Affordable Care Act ruling: Where things stand for the state, Washtenaw County and you
Demonstrators stand outside the Supreme Court in Washington on Thursday before the court's ruling on health care.
Evan Vucci | The Associated Press
Major provisions - including the individual mandate that came under question in the Supreme Court case - remain mainly untouched.
However, the court did strike down the provision that would cause states to lose Medicaid funding should they not expand the income thresholds for Medicaid as initially stated by the act.
Top state officials made statements against the Affordable Care Act in light of the Thursday ruling, including Gov. Rick Snyder and Attorney General Bill Schuette.
Schuette urged state lawmakers to delay implementation of the Affordable Care Act in Michigan Thursday, though Snyder said the state will move forward with the creation of health insurance exchanges.
With Thursday’s ruling, the states that did choose to not expand eligibility for Medicaid would only lose the federal funds that would have been used for expanded coverage.
One of the next benchmarks that will be implemented as a part of the Affordable Care Act that are statewide exchanges for individuals and companies to purchase insurance. The exchanges become effective Jan. 1, 2014.
Michigan legislators have previously received money to create the exchanges, but the House has stymied the acceptance of the money as they waited for the Supreme Court’s ruling before initiating the process.
The decision is one Marianne Udow-Phillips, director of the the Center for Healthcare Research and Transformation at the University of Michigan, said puts the state at risk for defaulting and letting the federal government run an exchange in the state.
Udow-Phillips is also heavily involved with the Washtenaw Health Initiative, a volunteer group working to prepare the Ann Arbor area for the implementation of federal health care reforms under the Affordable Care Act.
The city of Ann Arbor was recently asked to contribute $20,000 to funding the health initiative.
The exchanges would sell policies that offer particular important benefits that would be determined by a state board, at varying price ranges. Certain individuals and small businesses would be eligible for subsidies to purchase health insurance.
The purpose behind the exchange is to level the playing field for small employers to have a better choice of plans and insurance at a lower cost in the way large employers have.
In Washtenaw County, an estimated 30,000 people are uninsured, said Ellen Rabinowitz, director of the Washtenaw Health Plan. The plan connects uninsured, low-income residents with health care.
Once all the provisions of the ACA are fully implemented after 2014, the income thresholds for Medicaid enrollment will be expanded.
The threshold would be expanded to adults under the age 65 living below 133 percent of the poverty line.
Two-thirds of the 8,000 people the Washtenaw Health Plan serves will become eligible for Medicaid.
The majority of the uninsured are between the ages of 18 and 65, Rabinowitz said.
Rabinowitz broke it down for what it means in terms of Washtenaw County residents:
- 13,000 people will be newly eligible for Medicaid
- 11,000 people will be eligible to purchase insurance through an exchange
- 5,000 people will remain without insurance
Details about how the influx of people newly eligible for Medicaid will be able to access the program are still being worked out at the state level, Rabinowitz said.
About 2,700 people in Washtenaw County are eligible for Medicaid under the current income thresholds and aren’t enrolled. Workers at the Washtenaw Health Plan are focused on reaching as many of those people as possible before 2014, Rabinowitz said.
With the full extent of the healthcare reforms and more people enrolled in Medicaid, Rabinowitz estimated that fewer individuals will need the health plan services.
It's also estimated there could be as many as 34,545 additional primary care visits annually in Washtenaw County, a demand WHI leaders have said is not likely to be absorbed easily.
The University of Michigan Health System and St. Joseph Mercy Ann Arbor have made adjustments to improve their efficiency that help with accommodating the impacts of the Affordable Care Act, regardless of the Supreme Court's decision.
Many private health care providers don’t accept Medicaid, and even fewer dentists accept Medicaid patients, Udow-Phillips said.
The federal government will pay the difference between Medicaid payments and private insurance payments in 2013 and 2014 as an incentive, Udow-Phillips said. The state could absorb those payments in 2015.
At the individual level, the provisions in the ACA remain the same. Here's how they will affect you:
- Insured through your employer? Not much will change, although if a company is small enough they may decide to stop offering insurance.
- Uninsured, but employed at a business with more than 50 people? Businesses with more than 50 employees will be required to offer health insurance starting in 2014, or face a $2,000 penalty per worker. If you don't get insurance after 2014, you may face a penalty.
- Uninsured? You may become eligible for Medicaid, if in the correct income threshold. You may receive a subsidy for health insurance, available through an exchange. Again, no insurance after 2014, you may face a penalty.
Amy Biolchini covers Washtenaw County, health and environmental issues for AnnArbor.com. Reach her at (734) 623-2552, amybiolchini@annarbor.com or on Twitter.
Comments
shepard145
Mon, Jul 2, 2012 : 10:44 p.m.
My opinions are not for the fact checkers and footnote sniffers - they are for those already educated on these subjects and who know reality when they read it. When was the last time you think you heard a fact on bankrupt infotainment CNN, ABC, NBC, MSNBC or NPR? Even worse, when was the last time you questioned what "they told you on the tv"? Those of you who confidently believe yourselves well educated by a corrupt, biased, ignorant, mass media working full time to re-elect the worst president in a century are not likely to entertain lectures about the evils of obama's 'America in Decline Agenda'. As Herman Cain likes to say, I can only save the savable There is that silver lining however! If obama is re-elected and his putrid disaster rolls over the nation like a plague, I will greatly enjoy the poetic justice that results. Most of his supporters will live long enough to suffer from the fate they so arrogantly unleashed one vote at a time. You will not suffer a little, but a lot…..as will your children and grand children. I take comfort in the tidiness of that inevitable reality because the "unexpected consequences" of obamacare are not unexpected at all… ...but I am growing bored of lecturing to the unteachable....
hmsp
Mon, Jul 2, 2012 : 12:24 p.m.
@ shepard145, re: "One was legal and one was not. Do some homework." You'll have to do better than that. First, of course, you are in a small (if stridently vocal!) minority if you think it is not legal — had you been reading the news, you would know that the SCOTUS says it is, for instance. Second, you give no facts or opinions to support your position. So go back and do some homework yourself.
shepard145
Sun, Jul 1, 2012 : 9:22 p.m.
One was legal and one was not. Do some homework.
hmsp
Sun, Jul 1, 2012 : 6:48 p.m.
@ Shep: OK, we're all waiting — what IS the difference in your book that makes Romneycare good, and Obamacare bad? All we get is sneering posts with no information, hysterical statements about "socialist government takeover," and the like. And were you screaming at Nixon like that when he proposed his far-more-progressive health care plan?
NoMoreMrZero
Mon, Jul 9, 2012 : 12:01 a.m.
You wanted an answer here is your answer. The constitution does not give the federal government the power to regulate these activities. If all powers were rested in the federal government why would we need the state of michigan why would we need washtenaw county and least of all why would we need Ann Arbor. Arent all of those services being duplicated. What made the united states successful for all of this years was a lack of central planning. Some how as you rise from school board member to state representative and then perhaps on to the US house or Senate and with that move youve suddenly become so much more intelligent.
shepard145
Sun, Jul 1, 2012 : 3:14 p.m.
Amusing to see how many posters still don't understand the difference between states legally instituting a healthcare plan and obama's attempted socialist government takeover of 1/5 of the US economy. ..but shills are nothing new in politics – some will always find reasons, no matter how absurd, to have faith in the fearless leaders they crave. By the way, how much savings are generated by broke/fraud ridden Medicare/Medicate, the bankrupt Freddies, the broke US Post Office and broke Amtrak generate? Stossel is right – NO THEY CAN'T
shepard145
Sun, Jul 1, 2012 : 6:31 p.m.
Atom bombs and pineapples - not even a good try. Selective memory democrats are my fav type of simulated "historians". Republican Lincoln won the battle to free the slaves owned principally by democrats in the south. Safe to say that democrats are used to promoting bad ideas like slavery and socialism and used to losing. The debate is over - time for obama to apologize to voters and resign.
snark12
Sun, Jul 1, 2012 : 6:10 p.m.
So, was it more socialist when the federal government told the states that slavery was illegal, or when they told the states that polygamy was illegal? Or was it more socialist when the federal government developed the atom bomb to end WWII and save lives of citizens from ALL the states?
snark12
Sun, Jul 1, 2012 : 6:05 p.m.
I think we all understand the difference between a federal and a state plan, Shep. But since we're not living in 1825, we simply don't care. The Articles of Confederation were replaced by the Constitutiion in 1789. Time to move on.
hmsp
Sun, Jul 1, 2012 : 1:49 p.m.
