... and the illegals, poor, and minorities may thank the middle class whose premiums, deductible, and prescriptions have become so expensive that they, themselves, cannot afford to be sick. The net result of ACA/Obama Care was an increase in price of all that is healthcare related. Why is it difficult to understand why people are angry? The Government takes from those who work to give to those who won't. I despise our Government (both parties), the President, and all that DC represents. I am for anyone who will crush the rice bowl of the insiders, establishment, old guard, etc... Bitter? Absolutely. Voting? Absolutely.
43
The point of giving people access to healthcare and education is to increase the odds they will be productive citizens and participants in society. Having chronic illness which can be managed with modest expense allows people to work. Having the same chronic illness but no way of getting any healthcare means they become "disabled". Same with education - providing everyone with a decent education means more people have the confidence and impulse control it takes to be a constructive worker. If you were born in a dysfunctional environment and grew up on the streets, you are about as civilized as a stray dog, but a lot more dangerous due to your biologically superior brain. Providing structure and stimulation to the developing brain is critical to having productive workers who will not go "postal" at the slightest pretext or, more commonly, quit job after job because they cannot handle the routines and minor irritations of a steady job.
We can resent these things being done in an inept fashion. But if one ever feels the urge to get angry about helping the poor and disenfranchised please always consider the alternative. Good luck and enjoy your vote.
We can resent these things being done in an inept fashion. But if one ever feels the urge to get angry about helping the poor and disenfranchised please always consider the alternative. Good luck and enjoy your vote.
19
Insurance companies should be completely eliminated. They have no purpose other than to make money and collude with health care providers (mostly greedy hospitals) to make lots of profit together. Create universal health care. Ban paying privately for care. Gov't should set a fixed, low price for each service and stick to it. Single payer all the way.
24
This article ignored the 800 pound gorilla at the end of the sofa: while it is indisputably a good thing that more people have access to proper health care, it has happened because the middle class is now suffering under near unsustainable health insurance premium increases. If present trends continue and the ACA isn't somehow revised, we will be a nation in which the vast majority of households can only afford catastrophic health care policies. These policies, the Times may not realize, are like Russian roulette with six chambered bullets -- no matter how hard you try, you lose.
50
I wholeheartedly agree with you. I happen to be in that middle class of persons that's approaching being unable to afford unsustainable health insurance premium increases, even if they are employer subsidized.
And the increasing deductibles and co-pays don't make it any easier.
And the increasing deductibles and co-pays don't make it any easier.
24
You realize this was happening before the ACA right? And that rates of increase have dropped since implementation? Our healthcare system has been in a downward spiral with rising costs for decades. The difference now is that rate of increase is less and the cheapest policies are far better. Many are still quite "underinsured", but it IS better.
Many don't understand that the ACA didn't cause this, and it has actually helped. It certainly is not perfect and definitely caused new problems. But just "repealing it", as so many on the right champion, would be another huge step in the wrong direction.
The next step should be a national single-payer program. Hillary's solution to simply "get that last 5%" insured is asinine. Access to healthcare should never bankrupt someone nor be limited by how much they can afford.
Many don't understand that the ACA didn't cause this, and it has actually helped. It certainly is not perfect and definitely caused new problems. But just "repealing it", as so many on the right champion, would be another huge step in the wrong direction.
The next step should be a national single-payer program. Hillary's solution to simply "get that last 5%" insured is asinine. Access to healthcare should never bankrupt someone nor be limited by how much they can afford.
16
Just further proof that immigrants from Mexico are a net loss for the country.
32
Since you used the word "proof" - this article does not include the cost of immigrants from elsewhere compared to the cost of immigrants from Mexico. It does not include the cost of wealth generated by immigrants from Mexico vs using only citizens or citizens and non-Mexican immigrants.
Look at it this way, if they were a net loss, why are we letting so many live openly amongst us and hiring them in our farms and worksites on a daily and seasonal basis? Somebody powerful enough to hold off the law is making money off of illegal immigration. It cannot be the illegal immigrants themselves, can it? It is probably some of the folks who appear on CNBC, Bloomberg, CNN, Foxnews , and it is also some of the folks who are sitting in the next table from you at the fancy restaurant asking the waiter if the Chablis or the Sauvignon Blanc will go better with the Honey Glazed Herb Encrusted Salmon Nicoise or whatever.
Remember the Golden rule - he with the gold makes the rules.
Look at it this way, if they were a net loss, why are we letting so many live openly amongst us and hiring them in our farms and worksites on a daily and seasonal basis? Somebody powerful enough to hold off the law is making money off of illegal immigration. It cannot be the illegal immigrants themselves, can it? It is probably some of the folks who appear on CNBC, Bloomberg, CNN, Foxnews , and it is also some of the folks who are sitting in the next table from you at the fancy restaurant asking the waiter if the Chablis or the Sauvignon Blanc will go better with the Honey Glazed Herb Encrusted Salmon Nicoise or whatever.
Remember the Golden rule - he with the gold makes the rules.
8
"Hispanics are the Americans with the lowest level of coverage because so many are illegal" ---- um, those illegals are NOT Americans. That's the point.
46
This vitriol against ACA reminds me the vitriol against Hillary. All driven by right wing outlets...
9
One thing forgotten in this article is that the U S taxes Medical care, medical products and medical services.
ACA added taxes, established by gross sales, on to drugs and devices.
The U S also taxes inventory, transportation and selling , as well as employment in health care and insurance for health care costs.
These taxes are at the federal, state and local levels, and each of those taxes flows down to the end user in higher costs.
So of course we have high and rising medical costs - creating another income inequality gap
ACA added taxes, established by gross sales, on to drugs and devices.
The U S also taxes inventory, transportation and selling , as well as employment in health care and insurance for health care costs.
These taxes are at the federal, state and local levels, and each of those taxes flows down to the end user in higher costs.
So of course we have high and rising medical costs - creating another income inequality gap
7
In addition, of course, to the colossal giveaway to the insurance companies, for which Obamacare ranks as the greatest bonanza in their history. I guess this indirectly benefits their immigrant, poor and minority employees.
I suppose it would been asking too much for the framers to have included healthcare in the constitution as a fundamental right, although that seems to be the view now embraced by the current occupant of the White House. One of the obvious dilemmas relates directly to the issue of health care costs. If we were to assume for a moment that housing is a fundamental right, does everyone have a right to a mansion or do some people need to settle for a studio apartment? As long as many people get mansions, i.e. access to all the care they want regardless of costs, we won't make a dent in this.
I suppose it would been asking too much for the framers to have included healthcare in the constitution as a fundamental right, although that seems to be the view now embraced by the current occupant of the White House. One of the obvious dilemmas relates directly to the issue of health care costs. If we were to assume for a moment that housing is a fundamental right, does everyone have a right to a mansion or do some people need to settle for a studio apartment? As long as many people get mansions, i.e. access to all the care they want regardless of costs, we won't make a dent in this.
11
The ACA was principally about addressing the disparities in access to health insurance and, thus, healthcare. That the benefits principally accrued to poor and minorities while middle income individuals and families paid more was a result of the design.
Unlike Bernie Sanders plan there was no attempt to reconfigure the overall American healthcare system. It was about cost shifting and, Hillary's Clinton's plan for reducing prescription drug costs, follows the same path - cost shifting.
What we really need to look at is how to make health insurance and healthcare affordable to everyone. We now have middle income people, according to the Urban Institute, paying as much as 25% in annual income to health insurance/care.
While extending health insurance and health care to the poor and those with pre-existing conditions and closing the gap between minority and white Americans health care access is certainly a laudable accomplishment, it needed to be done without at the same time reducing other Americans access to healthcare and pricing them out of health insurance.
Far better to raise all boats than to bring some down and bring some up.
Unlike Bernie Sanders plan there was no attempt to reconfigure the overall American healthcare system. It was about cost shifting and, Hillary's Clinton's plan for reducing prescription drug costs, follows the same path - cost shifting.
What we really need to look at is how to make health insurance and healthcare affordable to everyone. We now have middle income people, according to the Urban Institute, paying as much as 25% in annual income to health insurance/care.
While extending health insurance and health care to the poor and those with pre-existing conditions and closing the gap between minority and white Americans health care access is certainly a laudable accomplishment, it needed to be done without at the same time reducing other Americans access to healthcare and pricing them out of health insurance.
Far better to raise all boats than to bring some down and bring some up.
14
A great achievement for Obama, Pelosi and the Democratic Party. Of course, the Sanders campaign is attacking the Affordable Care Act, which demonstrates that Republicans are not the only ones out of touch with reality.
11
Progress is great, but it doesn't mean we stop. We should all be critical of our healthcare system, it is still wildly broken. The ACA has been a stop gap, it has helped in many areas and hurt in others.
The Sanders campaign isn't attacking it, it is simply saying that it isn't enough. They are right, it isn't. Hillary was once a vocal proponent of Universal Healthcare, now she is (literally) the highest paid recipient of the healthcare lobbyists. Now she says it is "never, ever going to happen". It's not a hard connection to make.
