- Please send as far and wide as possible. Thanks, Robert Sterling Editor, The Konformist http://www.konformist.com http://robalini.blogspot.comMessage 1 of 4 , Apr 3, 2010View SourcePlease send as far and wide as possible.
Editor, The Konformist
So let's review: if a President John McCain (or a George W. Bush, for that matter) had passed a "health reform" bill that forced individuals buy health insurance in a highly unregulated market, slashed money going to the poor and elderly through cuts in Medicare and Medicaid, began to tax health benefits of mainly union workers to encourage companies to slash their insurance programs and pushed anti-abortion clauses into the deal, would it be praised as a progressive bill battling the inequities in our society? Somehow I don't think so...
Health Care Bill Fact Sheet
Friday, March 19, 2010
The FDL health care team has been covering the health care debate in congress since it began last year. They have put together a fact sheet to help readers sort through the myths and facts of the health care bill:
1. Myth: This is a universal health care bill.
Truth: The bill is neither universal health care nor universal health insurance.
Per the CBO:
Total uninsured in 2019 with no bill: 54 million
Total uninsured in 2019 with Senate bill: 24 million (44%)
2. Myth: Insurance companies hate this bill.
Truth: This bill is almost identical to the plan written by AHIP, the insurance company trade association, in 2009. The original Senate Finance Committee bill was authored by a former Wellpoint VP. Since Congress released the first of its health care bills on October 30, 2009, health care stocks have risen 28.35%.
3. Myth: The bill will significantly bring down insurance premiums for most Americans.
Truth: The bill will not bring down premiums significantly, and certainly not the $2,500/year that the President promised.
Annual premiums in 2016, status quo / with bill:
Small group market, single: $7,800 / $7,800
Small group market, family: $19,300 / $19,200
Large Group market, single: $7,400 / $7,300
Large group market, family: $21,100 / $21,300
Individual market, single: $5,500 / $5,800
Individual market, family: $13,100 / $15,200
4. Myth: The bill will make health care affordable for middle class Americans.
Truth: The bill will impose a financial hardship on middle class Americans who will be forced to buy a product that they can't afford to use.A family of four making $66,370 will be forced to pay $8,628 per year for insurance. After basic necessities, this leaves them with $8,307 in discretionary income out of which they would have to cover clothing, credit card and other debt, child care and education costs, in addition to $5,882 in annual out-of-pocket medical expenses for which families will be responsible.
5. Myth: This plan is similar to the Massachusetts plan, which makes health care affordable.
Truth: Many Massachusetts residents forgo health care because they can't afford it.
A 2009 study by the state of Massachusetts found that:
21% of residents forgo medical treatment because they can't afford it, including 12% of children
18% have health insurance but can't afford to use it
6. Myth: This bill provide health care to 31 million people who are currently uninsured.
Truth: This bill will mandate that millions of people who are currently uninsured must purchase insurance from private companies, or the IRS will collect up to 2% of their annual income in penalties. Some will be assisted with government subsidies.
7. Myth: You can keep the insurance you have if you like it.
Truth: The excise tax will result in employers switching to plans with higher co-pays and fewer covered services.
Older, less healthy employees with employer-based health care will be forced to pay much more in out-of-pocket expenses than they do now.
8. Myth: The "excise tax" will encourage employers to reduce the scope of health care benefits, and they will pass the savings on to employees in the form of higher wages.
Truth: There is insufficient evidence that employers pass savings from reduced benefits on to employees.
9. Myth: This bill employs nearly every cost control idea available to bring down costs.
Truth: This bill does not bring down costs and leaves out nearly every key cost control measure, including:
Public Option ($25-$110 billion)
Drug reimportation ($19 billion)
Medicare drug price negotiation ($300 billion)
Shorter pathway to generic biologics ($71 billion)
10. Myth: The bill will require big companies like WalMart to provide insurance for their employees.
Truth: The bill was written so that most WalMart employees will qualify for subsidies, and taxpayers will pick up a large portion of the cost of their coverage.
11. Myth: The bill "bends the cost curve" on health care.
Truth: The bill ignored proven ways to cut health care costs and still leaves 24 million people uninsured, all while slightly raising total annual costs by $234 million in 2019. "Bends the cost curve" is a misleading and trivial claim, as the US would still spend far more for care than other advanced countries.
In 2009, health care costs were 17.3% of GDP.
Annual cost of health care in 2019, status quo: $4,670.6 billion (20.8% of GDP)
Annual cost of health care in 2019, Senate bill: $4,693.5 billion (20.9% of GDP)
12. Myth: The bill will provide immediate access to insurance for Americans who are uninsured because of a pre-existing condition.
Truth: Access to the "high risk pool" is limited and the pool is underfunded. It will cover few people, and will run out of money in 2011 or 2012.
Only those who have been uninsured for more than six months will qualify for the high risk pool. Only 0.7% of those without insurance now will get coverage, and the CMS report estimates it will run out of funding by 2011 or 2012.
13. Myth: The bill prohibits dropping people in individual plans from coverage when they get sick.
Truth: The bill does not empower a regulatory body to keep people from being dropped when they're sick.
There are already many states that have laws on the books prohibiting people from being dropped when they're sick, but without an enforcement mechanism, there is little to hold the insurance companies in check.