The TP, "Starve The Beast" types who are commenting here make a big deal about the fact that the SC has called the opt-out penalty a tax. They always talk as though all taxes are evil, and unfortunately, they have poisoned the conversation to the point that using the word "tax" in a positive way has becomes one of those "third-rail" acts that get you politically electrocuted. None of us like wasteful spending, but many of us don't necessarily mind paying taxes per se — we like fire and police service, we like having our garbage picked up, we like driving on paved roads, and we like indoor plumbing. Frankly, I wish those TP types would just stop paying taxes if they hate it so much... and then stay off of my roads! These tax dodgers are precisely the type of people who Romney was talking about when he instituted the personal mandate in Mass. But of course, like Obama, he avoided using the word "tax": "It is a fee, it's an assessment," he said, on those who are "abusing the free care pool." His personal mandate was the "ultimate conservativism." He said that the "personal responsibility mandate..." was "essential for bringing the health care costs down for everyone and getting everyone the health insurance they need." And the idea was hardly new: a "personal responsibility mandate" to eliminate "freeloaders" was a big Republican talking point back in the '90s. As I said, many of us don't necessarily mind paying taxes per se, especially if, as in this case, overall savings are projected down the road. We certainly can't keep on the way we have been going!
shepard145
Sun, Jul 1, 2012 : 1:14 a.m.
Insurance is the problem but not because they are parasites. Insurance removes competition from the health care market and government Medicare and Medicaid short paying hospitals and doctors for services provided to the societies parasite patients make it worse. These factors alone account for the massive increases in healthcare costs. It is no the insurance companies, doctors, hospitals or nurses – it is democrats who are responsible. They block every effort to improve the system and are now trying to plant their socialist boot print on the entire nation. Democrats must go in November - every politician who voted for this disgrace and then a purge of every DC bureaucrat who had any hand in writing or promoting it – blackballed FOREVER. Time to send a message to the socialists who would bankrupt us!
Ron Granger
Sat, Jun 30, 2012 : 4:44 p.m.
Insurance companies are the real parasites. The lack of affordable health insurance is an obstacle to self-employment and entrepreneurship in this country. It is absurd that we must pay Individual rates. The ACA state pools will spread the risk and lower insurance costs.
maallen
Mon, Jul 2, 2012 : 2:21 p.m.
And because of these "state pools" the taxpayers will be funding people's health insurance premiums. If people purchase their insurance through these exchanges, they can get up to 85% of their premiums subsidized by the federal government.
Ron Granger
Sun, Jul 1, 2012 : 2:09 p.m.
Thanks for your attempt to clarify and spin my post as misinformation. I am well aware that insurance companies are still, unfortunately, involved. The gain is that people will have pools and not be forced into higher priced individual policies.
Michigan Man
Sat, Jun 30, 2012 : 5:37 p.m.
RG - You seem not to understand the "state pools" - it will be the INSURANCE COMPANIES who will participate in the "state pools" and provide insurance for those who select insurance through the "state pools" (assuming your state chooses to activate a "state pool"). Your state government is not getting into the healthcare insurance business for those who buy insurance through the "state "pool". Hope this clarifies your misinformation.
Sidetrack08
Sat, Jun 30, 2012 : 3:31 p.m.
Here's a link Bedrog,and Spm: might be intrested in reading. http://www.breitbart.com/Big-Government/2012/06/29/Seven-new-taxes http://www.westernjournalism.com/if-healthcare-law-is-a-tax-is-it-now-invalid/ Thought this might be helpful. If you do your homework extensively, you wouldn't call me a Obama basher. Which by the way was a direct hit......
James
Sat, Jun 30, 2012 : 5:37 a.m.
Social security by FDR was equally polarizing.
shepard145
Fri, Jun 29, 2012 : 10:17 p.m.
By accepting obama's attorney's arguments before him, and regardless of what obama claimed many times to the American people, obamacare is a massive tax, Justice Roberts was sending American voters a clear message: "You elected obama and now want the Supreme Court to clean up your mess. We will not – solve your own problems at the ballot box!!" The foundation of the Bill, an attack by the Federal Government on States Rights using the Commerce Clause, was thrown back in their socialist faces. Upheld was this horrible government's power to endlessly tax those Americans still working. OBAMA AND THE DEMOCRAT PARTY IS NOW CLEAR TO BEGIN A MASSIVE NEW TAX ON AMERICAN WORKING PEOPLE IN ORDER TO FUND THE DESTRUCTION OF THE OUR HEALTH CARE SYSTEM AS WE KNOW IT. Congratulations to those of you who FEED off working Americans - YOU ARE THE BIG WINNER THIS WEEK!
maallen
Mon, Jul 2, 2012 : 2:16 p.m.
1bit, It is very apparent you haven't read the Affordable Care Act. The "Health Care Exchanges" can be set up by the states or by the federal government for that state. But the actual 4 plans that will be offered in these "Exchanges" are mandated by the federal government. And with the taxpayers money, we will help subsidize up to 85% of someone's health insurance premiums in these exchanges. Now do you understand the States vs Federal government? And now do you understand how you and I will be paying for these exchanges big time? Please explain how adding a tax on Durable Medical Equipment creates competition and will save billions of dollars. These taxes are passed on to the consumer. If you are an insulin dependent diabetic, you will now pay $2,000 in additional taxes for your supplies. And how does this increase competition? I am not repeating anything someone else has told me. I read the bill, it's part of my job. It is you that is repeating what others have told you: The tax on "DME is a good thing too because it allows for competitive bidding and will save billions of dollars." Really, please explain.
Arborcomment
Sat, Jun 30, 2012 : 8:55 p.m.
You are correct 1bit, whether you chuckle or care about campaign ads will have zero effect - you'll just experience the results. Ruled a tax, a supermajority in the Senate may not be needed after the next election - so we could be back to the same or rebuild. You are articulate and could have a care about the ability to convince others - but that's your call. First attempted rammed through, including locked congressional conference rooms and sweet deals to swing votes. A potential reversal in the fall and maybe start anew? Uncertain, probably not - the media and the net make their living off it. Which brings us back to the campaign ads, I too will be "sadly" chuckling at BOTH our choices.
1bit
Sat, Jun 30, 2012 : 6:45 p.m.
maallen: A tax is a tax, whether at the State or Federal level. The "State's rights" argument is also false as you mistake the health exchanges for another provision of the law that allows States to create their own health care laws, as long as there is equal coverage of the populace. The DME is a good thing too because it allows for competitive bidding and will save billions of dollars, but apparently you think that is a bad thing. Seriously, you won't convince me repeating something someone else told you. shep: I smile at your posts. Thanks for the laugh and useless rhetoric. arbor: I chuckle when people think I care about political ads. Or when they think I care about convincing anyone about anything on the internet. Or when they have the hubris to presume that they know anything about me, my politics or who has my support. For giggles, though, I'll let you know that my preferred candidate isn't a choice in this election. Finally, I mostly am amused by anyone who thinks any single party has their interest in mind or that any single party can run the government without the help of the other.
Arborcomment
Sat, Jun 30, 2012 : 2:42 p.m.
1bit can chuckle at the campaign ads already being broadcast. Video clips of Obama saying Hillary's failed health plan included individual mandates (now called taxes, or "tax penalties" courtesy of the Supreme Court) and that he opposes them, and that his "plan" wouldn't have them. Followed by that famous "shame on you Barrack Obama" rant by Hillary, ending with Romney and a State's rights pitch and a promise to repeal Obamacare. You have 130 days to convince the majority of the American people that some or all of Obamacare must be saved by his re-election, and that we really are in a "recovery". Good luck - still chuckling 1 bit?
shepard145
Sat, Jun 30, 2012 : 2:24 p.m.
You have your facts wrong, will not be persuaded otherwise and will continue to believe whatever in order to support your socialist hero obama. Beck made a lot of money selling a book about folks like that. Those states who have the intellect will refuse obamacare and it will die the ugly death it deserves as every politician who voted in favor of it is removed from office by voters to return in disgrace to their states to sell aluminum siding or encyclopedias.
maallen
Sat, Jun 30, 2012 : 1 p.m.
1bit, You clearly missed the point. It's one thing, as a governor, you enact something for your own state, but it's entirely different as a president you enact something for the whole country which takes away state rights. "The states will be allowed to have their own plans." Well, not exactly. There will be 4 plans offered through the exchange. These 4 plans are designed by the federal government. So, the federal government designs the plans, but "allows" the states to sell them through the exchange. And as the Supreme Court already said, it's a tax. Not only for those who do not get the insurance, but the law also passed another tax that most people aren't aware of. There is now a tax on Durable Medical Equipoment that ObamaCare imposes. So, all those who are having a tough time affording wheelchairs, crutches, pacemakers, insulin pumps, prothesetic legs, arms, etc will now be paying an additional tax thanks to ObamaCare. ObamaCare is one massive tax.
