about two million.

The administration reached about two-thirds of its goal of enrolling 3.3 million by the end of 2013 after being fully operational one-third of the time.

And it turns out most of the enrollments came during the one-week extension the White House gave itself after the initial problems with the site became apparent.

Four million people have qualified for Medicaid, according to ACASignups.net.

Another 3.1 million young adults are covered by their parents’ health insurance, thanks to a provision in the Affordable Care Act (ACA).

This means over nine million people have gained coverage through the ACA since it first became law.

That number could easily shrink or grow as insurers report on how many people purchased ACA-compliant policies directly through them. It’s also unclear how many canceled policies were replaced by plans purchased through the exchanges.

Looking at the rate of enrollments for Medicare Part D, president of health research firm Avalere Health Dan Mendelson believes that the administration can hit its goal of seven million enrollments by the close of open enrollment on March 31.

http://www.nationalmemo.com/call-it-...ugh-obamacare/

The Party of Stupid and its equally stupid ST supporters, voters can eat .

[boutons_deux]

Top Obamacare Surprises in 2013, Starting With Health Sector’s Greed


Beyond the GOP’s efforts to overturn or cripple Obamacare, the wobbly rollout of the largest new government safety net in decades has led to some surprising revelations about healthcare in America in 2013.

Most surprising is how many stubbornly greedy players there are in the medical-industrial complex.

The foremost example is how the middlemen—insurers—have seized every opportunity to gouge the public before and after insurance-buying exchanges opened this past October 1.

Not only did premiums jump by double-digit amounts from coast [3] to coast [4] for many policyholders after the law’s passage [5] in 2009, but this fall the industry doubled down and jacked up [6] prices or canceled [7] policies for hundreds of thousands of people. That’s quite a way to say thank-you to the federal government for sending them millions of new customers.

But insurers are not the only greedy sector. Hospitals—many of which are chartered as non-profits [8] and get tax breaks—have been unmasked by astute reporters for shamelessly overcharging for just about anything that can be put in a bill. TheNew York Times reported that after a backyard fall, a leading San Francisco hospital charged $2,930 and $1,696, respectively, for three s ches and a dab of skin glue. The Times' detailed piece [9] said, “There is little science to how hospitals determine the prices they print on hospital bills.”

The same point can be made about the prescription drug industry and pharmacy chains, where the retail price [10] on labels is off the charts and bears no relation to co-pays.

And there’s also the not-exactly-compassionate decision by hospitals [11] and doctors [12] to reject patients under Obamacare via the new state or federal exchanges. That echoes physicians refusing to take Medicaid patients, saying government reimbursements are insufficient.

http://www.alternet.org/economy/top-...ter941851&t=12

[boutons_deux]

Millions More Denied Coverage By GOP Refusal To Expand Medicaid Than Obamacare Cancelations

Republicans purposely neglected to differentiate between the number of Americans whose plans were being canceled and those whose entire coverage was lost.

Now it turns out that the millions of notices that were sent out will result in just thousands of Americans losing access to affordable insurance.

A new report, however, from the minority staff of the House Committee on Energy and Commerce shows that only 0.2 percent of the approximately five million cancelations – the number often referenced by the Republican Party – will lose coverage because of Obamacare, and be unable to regain it.

In other words, only 10,000 people will lose complete coverage.

The report assumes that 4.7 million people will receive cancelation letters about their current plans. It then finds that half of that number will have the option to renew their 2013 plans, due to an administrative fix to the health law. Of the remaining 2.35 million Americans, 1.4 million would be eligible for tax credits through the ACA exchanges or Medicaid coverage, and out of the 950,000 individuals left, according to the report, “fewer than 10,000” people would lack access to an “affordable catastrophic plan.”

Ironically, as Republicans fret over the approximate 10,000 people who will lose coverage in 2014, they are to blame for the nearly five million Americans who will not have any health insurance this year because of the GOP’s refusal to expand Medicaid in various states across the country.

Though the Affordable Care Act provides complete funding through 2016 for Medicaid expansion in all states – and 90 percent funding in the following years – 25 Republican-controlled states have still refused to expand the program that offers coverage to the poor.

As a result, approximately 4.8 million people will find themselves inside the so-called “coverage gap,” which one report suggests could cost 27,000 Americans their lives in 2014.

http://www.nationalmemo.com/millions...-cancelations/

[SnakeBoy]

Another happy obamacare enrollee...

An Open Letter to the Obama Administration and American Citizens:

My family’s journey with securing our new insurance under the Affordable Care Act (ACA) started on October 1, 2013. I have decided to write this letter to let the American people know what it has been like for us. We are a family of four, with two little boys’ ages seven years old and three years old. My husband and I have had full time jobs for 6 years and 13 years respectively. We have been with the same two companies for those years. We are a middle class family; we own our three bedroom two bath house, we own two cars, and previously provided our own insurance for the four of us. We have coverage through Individual Blue from Blue Cross Blue Shield of Alabama until 12/31/13. Our premiums have been $380.00 a month, which also included dental coverage for all four of us.

On October, 1, 2013 we received our letters like other Alabamians about our new premiums and plans for 2014 from Blue Cross Blue Shield (BCBS) of Alabama. When I opened our letter to say I had sticker shock was an understatement. Our premiums for the Blue Saver Silver would now be $753.26. This included the ACA tax but did not include the additional $75.00 we would need to pay in order to keep dental for me and my husband. So we would need to pay total $828.26 to keep health and dental insurance for the four of us. This payment is roughly $64.00 less than what we pay for our mortgage each month. I was outraged that anyone thought we could afford this. Sure we have some savings, but with that price tag we would whittle it down to almost nothing very quickly. I consider savings as a rainy day fund, a start to saving for the kid’s college, our retirement, etc. I never dreamed in a million years we would need to use it to pay our insurance premiums each month – how in the world could this help the economy too?

