Anonymous wrote:

Anonymous wrote:What problems will ACA solve?

Access to health insurance. The ACA will reduce the number of people who don't have health insurance.

That has yet to be seen. First of all, you have to be able to actually enroll, which is difficult to impossible at this point. How many younger healthier people will just opt to pay the fine? Second, many folks with non- ACA compliant individual plans have had their insurance canceled, only to find that the plans on the exchanges are much more expensive and/or have much higher deductibles. Not to mention all of the folks who have their hours reduced below 30 hours, and dumped off their employers plan, and/or their employer has under 50 employees, and their insurance was non-ACA compliant, so they just stopped covering their employees altogether.

My understanding is that the "affordable" (subsidized) premium numbers being cited have high co-pays, which are not subsidized. That's going to be a shocker for some low-income folks when they actually try to go to the doctor.

At the end of the day, there very well could be fewer insured people in the US when this is done.

Anonymous wrote:9:49 ACA expanded Medicaid coverage. But it's state by state, and there are reports that millions will not be eligible.

Yes, millions will not be eligible. But that is not the fault of the ACA. It's the fault of the Supreme Court.

Before the ACA, states were required to provide Medicaid coverage to

1. pregnant women and children under age 6 with family incomes at or below 133% of the federal poverty level (FPL)
2. children ages 6 through 18 with family incomes at or below 100% federal poverty level
3. parents and caretaker relatives who meet the financial eligibility requirements for the former AFDC (cash assistance) program
4. elderly people and people with disabilities who qualify for Supplemental Security Income (SSI) benefits based on their low income and resources

They were not required to provide Medicaid coverage to non-disabled, non-pregnant adults without children. Medicaid eligibility for working parents was also very limited.

Under the ACA, states would have been required to also provide Medicaid coverage to every non-pregnant, non-disabled adult under 65 with an income at or below 138% of the federal poverty level, starting in 2014. The federal government would have paid for almost all of this coverage, from 100% in 2014-2016 decreasing to 90% in 2020 and thereafter.

The Supreme Court found this requirement unconstitutional.

Now it is up to the states to decide whether or not to accept the Medicaid expansion. Not surprisingly, this decision has gone according to party lines. States with governors from the party that opposes the ACA have not accepted the Medicaid expansion. Therefore, people who live in those states, who would have been covered under the Medicaid expansion in the ACA, will now not be covered.

Lots and lots and lots of detail here: http://kaiserfamilyfoundation.files.wordpress.com/2013/01/8347.pdf

Anonymous wrote:I know several families who currently have health insurance, they're self-insured, and who will save money under ACA because of their states' ACA offerings. (NJ, PA, MI). That's great, but it doesn't address the uninsured issue, does it?

Also, why did it take FOUR YEARS for this to come together? The President signed this into law in March 2010.

The whole thing, from the delays and the website that doesn't work to the Tea Party lunatics, is just so dispiriting.

It took 4 years because the law itself is poorly written AND its the government. Slow as syrup.

ITA it doesn't solve the uninsured problem. Many people will not find plans for under $750 and just pay the fine instead or lie on their taxes (whaaaat people lie on their taxes?!?)

I know several families who currently have health insurance, they're self-insured, and who will save money under ACA because of their states' ACA offerings. (NJ, PA, MI). That's great, but it doesn't address the uninsured issue, does it?

Also, why did it take FOUR YEARS for this to come together? The President signed this into law in March 2010.

The whole thing, from the delays and the website that doesn't work to the Tea Party lunatics, is just so dispiriting.

Anonymous wrote:9:49 ACA expanded Medicaid coverage. But it's state by state, and there are reports that millions will not be eligible.

In any event, people still need to pay for insurance under ACA. Where are the poor going to get the funds, even if ACA premiums are lower than self-insured premiums?

There are subsidies up to 400% of the poverty level. That's where the poor will get the funds.

9:49 ACA expanded Medicaid coverage. But it's state by state, and there are reports that millions will not be eligible.

In any event, people still need to pay for insurance under ACA. Where are the poor going to get the funds, even if ACA premiums are lower than self-insured premiums?