1bit
Sat, Jun 30, 2012 : 11:20 a.m.
You mistake me for someone who believes that the longer the post, the more informed or correct the poster. You are incorrect in most of the facts. The ACA allows states to have their own plans, so Romneycare will survive. The cognitive dissonance that allows you to rationalize the difference between Obamacare and Romneycare escapes me. I don't like state taxes any more than federal taxes, why do you? You do realize the Articles of Confederation was a failure? As far as the "socialist" thing goes, I assume you are for abolishing Medicare, Medicaid and Social Security? Those are much more "socialist" than Obamacare, because the latter keeps the private market. So, no, the sky isn't falling. Squawking louder and erroneously is unconvincing to say the least. And as the saying goes, if life hands you lemons make lemonade. The ACA is a framework, the states can fill in a lot of the details as can responsible parties in the federal government.
shepard145
Sat, Jun 30, 2012 : 3:32 a.m.
Was Romneycare a national program? You have your facts wrong and when did Romney run from it? He has promised to repeal obamacare as soon as he's elected. Clearly some here STILL do not know the difference between a state trying new something like this and a SOCIALIST FEDERAL GOVERNMENT TAKEOVER OF 1/5 OF THE UNITED STATES ECONOMY. What he did as governor was legal and legitimate in it's context – this is a socialist disaster like those bankrupting much of Europe. "….Well, I pay for health insurance so it doesn't affect me…." A PERFECT OBAMA SUPPORTER. Wrap me in government care and I shall be whole! In addition to all the other free goodies, now that insurance companies will "not be allowed" to turn away ANYONE, who do you think will be paying for all these wonderful obama hand outs? YOU will be paying for the largest tax increase in the history of the United States. YOU will be paying more for your own insurance and taxes to grant free health insurance to people who "cannot afford it." They are EXEMPT from paying for ANYTHING so who do you think pays? YOU PAY. Your beloved government has no money – they only have the right to seize YOURS and right now they are spending $10,000,000,000 per day more then they takes in. Do the math. ….you are far from fine.
1bit
Sat, Jun 30, 2012 : 1:26 a.m.
Very funny. The biggest irony of your post is that the GOP will nominate as its Presidential candidate the poster child for the individual mandate, Mitt Romney. This is HIS health care plan. He defended it, extolled it, and now runs from it. Here's something even more amusing, if Obamacare was struck down then Romneycare might have been struck down as well. Oh, and that terrible tax. Well, I pay for health insurance so it doesn't affect me. If you can afford insurance and aren't paying for it, then you're a freeloader and I'm glad you're being taxed because I'm paying for your health care already.
tim
Fri, Jun 29, 2012 : 6:20 p.m.
This ruling is just the first step, next is universal health care. The current system is bankrupting this country and Obama care isn't fixing that problem, but at least it will give the public a taste of universal care and that is a good thing.
maallen
Mon, Jul 2, 2012 : 2:02 p.m.
But 1bit, Obama sold the bill saying it WILL reduce the costs. It will reduce our health insurance premiums, it will reduce our healthcare costs. Unfortunately, so far, it hasn't done that. However, it has increased health insurance premiums and the overall cost of healthcare!
1bit
Sat, Jun 30, 2012 : 11:24 a.m.
tim: Providing health insurance coverage to everyone does not reduce costs. Having people make healthier choices reduces costs. Having access is only part of the equation.
maallen
Fri, Jun 29, 2012 : 11:10 p.m.
You don't think Universal health care is bankrupting other countries? Why is England, Canada, France, and others cutting back universal health care and moving toward private health care and insurance?
NoPC
Fri, Jun 29, 2012 : 3:22 p.m.
So, what happens if you can't afford to pay for the government mandated health insurance plan? Isn't there a $2000 penalty, or rather "tax"? What if you can't afford to pay the $2000 tax? I guess work it out with one of the new 16,000 IRS agents....
maallen
Fri, Jun 29, 2012 : 11:04 p.m.
Under the Affordable Care Act, the government greatly expanded medicaid, meaning more people qualify for free health insurance under medicaid. For those who don't qualify for medicaid and anyone else, The Affordable Care Act is setting up an Exchange where you can buy insurance. Depending on your income, you may qualify for up to 85% of your premiums being subsidized. Gee, I wonder who pays for medicaid? I wonder who pays for these premiums to be subsidized? Anyone care to guess?
shepard145
Fri, Jun 29, 2012 : 10:21 p.m.
Wow - the illusion of knowledge here is strong today. Who pays for low income people's endless tax credits, gimmies, food stamps, ADC and other goodies considering obama is spending $10,000,000,000 per day more then it takes in? Is that answer on this page as well?? LOL
mixmaster
Fri, Jun 29, 2012 : 6:01 p.m.
If you don't have enough $$ to pay the tax penalty, and your income is below a certain level you may enter an insurance exchange (marketplace), and get a tax credit to help purchase private health insurance from companies approved to be in the exchange.
snark12
Fri, Jun 29, 2012 : 5:50 p.m.
Low income people are exempt from the penalty and can join an exchange.
clownfish
Fri, Jun 29, 2012 : 3:58 p.m.
Answers are all on this page.
hmsp
Fri, Jun 29, 2012 : 2:54 p.m.
Julie Ravner, NPR's Health Policy Reporter, will be on the Diane Rehm Show Monday morning at 10AM, discussing in depth exactly how the ACA will affect the consumer. 91.7 on the FM dial. Say what you will about "liberal" NPR, Ravner is extremely sharp, and Diane Rehm will not stand for any BS on her show. No vitriol, and if you state something as a fact, you'd better be able to cite sources. If you are working, and can't listen, download the podcast. I'm willing to bet that this will be the most factual and informative hour on the subject that you will ever get. I know that I will be listening one way or another.
shepard145
Sat, Jun 30, 2012 : 2:13 p.m.
We know how leftists like NPR are persuaded back to reality by facts so here's an example: pelosi and obama sold obamacare to congress by stating categorically that it was not a tax. When arguing before the Supreme Court, obama's henchmen argued before the justices that this was not an over reach of the commerce clause – the individual mandate was just another tax. I don't think your heroes Pelosi and obama lied. I think they are so incompetent that they know little about the Constitution ant that obamacare violates it. They would never get away with such numbing socialist disregard for the rule of law without the press covering it up ever since and suddenly your buddy Diane Rehm has nothing to say! American voters oppose obamacare 48 to 34 and SHE HAS NOTHING TO SAY. How do you feel about a talking head NPR "reporter" who refuses to report to the American people any story unfavorable to her beloved federal government!! How does she resemble a reporter in the former SOVIET UNION? I will leave it up to you to now discover that she is in fact a CORRUPT, BIASED, LIBERAL HACK like the rest of NPR.
shepard145
Fri, Jun 29, 2012 : 10:24 p.m.
".....and Diane Rehm will not stand for any BS on her show. No vitriol, and if you state something as a fact, you'd better be able to cite sources...." Only applies to conservatives honey. Liberals can BS as much as they like and old Diane cannot think of anything to object to. She is one of the worst, most corrupt, biased talking heads on the radio today.
clownfish
Fri, Jun 29, 2012 : 4 p.m.
For an even better analysis of how it will affect consumers listen to the podcast from yesterday. Many rumors debunked, many good questions asked.
mixmaster
Fri, Jun 29, 2012 : 2:42 p.m.
The ACA provides for state run exchanges (marketplace) for people to choose from PRIVATE health insurance plans that meet the legal requirements for insurance companies under the law, such as the section the prohibits insurance companies from denying for pre existing conditions.
maallen
Fri, Jun 29, 2012 : 10:57 p.m.
Yeah, and the people who go through the exchange will get anywhere from 0% - 85% of their premiums subsidized! And who do you think is paying for these subsidies? Once companies realize the penalty for not offering insurance is a lot cheaper than offering insurance, they will be dropping their coverage and people will be left getting it on their own. And then the government is going to become alarmed and say that these "big bad" companies are dropping health insurance. Poor workers we need to do something about this and help them out! Ahhh, yes, then universal health care in america happens. Within 5 years it will be here. America will be just like every other country. It will no longer be the unique great country it was.
shepard145
Fri, Jun 29, 2012 : 10:29 p.m.
"......the section the prohibits insurance companies from denying for pre existing conditions." Wow - those evil insurance companies! Why did they ever prohibit pre existing conditions!? So mean! ....but now those folks will get all the treatment they need but won't have to pay for it!!! Wow great ..........but who will pay? The government is spending $10,000,000,000 more per DAY then it takes in today and every day. Who will pay? Europe is bankrupt because a decade ago they knew as much about socialism as you do now. ....and now it's time to PAY UP.
hmsp
Fri, Jun 29, 2012 : 2:41 p.m.
