Everything you need to know about the plans to ‘fix’ Obamacare

http://www.washingtonpost.com/blogs/wonkblog/wp/2013/11/14/everything-you-need-to-know-about-the-plans-to-fix-obamacare/?tid=pm_business_pop

The Republican Party's play is Fred Upton's "Keep Your Health Plan Act." The law is poorly named: It doesn't actually guarantee that you can keep your health care. Instead, it allows insurers to keep offering their current plans and also allows them to offer new plans that aren't ACA compliant.
At a slim 235 words, Upton's bill is a master class in the pitfalls of soundbite legislation. It manages to fail to solve the problem it's actually aimed at while creating a new political problem — this time, for Republicans.
The bill gives insurers the option of renewing their cancelled plans — but, crucially, it doesn't require them to do so. Few insurers want to renew those plans, as they don't expect them to be profitable in a post-Obamacare world. So Upton's bill doesn't mean people can keep their current health insurance, but it means they can begin (wrongly) blaming their health insurer rather than the Obama administration for the cancellation of that insurance.
Meanwhile, Upton's bill has a secondary provision allowing insurers to offer new plans in 2014 that don't comply with the Affordable Care Act's consumer protections. So if an insurer wants to continue turning people away for being sick, they can go right ahead. If they want to offer shoddy coverage that'll evaporate the moment a health crisis strikes, that's their prerogative. The result is that Upton guts the law's extremely popular insurance regulations. "A vote for the Upton bill, in short, is a vote for everything Americans say they hate about their health-care system," Jon Cohn writes.
Boehner is already telling Republicans that Upton's bill is a step towards repeal. That'll help it get Democratic votes.
Bottom line: Upton's bill doesn't solve the cancellations problem but it does manage to put Republicans on the side of insurers who want to continue discriminating against preexisting conditions. It also has no chance of passing the Senate.
Sen. Mary Landrieu's "Keeping the Affordable Care Act's Promise Act"
Landrieu's "Keeping the Affordable Care Act's Promise Act" essentially requires insurers to continue offering the plans they intended to cancel. So it actually does solve the problem of cancellations. At the same time, since it wants to move people into the insurance exchanges eventually, it demands that insurers send an annual letter to enrollees explaining why their plan doesn't meet Obamacare's standards.
"Many people may choose to sign up for plans on the exchanges once they have this information and know their options," says a Landrieu staffer. "But because no new people could sign up for these grandfathered plans, and over time grandfathered policyholders will likely seek better value and more comprehensive coverage, the number of grandfathered plans would decrease."
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The hope, in essence, is that the plans end up withering on the vine. But that hope may or may not pan out. In the meantime, premiums in Obamacare's exchanges will rise, as millions of mostly healthy people who would've migrated into the system remain in their old plans.
"I think it would be a real substantive mistake to do the Landrieu bill," says MIT health economist Jon Gruber, a supporter of the Affordable Care Act.
Sen. Mark Udall's "Continuous Coverage Act"
Udall's bill basically works like Landrieu's bill, but it only runs for two years. The idea is to give the Affordable Care Act time to get up and running before unwinding anyone's current plan. But unlike Landrieu, the idea is that once the Affordable Care Act is up and running, those plans should be unwound, whether people like it or not.
An upside to Udall's bill is that it ends before the Affordable Care Act's death-spiral protections end. So whatever temporary increases in premiums Udall's bill causes will be blunted by the law's protections, and then those increases will end before the protections do.
A downside, of course, is that the two-year extension could easily be renewed.
President Obama's plan
The White House has its own idea to stop the bleeding: Allow insurers to renew existing plans in 2014 (which means they could continue into 2015) while forcing them to send Landrieu-like letters explaining why their plans don't conform to the Affordable Care Act's standards.
This doesn't really ensure anyone can actually keep their plan — which means it also doesn't affect premiums in the exchanges. But it makes it easier for Democrats to blame insurers for canceling these plans. And it perhaps makes it easier for the White House to stop congressional Democrats from signing onto something like Landrieu or Udall.
The insurance industry is furious. They've been working with the White House to get HealthCare.Gov up and running and they've been devoting countless man hours to dealing with the problems and they've been taking the heat from their customers over canceled plans, and now the Obama administration wants to make them into a scapegoat.
“This doesn’t change anything other than force insurers to be the political flack jackets for the administration,” an insurance industry insider told Evan McMorris-Santoro. “So now, when we don't offer these policies, the White House can say it’s the insurers doing this and not being flexible.”
The question here is whether it's a good idea for the White House to enrage insurers whose cooperation it needs to fix HealthCare.Gov.
Fix the Web site
Of course, behind all this sits a fix that might actually solve a lot of the problems without creating any new ones: Fixing HealthCare.Gov. A working Web site would mean people getting cancellations could see if they could get a better deal in the marketplace — and many of them can. A working Web site would create a flood of winners who could get their stories into the media and ratchet down the pressure on congressional Democrats. And a working Web site would restore some of the congressional Democrats' faith in the Obama administration and give them reason to resist passing any laws that could undermine the now-functional law.