Throughout the month of October we read everything we could on what our plan would cover, and tried to get the information we needed about the ACA. I was also blown away when I realized that my son’s medical care, he has Attention Deficit Hyperactivity Disorder (ADHD), would cost us so much more out of pocket than it was currently costing us. My son has to go to his doctor every other month for his care. If we need to see a therapist we do that monthly, so you see on top of the premiums there are other out of pocket cost we have to factor in. He is also on medication that he takes daily. His medicine is a life saver for him and helps him function like a normal seven year old, without it he can’t focus, his grades slip and his mind literally goes back to the mind of a three or four year old. When he was first put on his medicine his reading went up 20 points and he went from writing one to two sentences to paragraphs, all in the course of a week. He is a straight A student and very bright, but without the proper medical care that could slip away from him. Under our new plan for 2014 we would need to pay a $55.00 co-pay, and then it would be covered at 80 percent once we reached his deductible, which would be $2,000 individual $4,000 family. Out of pocket max numbers are $6,350 individual and $12,700 family. All of this is enough to make anyone’s head spin. We were then forced to look at other options as none of this was affordable for our family.

I started to dig deeper into healthcare.gov. I was hearing all the horror stories through the news about the subpar website. I was reading right off their healthcare.gov Facebook page about other people’s terrible experiences trying to get coverage. Then the government announces that they are going to be working on the site and making it a better experience as well as making it more secure. They had already had three years to make this happen but they said would need the month of November to get it running right. So I waited patiently for them to get the site running so I could see if we would qualify for the subsidy and continue our health insurance through that route.

December 6, 2013 I went to healthcare.gov and started our application. The process took me over two hours to complete. Once it was completed it came back with our results. The results were that my husband and I qualified. That my three year old qualified for All Kids and that my seven year old did not qualify for anything through the exchange (ACA). I was so confused, how could a seven year old not qualify for a subsidy? I was also confused on why they wanted me to enroll one of my children in All Kids? So, I called the number they provided to speak to a representative. I was on hold for 20 minutes when a woman answered and offered to help me with the results. She told me that it is coming back that my seven year old son did not qualify and the only thing I could do was to file an appeal. I asked her a few more questions about how this could have happened, and I was told “she does not know and that all I can do is file an appeal”. She was reading her responses to me right off of a chart that I am sure they are given. So, I ended my conversation with her and proceeded to try to wrap my head around what was happening.

I decided to call back, this time I waited 15 minutes and spoke to a very nice gentleman who seemed to have an understanding for how the system was working. He looked up the results and said “this can’t be right, let’s start over and do an application over the phone”. So again I went through the application process. The results came back the exact same, we all qualified for something except my seven year old son. The gentleman could not understand how this could be happening and assured me it had to be a “glitch” in the system. He placed me on hold so he could speak with his supervisor on how to fix this error. I waited several minutes and when he came back he said “there was nothing more they could do tonight”. He said “we are sending your application to two different departments and that one of the departments would get back to me through a phone call with a fix to this problem”. He also told me “it could take 2-5 days but that I would receive a phone call when they had closed my case”.

So I waited until Tuesday December 10, 2013, which was day four and called them back. I was then told it would be 2-5 business days and if I had not heard from them at that time to call back. So that is what I did, I waited till 9:00 pm on that Friday December 13, 2013 with no phone call. I called Sunday December 15th, 2013 and spoke with my 3rd supervisor who told me “they were very sorry that I had not received a phone call and they were messaging the two departments to give me a call the following day”. He also said to go ahead and file with All Kids in my state because even though they send that information to them, they have no idea when they will receive it. So Monday I went and applied for All Kids for my children, it was a similar application to the healthcare.gov site. I called them to verify that they received my application and was told they cannot access it till sometime in January. They said once they could access it that they would be in touch and if the kids qualified the coverage would retro act to January 1, 2014. So that was a little bit of good news.

So here we are December 22, 2013, the day before the December 23rd deadline to sign up through the Health Insurance Marketplace’s Exchange. I decide I will call one last time to see what they can tell me about coverage, since I never received a phone call after my last conversation with a supervisor. I waited on hold for 1 hour and 15 minutes. I asked to speak with a supervisor and I was transferred. The supervisor pulled my file and was talking to me when she must have accidentally pressed a button and we got disconnected. I thought for sure she would call me back. That is one of the first things they ask for is your phone number. I did not receive a call back, so I call back and have to be placed on hold again to speak to someone. I waited another hour and a half before I get connected with a supervisor. She pulls up my file and tells me “there is nothing they can do and I have to wait the 90 days they have to contact me through the appeals process”. The supervisor tells me “that this whole time I have been told wrong by numerous people and that I should have been called back but that the two departments could do nothing for me”. I just have to wait the 90 days. I asked her, “so yet again an error, due to no fault of my own, has occurred all these times I have been calling and speaking with people and no one can really do anything”? She said “yes that is correct, I am sorry you have been told something different but that is all I can tell you”.

I have never been treated so poorly by any insurance company in my whole life. I have never experienced such terrible customer service in all my years on this earth. I can’t imagine how long a company would last in this country if they followed the same protocol as the ACA/Health Insurance Marketplace does. Most companies can fix a glitch in their systems pretty easily, or can connect you to someone who can. Not the ACA/ Health Insurance Marketplace, you spend all that time on hold to just be told, so sorry but you have to wait for someone to get back to you in a 90 day time span.

What is the most sickening thing to me is that we have been forced into the Health Insurance Marketplace’s Exchange. We wanted to continue our coverage through BSBC and pay as we always had been. But, we found out that option would not be affordable under the new Act, which is how we were forced into the Exchange. Furthermore, not only were we forced into the Exchange, but then forced again to submit an application to ALL Kids for our children. I just don’t understand how we go from being hard working middle class family who provides everything for our family to where we are today. I feel like everything that my husband and I have worked hard for is for nothing. I pray each night that we will get something resolved with our “glitch” in the system so our children will have health insurance coverage in January and by the time I have to purchase my son’s $400 a month ADHD medicine.