If we can pass the ACA with every single republican opposing it, we can pass universal healthcare. We need to stop accepting mediocrity.
The Sanders campaign isn't attacking it, it is simply saying that it isn't enough. They are right, it isn't. Hillary was once a vocal proponent of Universal Healthcare, now she is (literally) the highest paid recipient of the healthcare lobbyists. Now she says it is "never, ever going to happen". It's not a hard connection to make.
If we can pass the ACA with every single republican opposing it, we can pass universal healthcare. We need to stop accepting mediocrity.
15
Inch by inch, the US is actually becoming something like a decent country. God knows, it has an enormous distance to go, but this is a positive step in the right direction.
21
I greatly welcome all those benefits the poor and minorities are reaping from this law. What is more fundamental that having good health?
But, per many of the comments here, I'm not so sure a majority of my fellow Americans feel likewise. To me, this tends to show that a large percentage of our population is still excessively selfish -- esp GOP-ers.
As Bill Clinton said many years ago -- the GOP espouses a "Yo-Yo" philosophy -- "You're On Your Own." As opposed to the Dems being a "WITT" perspective -- "We're In This Together."
Succinct statement of the vast difference in the two Parties that divide our nation -- including its views on the AFCA.
But, per many of the comments here, I'm not so sure a majority of my fellow Americans feel likewise. To me, this tends to show that a large percentage of our population is still excessively selfish -- esp GOP-ers.
As Bill Clinton said many years ago -- the GOP espouses a "Yo-Yo" philosophy -- "You're On Your Own." As opposed to the Dems being a "WITT" perspective -- "We're In This Together."
Succinct statement of the vast difference in the two Parties that divide our nation -- including its views on the AFCA.
23
Excessively selfish? How can you possibly call those who work to support those who won't work selfish? What incredibly twisted logic. Your posting is exactly why Americans are supporting Trump. When all logic fails, go scorched earth.
27
I am wondering about the quality of care the newly insured get. I have Medicare and an expensive supplement, yet I do not get treated properly: most physicians don't want to bother giving treatment because they feel they don't get paid enough. Some are properly enraged by it, some simply refuse to see Medicare patients, some say it is the way of the future and predict it will get worse before it gets better. In the meantime, there is PBS and the Internet... I try to treat myself, but I don't get blood tests to check how I am doing because my doctor doesn't believe people my age should try to stay as healthy as possible...
11
Hi PChou, I totally agree with your comment and I have unfortunately seen the same thing happening in my neighbourhood as well where the medicaid as well as medicare patients are not treated fairly. On the other hand the employed people are also tied and bound to their employer insurance which is also a great source of anxiety as they will lose insurance if they are laid off or change jobs.
I think in the first step, all medicaid, medicare and private insurance must be merged into the common market place which is provided by healthcare dot gov. And after that we must push for single national payer for all essential and vital medical services.
I think in the first step, all medicaid, medicare and private insurance must be merged into the common market place which is provided by healthcare dot gov. And after that we must push for single national payer for all essential and vital medical services.
6
So, let me get this straight. We needed to reform healthcare because the costs were too high. And now the costs are higher because the real crux behind the 'reform' was to give healthcare away to the poor (who had medicaid, if they were truly poor versus the liberal definition that continues to expand). Even more, we are giving it away to the minority poor (<4% of whites received increased coverage, but make up the vast majority of the poor population).
And now the NYTimes is telling us that we should be paying for even more, but are not because a number of states did not expand medicaid.
Medicaid was implemented as a way to help the very poor in this country, as well as children whose parents became ill or died and were unable to get insurance. Obama redefined Medicaid and it's purpose, as well as Medicare and it's purpose. We have close to 42% of the population receiving subsidies, including those in Congress and the white house, while the rest of us have seen a tripling of costs.
This junk legislation did not cut costs - and don't tell me if the government pays less, and the people pay more, that we've cut costs. It did not increase the number of insured significantly, and has not impacted our ER visits from those that have no insurance - ER visits have actually gone up.
Just what were we trying to do?
And now the NYTimes is telling us that we should be paying for even more, but are not because a number of states did not expand medicaid.
Medicaid was implemented as a way to help the very poor in this country, as well as children whose parents became ill or died and were unable to get insurance. Obama redefined Medicaid and it's purpose, as well as Medicare and it's purpose. We have close to 42% of the population receiving subsidies, including those in Congress and the white house, while the rest of us have seen a tripling of costs.
This junk legislation did not cut costs - and don't tell me if the government pays less, and the people pay more, that we've cut costs. It did not increase the number of insured significantly, and has not impacted our ER visits from those that have no insurance - ER visits have actually gone up.
Just what were we trying to do?
36
Yes, it did cut costs, and quite substantially!
By the way, around 20% of WalMart employees get food stamps, who's fault it is, the government or WalMart?
By the way, around 20% of WalMart employees get food stamps, who's fault it is, the government or WalMart?
7
Carolinajoe - You are 100% wrong. Costs are rising because of the ACA. The people who have signed up for it are much sicker than expected. Know your facts.
20
President Obama had a plan called “ACA”, while the Republicans had simply no plan and called “ACA” a train wreck. So an imperfect “ACA” was better than the Florida/Texas GOP death panels.
Even if the percentage insured have increased, the problem is that many healthcare providers do not accept Medicaid. My neighbor having Obamacare in a blue state could not get X-ray for her back pain as no healthcare provider was accepting Medicaid in her vicinity.
With progressive policies in the short term, we need ensure that Medicaid is accepted by all healthcare providers. We need to transition from employer based plans to marketplace based employer independent plans.
In long term, we need national single payer system to cover all basic healthcare necessities like dialysis, diabetes medication, colonoscopy and basic blood tests.
Even if the percentage insured have increased, the problem is that many healthcare providers do not accept Medicaid. My neighbor having Obamacare in a blue state could not get X-ray for her back pain as no healthcare provider was accepting Medicaid in her vicinity.
With progressive policies in the short term, we need ensure that Medicaid is accepted by all healthcare providers. We need to transition from employer based plans to marketplace based employer independent plans.
In long term, we need national single payer system to cover all basic healthcare necessities like dialysis, diabetes medication, colonoscopy and basic blood tests.
8
I applaud Obama's intention, through the ACA, to offer Americans with pre-existing medical conditions a possibility of insurance. It was absolutely the right thing to do! But tax-paying middle class citizens have to pay for their medical coverage & deductibles and premiums are still quite high. If undocumented immigrants are given legal status, they will qualify for Medicaid, which is free coverage...how is that fair?
And what will be the financial repercussions be if the US gives status to millions upon millions of immigrants here illegally and provides them with free healthcare?Just the costs of dialysis alone for immigrants in the next couple of decades would represent a staggering sum. I recall an older Times article:http://www.nytimes.com/2009/11/21/health/policy/21grady.html
In the article, costs for free dialysis for 51 illegal immigrants had forced a public hospital on the brink of bankruptcy. Immigrants conceded that it was better to receive dialysis in the US because it's free. In Mexico, they would have to pay something! (Alfonso Sanchez states: "No place in Mexico would have offered dialysis for free,” he said, sitting in his spare apartment...It was better to be here. I'm grateful that it's possible in this country"...and dialysis patient Bertha Montelongo's daughter agreed: "In Mexico, it’s different. There, you have to pay.”
Why does the struggling middle class always have to foot the bills? This isn't xenophobia: it's fairness, common sense and simple math!
And what will be the financial repercussions be if the US gives status to millions upon millions of immigrants here illegally and provides them with free healthcare?Just the costs of dialysis alone for immigrants in the next couple of decades would represent a staggering sum. I recall an older Times article:http://www.nytimes.com/2009/11/21/health/policy/21grady.html
In the article, costs for free dialysis for 51 illegal immigrants had forced a public hospital on the brink of bankruptcy. Immigrants conceded that it was better to receive dialysis in the US because it's free. In Mexico, they would have to pay something! (Alfonso Sanchez states: "No place in Mexico would have offered dialysis for free,” he said, sitting in his spare apartment...It was better to be here. I'm grateful that it's possible in this country"...and dialysis patient Bertha Montelongo's daughter agreed: "In Mexico, it’s different. There, you have to pay.”
Why does the struggling middle class always have to foot the bills? This isn't xenophobia: it's fairness, common sense and simple math!
48
ACA is paid through taxes on those who make over $200 K, hardly middle class
1
You are correct, it will get much worse. MD's are refusing to treat Medicare/Medicaid patients because the amount they are reimbursed does not cover the cost of keeping their office open - much less pay the MD for their time. I just left my healthcare job after 10 years. Our office stopped taking all but a handful of private insurance and completely eliminated Medicaid. Current patients who are on Medicare will continue to be seen but no new patients with Medicare will be accepted. The Federal hoops that must be jumped through to see patients on these programs is simply not worth the trouble. Eventually we will all be treated the same. Horribly.
