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Thread: Affordable Care Act failure to meet its most important objective

  1. #1 Affordable Care Act failure to meet its most important objective 
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    One of the primary things the ACA was supposed to solve was the 40+ million uninsured Americans--most of which were either the desperate poor and disconnected or young adults with a "I'll live forever" mentality until of course they are rolled into an Emergency room cost us all billions for urgent care from an car accident, stroke or similar surprising mishap.

    Registration has closed for this year and sign ups are abysmal. Only about six million signed up, about 20% those will not actually be enrolled because they won't complete the payment. Worse is roughly 80% of those sign ups already had health insurance and simply changed plans. Well you do the math, at most only a couple million of roughly 40 million of uninsured now have health insurance. The law has mostly failed its most important target. The industry, which in large part wrote the law, is disappointed that the market in cahoots with the feds heavy tax and penalty hand hasn't added tens of millions of new customers.

    ACA is in large part a failed business model, it's only real benefit seems to be additional protections and standardization which has leveled cost the past couple years and likely cost savings that will vanish.

    The republics have no viable plan. The Dems want to continue to support a failed policy that still leaves tens of millions vulnerable and reduces quality of life for the poor.

    What's next?


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    I've always been under the impression that the ACA was not finished being worked. This is just ACA.0. the beta version. it will continually get tweaked and reworked over the years.


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    I reckon we'll have to wait a couple of weeks or more to see how the numbers really work out.

    According to the LA Times, RAND estimates that
    about two million previously uninsured people have enrolled in private coverage on Obamacare’s new marketplaces;
    about 4.5 million previously uninsured people have gained public coverage through Obamacare’s Medicaid expansion;
    and about three million previously uninsured young people are now covered on their parents’ insurance plans.
    Obamacare has led to health coverage for millions more people - latimes.com

    There needs to be some good analysis of the Medicaid, Medicare sign ups and the gaps in coverage because of various states refusing to participate in expansion before anyone can say anything definitive about what's good, bad, indifferent, successful or unsuccessful.

    I've given the link below to the site I found that on but I hate, hate, hate the way this crowd put their articles together. They're absolutely dripping with links which makes you think there's lots of info backing it up. but half the time they just go to other articles on the same site and the rest of the time you need two or more further clicks to get to the nitty-gritty or the real report you want to read for yourself. So I've more or less given up unless I'm really keen to track something down. Most of the time other sites do it better. (Personally I think the whole site went to the dogs when they switched to facebook and the like for login. It's the worst of the news+social media effect in all its tarnished glory. But that's just me. The comments!!! It's now just a mutual reinforcement site for non-republicans every bit as one-sided as all those rightwing sites. Social media style "likes" and "me, toos" instead of sensible discussion. You kids get off my lawn! Mutter, grumble.)

    At Least 9.5 Million Uninsured Americans Have Gained Coverage Under Obamacare | ThinkProgress
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    It didn't reduce the quality of care for the six million who signed-up The cost savings you mention are not expected to vanish; the costs should lessen as more come aboard .Is this from the Wall-Street Journal ? Sounds like it. What's next is greater enrolment, I expect. It's not as though our health system wasn't broken. The details will sort out. GOP resistance hasn't helped and red states opting out has complicated enactment of ACA. I remain optimistic.
    Quote Originally Posted by Lynx_Fox View Post
    One of the primary things the ACA was supposed to solve was the 40+ million uninsured Americans--most of which were either the desperate poor and disconnected or young adults with a "I'll live forever" mentality until of course they are rolled into an Emergency room cost us all billions for urgent care from an car accident, stroke or similar surprising mishap.

    Registration has closed for this year and sign ups are abysmal. Only about six million signed up, about 20% those will not actually be enrolled because they won't complete the payment. Worse is roughly 80% of those sign ups already had health insurance and simply changed plans. Well you do the math, at most only a couple million of roughly 40 million of uninsured now have health insurance. The law has mostly failed its most important target. The industry, which in large part wrote the law, is disappointed that the market in cahoots with the feds heavy tax and penalty hand hasn't added tens of millions of new customers.

    ACA is in large part a failed business model, it's only real benefit seems to be additional protections and standardization which has leveled cost the past couple years and likely cost savings that will vanish.

    The republics have no viable plan. The Dems want to continue to support a failed policy that still leaves tens of millions vulnerable and reduces quality of life for the poor.

    What's next?
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  6. #5  
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    Quote Originally Posted by umbradiago View Post
    It didn't reduce the quality of care for the six million who signed-up
    And the other 30+ million it was supposed to help?

    The cost savings you mention are not expected to vanish; the costs should lessen as more come aboard .Is this from the Wall-Street Journal ? Sounds like it.
    Cost are already starting to climb at an alarming rate according to the US Bureau of Economic Analysis (about as credible as it gets), the last quarter being the highest jump in more than ten years.
    Health care spending growth hits 10-year high