I really don’t know how our government can allow this to be taking place. What if something happens and one of my boys breaks an arm, or God forbid something worse? They don’t have insurance, so I guess we will then be paying the hospital monthly if that happens. We are almost completely debt free currently and now all I see is very large medical bills in our future until the government can fix the issues with the ACA/Exchange. I would really like them to rename the Affordable Care Act, because from where I am sitting it is anything but affordable or caring for my family.

Sincerely,
Karri Kinder

[boutons_deux]

Another happy obamacare enrollee...

so she and her family, uselessly anecdotal and probably written by Repug lobbyist, are getting screwed by an insurance company.

How is this news when millions have been screwed by insurance companies for decades, and how is ACA involved in the screwing?

[boutons_deux]

Here's How Obamacare Makes Americans More Free

Few values matter more to Americans than freedom. And now, as key provisions of the Affordable Care Act take effect, America is becoming a freer country.

In fact, though, Obamacare is a big step forward for freedom by helping people like Norvell do as they please. While the earlier landmark programs of Social Security and Medicare freed seniors from poverty, dependency on their children, or charity and gave Americans more life choices in old age, Obamacare will expand the personal horizons of every adult in their prime years.

Freedom is hard to achieve or experience if your life choices are curtailed by large forces outside your control. And that's been true for millions of people who are hindered from doing what they want because of health insurance choices. It's not just people like Norvell with pre-existing conditions. Ask anyone who is thinking of quitting a secure job to start their own business to name their top concerns and ensuring health coverage will be on their list.

America is supposed to be an entrepreneurial place where people can chart their own destiny via the free enterprise system. But our lousy health insurance system had deeply corroded that ideal. And even after Obamacare, it still does thanks to sky high prices for medical care that every other advanced country avoids by empowering government to dominate the healthcare marketplace.

Mythology aside, a higher percentage of Europeans are self employed than Americans. In a place like Denmark you can strike out to work for yourself without risking financial devastation due to health issues.

As I have often pointed out, nearly all the countries that are ranked as the most economically free by the Heritage Foundation or CATO have national health insurance systems.

Freedom should be front and center of the narrative over health reform as progressives gear up for the next big fight on this front: Which is imposing more government control over the pricing and delivery of medical care. In effect, state power needs to be used to sharply curtail the ability of doctors, drugmakers, hospitals, and other players to charge Americans whatever they want. And that won't happen without a massive political brawl in which reforms that make ordinary people more free are again depicted as a socialist plot to make them less free.

http://www.demos.org/blog/1/2/14/her...cans-more-free

[boutons_deux]

5 Reasons The GOP’s Obamacare Sabotage Will Have To Get Even More Desperate





House Republicans are prepared to confront the very serious issue of data breaches to HeathCare.gov — breaches that have never occurred.

Why would Minority Leader Eric Cantor (R-VA) be hyping a problem that doesn’t exist? He could be trying to sow fear in the public in an effort to drive down enrollments in health insurance, as MSNBC’s Steve Benen has posited.

Or it could be simply that this is the best they’ve got to continue their never-ending siege on the effort to reform the United States’ broken, costly and cruel health care system.

the public never supported repealing the law when presented with an opportunity to fix it.

A majority of Americans has consistently been in favor of the law — or something more liberal.


1. They Focused On Problems That Have Mostly Gone Away



2. Repeal Isn’t An Option



3. Repeal Is The Only Option



4. Rejecting Medicaid Expansion Could Turn Red States Purple



5. They Have To Pretend That Obamacare Isn’t Helping Anyone



http://www.nationalmemo.com/5-reason...ore-desperate/

[boutons_deux]

Rand Paul is ing stupid, as is his son, and they use their exmplerary red-state stupidity to trash healthcare.gov and KyNect

How did Rand Paul’s son end up on Medicaid?

1. Kentucky, unlike some states that expanded Medicaid, decided not to allow automatic enrollment into Medicaid, according to Gwenda Bond, spokeswoman for the Kentucky Cabinet for Health and Family Services.

Instead, you must fill out income and family information, and then the system will decide whether or not you can purchase a health plan but qualify for a subsidy, or whether you qualify for Medicaid.

“No one is automatically enrolled in Medicaid unless they apply for it,” she said, adding that she could not comment specifically on individual applications.

At the beginning of the process, Bond says, there is an option to go directly to a qualified health plan — that’s apparently the QHP that Paul mentioned — if you think you don’t qualify for subsidies.

But as for Paul’s description, “that doesn’t seem like a screen that I am familiar with,” she said.

2. Kynect’s paper application for financial assistance specifically tells the applicant to stop if you are claimed as a dependent. (See question 27.)

“Senator Paul and his son were attempting to enroll in a non-Medicaid plan through the exchange Web site,” said Paul spokesman Brian Darling. “They did not fill out this form, nor were they asked to provide household income information online or otherwise.”

But Bond says this is impossible, unless a mistake was made: “An application for coverage would need to be completed and submitted before an individual would receive Medicaid coverage.”

3. There is another wrinkle. As a full-time student, Paul’s son is eligible to get insurance through the University of Kentucky, which has an excellent medical center. UK students already pay a mandatory health fee that covers most university services, but the university recommends insurance for procedures not covered by the fee. UnitedHealth Plan charges about $1,900 for an annual plan, or about $150 a month. So why didn’t Paul’s son take that route?

“Senator Paul was attempting to use the Kentucky health insurance exchange Web site to explore plan options for his family when his son was automatically enrolled in Medicaid,” Darling said. “He has not made a final determination about health insurance coverage at this time and continues to explore possible options for purchasing coverage.”

http://www.washingtonpost.com/blogs/fact-checker/wp/2014/01/10/how-did-rand-pauls-son-end-up-on-medicaid/?tid=hpModule_f8335a3c-868c-11e2-9d71-f0feafdd1394&hpid=z9

ideology, eg libertarianism, makes you as stupid as Bible-literalist religion does

[boutons_deux]

Insurers under fire as Obamacare kicks in

Consumers are easing up on criticism of government exchanges and turning their frustration and fury toward some of the nation's biggest health insurers. All too often, new policyholders say, the companies can't confirm coverage, won't answer basic questions, and haven't issued identification numbers needed to fill prescriptions or get medical care.

