Clarity on Obamacare.

I have to admit, I am not familiar with Obamacare at all. Personally, I don't give much thought to it. I am in a place where health care is given freely to the people, the people pay for it in taxes, most are quite happy with it as the cost is not unbearable and the pay off in return (accessible, convenient healthcare) is adequate.

I see Obamacare is a very touchy subject with people, most people hate it, can't see why. I am simply stating I am uninformed.

I see the government's position on it, and I see that it is mostly other government, and special interest groups that are vehemently against it. Which makes me wonder why people hate it so much, because usually when members of government, along with special interest hate something, it's actually good for people...

So I am curious if people could clear up what actually is going on, or what the real facts are on these bullet points... is the following true/false, is it actually good or bad for people, and why?

1. Expands healthcare coverage to 30 million uninsured Americans,
2. Requires many health insurance plans to cover prevention and wellness benefits with no co-pay or deductibles for 54 million Americans that have private insurance,
3. Eliminates the lifetime coverage limit for 105 million Americans already insured,
4. Gives 2.3 million elderly Medicare patients access to annual wellness checkups,
5. Provides prescription care “donut hole” coverage for 5.1 million seniors, and
6. Requires insurers to cover those with pre-existing conditions, including 17 million of the 74.9 million children ages 0-17 years old residing in the U.S.,

Most people only know about three portions of the law that have already gone into effect: 1. The part that closes the donut hole for prescription drug coverage;
2. The provision that has enabled 2.5 million kids up to the age of 26 to piggy back off their parents’ insurance; and,
3. The part which stops health insurers form denying coverage for children and other people with preexisting conditions.

Is the following true or false?

WHO BENEFITS FROM THE LAW:

Infants, Babies, Children and Teens: Under the Act, insurers cannot charge a co-pay for preventiative health services including immunizations, pediatrician visits, vision and hearing screenings, counseling to address childhood obesity, flu shots and other preventative health services for infants, children and adolescents. Also, low-income families whose children qualify for the Children’s Health Insurance Program, administered through States, can’t be cut until 2019 even if a state has a budget shortfall. The CHIP provides for doctor visits, emergency care, hospital care, vaccinations, prescription drugs, vision, hearing and dental care for babies, children and teenagers.

Nineteen to 26-year olds: About 24 million young people who have not been fortunate enough to secure a job that offers them health insurance will be able to remain on their parents’ health insurance.

Babies, children, and teens with pre-existing medical conditions: Kids who contracted a condition for six months before their parents tried to get medical coverage cannot be denied care based on that condition.

Families that already have insurance: New health plans will have to cover, without charge, a co-pay for adult preventative services such as annual check ups, breast and colon cancer screenings, screenings for vitamin deficiencies during pregnancy, high cholesterol, and high blood pressure. Smoking cessation programs are also covered.

Medicare patients: Free Annual Wellness visits: Beginning this year, those on Medicare will be able to get an annual checkup. As is known, it is during annual visits that many diseases and conditions are diagnosed. If caught early, treatment can extend a patient’s life and prevent an early death.

Small businesses: Small businesses are given a tax credit to offset costs of having to get health insurance for employees. This provides more incentive for companies to offer health care to more families. Approximately 6 million small businesses would qualify for the tax credit.

Early Retirees: Grandparents who may want to retire between the ages of 55 and 64 because of their age, illness or an interest in spending more time with their families would have the option of having their employers continue to cover them as part of a temporary reinsurance program. With most ailments and conditions on setting during advanced years, it would be a risk to go without insurance until Medicaid kicks in.

Uninsured adults with pre-existing conditions: Those suffering from chronic or depilating diseases or illnesses and cannot get insurance will be able to get heath care through a new program that starts this year. This coverage could help them live longer lives and give them more time to spend with their spouses and children rather than them having to live without getting treatment and risk deteriorating rapidly and eventually dying an early or untimely death.

Hospitals: Beginning in 2012, Centers for Medicare and Medicaid Services, which oversee the government programs, begin tracking hospital readmission rates and will put in place financial incentives to reduce preventable readmissions. The idea is to reward institutions for doing their best to treat people and keep them healthy versus providing the basic and minimal care only to have those same patients readmitted for the same or related causes.

Taxpayers: Beginning in 2013, the threshold for claiming medical expenses on itemized tax returns is raised to 10 percent from 7.5 percent of income though it would remain at 7.5 percent for the elderly through 2016.