14
Readers have pointed out the many flaws in Obamacare. It will take many adjustments in the law until we get it right. However, our do-nothing Republican congress will never work to fix the thing. "Repeal and replace" is their code for "Get a job with benefits, or you don't deserve to live".
8
So an American family hires an El Salvodorean nanny, pays her insufficient wages to unable her to buy health insurance, and American taxpayers who cannot themselves afford so much as a babysitter must subsidize their neighbor's penchant for live-in child care. Great. . . .
31
The Times would do its readers a service if it explained how the Affordable Care Act is financed. My impression is that the increase in our taxes due to passage of the ACA is a few hundred dollars a year, levied on a retirement income in the low six figures, and at that price the ACA is a bargain. But it's only a guess, and it would be nice if the Times would do more reporting on the policy aspects of the ACA.
9
Your report ignores so much of what's really going on in the health care "marketplace"that it genuinely comes across as propaganda - you are unabashedly defending a deeply flawed and deliberately inefficient system that is bankrupting the rest of us.
32
2,000 years ago Jesus came to free the people. He gave us Personal Responsibility and Individual Freedom. The Democrats have been attempting to take this away from us ever since. You are responsible for your own actions. Democrats, the Party of Slavery since 1856. The entire basis for Obamacare is to control us of the Unwashed Masses, not to assist us. They are following the Communist line, stating that they want to assist the people. If you believe that, I have a bridge in Brooklyn to sell you. The average Federal Employee makes $120,000.00 a year, the average working man makes $53,000.00 a year. The real reason to expand Government.
9
For all the good things that a single payer could do here is the crude financial reality of it. We spent $3.8 Trillion dollars on health related costs last year. If you match that with 120 million tax returns filed last year and you reduce that by 50% who do not have any tax liability and you are left with $3.8 trillion divided by 60 million taxpayers that translates to an additional $63,000.00 on every single taxpayer who does have a tax liability.
Please ask Bernie Sanders why Vermont never implemented their single payer universal plan. I'll give you a hint. The tax hike would have cost him and many others their political future.
Please ask Bernie Sanders why Vermont never implemented their single payer universal plan. I'll give you a hint. The tax hike would have cost him and many others their political future.
22
Immigrants, the Poor and Minorities Gain Sharply Under Health Act? Of course the Republicans want to nix the health act.
8
It is my understanding the poor and minorities were receiving healthcare before the AVA. Perhaps they did not have healthcare insurance but they had access to healthcare. By immigrants, I think you mean illegal immigrants/aliens? If you are here illegally, you should receive zero benefits of any kind.
20
The ACA addressed one of the major issues in our country to take care of the vulnerable and underserved members of our community. It was a well intentioned effort that required the help of those who have more resources. Yes, the greater tax contributions from higher earners are resulting in much disapproval from that group, but let's think about the long term benefits that we will see in the future. This all hands on deck effort will improve health outcomes, and as a result of this, lower costs tied to obesity and chronic illness, excessive emergency room visits, unnecessary lab tests and fee for service systems that inflated health care costs for the last few centuries. The Obama administration is taking our country in the appropriate direction to solve this complicated problem integrated with countless other policies (immigration, education, tax reform). We have to keep the big picture in mind as we debate and continue to reform health care in the US.
17
Excuse me, but I don't believe " fee for service systems that inflated health care costs for the last few centuries" have been around for CENTURIES. What have you been smoking?
5
It is important to stress that the ACA benefits are limited to legal residents and are not given to those who entered without approval and still do not have a path to citizenship.
It is also important to stress that the benefits of healthier individuals add up to safer, healthier and more productive communities. Denying access to health care means damaging the whole society as well as individuals.
The ACA was not a perfect solution and the obstructionism of the Republicans created even more problems, however, as this article tells, the lives of individuals were improved and those states which expanded Medicaid to serve the poorest of the poor benefited.
It is also important to stress that the benefits of healthier individuals add up to safer, healthier and more productive communities. Denying access to health care means damaging the whole society as well as individuals.
The ACA was not a perfect solution and the obstructionism of the Republicans created even more problems, however, as this article tells, the lives of individuals were improved and those states which expanded Medicaid to serve the poorest of the poor benefited.
11
It's illegal to ask a patient if they are here illegally. So, we are paying for illegal immigrants. Every day.
32
Just how does giving healthcare to those that have no intention or desire to live a healthier life increase the health of the nation?
14
How does this years version of the ACA Marketplace expect people to pay for monthly premiums at the same time they are paying out of pocket for everything---dr. visits, tests, scans, x-rays, prescriptions---because of the outrageous deductables on these policies, including the gold and silver ones?
Even people who are poor enough to qualify for a subsidy have to meet $2500-6000 deductables before they are covered for even a single doctor's visit or prescription.
The new, extreme deductables severely limit who has access to medical care and effectively make all the policies only usable for catastrophic illness, which I guess, is the point.
No matter that it undermines the whole idea of the ACA.
After one year of ACA living up to its promise, the insurance companies demanded changes that have restored the crippling policy costs to individuals, disguised as deductables, and once again put good health care out of reach for most people.
Of course it affects the lowest earners most harshly of all. So for now, the Marketplace offers few options to those who aren't covered at their jobs or by programs like Medicaid. The insurance companies have made sure of that.
Even people who are poor enough to qualify for a subsidy have to meet $2500-6000 deductables before they are covered for even a single doctor's visit or prescription.
The new, extreme deductables severely limit who has access to medical care and effectively make all the policies only usable for catastrophic illness, which I guess, is the point.
No matter that it undermines the whole idea of the ACA.
After one year of ACA living up to its promise, the insurance companies demanded changes that have restored the crippling policy costs to individuals, disguised as deductables, and once again put good health care out of reach for most people.
Of course it affects the lowest earners most harshly of all. So for now, the Marketplace offers few options to those who aren't covered at their jobs or by programs like Medicaid. The insurance companies have made sure of that.
16
Ot's hard to know why it's so hard to get people to understand that this isn't true: because of the PPACA, your checkups, regular tests, and vaccinations come free of charge to you.
By the way, it's not as though there were no deductibles previously. And by the way? ALL the Republican plans emphasize HSAs and HRAs.
These are all, by definition, HDHPs. That means "high deductible heatlh plan." The idea is to incentivize people totake better care of themselves.
By the way, it's not as though there were no deductibles previously. And by the way? ALL the Republican plans emphasize HSAs and HRAs.
These are all, by definition, HDHPs. That means "high deductible heatlh plan." The idea is to incentivize people totake better care of themselves.
2
It's not insurance to have a $6450 or $3000 deductible people can't afford things like diabetes supplies with all the copays and deductibles.
Why was the maximum deductible not capped and tied to a person's income level?
Why was the maximum deductible not capped and tied to a person's income level?
19
Because it was. Your out-of-pocket total yearly costs are limited to around 9% of annual income.
6
Insurance companies will never agree to sliding scale deductibles, and the system should not. Medicaid already provides care for these individuals. The whole idea was to lower the overall cost of healthcare for everyone, but that is not what ACA accomplished. Yes, many previously uninsured, many legal but not citizens can now be covered, however many other citizens still cannot afford healthcare under ACA, face a penalty for not doing so, and now those who were never insured are being cared for at high expense for the most part because they are finally able to take care of conditions they have long suffered from. The middle is still paying the far and away greater weight of this program. I know because I do my company's insurance negotiations, and the health insurance companies have lost nothing, have more members, companies are paying more for less, need to offer very high deductible plans just to be able to afford it for employees. Its a joke of a plan, and I mean no disrespect for those who are now covered, but my daughter works full time for a pittance and is still exempt from state help with the cost of insurance, therefore cannot afford it.
10
The compromises necessary to get the ACA through Congress, after Republicans and the insurance, pharmaceuticals, medical equipment etc. lobbies all obstructed at everything, made the program an extremely far cry from what it should be. I am both a recipient and someone who has worked in an official capacity helping people apply for coverage, so am very familiar with both its benefits and limitations.
The parameters of deductibles, co-pays, covered services and supplies depend in part on the metal level and plan you choose, i.e. bronze blue cross, or gold aetna, but suffice it to say that for any of them what you get is worse than it should be but much better than the alternative.
If a Republican is elected president it will all be undone and we will be up a creek again with no coverage to complain about. If we get a Democrat we will at least be no worse off, and hopefully see improvements.
The parameters of deductibles, co-pays, covered services and supplies depend in part on the metal level and plan you choose, i.e. bronze blue cross, or gold aetna, but suffice it to say that for any of them what you get is worse than it should be but much better than the alternative.
If a Republican is elected president it will all be undone and we will be up a creek again with no coverage to complain about. If we get a Democrat we will at least be no worse off, and hopefully see improvements.
4
Angela Cruz, who is still a citizen of El Salvador though she has been here legally for 25 years, is a prime example of people who now have a responsibility to become American citizens and TO VOTE and to vote for the Democratic Party and all its candidates because it is the Democratic Party that gave her the peace and security and good healthcare that comes from health coverage just as it is the Democratic Party that gave seniors Medicare, gave poor people Medicaid and gave everyone Social Security for the aged and the disabled.