14. Myth: The bill ensures consumers have access to an effective internal and external appeals process to challenge new insurance plan decisions.
Truth: The "internal appeals process" is in the hands of the insurance companies themselves, and the "external" one is up to each state.
Ensuring that consumers have access to "internal appeals" simply means the insurance companies have to review their own decisions. And it is the responsibility of each state to provide an "external appeals process," as there is neither funding nor a regulatory mechanism for enforcement at the federal level.
15. Myth: This bill will stop insurance companies from hiking rates 30%-40% per year.
Truth: This bill does not limit insurance company rate hikes. Private insurers continue to be exempt from anti-trust laws, and are free to raise rates without fear of competition in many areas of the country.
16. Myth: When the bill passes, people will begin receiving benefits under this bill immediately
Truth: Most provisions in this bill, such as an end to the ban on pre-existing conditions for adults, do not take effect until 2014. Six months from the date of passage, children could not be excluded from coverage due to pre-existing conditions, though insurance companies could charge more to cover them. Children would also be allowed to stay on their parents' plans until age 26. There will be an elimination of lifetime coverage limits, a high risk pool for those who have been uninsured for more than 6 months, and community health centers will start receiving money.
17. Myth: The bill creates a pathway for single payer.
Truth: Bernie Sanders' provision in the Senate bill does not start until 2017, and does not cover the Department of Labor, so no, it doesn't create a pathway for single payer.
Obama told Dennis Kucinich that the Ohio Representative's amendment is similar to Bernie Sanders' provision in the Senate bill, and creates a pathway to single payer. Since the waiver does not start until 2017, and does not cover the Department of Labor, it is nearly impossible to see how it gets around the ERISA laws that stand in the way of any practical state single payer system.
18. Myth: The bill will end medical bankruptcy and provide all Americans with peace of mind.
Truth: Most people with medical bankruptcies already have insurance, and out-of-pocket expenses will continue to be a burden on the middle class.
In 2009, 1.5 million Americans declared bankruptcy
Of those, 62% were medically related
Three-quarters of those had health insurance
The Obama bill leaves 24 million without insurance
The maximum yearly out-of-pocket limit for a family will be $11,900 (PDF) on top of premiums
A family with serious medical problems that last for a few years could easily be financially crushed by medical costs
*Cost of premiums goes up somewhat due to subsidies and mandates of better coverage. CBO assumes that cost of individual policies goes down 7-10%, and that people will buy more generous policies.
Enron's Ghosts Capture Health Insurance Reform
Thursday March 18, 2010
Last July, I wrote a post on how Enron's free market views influenced the original design of the California electricity market and contributed later to its collapse. I pointed out the parallels between Enron's flawed market designs and the debate over the public option in the proposed health insurance reforms.
It's worth revisiting, because matters are now much worse than they were then.
So what kind of structure and rules did Enron demand? First, it needed to eliminate competing institutions that might be able to connect producers and consumers more directly and efficiently. It argued for, and got, a structure that tended to require middlemen.
There was a proposal for a quasi-government "power pool" a public pool in which producers could sell and consumers/buyers could purchase power directly without a middleman. For a year of debates, Enron and other marketers did their best to eliminate that "socialist," government-controlled concept, but the small band of bureaucrats and allies convinced the state to keep the pool.
Second, once the pool was accepted, Enron's next tactic was to limit access to the pool. Enron argued for rules that required all non-utility buyers to arrange private contracts to cover their needs, instead of relying on the public pool. That would result in many more opportunities for Enron to be the middleman in those private contracts. The small band of bureaucrats argued against that limitation with some success, but Enron got concessions that tended to discourage many parties from using the public pool.
Enron's third tactic was to demand operating rules that would force the public pool to operate at higher costs. The bureaucrats objected to these rules and took the dispute all the way to the Governor's office, but they lost to the Governor's largest campaign contributors (he still had debts from a failed Presidential run). It was an important defeat.
The Power Pool was eventually created, but it's rules hobbled it and forced it to operate at higher costs. One particular rule required the public pool to ignore feasible cost-savings and instead deliberately choose higher cost energy when serving customers of the public pool. That made non-pool contracts more attractive and drove non-utility buyers/sellers to Enron's traders.
Enron and its gullible supporters convinced state and federal regulators that since they were market competitors, their competition would always achieve the lowest cost results, so the public plan should be deliberately forced not to achieve the lowest cost, because that would drive marketers out of business, and they should be protected. California's largest electricity customers, and federal regulators, bought this ridiculous argument.
Finally, Enron demanded, and got, rules that required the grid system operator to be separated from a part of the public pool the market separation fallacy. When combined with other ill-advised rules, this meant that the public plan and system operator were often flying "blind," unaware of grid conditions when Enron and other parties were manipulating the market. The result: Enron and others manipulated the market with virtual impunity, raking off hundreds of millions (and some claim billions) of dollars.
If you recognize this pattern, it's because we're seeing analogous tactics and strategies in the current health care reform debates.
We see a powerful group of middlemen, the insurance industry, trying to structure the market to require that they remain in the middle of, and extract a rent from, all money flows between providers and patients, as though that's the only logical structure, even though it's not.
We see efforts to eliminate any public alternative the public plan (operating inside a public exchange) that might be more efficient in reducing and covering costs.
