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

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

Well, I'm glad it worked out then

Well thank you. It's interesting because although I have told a lot of people how my experience went, I don't know of too many other people who got insurance through the exchanges. The fact is, 7.1 million really isn't terribly many. I hope that these stories get out, and that people who have nothing are able to fix that. The fact is, what those of you who pay more taxes than me contribute to my insurance through the subsidy should be much less in the long run than the cost of emergency procedures at the ER. I won't pretend to understand the economics of the thing, but I truly believe that our system needed fixing, and that this is a step in the right direction.
 
Re: The PPACA Implementation Phase II - Love it or Lose it!

Well thank you. It's interesting because although I have told a lot of people how my experience went, I don't know of too many other people who got insurance through the exchanges. The fact is, 7.1 million really isn't terribly many. I hope that these stories get out, and that people who have nothing are able to fix that. The fact is, what those of you who pay more taxes than me contribute to my insurance through the subsidy should be much less in the long run than the cost of emergency procedures at the ER. I won't pretend to understand the economics of the thing, but I truly believe that our system needed fixing, and that this is a step in the right direction.

Yeah, for the most part, I'm still very, very skeptical about the effectiveness of the PPACA and what it means even 10 years from now. (Which isn't to say that I don't think the PPACA is devoid of benefits.) I'd like to see a better system replace it. But I also don't like the prospect of single payer. I get there are benefits of a system like that, but I'm also very skeptical that the government can run a system that large.
 
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Well thank you. It's interesting because although I have told a lot of people how my experience went, I don't know of too many other people who got insurance through the exchanges. The fact is, 7.1 million really isn't terribly many. I hope that these stories get out, and that people who have nothing are able to fix that. The fact is, what those of you who pay more taxes than me contribute to my insurance through the subsidy should be much less in the long run than the cost of emergency procedures at the ER. I won't pretend to understand the economics of the thing, but I truly believe that our system needed fixing, and that this is a step in the right direction.

7.1m is about 2.2% of the U.S. population. It's about 3.6% of the working age population (18-64). That's not nothing. It's one out of every 30 people or so.
 
Re: The PPACA Implementation Phase II - Love it or Lose it!

7.1m is about 2.2% of the U.S. population. It's about 3.6% of the working age population (18-64). That's not nothing. It's one out of every 30 people or so.

Indeed, and my intent wasn't to say that it's nobody, but since I don't discuss my health insurance situation with everyone I meet, if it is one out of every 30 people, I won't likely happen to discuss this with many others who took advantage of it.


I also understand the skepticism. My feeling is that large numbers of people will be skeptical of any change. Personally, my hope is that we eventually get to single payer.

You just go ahead and declare anything you like. Facts have never stopped you before!

Ahh, who among us has ever allowed facts to get in the way of a good declaration.
 
Re: The PPACA Implementation Phase II - Love it or Lose it!

This report was released March 5, but I don't recall it being discussed. With people championing the PPACA as a "cost neutral" event for the gov't because the increased taxes were paying for the increased costs to the Fed budget. The CBO's most recent figures (compiled with data through December 2013) show something else entirely.

http://www.cbo.gov/publication/45159

CBO and JCT Estimate That the Coverage Provisions of the ACA Will Have a Net Cost to the Federal Government of $1.5 Trillion Over the 2015–2024 Period

In the current interim projections, CBO and JCT estimate that the ACA’s coverage provisions will result in a net cost to the federal government of $41 billion in 2014 and $1,487 billion over the 2015–2024 period. (All of the dollar amounts discussed here are for federal fiscal years, which run from October 1 through September 30.) Compared with last year’s projections, which spanned the 2014–2023 period, the new estimate represents a downward revision of $9 billion in the net costs of those provisions over that 10-year period. (That revision is discussed in more detail in the last section.)

The estimated net costs in 2014 stem almost entirely from spending for subsidies that will be provided through exchanges and from an increase in spending for Medicaid. For the 2015–2024 period, the projected net costs consist of the following:

*Gross costs of $2,004 billion for Medicaid, the Children’s Health Insurance Program (CHIP), subsidies and related spending for insurance obtained through exchanges, and tax credits for small employers; and

*Receipts of $517 billion from penalties on certain uninsured people and certain employers, an excise tax on high-premium insurance plans, and other budgetary effects—mostly increases in tax revenues.

The annual net costs are projected to rise noticeably over the next few years—to $151 billion in 2018— and then grow by more modest amounts in the following several years, reaching $173 billion in 2024.
 
Re: The PPACA Implementation Phase II - Love it or Lose it!