    And I completely agree the system was broken before, with increasing unsustainable cost, record numbers of health care cost driven bankruptcies, lots of people kicked off plans as they got sick and needed it most, or just being left without for some condition. As it is though ACA is a mess--perhaps it's only improvement being the protections it offers and forcing providers toward more modern and standardized processes. I wouldn't liken it to a beta test....I'd say it's more like an alpha test that needs a major rewrite with a hard look at proven successful programs overseas.
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    i know i do not know the usa very well but it seems that those who are against a government health plan are those who already have good insurance ? please explain that this is incorrect or explain something else to me.
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  8. #7  
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    Quote Originally Posted by Chucknorium View Post
    i know i do not know the usa very well but it seems that those who are against a government health plan are those who already have good insurance ? please explain that this is incorrect or explain something else to me.
    Perhaps but I doubt it's a strong effect. While I've seen no direct polling by that measure, even among the poor, which are more likely not to have good coverage, nearly half disapprove and among tea partiers, which are also in large part poor, there's strong opposition.
    ACA at Age 4: More Disapproval than Approval | Pew Research Center for the People and the Press
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    Quote Originally Posted by Lynx_Fox View Post
    Quote Originally Posted by Chucknorium View Post
    i know i do not know the usa very well but it seems that those who are against a government health plan are those who already have good insurance ? please explain that this is incorrect or explain something else to me.
    Perhaps but I doubt it's a strong effect. While I've seen no direct polling by that measure, even among the poor, which are more likely not to have good coverage, nearly half disapprove and among tea partiers, which are also in large part poor, there's strong opposition.
    ACA at Age 4: More Disapproval than Approval | Pew Research Center for the People and the Press
    ok. thank you.
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    is this true ? my friends tell me that if the other polit party gets power then this government health care will be deleted ? this seems like very large waste of money then ?
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  11. #10  
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    Quote Originally Posted by Lynx_Fox View Post
    Quote Originally Posted by umbradiago View Post
    It didn't reduce the quality of care for the six million who signed-up
    And the other 30+ million it was supposed to help?
    I thought the objective of this portion of this plan at this time was to get 7 - 10 million people coverage that they didn't have before. It depends on how you do the number crunching, but 6 million signed up for appropriate private or government insurance and health coverage they couldn't previously afford, or were denied, or didn't even know about earlier, is reasonable. Though I wonder how many missed out on 31st March itself. I saw a report on PBS that the system more or less crashed under the load of a million+ plus people all trying to sign up on the same, last gasp, day. Apparently, there's a system for following up on late/delayed applications. Someone mentioned that a lot of people would be getting emails to help them fix things up. I rather fancy the next publicity drive will be along the lines of "better late than never".

    I don't see how the federal government can get all 40 million uninsured people into coverage when so many of them live in states which refuse to cooperate in Medicare/Medicaid expansion. (I can never get my head straight on which scheme is which.) I don't recall anyone saying that they would do it all by themselves - they were saying that people would be covered if the states signed up for the scheme. It would have been impolite to say out loud that some states were actively working against the best interests of their own residents, but they are.
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    That's close enough Chuck; flesh it out.
    Quote Originally Posted by Chucknorium View Post
    i know i do not know the usa very well but it seems that those who are against a government health plan are those who already have good insurance ? please explain that this is incorrect or explain something else to me.
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    It's not impolite, at all. It's true. The states, like mine, are dragging their respective feet. The individual gets the blame.
    Quote Originally Posted by adelady View Post
    Quote Originally Posted by Lynx_Fox View Post
    Quote Originally Posted by umbradiago View Post
    It didn't reduce the quality of care for the six million who signed-up
    And the other 30+ million it was supposed to help?
    I thought the objective of this portion of this plan at this time was to get 7 - 10 million people coverage that they didn't have before. It depends on how you do the number crunching, but 6 million signed up for appropriate private or government insurance and health coverage they couldn't previously afford, or were denied, or didn't even know about earlier, is reasonable. Though I wonder how many missed out on 31st March itself. I saw a report on PBS that the system more or less crashed under the load of a million+ plus people all trying to sign up on the same, last gasp, day. Apparently, there's a system for following up on late/delayed applications. Someone mentioned that a lot of people would be getting emails to help them fix things up. I rather fancy the next publicity drive will be along the lines of "better late than never".

    I don't see how the federal government can get all 40 million uninsured people into coverage when so many of them live in states which refuse to cooperate in Medicare/Medicaid expansion. (I can never get my head straight on which scheme is which.) I don't recall anyone saying that they would do it all by themselves - they were saying that people would be covered if the states signed up for the scheme. It would have been impolite to say out loud that some states were actively working against the best interests of their own residents, but they are.
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    Most of the states that don't want the plan have a majority of their constituents that don't want any part of a federal program, crafted without their cooperation in the Washington beltway than attempted to be forced on the states--they'd rather pay the fines and taxes than be told what to do by the federal government.
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    Quote Originally Posted by adelady View Post
    I thought the objective of this portion of this plan at this time was to get 7 - 10 million people coverage that they didn't have before.
    I thought the 7 million or whatever was just the people who signed up. No indication if they had coverage before or not.
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    Quote Originally Posted by Harold14370 View Post
    Quote Originally Posted by adelady View Post
    I thought the objective of this portion of this plan at this time was to get 7 - 10 million people coverage that they didn't have before.
    I thought the 7 million or whatever was just the people who signed up. No indication if they had coverage before or not.
    It was my understanding if they already had coverage (through an employer or some way like that) that they really weren't eligible to sign up for it because it wouldn't be cheaper than what you get through your employer.
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    It was my understanding if they already had coverage (through an employer or some way like that) that they really weren't eligible to sign up for it because it wouldn't be cheaper than what you get through your employer.
    Oooh. Errrk. Turns out this is waaaay more complicated than I'd first thought.

    Bits from one report.

    The lowest-priced plan in 2014 on the Affordable Care Act's exchanges carries on average a premium that is 20 percent less than a comparable employer-sponsored plan, according to the report from the Health Research Institute at PricewaterhouseCoopers.
    The researchers calculated the total average costs of employer-sponsored coverage—both those paid by the employee and by the employer. They then weighed those costs against the total average cost of lowest-price gold and platinum plans on the exchanges, before subsidies. ...
    For large firms, the question of cost comparison is academic: They are required to provide their employees with health insurance or face a tax penalty.
    ...
    if (small) businesses do decide to offer coverage, their employees are no longer eligible for federal subsidies. ...


    Study: Obamacare Is Cheaper Than Employer-Backed Plans - NationalJournal.com

    I looked at a couple of others and they were even less helpful.
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  18. #17  
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    Quote Originally Posted by adelady View Post
    It was my understanding if they already had coverage (through an employer or some way like that) that they really weren't eligible to sign up for it because it wouldn't be cheaper than what you get through your employer.
    Oooh. Errrk. Turns out this is waaaay more complicated than I'd first thought.

    Bits from one report.