It is up to Ms. Cruz to become a citizen, vote and make sure that someone like Sen. Cruz never becomes president with the state objective of taking away her health coverage and healthcare.
It is up to Ms. Cruz to become a citizen, vote and make sure that someone like Sen. Cruz never becomes president with the state objective of taking away her health coverage and healthcare.
7
So you're saying that the Democrats have given social security Benefits that I paid for to illegal immigrants? That doesn't sound fair to me at all.
9
Imagine if the Supreme Court didn't permit the states to opt out of the Medicaid expansion.
Imagine the lives saved.
Vote as if your life or the lives of others matter to you.
Imagine the lives saved.
Vote as if your life or the lives of others matter to you.
10
I live in one of the 19 states that will not expand Medicaid programs for the poor. The attached article from Kaiser Health News examines the increased costs of uncompensated care.
http://khn.org/news/not-expanding-medicaid-can-cost-local-taxpayers/
“Nationwide, the cost of caring for uninsured people in non-expansion states between now and 2024 is projected to reach $266 billion if no new states decide to expand Medicaid, according to a report in April from the Kaiser Family Foundation. If all states decided to expand, that cost would drop by a third.”
"The Urban Institute estimates that if Texas had expanded Medicaid in 2014, over the next 10 years it would have spent $5.7 billion as its share of Medicaid expenses for the newly eligible population, while drawing down nearly $66 billion in matching federal Medicaid funds."
The Texas Medical Association describes Texas as “the uninsured capital of the United States. More than 5.04 million Texans - including 784,000 children - lack health insurance. Texas' uninsurance rates, 1.5 to 2 times the national average, create significant problems in the financing and delivery of health care to all Texans. Those who lack insurance coverage typically enjoy far-worse health status than their insured counterparts.”
I am still not clear on intent -- i.e., why the governor(s) and legislature refuse to expand Medicaid for the people. The costs are far reaching.
http://khn.org/news/not-expanding-medicaid-can-cost-local-taxpayers/
“Nationwide, the cost of caring for uninsured people in non-expansion states between now and 2024 is projected to reach $266 billion if no new states decide to expand Medicaid, according to a report in April from the Kaiser Family Foundation. If all states decided to expand, that cost would drop by a third.”
"The Urban Institute estimates that if Texas had expanded Medicaid in 2014, over the next 10 years it would have spent $5.7 billion as its share of Medicaid expenses for the newly eligible population, while drawing down nearly $66 billion in matching federal Medicaid funds."
The Texas Medical Association describes Texas as “the uninsured capital of the United States. More than 5.04 million Texans - including 784,000 children - lack health insurance. Texas' uninsurance rates, 1.5 to 2 times the national average, create significant problems in the financing and delivery of health care to all Texans. Those who lack insurance coverage typically enjoy far-worse health status than their insured counterparts.”
I am still not clear on intent -- i.e., why the governor(s) and legislature refuse to expand Medicaid for the people. The costs are far reaching.
11
Obamacare has been a financial disaster for my wife and me. Our monthly health insurance cost is over $1,600 which is almost as much our mortgage! This program is another example of government taxing the middle class to provide entitlements to the "poor."
62
So stop buying on the individual market, and go shop on CoveredCalifornia. Try an HMO or HSA.
5
@Robert: The lowest cost bronze plan on CoveredCalifornia is $1700 per month so that is no bargain either. The plan I have is an HMO. So much for your uninformed suggestions....
17
The ACA cap is about 13,000 a year......
2
Now all of those people who have benefited from the ACA need to get out and vote for the Democrats who will strengthen this law or even try to bring universal health care into being. I know some of them will face barriers of not having the right ID or having to stand in line a long time (barriers put up by the Republicans who are against the ACA), but there are many Democrats who just don't bother to vote. I saw a study done before the 2012 election on people who don't vote. It was determined that the vast majority would vote for Democrats if they did vote and that Obama would win the election in a landslide if they all turned out. There stated reason for not voting? They said they didn't have the time.
3
Question. Will increases in the minimum wage push poor workers out of Medicaid? Will they now be eligible for subsidies? If you increase the minimum wage in states not expanding Medicaid will poor workers be eligible for subsidies?
The ACA is extremely imperfect as it puts help out of the reach of those over the limits for subsidies and increases the burden of health care on the middle class. It is a windfall for insurance companies. It needs an expansion of subsidies or to be scrapped for a single payer health plan, the latter of which is by far preferable.
The ACA is extremely imperfect as it puts help out of the reach of those over the limits for subsidies and increases the burden of health care on the middle class. It is a windfall for insurance companies. It needs an expansion of subsidies or to be scrapped for a single payer health plan, the latter of which is by far preferable.
9
The ACA has had a huge impact on poor and working poor populations, as article details. Yet it also affords all Americans with protections from being dropped by insurers due to pre-existing condtions, and caps on insurance coverage that bankrupted many families. Healthcare bankruptcies have been virtually eliminated. Uninsured rate is lowest in history, 90% of Americans have insurance, and healthcare costs have risen at their lowest rate in 50 years. "Obamacare" is not just a success for the poor, but for all Americans.
6
You could never be 'dropped' for pre-existing conditions. Even before the ACA, once insurance companies took you, they were stuck with you. That is one of the reasons they were very picky about who they took.
7
Not true. The way you could be dropped was they would open a new, reasonably priced "group" open only to the healthy. When everyone who could move did, they'd jack the price up on the rest.
5
at 12,000 per family in out of pocket max per year - health care bankruptcy has not been eliminated
MA aka Romneycare saw NO decline in healthcare bankruptcy in the 4 years they ran the program pre-ACA passage
The health care costs are not related to ACA - but instead due to a depressed economy where people can not afford to go to a doctor and pay the high copays and out of pocket
Premiums - now that the false price setting structure has expired - are expected to rise even more in 2017 than in 2016 - when premiums increased on average 8%
MA aka Romneycare saw NO decline in healthcare bankruptcy in the 4 years they ran the program pre-ACA passage
The health care costs are not related to ACA - but instead due to a depressed economy where people can not afford to go to a doctor and pay the high copays and out of pocket
Premiums - now that the false price setting structure has expired - are expected to rise even more in 2017 than in 2016 - when premiums increased on average 8%
3
The headline alone is enough to strengthen Republican resolve to repeal Obamacare.
14
Why did the President and his friends in Congress build blatant and outright age discrimination into the law ? I am age 55 and would like to purchase a bare-bones catastrophic policy, but the law states that is not a qualified plan for a person my age.
An injustice that I hope will be completely repealed in 2017.
http://www.nytimes.com/2013/10/05/your-money/estimating-income-and-other...
Adult children lose coverage through a parent’s policy on their 26th birthday. But they can then immediately enroll on the exchange — even outside the open enrollment period, which ends on March 31. Individuals under age 30 may also qualify for a “catastrophic” plan, which carries a lower premium but a very high deductible (equivalent to the out-of-pocket maximum, or $6,350 for a single person, in 2014). Tax credits, however, cannot be applied to catastrophic plans.
An injustice that I hope will be completely repealed in 2017.
http://www.nytimes.com/2013/10/05/your-money/estimating-income-and-other...
Adult children lose coverage through a parent’s policy on their 26th birthday. But they can then immediately enroll on the exchange — even outside the open enrollment period, which ends on March 31. Individuals under age 30 may also qualify for a “catastrophic” plan, which carries a lower premium but a very high deductible (equivalent to the out-of-pocket maximum, or $6,350 for a single person, in 2014). Tax credits, however, cannot be applied to catastrophic plans.
9
It's "not qualified," because it is extremely unwise for somebody 55 or older to underinsure themselves this way.
You can still buy a "Bronze," plan--or if you make within 400% of FPL, look at a "Silver," plan and its subsidies or tax credits.
You can still buy a "Bronze," plan--or if you make within 400% of FPL, look at a "Silver," plan and its subsidies or tax credits.
4
Obamacare is exactly the opposite of what the country needs, since it fails to address the exorbitant costs of US health care and in fact it is designed to perpetuate them. Obamacare is essentially a gift to the health care and insurance industries, to be paid for by working middle-class Americans. It is unsustainable without massive premium/co-pay/deductible increases for working middle-class Americans, and thus a threat to the overall economy. What is needed is to bring US health care costs in line with those in other developed countries.
42
Assertions without proof are pointless. You have repeated every cliche about Obamacare available.
2
what the usa needs is a single payer system. whether it is managed by the government or a conglomerate of companies, it is upto you. but you need to cut all the middlemen and have one sheet which the doctor completes for each visit.
6
Does that sheet include the fee? If so, who would determine the fee, the doctor or the government?
If doctors didn't like what the government paid, could they just set up on their own and collect their fees in cash?
If doctors didn't like what the government paid, could they just set up on their own and collect their fees in cash?
2
Healthcare is a public good. It's a 'no brainer' for anyone with a brain.
