The PPACA Implementation Phase II - Love it or Lose it!

[SJHovey]

Re: The PPACA Implementation Phase II - Love it or Lose it!

Not really sure why, but I do find it kind of humorous that the mysterious website girl has now been discovered. She isn't even a citizen, but apparently from Columbia or somewhere, on permanent resident status who apparently traded that picture in exchange for something trivial, like a family portrait, and now finds her picture at the center of all of the complaining about the website.

 

[St. Clown]

Re: The PPACA Implementation Phase II - Love it or Lose it!

Not really sure why, but I do find it kind of humorous that the mysterious website girl has now been discovered. She isn't even a citizen, but apparently from Columbia or somewhere, on permanent resident status who apparently traded that picture in exchange for something trivial, like a family portrait, and now finds her picture at the center of all of the complaining about the website.

I don't understand why people are fixating on the woman's picture from the site. She's a woman, and she was paid (in lieu of cash, as we've now learned) for her photo. Big deal.

 

[Rover]

Re: The PPACA Implementation Phase II - Love it or Lose it!

106,185 - that's how many people signed up for coverage in the first month. Only 26,794 of those were able to do so through the federal website, a horrible ratio when it comes to leveraging technological efficiencies. I'd provide a link, but my browser crashes every time I try to get back into the politics section on CNN's site. Those numbers are not at all good if we're requiring some +30 million to sign up for care, and even more than that after people that had existing coverage find themselves now having to seek out new plans because their plans were canceled. And no, I don't think Congress will get a fix to the president prior to year's end.

Its actually not bad considering the web site doesn't work! If there really are 900K people who've gone through all the steps but just haven't chosen a plan yet, one has to think if they went through all that trouble to get that far they will most likely end up choosing a plan. Big thing now is getting the d@mn thing to work by end of November.

 

[SteveP]

Re: The PPACA Implementation Phase II - Love it or Lose it!

106,185 - that's how many people signed up for coverage in the first month.

That's less than the official capacity of Beaver Stadium and the Big House.

 

[unofan]

That's less than the official capacity of Beaver Stadium and the Big House.

But how many Rhode Islands or gallons of milk does it equal?

 

[SJHovey]

Re: The PPACA Implementation Phase II - Love it or Lose it!

Its actually not bad considering the web site doesn't work! If there really are 900K people who've gone through all the steps but just haven't chosen a plan yet, one has to think if they went through all that trouble to get that far they will most likely end up choosing a plan. Big thing now is getting the d@mn thing to work by end of November.

I haven't gone to the website, so I'm not sure exactly how it works. But from what I understood the 900K went through the steps, learned what plans are available and what the cost will be, and also learned whether they are eligible for any "subsidies", and in what amount, but just haven't pushed to "apply" or some such button yet? Is that what you understand, because that's how I understood it when I saw that story on tv.

What I wondered was if the failure to apply was due to any sort of "sticker shock" by people? Have people just held off because the monthly cost is higher, and the subsidies lower, than what they expected, and are waiting to see what alternatives might exist, or say the heck with it and pay the penalty? Don't know. Purely speculating. But when I saw the same report you apparently did, I was surprised nearly a million went through all the trouble of the process, but so few actually finished the deal.

 

[Rover]

Re: The PPACA Implementation Phase II - Love it or Lose it!

I haven't gone to the website, so I'm not sure exactly how it works. But from what I understood the 900K went through the steps, learned what plans are available and what the cost will be, and also learned whether they are eligible for any "subsidies", and in what amount, but just haven't pushed to "apply" or some such button yet? Is that what you understand, because that's how I understood it when I saw that story on tv.

What I wondered was if the failure to apply was due to any sort of "sticker shock" by people? Have people just held off because the monthly cost is higher, and the subsidies lower, than what they expected, and are waiting to see what alternatives might exist, or say the heck with it and pay the penalty? Don't know. Purely speculating. But when I saw the same report you apparently did, I was surprised nearly a million went through all the trouble of the process, but so few actually finished the deal.