at work today while I was busy earning some tax dollars for all those other poor people. I heard Obama on the news saying that he was allowing insurance companies to extend peoples plans for a year.

so what your saying is you hate that idea?

or are you ok with the idea and want to make sure that republicans get no kudos for at least trying to stave off a rather difficult situation for MILLIONS of Americans created solely by DEMOCRATS?

Chrissy wrote:at work today while I was busy earning some tax dollars for all those other poor people. I heard Obama on the news saying that he was allowing insurance companies to extend peoples plans for a year.

so what your saying is you hate that idea?

or are you ok with the idea and want to make sure that republicans get no kudos for at least trying to stave off a rather difficult situation for MILLIONS of Americans created solely by DEMOCRATS?

********************************************************

Republicans getting kudos? OMG, you are in denial or just are not serious Chrissy. They are the same group who done nothing but impede, obstruct and deny without ever offering an alternative . . . that is pathetic.

knothead wrote:

Chrissy wrote:at work today while I was busy earning some tax dollars for all those other poor people. I heard Obama on the news saying that he was allowing insurance companies to extend peoples plans for a year.

so what your saying is you hate that idea?

or are you ok with the idea and want to make sure that republicans get no kudos for at least trying to stave off a rather difficult situation for MILLIONS of Americans created solely by DEMOCRATS?

********************************************************

Republicans getting kudos? OMG, you are in denial or just are not serious Chrissy.  They are the same group who done nothing but impede, obstruct and deny without ever offering an alternative . . . that is pathetic.

There were alternatives offered.  Maybe you were just too busy believing everything Obama told you. 

http://healthpolicyandmarket.blogspot.com/2007/10/analysis-of-senator-john-mccains-health.html

http://www.kaiserhealthnews.org/stories/2009/november/03/republican-health-bill.aspx

It seems to be in a death spiral at the cost of billion's of dollars.

knothead wrote:

Chrissy wrote:at work today while I was busy earning some tax dollars for all those other poor people. I heard Obama on the news saying that he was allowing insurance companies to extend peoples plans for a year.

so what your saying is you hate that idea?

or are you ok with the idea and want to make sure that republicans get no kudos for at least trying to stave off a rather difficult situation for MILLIONS of Americans created solely by DEMOCRATS?

********************************************************

Republicans getting kudos? OMG, you are in denial or just are not serious Chrissy.  They are the same group who done nothing but impede, obstruct and deny without ever offering an alternative . . . that is pathetic.

I ask you a question knot. can you answer it?

do you support the "keep your healthcare plan act"?

are you confused?

We've gotten a small look at the mix. If it continues that medicaid outpaces sign ups 4:1 the reality may wake some up.

That doesn't even take into account the subsidized or the displaced from other plans... or sadly those who lost coverage.

I hope the web site is fixed very soon... I want to see unadulterated and clear results... fall where they may.

knothead,  

Here's the part that you and the other supporters of the ACA don't understand.  It's not possible to force the insurance companies to insure everyone with a pre-existing condition without drastic increases in premiums for all. Insurance companies (just like every other private enterprise) have to make a profit in order to stay in business.  It's no different than calling the car insurance company and saying I just wrecked my car and I can't afford the $3000 the mechanic wants to fix it so I want to purchase an insurance policy for $50 per month and let the insurance company pay the repair bill. That's not how insurance works.  I know you don't think that is fair and that the insurance companies are evil, but that's the reality of how business works.  