Ted Kennedy, who fought tirelessly for universal health care throughout his entire career, went to his grave wishing that he had accepted Richard Nixon's compromise, which was far more progressive than "Obamacare." Can you believe it?! Obama faces TP crowds screaming that he is a "socialist," when he is more conservative than Richard Nixon! Say it out loud a few times — Richard Nixon! Richard Effing Nixon!! It is sad that with people like Newt Gingrich coming on the scene, with his, "call all of your opponents traitors" talking points, and with the advent of Fox News and the like, with all of their inflammatory rhetoric and poison, this country has become more and more angrily-conservative, with no solutions posed except for ones like Grover-Norquist's "Starve the Beast" tactics — i.e. cut taxes to the point that the government collapses. People whose express, stated, purpose is to destroy the government are usually called traitors. Timothy McVeigh ended up being executed, but, because he is non-violent, Norquist walks the halls of Congress, bullying members into signing his treasonous contracts. I apologize for broadening the scope of the conversation, but the point is that spittle-spraying naysaying is not patriotism, you have to make at least some productive points. So I appreciate Madhatter's willingness to pose thoughtful questions, even though he opposed ACA. And I appreciate those posters here who actually answered his questions factually to the best of their ability. So now we have some form of universal health care. We are no longer the most backwards country in the developed world. Even TP types can be happy with it, once they get past a knee-jerk reaction to the word "tax" — while there will be specific spending increases, the CBO's assessment is that there will indeed be overall savings going out 5-10 years. Let's try it out, fix what needs to be fixed, and get on with it in a positive way.
shepard145
Sat, Jun 30, 2012 : 3:33 a.m.
They are dancing in the street in Detroit.
tim
Fri, Jun 29, 2012 : 6:30 p.m.
If you really wanted to get people fired up you could re-name employee payroll health insurance contributions to " private tax to private companies". Funny how TP types don't seem to care how much money people spend as long as they don't name it tax. If you really want to be conservative then conserve . Universal care would be much cheaper.
Paul Wiener
Fri, Jun 29, 2012 : 2:19 p.m.
Here is how CNN's news bulletin(s) came in to my email yesterday. Obama too, apparently, was fooled by this long-corrupted laughingstock of a news organization and nearly made a blunder of his own. Rarely has "live coverage" been so brain-dead. CNN Breaking News ✆ via ema3lsv06.turner.com 10:09 AM (2 hours ago) to textbreakingne. The Supreme Court has struck down the individual mandate for health care - the legislation that requires all to have health insurance. Get more details on http://cnn.com/thisjustin and watch live coverage and analysis of this momentous ruling now on CNN TV, CNN’s mobile apps and http://cnn.com/live CNN Breaking News ✆ via ema3lsv06.turner.com 10:18 AM (2 hours ago) to textbreakingne. Correction: The Supreme Court backs all parts of President Obama’s signature health care law, including the individual mandate that requires all to have health insurance. Watch live coverage and analysis of the pivotal decision, its impact on you and on the presidential race now on CNN TV, CNN’s mobile apps and http://cnn.com/live
clownfish
Fri, Jun 29, 2012 : 1:33 p.m.
Most of all the new law is about personal responsibility. If you can afford it you will be required to carry insurance, and not be able to freeload off the rest of us when you seek medical care. If you cannot afford the private insurance you will be allowed to access Medicaid. If you are not now on Medicaid and seek care, we all pay for it now. Hopefully allowing people to access Primary Care through a regular doctors office and not use Emergency rooms as Primary care costs will drop. why are so many people opposed to not allowing their fellow Americans access to health care? What is it that drives you to see millions of people suffer?
maallen
Fri, Jun 29, 2012 : 10:43 p.m.
Clownfish, Who do you think pays for Medicaid? Also, for those who aren't eligible for Medicaid, can still get their health insurance through the Exchange and have their premiums subsidized up to 85% by the government! And who do you think pays for these subsidies? And how is it that people are being denied access to health care when you keep preaching that they are using the emergency rooms?
Michigan Man
Fri, Jun 29, 2012 : 2:05 p.m.
Clown - Medicaid program in Illinois just a few days ago reduced its budget by $2.7 BILLION! $2.7BILLION worth of services and benefits just gone. No one asked the poor people about these cuts. State of Illinois just flat out of money. Would be quite happy, for the good tax paying people of Illinois to propose a trade - Michigan can have Gov. Quinn and Illinois gets Synder? Even up trade? You need to understand Medicaid is not the solution - it is the problem. Why is this so hard to grasp?
Arno B
Fri, Jun 29, 2012 : 1:11 p.m.
Hi folks! I just can't wait for all of these benefits to start flowing my way and yours! Dependant health insurance extended to age 26 at no cost [no insurance company was heard to complain!] One minor detail was not mentioned - those under 26 who are married, some already with children. All "free" perhaps! Those with "prior conditions" - this is not health insurance - it is health maintenance, again with no squawks from the insurance companies. I'm glad that this is all "free" too! For folks who don't have enough funds to purchase health insurance - welcome aboard! It will be "free" to you too! I'm glad to hear that our famous Tooth Fairy Dingell is crowing about these great bargains. I'll sure vote for him since he helps bring such glad tidings to all. I am curious about one small item though. Why is it that all of these politicians advocating these great cascades of health care benefits specifically exempt themselves from it? Never a word from them who definitely don't want it for themselves! Note: When this Act was only 600 pages long, they were specifically included (I read it myself). However, the inclusion didn't last long. Ayn Rand once listed three words about political promises such as these and pointed out that they were hardly ever asked: "At whose expense"?? I suggest looking in the mirror.
arborani
Sun, Jul 1, 2012 : 4:36 p.m.
Ayn Rand - last refuge of the "me first, too bad about you" contingent.
maallen
Fri, Jun 29, 2012 : 10:37 p.m.
Snark12, Under the Affordable Care Act, states (or with the federal government's help) have to set up Exchanges. In these Exchanges there will be 4 types of plans (benefits to be decided by the government, because apparently the government is really really smart). So yes, these 4 different types of health insurance plans will be different than what you can get in the private sector. Now, if you currently have insurance, but switch to the exchange, you won't be able to get your old insurance plan back.
snark12
Fri, Jun 29, 2012 : 5:47 p.m.
Also, the ACA does not proscribe any new health insurance plan. There is nothing for congressmen to be exempt from other than, for instance, to get some form of insurance, which they already have.
snark12
Fri, Jun 29, 2012 : 5:44 p.m.
Where did anyone say the ACA provides these benefits for free?
DonBee
Fri, Jun 29, 2012 : 2:55 p.m.
I read the final bill - it took weeks of evening reading. It greatly exceeds the 600 pages you are speaking of. I don't know what the rules are or what the impact will be on people - BECAUSE - so much of the final rules will be written by new agencies - with new staff. I suspect by 2014, we will have another 50,000 to 100,000 pages of regulation that deals with how this law will impact the average consumer.
clownfish
Fri, Jun 29, 2012 : 1:23 p.m.
Where is Ayn mentioned in the laws of the USA? Right now YOU pay for medical care for thousands of people. You pay it in your insurance premiums, at your doctors office and at the hospital. "WASHINGTON — Uninsured Americans — including those with incomes well above the poverty line — leave hospitals with unpaid tabs of up to $49 billion a year, according to a USA TODAY analysis of government statistics. the government pays about 75% of those unpaid hospital bills either by direct payment or through a disproportionate payment of Medicaid.- USA Today 5/13/2011
mixmaster
Fri, Jun 29, 2012 : 1:05 p.m.
The ACA is all about personal responsibility. Why does anyone want to defend the heath care freeloaders? Those who use the services at the emergency room but pay nothing? Those who are young and healthy, pay nothing and won't get insurance until they have to. We are all paying for the insurance and health care freeloaders. Now is their time to get on board.
maallen
Fri, Jun 29, 2012 : 10:29 p.m.
Ok, you do understand that medicaid is now going to be greatly expanded, right? People on medicaid get it for free or for $10 a month. Both the state and federal government supplies the money for the medicaid program. But where does the state and federal government get the money from? Ah, the taxpayers! So let's see, medicaid is about to be expanded greatly which means more costs. Hmmmm....government needs more money to cover those costs. Raise taxes! We can go on and on how Affordable Healthcare Act is NOT affordable at all. The above is just one small example of rising costs and taxes.
mixmaster
Fri, Jun 29, 2012 : 2:51 p.m.
Funny that the highest debt statistic is in the Southeast. Primarily Conservative and Republican. I'm not a big believer in statistics. But 2% higher than the national average?
mixmaster
Fri, Jun 29, 2012 : 2:46 p.m.