Day after day, people say, they contact insurance company call centers waiting hours at a time with no response. Meantime, insurers have already taken many customers' payments for coverage intended to take effect Jan. 1.
But without proof of insurance, patients are having to pay hundreds of dollars out of pocket for medications and doctor visits, if they can afford it. Insurance agents say dismal service has become commonplace across many companies.

"There's equal opportunity for incompetence by the public and private sector in administering such a large new program," he said. "People are deservedly angry and resentful."

But some consumers think big insurers had plenty of opportunity to get ready.

"Insurance companies of this size should have been far better prepared. They knew it was coming,"

"The company is not set up to handle the volume coming through,"

Blue Shield of California apologized to customers for its "unacceptable" performance on its Facebook page this week.

"While we anticipated and planned for increased traffic, the sheer volume of enrollments has swamped all major health plans,"

WellPoint, the nation's second-largest health insurer and parent of Anthem Blue Cross, has drawn the ire of many customers in California and 13 other states where it's selling policies on and off government exchanges.

The company said it responded to more than 1 million customer calls over two days last week, equal to the amount it typically receives over an entire month. It said it has more than 1,000 employees answering calls.

Even insurance agents say they can't get through to the companies to assist their clients.

"This whole law is a gift to insurance companies," said Helena Ruffin, a health insurance agent in Venice. "They owe us good customer service."

http://touch.latimes.com/#section/17.../p2p-78839911/

yes another irrefutable argument for a hard-core public health insurance program, Medicare for All, from birth. And for govt owned and operated non-profit hospitals, clinics, and govt doctors and medical staff on govt pay scale.

[boutons_deux]

from an email for the WH

yeah, just anecdotes, but anyway

JoAnn S., Florida

"I haven't had insurance in years and my husband had a shared insurance junk-type policy. The day I signed up on Dec 10, I actually cried when the application went through. I got my first premium notice in the mail yesterday and was never so happy to see a bill before."

Gayla W., New Hampshire

"I lost my job last April. My partner and I both have pre-existing conditions so our only option was to COBRA my employer-provided plan -- at a cost of $1,676 a month. It was a good plan, but now we have a comparable plan through the ACA for $87 a month. I can't describe just how life changing this is for us. We can afford to live again."

Stella R., California

"For me this makes all the difference between having good health or not. I recently had a CAT scan (which I had to pay out of pocket for) because I was losing a lot of weight. It turns out that something was found and now I will need to see specialists and have further procedures done to make sure it is not cancer. My first appointment is on January 6 with a specialist. If I did not have health insurance, I would not be able to see a specialist. It would wipe out any savings I have and leave me medically at high risk."

Brian F., Florida

"I have not had Insurance for over 10 years. I had a pre-existing condition that made me uninsurable -- even though I was perfectly healthy. The last quote I got was in 2008: It was $1,750 a month with a $10,000 deductible. There was no way to ever afford that. …This insurance changes everything for me. I do not have to worry anymore when I get a sore throat or an infected cut that I will have to go to the emergency room -- run up thousands in bills and then have to file bankruptcy. This is a great day. Thank you for the ACA. It is a life changer."

Elina K., Colorado

"My mom, who is 61 and works as a freelance Russian interpreter, went to the ER in November. She, her partner and myself are uninsured. Tests confirmed she had a major blockage and would need surgery. The mass appears to be cancerous and is pushing down on her internal organs. She has been in severe pain for weeks. … Last night, around 3 a.m., she was admitted to the hospital and will be having surgery which she had to put off until her ACA policy kicked in at midnight. She now has expert care in a facility that in less than 24 hours changed her medication and treated her symptoms with noticeable results. When my stepdad came home tonight, exhausted after spending all day at the hospital, all he could say was 'thank god for Obamacare' …It may well end up saving her life."

Kendra S., Oklahoma

"Just this past October, my husband was diagnosed with stage IV lung cancer. This devastating news was compounded by the fact we were not insured, my husband could no longer work, and the rapid medical procedures that occurred quickly ran up thousands of dollars that we don't have the money to pay. We quickly began researching the ACA, made an appointment with a local Community Care office and after many hours of research, to determine the coverage that we could afford. We are so grateful for the ACA. With the incredibly terrible stress that has befallen upon our family, at least now we know his medical expenses are covered."

Rac e L., Florida

"My 28-year-old daughter was able to get healthcare coverage on her own for the first time through the ACA. She has a pre-existing condition, a genetic kidney disease that prevented her from getting coverage in 2009 at the age of 24 when she had to come off of our policy due to the age requirement. Her Cobra payments were $650 a month because she could not get more reasonable private coverage due to her pre-existing condition. In 2010, she was able to come back on our BCBS plan because of the ACA and was able to remain there until she finished school. We signed her up through the website and paid for her plan directly through Cigna on December 2: $298/month for a silver plan with a $0 deductible! She received her new insurance card on December 27th for coverage starting Jan 1! We now have peace of mind that all of her medical needs will be covered at a reasonable cost."

Curtis D., Washington

"Our new coverage has begun. I am 62, and my wife is 55. We are both self employed and neither of us have had coverage for the past seven years. Thankfully we are both pretty healthy, but it feels good to know we can schedule a checkup and take care of any lingering issues we've been putting off. Thank you for making improvements to the health care of the country."

Kelly M., Maryland

"I have a new plan. I haven't had insurance for years. When I applied for insurance before, I was denied for pre-existing conditions, even for plans with huge deductibles. I signed up on the Maryland Healthcare Exchange back in October, and by January 1st, I was holding an insurance card from Carefirst Blueshield and have already had my first doctor's appointment. It works. I am proof. And I'm so grateful that I can take care of myself with dignity without having to go to the ER whenever I'm sick or have to spend half of my paycheck at an urgent care center. I can do all of the preventative measures that I have been putting off, and get back on the road to health. It's a good feeling."