    The lowest-priced plan in 2014 on the Affordable Care Act's exchanges carries on average a premium that is 20 percent less than a comparable employer-sponsored plan, according to the report from the Health Research Institute at PricewaterhouseCoopers.
    The researchers calculated the total average costs of employer-sponsored coverage—both those paid by the employee and by the employer. They then weighed those costs against the total average cost of lowest-price gold and platinum plans on the exchanges, before subsidies. ...
    For large firms, the question of cost comparison is academic: They are required to provide their employees with health insurance or face a tax penalty.
    ...
    if (small) businesses do decide to offer coverage, their employees are no longer eligible for federal subsidies. ...


    Study: Obamacare Is Cheaper Than Employer-Backed Plans - NationalJournal.com

    I looked at a couple of others and they were even less helpful.
    yeah, but based on your income you may not be able to sign up for obamacare and if your employer doesn't offer benefits you're screwed.
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    if your employer doesn't offer benefits you're screwed.
    Yet more fussing and faffing about.

    Most importantly - from ObamaCare Employer Mandate for employers. - telling them the penalty for failing to provide coverage. (Different requirements with different timelines for different sizes of employers.)

    • The annual fee is $2,000 per employee if insurance isn't offered (the first 30 full-time employees are exempt).


    • If at least one full-time employee receives a premium tax credit because coverage is either unaffordable or does not cover 60 percent of total costs, the employer must pay the lesser of $3,000 for each of those employees receiving a credit or $750 for each of their full-time employees total.
    And for employees Obamacare Exchanges Vs. Employer Health Insurance | Bankrate.com (couldn't find an exact "mirror" to the employer stuff on the official site)

    Here's the big hiccup: Unless your employer's coverage for an individual is considered unaffordable under the law (that is, if your share of the premiums costs more than 9.5 percent of your household income) or inadequate (picking up less than 60 percent of the cost of covered benefits), you aren't eligible for a government subsidy to help pay for your insurance. Subsidies are one of the things that can make plans on the new state exchanges appealing.


    I all comes down to how affordable is defined for the purposes of the act as far as I can see. Which seems to be included in the employer provisions - the premium has to be less than 9.5% of household income and/or the coverage purchased for that premium must pay for at least 60% of total costs. (I have no idea how the compulsory no-co-pay, no-deductible annual health check and other similar provisions fit in with all that.)

    If an employer provides insurance that just barely meets the official requirements, then an employee might have been better off getting private cover and an associated premium subsidy. But such an employer is basically gambling on all their employees being in households where the total income is reliably higher enough for the premium payment not to exceed the limit. They'll be much safer if they worked on the assumption that the employee's salary was the whole of the household income so that insurance meeting that limit would automatically meet the total household income limit. (I think that the reason some people are surprised by the premiums, with or without subsidy, is that they weren't fully aware of how much the employer was paying into their insurance policy.)
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    The emporer mandates were supposed to start this year, but were extended another year for those over 100 employees, and two years for those over 50. Those under 50 are not required to provide coverage at any point. In addition, even for those that are required to provide coverage, it only applies to full-time employees, defined as those doing more than 30 hours per week. So far I haven't seen anything that implies businesses are going to reconfigure their workers for less than 30 hour weeks--but many predict that is what will happen, especially for the unskilled workforce that needs the insurance the most.

    ObamaCare Employer Mandate
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    THis I received from a very old friend of mine who is having horrible health issues"


    ok, dear friends....after lots of research and thought, I signed up for Anthem Blue Cross thru Covered CA in December.....and began making my monthly payments on January 1...Unfortunately, none of my doctors are taking Anthem Blue Cross under Covered California. Their names appear on the provider list, but it appears that our doctors are ONLY accepting Blue Cross through private pay. I was sent a list of 250 doctors in a 75 mile radius of my home. I have not found one that I can use. Now I'm making monthly payments and paying full "cash up front" for my doctors.. And yes: I've called EVERYONE. Today is March 31 -- and I have no resolution to a horrific problem. And I'm afraid many are in the same position..

    her second post:

    OK.....here's a thought: 6,000,000 people signed up for health care. With or without government subsidies that equates to about $420,000,000,000......So how many people can actually USE the insurance? I signed up last fall, have made monthly payments since January, and I can't find a doctor who will accept my Blue Cross coverage that I bought thru CoveredCA........This is not an April Fool's joke.........
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    Lynx
    In addition, even for those that are required to provide coverage, it only applies to full-time employees, defined as those doing more than 30 hours per week.
    Any employer relying on this could find themselves in a bit of strife.


    Employer mandate update: Small businesses with 50-99full-time equivalent employees will need to start insuring workers by 2016. Those with a 100 or more will need to start providing health benefits in 2015. Health care tax credits have been retroactively available to small businesses with 25 or less full-time equivalent employees since 2010.
    Anyone with 60 employees working 35 hours converting that to 85 people working 25 hours will have the same liability as they had before to provide insurance cover. (Though I have no idea how that works or how the penalties apply.)

    babe
    So how many people can actually USE the insurance? I signed up last fall, have made monthly payments since January, and I can't find a doctor who will accept my Blue Cross coverage
    I saw a couple of items on various places today suggesting that insurance companies and employers were "narrowing" the range of health providers on their lists to contain their own costs. Which means that there will be quite a few practices who are no longer part of several insured networks when they might have been six or twelve months ago. I understand that these things used to change from time to time in the past, but this wholesale reorganisation is a new thing. Nobody seems very sure how long it will take for the new arrangements to settle into something people find easy or comfortable to navigate.

    Don't Blue Cross themselves have a list of affiliated practitioners/ clinics/ whatever? Presumably they'd keep it up to date.
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    Quote Originally Posted by adelady View Post
    Lynx
    In addition, even for those that are required to provide coverage, it only applies to full-time employees, defined as those doing more than 30 hours per week.
    Any employer relying on this could find themselves in a bit of strife.