10
But why does the public have to pay for it? Shouldn't the recipients pay. When you reward the laggards and deadbeats of society with free healthcare their behavior is going to be even worse since they figure they will get patched up at the taxpayer's expense.
7
There you have it, folks. The Great Lie stated to near perfection. Everyone receiving any form of public assistance is a deadbeat and laggard who should pay their own way or do without. The only result of public assistance is to cause those receiving it to become more laggardly and increasingly dead-beated. I wish my mother, who worked hard all her life in raising a family and then in modest-paying jobs as a medical transcriptionist, would have known this while she reaped the benefits of medicare and medicaid before she died...
5
Tell that to the laggards and deadbeats collecting their social security checks and Medicare payments.
1
Wonderful that millions more got health insurance. Unfortunately, they (and we who already had it) do not have speedy access to care. Not enough doctors, long waits for appointments in addition to ever higher premiums. So great that they have insurance, but what good is it if you have pneumonia? You still end up in the emergency room.
5
This is untrue. Stating this is based on false information. Millions have benefited.
3
if they add 10 more students to every medical class, they will have the necessary doctors in no time. instead of importing doctors from all over the world.
6
Most cities and towns have walk-in care. I have Medicare and a Supplemental Plan with Prudential. However, I have also used walk-in care, paying with my Medicare. You do not have to find a crowded ER room; look for the nearest walk-in, staffed with competent doctors and nurses and equipped with x-ray machines.
4
I appreciated the analysis of the law's impact and who is and isn't being helped. I thought the political analysis was unnecessary. The assessment of the health effects of the ACA is evidence-based and should stand alone. Political writers can speculate elsewhere.
3
Single Payer now.
The rich will still be able to have fancier health care than everyone else - they shouldn't be worried. Happily have my taxes increased to cover it (currently paying $1700+/mo in premiums, so it can't be worse than that). What a democratizer it would be.
The rich will still be able to have fancier health care than everyone else - they shouldn't be worried. Happily have my taxes increased to cover it (currently paying $1700+/mo in premiums, so it can't be worse than that). What a democratizer it would be.
5
Thanks for the information. It helps to clarify Republican opposition, since the ACA would tend to assist those who might vote Democratic.
8
Politically speaking, that is the big problem. The people the ACA helped were already 99% Democrats. The people it hurt were about 50-50 Dems/Reps. That is why it was a foolish move on the part of the Dems, as they have alienated part of their own base.
15
Obamacare did no such thing. Do you just make up assertions, then state them?
2
ACA was a moral thing to do! You understand what moral is? If not, than forget about it....
1
Kudos to the leadership of President Obama and the Democratic Party in securing the passage of the ACA. Is the ACA (and its implementation) flawed? Could it be improved? Yes, but it is a move in a more just direction for America's poor, working poor and our country. The Republican Party will be judged as on the wrong side of history on this issue.
9
It would be interesting to see a follow-up to this assessment that looked at the effects of closing the "donut hole," in Medicare Part D benefits, which often had cost seniors a couple thousand a year.
As for a lot of the comments here--it's not that hard to jump on kff.org, read the various primers and introductions to the PPACA, kind of find out what you're talking about before you start ranting about paying for flu shots and checkups, going off about deductibles before knowing that for the first time, your annual out of pocket costs are capped at around 9% of income, or screaming about the failure to train new docs, practitioners, and PAs, stuff like that.
Wouldn't hurt the single-payer advocates to find out how health systems around the world actually work, or what the Medicare for all costs really are, either.
As for a lot of the comments here--it's not that hard to jump on kff.org, read the various primers and introductions to the PPACA, kind of find out what you're talking about before you start ranting about paying for flu shots and checkups, going off about deductibles before knowing that for the first time, your annual out of pocket costs are capped at around 9% of income, or screaming about the failure to train new docs, practitioners, and PAs, stuff like that.
Wouldn't hurt the single-payer advocates to find out how health systems around the world actually work, or what the Medicare for all costs really are, either.
8
The out of pocket cap only applies to below a specific income level
Medicare - the on the budget costs - work out to over 12,000 per person per year, and leave 20% and drug costs unpaid
Medicare - the on the budget costs - work out to over 12,000 per person per year, and leave 20% and drug costs unpaid
6
I'm amazed that people including the NYT didn't see this financial disaster for the productive middle class coming when the bill was passed. Or maybe the voters did and that is at least part of of the reason why the GOP took the House in 2010 and now controls both houses of Congress.
35
It's probably because the PPACA hasn't caused any such thing.
4
Help the most vulnerable? The 1% and Congress can't stand for this. AHA must be repealed.
2
For years the white house has aided Mexican immigrants, but why? Because a tremendous economy exists between U.S. and Mexican businessmen. Most major American stores are happy doing business in Mexico.
The U.S. needs Mexico for cheap labor. There are over one million Mexicans working in over 3,000 maquinadora manufacturing or export assembly plants in northern Mexico, producing parts and products for the United States. Mexican labor is inexpensive and courtesy of NAFTA (the North American Free Trade Agreement), taxes and custom fees are almost nonexistent, which benefit the profits of corporations. Most of these maquinadora lie within a short drive of the U.S.-Mexico border. Maquinadoras are owned by U.S., Japanese, and European countries and some could be considered "sweatshops" composed of young women working for as little as 50 cents an hour, for up to ten hours a day, six days a week.
The answer is for the U.S. government to hold the Mexican government responsible, with heavy penalties until they rectify their problems.
Carlos Slim Helú is a Mexican business magnate, investor, and philanthropist. From 2010 to 2013, Slim was ranked as the richest person in the world. Known as the "Warren Buffett of Mexico", he derived his fortune from his extensive holdings in a considerable number of Mexican companies through his conglomerate, Grupo Carso. As of 3 November 2015 he was #2 on Forbes list of billionaires, with net worth estimated at US$77.1 billion.
The U.S. needs Mexico for cheap labor. There are over one million Mexicans working in over 3,000 maquinadora manufacturing or export assembly plants in northern Mexico, producing parts and products for the United States. Mexican labor is inexpensive and courtesy of NAFTA (the North American Free Trade Agreement), taxes and custom fees are almost nonexistent, which benefit the profits of corporations. Most of these maquinadora lie within a short drive of the U.S.-Mexico border. Maquinadoras are owned by U.S., Japanese, and European countries and some could be considered "sweatshops" composed of young women working for as little as 50 cents an hour, for up to ten hours a day, six days a week.
The answer is for the U.S. government to hold the Mexican government responsible, with heavy penalties until they rectify their problems.
Carlos Slim Helú is a Mexican business magnate, investor, and philanthropist. From 2010 to 2013, Slim was ranked as the richest person in the world. Known as the "Warren Buffett of Mexico", he derived his fortune from his extensive holdings in a considerable number of Mexican companies through his conglomerate, Grupo Carso. As of 3 November 2015 he was #2 on Forbes list of billionaires, with net worth estimated at US$77.1 billion.
8
it is Machiladora-my manufacturing company has 2 locations in Mexico and 4 here in the US. Whether I like it or not, the tier 1 automotive customers insist that we have access to manufacturing in MX, or we lose them. We get ancillary mfg and a lot of other customers for our US plants due to the same customers demanding some things be made here. I may not like it, but the plain fact of the day is that if my boss didn't set up the maquiladora plants, our 4 US locations would be done. 1500 good paying engineering and manufacturing jobs, gone tomorrow. I know nothing about all the maquiladoras, but ironically, ours pays one of the higher rates and the employees are very strongly protected from losing their jobs, meals are provided and.....free nursing and dr provided healthcare in the area. These people want to work in MX, not here. I know many of them.
4
The law helps the very poor, and doesn't really affect the very rich. The middle class without employer-funded insurance plans get the shaft, because the insurance is simply too expensive to be of any use. Furthermore, it is so poorly managed. I had to call at least 15 times to ask why my mother's insurance was cancelled despite her being a citizen, and it turns out the rep didn't put a leading "0" before her Alien No. To add insult to injury, she had to pay penalty taxes for the 8 months she was without insurance while we fixed this mess.
51
Therein lies the crux of the ACA's problem - it's run by HHS/CMS, i.e. the government. The government cannot run anything.
6
The simple truth is, health care costs a lot. Whether you're wealthy or poor, the basic costs of health care are the same. All the ACA does is attempt to cover the costs of those who can't afford insurance otherwise, but of course that makes people who can afford it unhappy. There really is no way around that; those with more wealth will simply have to help pay for those with less. Either that or just leave them to die without access to medical care. I suppose that would be a reasonable solution for a certain portion of the population ...
In short, all of the arguments against the ACA generally boil down to disgruntled people who don't want to pony up for those who can't pony up.
In short, all of the arguments against the ACA generally boil down to disgruntled people who don't want to pony up for those who can't pony up.
20
Good to see a little healthcare humanity in America despite the right-wing opposition to helping the least among us.
Now let's fix the rest of America's 0.1% healthcare hijacking.
FROM http://www.usatoday.com/story/money/business/2015/11/14/24-7-wall-st-cou...