And we see the middlemen and their political supporters in Congress deliberately hobbling the public plan, raising its costs, and restricting access to that public option, on the theory that we shouldn't do anything to undermine the current private insurance industry. After all, they argue, private markets are always more efficient than a government operation.
That was how I saw the parallels last July, when the public option was still a possibility, but I warned that differences between products, markets, institutions, etc, made such comparisons risky. Yet the sad and astonishing part is that as the health care debate has evolved, the Enron free market view from 15 years ago has triumphed in the proposed health insurance reforms.
There is no public option, so there will be no public insurance altenative and safety net to protect consumers from private insurance discrimination, excessive rates, and other abuses. The insurance market now embedded in the Senate bill is worse that what Enron and its political allies helped design for California's electricity markets.
We can now see other parallels and predict what might occur in this new insurance market. In California, state and federal regulators failed to pay attention to the concentration of producers only a few large firms controlled most of the generation, even after the utilities were induced to divest much of their generation monopolies. The predictable problem of market power would then combine with the ability of Enron and other financial marketers to manipulate Enron's flawed rules. They would then create artificial shortages, exacerbate real shortages (from droughts, nuclear outages, etc) and then bilk consumers for hundred of millions of dollars. And on top of that, state regulators imposed a mandate on utilities to purchase all their residual power from the new flawed "exchange" market. Sound familiar?
Will something analogous happen in health insurance markets? We don't know, and all crises are different. But we know the health insurance and provider markets are egregiously concentrated one or two mega-firms control most of the market in most states. We know the industry is still protected from anti-trust laws; until that's fixed, there's no way for state or federal governments to bust up the firms with the most market power or prevent collusion to fix prices. And we know consumers will be forced to purchase insurance within this concentrated market and given subsidies to help them do it.
We know there won't be any meaningful rate regulation. That is what the demise of the rate regulator means. Insurers and providers are essentially free today to raise rates at will; there is nothing to change that. This Administration and Congressional leaders are apparently content to throw up their hands and have this important public policy decided by a virtually unknown "parliamentarian," but it's their sin, not his.
And we know that the very nature of health insurance is such that the theories of efficient competition and competitive pricing simply do not apply. Economists since Ken Arrow have told us this. Yet we still have governments and institutions enthralled by the virtues of free enterprise.
Without rate regulation, without anti-trust enforcement, without a viable public option as escape hatch, without a credible theory of competition, and with virtually no constraints on the industry's ability to bribe and control the Congress and the White House, there is no way consumers can win in the new health insurance markets. Only an idiot [e.g., a member of the Texas School Board] would believe this will turn out well.
The only question we have left is how the inevitable market collapse, consumer crisis and government bailout will occur. And they will occur.
A reconciliation bill could have fixed much of the Enron-designed market structure in the Senate bill, but the White House didn't want that. It cut its deals, just as California's Governor cut his deals in 1996. But no one remembers Pete Wilson.
Entertainment attorney, writer, and political activist
March 16, 2010
NY Times Reporter Confirms Obama Made Deal to Kill Public Option
For months I've been reporting in The Huffington Post that President Obama made a backroom deal last summer with the for-profit hospital lobby that he would make sure there would be no national public option in the final health reform legislation. I've been increasingly frustrated that except for an initial story last August in the New York Times, no major media outlet has picked up this important story and investigated further.
Hopefully, that's changing. On Monday, Ed Shultz interviewed New York Times Washington reporter David Kirkpatrick on his MSNBC TV show, and Kirkpatrick confirmed the existence of the deal. Shultz quoted Chip Kahn, chief lobbyist for the for-profit hospital industry on Kahn's confidence that the White House would honor the no public option deal, and Kirkpatrick responded:
"That's a lobbyist for the hospital industry and he's talking about the hospital industry's specific deal with the White House and the Senate Finance Committee and, yeah, I think the hospital industry's got a deal here. There really were only two deals, meaning quid pro quo handshake deals on both sides, one with the hospitals and the other with the drug industry. And I think what you're interested in is that in the background of these deals was the presumption, shared on behalf of the lobbyists on the one side and the White House on the other, that the public option was not going to be in the final product."
Kirkpatrick also acknowledged that White House Deputy Chief of Staff Jim Messina had confirmed the existence of the deal.
This should be big news. Even while President Obama was saying that he thought a public option was a good idea and encouraging supporters to believe his healthcare plan would include one, he had promised for-profit hospital lobbyists that there would be no public option in the final bill.
The media should be digging deeper into this story. Washington reporters should be asking Robert Gibbs if President Obama is still honoring this deal. They should be calling Jim Messina and hospital lobbyist Chip Kahn to confirm the specifics of the deal. They should be asking Nancy Pelosi and Senate Democratic leaders Dick Durbin and Harry Reid the extent of their knowledge of this deal. They should be asking Pelosi if the reason she's refusing to include a public option in the House reconciliation bill to be sent to the Senate is that there are at least 51 Senate Democrats who would vote for it and she needs to insure that a final bill with a public option does not end up on President Obama's desk where he would then have to break his deal with the hospital lobbyists and sign it, or veto it to honor his deal.
