The ACA, Pope Francis & Me

affordable care act

(By Joanne Boyer, cross-posted at Wisdom Voices)

“When a society—whether local, national, or global—is willing to leave a part of itself on the fringes, no political programs or resources spent on law enforcement or surveillance systems can indefinitely guarantee tranquility.”

–Pope Francis, Apostolic Exhortation

Pope Francis has been making headlines for his recent Apostolic Exhortation Evangelii Gaudium and his condemnation of consumerism, trickle down economics, and his critique of the modern capitalist economy. I was stuck by the above quote as I officially joined the ranks of the insured through the Affordable Care Act this week. For the last six months I’ve chronicled what it’s like to wait and wonder what my state health exchange would look like, what plans would be available to someone such as myself with a pre-existing condition and stuck in a “high risk pool” that offered policies that essentially covered nothing, and what type of financial savings I would achieve.

How did it go? In today’s bullet-point, 30-second attention span society, here are the highlights:

- My husband (also in the high risk pool) and I found top-of-the-line platinum coverage ($2,000 deductible/each and 100 percent coverage of everything after the deductible is met) for a combined monthly premium of $814. Thank you MNSure, the Minnesota State Exchange for the great plan offerings on your site. Minnesota produced the lowest plan rates in the country.

- We were ineligible for tax credits as our combined income is far less than six figures but above poverty levels (for which I am grateful).

- No one asked for our medical history; no plan on the Exchange has a life-time maximum benefit (thank you ACA).

- We used a licensed professional insurance broker to bob and weave through the intricacies of the multitude of plans offered. Thank you Sheryl Frieman of Array Financial Services.

- It’s impossible to calculate how much we saved on premiums as the high-risk pool is dissolving and no 2014 rates were available to produce and apples-to-apples comparison.

But what does success look like for those “on the fringe” as Francis reminds us. Think for a minute of the millions of Americans struggling far more than me to make ends meet. A major goal of the ACA was to provide them a lifeline to health care coverage. For those lucky enough to live in states with governors who are expanding Medicaid, the real success stories are happening. The ACA is providing those “on the fringe” with health care, human dignity, and hope for a healthier life. If the ACA can move Americans past the “me, me, me” scenario that dominates our culture today into a conversation focused on “we,” then as a people and a country we will all be better off because of the ACA.

How is it in the course of my lifetime, greed and individualism has hardened our hearts to the cry of those on the fringe who simply want to see a doctor? And for those Republican governors who refuse to expand Medicaid coverage, I wonder, how do they sleep at night? What do they think when they hear the words of Francis?

“One cause of this situation is found in our relationship with money, since we calmly accept its dominion over ourselves and our societies. … The worship of the ancient golden calf has returned in a new and ruthless guise in the idolatry of money and the dictatorship of an impersonal economy lacking a truly human purpose. The worldwide crisis affecting finance and the economy lays bare their imbalances and, above all, their lack of real concern for human beings. …”

Anyone who reads these pages knows that I am an outspoken supporter of single payer—Medicare For All (without for-profit supplemental health plans). But we continue to be the only educated country on the globe who refuses to provide health care for all of its citizens. So, we have the ACA—a step in the right direction.

I succeeded in securing health care for 2014. But there’s a hollow sense of accomplishment when I realize so many of my fellow citizens remain “on the fringe.” I take my hope from Cindy Young, from Campaign For A Healthy California, the group working to bring single payer to that state. Earlier this year she told me:

“My hope is that once all of the ACA is fully implemented people will see that there is still a need for a universal health care plan. And as was shown in Massachusetts, their individual mandate does not prevent medical bankruptcies. I am hopeful because when something like this (the ACA) happens, there’s a shift. And, I think the shift will be that more folks will realize that we tried with the ACA and we got only so far and that we have more work to do.”

And that will be the ultimate ACA success story..if it moves us to single payer.