(Cont)

These people don't like it.

Is this true?

WHO MAY WANT REPEAL

Pharmaceutical companies: Beginning in 2014, the law imposes an annual fee on them based on their share of the drug market. The fee does not apply to those small companies that have sales of $5 million or less. The delayed start date of the fee was part of the a negotiated compromise between the industry and lawmakers before the bill passed.

Indoor tanning services: Indoor tanning salons will be assessed a 10% tax on their use of ultraviolet lamps. The provision was included to discourage the skin-cancer causing service while seeking to raise $2.7 billion dollars from the industry by 2019.

Health Insurers: Starting last year, health insurers were banned from;

1. excluding children from coverage because of pre-existing conditions;

2. dropping people from coverage when they get sick;

3. instituting lifetime limits; and

4. dropping dependents from plans after they turn 19 or finish college.

Insurance companies will begin paying a fee based on their share of the insurance industry in 2014.

Employers: Those companies that may not want to provide insurance to early retirees through the temporary reinsurance programs may prefer a repeal. Also, employers with 50 or more works who do not offer coverage face a fine of $2,000 for each employee if any worker receives subsidized insurance on the exchange. The first 30 employees are counted for the fine.

Medical Device Industry: Beginning in 2013, a 2.9% excise tax will be imposed on the sale of medical devices though anything generally purchased at the retail level by the public is excluded from the tax. There doesn’t appear to be anything stopping that industry from passing on that tax to consumers via a higher price for the devices, however. This provision won’t go into effect for a couple of years which, in of itself, was also a compromise before the bill passed into law in 2009.

Those who do not want insurance: Beginning in 2014, all American adults will be required to obtain health insurance coverage or pay a fine of $325 if they don’t. Arguably, this provision is one of the most controversial and one which may indeed be undone, one way or another. The government did provide for a healthcare tax credit to help those with incomes up to 400 percent of the poverty level purchase coverage.

I realize there may be some bias in the Source. But it seems like (according to them) the health care act will make big business suffer and the people will benefit. I want to know if this is correct or not. And I'm not looking for simple rhetoric to dismiss it.

I think the biggest complaint people have about it is that it's not affordable at all, unless by affordable you meant mandatory, and by mandatory you meant you have to pay for it. If you don't have health insurance you get a fine (tax) which is being run by the fine "gentlemen" in the IRS.

if it is so dam good, then why are the people in gov't , unions, big business, gov't aides, etc., etc. trying to be or getting exempt from it ? that's my question on it.


clarity and obamacare should never be used in the same sentence.

1. Expands healthcare coverage to 30 million uninsured Americans,
2. Requires many health insurance plans to cover prevention and wellness benefits with no co-pay or deductibles for 54 million Americans that have private insurance,
3. Eliminates the lifetime coverage limit for 105 million Americans already insured,
4. Gives 2.3 million elderly Medicare patients access to annual wellness checkups,
5. Provides prescription care “donut hole” coverage for 5.1 million seniors, and
6. Requires insurers to cover those with pre-existing conditions, including 17 million of the 74.9 million children ages 0-17 years old residing in the U.S.,

Partially True, BUT.....

A new Congressional Budget Office (CBO) report says that under the Affordable Care Act, a.k.a. Obamacare, 30 million non-elderly Americans will remain without health insurance in 2022.

One of the main arguments the Obama administration made for passing the Affordable Care Act was that it would provide coverage for the uninsured.

Currently, accoriding to CBO, there are 53 million uninsured persons in the United States, including uninsured illegal aliens. The CBO estimates that in 2022--8 years after the Affordable Care Act has been fully implemented--30 million people will remain uninsured.
CBO: Obamacare Will Leave 30 Million Uninsured

The 'Expansion' is mandated, not necessarily by individual choice.

Originally posted by thishereguy
if it is so dam good, then why are the people in gov't , unions, big business, gov't aides, etc., etc. trying to be or getting exempt from it ? that's my question on it.


clarity and obamacare should never be used in the same sentence.

edit on 27-8-2013 by thishereguy because: (no reason given)

That's my whole point though, since when did any of those organizations fight for an individual's benefit over their own? And by own, I mean -Own career- -Own lifestyle- -Company benefit over personal-

etc, etc, etc...

Here's some clarity:

As long as there are obscene profits to be made from the misery of others and their need for health care, the unbridled capitalistic implementation of ACA (obamacare) will harm far more people than it helps.