More deeply, there are serious questions about the extent to which Obama, with the help of Rahm Emanuel, used a K Street strategy to pursue health care reform. The strategy seems to have been to make backroom deals to protect the interests of the likes of the drug industry and the for-profit hospital industry in exchange for campaign cash, even if this meant reversing campaign promises to include a public option to put competitive pressure on private insurance premiums, and to allow Medicare to negotiate for lower drug prices and Americans to buy cheaper drugs from Canada. The result is a health care bill that is generally unpopular with voters. Questions need to be asked, too, about the extent to which the White House is following a similar K Street strategy with Wall Street financiers when it comes to shaping financial reform and new regulations to reign in the banks who brought the economy to its knees.
Voters viscerally sense that the White House and Congressional Democrats may be as concerned with protecting special interests -- whether it's drug companies, private hospitals, or Wall Street bank -- than they are with protecting the people, and this is feeding a populist backlash against Democrats that resulted in Scott Brown's victory in Massachusetts and is making a Democratic bloodbath in the fall elections increasingly likely.
Polls indicate that about 60% of voters support a public option while only about 1/3 support the overall Democratic healthcare bill. There still time -- very little time -- for Democrats to shift course and include a public option in the final bill, even if it means going back on the White House's backroom deal with the hospital industry. If the media picks up on this story, perhaps the White House and Congressional Democrats can be embarrassed into changing course. If, on the other hand, Democrats continue to honor these special interest deals, then passing an unpopular health care bill may just be walking into a Republican trap.
- Please send as far and wide as possible. Thanks, Robert Sterling Editor, The Konformist http://www.konformist.com http://robalini.blogspot.comMessage 2 of 4 , Sep 27, 2010View SourcePlease send as far and wide as possible.
Editor, The Konformist
The Health Care Bill Nobody Wants to Talk About
Tuesday August 31, 2010
As Jay Cost of Real Clear Politics notes, it's pretty obvious that the Democrats' electoral woes are directly tied to the passage of the health care bill. But somehow horserace analysts like Jonathan Alter, Jim Vanderhei and Mike Allen don't want to talk about that.
Well, we've been talking about it for months now.
Nate Silver describes Jay Cost as an "outstanding analyst." Looking at the generic ballot average, Cost says:
Partisans on both sides tell themselves stories about why they're up, why they're down, and why the other side is where it is. These stories usually contain at least a grain of truth, but they also help encourage ideologues in the face of an impending rejection by the electorate. Democrats ignored the political problem of health care in the fall and winter arguing that Martha Coakley and Creigh Deeds were bad candidates, that voters had been turned off by the health care bill because of the process, and that they would come around once the many benefits kicked in. Now, they're pointing to the economy as the only significant reason why the party is in trouble.
It would be difficult for any strong partisan to admit that such an accomplishment was so deeply unpopular. Yet the polling is pretty unequivocal on the relationship between the Democrats' fortunes and the health care bill. It was during the health care debate that the essential building block of the Democratic majority Independent voters began to crumble. It was evident in the generic ballot. It was evident in the President's job approval numbers. It was evident in Virginia, New Jersey, and Massachusetts.
Reconstructing the Democrats' meme, we can fairly say that the economy is a huge problem for the party. Of this, there can be no doubt. We can also say that the stalled recovery denied the Democrats a chance to win back the voters they lost over health care. But the process and passage of health care reform were crucial elements in the story. That's when the party started losing the voters it needs to retain control of the government.
VanderHei and John Harris recently wrote a piece criticizing "liberal bloggers" who were obsessively naval gazing about the Dave Weigel/Journolist incident, and didn't care about the fact that Democrats could lose seats in the House this fall.
In fact, FDL did polling at the first of the year that indicated that the health care bill was extremely unpopular with independents, and warned that the Democrats were living in la-la land to ignore it.
January 14, 2010: FDL commissions SurveyUSA to do polling in swing districts to try and ascertain how the health care bill (particularly the individual mandate) will affect Democratic incumbents.
January 14, 2010: The first SurveyUSA poll finds that Vic Snyder is trailing GOP challenger Tim Griffin by 56% to 39%, and that the individual mandate is unpopular with 3 out of 4 voters. If Snyder votes for the health care bill with the individual mandate, he loses another 6 points to Griffin.
January 15, 2010: Our second SurveyUSA poll finds that Steve Driehaus trails Steve Chabot in a rematch of their 2008 race, 39%-56%. When asked if their opinion of Driehaus changes if he votes for the health care bill, 55% of Independents say that their opinion of him would go down.
January 20: SurveyUSA polls one of the suburban districts that will be key to the Democrats' ability to hold the House in 2010, this time Tim Bishop in (NY-01). Bishop holds a 2 point lead over potential GOP challenger Randy Altschuler, who was already up on the air with ads. Unlike Snyder and Driehaus's GOP-leaning districts, Bishop's district has a +3 PVI Democratic advantage. Party affiliation in the district is 27% GOP, 33% Democratic and 39% Independent. When asked how they feel about a health care bill which forces them to buy insurance or pay a penalty, 66% of Independents say they are opposed and 48% say they are strongly opposed.
January 21, 2010: SurveyUSA finds that Baron Hill is trailing Republican Mike Sodrel by 8 points if they matched up once again. Again, 60% of Independents say that their opinion of Hill goes down if he votes for a health care bill forcing them to buy insurance or pay a penalty.