Percentages may look small, but the primary numbers are pretty big so the percentage are no small beans. Those debts are essentially "waste" costs that need to be eliminated. Every little bit helps.
brb11
Fri, Jun 29, 2012 : 2:09 p.m.
I get what you're saying, and I'm pretty sure I see eye to eye to you on this issue. But to me, this issue highlights the need for single-payer, universal health care. Receiving health care just isn't an optional market. You will need it at some point. We all foot the bill for others, even with private insurance. Perhaps even moreso now because our system isn't really designed to accommodate people who receive health care but don't pay into the system. If we had a progressive tax plan designed such that everyone can receive quality health care through pooled resources, we could lessen the burden significantly on those who need it the most.
Madhatter
Fri, Jun 29, 2012 : 1:49 p.m.
"The national average for bad debt is 2.38 percent, 2.50 percent for charity and 4.88 percent for total uncollectable accounts. The Southeast region of the U.S. had the highest percentage of total uncollectable accounts at 6.88 percent. (Source: The Hospital Accounts Report Analysis on Fourth Quarter 2010.) " That hardly seems like a major problem. A 4.88% national average for uncollected accounts suggests to me that 95.12% of accounts are paid. This hardly sounds like a crisis. Am I misinterpreting this information?
clownfish
Fri, Jun 29, 2012 : 1:38 p.m.
MAD- look here for some stats: http://www.acainternational.org/products-health-care-collection-statistics-5434.aspx
Madhatter
Fri, Jun 29, 2012 : 1:26 p.m.
Well, that is a good point. Is there any data that shows how often this occurs?
clownfish
Fri, Jun 29, 2012 : 1:17 p.m.
THANK YOU! Why is it that so many that oppose this new law (yet know little about it) are in favor of Other People paying for medical bills?
Lac Court Orilles
Fri, Jun 29, 2012 : 12:54 p.m.
Rick the nerd Snyder is not your friend. In his infinite arrogance, he delayed establishing an exchange where you can purchase health insurance. Your best interests are not a part of his wealthy class plan. Now Michigan will suffer the consequences for dragging it's feet. Still many people are left uninsured because we still stupidly feet that health insurance should be somehow attached to a job. Why in the world should health insurance be attached to a job? We need National Health Care to level the playing field for businesses to compete in a global economy. The USA is the only industrialized nation that does not have national health care. We shouldn't be so backward. Insurance companies only make money by denying care to it's subscribers. Think for a moment about this statement.... . Businesses need to be focused on producing a product or service not in the health care business. Free businesses from this ball and chain so they can compete, establish national health care next!
maallen
Fri, Jun 29, 2012 : 2:49 p.m.
Lac Court Orilles, Rick "the nerd" Snyder did not delay establishing the exchange. He was pushing it forward. It was the Michigan lawmakers who wanted the delay. Which made sense because why spend all that money and have the Supreme Court strike the law down? Now that supreme court ruled in favor, they can go ahead and implement it in time for 2014. "The USA is the only industrialized nation that does not have national health care." Maybe that is one of the reasons why USA was so great! If national health care is so great then why are so many people leaving their country and coming to the USA?
Carole
Fri, Jun 29, 2012 : 12:47 p.m.
Sure wished congress abided by the Constitution of the United Sates of America. With this ruling what next, they will be telling me I can't go on my computer. It is disgusting.
snark12
Fri, Jun 29, 2012 : 3:25 p.m.
Mad, the government has long taxed and credited us on behavior that is deemed "good" by our elected representatives. Thus, taxes on cigarettes. Tax credits for having children. Luxury taxes on very expensive cars and yachts. Tax credits on mortgage payments (provided the home isn't too expensive). I know many people will continue to be outraged by that government ability, but it has existed for decades. And, yes, I expect that at some point they will put a tax on fattening food, just as they do on cigarettes.
johnnya2
Fri, Jun 29, 2012 : 3:07 p.m.
Just for the record, the CONSTITUTION says the group in charge of deciding whether something is constitutional is the SUPREME COURT. So it does not matter what you think.. Why not tell us what YOUR qualifications to know the constitution are?
mixmaster
Fri, Jun 29, 2012 : 1:11 p.m.
They did. Congress objected to the law as unconstitutional. The Supreme Court thought otherwise. The Constitution, you know the document that says that there are three separate but equal parts of government, give the Constitutional right to the Supreme Court to decide. The Supreme Court, the law of the land, decided the health care law IS constitutional. They have the Constitutional right to do so. Constitution abided by. You comment about your computer is silly.
clownfish
Fri, Jun 29, 2012 : 1:04 p.m.
According to Chief Justice Roberts, the congress DID abide by the Constitution. Maybe time for a remedial Government Studies class? How do you pay for your health care now?
Madhatter
Fri, Jun 29, 2012 : 1 p.m.
Well, from my prespective, it appears they can't order you to buy or do something. However, they can tax the things you do that are considered unfavorable. I am curious to know if this opens the door to things like fat taxes and other forms of "behavior correcting" taxes. The government won't order you to lose weight, they will charge you an "excess poundage" tax. You'll have the right to be fat, it will just end up costing you in taxes. It seems unfathomable to me, but it appears to be the slippery slope we face--from my interpretation.
Peter
Fri, Jun 29, 2012 : 12:57 p.m.
What do you think is unconstitutional about this bill?
clownfish
Fri, Jun 29, 2012 : 12:43 p.m.
The IRS myth: "The IRS budget request for fiscal year 2012 shows that the agency is seeking at least 1,269 full-time equivalent employees (FTEs) at a cost of $473 million to help implement the Patient Protection and Affordable Care Act. But many of them are needed to deliver new tax credits, not to dun taxpayers. The agency is seeking to add 291 "revenue agents" — most of them (193) to "ensure accurate delivery of tax credits." The agency's technology staff would see the biggest increase with the addition of 537 IT program analysts and specialists. As we have seen before, the increased staffing needed at the IRS to administer the many tax changes in the health care law has generated a lot of misinformation. In March 2010, we debunked Rep. Ron Paul's false claim that the IRS would hire "16,500 armed bureaucrats" to enforce the law. We called his statement "wildly inaccurate." Now we know exactly how wild and inaccurate it is."- FACTCHECK.org
clownfish
Fri, Jun 29, 2012 : 12:35 p.m.
So much misinformation floating around. If the bill is too complex for you to read, maybe you are not smart enough to comment on it. The info is out there if the bill is to complex for you. Use a website that is not a schill for the TP or the GOP to seek out the truth, it's not that hard. The mandate was a republican idea, until passed by a Black democrat. The law was partly based on Romneys plan in Mass, which appears to be WORKING. Illegal aliens will not be allowed to use the Exchanges, nor have access to insurance they do not already have access to. If you cannot afford the tax penalty, you will be exempt. You will not be required to change doctors, unless your insurance company has different "networks", same policy as are in existence now. There are no "death panels". The government will not be getting between you and your doctor (unless you need an abortion, then the GOP will be there with you passing judgment) The law requires PRIVATE insurance, not government health care. No new government hospitals are being built to supply "Obamacare". Unless you are a vet and access the VA you will not be seeing "government doctors". You will see the same physicians as you saw last year. Small businesses willhave access to tax credits to help them supply insurance to their employees . (stop by Downtown Home and Garden, speak to the owner about how it works for him. He HIRED BECAUSE of the new law) there will be no more rationing than currently exists, maybe less. Insurance companies will not be able to ration via dropping you just as you are diagnosed with illness. The "donut hole" created when GWB passed the unfunded Medicare Part "D" (aka as "socialized" prescription coverage) will be closed. Illegal immigrants will not be eligible for Exchanges OR Medicaid. Is this a perfect law? By no means. But, it is better than the alternative offered, which was ...tax cuts. Now we can work on modifying the new l
maallen
Fri, Jun 29, 2012 : 2:42 p.m.
Clownfish, "The government will not be getting between you and your doctor." Apparently you didn't read all the pages of the Affordable Care Act. You do realize under this law, doctors are forced to send your BMI (body mass index) and other information electronically to the health department? And then from there, the health department can share your information with other departments as they see fit. Apparently you did not read the part where different boards decide what is covered and what will not be covered. "A recommendation of the Advisory Committee is considered to be "in effect" after it has been adopted by the Director of the Centers for Disease Control and Prevention." And then just on Monday, the U.S. Preventive Services Task Force instructed doctors to identify patients with a BMI of 30 or higher and provide counseling or put them in programs for weight loss. The Federal Health Information Technology Strategic Plan says this "Record Patient information such as gender, race, preferred language, height, weight, smoking status, and blood pressure. Use software application to inform clinical decisions." And it goes on to say "It will also require more rigorous standars to support interoperablility so that the dat that is exchanged can be used for multiple purposes." The government will reward improvements against predetermined thresholds that are associated with the adoption and use of the EHR's (Eelctronic Health Records--what was described above.) If you don't agree with these "boards" about what is covered or not covered in the health insurance packages, then who can you sue? The federal government? Don't be fooled into thinking the federal government won't be involved in your health care on a personal level.
clownfish
Fri, Jun 29, 2012 : 1:25 p.m.