As you say this is purely my interpretation but I believe the main issue is that you don't have to pull the trigger for awhile longer so you can stew on it for a little while, as in if you're trying to decide between Gold, Silver, Bronze plans. Even if they reached their 1st month expectations of 500K, that's a fraction of the total expected sign-ups of 7M so the idea was that more people would get on board towards the end of the enrollment period.

Mind you, as you also mention some of these people might not buy the insurance if they don't like the cost. From the current data of the 900K applications filled out they represent 1.5M people potentially.

 

[FreshFish]

Re: The PPACA Implementation Phase II - Love it or Lose it!

Well, that didn't take long....Bubba still rules!

President Barack Obama said Thursday that insurers will be able to continue health-insurance coverage next year for current policyholders that otherwise would be canceled under the new health-care law.

The change marks a significant policy retreat by the president, one that he hopes will quell an intensifying protest over his faulty promise that Americans can keep their insurance plans under the new law.

Mr. Obama's announcement came on the eve of a House vote on a Republican bill to change the law, which was gaining traction among Democrats, particularly after the administration's release Wednesday of low enrollment figures for the first month of the federal government's problem-prone online insurance marketplace.

With millions of Americans set to lose their current health insurance, Mr. Obama said he understands that getting a cancellation notice is upsetting, "particularly after assurances they heard from me that if they had a plan that they liked they could keep it." He added: "To those Americans, I hear you loud and clear. I said that I would do everything we can to fix this problem. And today I'm offering an idea that will help do it."

Amazing how BHO can just re-write the law whenever he feels like it, eh? Don't like a provision? let's just ignore it and pretend it isn't there.

all politics, all the time. Just to co-opt the Republicans when they finally (!) have a decent idea. Just suck the wind from their sails.

 

[joecct]

Re: The PPACA Implementation Phase II - Love it or Lose it!

Well, that didn't take long....Bubba still rules!



Amazing how BHO can just re-write the law whenever he feels like it, eh? Don't like a provision? let's just ignore it and pretend it isn't there.

all politics, all the time. Just to co-opt the Republicans when they finally (!) have a decent idea. Just suck the wind from their sails.

But there is nothing that requires the insurance companies to reinstate the canceled policies. Further, just because El Presidente has said it, it does not make it so. HHS has to redo the regulation on what constitutes a "major change" that forced a number of companies to discontinue existing policies. I THINK it is at least 90 days before it takes effect.

The proposed reg has to be vetted all through HHS, from the Agency, through the lawyers, and I would imagine for something this sensitive, the White House and OMB. Then it gets published in the Federal Register and there is, I believe, a 90 day comment window. Then the comments come back, HHS reviews them and issues the final regulation. We're looking at around 3 - 4 months before any change is going to take place.

 

[Rover]

Re: The PPACA Implementation Phase II - Love it or Lose it!

But there is nothing that requires the insurance companies to reinstate the canceled policies. Further, just because El Presidente has said it, it does not make it so. HHS has to redo the regulation on what constitutes a "major change" that forced a number of companies to discontinue existing policies. I THINK it is at least 90 days before it takes effect.

The proposed reg has to be vetted all through HHS, from the Agency, through the lawyers, and I would imagine for something this sensitive, the White House and OMB. Then it gets published in the Federal Register and there is, I believe, a 90 day comment window. Then the comments come back, HHS reviews them and issues the final regulation. We're looking at around 3 - 4 months before any change is going to take place.

Two points here: 1) If insurance companies do this voluntarily, there's no issue. Yes, they can choose not to but then the onus is on them. 2) March 15th I believe is the deadline for signing up to not pay the penalty. That gives more than 90 days to get this done.

 

[LynahFan]

Re: The PPACA Implementation Phase II - Love it or Lose it!

Yes, they can choose not to but then the onus is on them.

And that's exactly the crux of the matter - Obama doesn't care if those policies get canceled (actually, check that - he still wants those policies canceled), he just doesn't want to take the blame for it.

The probability that any plan that was slated for cancellation yesterday gets reinstated is effectively zero.

 

[FreshFish]

Re: The PPACA Implementation Phase II - Love it or Lose it!

I haven't had a chance to read this opinion piece from today's WSJ. It purports to be a conservative alternative to PPACA.