February 16, 2010: Rather than thank us for the head's up that their caucus is going to be slaughtered if they vote for the health care bill, Mark Ambinder reports that "Already, the Democratic Congressional Campaign Committee is blasting Democratic activist Jane Hamsher for using Survey USA to essentially poll-pressure Blue Dog Democrats into retirement."
March 13: I talk with a Democratic operative, who tells me that by forcing Congress to vote for the health care bill, Democratic leadership and the White House are like the generals in Paths of Glory, "firing on their own men in the trenches."
March 17: I wrote "There are currently 36 resolutions in states across the country to ban the mandate which forces people to buy private insurance, or face a penalty of up to 2% of their income that the IRS will collect the very thing that Obama campaigned against. It will become a rallying cry for the right."
July 21: A new SurveyUSA poll shows Tom Perriello trailing his GOP opponent by 23 points. Prior to voting for the health care bill, a PPP poll showed Perriello essentially tied with Hurt:
This confirms what FDL has been saying for months: forcing members of Congress like Tom Perriello to vote for the health care bill was truly a Paths of Glory move by House leadership and the administration. As our SurveyUSA polling indicated at the time, the health care bill was hugely unpopular in swing districts.
August 4, 2010: 71% of Missouri voters support Proposition C, which "would prohibit the government from requiring people to have health insurance or from penalizing them for not having it." It's a non-binding initiative, but a clear indication of where public sentiment is in a bellwether state.
The DCCC was very good at getting not-so-savvy poll analysts to try and discredit the SurveyUSA polling. (Those same pollsters, ironically, didn't see anything weird in the Research 2000 polls they were quoting authoritatively at the time, which many now find suspect though Jerome Armstrong spotted it). Somehow Democratic members of Congress engaged in magical thinking and believed Rahm's BS about the popularity of the health care bill increasing if it passed.
Rather than focus on jobs creation in a country with climbing unemployment rates, Obama spent the better part of a year focused on passing a health care bill that looks like it will play no small part in the Democratic Party's upcoming electoral woes.
Well, we warned you.
Obama Aims Barbs at Liberals, But Catches Moderates in the Crossfire
By: Blue Texan
Sunday September 19, 2010
Although Jane, Glenn and Digby have already weighed in smartly on this little tantrum from the President, I think it's worth revisiting.
"Democrats, just congenitally, tend to get to see the glass as half empty. (Laughter.) If we get an historic health care bill passed oh, well, the public option wasn't there. [...] And gosh, we haven't yet brought about world peace and (laughter.) I thought that was going to happen quicker. (Laughter.)"
This is of course, terrible politics. Ridiculing your base when you're at you're most vulnerable right before the midterms in your first term is just criminally stupid.
But even leaving that aside, Obama's chosen poor issues to flog liberals with. He's unfortunately highlighted areas where the administration has lost the center.
The health care bill is unpopular. And it's not unpopular because of the "professional left." It's unpopular because people really hate insurance companies and they're now being forced to buy their shitty product, which they can't afford. The public option, which was a workaround that problem, had broad, popular support not just among glass-half-empty liberals. Doesn't take a genius to figure out what happened.
As for mocking the idea of "world peace" again, this is an area where the White House has lost the middle. The President's choice to double-down in Afghanistan is deeply unpopular. Unless you think 57% of the country are pacifist peaceniks, it's absurd to blame "Democrats" for the fact that your central national security initiative is failing with the public.
Americans simply don't like health care reform and they don't like the war. By using these two to chastise liberals, the President is also wagging his finger at the majority of the country.
Pre-Existing Condition Insurance Plan Out of Reach
Friday September 17, 2010
I don't think the site has addressed this in a while, but the new Preexisting Condition Insurance Plan has been rolled out across the country now, and the more I look into it, the more I think this is emblematic of everything that was wrong with Obama's health care reform bill. Remember, this is the temporary high risk pool to act as a holdover until the exchanges kick in in 2014. I had high hopes for this, as my Mother is a 61 year old widow who has low income but is too young for Medicare and who we (my brother and I) have been paying $1,000+/mo for Anthem Blue Cross individual market insurance for the last three years to keep her insured. I thought the new high risk plan was going to be standardized with a 4-1 age ratio and also "affordable" for people who cannot get affordable coverage in the individual market. I looked up the rates for California where she lives, and her premium will be $799/mo with no subsidy under the new plan . Meanwhile, the premium for a child under 15 is $142/mo how is that 4-1? How is that even remotely affordable?
Instead of imposing a unified structure with standardized rates, the bill gave extreme leeway for each State to set up its own program using private contractors guided only by very loose language regarding premiums and coverage structure. This has resulted in some states charging $600/mo for 60+ and areas of California charging $800 or more.
I'm so dejected at this point. I had such high hopes for this program and I feel like I've been kicked in the stomach. I cheered this bill, telling my brother, "help is on the way," and soon we will be able to get coverage at a more reasonable rate compared to the way Anthem was ripping us off. We just can't afford to pay $800+ per month in health insurance when we are already completely financially supporting our Mother. You mean to tell me that all this bill is going to save us for the next 4 years is 200 bucks a month? That we still have to pay 800/mo not including cost sharing? My Mom doesn't even have a super-serious preexisting condition she doesn't have cancer, hasn't had any debilitating illnesses. She is a smoker who gets episodic panic attacks.