Celebrating ObamaCare Success Stories

ObamaCare Success

Since the October 1 launch of the health care exchanges, vast numbers of Americans have benefitted from the Affordable Care Act, also known as “ObamaCare.”  In the first month of the exchanges, more than 500,000 people gained insurance coverage, and enrollment has surged since then in at least the state-run exchanges.  Many of these newly insured have been unable to afford insurance for years and live in poor areas, such as rural eastern Kentucky, where health services for the uninsured have long been scarce.  And the benefits of ObamaCare go far beyond just the exchanges.  Three to six million young adults have gained coverage thanks to ObamaCare’s requirement that parents be able to keep their children on their policies until age 26.  Seniors and people with disabilities have saved $8.9 billion in prescription drugs since 2010.  Between 36 million and 122 million Americans no longer have to worry about a pre-existing condition exclusion foreclosing their ability to gain coverage.  And ObamaCare’s cost-savings provisions have helped achieve the significant reduction in the increase in health care spending that has occurred over the past few years.

Despite the widespread benefits of the Affordable Care Act, the media over the past two months has been obsessively focused on two problems.  The first is the widely reported flaws in the federal health insurance exchange website, HealthCare.gov.  The failure to have the website ready to go right off the bat was a major screw up.  The website problems are, however, fixable and, in fact, are largely being fixed.  More importantly, the success of ObamaCare in states such as Kentucky, Connecticut, Washington, and California that set up their own exchanges shows that the website issues are a problem with implementation rather than with the substance of the law itself.

Second, the media has kept a constant spotlight on people in the individual insurance market whose policies fail to meet the consumer protection requirements set forth in the Affordable Care Act.  While the media has portrayed those people – which make up approximately 5.7% of the population that are not Medicare recipients –  as “losing their insurance” or having their policies “cancelled,” the reality is that each of these people can purchase new, typically better, policies on the health insurance exchanges.  While those higher quality policies will often (though not always) cost more, the large majority of people in the individual market are eligible for subsidies under the Affordable Care Act that will make their out of pocket premium costs lower than they were pre-ObamaCare. A recent analysis found that only approximately 0.6% of the non-Medicare recipient population in the end are likely to pay more for (better) insurance under ObamaCare.  And, in fact, many Americans are happy to have the opportunity to replace their substandard pre-ObamaCare policies.

It is, of course, not surprising or inappropriate that the media would cover the website problems and the story of the people whose existing insurance policies are being replaced.  But given the small proportion of people who may pay more for better insurance policies, and the relatively transient nature of the website problems, the media’s singular wall-to-wall coverage of these two issues is vastly overstated, especially in comparison to the almost entire lack of coverage of the far larger group of people who are benefitting from the Affordable Care Act.  The media’s obsessive coverage also plays directly into the hands of Congressional Republicans, who are implementing a structured and well-coordinated effort to jump on every issue in the implementation of the Affordable Care Act in a desperate attempt to continue their long-term effort to sabotage the law.

With both the media and the Republican Party committed to trumpeting every kink in the ObamaCare implementation, it is up to us progressives to spread the word about the far more numerous and important benefits that the Affordable Care Act is providing to people throughout the US.  And while studies and analyses explaining how ObamaCare will help repair our broken health insurance system are important, personal stories of how individuals have benefitted are far more politically persuasive.  We’re trying to do our part by collecting as many of those success stories as we can find at our ObamaCare Success Stories page.

Here are brief summaries of just a few of the stories that we have collected so far:

* A family that has a son who was born with a brain tumor, but that no longer has to worry about financial ruin thanks to ObamaCare’s ban on annual and lifetime benefit limits

* A 36-year-old self-employed cancer survivor who will be saving $628 per month on health insurance

* A family in southwest Michigan that twice had to sell the family farm to pay hospital bills after an illness, but that now has a quality and affordable insurance policy

* A family in Utah paying only $123 per month for health insurance under ObamaCare

* A 39-year-old Pennsylvanian who has lupus who will be saving $50 per month on a better health insurance plan

Most of the stories we’ve collected are from letters to the editor, blogs, and newspaper coverage over the past two months.  The more personal stories we can collect the better, however, so we urge our readers to share their own stories of getting better quality and/or lower cost health insurance thanks to ObamaCare. And, of course, the purpose of collecting these stories is so we can all share them with the public more broadly.  We encourage all of our readers to do so through writing letters to your local newspaper editors, contacting your Congresspeople, and spreading the ObamaCare success stories widely on your social media networks.