We've far too many multimillionaire healthcare CEOs in insurance, hospitals (including non-profit) and big pharma to have any kind of affordable health care system, much less any sort of compassionate care practices.

Take all the profit out of health care and the problem is solvable.
It all comes down to the highest priorities of government being strictly economic and completely in line with their corporate masters.

ganjoa

1. Expands healthcare coverage to 30 million uninsured Americans,

2. Requires many health insurance plans to cover prevention and wellness benefits with no co-pay or deductibles for 54 million Americans that have private insurance,

3. Eliminates the lifetime coverage limit for 105 million Americans already insured,
4. Gives 2.3 million elderly Medicare patients access to annual wellness checkups,
5. Provides prescription care “donut hole” coverage for 5.1 million seniors, and
6. Requires insurers to cover those with pre-existing conditions, including 17 million of the 74.9 million children ages 0-17 years old residing in the U.S.,

True, BUT

That is one main reason for the rate increases for people who are paying the rates.

People who end up on new Medicaid rolls will get a free pass at taxpayer expense.
Taxpayers will ultimately pay for the Medicaid expansions.

Employees of employers will get less raises, if any at all.

.................. premium increases are due in large part to the fact that multiple new “Preventative Care” mandates were imposed upon all “non-grandfathered” health insurance plans as of 9/23/2010 under the PPACA (Patient Protection & Affordable Care Act). A “Non-grandfathered” health insurance plan is a plan that was purchased after the PPACA (a.k.a “Obamacare”) was signed in to law on March 23, 2010. Keep in mind, these were ALL mandated to be covered no later than 1/1/2011 WITHOUT a co pay or a DEDUCTIBLE (a.k.a. “free”). The entire list is as follows: ................
Why Are Health Insurance Premiums Still Increasing After The PPACA?

Originally posted by xuenchen

1. Expands healthcare coverage to 30 million uninsured Americans,
2. Requires many health insurance plans to cover prevention and wellness benefits with no co-pay or deductibles for 54 million Americans that have private insurance,
3. Eliminates the lifetime coverage limit for 105 million Americans already insured,
4. Gives 2.3 million elderly Medicare patients access to annual wellness checkups,
5. Provides prescription care “donut hole” coverage for 5.1 million seniors, and
6. Requires insurers to cover those with pre-existing conditions, including 17 million of the 74.9 million children ages 0-17 years old residing in the U.S.,

Partially True, BUT.....

A new Congressional Budget Office (CBO) report says that under the Affordable Care Act, a.k.a. Obamacare, 30 million non-elderly Americans will remain without health insurance in 2022.

One of the main arguments the Obama administration made for passing the Affordable Care Act was that it would provide coverage for the uninsured.

Currently, accoriding to CBO, there are 53 million uninsured persons in the United States, including uninsured illegal aliens. The CBO estimates that in 2022--8 years after the Affordable Care Act has been fully implemented--30 million people will remain uninsured.
CBO: Obamacare Will Leave 30 Million Uninsured

The 'Expansion' is mandated, not necessarily by individual choice.

Kinda my point, did you read the article you posted? So it starts talking about illegal residents not having coverage, then says there's 30 million without coverage, but that drops to 8 million by 2022, but then says 30 million will still not have coverage. And kind of implies 30 million people without coverage with or without obamacare. But the graphic from the report its quoting:



Is this saying there would be 60 million people under the old system, and now 30 million under the new system?

The entire structure of the article doesn't really make sense. And you are getting it from a right wing source. Which, I'm not saying left wing sources are any better for clarity case by case, but any right wing source tends to be completely against it.

In partisan politics, it's hard to find out what's actually going on. Hence me making this thread.

Plonking down a biased article doesn't really help...

Originally posted by ganjoa
Here's some clarity:

As long as there are obscene profits to be made from the misery of others and their need for health care, the unbridled capitalistic implementation of ACA (obamacare) will harm far more people than it helps.

We've far too many multimillionaire healthcare CEOs in insurance, hospitals (including non-profit) and big pharma to have any kind of affordable health care system, much less any sort of compassionate care practices.

Take all the profit out of health care and the problem is solvable.
It all comes down to the highest priorities of government being strictly economic and completely in line with their corporate masters.

ganjoa

So is it true then all the following is correct and that is why they don't like it:

Pharmaceutical companies: Beginning in 2014, the law imposes an annual fee on them based on their share of the drug market. The fee does not apply to those small companies that have sales of $5 million or less. The delayed start date of the fee was part of the a negotiated compromise between the industry and lawmakers before the bill passed.