Think for a minute where most of us would be without the insurance company.  Where else could you pay a $600 premium today...have a heart attack tomorrow...get bypass surgery...spend a few days in the hospital....have $100,000 of hospital, doctor and lab fees...and have the insurance company pay the bill?  For the vast majority of people that's how the system works.  Do we need to find additional ways to find care for those that can't qualify for health insurance?  Of course we do.  But not by destroying a system that works for the majority of Americans.

I mentioned in an earlier post on a different thread that what we have today is not health insurance.  Instead, we have what I call health maintenance contracts.  The purpose of insurance is to help mitigate risks of relatively rare but expensive events.  Just as your car insurance policy doesn't pay for new windshield wipers or oil changes, health insurance shouldn't pay for things like high blood pressure pills, birth control pills, blood tests and physicals.  I believe that if people had to pay out of pocket for their high blood pressure pills they would probably take better care of themselves.  Plus the health insurance policies would be a lot less expensive.  

In my opinion, the ACA was created by a bunch of academic types that have no real understanding of insurance and certainly no understanding of what it takes to operate a for profit business.  That little conspiracy theory guy that lives way in the back of my head keeps telling me that the ACA was really designed to fail so that we could get to a single payer system.  But I'm sure he's wrong about that.   Anyway, I am convinced that we haven't begun to see the worst of the ACA.  The problem with the website is just a distraction compared to what's going to happen when they try to transition the group policies to Obamacare.

Stepping down from the soapbox...

do you support the "keep your healthcare plan act"?

are you confused?


Sorry Chrissy I wasn't ignoring you at all but just came back to read your inquiry . . . confused? Of course, we all are to a degree. I posted this article to give all sides and the political gamesmanship underway to seek the best next steps. Do I support the "Keep your healthcare plan act"? Absolutely, I support Sen. Udall's version to create some time and space obviously needed in lieu of Mary Landrieu's bill.

bizguy wrote:knothead,  

Here's the part that you and the other supporters of the ACA don't understand.  It's not possible to force the insurance companies to insure everyone with a pre-existing condition without drastic increases in premiums for all. Insurance companies (just like every other private enterprise) have to make a profit in order to stay in business.  It's no different than calling the car insurance company and saying I just wrecked my car and I can't afford the $3000 the mechanic wants to fix it so I want to purchase an insurance policy for $50 per month and let the insurance company pay the repair bill. That's not how insurance works.  I know you don't think that is fair and that the insurance companies are evil, but that's the reality of how business works.  

Think for a minute where most of us would be without the insurance company.  Where else could you pay a $600 premium today...have a heart attack tomorrow...get bypass surgery...spend a few days in the hospital....have $100,000 of hospital, doctor and lab fees...and have the insurance company pay the bill?  For the vast majority of people that's how the system works.  Do we need to find additional ways to find care for those that can't qualify for health insurance?  Of course we do.  But not by destroying a system that works for the majority of Americans.

I mentioned in an earlier post on a different thread that what we have today is not health insurance.  Instead, we have what I call health maintenance contracts.  The purpose of insurance is to help mitigate risks of relatively rare but expensive events.  Just as your car insurance policy doesn't pay for new windshield wipers or oil changes, health insurance shouldn't pay for things like high blood pressure pills, birth control pills, blood tests and physicals.  I believe that if people had to pay out of pocket for their high blood pressure pills they would probably take better care of themselves.  Plus the health insurance policies would be a lot less expensive.  

In my opinion, the ACA was created by a bunch of academic types that have no real understanding of insurance and certainly no understanding of what it takes to operate a for profit business.  That little conspiracy theory guy that lives way in the back of my head keeps telling me that the ACA was really designed to fail so that we could get to a single payer system.  But I'm sure he's wrong about that.   Anyway, I am convinced that we haven't begun to see the worst of the ACA.  The problem with the website is just a distraction compared to what's going to happen when they try to transition the group policies to Obamacare.

Stepping down from the soapbox...

Climb back up..... 