    Employer mandate update: Small businesses with 50-99full-time equivalent employees will need to start insuring workers by 2016. Those with a 100 or more will need to start providing health benefits in 2015. Health care tax credits have been retroactively available to small businesses with 25 or less full-time equivalent employees since 2010.
    Anyone with 60 employees working 35 hours converting that to 85 people working 25 hours will have the same liability as they had before to provide insurance cover. (Though I have no idea how that works or how the penalties apply.)
    That's not how it works. When they had 60 full time employees that were required to provide insurance for those 60.
    If they figured how to switch to 85, part time employee, they'd no longer be in the >50 full time employee bracket and wouldn't be required to provide health insurance for any of their employees.
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    they'd no longer be in the >50 full time employee bracket
    Here's the relevant bit.

    The annual employer mandate fee (officially called an Employer Shared Responsibility Payment) is a per employee fee for employers with over 50 full-time equivalent employees who don't offer health coverage to full-time employees.


    • The employer mandate is based on full-time equivalent employees, not just full-time employees.

    • The fee is based on whether or not you offer affordable health insurance to your employees that provides minimum value (explained below).


    • The annual fee is $2,000 per employee if insurance isn't offered (the first 30 full-time employees are exempt).

    • If at least one full-time employee receives a premium tax credit because coverage is either unaffordable or does not cover 60 percent of total costs, the employer must pay the lesser of $3,000 for each of those employees receiving a credit or $750 for each of their full-time employees total.
    OK

    Insurance has to be provided to fulltime employees - where the employer has more than 50 full time equivalent employees. So if you have fewer than 50 full time staff, your liability to provide health insurance only to them depends on the total hours worked by the whole of your staff. If the number of full time staff + casual hours worked by all casual staff divided by 30 add up to more than 50 FTEs then you have to provide health insurance to the 2 or 12 or 20 or 42 full time staff. It'd be a pretty rare set up where that much work resulted in nobody at all being classified as full time.
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    Ok I get it now....the "equivalent" part. Thanks.
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    There's still a loophole that could make it advantageous to cut employees back to part time.
    ObamaCare Employer Mandate
    Consider a firm with the equivalent of 60 full-time employees, to comply with the employer mandate they could either cut back worker hours by over 10 full-time equivalent workers, choose not to insure their full-time workers and pay a fee, or cut back full-time workers to part-time and insure less employees.
    If the firm kept only 30 workers at full-time, and didn't offer any employees health insurance, they would avoid the fee completely since their first 30 workers are exempt yet their total number of full-time equivalent employee hours wouldn't have changed. Unfortunately it is loophole's like this which has caused some businesses to cut back employee hours down to a safe 27 hour part-time status. While this is cost affective for the firm, it's not great for employees who will see a lower income and be left without employer based health coverage.
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    Quote Originally Posted by Harold14370 View Post
    There's still a loophole that could make it advantageous to cut employees back to part time.
    ObamaCare Employer Mandate
    Consider a firm with the equivalent of 60 full-time employees, to comply with the employer mandate they could either cut back worker hours by over 10 full-time equivalent workers, choose not to insure their full-time workers and pay a fee, or cut back full-time workers to part-time and insure less employees.
    If the firm kept only 30 workers at full-time, and didn't offer any employees health insurance, they would avoid the fee completely since their first 30 workers are exempt yet their total number of full-time equivalent employee hours wouldn't have changed. Unfortunately it is loophole's like this which has caused some businesses to cut back employee hours down to a safe 27 hour part-time status. While this is cost affective for the firm, it's not great for employees who will see a lower income and be left without employer based health coverage.
    There are always marginal cases where this sort of manipulation is possible. As soon as you allow any leeway at all, the problem would arise at whatever point you set the exemption level. Whether you allow one, or ten, or forty five - whatever businesses there are at the designated margin, there'll be some who will change their business practices to get themselves on the other side of the demarcation.

    I'd suggest the boffins in the IRS and Treasury and the insurance companies had to juggle quite a few combinations to work this out. The insurance companies would have an issue with the admin costs of too many employers with too few employees to make the policy packages economic for them. The IRS wouldn't want to be saddled with enforcing compliance and imposing penalties on too many people with only a handful of relevant employees. Treasury would have crunched the numbers on who pays what for what purposes and how productive the related admin and enforcement numbers balanced out.

    Remembering always that once the employers are below the cutoff points and don't provide insurance, whether by chance or by manipulation, then all of their staff would become eligible for individual insurance packages with possible government subsidies. And many of them will be better off for that anyway. Personally I'd be a bit peeved if I worked for someone who did provide complying insurance - but I found policies on the private market that were better than what the employer provides.
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    Quote Originally Posted by adelady View Post
    if your employer doesn't offer benefits you're screwed.
    Yet more fussing and faffing about.
    ???? what do you mean? I don't get it? this really happens. My in-laws are in this boat.

    Quote Originally Posted by adelady
    Most importantly - from ObamaCare Employer Mandate for employers. - telling them the penalty for failing to provide coverage. (Different requirements with different timelines for different sizes of employers.)
    from what I understand the penalties in some cases are cheaper than covering your workforce. Not good form.

    Quote Originally Posted by adelady
    • The annual fee is $2,000 per employee if insurance isn't offered

    often times a good health care package runs $2,500 and up.

    Quote Originally Posted by adelady
    (the first 30 full-time employees are exempt).

    ? that makes no sense. So an employer with 35 gets to determine who gets insurance and who to toss to the wolves?


    Quote Originally Posted by adelady
    • If at least one full-time employee receives a premium tax credit because coverage is either unaffordable or does not cover 60 percent of total costs, the employer must pay the lesser of $3,000 for each of those employees receiving a credit or $750 for each of their full-time employees total.
    How does one determine if they receive a premium tax credit?