Carole, right now, if you have insurance, you are controlled by UN-elected bureaucrats. Would you feel better if Duke Cunningham or John Edwards were elected to run the program?
Carole
Fri, Jun 29, 2012 : 12:49 p.m.
A new Human Health Service coordinator, to my understanding, will be appointed by the powers that be to handle all of this -- no elected official will be involved. We will be in a terrible fix if this remains.
Diagenes
Fri, Jun 29, 2012 : 12:22 p.m.
The saga continues. The "affordable care act" was passed with only a bare minimum of democrat votes by bribing Senators with all kinds of perks, telling the american people our taxes would not go up, ect. ect. ect. Justice Roberts pulled the veil back and showed us that congress, lead by Rep. Dingell, has increased taxes on ALL americans. This is a bad piece of legislation that will do very little to improve the delivery of health care in the U.S. It does create lots of jobs for federal regulators and IRS agents.
justcurious
Fri, Jun 29, 2012 : 12:19 p.m.
Having retired from the local healthcare industry fairly recently, I am curious to know what safeguards will be put in place that will assure me that I will not be paying for non citizens health care. I was amazed at how many persons who were obviously not citizens of this country were being treated as any tax paying citizen was. So called charity care was rampant. The facility I worked at never turned anyone down for care, yet someone paid - us. Will that change?
1bit
Fri, Jun 29, 2012 : 11:04 p.m.
jc: Your facility that you worked at didn't turn anyone down because that is the law. Generally, at a Hospital or ED you cannot deny treatment for lack of an ability to pay. The ACA has nothing to do with that.
johnnya2
Fri, Jun 29, 2012 : 3:04 p.m.
". I was amazed at how many persons who were obviously not citizens " Really? If this is not the most racist statement I have ever heard in my life. Tell us how they OBVIOUSLY were not citizens? Was it their language? Their last name? Their skin color? You disgust me.
clownfish
Fri, Jun 29, 2012 : 12:40 p.m.
Right now, or in the recent past, we ALL paid for health care for those that could not (or would not) pay. The new law exempts illegal aliens from Exchanges and Medicaid. Curious, would you turn away a 9 year old illegal alien from a doctors office if he/she needed immediate attention? At what age would you start turning away sick/injured people?
mixmaster
Fri, Jun 29, 2012 : 12:17 p.m.
Everyone is still learning about this. Health care in this day and age is not like buying socks. Change can be difficult (but wouldn't be so much if the antis weren't spreading vicious rumors and outright lies). Remember the elderly Tea Partiers in 2010 who cried "I hate socialized medicine but Don't mess with my Medicare"? I do. And hopefully if all the the noise from the right lets up so everyone can make sense of this instead of all the noise, people will begin to understand how this helps EVERYONE who needs insurance and access to good health care. Like Social Security and Medicare, both of which were roundly ridiculed and lied about by the "anti's" when first instituted, they are both now part of the national landscape, making the lives of millions better, particularly seniors and children. We'll all learn more as the program is implemented. Congress will make changes along the way, improving the program. By 2014, we'll all know more and feel better about it. Patience and stop watching Fox News.
clownfish
Fri, Jun 29, 2012 : 7:21 p.m.
So, MICHMAN, how to you square the falsehoods being promoted by the FOX viewers with reality? No IRS agents in the emergency rooms, no Obama saying he would not take this for his family, no Death Panels, etc. If this law is sooo bad, why is there so much misinformation being spread against it? Why not just tell the truth? Answer: most people like the provisions when they are explained.
Michigan Man
Fri, Jun 29, 2012 : 2:43 p.m.
Love Fox News! My condolences to those who are addicted to MSNBC. Remember, addiction, which is treatable, is a chronic, progressive and often fatal disease.
Enso
Fri, Jun 29, 2012 : 2:17 p.m.
@Dick, and the others, No, he says stop watching Fox News because because study after study has consistently shown that viewers of Fox News are less informed, including MISinformed, about the news more than viewers of other news media. Fox News is not News. It is right wing editorial disguised as news. Besides, the Founder of Fox News is an immoral crook of the highest degree.
Madhatter
Fri, Jun 29, 2012 : 1:52 p.m.
Do you watch MSNBC? If so, will you stop watching MSNBC if I stop watching Fox News?
mixmaster
Fri, Jun 29, 2012 : 12:40 p.m.
Because Fox News is the main purveyor or rumor and lies about the ACA. Their guests all have personal agendas to rid the country of PResident Obama. So spreading lies anrd rumors is their game. For them it's all about making as much noise as possible to drown out the facts
clownfish
Fri, Jun 29, 2012 : 12:37 p.m.
Where did MIX say he was going to monitor people or install sensors?
Pickforddick
Fri, Jun 29, 2012 : 12:21 p.m.
You were making sense until you tried telling people what to watch for news....what is it you are afraid of in trying to sensor people?
Sidetrack08
Fri, Jun 29, 2012 : 12:11 p.m.
What was not mentioned in these comments was..... Obama was asked at a press confrence if this plan was good enoungh for "his family", his reply, "No". Well folks, that is very sad. How are people going to afford to pay the penalty of $2,ooo when they can't afford healthcare in the first place?? This is a very bad thing.....
snark12
Fri, Jun 29, 2012 : 5:32 p.m.
Thanks for the link, spm. Obviously the facts bear no resemblance to the stated anecdote.
spm
Fri, Jun 29, 2012 : 4:54 p.m.
According to Snopes this isn't how this went down - with video - http://www.snopes.com/politics/medical/network.asp
bedrog
Fri, Jun 29, 2012 : 2:48 p.m.
and im sure that a welfare standard of living wouldnt be good enough for his family ..or Romney's ..or mine or yours... these programs are safety nets for the vulnerable ( and in some cases seemingly self -destructive via lack of insurance, who will still cost taxpayers money and harm innocents in their own families)...so its a great program in other words what is your ( or other obama bashers')point?? Ever!
clownfish
Fri, Jun 29, 2012 : 12:20 p.m.
The minimum assessment will be $695 per person (but no more than $2,085 per family) in 2016, when fully phased in. The amount can be higher depending on income. But there are exemptions for low-income persons and others. If a person, or family, cannot afford insurance they will be eligible for Medicaid. If they earn too much for Medicaid, but cannot afford a plan through the new Exchange, they will be exempt from the tax.
mixmaster
Fri, Jun 29, 2012 : 12:18 p.m.
Please provide the quote or the video clip. Pics or it didn't happen.
Michigan Man
Fri, Jun 29, 2012 : 11:24 a.m.
Get ready for IRS agents stalking the hallways and waiting rooms of Ann Arbor hospitals and medical offices profiling for those without healthcare insurance and then pouncing on them to levy the IRS tax. Perhaps Obama can employ the 800,000 illegals he spoke about recently and then have that cohort administer the new IRS tax. Bunch of new winners in that scenario. Even better - have the 800,000 illegals levy the tax against legal but poor Americans without healthcare insurance. According to the article above, 27,000 Washtenaw county residents are without insurance today so one could reasonably assume that the IRS (enforcement group for Obamacare tax) will be a good growth industry. Make sure your daughters and sons study accounting/finance/patient accounting in college as good IRS healthcare tax jobs will open up soon for many. One of the poorer pieces of federal legislation in my lifetime - will only, I am sorry to say, make the healthcare system more complicated, less efficient, will lower quality for all and eventually succumb under the weight of the misdirected folly. Obama, of course, will now think he is able to move forward with the "single payor" theory of gloom.
Michigan Man
Fri, Jun 29, 2012 : 8:22 p.m.
Clown - You have no answers that would be correct. My condolences that your nectar of naivete is so delusional. Finally, I trust that you are young (under 40) as that might begin to explain some of your thinking. I will, however, try not to hold that against you.
clownfish
Fri, Jun 29, 2012 : 7:15 p.m.
MICHMAN, you are free to live under whatever delusions suit you. I have posted factual statements, not what some pundit fears in the darkness of his closet. Like 15% unemployment, $5/gal gas and 10% inflation predicted by those same pundits in 2009, most of your fears are not based in reality.
johnnya2
Fri, Jun 29, 2012 : 3:02 p.m.