The health maintenance we now have ia a direct result of Hillarycare. HMO is a system that dictates to the patients, physicians, and hospitals what they medically can and can not do. If you do not follow the insurance recommendations and guidelines they will not pay for services rendered, they can and do drop physicians from their network, and will drop hospitals if they do not comply. Insurance companies retain physicians, on their payroll, to dispute and deny medically recommended treatments. There ia also a clause....if the insurance physicians is wrong...they can not be held accountable.

Insurance /HMO's dictate to physicians, ancillary services, and hospitals the amount they will pay for services rendered. In order to be a provider.....health care facilities and physicians must agree to the charges set by the insurance  company. They have to have prior approval for tests, procedures, and admissions. Due to the large number of patients insured.....hospitals and physicians either agree or lose a huge patient data base.


The problem with healthcare is and has been insurance. We need to surgically remove the hand of the insurance company from our collective balls.

knothead wrote:http://www.washingtonpost.com/blogs/wonkblog/wp/2013/11/14/everything-you-need-to-know-about-the-plans-to-fix-obamacare/?tid=pm_business_pop

Knothead, here is everything you really need to know about the pathetic effort to resurrect ObamaCare.

knothead wrote:do you support the "keep your healthcare plan act"?

are you confused?


Sorry Chrissy I wasn't ignoring you at all but just came back to read your inquiry . . . confused? Of course, we all are to a degree.  I posted this article to give all sides and the political gamesmanship underway to seek the best next steps.  Do I support the "Keep your healthcare plan act"? Absolutely, I support Sen. Udall's version to create some time and space obviously needed in lieu of Mary Landrieu's bill.

of course you do as long as it doesn't include any republicans in the picture, you know because those republicans are not even offering any ideas, they are just stalling and impeding. and they created the keep your health plan act.

you don't care about people, you only care about politics just like the dear leader.

[quote="Joanimaroni"]
Climb back up..... 

The health maintenance we now have ia a direct result of Hillarycare. HMO is a system that dictates to the patients, physicians, and hospitals what they medically can and can not do. If you do not follow the insurance recommendations and guidelines they will not pay for services rendered, they can and do drop physicians from their network, and will drop hospitals if they do not comply. Insurance companies retain physicians, on their payroll, to dispute and deny medically recommended treatments. There ia also a clause....if the insurance physicians is wrong...they can not be held accountable.


I'm up...I have a different take.  HMO's have been around since way before Hillarycare.  The Health Maintenance Organization Act was signed in the early 1970's.  However, when I used the term health maintenance contracts I was not referring to an HMO type plan.  I'm talking about how the industry has changed from true insurance to plans that pay benefits for simple things like a runny nose or a cough.  My point is that your health insurance plan should not pay for these things...just as your car insurance policy doesn't pay for oil changes.  

Insurance /HMO's dictate to physicians, ancillary services, and hospitals the amount they will pay for services rendered. In order to be a provider.....health care facilities and physicians must agree to the charges set by the insurance  company. They have to have prior approval for tests, procedures, and admissions. Due to the large number of patients insured.....hospitals and physicians either agree or lose a huge patient data base.


HMO's don't dictate prices, they negotiate prices in an effort to reduce costs.  That's just prudent business practice.  He who pays makes the rules.  

The problem with healthcare is and has been insurance. We need to surgically remove the hand of the insurance company from our collective balls.

When we need them we ask the insurance company to pay out significantly more in claims than we pay in premiums.  Then we get mad because the contract that we agreed to has terms and conditions.  To continue with the anatomy analogy...I think we need to ween ourselves off the teat of the insurance company by going back to true insurance coverage for relatively rare but expensive events.  Going to see a doctor because you have a cold or flu should not be an event that involves the insurance company.  That should be a transaction between you and the doctor and paid for at the time of service.  That would greatly reduce the operating expenses of the doctor and in turn reduce the cost of the office visit.  If I have the flu or cut my hand and need a few stitches I can go to a clinic in Gulf Breeze and pay $50 to be seen.  For those that can't afford it, there are free clinics operated by charitable organizations that will provide free medical and dental care.  Interfaith ministries operates a free clinic in the Gulf Breeze area that treats about 4000 patients a year and doesn't charge them anything.

http://www.cms.gov/CCIIO/Resources/Letters/Downloads/commissioner-letter-11-14-2013.PDF


Yep, bizguy is right HMO's were around long before Hillary. But they do dictate prices, (capitation) and very restrictive. I have seen more procedure's denied under an HMO than a PPO, in fact I don't believe I have ever personally seen any denied on a PPO.