This one line did catch my eye:

The biggest Republican misconception about health care is that the system before ObamaCare was a free-market paradise. On the contrary: It has consisted chiefly of massive and inefficient entitlements that threaten to bankrupt the nation; the lopsided tax treatment of employer-provided coverage that creates incentives for waste and overspending; and an underdeveloped individual market struggling to fill the gaps.

Exploding health-care costs and millions left needlessly uninsured are a result of misguided federal policies. Solutions require targeted reforms to those policies.

 

[Rover]

Re: The PPACA Implementation Phase II - Love it or Lose it!

And that's exactly the crux of the matter - Obama doesn't care if those policies get canceled (actually, check that - he still wants those policies canceled), he just doesn't want to take the blame for it.

The probability that any plan that was slated for cancellation yesterday gets reinstated is effectively zero.

Lynah please. You're looking for fairness in politics?!? Good luck.

My view is like this, and no it doesn't make Obama out to be swell guy: The ACA can handle hyped up story at a time but not two. Had the websites been working, all of these people would already know if they had subsidies and better plans on the exchanges. The problem is the double whammy. You get cancelled, but don't know what the alternative is yet due to balky website. Even I can't defend that. Neither could Congressional Dems, which is why Obama got off his *** and did something about it.

Yes some policies will still be cancelled this year and all will be gone next year. However what Obama needed was breathing room. This gives more time for website fix and placates the group with the most easy to relate to issue. Now anybody informed that they have a substandard policy has a year to find out what the choices are for a replacement.

 

[FreshFish]

Re: The PPACA Implementation Phase II - Love it or Lose it!

Now anybody informed that they have a substandard policy has a year to find out what the choices are for a replacement.

No one has yet explained how replacing a so-called "substandard" policy with one that is even worse is somehow an improvement.

The next outburst of real outrage will come when people find out how limited the provider networks are, and how there is generally NO out-of-network coverage at all.

 

[FreshFish]

Re: The PPACA Implementation Phase II - Love it or Lose it!

Here's one of those hyperventilating mass emails that mookie loves....

The Affordable Boat Act

The US government has just passed a new law called: "The Affordable Boat Act" declaring that every citizen MUST purchase a new boat, by April 2014. These "affordable" boats will cost an average of $54,000-$155,000 each. This does not include taxes, trailers, towing fees, licensing and registration fees, fuel, docking and storage fees, maintenance or repair costs.

This law has been passed, because until now, typically only wealthy and financially responsible people have been able to purchase boats. This new law ensures that every American can now have an "affordable" boat of their own, because everyone is entitled to a new boat. If you purchase your boat before the end of the year, you will receive 4 "free" life jackets; not including monthly usage fees. In order to make sure everyone purchases an affordable boat, the costs of owning a boat will increase on average of 250-400% per year. This way, wealthy people will pay a little more for something that other people don't want or can't afford to maintain.

But to be fair, people who can't afford to maintain their boat will be regularly fined, and children (under the age of 26) can use their parent’s boats to party on until they turn 27; then must purchase their own boat. If you already have a boat, you can keep yours (just kidding; no you can’t). If you don't want or don't need a boat, you are required to buy one anyhow. If you refuse to buy one or can't afford one, you will be regularly fined $800 until you purchase one, or face imprisonment. Failure to use the boat will also result in fines. People living in the desert, ghettos, inner cities or areas with no access to lakes are not exempt. Age, motion sickness, experience, knowledge, nor lack of desire are acceptable excuses for not using your boat.

A government review board (that doesn't know the difference between the port, starboard or stern sides of a boat) will decide everything, including; when, where, how often and for what purposes you can use your boat along with how many people can ride your boat, and determine if one is too old or healthy enough to be able to use their boat. They will also decide if your boat has outlived its usefulness, or if you must purchase specific accessories (like a $500 compass), or a newer and more expensive boat. Those who can afford yachts will be required to do so…it’s only fair. The government will also decide the name for each boat. Failure to comply with these rules will result in fines and possible imprisonment.

Government officials are exempt from this new law. If they want a boat, they and their families can obtain boats free, at the expense of taxpayers. Unions, bankers and mega companies with large political affiliations are also exempt.