Mich Man, Everybody is entitled to free speech, but when you tell OUTRIGHT lies, don't be shocked when you are called on it. You somehow manage to tie immigration and health care as some socialist plot to destroy the country. Nothing could be further from the truth. The fact that the law states 80% of all premiums MUST go towards patient care is huge. Guess how much money these insurance companies are paying back to their insured before August 1st? Over a BILLION dollars. I will be receiving a check as will my employer. Once these checks start coming in, people will start to see more of the benefits of the ACA. The preferred method would be single payer. The right wing would not talk about that, so the mistake Obama made was negotiating from the middle, where not a SINGEL republican offered any idea or proposal to health care reform. Oh wait, no, republicans DID offer almost this exact proposal, but once Obama supported it, they ran from it.
Michigan Man
Fri, Jun 29, 2012 : 1:49 p.m.
MA + Clown + MM = Don't you love free speech and free thought? Important principles for the Ann Arbor crowd, one would think. I know my ideas give you disequilibrium and are difficult for your lefty mind to understand. Make sure you bring you picture ID to your next healthcare appointment and be careful about the motives of the person next to you in the waiting room. My guess is that the IRS agents will be able to make unannounced and will need no consent for them to profile you in your healthcare providers office - just like all federal agents are allowed to do. Finally, MA you would be correct that I would favor all legal Americans having work before any illegal American. How many of the 800,000 illegals spoken about weeks ago by Team Obmama are now gainfully employed? Hey, even better perhaps the new IRS tax can be levied on this people using our healthcare system and then not paying bills? Sure hope the 800,000 illegals are not cutting in line and finding work when legal Americans have none.
mixmaster
Fri, Jun 29, 2012 : 12:19 p.m.
Been listening to Fox News lately? Because I do and this is exactly what they're telling people. Stop rumor mongering.
clownfish
Fri, Jun 29, 2012 : 12:18 p.m.
The tax will be charged to your 2015 taxes, IF you don't have insurance. No IRS agents will be patrolling emergency rooms. That is as false as "Death Panels". How do you pay for your health care now? Do you have insurance or do you pay out of pocket for each service?
Modern_Atheist
Fri, Jun 29, 2012 : 12:05 p.m.
you're probably much happier with these "illegals" making $.25 an hour picking berries for you, aren't you?
Technojunkie
Fri, Jun 29, 2012 : 11:21 a.m.
Government helps to make people chronically ill with unhealthy food and medical policy, big pharma and the rest of the medical industrial complex treat the resulting symptoms but rarely cure causes, and we're supposed to say thank you to the Democrats for "helping" us stay in this sick corporatist system. I'm not kidding. It's not socialist. Big health care providers are very willing partners in this game. This is private ownership with government control, the definition of corporatism (or fascism). How adding more government bureaucracy to big company bureaucracy is going to produce efficiencies is not exactly clear. Want to opt out of this charade? You used to be able to buy inexpensive high-deductible insurance and maybe pair it with a HSA. It was cheaper than the ACA penalty tax. The ACA slashed the legal maximum deductible, dramatically raising the price. You can still choose to ignore the dietary advice of our federal minders and eat healthy food: no grains, pastured meats, healthy fats, organic veggies, as local as you can find them, but armed government raids on small farmers at the request of government's corporatist Big Ag partners limit your choices when they think they can get away with it. Heaven help you if you want to buy local grass-fed raw milk but factory farm milk from cows pumped full of growth hormones and antibiotics and fed GMO grains and worse is perfectly OK in the eyes of our masters. Dependent people are controlled people. Especially when they think that Big Brother loves them.
brb11
Fri, Jun 29, 2012 : 1:53 p.m.
It's not that the government is forcing us to eat certain foods, per se. The problem is that due to the subsidies on corn, etc. it has become very cheap to use it in everything. We feed (most of) our livestock corn because it's cheaper than their natural diet of grass. However, this drives up the Omega-6/Omega-3 ratio of fatty acids in their bodies, which is linked to all sorts of health problems for us when we eat those animal products. I seek out grass-fed beef specifically for this reason, although the price is usually higher. The price of corn is so low that it can be made into a sweetener (HFCS) that is much cheaper than sugar and just as bad for you. So we can make bland things taste better very cheaply by loading it with sugar (take a look at the ingredients for your bread sometime, there's a good chance it has HFCS in it). It's in crackers, peanut butter, all sorts of products you wouldn't expect, because it's very cheap. So no, the government isn't forcing us to eat things by force. But ultimately we are hurting ourselves (through the government) by subsidizing and stockpiling massive amounts of corn, which is easily and cheaply processed into forms devoid of nutrition. This is why there is an obesity problem among the low-income demographic -- healthy meats and vegetables are expensive, while processed foods laden with corn-based sugars are very inexpensive. I would actually be in favor of shifting the subsidization of crops from corn to healthier greens, etc. That's nowhere near happening, though, because unfortunately there are powerful lobbying forces at work to keep the status quo.
Modern_Atheist
Fri, Jun 29, 2012 : 12:15 p.m.
yeah, the government is forcing pork rinds and soda down my throat.
justcurious
Fri, Jun 29, 2012 : 12:13 p.m.
I agree with your post concerning what we eat totally. King Corn makes us sick.
1bit
Fri, Jun 29, 2012 : 10:45 a.m.
Amy, all individuals and small businesses (less than 100 employees) are eligible to purchase insurance through the health care exchange.
justcurious
Fri, Jun 29, 2012 : 12:28 p.m.
Businesses with fewer than 50 employees would be exempt from the mandate. However, a small business could earn tax credits for paying employee premiums if it chooses to. Businesses with 50 or more employees could opt out and pay a penalty, which might be cheaper than the premiums. Businesses with more than 50 employees will be blocked from forcing employees to pay more than 9.5 percent of their household income in premiums. However, the New York Times has pointed out that employers have no way of knowing an employee's household income, and cannot determine whether an employee's required premiums would be deemed "unaffordable" and subject the employer to penalties.
Madhatter
Fri, Jun 29, 2012 : 10:41 a.m.
I am hearing people say things like "I'll get healthcare now" and "I won't go bankrupt with medical bills now," but I have more questions about that. Like before, I am not trying to use party lines here. How good will the coverage be? It seems to me like a lot of people are acting like this is a giveaway and they won't need to worry about paying medical bills. While I have been critical of this bill, I am really trying to be open-minded and ask questions that I feel are important. I mean, do people you know really understand that this is not "free" health insurance, but rather a law that requires them to buy insurance? Also, do people realize that there are still going to be copays that need to be made? My impression is that poor people or people getting subsidies will buy insurance that they can afford, and it will likely be some minimum policy. Well, let's say the policy covers 70% of operation costs. If someone has a $15,000 operation, the copay would be $4,500. If it turns out to be $100,000 the cost of copay would rise to $30,000. If they are poor, how will they pay that expense? It seems to me like these people are still going to get stuck with bills that can put them into bankruptcy. I would like people that have read this bill or studied it to please explain this to me. It seems like this is a windfall for insurance companies and medical services providers. How is this law going to help? Party lines aside and no logical fallacies, I really want to be enlightened here. You have my ear and I am willing to listen.
Arborcomment
Sat, Jun 30, 2012 : 2:09 p.m.
Mad's entire exchange illustrates current complexity of health care and the huge degree of uncertainty and things left undecided, not thought of, or "we'll get to it later" of ACA. If Obamacare survives the 2012 election, no matter how the benefits actually pan out, there are a couple of certain winners: 1) Lawyers (a whole new generation of disability claim type health care ambulance chasers). 2) Lobbyists (influencing implementation regulations or amendments).
johnnya2
Fri, Jun 29, 2012 : 2:54 p.m.
These questions can not be answered at this time, because the state of Michigan has chosen to drag their feet and wait until the Supremes ruled. So there is not a person on this planet who can accurately answer any of your questions at this time. The Snyder/ Schuette crowd put all their eggs in one basket and thought they were not going to have the law. This is quite frankly piss poor leadership on the part of them. They had an OBLIGATION to prepare for the law right away. It is the same as the bar owners who "suddenly" were forced to deal with the smoking ban. NO, it was not sudden. Thhey had plenty of time to prepare, they preferred to hope it would go away.
snark12
Fri, Jun 29, 2012 : 2:53 p.m.
Mad, you're asking very good questions and I, at least, appreciate moving the discussion onto operational details as you are. The answers, however, will really come from the specific implementations. The law itself prescribes lower thresholds for care that the exchanges must meet. For instance, with regards to co-pays, there will be no co-pays for preventative care visits (mammograms, prostate exams, etc.). Depending upon the exchange and the premiums, there may still be co-pays for other doctor visits. The *affordable* care part of the ACA largely comes from changes in the way medicine is delivered. The law, for instance, prescribes that doctors are rewarded for "outcome-based medicine" not just delivering medical treatment. These changes are viewed negatively by many people but they are already slowing the increase of healthcare costs.