    Quote Originally Posted by adelady
    Quote Originally Posted by adelady
    And for employees Obamacare Exchanges Vs. Employer Health Insurance | Bankrate.com (couldn't find an exact "mirror" to the employer stuff on the official site)
    Here's the big hiccup: Unless your employer's coverage for an individual is considered unaffordable under the law (that is, if your share of the premiums costs more than 9.5 percent of your household income) or inadequate (picking up less than 60 percent of the cost of covered benefits), you aren't eligible for a government subsidy to help pay for your insurance. Subsidies are one of the things that can make plans on the new state exchanges appealing.


    I all comes down to how affordable is defined for the purposes of the act as far as I can see. Which seems to be included in the employer provisions - the premium has to be less than 9.5% of household income and/or the coverage purchased for that premium must pay for at least 60% of total costs. (I have no idea how the compulsory no-co-pay, no-deductible annual health check and other similar provisions fit in with all that.)

    If an employer provides insurance that just barely meets the official requirements, then an employee might have been better off getting private cover and an associated premium subsidy. But such an employer is basically gambling on all their employees being in households where the total income is reliably higher enough for the premium payment not to exceed the limit. They'll be much safer if they worked on the assumption that the employee's salary was the whole of the household income so that insurance meeting that limit would automatically meet the total household income limit. (I think that the reason some people are surprised by the premiums, with or without subsidy, is that they weren't fully aware of how much the employer was paying into their insurance policy.)
    My father -in-law's job pays ZERO health benefits. He had to get it himself under the exchange, or face being penalized on next years taxes. the best they could get was $800 a month. that's premium crack prices right there!
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    Quote Originally Posted by babe View Post
    THis I received from a very old friend of mine who is having horrible health issues"


    ok, dear friends....after lots of research and thought, I signed up for Anthem Blue Cross thru Covered CA in December.....and began making my monthly payments on January 1...Unfortunately, none of my doctors are taking Anthem Blue Cross under Covered California. Their names appear on the provider list, but it appears that our doctors are ONLY accepting Blue Cross through private pay. I was sent a list of 250 doctors in a 75 mile radius of my home. I have not found one that I can use. Now I'm making monthly payments and paying full "cash up front" for my doctors.. And yes: I've called EVERYONE. Today is March 31 -- and I have no resolution to a horrific problem. And I'm afraid many are in the same position..

    her second post:

    OK.....here's a thought: 6,000,000 people signed up for health care. With or without government subsidies that equates to about $420,000,000,000......So how many people can actually USE the insurance? I signed up last fall, have made monthly payments since January, and I can't find a doctor who will accept my Blue Cross coverage that I bought thru CoveredCA........This is not an April Fool's joke.........
    Time to get a lawyer. if they're listed as accepting that insurance and do not, that sounds like false advertising to me.
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    Quote Originally Posted by Lynx_Fox View Post
    Quote Originally Posted by adelady View Post
    Lynx
    In addition, even for those that are required to provide coverage, it only applies to full-time employees, defined as those doing more than 30 hours per week.
    Any employer relying on this could find themselves in a bit of strife.


    Employer mandate update: Small businesses with 50-99full-time equivalent employees will need to start insuring workers by 2016. Those with a 100 or more will need to start providing health benefits in 2015. Health care tax credits have been retroactively available to small businesses with 25 or less full-time equivalent employees since 2010.
    Anyone with 60 employees working 35 hours converting that to 85 people working 25 hours will have the same liability as they had before to provide insurance cover. (Though I have no idea how that works or how the penalties apply.)
    That's not how it works. When they had 60 full time employees that were required to provide insurance for those 60.
    If they figured how to switch to 85, part time employee, they'd no longer be in the >50 full time employee bracket and wouldn't be required to provide health insurance for any of their employees.
    All that really does is make the employer look bad. Look what happened to papa john pizza.
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    Quote Originally Posted by grmpysmrf View Post
    All that really does is make the employer look bad. Look what happened to papa john pizza.
    You mean their record profits and growth for the past few years growing to be the 3rd largest Pizza business?

    More related to the thread though...what happened related to health insurance?
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    Quote Originally Posted by adelady View Post
    Lynx
    In addition, even for those that are required to provide coverage, it only applies to full-time employees, defined as those doing more than 30 hours per week.
    Any employer relying on this could find themselves in a bit of strife.


    Employer mandate update: Small businesses with 50-99full-time equivalent employees will need to start insuring workers by 2016. Those with a 100 or more will need to start providing health benefits in 2015. Health care tax credits have been retroactively available to small businesses with 25 or less full-time equivalent employees since 2010.
    Anyone with 60 employees working 35 hours converting that to 85 people working 25 hours will have the same liability as they had before to provide insurance cover. (Though I have no idea how that works or how the penalties apply.)

    babe
    So how many people can actually USE the insurance? I signed up last fall, have made monthly payments since January, and I can't find a doctor who will accept my Blue Cross coverage
    I saw a couple of items on various places today suggesting that insurance companies and employers were "narrowing" the range of health providers on their lists to contain their own costs. Which means that there will be quite a few practices who are no longer part of several insured networks when they might have been six or twelve months ago. I understand that these things used to change from time to time in the past, but this wholesale reorganisation is a new thing. Nobody seems very sure how long it will take for the new arrangements to settle into something people find easy or comfortable to navigate.