I know there are lots of horror stories worse than this, but this type of disappointment is going to keep happening as each new element of this bill is rolled out. When 2014 hits and the means-tested subsidized rates are still going to be unaffordable for anyone but the poorest of the poor, the bill's popularity will continue to tank.
And they wonder why there is an enthusiasm gap!
The Half-Empty Glass: Connecticut Insurance Rates Soar to Pay For Health Care Bill Provisions
Monday September 20, 2010
I still can't quite wrap my head around the fact that Obama thought it was a good idea, in midst of 9.6% unemployment, and on the day after the census bureau announces that 1 in 7 Americans are living in poverty, to show up at the gated Connecticut mansion of a guy named Rich Richman and tell a privileged few at a private $30,000 a plate fundraiser that people who see their glass "half empty" are pessimists and that the health care bill represents "the most productive, progressive legislative session in at least a generation."
The people in Connecticut who couldn't afford $30,000 to attend an event that raised $1 million for the DNC might not see it that way:
Sept. 19 Connecticut regulators in recent days approved increases of more than 20 percent on some health plans starting Oct. 1, including a series of rates requested by Anthem Blue Cross & Blue Shield, by far the largest health insurer in the state...
The higher prices, however, are a glimpse of what may be in store later this year when insurers propose new rates for 2011.
The major difference between rising prices this year and years past is the cost of new benefits added to health plans starting Thursday as mandated by the sweeping reform approved by Congress in March.
Insurers say the cost of new benefits will increase prices more than 20 percent for certain plans.
When Obama was selling his health care plan to the public on June 22, 2010, he said that the changes mandated by the health care bill this year meant that people would be seeing benefits immediately:
[S]tarting in September, some of the worst abuses will be banned forever. No more discriminating against children with preexisting conditions. No more retroactively dropping somebody's policy when they get sick if they made an unintentional mistake on an application. No more lifetime limits or restrictive annual limits on coverage. Those days are over.
He also said "we've got to make sure that this new law is not being used as an excuse to simply drive up costs."
But that's exactly what's happening in Connecticut.
Anthem Blue Cross Blue Shield, the largest insurer in Connecticut, has already requested and received increases on individual market plans to cover the cost of new benefits mandated by the health care bill that start this year:
4.8% increase related to the mandate about pre-existing conditions for children
up to 8.5% increases for mandated preventive care with no deductibles
Anthem has also said that removing annual spending caps would cause the cost of individual market plans to "rise by as much as 22.9 percent."
Obama, the Urban Institute and others were relying on estimates made by the Department of Labor that were used to calculate the impact of the health care bill's 2010 mandates:
Removal of annual spending caps: "The Departments estimate that the transfer would be three-quarters of a percent or less for lifetime limits and one-tenth of a percent or less for annual limits, under a situation of pure community rating where all the costs get spread across the insured population."
Mandates for preventive care: "There will likely be negligible transfers due to this provision given no changes in coverage or cost-sharing."
Coverage for children with preexisting conditions: "Even in States with community rating, the cost and transfer effects will be relatively small, at most a few tenths of a percent over the next few years."
But Connecticut isn't the only place this is happening. As the Wall Street Journal reported last week, the health care bill is being used as an excuse by insurance companies to jack up rates all across the country.
It's clear that the rate increases are far in excess of what these reform provisions actually cost. And there is nothing in the health care bill that stops them from doing so. In a free market, other insurance companies would be able to enter the market and provide a better product at a lower price. But health insurance companies are exempt from anti-trust regulation, and can legally operate as monopolies and engage in monopolistic practices. The health care bill did nothing to stop that.
That's why the people Obama now mocks wanted a public option. If the government is going to assign its right to collect taxes to private companies (which is what they did when they passed the mandate), and allow the IRS to be used as an enforcement mechanism, people wanted to feel like there was an alternative. Faced with looming rate increases far in excess of anything they were told when the bill was being sold to them, in the wake of rising economic insecurity and high unemployment, people are justifiably anxious.
Single mother Susie Madrack explains why people like her found Obama's comments upsetting:
[T]hose of us left living on a wing and prayer thanks to your "half full," half-assed economic policies just don't have a sense of humor about our continuing plight. I know it's been a long time since your mom got food stamps, but you might want to give that empathy thing some thought."
The usual suspects are cheering Obama's comments, including the American Prospect, who call them "justified mockery." But those who enjoy a "subsidized existence vomiting up flabby consensus received opinions within the federal zone" generally aren't the working class single moms who have to worry about things like rising health insurance premiums. So it's no surprise they wouldn't understand why someone might feel their glass is "half empty" these days.
Big health insurers to stop selling new child-only policies
Anthem Blue Cross, Aetna Inc. and others say they will make the move as soon as Thursday when parts of the new healthcare law take effect. They cite potentially huge and unexpected costs for insuring children.
Duke Helfand, Los Angeles Times
September 21, 2010
Major health insurance companies in California and other states have decided to stop selling policies for children rather than comply with a new federal healthcare law that bars them from rejecting youngsters with preexisting medical conditions.
Anthem Blue Cross, Aetna Inc. and others will halt new child-only policies in California, Illinois, Florida, Connecticut and elsewhere as early as Thursday when provisions of the nation's new healthcare law take effect, including a requirement that insurers cover children under age 19 regardless of their health histories.