Kate S., Connecticut

"This healthcare reform is a life-changing event for my family. My husband and I have had to carry our own insurance for the past 25 years and, with the family insurance we had, we were paying $2,500.00 a MONTH for coverage, which we could not afford. Once the children graduated from high school, we had to take them off our policy because we could not afford it anymore. … We have never been high wage earners and the costs of our insurance have for years been an impossible burden. Now that the system is fair and goes by our income, we finally may be able to set money aside and save for our future."

http://www.whitehouse.gov/americans-...uh8Y1gjMKLEQ.0

Dems causing PROGRESS in USA, progress that the sociopathic, retrograde Repugs/tea baggers/VRWC/ALEC continue to try to kill.

[TSA]

And for govt owned and operated non-profit hospitals, clinics, and govt doctors and medical staff on govt pay scale.

I'm sure those would be ultra efficient.

[boutons_deux]

I'm sure those would be ultra efficient.

More efficient than the for-profit disaster we have now.

Of course, you have no suggestions.

[Nbadan]

[Nbadan]

Obamacare Enrollment Exploded In December To 2.2 Million
Source: TPM

The December enrollment surge for the Affordable Care Act that the Obama administration long predicted -- and desperately needed -- has come to fruition.

As of Dec. 28, 2.2 million Americans have enrolled in private health coverage, according to new data released Monday by the U.S. Department of Health and Human Services. More than 1.8 million of them signed up in December alone, a huge e that has gotten the law closer to its original goals than most would have thought possible after HealthCare.gov's disastrous rollout in October.

The administration's original projection was 3.3 million enrollments in private health insurance by the end of 2013, so Obamacare isn't quite back on track yet. But considering the combined total in October and November was less than the administration had targeted for just the month of October, it's much closer to the mark.

Administration officials have said since before the enrollment period launched in October that they expected sign-ups to surge around the law's deadlines, including the late December deadline to enroll in coverage that started on Jan. 1. But that effectively became an imperative after the federal website's problems left enrollment straggling far behind what the administration had originally expected.Young adults make up one-fourth of Obamacare enrollees

Read more: http://www.politico.com/story/2014/0...#ixzz2qJd8gk6N

[boutons_deux]

5 Reasons To Be Optimistic About Obamacare


HealthCare.gov Is A Non-Issue

How do you know that the Obama administration has achieved its goal of the site working for most people? Republicans have stopped complaining about it.


Signups Resemble Massachusetts Rollout




People Are Picking Higher-Benefit Plans


If The Law Continues To Control Costs As It Has, Our Long-Term Debt Crisis Fades Away






Millions of Americans Now Have Health Insurance

The HealthCare.gov crisis and constant Republican attempts to derail the law obscure the historic nature of what’s occurring in America right now.

For the first time ever, sick people cannot be denied coverage. Insurance companies have to meet minimum standards and spend at least 80 percent of their premiums on actual care. The federal government is actively trying to enroll millions of Americans in health insurance using exchanges that will be the foundation for increased compe ion and innovation. And all Americans who earn up to 400 percent of the poverty level — except in states that refuse to expand Medicaid — are being offered financial help paid for by new taxes on the rich and corporations to get insurance they can afford.

Though holes remain in our health care system, which simultaneously has the highest costs in the industrialized world along with the highest rate of uninsured citizens, this is the first effort to make health insurance a basic expectation for all Americans.

Millions of Americans have gotten covered through the Affordable Care Act. Freelance journalist Anna Clark described her experience signing up for the exchange and the unexpected emotion she felt:

Two days before the enrollment deadline, I finally logged on to HealthCare.gov for the first time. Item by item, I typed in my information.

An hour later — with no delays or glitches — I had health insurance.

With some modest budget adjustments, I can afford it too: It is about $232 a month for the Humana Connect Platinum 1000/1500 Plan. An HMO with a $1,000 deductible, it costs $25 for primary-care visits and $35 for specialists. My medical out-of-pocket maximum (including drugs) is $1,500.

This stunned me. For many long moments that snowy morning, I sat still. My coffee cooled beside me, and my skin bristled. With a shock, I felt, for the first time, how unsafe I had been over the years. Before, there was no use noticing this fear.

But with the email confirming my enrollment blinking before me, I suddenly had permission to recognize the fear and relief that welled up in me, and it took my breath away.

http://www.nationalmemo.com/5-reason...out-obamacare/

[boutons_deux]

Judge Rejects Lawsuit Aimed At Blowing Up Obamacare

A legal challenge seeking to cripple Obamacare suffered a huge setback Wednesday as it was defeated in federal court.

The U.S. District Court for the District of Columbia ruled against the challengers, who argued that that the text of Obamacare did not allow the law's premium tax credits to be offered on federal insurance exchanges -- that they must only be available through state-based exchanges.

Judge Paul L. Friedman called that argument "unpersuasive," saying it didn't pass legal muster and ran counter to the central purpose of the Affordable Care Act.

"Plaintiffs' proposed construction in this case – that tax credits are available only for those purchasing insurance from state-run Exchanges – runs counter to this central purpose of the ACA: to provide affordable health care to virtually all Americans," Friedman wrote in a 39-page decision. "Such an interpretation would violate the basic rule of statutory construction that a court must interpret a statute in light of its history and purpose."

His reasoning? The federal exchanges -- which the Obama administration is constructing for 34 states that declined to build their own -- "would have no customers, and no purpose" if the challengers' logic were adopted.

"In other words, even where a state does not actually establish an Exchange, the federal government can create 'an Exchange established by the State under [42 U.S.C. § 18031]' on behalf of that state,"

The challenge was seen as a longshot from the start given the fact that government agencies generally have broad discretion to interpret ambiguities in the law, and the I.R.S. has ruled that federal Obamacare exchanges may provide subsidies. The other problem was the lack of evidence that the law's architects sought to limit the premium tax credits in this manner.