The US spends far more on health care than any other nation and has a LOWER life expectancy than the OECD average and the lowest life expectancy among top spending nations.
United States health expenditures are a criminal 16.4% of GDP.
The US spends around $8,700 per capita each year on health care, more than double the OECD average and well more than second place Switzerland.
Switzerland 11.1% of GDP
With universal health care for every citizen, Switzerland spends more on health care per capita than every country except for the United States. Higher spending in Switzerland is accompanied by better health outcomes.
Norway 8.9% of GDP
As in a number of other European nations, health care is universal in Norway. Through an agreement with the European Union (EU), all EU citizens are covered by the system, and undocumented immigrants are permitted free emergency treatment only.
Netherlands 11.1% of GDP
Residents of the Netherlands, except for conscientious objectors and members of the military, are required to purchase health care by a government mandate.
Sweden 11% of GDP
America is exceptional at economically and intellectually torturing it citizens with healthcare.
Now let's fix the rest of America's 0.1% healthcare hijacking.
FROM http://www.usatoday.com/story/money/business/2015/11/14/24-7-wall-st-cou...
The US spends far more on health care than any other nation and has a LOWER life expectancy than the OECD average and the lowest life expectancy among top spending nations.
United States health expenditures are a criminal 16.4% of GDP.
The US spends around $8,700 per capita each year on health care, more than double the OECD average and well more than second place Switzerland.
Switzerland 11.1% of GDP
With universal health care for every citizen, Switzerland spends more on health care per capita than every country except for the United States. Higher spending in Switzerland is accompanied by better health outcomes.
Norway 8.9% of GDP
As in a number of other European nations, health care is universal in Norway. Through an agreement with the European Union (EU), all EU citizens are covered by the system, and undocumented immigrants are permitted free emergency treatment only.
Netherlands 11.1% of GDP
Residents of the Netherlands, except for conscientious objectors and members of the military, are required to purchase health care by a government mandate.
Sweden 11% of GDP
America is exceptional at economically and intellectually torturing it citizens with healthcare.
48
You might want to look at the average salaries of medical professionals in these various countries. While the average specialist MD makes $235K in the US, their salaries are much lower in Germany and France. Some specialties are higher - the average gastroenterologist in the US makes $360K, and the average orthopedic surgeon makes $405K. Then there are the entrepreneur physicians who own their own clinics and really rake it in.
You might say that these are fine physicians who provide the best care in the world. I would say that the care they provide is so good, we can't pay for it!
You might say that these are fine physicians who provide the best care in the world. I would say that the care they provide is so good, we can't pay for it!
8
you might want to look at the government imposed costs on health care in those countries
In the U S - and expanded by ACA - health care and medication are a revenue stream for the U S government
In the U S - and expanded by ACA - health care and medication are a revenue stream for the U S government
2
Enjoy it for another year.
Because in January 2017 the first law President Trump or President Cruz will sign on his first day in office will be the law to eliminate the health care coverage of millions of Americans and replace it with...nothing.
Because in January 2017 the first law President Trump or President Cruz will sign on his first day in office will be the law to eliminate the health care coverage of millions of Americans and replace it with...nothing.
5
One may agree with the sentiment without forgetting that a President doesn't get to make up his own laws.
3
Absolute nonsense and muckraking. Same hate mongering DNC has been doing since they fought so hard to not allow the Civil Rights bill in 1964, then later claimed to be the guardians of the poor
Aca is as poorly writtwn as the language the founders used for how to count slaves for determing representation.
The number enrolled is about as bad a metric as you can find to determine effectiveness of the law.
The fact that the Dems will not work with the GOP to fix the law, leads to the need to repeal and start over discussion. We have had an absentee, disengaged President who has split the country to as dangerous a level since Buchanan.
Aca is as poorly writtwn as the language the founders used for how to count slaves for determing representation.
The number enrolled is about as bad a metric as you can find to determine effectiveness of the law.
The fact that the Dems will not work with the GOP to fix the law, leads to the need to repeal and start over discussion. We have had an absentee, disengaged President who has split the country to as dangerous a level since Buchanan.
8
There is nothing to work with GOP on. Any legislation that is. Never heard anything otherwise. Pure rubbish. Yes, Dems worked with GOP on Iraq invasion. NEVER AGAIN!
1
Indeed it is my "privilege" as a university professor and member of the productive element in American society, to pay for Obamacare through my higher taxes. It is a very nice break for the non-achievers, lucky they are.
30
I am just all gosh-darn sorry that you are asked to help your fellow Americans in any way at all. Of course you should have the university job they pay for without the slightest thought for anybody else: it's so unfair.
Oh, by the way? The uninsured have added around $1500 to your annual premium for the last couple decades.
Oh, by the way? The uninsured have added around $1500 to your annual premium for the last couple decades.
12
Your "compassion" is depressing. Not all uninsured are non-achievers. Many uninsured who show up in ERs are what you call achievers who were too arrogant to obtain insurances. Others simply could not afford any under the old system.
9
And if the people who are most helped aren't allowed to vote, because of ever more stringent and ever more ludicrous voter ID laws, then the political impact of this massive boon to Americans is....?
Wait...I know! Republicans will keep talking about what a disaster it is because the only benefit the 1% see is that their hired and often underpaid help is healthier and takes fewer sick days. Who would pay for that!
Wait...I know! Republicans will keep talking about what a disaster it is because the only benefit the 1% see is that their hired and often underpaid help is healthier and takes fewer sick days. Who would pay for that!
2
Would you rather have to pay for the life-long disability payments that have resulted from lack of access to health care and medications? I have seen Social Security cases where people who couldn't afford care and medications for chronic conditions such as diabetes, hypertension and rheumatoid arthritis qualify for disability when they lose kidney function, suffer congestive heart failure or stroke out? I would love some studies done comparing the states that have embraced the ACA and those that have not, and see how it have affected Social Security disability. We should have the statistics by now to demonstrate that under reported perspective on the importance of this landmark legislation.
6
Social Security Disability is very hard to access; I know this because I worked in benefits for a large East Coast corporation for 33 years. It was not difficult to access Workers Comp, and to stay on it for a long time with periodic exams; it was much more difficult to get Disability coverage, many required exams required, more than one doctor signing off. Disability coverage is so expensive that many States do not have it, cannot afford it.
1
You can judge a country by how it treats its poor and needy. We can do better.
10
Really? What good is health insurance with 8000-10,000 $ deductables?
Are the low income folks with this kind of insurance paying these kinds of deductables in order to go to the doctor for a flu shot? I think not.
How are the poor keeping up with the massive premium increases even if they are getting subsidized by the taxpayer?
Remove and replace obomacare. Vote for NO democrats of any stripe!!
Are the low income folks with this kind of insurance paying these kinds of deductables in order to go to the doctor for a flu shot? I think not.
How are the poor keeping up with the massive premium increases even if they are getting subsidized by the taxpayer?
Remove and replace obomacare. Vote for NO democrats of any stripe!!
20
First off, your flu shots--like your checkups and basic tests--no longer cost you a single, solitary dime.
Guess why?
Guess why?
4
The 8 months between the beginning of a new year and on-set of Medicare coverge, was 'un-covered' time for me and with my medical history, it could have been a financil disaster. I woked hard for months to get covered under the ACA for those 8 monhs, and even hough I had been covered by corporate insurance most of my adult life, the initial ACA coverage that I actually qualified for was -BY FAR- the best insurance coverage I EVER had.
So, regardless of what every rethuglicon will read to you off their talking points handouts from the RNC, those talking points are ALL A LIE. ACA coverage for older folks is something to be explored in-depth. It's a great deal if you need coverage because you're prone to be ill as you age... Dduuhh.. And for the younger, it's great !!
DON'T IGNORE THE ACA. YOU'LL DO IT AT YOUR OWN DEMISE.
So, regardless of what every rethuglicon will read to you off their talking points handouts from the RNC, those talking points are ALL A LIE. ACA coverage for older folks is something to be explored in-depth. It's a great deal if you need coverage because you're prone to be ill as you age... Dduuhh.. And for the younger, it's great !!
DON'T IGNORE THE ACA. YOU'LL DO IT AT YOUR OWN DEMISE.
5
I don't care. I still do not have health coverage because the deductibles are too high. All ACA meant to me was the obligation to pay for a high-deductible/co-pay plan THAT STILL DOES NOT GIVE ME ACCESS TO HEALTHCARE. It is just a tax that subsidizes someone else.
62
It woulda helpd if your state had expanded Medicaid, which--assuming that you make little money--would have given you better access.
But it might be noted that people who refuse to get covered, one way or another--looks like that'd be YOU--are also moochers.
Because you wait till you get sick or hurt, show up without insurance in the ER, and WE pick up your tab.
Thanks a bunch.
But more usefully, your dductible may be high--but for the first time ever, at least you know you won't lose your house because of your medical bills.
But it might be noted that people who refuse to get covered, one way or another--looks like that'd be YOU--are also moochers.