The action will apply only to new coverage sought for children and not to existing child-only plans, family policies or insurance provided to youngsters through their parents' employers. An estimated 80,000 California children currently without insurance and as many as 500,000 nationwide would be affected, according to experts.
Insurers said they were acting because the new federal requirement could create huge and unexpected costs for covering children. They said the rule might prompt parents to buy policies only after their kids became sick, producing a glut of ill youngsters to insure. As a result, they said, many companies would flee the marketplace, leaving behind a handful to shoulder a huge financial burden.
The insurers said they now sell relatively few child-only policies, and thus the changes will have a small effect on families.
"Unfortunately, this has created an un-level competitive environment," Anthem Blue Cross, California's largest for-profit insurer, said in a statement declaring its intention to "suspend the sale of child-only policies" on Thursday, six months after the healthcare overhaul was signed.
The change has angered lawmakers, regulators and healthcare advocates, who say it will force more families to enroll in already strained public insurance programs such as Medi-Cal for the poor in California.
The White House weighed in Tuesday, condemning Anthem corporate parent WellPoint Inc. and others that plan to stop selling child-only policies.
"It's obviously very unfortunate that insurance companies continue to make decisions on the backs of children and families that need their help," White House Press Secretary Robert Gibbs said at a news briefing.
The Obama administration had told insurers they could solve the problem by issuing policies only during designated enrollment periods. Some White House officials, however, noted that families who can't find policies might be able to sign up for high-risk pools being set up around the country as part of the new healthcare law.
In California, the stakes may be particularly high for insurers who abandon child-only policies. A bill awaiting Gov. Arnold Schwarzenegger's signature would bar such companies from selling insurance in the lucrative individual market for five years. A Schwarzenegger spokeswoman said the governor had not yet taken a position on the measure.
Assemblyman Mike Feuer (D- Los Angeles), the bill's author, voiced frustration over the insurers' plans and singled out Anthem Blue Cross, whose corporate parent notified brokers nationwide Friday of its decision to exit the child-only business in 10 states, including Colorado, Connecticut, Missouri, Nevada and Georgia as well as California.
"At a time when we are launching a national approach to ensure that all children have access to healthcare, Anthem's actions represent a step backwards," Feuer said. "By threatening to drop child-only policies in California, the company jeopardizes the health of families and children. I call on Anthem to reconsider its plan."
Other regional and national insurers also plan to stop selling insurance policies exclusively for children. Among the companies is UnitedHealth Group Inc., the nation's largest insurer by revenue. It did not say which states would be affected.
"We continue to believe that regulations can be structured that will enable child-only plans to be offered, and we are working toward that goal," spokesman Tyler Mason said.
Aetna said that effective Oct. 1 it would no longer offer policies in the 32 states where it conducts business, including California, Florida, Illinois, Virginia and Pennsylvania.
Cigna Corp. will halt the policies in 10 states, including California, Arizona, Colorado, Tennessee and Texas.
"We made a decision to stop offering child-only policies to ensure that we can remain competitive in the 10 markets where we sell individual and family plans," Cigna spokeswoman Gwyn Dilday said. "We'll continue to evaluate this policy and could reconsider changing this position as market dynamics change."
The explanations left healthcare advocates fuming. They accused insurers of trying to skirt the law's new requirement to cover children with health problems.
"Insurers need to decide if they are in the business of providing care or denying coverage," said Anthony Wright, executive director of Health Access California, a consumer group. "In California, we hope our insurers come to an equitable compromise that allows access for all children and affordability for those with preexisting conditions."
In Colorado, regulators and insurance carriers are trying to work out such a compromise. The state's insurance commissioner met Friday with several insurers, including Anthem, Cigna and Aetna. The two sides did not reach an agreement, but officials remain hopeful they can broker a deal before Thursday.
"Obviously this deadline looms large," said Jo Donlin, director of external affairs for the Colorado Division of Insurance. "The commissioner wants families to have access to the insurance they need. Both sides of this want to find a solution."
Noam N. Levey in the Washington bureau contributed to this report.
- Please send as far and wide as possible. Thanks, Robert Sterling Editor, The Konformist http://www.konformist.com http://robalini.blogspot.comMessage 3 of 4 , Sep 17, 2012View SourcePlease send as far and wide as possible.
Editor, The Konformist
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Obamacare Constitutional but Still Sucks
Robert Sterling, Konformist.com
In a last minute reversal by Chief Justice John Roberts, Obamacare was ruled constitutional by the Supreme Court. It is important to note that in upholding the law, the Supremes rejected the usage of the Commerce Clause to justify the individual mandate, which is a victory for those who found such an argument to be insidious. Obviously, include myself in that group.
The claim that mere existence made one involved in commerce (which was central to the Commerce Clause argument) had no historical precedent, as even judges who had previously upheld the law had agreed in unanimty. Even worse, any precedent that was even close to this was one that no self-respecting progressive should ever embrace. (The most notable precedent being written by Antonin Scalia, where he argued that due to the Commerce Clause, the War on Drugs trumps the power of states to legalize marijuana for medicinal purposes.) It was disappointing to see so many so-called liberals, in their desperation to defend Obamacare, to be totally oblivious and dismissive of such concerns. It shouldn't be surprising, as in the last four years what has passed for liberalism has bottomed out to merely mean being a pathetic shill for Barack Obama rather than represent any coherent philosophy.