While I agree insurance should go back to the old days and you pay for minor things I don't think the docs would go back to the old days with their prices.

http://www.washingtonpost.com/opinions/charles-krauthammer-why-liberals-are-panicked-about-obamacare/2013/11/14/bd2e9834-4d6f-11e3-be6b-d3d28122e6d4_print.html



Why liberals are panicked about Obamacare


By Charles Krauthammer, Published: November 14
“Even if it takes a change to the law, the president should honor the commitment the federal government made to those people and let them keep what they got.”
— Bill Clinton, Nov. 12

So the former president asserts that the current president continues to dishonor his “you like your plan, you can keep your plan” pledge. And calls for the Affordable Care Act to be changed, despite furious White House resistance to the very idea.
Coming from the dean of the Democratic Party, this one line marked the breaching of the dam. It legitimized the brewing rebellion of panicked Democrats against Obamacare. Within hours, that rebellion went loudly public. By Thursday, President Obama had been forced into a rear-guard holding action, asking insurers to grant a one-year extension of current plans.
The damage to the Obama presidency, however, is already done. His approval rating has fallen to 39 percent, his lowest ever. And, for the first time, a majority considers him untrustworthy. That bond is not easily repaired.
At stake, however, is more than the fate of one presidency or of the current Democratic majority in the Senate. At stake is the new, more ambitious, social-democratic brand of American liberalism introduced by Obama, of which Obamacare is both symbol and concrete embodiment.
Precisely when the GOP was returning to a more constitutionalist conservatism committed to reforming, restructuring and reining in the welfare state (see, for example, the Paul Ryan Medicare reform passed by House Republicans with near-unanimity), Obama offered a transformational liberalism designed to expand the role of government, enlarge the welfare state and create yet more new entitlements (see, for example, his call for universal preschool in his most recent State of the Union address).
The centerpiece of this vision is, of course, Obamacare, the most sweeping social reform in the past half-century, affecting one-sixth of the economy and directly touching the most vital area of life of every citizen.
As the only socially transformational legislation in modern American history to be enacted on a straight party-line vote, Obamacare is wholly owned by the Democrats. Its unraveling would catastrophically undermine their underlying ideology of ever-expansive central government providing cradle-to-grave care for an ever-grateful citizenry.
For four years, this debate has been theoretical. Now it’s real. And for Democrats, it’s a disaster.
It begins with the bungled rollout. If Washington can’t even do the Web site — the literal portal to this brave new world — how does it propose to regulate the vast ecosystem of American medicine?
Beyond the competence issue is the arrogance. Five million freely chosen, freely purchased, freely renewed health-care plans are summarily canceled. Why? Because they don’t meet some arbitrary standard set by the experts in Washington.
For all his news conference gyrations about not deliberately deceiving people with his “if you like it” promise, the law Obama so triumphantly gave us allows you to keep your plan only if he likes it. This is life imitating comedy — that old line about a liberal being someone who doesn’t care what you do as long as it’s mandatory.
Lastly, deception. The essence of the entitlement state is government giving away free stuff. Hence Obamacare would provide insurance for 30 million uninsured, while giving everybody tons of free medical services — without adding “one dime to our deficits,” promised Obama.
This being inherently impossible, there had to be a catch. Now we know it: hidden subsidies. Toss millions of the insured off their plans and onto the Obamacare “exchanges,” where they would be forced into more expensive insurance packed with coverage they don’t want and don’t need — so that the overcharge can be used to subsidize others.
The reaction to the incompetence, arrogance and deception has ranged from ridicule to anger. But more is in jeopardy than just panicked congressional Democrats. This is the signature legislative achievement of the Obama presidency, the embodiment of his new entitlement-state liberalism. If Obamacare goes down, there will be little left of its underlying ideology.
Perhaps it won’t go down. Perhaps the Web portal hums beautifully on Nov. 30. Perhaps they’ll find a way to restore the canceled policies without wrecking the financial underpinning of the exchanges.
Perhaps. The more likely scenario, however, is that Obamacare does fail. It either fails politically, renounced by a wide consensus that includes a growing number of Democrats, or it succumbs to the financial complications (the insurance “death spiral”) of the very amendments desperately tacked on to save it.
If it does fail, the effect will be historic. Obamacare will take down with it more than Mary Landrieu and Co. It will discredit Obama’s new liberalism for years to come.