ObamaCare is working to expand affordable health insurance coverage to tens of millions of Americans, end abusive health insurance industry practices, and make our health care system more efficient.  But it is also facing a concerted, determined, and well-funded effort by conservatives to try to make sure the law does not succeed.  Now is the time for all of us to fight back by highlighting the significant benefits that ObamaCare is already providing to real Americans throughout the country.

My Junk Insurance Policy Canceled? I Jumped For Joy

Insurance Cancellation

(By Joanne Boyer, cross-posted at Wisdom Voices)

This is what a Junk Insurance policy cancelation notice looks like. I jumped for joy when I received mine. I believe for a great majority of people who forced the noise machine chorus of “you promised I could keep my policy” that if they knew even a morsel of how our for-profit health care delivery system worked, they would have jumped for joy as well. (I still believe that President Obama was talking to people with employee-sponsored health plans when he made that statement. But then, that would require the populace to understand the difference between an employer-sponsored health care plan and individual Junk Insurance plans that most of the three million who received cancellation notices carry.)

I’ve written before about how I don’t have health insurance—I have bankruptcy insurance. That’s all about to change—in just over a month. Do you know what my now never-again-to-be-offered Junk Insurance plan covered? It basically covered NOTHING. I paid $329.21 per month for over two years and had a policy that covered a $25 flu shot once a year. Other than that, I paid for every visit to any medical professional, out of pocket, because my Junk Insurance policy carried a $10,000 deductible. I often wonder, does the U.S. populace understand what a “high deducible” policy even means?

My for-profit health insurance company forced me off my private policy several years ago after my diagnosis of breast cancer when they increased my monthly premium 20 percent for the two years after the diagnosis, making my monthly premium payment $705/month for a $5,000 deducible policy. (Yes, for-profit insurance companies have been raising rates forever when your policy due date arrives). Even at that, I was “luckier” than most people around the country because Minnesota has/had a “high risk” pool insurance group called the Minnesota Comprehensive Health Association (MCHA). What that basically meant was that anyone with a pre-existing condition who was denied insurance coverage (like me and my husband) and who had deep enough pockets and who basically didn’t need to see a medical professional, could get bankruptcy insurance. Yes, the $10,000 deductible policy that I no longer can purchase because of the Affordable Care Act (ACA)—did nothing more than provide a backstop for a bankruptcy if I had developed any major medical problem. It was Junk Insurance.

Minnesota continues to be one of the states leading the way in implementation of the ACA—even when it comes to cancellation notices. Take a closer look at what the notice tells me:

“Don’t wait until MCHA closes in December 2014. Take advantage of the new insurance market during the open enrollment period, Oct. 1, 2013-Mar. 31, 2014 (plans purchased before Dec. 15, 2013 will take effect on Jan. 1, 2014). To find a new plan, visit MNsure.org or call 1-900-657-3629. You can also call your agent, or search for one at www.myMCHAagent.com

My Junk Insurance policy no longer available to me? I couldn’t be happier.

I will see my insurance broker on Tuesday December 2, 2013 to discuss my ACA options. Over the phone, she’s informed that she’s found plans (as did I when I went to MNSure) that could save my husband and me nearly $350/month on premiums. And you know what else? These ACA plans will actually cover preventative health procedures and they have deductibles we can meet without thinking bankruptcy.

Is it single payer (which is the only really answer to the chaos of our health care delivery system)? Nope. But for now, it’s what we have.

In Search of a Gotcha Moment

debunkingtheright500

(By The Political Pragmatic)

The idea that journalists have no responsibility to the dissemination of helpful information is ridiculous to me. It certainly is not the media’s job to accommodate misinformation and falsehoods.  The presentation of facts is not a partisan issue.  I can’t help but wonder what ethics their willingness to peddle partisan bullshit supports.

Contrary to Chuck Todd’s assertions, if the media would point out the lies and distortions that have been launched against Obamacare, they wouldn’t be picking sides, they’d be doing their jobs and doing right by their audience.

What the president said about the Affordable Care Act is true….”if you like your insurance you can keep it”…unless providers or employers change it, which they often do, but that’s not a requirement under ObamaCare. Most people already have good coverage from their employer, Medicare, Medicaid or Tricare, so I never thought that declaration applied to the  small percentage of individual policyholders because health insurers have been canceling and replacing individual policies for years. I should know…I’m an individual policyholder.  They slash benefits, raise deductibles and increase premiums. The majority of those buying individual policies who are now whining to keep them, have done so in the past because they had no other options.