 

[Rover]

Re: The PPACA Implementation Phase II - Love it or Lose it!

No one has yet explained how replacing a so-called "substandard" policy with one that is even worse is somehow an improvement.

The next outburst of real outrage will come when people find out how limited the provider networks are, and how there is generally NO out-of-network coverage at all.

Nobody knows if its an improvement until they get to compare policies, which is difficult to do at present for reasons that I think we're all aware of.

How are provider networks under the ACA going to be any different than they are now??? There is little out of network coverage in employer insurance as well in case you haven't noticed.

 

[FreshFish]

Re: The PPACA Implementation Phase II - Love it or Lose it!

How are provider networks under the ACA going to be any different than they are now???

Seriously? you pass yourself off as the most intelligent person on the board yet you can't figure this one out?

ACA exchange policies are deliberately using restricted provider networks by design as a planned cost-control measure. I'd have to search to find the link, there is a county in Florida for example that has 250,000 people in it, and the exchange network has six pediatricians in it. Not six practices, six individual doctors.

Look, I understand your Obama's biggest sycophant here, but once in a while an ability to recognize the obvious might give you some credibility.

 

[Rover]

Re: The PPACA Implementation Phase II - Love it or Lose it!

Seriously? you pass yourself off as the most intelligent person on the board yet you can't figure this one out?

ACA exchange policies are deliberately using restricted provider networks by design as a planned cost-control measure. I'd have to search to find the link, there is a county in Florida for example that has 250,000 people in it, and the exchange network has six pediatricians in it. Not six practices, six individual doctors.

Look, I understand your Obama's biggest sycophant here, but once in a while an ability to recognize the obvious might give you some credibility.

Fishy, insurers are going to have its own network or networks that it wants you to use. That's part of keeping their costs down already. Feel free to post a link showing how this is different. I will hold off on further commentary until you do on this subject.

As far as being the smartest person on the board, I'd have to defer to the wisdom of several of my fellow BU alums, as well as learned and scholarly people such as Chuck Murray, Les, Priceless, DrDimento, and Lynah amongst others. However, I am smarter than USCHO knuckledraggers, which is most likely where your comment sprung from.

Best looking on the board? I'm in the running on that one.

 

[jerphisch]

Re: The PPACA Implementation Phase II - Love it or Lose it!

ACA exchange policies are deliberately using restricted provider networks by design as a planned cost-control measure. I'd have to search to find the link, there is a county in Florida for example that has 250,000 people in it, and the exchange network has six pediatricians in it. Not six practices, six individual doctors.

Of the 250,000 how many are children (this is Florida after all)? What is a typical patient to doctor ratio for pediatricians? Meaningless statistics are meaningless.

 

[DrDemento]

Re: The PPACA Implementation Phase II - Love it or Lose it!

Of the 250,000 how many are children (this is Florida after all)? What is a typical patient to doctor ratio for pediatricians? Meaningless statistics are meaningless.

FF makes an important point however. You can sign up the entire world for medicaid-but then try to find a physician who will accept it as payment-harder still, try and find a certifed, competent, specialist who will accept the patient and the payment from medicaid. I just do not see this being very different with the ACA. it is correct that the insurers already steer people to in network providers but if the ACA is going to succeed in any fashion at all it will have to show that patients will have far greater access than what has happened with medicaid over the years.

Just one personal anecdote here-back in 1975 my office accepted anyone, anytime, with any coverage. Medicaid paid us the great sum of $6.62 for an office visit to see a patient. We figured that it cost us in overhead about $10.00 to see each patient. How much sense did it make for us to see those with medicaid? For me it was a no brainer, I wanted to continue to participate as it was still helping to build our practice with patients who might refer others who were not covered by medicaid. But eventually it was just not something we could continue and had to limit medicaid acceptance to those we had already seen and did not accept any more new medicaid patients. Just as the ACA needs a percentage of young healthy individuals to sign up to keep costs in the ballpark-we too had to make sure we had enough insured or self paid patients to be able to see those with medicaid. Just thinking locally now-i am not sure i can find a single physician who is accepting any new medicaid patients in most of the specialties.