7.1m is about 2.2% of the U.S. population. It's about 3.6% of the working age population (18-64). That's not nothing. It's one out of every 30 people or so.
Nitpicking, but 2.2% = 1 out of 45 people. In the run-up to the passage of PPACA, we were bombarded by the fact that there were ~50M uninsured Americans. We went through all that to solve 15% of the problem? Yes, I know there are more people on medicaid now as well, and the 22-26ers can stay on their parents insurance and they're not part of the 7.1M, but did we really need a comprehensive PPACA to make those two things happen?
 
Nitpicking, but 2.2% = 1 out of 45 people. In the run-up to the passage of PPACA, we were bombarded by the fact that there were ~50M uninsured Americans. We went through all that to solve 15% of the problem? Yes, I know there are more people on medicaid now as well, and the 22-26ers can stay on their parents insurance and they're not part of the 7.1M, but did we really need a comprehensive PPACA to make those two things happen?

3.6% = ~1/30. There's no point in counting those under 18 or those over 65 for this discussion.
 
Re: The PPACA Implementation Phase II - Love it or Lose it!

3.6% = ~1/30. There's no point in counting those under 18 or those over 65 for this discussion.
Then say 1 out of 30 workers, not people. Like I said, it's nitpicking, but I rather suspect that it was not a coincidence that your mixing and matching just happened to end up making things appear more favorable to your point of view...
 
Then say 1 out of 30 workers, not people. Like I said, it's nitpicking, but I rather suspect that it was not a coincidence that your mixing and matching just happened to end up making things appear more favorable to your point of view...


My bad. Next time I won't assume you are bright enough to figure out that when I use two percentages and one fraction, and the fraction matches one of the percentages, that I was using it to refer back to the one to which it was equal.

Further, why would we include 65+ year olds when they already have single payer and have nothing to do with the exchanges? That's not mixing and matching, that's picking the proper population.
 
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Re: The PPACA Implementation Phase II - Love it or Lose it!

My bad. Next time I won't assume you are bright enough to figure out that when I use two percentages and one fraction, and the fraction matches one of the percentages, that I was using it to refer back to the one to which it was equal.

Further, why would we include 65+ year olds when they already have single payer and have nothing to do with the exchanges? That's not mixing and matching, that's picking the proper population.
Unfortunately for you, I AM bright enough to figure it out, so slipping in "1 out of 30 people" at the end as your tag line didn't escape my attention. I'd be more than satisfied if you picked the "proper population" and were consistent about it.
 
Re: The PPACA Implementation Phase II - Love it or Lose it!

This report was released March 5, but I don't recall it being discussed. With people championing the PPACA as a "cost neutral" event for the gov't because the increased taxes were paying for the increased costs to the Fed budget. The CBO's most recent figures (compiled with data through December 2013) show something else entirely.

http://www.cbo.gov/publication/45159



Looks like you left out a bunch of stuff...

The CBO's letter to The Boner about the costs of repeal and how it raises the deficit.

CBO and the staff of the Joint Committee on Taxation (JCT) have estimated the direct spending and revenue effects of H.R. 6079, the Repeal of Obamacare Act, as passed by the House of Representatives on July 11, 2012. H.R. 6079 would repeal the Affordable Care Act (ACA), with the exception of one subsection that has no budgetary effect. This estimate reflects the spending and revenue projections in CBO’s March 2012 baseline as adjusted to take into account the effects of the recent Supreme Court decision regarding the ACA.

For various reasons discussed in the report, the estimated budgetary effects of repealing the ACA by enacting H.R. 6079 are close to, but not equivalent to, an estimate of the budgetary effects of the ACA with the signs reversed.

What Is the Impact of Repealing the ACA on the Federal Budget?

Assuming that H.R. 6079 is enacted near the beginning of fiscal year 2013, CBO and JCT estimate that, on balance, the direct spending and revenue effects of enacting that legislation would cause a net increase in federal budget deficits of $109 billion over the 2013–2022 period. Specifically, we estimate that H.R. 6079 would reduce direct spending by $890 billion and reduce revenues by $1 trillion between 2013 and 2022, thus adding $109 billion to federal budget deficits over that period.

What Major Components Result in the Net Increase in Deficits?

Deficits would be increased under H.R. 6079 because the net savings from eliminating the insurance coverage provisions would be more than offset by the combination of other spending increases and revenue reductions:
The ACA contains a set of provisions designed to expand health insurance coverage, which, on net, are projected to cost the government money. The costs of those coverage expansions—which include the cost of the subsidies to be provided through the exchanges, increased outlays for Medicaid and the Children’s Health Insurance Program (CHIP), and tax credits for certain small employers—will be partially offset by penalty payments from employers and uninsured individuals, revenues from the excise tax on high-premium insurance plans, and net savings from other coverage-related effects. By repealing those coverage provisions of the ACA, over the 2013–2022 period, H.R. 6079 would yield gross savings of an estimated $1,677 billion and net savings (after accounting for the offsets just mentioned) of $1,171 billion. The ACA also includes a number of other provisions related to health care that are estimated to reduce net federal outlays (primarily for Medicare). By repealing those provisions, H.R. 6079 would increase other direct spending in the next decade by an estimated $711 billion.
The ACA includes a number of provisions that are estimated to increase federal revenues (apart from the effect of provisions related to insurance coverage), mostly by increasing the Hospital Insurance (HI) payroll tax and extending it to net investment income for high- income taxpayers, and imposing fees or excise taxes on certain manufacturers and insurers. Repealing those provisions would reduce revenues by an estimated $569 billion over the 2013–2022 period.
 