Because you wait till you get sick or hurt, show up without insurance in the ER, and WE pick up your tab.
Thanks a bunch.
But more usefully, your dductible may be high--but for the first time ever, at least you know you won't lose your house because of your medical bills.
2
Robert - That is certainly not true. If you show up at the emergency room without insurance, you have to pay the bill yourself. If you are not entitled to subsidized insurance, and have to pay a penalty, you probably have considerable personal assets.
7
You are almost right about the Texas thing. The fact is our household income is slightly over the ceiling (less than $3000) for Medicaid expansion. My subsidized contribution, at 8 percent of gross income, I CANNOT AFFORD. If you are being forced --FORCED -- to spend 8 percent of your income, you should get some healthcare, right? (A checkup and a periodic colonoscopy are not actual healthcare.) Well, the only plan in my price range has a $6500 deductible. Add that to my monthly contribution and I spend almost $9500 before I receive dollar one in health benefits. That is over 40 percent of my take home pay.
Oh, and I do not own a house.
The ACA did not anticipate that men over 50 would 1) suffer a HUGE drop in earnings after the 2009 recession; and 2) be required to pay huge deductibles. The ACA does not work for us. It is a sop to the insurance industry.
Oh, and I do not own a house.
The ACA did not anticipate that men over 50 would 1) suffer a HUGE drop in earnings after the 2009 recession; and 2) be required to pay huge deductibles. The ACA does not work for us. It is a sop to the insurance industry.
15
The problem with Obamacare is the degree of selectivity (a/k/a "cherry picking") required to champion it . In Obama's case, he didn't cherry pick before it was passed. He just obfuscated to cover up the negatives. Now his Administration simply ignores the negatives by cherry picking.
For all of those who are not subsidized and cannot access their health care because of high premiums and out of pockets, narrow networks, etc., life's a bowl of cherries!
For all of those who are not subsidized and cannot access their health care because of high premiums and out of pockets, narrow networks, etc., life's a bowl of cherries!
13
"OBFUSCATED" my heinie.
HE LIED. Obama lied. And lied and lied and lied and lied, to get his pet bill passed.
He is a liar. He said we could could keep our insurance, our doctors. He said we'd get $2500 in direct savings.
HE LIED. None of this was true.
Jonathan Gruber "outted" Obama, but a corrupt SCOTUS forced us to pay anyways.
They are all in on the "fix".
HE LIED. Obama lied. And lied and lied and lied and lied, to get his pet bill passed.
He is a liar. He said we could could keep our insurance, our doctors. He said we'd get $2500 in direct savings.
HE LIED. None of this was true.
Jonathan Gruber "outted" Obama, but a corrupt SCOTUS forced us to pay anyways.
They are all in on the "fix".
9
Around 97% of Americans keep their doctor....
2
The ACA is the most inefficient health care system among our peer countries. Having said that it is light yrs better than the previous de facto criminal republican plan or be rich or don't get sick or have a bad life event.
16
Well, we've finally made it -- to each according to his need, from each according to his ability. Karl Marx would be so proud.
The rest of us are throwing up at the ever-expanding grifter class in the once great United States of America, where an opportunity is all that one ever needed or wanted. Now, all one (like our fine Mr. Ortega here) wants is someone else to pay the bill so we don't have to.
There's nothing special or unique or worthy of celebration in the likes of Mr. Ortega. He's a grifter, nothing more. He's a burden to society, contributing nothing in return. He takes, nothing more. And there are tens, hundreds of millions more like him in this country. Takers, grifters.
The rest of us are throwing up at the ever-expanding grifter class in the once great United States of America, where an opportunity is all that one ever needed or wanted. Now, all one (like our fine Mr. Ortega here) wants is someone else to pay the bill so we don't have to.
There's nothing special or unique or worthy of celebration in the likes of Mr. Ortega. He's a grifter, nothing more. He's a burden to society, contributing nothing in return. He takes, nothing more. And there are tens, hundreds of millions more like him in this country. Takers, grifters.
27
It's been 6 years since the ACA was passed without a single Republican vote. It has survived some 60 attempts by Republicans to repeal it. Despite its obvious deficiencies, it has improved access to healthcare for millions of Americans. Not once in 6 years have Republicans proposed a viable alternative. Until they do, I vote for staying with the ACA and improving on it.
23
Everybody should be able to buy into the insurance program that Congress gives itself on a sliding scale based on wealth and income. In any state.
33
On this I can agree, what they think they are entitled to should not be out of reach for legal tax paying citizens.
What needs to be controlled are the costs or the charges that are outrageous and vary widely.
What needs to be controlled are the costs or the charges that are outrageous and vary widely.
5
Obamacare is a successful step toward reasonably priced health insurance for all. Maybe Hillary will get a public option through the Congress if enough Americans vote and the Democrats take the Senate?
5
Reasonably priced?! Are you crazy?
7
I hadn't known that "crazy," meant, "knows the numbers I couldn't be bothered to look up."
It is shocking that the NYT is not reporting on how many illegal aliens that my tax dollars are paying health insurance for and now I am learning a new label: "legal residents who are not citizens" for which more than a million now get insurance on my dime.
There should not no illegal aliens, nor non-citizens of any kind getting any American benefits. This type of policy dilutes and diminishes the substance of each American citizen and our country.
And, that I am paying for non-Citizens is "slavery." Now there is an old label that is the new reality - this government and its ideological progressive liberal policies are enslaving wealth producing American citizens.
There should not no illegal aliens, nor non-citizens of any kind getting any American benefits. This type of policy dilutes and diminishes the substance of each American citizen and our country.
And, that I am paying for non-Citizens is "slavery." Now there is an old label that is the new reality - this government and its ideological progressive liberal policies are enslaving wealth producing American citizens.
44
If as a newly designated slave you find this level of oppression offensive wait until they tie you to your oar in the hold of the ship for the Middle Crossing.
2
It's not so long ago, Mr. Granatotsky, that people with your sorts of names got sneered at as illegals.
5
Guess what, you were paying for them before with your taxes, as hospitals and physicians had to treat them anyway when the came to the ER.
7
Always amazed at how Republicans loathe a Republican-styled change to our healthcare system that helps poor people which is so consistent with Judeo-Christian doctrine ( https://www.kingjamesbibleonline.org/Bible-Verses-About-Helping-The-Poor/ ). But of course it was Obama who implemented the change.
Now if the government could only improve the healthcare system according to Democratic values...maybe after the next presidential election?
Now if the government could only improve the healthcare system according to Democratic values...maybe after the next presidential election?
6
The NY Times, as usual, is advocating for the law. Any honest assessment (and once in a while, you find it in the readers comments) and you know that most people who are newly covered, don't use the coverage very much because the deductibles are so high. On top of that, the number of nurses and doctors hasn't exactly increased to treat all these new patients - so wait times are even longer. Then try finding a doctor who takes medicare or medicaid! Or a good one anyway!
Single payer is the only answer - single payer including traditional modalities such as acupuncture, herbs, homeopathy, ayurveda - all equally if not more effective, less expensive and less toxic than western medicine (except for physical injuries.) On top of that, we need to emulate Cuba (gasp!) and offer free medical training in exchange for promises to work in underserved areas. Along with that, we need to increase the number of medical schools, acupuncture schools, physicians assistant programs etc.
Single payer is the only answer - single payer including traditional modalities such as acupuncture, herbs, homeopathy, ayurveda - all equally if not more effective, less expensive and less toxic than western medicine (except for physical injuries.) On top of that, we need to emulate Cuba (gasp!) and offer free medical training in exchange for promises to work in underserved areas. Along with that, we need to increase the number of medical schools, acupuncture schools, physicians assistant programs etc.
19
Considering that you're advocating various quackeries, don't know that the primary physician shortage has been a prob for two decades and has zip to do woth the PPACA, don't know that the PPACA invests a lot in physician, PA and NP training....
Well, I find your argument less than convincing.
Well, I find your argument less than convincing.
2
I think the NYT would agree that single payer is the answer. Nevertheless, it is important to at least see if and how the new law is better than what we had before.
1
No, we don't need to increase the number of medical schools. And we already have loan forgiveness if you work in an under-served area. Problem is, you cannot get into the program if you're not a minority.
We must stop affirmative action when it comes to universities and advanced degrees - we are graduating too many that do not have the capacity for practicing. And worse, many are getting out of med school and looking for other careers as they are finding they are wards of the state.
We must stop affirmative action when it comes to universities and advanced degrees - we are graduating too many that do not have the capacity for practicing. And worse, many are getting out of med school and looking for other careers as they are finding they are wards of the state.
3
Shouldn't we as a country applaud a law that has bettered the lives of the less fortunate in our society. Yes, it is a flawed law, but it is a well-intentioned law that is helping real people make it through the day with less pain and more ability to earn a living and take care of a family. What is most troubling, are candidates and an entire party who would vilify a law because they truly believe that the less fortunate do not deserve a better life.