"This argument made no sense from the beginning," ( since when did sense ever apply to bad-faith/screw-the-citizens Repug/tea bagger politicking? )



http://talkingpointsmemo.com/dc/obam...+%28TPMNews%29

[Nbadan]

According to Rep. Elijah mings (D-MD), Darrell Issa has jeopardized the security of the ACA website by leaking sensitive Obamacare do ents to unauthorized consultants.

mings wrote,

On several occasions since November, I have written to you to request that we meet to discuss the adoption of a bipartisan protocol to safeguard sensitive do ents obtained during this investigation and to develop a responsible approach to making information public that the Committee determines is important to its investigation.

I also remain concerned with the unilateral release by your office of partial transcripts and select do ent excerpts to promote partisan narratives that often turn out to be inaccurate, particularly when these releases are not part of any official report, correspondence, or other Committee action. Not only is this a disservice to the American people and the goals we share, but it undermines the credibility and integrity of the Committee.

Another concern is the security of do ents in the custody of the Committee. Currently, the Committee has no procedure governing the storage and handling of these sensitive do ents. As a result, there have been two separate occasions last week when sensitive do ents were left unattended in unlocked rooms accessible by the public. Although I understand that your office believes these do ents are not sensitive, one was produced to the Committee in encrypted, password-protected format, and both were marked as sensitive do ents that require special handling.

A third concern relates to providing access to sensitive information to individuals outside the Committee. In December, you stated that you intended to “consult carefully with non-conflicted experts to ensure no information is released that could further jeopardize the website’s security.” Several days later, you wrote a letter to the Department of Health and Human Services indicating that you had already begun this process, stating that you would “continue” consulting with outside security experts.

Based on your statements, it is unclear who these outside experts are, who they work for, and who they may be affiliated with, raising concerns about what they may do with the information. If they do not work for the government or any of its contractors, it is unclear what contractual or other restrictions they are under not to disclose this sensitive information further. There have been multiple reports about organizations and individuals who are deliberately targeting the Healthcare.gov website for malicious purposes. The risk that this information could get into the wrong hands increases dramatically as more individuals gain access to it, particularly when these individuals are under no obligation to safeguard it.

Darrell Issa is leaking sensitive Obamacare do ents to consultants that he refuses to name. Even more troubling is the fact that he will not disclose what the individuals intend to do with this information. Rep. Issa is clearly not securing important do ents, and making those do ents available to parties that he refuses to identify. Given his partisan bent, it is a safe guess that this is all part of an attempt to destroy Obamacare.

Twice last week someone left sensitive do ents unattended in an unlocked room that is accessible to the public. Why do you think someone would do that? Carelessness perhaps, but a more likely answer is that someone wanted those do ents available to people who aren’t authorized to view them.
(more)

http://www.politicususa.com/2014/01/...do ents.html

[boutons_deux]

I posted an article a couple months back about govt depts that were point-blank refusing 0.1%er Issa's requests for sensitive docs because he had been leaking damn near everything. I wonder how those refusals would stand up in court?

[boutons_deux]

Confederates continue to sabotage ACA
Nightmare Tennessee bill could force hospitals to ban only Obamacare website users

Tennessee lawmakers who are doing their best to stop President Barack Obama’s health care law have introduced a bill that could have the unintended consequence of forcing hospitals to verify and ban patients if they purchased insurance through the Healthcare.gov website.

At a press conference on Wednesday, state Sen. Mae Beavers (R) and state Rep. Mark Pody (R) announced legislation that would prevent any state agency from cooperating in any way with the Affordable Care Act.

“The federal government does not have cons utional authority to commandeer state and local governments to enforce or implement these federal health care mandates,” Beavers explained. “This legislation takes a very strong stand to resist this federal overreach of power.”

Beavers said that it was not immediately clear how the law would affect the more than 36,000 Tennesseans who had already purchased insurance through the federal health care exchanges. And would also cause problems for Tennessee’s Medicaid program, TennCare, which uses the HealthCare.gov website.

The bill would make it illegal for state and local officials to “assist in implementing” anything to do with the federal law. Employees and contractors in local, state and education ins utions would be forbid from using the health care exchanges.

But the Nashville Scene‘s Betsy Phillips pointed out that the wording of the legislation could also put university hospitals in the difficult position of having to verify how a person purchased coverage because the same plans are often available through the Healthcare.gov website and directly through insurance companies.

“The real question, and one that Beavers and Pody haven’t addressed is what ‘no powers, assets, employees, agents or contractors of the state or its local government subdivisions, including higher education ins utions, can be used to implement or administer the federal health care program’ means, specifically, what ‘implement or administer’ in this context means,” Phillips wrote.
“So, say this law passes and I bought my insurance through the Obamacare website. Now, say I show up at the University of Tennessee Medical Center (a higher education ins ution) with my Obamacare-procured insurance and an emergency,” she continued. “Could the hospital take my insurance or would that be aiding in the implementation (since I don’t really, practically, have insurance unless a hospital will take it) or administering (since the hospital’s billing department will have to work with my Obamacare-procured insurance company in order to get paid) of the Affordable Care Act?”

http://www.rawstory.com/rs/2014/01/1...e+Raw+Story%29

[boutons_deux]

One target for ACA or any health care reform is the huge variation in prices for some work

California hospitals charge $3,000 to $37,000 for childbirth

Amid growing scrutiny of hospital billing, a new study finds that California hospitals charged mothers $3,296 to $37,227 for a routine delivery.

For women having a cesarean section, the UC San Francisco study found patients were billed $8,312 to nearly $71,000. Few of the patients in the study released Thursday had serious health issues, and most were discharged within six days of admission.

"Childbirth is the most common reason for hospitalization, and even for an uncomplicated childbirth, we see a staggering difference in what hospitals charge," said lead author Renee Y. Hsia, an associate professor of emergency medicine at UC San Francisco.