Of course, that Obamacare is constitutional should be the minimum standards one should expect for a law. (Alas, in the age of torture and the Patriot Act, such minimum standards is increasingly becoming a norm.) Another standard is how popular it is with the public. On this score, Obamacare has been a major flop since its inception. A June 2012 NY Times/CBS News poll before the Supreme Court ruling underscored this: 41 percent of all polled believed the entire law should be overturned, while 27 percent wanted an overturn of the mandate. Only 24 percent wanted the law to be upheld. This was despite a relentless push by the White House, Democratic Party and the media establishment to sell the public on the law as some sort of progressive victory. While there was a slight increase in approval of Obamacare after the ruling (a bump that is normal in terms of how polling goes) the general trend on Obamacare is unpopular with a bullet downward.
That Obamacare is unpopular shouldn't be too surprising, and I for one am someone who warned of this when the law passed. And the establishment liberal response to this unpopularity, merely dismissing the opposition to ignorant dupes, is not only false but highly insulting to voters. In this case, the public rightfully smells a loser here. While Obamacare is sold as a progressive law, all its origins come from from right-wing think tanks, and its premises are all based on snide contempt for the poor and working class. It's solutions are based on slashing funds to Medicare (a fact which proves the widely mocked "death panels" cry to be not completely off-base) and the individual mandate is based on the premise that poor young people are somehow cheating the system by not purchasing health insurance they can't afford. It is a Marie Antoinette solution to our health care crisis, except cake is a lot cheaper and not manufactured by parasitic oligopolies that rip off its customers at every opportunity. (The opportunities, thanks to Obamacare, will soon radically increase.) The worst thing about Obamacare isn't Obamacare itself, which I assume will eventually fail and die due to its fundamental flaws. The worst thing about Obamacare is whenever a real progressive reform is ever proposed in the future, it will be called Obamacare II, and it will be that much harder for it to pass. Sadly, any such skepticism will be deserved, as the liberal apologism for the reactionary law known as Obamacare should rightfully discredit any supporters further arguments on the issue of health care.
Poll URL source:
John Roberts, evil genius
ROBERT E. MALCHMAN
Chief Justice John G. Roberts is an evil genius. The ruling to uphold the Affordable Care Act is, on its face, a win for President Obama both because the media are saying it is and because it is the signature piece of legislation of his first term. But it may turn out to be a pyrrhic victory, as Roberts accomplished numerous, subtle victories for conservative Republicans.
First, remember that "Obamacare" and the individual mandate started out as a proposal from the conservative Heritage Foundation as a counterproposal to the Clinton administration's health care plan. The only reasons Republicans are now opposed to it is because Obama proposed it and is getting credit for it. Before it was Obamacare, the program was known as Romneycare in Massachusetts and if the 2008 election had gone the other way, it might be known as McCaincare today.
Meantime, the survival of the Affordable Care Act eliminates any clamor for real, progressive health care reform, whether universal Medicare or for the creation of a public insurance option. Such programs are anathema to conservatives who want most things privatized either for ideological reasons or so that their corporate masters can further enrich themselves.
The effect of the law will be to drive millions of people to buy insurance from insurance companies in many cases with federally subsidized funds, lining the pockets of those corporations with the public's money. Is it any surprise that health care stocks were surging in the wake of the ruling?
MLRs: Obamacare Silver Lining
Let's give Obamacare credit where it does deserve some: with the inclusion in the law of Medical Loss Ratio. From NBC News:
Affordable Care Act means $1.1 billion insurance rebate
Herb Weisbaum, The ConsumerMan
The nation's health insurance companies will refund approximately $1.1 billion to their customers this summer. It's one of the new benefits of the health care reform law.
The U.S. Health and Human Services Department expects 12.8 million Americans to get some of this money although in the majority of cases that refund will be sent to employers.
Under the Affordable Care Act, health insurance companies are required to disclose how much of your premium dollar they actually spend on health care and how much they spend on administration, such as salaries and marketing. In the past, consumers did not have a right to this information.
But here's the real game-changer: The 80/20 rule. If the insurance company spends less than 80 percent of premiums on medical care it must rebate the excess. For large group plans (the kind provided by companies that employ 50 people or more), health insurance companies must spend 85 percent of the premiums on medical care...
The new law also requires health insurance companies to tell customers whether they hit, exceeded or missed the 80/20 mark. If they missed the goal, they must say by how much and what percentage of your premium will be rebated. This new transparency is unprecedented...
Health and Human Services says it expects the average rebate for a family that buys its own insurance to be $151. The states with the highest average rebates per family in the individual market are: Mississippi ($651), Alabama ($582), Maryland ($496), Delaware ($461) and West Virginia ($383). The average rebate in the individual insurance market is zero for families in Arkansas, Hawaii, Iowa, Maine, New Mexico, Rhode Island and Vermont...
The bottom line:
The new 80/20 rule is a major step forward in making health insurance companies responsible to their policy holders. It is hoped it will motivate insurers to lower prices and/or improve their coverage to meet the new standard.
So what about this summer's rebates? Any way you look at it, a billion dollars is a lot of money. But it won't solve the problem of skyrocketing medical bills. It's just a drop in the bucket...