60
You are absolutely right. I have a marvelous friend who would have no health insurance if it weren't for this law. And, as to its flaws, maybe it would have had fewer flaws if the GOP hadn't kept putting up roadblocks with no good alternatives.
17
The ACA has been a huge improvement for some. When it went into effect I was a single mother, two jobs, and had to choose between paying for pre-K or health insurance, and of course I chose pre-K. The day I got health insurance was one of the top 5 days of my life, the stress I lived under before that was huge. I've been able to address things I couldn't before.
However, it is important to me how the law impacts people in the middle and I don't want my relief to be prohibitively burdensome for others. Until all the costs associated with health care are addressed, it's not going to fully work.
However, it is important to me how the law impacts people in the middle and I don't want my relief to be prohibitively burdensome for others. Until all the costs associated with health care are addressed, it's not going to fully work.
14
So flawed and well intentioned make it right? There's a real disconnect there.
3
Immigrants, the poor, minorities and everyone else except Big Pharma and the Health Insurance industry would gain a lot more with single payer.
But, then, who's more important in our capitalist society? The majority of the population or the one percent who rake in obscene corporate profits on the backs of sick people?
But, then, who's more important in our capitalist society? The majority of the population or the one percent who rake in obscene corporate profits on the backs of sick people?
38
It is interesting to note that the biggest group of people in the top 1% are....doctors. According to the NY Times itself, 27.2% of all doctors have a household income that puts them in the top 1% of households.
6
Yes it's helped the working poor and has helped people with preexisting conditions get insurance. all a great thing.
But it fails to address the handouts to big Pharm and the outrageous costs of health care in this country. It absorbs far too much of our GDP, much more then any country with socialized medicine.
It's simply an unworkable model. It cannot sustain itself.
But it fails to address the handouts to big Pharm and the outrageous costs of health care in this country. It absorbs far too much of our GDP, much more then any country with socialized medicine.
It's simply an unworkable model. It cannot sustain itself.
31
Filling the pockets of the pharmaceutical and insurance industries is what is unsustainable.
11
Know what would best assist the poor and minorities and all of us and the health of the nation as well universal single payer health care just like every other first world nation has. Let's understand the reality of Obamacare it is a scheme to force us to buy a product from private companies called insurance companies. Those who can't afford the product gov't pays these private insurers for them. The big winner here is the health car insurance industry.
48
"the gov't" paying is you and I.
3
The lesson should be universal health care, so that no one needs to settle for celebrating a 51-year-old getting amputation and a prosthetic leg. Universal basic care could have prevented the amputation. Without that, we can only hope none of the large numbers of the uninsured have or will develop diabetes.
5
...and the Law did so by a dramatic payer shift from the insurance companies and the government to the harder working people of America. As an example for my spouse and I we would pay $1,500.00 monthly and that cost will not include copays or deductibles bringing our total monthly cost to over $2,000.00 per month. The COBRA from my employer would be $1,720. monthly. As a person who has dedicated his working life to helping lower income and those in need the outrage one feels at this shell game is palpable. The POTUS trumps his victory, the insurance companies have a new cash cow and it's because we the people who spend decades working our tails off now pay for those who did not, could not or would not. Let's at least be honest about that.
68
ACA capped the overhead of insurance companies to 20%. Before the law passage it was often much bigger than that.
But please, do keep up the rant. $1500 per month buys a golden healthcare plan for a family of two. You can easily decrease your cost by shopping for a better plan.
But please, do keep up the rant. $1500 per month buys a golden healthcare plan for a family of two. You can easily decrease your cost by shopping for a better plan.
2
"... those in need..." Always about "need" with Liberals. Always about finding new and onerous ways to perennially subordinate ability to your cherished "need."
But then, what does one expect from the Grifter Class.
But then, what does one expect from the Grifter Class.
6
I sympathize with your complaints about health insurance, but what exactly do you mean by "harder working people"? Just because people earn low wages, are poor or are members of minority groups does not mean they are less hard working than you are. Let's be honest about that.
3
More evidence, if needed, that explains the GOP's pathological hatred of the law. Why help anyone other than the 1%?
21
Its wonderful that many more working poor people are covered, but when is the NY Times going to start examining not just how many people are "insured," but how many people cannot afford to use the insurance they have?
71
There's a reason the Administration trumpets "newly insured", those who can now access health care who could not before. It wants to avoid completely everyone else.
Why do you think democrats were trounced in the mid-term?
Why do you think democrats were trounced in the mid-term?
13
ACA hits those close to but not at retirement age the hardest. It is in this age bracket where you will find the highest insurance rates. Who can afford to pay $1,800 per month for two people, and on top of that pay for medical care until the $10,000 deductible is met? It's impossible. That's why so many go without insurance. Unable to get a reduction, these folks simply go without. So, ACA is helping some while leaving others out.
The Democrats had a chance to provide insurance for all. Instead they left the insurance companies in place. Did anyone mention that to pay for ACA money is diverted from Social Security?
The Democrats had a chance to provide insurance for all. Instead they left the insurance companies in place. Did anyone mention that to pay for ACA money is diverted from Social Security?
37
The ACA has absolutely zip to do with premium costs for early retirees. nada. Zero.
1
Yup. My hairdresser is covered now. No more worries about what that lump in her breast was. But it is costing my family more than if I had paid for her treatment myself. Where did the extra money go? The insurance companies' CEOs' pockets.
75
Actually, the extra money is definitely not going into the CEO's pockets. The Affordable Care Act has fundamentally changed the nature of health care. The ACA changed all insurance into a fixed percentage limit to CEO and other overhead costs for the first time. Under the ACA, your insurance company must spend no less than 80% on actual care. (see: https://www.healthcare.gov/health-care-law-protections/rate-review/ )
Also, there is much less cost shifting in that everybody needs to be covered, and hospitals do not need to shift costs nearly as much. So your costs are much more your cost (or the average of your insurance pool).
But cost do go up, although the rate of increase on average is down. And now there are limits to your payments based on income.
So, no, your CEO is not benefiting by you paying more. Only that insurance companies have more customers. And your insurance now is guaranteed to give you 100% of the care you need medically with no exception and you no longer need to worry about losing access to medical care. So you may be paying more for that.
Also, there is much less cost shifting in that everybody needs to be covered, and hospitals do not need to shift costs nearly as much. So your costs are much more your cost (or the average of your insurance pool).
But cost do go up, although the rate of increase on average is down. And now there are limits to your payments based on income.
So, no, your CEO is not benefiting by you paying more. Only that insurance companies have more customers. And your insurance now is guaranteed to give you 100% of the care you need medically with no exception and you no longer need to worry about losing access to medical care. So you may be paying more for that.
5
One hundred percent? The policies this year don't give ANY care. The deductables are impossible to satisfy for all but the rich. I know many people who have just given up on the whole idea and now once again have no health insurance.
9
The law has helped the poor, but hurt everyone else. This is unwise public policy, because everyone else are the people who run the country. The backlash will, therefore, be very violent and disruptive. It didn't have to be that way, but the promoters of the law chose not engage all sectors of the population.
58
But, I thought if you liked your doctor you could keep your doctor. Do you mean Obama was lying through his teeth? Shocking!
28
Had the promoters "engaged all sectors of the population" there would still be no law and the poor would be more underserved than they still are even with improvements resulting from the ACA. The perception (and perhaps the reality) is that this law may has been hardest on the middle to lower middle classes. And of course, the rich are not effected in the slightest.
26
@Judy - The rich never are impacted, but people of considerable affluence are. Even if you have $150K a year, it is annoying to pay $15K for insurance and get nothing.
The wise move would have been to tackle high costs, not schemes of payment. The big money goes not to insurance companies, but to doctors, hospitals, and drug companies. Until we cut these costs, we'll be arguing how we can possibly pay these huge amounts. The simple answer is that we can't. The population of the US cannot afford the price charged by the medical providers of the US.
The wise move would have been to tackle high costs, not schemes of payment. The big money goes not to insurance companies, but to doctors, hospitals, and drug companies. Until we cut these costs, we'll be arguing how we can possibly pay these huge amounts. The simple answer is that we can't. The population of the US cannot afford the price charged by the medical providers of the US.
18
We could sit and make a list of people to blame and berate. Or we could own up to the realities of runaway healthcare costs since the 1990s. How much of it is because the Baby Boomer generation is entering middle to senior age when most healthcare needs emerge? How much of it is due to the reality that we are now getting medicines, often costing close to the median annual income for a family, for conditions which people never treated just 40-50 years ago? How much of it is due to the whole "better living through Chemistry" mindset being practised by doctors who are hesitant to tell their patients a lot of their maladies would go away if they did not smoke, drink, overeat and overindulge so much? If they paced their worklife better? If they traded an extra $500 a month in income today for a better quality of life in their 50s and later?
We need to be a grownup society that asks the right questions without fear or favor and then finds the answers for them. My guess is we will end up with Wellness education starting in school, better school lunches, non-profit Health insurance (like Germany, Japan, Taiwan), and realistic life expectations and not live forever hype.
Question is how soon?