    Don't Blue Cross themselves have a list of affiliated practitioners/ clinics/ whatever? Presumably they'd keep it up to date.
    My friend is a retired teacher. She signed up for Obamacare, and this is her dilemma, not mine
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    Quote Originally Posted by grmpysmrf View Post
    Quote Originally Posted by babe View Post
    THis I received from a very old friend of mine who is having horrible health issues"


    ok, dear friends....after lots of research and thought, I signed up for Anthem Blue Cross thru Covered CA in December.....and began making my monthly payments on January 1...Unfortunately, none of my doctors are taking Anthem Blue Cross under Covered California. Their names appear on the provider list, but it appears that our doctors are ONLY accepting Blue Cross through private pay. I was sent a list of 250 doctors in a 75 mile radius of my home. I have not found one that I can use. Now I'm making monthly payments and paying full "cash up front" for my doctors.. And yes: I've called EVERYONE. Today is March 31 -- and I have no resolution to a horrific problem. And I'm afraid many are in the same position..

    her second post:

    OK.....here's a thought: 6,000,000 people signed up for health care. With or without government subsidies that equates to about $420,000,000,000......So how many people can actually USE the insurance? I signed up last fall, have made monthly payments since January, and I can't find a doctor who will accept my Blue Cross coverage that I bought thru CoveredCA........This is not an April Fool's joke.........
    Time to get a lawyer. if they're listed as accepting that insurance and do not, that sounds like false advertising to me.
    She signed up for OBAMACARE!
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    Quote Originally Posted by babe View Post
    THis I received from a very old friend of mine who is having horrible health issues"


    ok, dear friends....after lots of research and thought, I signed up for Anthem Blue Cross thru Covered CA in December.....and began making my monthly payments on January 1...Unfortunately, none of my doctors are taking Anthem Blue Cross under Covered California. Their names appear on the provider list, but it appears that our doctors are ONLY accepting Blue Cross through private pay. I was sent a list of 250 doctors in a 75 mile radius of my home. I have not found one that I can use. Now I'm making monthly payments and paying full "cash up front" for my doctors.. And yes: I've called EVERYONE. Today is March 31 -- and I have no resolution to a horrific problem. And I'm afraid many are in the same position..

    her second post:

    OK.....here's a thought: 6,000,000 people signed up for health care. With or without government subsidies that equates to about $420,000,000,000......So how many people can actually USE the insurance? I signed up last fall, have made monthly payments since January, and I can't find a doctor who will accept my Blue Cross coverage that I bought thru CoveredCA........This is not an April Fool's joke.........
    How can she not find even one doctor among 250 in her area? Do none of them accept Blue Cross? What is "Private Pay"?
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    A lot of the problem is that it's a pain in the arse to sign up. Confusing website together with the requirement for all kinds of personal data a person probably doesn't even know about them self.

    I think half the reason requiring employers to provide insurance worked so well is because the employer was filing most of the paperwork, and whatever the employee had to fill out they were getting walked through it by their boss.

    Bureaucratic obstruction is almost as big a deterrent as high price. Especially for the poorest workers who often hold more than one job and simply don't have a lot of time to waste pencil pushing.
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    Quote Originally Posted by Lynx_Fox View Post
    Quote Originally Posted by grmpysmrf View Post
    All that really does is make the employer look bad. Look what happened to papa john pizza.
    You mean their record profits and growth for the past few years growing to be the 3rd largest Pizza business?
    Kinda blows holes in their "we can't afford it" complaint, doesn't ?
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    Quote Originally Posted by babe View Post
    Quote Originally Posted by grmpysmrf View Post
    Quote Originally Posted by babe View Post
    THis I received from a very old friend of mine who is having horrible health issues"


    ok, dear friends....after lots of research and thought, I signed up for Anthem Blue Cross thru Covered CA in December.....and began making my monthly payments on January 1...Unfortunately, none of my doctors are taking Anthem Blue Cross under Covered California. Their names appear on the provider list, but it appears that our doctors are ONLY accepting Blue Cross through private pay. I was sent a list of 250 doctors in a 75 mile radius of my home. I have not found one that I can use. Now I'm making monthly payments and paying full "cash up front" for my doctors.. And yes: I've called EVERYONE. Today is March 31 -- and I have no resolution to a horrific problem. And I'm afraid many are in the same position..

    her second post:

    OK.....here's a thought: 6,000,000 people signed up for health care. With or without government subsidies that equates to about $420,000,000,000......So how many people can actually USE the insurance? I signed up last fall, have made monthly payments since January, and I can't find a doctor who will accept my Blue Cross coverage that I bought thru CoveredCA........This is not an April Fool's joke.........
    Time to get a lawyer. if they're listed as accepting that insurance and do not, that sounds like false advertising to me.
    She signed up for OBAMACARE!
    I got that. If those doctors are advertised as accepting that insurance under obamacare and now they don't that would appear to be false advertising, wouldn't it?
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  38. #37  
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    Quote Originally Posted by grmpysmrf View Post
    Quote Originally Posted by Lynx_Fox View Post
    Quote Originally Posted by grmpysmrf View Post
    All that really does is make the employer look bad. Look what happened to papa john pizza.
    You mean their record profits and growth for the past few years growing to be the 3rd largest Pizza business?
    Kinda blows holes in their "we can't afford it" complaint, doesn't ?
    I don't know what you are talking about, never heard anything about what you are referring and don't know much else beyond their stock information and that I might have had a slice of their pizza at one time.

    I do wish I'd invested in them though. Did you?
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    Quote Originally Posted by Lynx_Fox View Post
    Quote Originally Posted by grmpysmrf View Post
    Quote Originally Posted by Lynx_Fox View Post
    Quote Originally Posted by grmpysmrf View Post
    All that really does is make the employer look bad. Look what happened to papa john pizza.
    You mean their record profits and growth for the past few years growing to be the 3rd largest Pizza business?
    Kinda blows holes in their "we can't afford it" complaint, doesn't ?
    I don't know what you are talking about, never heard anything about what you are referring and don't know much else beyond their stock information and that I might have had a slice of their pizza at one time.

    I do wish I'd invested in them though. Did you?
    I don't play the stock market. Vegas is much cheaper.

    Seriously, you've never heard of the fit that the Papa John's CEO threw when the ACA passed?