So should the media tell the public that some insurance companies are sending cancellation notices or other “misleading” letters to customers in an attempt to push them into pricier alternatives?  Of course they should!  If they can’t alert us to a possible rip-off, what purpose do they serve?

Here’s what really galls me about the media.  The regulations regarding individual policies was issued in June of 2010.  There has been more than adequate time to question the policy, and inform and prepare the public.  In fact, issuance of the guidelines caused the usual objections by Republicans and the media reported on it way back then.  Suppose they forgot?  I don’t think so…they’re just looking for a gotcha moment.

It’s what they do.

A good newsstory informs and educates the public.  Having said as much, we also have a responsibility to ferret out some information ourselves.  But as it is, we have a media that plays up every racist intonation, reports and promotes every criticism of the President, polls every thought and attitude…misleads, misinforms and mismanages the truth.  It’s yellow journalism; exaggerations of news events, scandal-mongering, and sensationalism; biased opinion masquerading as objective fact.

I frankly, am losing all faith in the people who are paid to keep us informed.  I know there are still journalists who take pride in a job well done.  Who do you trust?

 

Hurricane Katrina Vs. ObamaCare

ObamaCare enrollment

(By The Political Pragmatic)

Hurricane Katrina was the deadliest and most destructive cyclone of the Atlantic hurricane season.  Over 1,800 people died in the hurricane and subsequent floods; total property damage was estimated at $81 billion.

Despite massive death and destruction, the Republicans are comparing the technical rollout of ObamaCare to the one of the gravest human disasters in the history of the country.  I say the comparison is a bridge way too far.

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During Katrina, hundreds of people drowned.

Thanks to ObamaCare, people will no longer drown in medical debt.

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During Katrina, thousands of children were left homeless and helpless.  They wandered, worried and waited for help to arrive.

Thanks to ObamaCare, Children don’t have to wait for the vital services that will keep them healthy.  Through an expansion of Medicaid and the Children’s Health Insurance Program (CHIP), there is  free or low-cost health coverage for available that includes emergency services and newborn care, pediatric dental and vision care through age 19 .

Children under 19 with disabilities or pre-existing conditions, like asthma, diabetes and cancer, cannot be denied coverage or dropped from a plan.  The program brought the uninsured rate for kids to record lows in 2011.

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During Katrina, thousands were left stranded for days without clean water to drink or food to eat.

ObamaCare is a lifeline for millions who cannot afford healthcare or have been turned away because of pre-existing conditions.

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Battered by wind, rain and storm surge, some neighborhoods were completely leveled.  People lost everything they owned.  A number of streets and bridges were washed away.  Dead bodies lay decomposing in the streets.

 

 

Before ObamaCare, medical bills sometimes cost people their homes and economic stability.  Some people had to deplete their savings to pay off medical bills. They’re battling cancer, major injuries and debilitating disease.

To save money, some cut corners with their treatments, or skipped doses of prescribed medicine or simply delayed refilling prescriptions. Many were unable to pay for basic necessities like rent, food and heat.

Illness and medical bills contributed to a large share of U.S. bankruptcies. According to a Harvard Medical School study,  62.1% of all bankruptcies in 2007 were caused by medical debt and  three quarters of the individuals who filed for medical bankruptcy had health insurance.

ObamaCare gives people choices.  No longer will people be required to sacrifice everything to receive the medical care that can save their lives.

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During Katrina, many sick and elderly were simply left to die.

ObamaCare, arms them with the weapons to fight for life.  Essential health benefits include: ambulatory patient services; emergency services; hospitalization; maternity and newborn care; mental health and substance use disorder services, including behavioral health treatment; prescription drugs; rehabilitative and habilitative services and devices; laboratory services; preventive and wellness services and chronic disease management.

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During Katrina, parents worried they would not be able to protect their children and secure their future.

ObamaCare requires insurance plans to make coverage available under a parent’s plan until the adult child reaches the age of 26. Many parents and their children who worried about losing health insurance after the child reached age 18 or graduated from college no longer have to worry.  Thanks to ObamaCare.