A PP poster mentioned that we already had health insurance for the "truly poor," and I'd like to know what that insurance is? TO be covered by Medicaid you need to be disabled. So, what, before the ACA was the health insurance provided to poor people, including the "working poor" not covered by their jobs?

Anonymous wrote:What problems will ACA solve?

Access to health insurance. The ACA will reduce the number of people who don't have health insurance.

Anonymous wrote:How does ACA improve access? If anyone has the funds, they can get health insurance on their own. I've been self-insured since April 2007. This is a CROCK. It's not affordable. That said, ACA may help those with pre-existing conditions get coverage for the first time, or lower their premiums. I just don't understand why the government and the health insurance industry didn't figure out a way to do this outside of the government. No reason health insurance should be linked to the IRS, with a tax penalty if you don't get insurance. Outfuckingrageous considering all the tax breaks the rich and corporates get!

How does the ACA improve access? Well, let's see.

1. No excluding based on pre-existing conditions.
2. No lifetime benefit cap.
3. Children can stay on their parents' plan until they're 26.
4. Employers with 50+ employees must provide health insurance to their employees or pay a penalty.
5. Households with incomes of 100-400% of the poverty level get subsidies to pay for health insurance.
6. People under 65 with family incomes of up to 133% of the poverty level qualify for Medicaid (in states that accepted the Medicaid expansion).

As for the reason health insurance is linked to the IRS -- well, what is your suggestion for making sure that everybody (sick and healthy) complies with the requirement to have health insurance?

And saying "if anyone has the funds, they can get health insurance on their own" is kind of missing the point. Yes, if you have enough money, you can buy anything. The point was that lots and lots and lots of people did not have enough money to get health insurance on their own.

Anonymous wrote:How does ACA improve access? If anyone has the funds, they can get health insurance on their own. I've been self-insured since April 2007. This is a CROCK. It's not affordable. That said, ACA may help those with pre-existing conditions get coverage for the first time, or lower their premiums. I just don't understand why the government and the health insurance industry didn't figure out a way to do this outside of the government. No reason health insurance should be linked to the IRS, with a tax penalty if you don't get insurance. Outfuckingrageous considering all the tax breaks the rich and corporates get!

It's an absolute joke. I was a huge supporter of the ACA. I feel foolish for believing all the crap we were fed. Turns out my FoxNews watching parents were dead right about this.

What problems will ACA solve?

Correction: If anyone has the funds, and doesn't have a pre-existing condition ... But there I am confused as I know tons of folks with pre-existing conditions who are self-insured. Three close friends, a sibling and their spouse, so this is not a friend of a friend hearsay, this is straight from the horse's mouth. Conditions include cancer (advanced), rare condition, hip injury from car accident that needs followup surgery, back injury that also required surgery, diabetes ... Yes their insurance is expensive, not sure if it will be less so.

The other thing is the cost differentials among states. I just tried to fill out DC and they have my address wrong so I can't complete the application. Sigh.

Yes, the ACA did not solve all of the problems. But it will solve some of the problems. That's a start.

How does ACA improve access? If anyone has the funds, they can get health insurance on their own. I've been self-insured since April 2007. This is a CROCK. It's not affordable. That said, ACA may help those with pre-existing conditions get coverage for the first time, or lower their premiums. I just don't understand why the government and the health insurance industry didn't figure out a way to do this outside of the government. No reason health insurance should be linked to the IRS, with a tax penalty if you don't get insurance. Outfuckingrageous considering all the tax breaks the rich and corporates get!

I am also a supporter of the ACA, but it needs a lot of work. The benefits are very rich, which is great, but it means it will be more expensive. The ACA sought to improve access to healthcare, a noble intent, but did very little to curb costs. It mainly targeted the insurance companies, which needed reform, but they still have to pay for the hospital, pharma companies, and medical device companies to make GAZILLIONS in profit each year and be able to charge whatever they want because hey, insurance will pay for it. But insurance is either paid for by employers or by public programs so it does little to curb costs.