    Papa Johns Obamacare
    just search papa john's obamacare and you'll get a ton of hits on the topic
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    There is no mandate yet, it is delayed. Thus is is not effecting their profits unless they are already doing it ahead of time.
    Are you following the conversation?
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    Quote Originally Posted by Lynx_Fox View Post
    There is no mandate yet, it is delayed. Thus is is not effecting their profits unless they are already doing it ahead of time.
    Are you following the conversation?
    Yes, I am following fine. I'm talking about Papa John's knee jerk reaction to the ACA. I understand the mandate is delayed but that didn't stop Papa John's from spouting off about it... And you think I'm slow on this.
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    Quote Originally Posted by grmpysmrf View Post
    Quote Originally Posted by Lynx_Fox View Post
    There is no mandate yet, it is delayed. Thus is is not effecting their profits unless they are already doing it ahead of time.
    Are you following the conversation?
    Yes, I am following fine. I'm talking about Papa John's knee jerk reaction to the ACA. I understand the mandate is delayed but that didn't stop Papa John's from spouting off about it... And you think I'm slow on this.
    And you have enough knowledge about their books to assess the accuracy of his statements? Though I'm not doubting he is worse casing any projections as he probably should as well as most likely cost to meet the new requirements.
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    Quote Originally Posted by Lynx_Fox View Post
    Quote Originally Posted by grmpysmrf View Post
    Quote Originally Posted by Lynx_Fox View Post
    There is no mandate yet, it is delayed. Thus is is not effecting their profits unless they are already doing it ahead of time.
    Are you following the conversation?
    Yes, I am following fine. I'm talking about Papa John's knee jerk reaction to the ACA. I understand the mandate is delayed but that didn't stop Papa John's from spouting off about it... And you think I'm slow on this.
    And you have enough knowledge about their books to assess the accuracy of his statements? Though I'm not doubting he is worse casing any projections as he probably should as well as most likely cost to meet the new requirements.
    Why would I? I'm going on what he had said. He is in a better position to know the books than I. this last little bit of banter is not really the point that was being made be him or me.
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    Quote Originally Posted by grmpysmrf View Post
    . this last little bit of banter is not really the point that was being made be him or me.
    Fair enough. What was the point?

    We can probably assume he known the pains of growing a business. His company has done very well. He might have exaggerated the cost--but we can certainly understand any company's reluctance to take on more cost. And the 50+% of Americans who invest in companies also understand it.
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    Quote Originally Posted by grmpysmrf View Post
    Quote Originally Posted by babe View Post
    Quote Originally Posted by grmpysmrf View Post
    Quote Originally Posted by babe View Post
    THis I received from a very old friend of mine who is having horrible health issues"


    ok, dear friends....after lots of research and thought, I signed up for Anthem Blue Cross thru Covered CA in December.....and began making my monthly payments on January 1...Unfortunately, none of my doctors are taking Anthem Blue Cross under Covered California. Their names appear on the provider list, but it appears that our doctors are ONLY accepting Blue Cross through private pay. I was sent a list of 250 doctors in a 75 mile radius of my home. I have not found one that I can use. Now I'm making monthly payments and paying full "cash up front" for my doctors.. And yes: I've called EVERYONE. Today is March 31 -- and I have no resolution to a horrific problem. And I'm afraid many are in the same position..

    her second post:

    OK.....here's a thought: 6,000,000 people signed up for health care. With or without government subsidies that equates to about $420,000,000,000......So how many people can actually USE the insurance? I signed up last fall, have made monthly payments since January, and I can't find a doctor who will accept my Blue Cross coverage that I bought thru CoveredCA........This is not an April Fool's joke.........
    Time to get a lawyer. if they're listed as accepting that insurance and do not, that sounds like false advertising to me.
    She signed up for OBAMACARE!
    I got that. If those doctors are advertised as accepting that insurance under obamacare and now they don't that would appear to be false advertising, wouldn't it?
    NO. That was the list the Obamacare people gave her. Those doctors could have opted out and the information given to her by the Obamacare people was not, thugh should have been accurate as that is why she signed.

    She is SCREWED!

    Thing is she has been a strong supporter of Obamacare, and to say she is "upset", is putting it mildly. She has health issues, serious ones and doesn't LIVE close to any doctors now, that she could use.

    The misrepresentation was not done on the doctors part. The information as to which doctors are participating changed and the list wasn't updated.
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    I think half the reason requiring employers to provide insurance worked so well is because the employer was filing most of the paperwork, and whatever the employee had to fill out they were getting walked through it by their boss.
    That's just everyone's bureaucratic inertia. In other countries where people have always purchased private insurance as individuals, the issue used to be getting employers to do the payments straight out of salary/wage payments.

    These are just teething problems. Once the system is in place - for given values of "system" - then it won't be so much of a hassle. People who get fulltime jobs might have to give up good private insurance along with their preferred practitioners in favour of a less attractive plan offered by the employer. Others who can only get or only want part time work will find a suitable plan and stick with it until and unless their circumstances change substantially. (Of course, this might drive some improvements in the employer linked plans. Employers will not have the lazy option of just signing up for the cheapest option they can find with humongous deductibles and/or co-pays for the insured employees because they'll lose out on some prospective employees who won't accept a substantial reduction in their healthcare options.)

    But these will just be individual changes happening at a statistically predictable rate. This will eventually be regarded as a historical, statistical blip.
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    Quote Originally Posted by Lynx_Fox View Post
    Quote Originally Posted by grmpysmrf View Post
    . this last little bit of banter is not really the point that was being made be him or me.
    Fair enough. What was the point?

    We can probably assume he known the pains of growing a business. His company has done very well. He might have exaggerated the cost--but we can certainly understand any company's reluctance to take on more cost. And the 50+% of Americans who invest in companies also understand it.
    The point I was making was that businesses complaining about having to have a healthy work force (especially in the food industry) seems a bit petty and callous considering the tremendous profits they are making (in the example of Papa John's that is)

    I suppose since single payer was rejected by the right ACA is now just part of the cost of growing/starting a business. Nothing's free not even for businesses.
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    Quote Originally Posted by grmpysmrf View Post
    I suppose since single payer was rejected by the right ACA is now just part of the cost of growing/starting a business. Nothing's free not even for businesses.
    Nearly 80% of small (<500 employees) business fail in the US.

    The mandatory health insurance hits small business.