Hospitals say these average charges are irrelevant because they have little or no bearing on what they actually get paid by the government, insurers or patients.

On average, this study said, the discounted prices paid by insurers amounted to 37% of the original hospital bill. The researchers said the hospitals in the study billed $1.3 billion in excess charges beyond what they received in reimbursement.

Hsia said these billed amounts can influence what insurers and patients ultimately pay.

"These charges affect not only the uninsured, but also the fee-for-service reimbursements by some private insurers, which can translate to out-of-pocket costs for patients," she said.

http://touch.latimes.com/#section/5/.../p2p-78921225/

iow, America has a really ed up kludgeocracy of a health care system, and its major players fight extremely hard to keep it that way.

[AntiChrist]

[boutons_deux]

here's what driving health care costs. providers charge what they simply because they can, like telco, cable, financial, etc corporations ing us because they can.

and they do, relentlessly

how much for removing a tiny non-threathening skin cancer tumor? $25K

Patients’ Costs Skyrocket; Specialists’ Incomes Soar

Kim Little had not thought much about the tiny white spot on the side of her cheek until a physician’s assistant at her dermatologist’s office warned that it might be cancerous. He took a biopsy, returning 15 minutes later to confirm the diagnosis and schedule her for an outpatient procedure at the Arkansas Skin Cancer Center in Little Rock, 30 miles away.
That was the prelude to a daylong medical odyssey several weeks later, through different private offices on the manicured campus at the Baptist Health Medical Center that involved a dermatologist, an anesthesiologist and an ophthalmologist who practices plastic surgery. It generated bills of more than $25,000.

“I felt like I was a hostage,” said Ms. Little, a professor of history at the University of Central Arkansas, who had been told beforehand that she would need just a couple of s ches. “I didn’t have any clue how much they were going to bill. I had no idea it would be so much.”

Ms. Little’s seemingly minor medical problem — she had the least dangerous form of skin cancer, basal cell carcinomas — racked up big bills because it involved three doctors from specialties that are among the highest compensated in medicine, and it was done on the grounds of a hospital. Many specialists have become particularly adept at the business of medicine by becoming more entrepreneurial, protecting their turf through aggressive lobbying by their medical societies, and most of all, increasing revenues by offering new procedures — or doing more of lucrative ones.

Kyle Snow Schwartz was billed $500 for the five-minute removal of a wart at New York University Medical Center.

It does not matter if the procedure is big or small, learned in a decade of training or a weeklong course. In fact, minor procedures typically offer the best return on investment: A cardiac surgeon can perform only a couple of bypass operations a day, but other specialists can perform a dozen procedures in that time span.

That math explains why the incomes of dermatologists, gastroenterologists and oncologists rose 50 percent or more between 1995 and 2012, even when adjusted for inflation, while those for primary care physicians rose only 10 percent and lag far behind, since insurers pay far less for traditional doctoring tasks like listening for a heart murmur or prescribing the right antibiotic.

By 2012, dermatologists — whose incomes were more or less on par with internists in 1985 — had become the fourth-highest earners in American medicine in some surveys, bringing in an average of $471,555, according to the Medical Group Management Association, which tracks doctors’ income, though their workload is one of the lightest.

In addition, salary figures often understate physician earning power since they often do not include revenue from business activities: fees for blood or pathology tests at a lab that the doctor owns or “facility” charges at an ambulatory surgery center where the physician is an investor, for example.

“The high earning in many fields relates mostly to how well they’ve managed to monetize treatment — if you freeze off 18 lesions and bill separately for surgery for each, it can be very lucrative,”

Doctors’ charges — and the incentives they reflect — are a major factor in thenation’s $2.7 trillion medical bill. Payments to doctors in the United States, who make far more than their counterparts in other developed countries, account for 20 percent of American health care expenses, second only to hospital costs.

Only an estimated 25 percent of new physicians end up in primary care, at the very time that health policy experts say front-line doctors are badly needed, according to Dr. Christine Sinsky, an Iowa internist who studies physician satisfaction. In fact, many pediatricians and general doctors in private practice say they are struggling to survive.

Studies show that more specialists mean more tests and more expensive care. “It may be better to wait and see, but waiting doesn’t make you money,”

“It’s ‘Let me do a little snip of tissue’ and then they get professional, lab and facility fees. Each patient is like an ATM machine.”

Hospitals seeking to hire a staff dermatologist for Mohs surgery had to offer an average of $586,083 in 2010, even more than for a cardiac surgeon,

Patient Given No Choice

she asked Dr. Randall Breau, the dermatologist, why the tiny growth needed the specialized surgery, as she had asked the physician’s assistant earlier. They both answered that it was because it was on her eyelid, a delicate area where Mohs surgery is always required; she repeatedly insisted that it was on her cheekbone below her eye.

After the 30-minute removal, the dermatologist told her that she would have to go across the street to the Arkansas Center for Oculoplastic Surgery, another private doctors’ office on the hospital’s campus, to have the wound closed by a plastic surgeon with “a couple of s ches.”

When Ms. Little protested that she did not want a plastic surgeon and did not care about having a tiny scar, the doctor told her she had no choice, she said. The vast majority of Mohs procedures are sewed up by the dermatologist or just bandaged and left to heal. Yet when Ms. Little arrived at the second practice, nurses took her clothes, put in an IV, and introduced her to an anesthesiologist who would sedate her in an operating room.

Her bills included $1,833 for the Mohs surgery, $14,407 for the plastic surgeon, $1,000 for the anesthesiologist, and $8,774 for the hospital charges.

“When I make decisions concerning patient care, I have only the patient’s best interests in mind.” ( "patient's best interests" is a synonym for "my wealth" )

that many urologists make 50 percent of their income from dealing with patients and the rest from investing in the machines that deliver radiation for prostate cancer or to treat kidney stones. In 2012, urologists had an average income of $416,322, according to Medical Group Management Association data, which often does not include the investment income.