Health Insurers: Starting last year, health insurers were banned from;

1. excluding children from coverage because of pre-existing conditions;

2. dropping people from coverage when they get sick;

3. instituting lifetime limits; and

4. dropping dependents from plans after they turn 19 or finish college.

Insurance companies will begin paying a fee based on their share of the insurance industry in 2014.

I guess I should have focused more on why people *don't like it* rather than like it. And specifically, why do all the people who normal average people hate, not like it?

Big business, pharma, insuance, etc... All don't like Obamacare, (as far as I can tell) so I guess the question is... Why do they not like it? Because they are not looking out for the average person in America... They are looking out for profit margins.

reply to post by boncho


While there are those of us who believe that the only real solution is a not-for-profit, single payer, Medicare for all system, that's not to say that we're totally opposed to ObamaCare. We're primarily opposed to the fact that the private healthcare insurance industry is included in the program at all, but with time we'll fix that.

With respect to those who's opposition to it is so strong that they would shut down the government in their pursuit to de-fund it, well truth be told, they liked it right up until Obama proposed it. Like most things nowadays, the moment President Obama comes out in favor of something, (even if it was a Republican idea to begin with, which the individual mandate was) the Republican party immediately opposes it.

In a nutshell, they don't like it because Obama proposed it.

reply to post by boncho


The chart is from the Congressional Budget Office.

*****
Uninsured Population Given the Supreme Court Decision
Number of Uninsured Nonelderly People.

2012 starts at 53 million.

2022 says 30 million.
*****

the confusion in the article may be this:

Under Obamacare, 8 percent of legal U.S. residents will remain without health insurance in 2022, according to CBO.

The article says nothing about '8 million people'.

1. Expands healthcare coverage to 30 million uninsured Americans,
2. Requires many health insurance plans to cover prevention and wellness benefits with no co-pay or deductibles for 54 million Americans that have private insurance,

3. Eliminates the lifetime coverage limit for 105 million Americans already insured,

4. Gives 2.3 million elderly Medicare patients access to annual wellness checkups,
5. Provides prescription care “donut hole” coverage for 5.1 million seniors, and
6. Requires insurers to cover those with pre-existing conditions, including 17 million of the 74.9 million children ages 0-17 years old residing in the U.S.,

This works, but again, it probably contributes to rate increases.
If people can afford the price increases, it's good.
This provision deals with 'costs of treatments limits', not rate limits.

Q. Does the new health care reform law eliminate annual and lifetime limits on health care coverage in insurance policies?

Yes. On Sept. 23, lifetime limits are effectively banned for all plans that begin or are renewed after that date. Insurance companies can no longer cut off policy holders when their medical expenses reach a lifetime limit. Annual limits on coverage will be phased out over the next few years, beginning this year.

Currently, more than 100 million Americans have insurance that stops when medical claims exceed their policy’s lifetime limit. The new rule especially will help people with serious diseases that require expensive treatment. Ten percent of cancer patients surveyed recently said they hit their lifetime limit and their insurers would not pay for further medical care. Federal health officials mention the example of an Indiana teenager battling leukemia who reached the $1 million lifetime limit on his family’s policy in a couple of months. To pay for his bone marrow transplant, his desperate parents appealed to the public for donations and raised more than $500,000.
The New Health Care Law and Annual and Lifetime Coverage Limits

Summary

The Act defines certain categories of benefits as "Essential Health Benefits." The categories of essential health benefits are:

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
Pediatric services, including oral and vision care

Essential Health Benefits

Related: Aetna’s take and action

Originally posted by xuenchen
reply to post by boncho

 

The chart is from the Congressional Budget Office.

*****
Uninsured Population Given the Supreme Court Decision
Number of Uninsured Nonelderly People.

2012 starts at 53 million.

2022 says 30 million.
*****

the confusion in the article may be this:

Under Obamacare, 8 percent of legal U.S. residents will remain without health insurance in 2022, according to CBO.

The article says nothing about '8 million people'.

Correct, I made a mix up. I hate this other article open at the same time too, which wasn't helping... While There Are About 12 Million Illegal Aliens in U.S. Today, CBO Estimates That Senate Health Reform Would Leave About 8 Million Illegals Uninsured