    It's a heck of a lot more than "Just part of the cost of growing/starting a business." It's an extra expense that impacts businesses just when they are the most vulnerable. Just one more incentive for businesses to move overseas...or just not expand and employ more people. Studies of early parts of the plan are showing that even the tax offsets cost are increasing for about 2/3 of small businesses (Introduction to the Affordable Care Act, Part 1National Federation of Independent Business | National Federation of Independent Business).

    It's damn sure no good way to grow the US economy.
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    I agree with what you have said. I have read the same information from The Week. Forget the 7.1 million: ObamaCare's real enrollment numbers are still to come - The Week

    I also have to point out how massive of a change this is for American health insurance. It was Obama's political strike against the private insurance industry, and now we're scrambling to pick up the pieces. Things will evolve slowly because this was a massive change for America, and there will always be changes made to a system as new as this. As stated in the article, they plan to "more than triple the enrollment" by 2016 - which requires a lot of demographic research and funding to see which Americans are not getting enrolled, and why, and then to patch those holes and make certain they can provide affordable insurance to more people.

    I'm not too happy with how Obamacare rolled into the US, but we have to see where it will go.
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    Quote Originally Posted by Lynx_Fox View Post
    Quote Originally Posted by grmpysmrf View Post
    I suppose since single payer was rejected by the right ACA is now just part of the cost of growing/starting a business. Nothing's free not even for businesses.
    Nearly 80% of small (<500 employees) business fail in the US.

    The mandatory health insurance hits small business.

    It's a heck of a lot more than "Just part of the cost of growing/starting a business." It's an extra expense that impacts businesses just when they are the most vulnerable. Just one more incentive for businesses to move overseas...or just not expand and employ more people. Studies of early parts of the plan are showing that even the tax offsets cost are increasing for about 2/3 of small businesses (Introduction to the Affordable Care Act, Part 1National Federation of Independent Business | National Federation of Independent Business).

    It's damn sure no good way to grow the US economy.
    I'd hardly call a business with more than 30 employees a "small business."
    That just sounds like greed to me. They are still profitable they just want more at the expense of their workers.
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    Quote Originally Posted by ByAccident13_7 View Post
    It was Obama's political strike against the private insurance industry.
    This is misleading. you can call Insurance industries "private" if you want but this business is a monopoly which would already be illegal for anyone else. It put their customers at a disadvantage and before obamacare they were selecting their customer base and then denying coverage any way they could to anybody they did allow in. This is not "Private industry" sounds more like the definition of racketeering
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    Quote Originally Posted by ByAccident13_7 View Post
    I agree with what you have said. I have read the same information from The Week. Forget the 7.1 million: ObamaCare's real enrollment numbers are still to come - The Week

    I also have to point out how massive of a change this is for American health insurance. It was Obama's political strike against the private insurance industry, and now we're scrambling to pick up the pieces. .
    Huh? It was in large part WRITTEN by the private insurance company...a way to guarantee tens of millions forced onto being customers, whether they wanted it or not-- a faustian deal that traded additional protections for expanding their businesses.
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    Well even when we were a small business...we paid for our employees health insurance ...and they could add their family on but that part they had to pay for them and attat time was at a very nominal amount.

    It isn't anymore.
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    Quote Originally Posted by grmpysmrf View Post
    Quote Originally Posted by ByAccident13_7 View Post
    It was Obama's political strike against the private insurance industry.
    This is misleading. you can call Insurance industries "private" if you want but this business is a monopoly which would already be illegal for anyone else. It put their customers at a disadvantage and before obamacare they were selecting their customer base and then denying coverage any way they could to anybody they did allow in. This is not "Private industry" sounds more like the definition of racketeering
    I agree. Calling them "private" is misleading, I understand,. But I'm really just using a single easy word to label the standard of insurance we had before the ACA, that provided private insurance policies in a consumer-driven as opposed to government driven market. I would also argue the possibility (based on personal speculation, and I don't firmly believe this) that the standard of insurance we had before the ACA was owned by an oligopoly, and my evidence is based on the insurance companies that we see at healthcare.gov. It's really just a large selection of big-named insurance companies that have been around since long before the ACA was even a thought.

    And Lynx:

    Where did you find your information pertaining to who wrote the ACA? (for some reason the quote function isn't working right now) And is it that the ACA was written by insurance companies, or influenced by insurance company lobbyists?
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    I have a problem with the claim the primary purpose was to sign up more people for better health care.
    I think the primary purpose was to reduce the cost to the govt of health care.
    USA spends more in taxes per person on health care than almost any other country. On top of that the insurance companies all charge their own fees.
    This makes American health care very expensive, possibly the most expensive system in the whole world.

    I think Obamacare failed on this point, and the fact the insurance industry was involved is probably a large reason why it failed.
    Last edited by dan hunter; April 6th, 2014 at 01:55 PM.
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    Quote Originally Posted by dan hunter View Post
    I have a problem with the claim the primary purpose was to sign up more people for better health care.
    well, the whole "no denying coverage to pre existing conditions" bit would suggest "better coverage"

    Quote Originally Posted by dan hunter View Post
    I think the primary purpose was to reduce the cost to the govt of health care.
    I don't know it was the "primary" reason but I do think it was certainly one of the more important reasons. and by creating a pool of 7 million people, that should certainly bring down the cost.
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    Walmart has 14,000-plus full-time employees who collect food stamps/supplemental nutrition assistance program. What's wrong, here ?
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    Quote Originally Posted by token resistance View Post
    Walmart has 14,000-plus full-time employees who collect food stamps/supplemental nutrition assistance program. What's wrong, here ?
    What's that got to do with health care?
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    Quote Originally Posted by Lynx_Fox View Post
    Quote Originally Posted by token resistance View Post
    Walmart has 14,000-plus full-time employees who collect food stamps/supplemental nutrition assistance program. What's wrong, here ?
    What's that got to do with health care?
    If they've found a way to screw their workforce out of a living wage, what makes you think they're gonna pony up health care? ... I think was the jist of his comment, but that's just speculation.
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