Re: The PPACA Implementation Phase II - Love it or Lose it!

acasignups.net has the answers to a lot of these questions. The bottom line is you can't just look at 7M people and say "oh, that's not a lot compared to the total population". The ACA is dealing with about 40M uninsured because illegal immigrants are specifically barred from coverage.

So dealing with the 40M, the exchanges + expanded Medicare + private insurance + under 26 on parents policies make up the coverage. There's also something called "woodworkers" which is people who realized they are eligible for the old Medicaid program even before the expansion. These people aren't included in ACA #'s, but would be included when Gallup does a survey of uninsured rates (for example, someone walks into South Carolina heath office and wants to sign up for Obamacare Medicare expansion. State says they don't do that but realizes they qualified for existing program all along).

While a lot of this is still in flux, I think you're looking at maybe 10-15M new people being covered this year and that will rise up to about 23M over time (some states, such as NH and MI, just started their Medicare expansion, and others such as VA are working on it).
 
Re: The PPACA Implementation Phase II - Love it or Lose it!

Anybody notice this little item in the paper today? Speaks volumes about the sincerity of Hobby Lobby.

http://abcnews.go.com/Health/wireStory/hobby-lobby-401k-invests-birth-control-makers-23164953

Oh, my..................how do they square that revelation. Seriously that is messed up. Bob?

In their Supreme Court complaint, Hobby Lobby's owners chronicle the many ways in which they avoid entanglements with objectionable companies. Hobby Lobby stores do not sell shot glasses, for example, and the Greens decline requests from beer distributors to back-haul beer on Hobby Lobby trucks.

Similar options exist for companies that want to practice what's sometimes called faith-based investing. To avoid supporting companies that manufacture abortion drugs—or products such as alcohol or pornography—religious investors can turn to a cottage industry of mutual funds that screen out stocks that religious people might consider morally objectionable. The Timothy Plan and the Ave Maria Fund, for example, screen for companies that manufacture abortion drugs, support Planned Parenthood, or engage in embryonic stem cell research. Dan Hardt, a Kentucky financial planner who specializes in faith-based investing, says the performances of these funds are about the same as if they had not been screened. But Hobby Lobby's managers either were not aware of these options or chose not to invest in them.

http://abcnews.go.com/Health/wireStory/hobby-lobby-401k-invests-birth-control-makers-23164953
 
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Re: The PPACA Implementation Phase II - Love it or Lose it!

Oh, my..................how do they square that revelation. Seriously that is messed up. Bob?



http://abcnews.go.com/Health/wireStory/hobby-lobby-401k-invests-birth-control-makers-23164953


Anyone know if Hobby Lobby actually knew this was going on? If they farmed out the management of the fund, they likely have no say in what they are doing with the $$$ as long as it is producing. Or if they knew that there are options on how to invest to avoid things like this? I have no clue what my 401k invests in, so if they have hired someone to manage the fund they might not know either. Go ahead and say they should know or that's true they are clueless. I challenge anyone to list every company they are invested in with a mutual fund at any exact moment.
 
Re: The PPACA Implementation Phase II - Love it or Lose it!

Anyone know if Hobby Lobby actually knew this was going on? If they farmed out the management of the fund, they likely have no say in what they are doing with the $$$ as long as it is producing. Or if they knew that there are options on how to invest to avoid things like this? I have no clue what my 401k invests in, so if they have hired someone to manage the fund they might not know either. Go ahead and say they should know or that's true they are clueless. I challenge anyone to list every company they are invested in with a mutual fund at any exact moment.

Do you have any idea what medications are covered by your health insurance plan? I fail to see how knowing what you invest a 401k in is any different from knowing every medication covered by your health plan. Seems a perfect comparison to me.
 
Re: The PPACA Implementation Phase II - Love it or Lose it!

Anyone know if Hobby Lobby actually knew this was going on? If they farmed out the management of the fund, they likely have no say in what they are doing with the $$$ as long as it is producing. Or if they knew that there are options on how to invest to avoid things like this? I have no clue what my 401k invests in, so if they have hired someone to manage the fund they might not know either. Go ahead and say they should know or that's true they are clueless. I challenge anyone to list every company they are invested in with a mutual fund at any exact moment.

They also have no idea what medications their employees are taking. Yet, that's a big deal to them.
 
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