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So, how the Republicans can possibly compare ObamaCare to Katrina is a mystery to me.  The Bush administration’s response to Katrina was not only criminally negligent, it was a failure of duty to citizens of the United States of America.  Some consider it one of the worst disasters ever seen in a presidency; lives were lost and hundreds of thousands were displaced, like refugees in some foreign country.

Whether or not Katrina was Bush’s worst failure depends on whether you believe he ignored warnings about the 9/11 terrorist attack that cost 3,000 American lives.  And let’s not forget the lies and misleading declarations that led to the Iraq War and the deaths of over 4700 American soldiers.

To my way of thinking, it would have made more sense to compare President Obama’s botched ObamaCare rollout to Bush’s botched Prescription Drug rollout.  But then again, that too could have been a matter of life and death, since people often received the wrong medication or were unable to get their lifesaving drugs at all.

So no matter how the Republicans frame the botched rollout of ObamaCare, they will never be able to rehabilitate the legacy of George Bush because ObamaCare won’t cost lives, ObamaCare will save lives.

 

The GOP’s Partisan Hypocrisy on ObamaCare

obamacare

 (By The Political Pragmatic)

“I am not trying to make excuses or minimize the difficulties some are having. Those problems need to be fixed, and fixed fast. By all accounts, everyone is working hard to get them resolved. … The point is, the opponents of this new benefit will complain and fight it no matter what happens.  I hope everyone remembers that.”

That’s what Sen. Charles Grassley said on the Senate floor in 2006, in defense of the disasterous launch of the Republican Medicare expansion.

Tea Party members and Republicans rail about the fact that ObamaCare was passed with all Democratic votes.  Oddly, it never seemed to bother them that Republicans passed the Medicare expansion at three o’clock on a Saturday morning while the nation slept. The primary difference…Bush’s multi-billion dollar giveaway was completely unfunded; a gift basket of taxpayer subsidies to insurance and prescription drug companies. It had no dedicated financing, no offsets and no revenue-raisers, while ObamaCare employs all these financing mechanisms.

More importantly, the launch of the new Medicare program was a disaster.  Millions of seniors faced the prospect of going without life-saving medicines because of untrained pharmacists and computer glitches. More than a dozen states declared health emergencies because many of the nation’s sickest and poorest elderly and disabled people were being turned away or overcharged at pharmacies.

A House Committee on Energy and Commerce memorandum, (Hearing on Medicare Part D: Implementation of the New Drug Benefit) reviews the initial months of implementation of the Medicare Part D drug benefit.

This is what headlines looked like:

Straighten out the Part D Maze, Cleveland Plain Dealer (Nov. 20, 2005).

Confusion Reigns over Drug Plans, Sacramento Bee (Jan. 7, 2006).

New Medicare Law Trips Up the Poor; Doctors, pharmacists say some will die for lack of medicine, San Diego Union Tribune (Jan. 12, 2006).

Medicare Part D: Not ready for prime time, Milwaukee Journal Sentinel (Jan. 16, 2006).

Prescription-Drug Plan Part D gets an early ‘F’, Philadelphia Inquirer (Jan. 14, 2006).

Medicare Guide is in Need of Rx, Newsday (Oct. 8, 2005).

Glitches Jam Medicare Drug Plan, Orlando Sentinel (Jan. 8, 2006).

Still, unlike today’s Republican Governors who are today denying Medicaid coverage to their constituents, Democratic governors spent tens of millions of dollars or more to assure seniors had access to the new benefits under Medicare.

The States Step in as Medicare FaltersWashington Post (Jan. 14, 2006)

Unlike today’s Congressional Republicans who:

Went all the way to the Supreme Court in an attempt to overturn ObamaCare;

Attempted to repeal and defund the law more than forty times, wasting more than $50 million;

Blocked the expansion of Medicaid in Republican-led states;

Refused to set up state health care exchanges;

Sought to cut-off funds for outreach and customer service;

and finally shutdown the government squandering an estimated $24 billion and hundreds of thousands of jobs,

Democrats put aside partisan thoughts and worked with Republicans to get the Medicare prescription drug program up and running.  By contrast, today’s GOP has tried to sabotage ObamaCare every step of the way. 

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