Read more from Charles Krauthammer’s archive, follow him on Twitter or subscribe to his updates on Facebook.

Well everyone is always in panic in D.C. nothing new here.

While I hope this get's overhauled I have seen many here locally get insurance that could not get it before because of uninsurable conditions this past week. In the past month it's has been you either get a subsidy or not. the not's do not even qualify for medicaid here in Florida or the other state's that did not expand medicaid, so I do not believe (since there are more states that did not) that more people are going into medicaid in this country because of it.

I think most everyone wants people to be able to get affordable insurance.  I saw Bob post on the other thread that you helped him get insurance.  I'm glad because I know he's been worried about it.

It's simply amazing that anyone is even attempting to try and defend Obama and the Dems in this fiasco.

Simply amazing.

How much Koolaid is needed?

stormwatch89 wrote:It's simply amazing that anyone is even attempting to try and defend Obama and the Dems in this fiasco.

Simply amazing.

How much Koolaid is needed?

After praising Obamacare for over 3 years and calling Republicans "haters of the working poor", what else can they do but defend it?

Of course,we needed reform. People with pre-existing conditions should be able to obtain affordable insurance.  But throwing the whole system out the window to help 5 or 10 percent of the population is and was insane!

Nekochan wrote:

stormwatch89 wrote:It's simply amazing that anyone is even attempting to try and defend Obama and the Dems in this fiasco.

Simply amazing.

How much Koolaid is needed?

After praising Obamacare for over 3 years and calling Republicans "haters of the working poor", what else can they do but defend it?

Of course,we needed reform. People with pre-existing conditions should be able to obtain affordable insurance.  But throwing the whole system out the window to help 5 or 10 percent of the population is and was insane!

I wish someone knew the true figure of one's with prex. I can truthfully say in 17 years that about 30% of any application's I have taken either were turned down, body parts excluded or rated up for conditions they were taking meds for. But then again the underwriting for the company I represent was one of the toughest in the industry. But at least they let you know up front and most other company's approved you and then when you had a claim would look back into your medical history to see if that could have existed before you received your policy.

If people knew more about the origin of the health ins corps and govt directives... they would be much less surprised that the system wound up as it did. We've simply arrived at a predictable conclusion. The morphing of govt and corp.

[quote="ppaca"]

Nekochan wrote:

stormwatch89 wrote:It's simply amazing that anyone is even attempting to try and defend Obama and the Dems in this fiasco.

Simply amazing.

How much Koolaid is needed?

After praising Obamacare for over 3 years and calling Republicans "haters of the working poor", what else can they do but defend it?

Of course,we needed reform. People with pre-existing conditions should be able to obtain affordable insurance.  But throwing the whole system out the window to help 5 or 10 percent of the population is and was insane!

I wish someone knew the true figure of one's with prex. I can truthfully say in 17 years that about 30% of any application's I have taken either were turned down, body parts excluded or rated up for conditions they were taking meds for. But then again the underwriting for the company I represent was one of the toughest in the industry. But at least they let you know up front and most other company's approved you and then when you had a claim would look back into your medical history to see if that could have existed before you received your policy.[/quote

I'm sure you know more than I about the issuance of policies and payment of claims, yet I'm quite sure adding Govt to the mix will only result in far worse conditions.

They do have a remarkable history of failure, especially under this "transparent and scandal free" administration.

[quote="Nekochan"]

stormwatch89 wrote:It's simply amazing that anyone is even attempting to try and defend Obama and the Dems in this fiasco.

Simply amazing.

How much Koolaid is needed?

After praising Obamacare for over 3 years and calling Republicans "haters of the working poor", what else can they do but defend it?

Of course,we needed reform. People with pre-existing conditions should be able to obtain affordable insurance.  But throwing the whole system out the window to help 5 or 10 percent of the population is and was insane![/quote

Well, Neko, I'm just glad they found such an abject failure for a President to push their progressive agenda.

His true colors are showing and no, I don't mean that racially........