Oncologists benefit from the ability to mark up (and profit from) each dose of chemotherapy they administer in private offices, a practice increased dramatically in the late 1990s. The median compensation for oncologists nearly doubled from 1995 to 2004, to $350,000,

(btw, chemo works so well there are 600K USA cancer deaths/year)

attributed 65 percent of the revenue in a typical oncology practice to such payments.

When policy makers reduce one type of payment, some specialists find another.

American physicians may feel en led to high fees, especially because they face costs that their European counterparts do not: Medical school is expensive and new doctors graduate with an average of about $150,000 in debt. Likewise, some specialists face malpractice premiums of over $100,000 a year.

( iow, EVERYBODY is greedy, on the make, in on the scam, extracting wealth from the consumer as endpoint of their predatory greed )

The Medical Lobby

More than 750 lobbyists represent groups of health professionals in Washington, pushing back on any effort to limit their incomes. The biggest spenders on lobbying — $80 million annually by health professionals — closely align with the highest-paid specialties.

renegotiating payments involves a highly contentious process that plays out behind closed doors at the American Medical Association’s Relative Value Scale Update Committee, which consists of doctors representing 26 medical disciplines who advise Medicare. In dermatology trade journals, Dr. Coldiron, who has served on the committee, describes it like this: “Everybody sits around a table and tries to strip money away from another specialty.” It’s like “26 sharks in a tank with nothing to eat but each other.”

“That committee keeps the perverse incentives in place,”

Critics say the robust revenues from doing procedures has led to overuse — colonoscopies by gastroenterologists, steroid injections by pain specialists and M.R.I. scans by orthopedists

insurers pay so little for time with patients. Dr. Stephen Asher, a neurologist in Boise, Idaho, said his 50 to 60 hours a week seeing patients accounts for only about 10 percent of his income. To cover office expenses he relies on revenue from performing a few procedures — Botox injections for eye movement disorders and muscle conduction studies — as well as from an M.R.I. scanner that he co-owns with a group of orthopedists and neurologists.

Outrage at Charges

left Baptist Health Medical Center with a tiny skin flap and more than two dozen s ches. For five days she said she was “hung over” from the IV sedation that she had not wanted — a problem because she drives 60 miles on rural Arkansas roads to her university each day.

She spent months arguing down her bills, which were finally reduced: About $1,400 for the Mohs surgeon, $765 for the anesthesiologist, $1,375 for the ophthalmological plastic surgeon, plus $1,050 in operating-room charges from the hospital.

For her follow-up, she refused to return to Baptist Health and went instead to the University of Arkansas Medical Center, where a dermatologist told her she likely had not needed such an extensive procedure. But that was hard to judge, since the records forwarded from Baptist did not include the photo that was taken of the initial lesion.

( multiple $Ks but nobody took a set of "free" digital pics as part of the treatment file?? )

outraged as she wrote checks for the nearly $3,000 she owed to the doctors under the terms of her insurance. “It was like, ‘Take out your purse, we’re robbing you,' ”

http://mobile.nytimes.com/2014/01/19...?from=homepage

[boutons_deux]

Medical Price Gouging and Waste Are Skyrocketing


The latest in this medical cost saga comes from new data released last week by National Nurses United (NNU), the nation's largest nurse's organization. In a news release, NNU revealed that fourteen hospitals in the United States are charging more than ten times their costs for treatment. Specifically, for every $100 one of these hospitals spends, the charge on the corresponding bill is nearly $1,200.

According to NNU's data, thetop 10 Most Expensive Hospitals in the U.S. listed according to the huge percentage of their charges relative to their costs are:

1. Meadowlands Hospital Medical Center, Secaucus, NJ - 1192%

2. Paul B. Hall Regional Medical Center, Painsville, KY - 1186%

3. Orange Park Medical Center, Orange Park, FL - 1139%

4. North Okaloosa Medical Center, Crestview, FL - 1137%

5. Gadsden Regional Medical Center, Gadsden, AL - 1128%

6. Bayonne Medical Center, Bayonne, NJ - 1084%

7. Brooksville Regional Hospital, Brooksville, FL - 1083%

8. Heart of Florida Regional Medical Center, Davenport, FL - 1058%

9. Chestnut Hill Hospital, Philadelphia, PA - 1058%

10. Oak Hill Hospital, Spring Hill, FL - 1052%

Enacting a single payer, full Medicare-for-all system is the only chance the United States has of unwinding itself from the spider web of waste, harm, and bloat that currently comprise its highly flawed health insurance and health care systems. It's time to cut out the corporate profiteers and purveyors of waste and fraud and introduce a system that works for everybody.

http://readersupportednews.org/opinion2/272-39/21585-medical-price-gouging-and-waste-are-skyrocketing

THANKS, OBAMA!

[boutons_deux]

How Ted Cruz Helped Fund Obamacare

Without any fanfare, 166 House Republicans voted to fund Obamacare on Wednesday.

The next day, 17 Republican senators did the same thing.

By the end of the shutdown, Republicans had reached new levels of unpopularity and briefly seemed in danger of losing their gift-wrapped-by-gerrymandering House majority. Luckily for the GOP, the briefly disastrous rollout of the Obamacare online exchanges wiped the shutdown’s hangover from the news. However, the unpopularity lingered, putting the party in a fundraising slump it still hasn’t broken out of.

when it came time to vote on a two-year budget agreement negotiated by Rep. Paul Ryan (R-WI) and Senator Patty Murray (D-WA), Ted Cruz and the outside groups that champion him warned Republicans that they’d better not vote for it or they’re gonna get it, somehow, some way. You just watch!

The budget passed easily, but before it came time to fill in the actual numbers and fund that budget, Cruz demanded a vote to defund Obamacare. The senator’s spokesTwitterer summed up what happened:

Cruz asked for a vote to defund Obamacare and fund military pensions. Denied. Couldn't even get a VOTE on it.

http://www.nationalmemo.com/how-ted-...und-obamacare/