Madhatter
Fri, Jun 29, 2012 : 12:45 p.m.
Except for 1bit, I really haven't received any helpful answers on this. Like I wrote before, let's set partisan politics aside. Democrats: the Supreme Court declared you the winners yesterday. Please enlighten us and explain what makes ObamaCare great. You have my attention, would you care to answer my questions please?
mixmaster
Fri, Jun 29, 2012 : 12:34 p.m.
The primary reason that people don't understand the LAW is because the anti crowd purposely makes NOISE, spread so many lies and rumors that people are rightfully confused and can't hear the facts. Stop making noise and listen. This law is as much about personal responsibility as it is about health care.
Pickforddick
Fri, Jun 29, 2012 : 10:58 a.m.
I believe the problem here is that No One really can explain this bill.......our members of Congress have not read the bill but they somehow found the gall to vote it in....the Supreme court has not even read the bill entirely and they have voted to keep it...you want answers but there is no one in America that can give them to you....Amazing isn't it?
1bit
Fri, Jun 29, 2012 : 10:56 a.m.
Madhatter, you are asking important questions because ultimately the details are what matter. There has been a misconception that health care will be "free", when really the law is just trying to make insurance more affordable. The laws provisions still are a couple years away from full implementation. The biggest feature that will determine the answers to your questions is the health care exchange. Certain guidelines (like limited deductibles, rates, waiting periods, benefits provided, etc) will make the plans theoretically more comparable. There is a lot of thinking that the exchanges will cause a shift from employer based health care (for small businesses) to purchasing your own insurance. Google "health insurance exchange" and you will get a lot of links that will answer many of your questions.
Madhatter
Fri, Jun 29, 2012 : 10:38 a.m.
I bow my head in defeat to the democrats, you won your battle fair and square. Now I have some questions... All party lines aside, I really don't know what to think of this law. I see comments indicating they are free to switch jobs and not have to worry about getting denied, but I have a lot of questions about that part. If I decide to leave the company I work for and then go work for a different company, there usually is a probationaly period--like three to six months. So that would mean I would have to go without insurance for three to six months. I know people are going to mention cobra, but let me explain a little about that. I switched employers before and during one switch in 2002 the cost of cobra was about $700 per month. That's a very unmanagable cost for many people, and I'm sure it went up over the years. So would going without health insurance for three to six months mean I have to pay a penalty to the government because I switched jobs and couldn't afford cobra? If so, it seems like I really would have less freedom and would be tied to an employer so I wouldn't lose my health coverage. Another question involved those that make a decent salary. Lets say someone makes $45,000 per year and suddenly loses his or her job in the middle of the year. SInce the person has no money coming in he or she may not be able to afford health care. Would the person qualify for a government subsidy considering he or she already has significant earnings on record for the year, or will the government tell them they are out of luck and stick them with a tax penalty? Like I said, party lines aside, these are legitimate questions that I would like answers on. I'm not looking for a biased response or a vague reply supporting one side or another, I am looking for genuine accurate answers. The bickering over the law is done as it has been decided by the Supreme Court. Does someone know how to answer these questions?
maallen
Fri, Jun 29, 2012 : 10:12 p.m.
Madhatter, As of right now, if you currently have insurance and have not had a break in the coverage of more than 60 days then if you decide to switch coverages then that new carrier must cover your pre-existing condition immediately. However, if you do not have insurance or have not had insurance for more than 60 days then carriers can apply up to 6 months probationary period on that pre existing condition. Keep in mind, you are still covered, but just not for any pre-existing conditions until you have met your probationary period. As of right now, unless the federal government changes it, it is up to the employers to decide when a new hire gets his/her insurance, in 30 days, 60 days, 90 days, etc. For the record, I keep seeing people write COBRA is expensive. What they fail to realize is the premium you are paying under "cobra" is the exact same premium that your employer was paying for your coverage! By law, when you go on COBRA you are responsible for 100% of the premium. Whoever administers the COBRA can only charge a 2% administrative fee
DonBee
Fri, Jun 29, 2012 : 2:59 p.m.
Madhatter - I have taken the time to read the law and to look up many of the references in the law to understand some of what it means but... I am sorry, I doubt the answers to many of your questions exist. The regulations have not been drafted, placed in the Federal Register, commented on and revised. The law requires that 100's of new regulations be written and most of them do not exist. Hang on to your hat - by 2014 - we will have an idea of what the law means to you and I.
Madhatter
Fri, Jun 29, 2012 : 1:29 p.m.
So is it a 60 day gap for pre-existing conditions, or is it a 60 day gap between employer plans? I want to make sure we're on the same page.
brb11
Fri, Jun 29, 2012 : 1:26 p.m.
One thing to note is that since COBRA can be applied retroactively, you can wait until near the end of the 60 day window to see how your out-of-pocket expenses compare to the cost of the premium + OOP expenses for the group health plan, and then choose whichever is cheaper. You have to take care to make sure you meet COBRA filing deadlines, but there is a bit less risk involved there for that situation. I recently had exactly a 60 day gap in coverage between employers, so I was able to wait during the full coverage gap to compare expenses. Since COBRA is so expensive, I saved money (but not much) by not electing to continue with it. I also didn't have to worry about pre-existing conditions because the coverage gap was small enough. That being said, I do wish COBRA were less expensive. $700 is not very manageable without any income.
Madhatter
Fri, Jun 29, 2012 : 1:17 p.m.
I'm most interested in the probationary period an employee has when he or she starts a new job. Employees typically have to wait 90-180 days before they can join a company's group policy. Will the employer's probationary period change due to this law? Will the employer face a fine for not immediately offering the policy, or will the employee face a fine for the 90-180 day lapse in coverage? This is a big deal for people that change jobs. How will the change in employment affect the health care policy considering the unaffordable cost of COBRA? One commentor wrote about exchanges, but what if we are still using an employer-based plan?
Madhatter
Fri, Jun 29, 2012 : 1:11 p.m.
Adding to that last reply, yes i have found some answers by the replies to my question, but some additional questions exist. How will these poor people address copays and other fees? How will this prevent them from filing bankruptcy? Is there some type of mechanism that kicks in and protects them from these costs, or is there a mandate on the types of coverage offered?
maallen
Fri, Jun 29, 2012 : 1:10 p.m.
If you have not had insurance before, there still will be a probationary period of up to 6 months for pre-existing conditions. If you have had insurance, but with no break in coverage of more than 60 days, then there is no probationary period for pre-existing conditions. Now, to address the main issue with the Affordable Care Act: There is nothing affordable about this law. Nothing in this law has helped or will help drive down the costs of health insurance. Kathleen Sebelius, Secretary of Health and Human Services even stated this. All the added benefits that they are mandating the insurance carriers to provide have increased costs. Now, another big question is, medicaid is going to be expanding, we will be subsidizing people's health insurance premiums, where the heck are we going to get the money to do this?
Madhatter
Fri, Jun 29, 2012 : 1:08 p.m.
Can you point out where some of those answers are? Maybe I'm just not seeing them. Where does it answer my questions? Telling me to read the bill or pay attention doesn't really help me or other people that desire to know the answers. Please enlighten us.
mixmaster
Fri, Jun 29, 2012 : 1:02 p.m.
Then start by reading some of the comments and replies here that are in favor. People are answering your questions, but you must pay attention, rise above the noise and take some personal responsibility for understanding this instead of relying on others to tell you.
clownfish
Fri, Jun 29, 2012 : 12:56 p.m.
Excellent questions, MAD. As far as I know (and I could be wrong on this one), COBRA is still effective, and expensive, so that does not change. As you leave your job you should be able to access the new Exchanges, if your income allows it. If you need a new policy the insurance company will NOT be allowed to exclude you due to existing conditions, as they are allowed to do now. There should be no probationary period. Again, the new law is not perfect, there are holes and things that need to be fixed but overall it should benefit more people than it harms and in most cases people that move jobs should be better off. Will there be exceptions to that? You bet. Life ain't always fair, now is it?
Madhatter
Fri, Jun 29, 2012 : 12:41 p.m.
Would you care to address the questions I asked? I really am interested in knowing what impact this law will have on the questions I asked above. Let's set partisan politics aside, and get the information that so many are seeking.
mixmaster
Fri, Jun 29, 2012 : 12:30 p.m.
I don't think you'll get many "answers" to your "questions" because your mind is already made up. You believed all the rumors, lies and innuendo spread by the antis, the Tea Partiers and Fox News. The anti crowds main purpose is to make as much noise as possible so everybody else can't actually hear what the story is. Patience, read, listen and stop making so much noise. It makes it hard to hear what's really going on.