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troung
04 Oct 16,, 22:41
No shit.

Dems turn on ObamaCare amid premium hikes, Bill Clinton laments ‘crazy system’
Published October 04, 2016 FoxNews.com
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http://www.foxnews.com/politics/2016/10/04/dems-turn-on-obamacare-amid-premium-hikes-bill-clinton-laments-crazy-system.html



ObamaCare has survived dozens of Republican attempts to repeal and undermine it, but a new wave of Democratic complaints -- led most recently by former President Bill Clinton -- about the cost crush facing consumers is posing a fresh challenge.

Bill Clinton, on the campaign trail for Hillary Clinton, told voters in Michigan on Monday that the legislation has created a “crazy system” where millions more people have health care but those unable to qualify for subsidies are getting “killed.”

“The people … out there busting it, sometimes 60 hours a week, wind up with their premiums doubled and their coverage cut in half,” Clinton said. “It’s the craziest thing in the world.”

The comments come as Republican and Democratic administrations at the state level all grapple with fresh complications from the law, as insurers threaten to leave the ObamaCare exchanges amid financial concerns and customers face the prospect of rising premiums for the plans available.

Asked Tuesday about the Clinton comments, White House Press Secretary Josh Earnest said President Obama has “continued strong confidence” in the benefits provided under the health law.

“Twenty million Americans have access to quality affordable health insurance today that didn’t have it” before, he said. At the same time, Earnest said Obama acknowledges more can be done to “further strengthen the law” – and noted Hillary Clinton has signaled interest in doing so.
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Amid the fallout from the ex-president’s remarks, Clinton spokesman Angel Urena clarified he was trying to speak about the “good it has done” in expanding coverage while addressing room for improvement.

“And while he was slightly short-handed, it's clear to everyone, including President Obama, that improvements are needed. That’s why Secretary Clinton has proposed measures including tax relief to cover excessive out-of-pocket costs, a public option and Medicare buy-in for those over 55,” Urena said.

In his remarks, Clinton also railed against the “insurance model” as a whole.

Clinton’s comments in Michigan follow officials in nearby Minnesota recently agreeing to huge price hikes in order to convince insurers to stay. Commerce Commissioner Mike Rothman announced Friday that individual market plans could raise rates as high as 67 percent next year. The jump in cost follows this year’s hike of 14 percent to 49 percent.

In a written statement, Rothman, who serves in a Democratic administration, said middle-class residents are getting “crushed” and called for urgent reforms in the state’s individual market.

“This year the need for reform is now without any doubt even more serious and urgent,” Rothman said. He called the soaring rates “unsustainable and unfair,” while saying the steps they took were necessary to “avert a collapse this year” – after the state’s largest health insurer, Blue Cross Blue Shield of Minnesota, announced it would stop selling health plans to individuals and families in 2017 and other insurers had threatened to follow.

The insurance giant said extraordinary financial losses drove its decision. The company said it was “projecting a total loss of more than $500 million in the individual [health plan] segment over three years.”

Many states are facing similar challenges.

“Employer markets are fairly stable, but the individual insurance market does not feel stable at all,” Janet S. Trautwein, chief executive of the National Association of Health Underwriters, told The New York Times. “In many states, the individual market is in shambles.”

Democrats, who once enthusiastically supported President Obama’s landmark legislation, are feeling the heat and looking for ways to cut consumer costs.

One Democrat-touted solution is the so-called public option.

Democratic presidential nominee Hillary Clinton, multiple members of Congress and even Obama himself are floating it as a cure for the growing crisis.

A public option -- or insurance plan offered by the government -- had been written into early versions of the bill but failed to make the final cut in the law signed by Obama in March 2010.

Thirty-three Democrats signed a non-binding Senate resolution last month to add the public option to ObamaCare.

Obama wrote recently in the Journal of the American Medical Association that “Congress should revisit a public plan to compete alongside private insurers in areas of the country where competition is limited.”

Oregon Democratic Sen. Jeff Merkley’s resolution isn’t likely to pass – since Republicans have a majority and generally oppose the idea as a way to fix ObamaCare.

Republican presidential nominee Donald Trump and several GOP lawmakers, including Sen. John McCain, of Arizona, argue the public option isn’t an option at all.

Arizona in particular is bracing for double-digit premium hikes next year. McCain, who has been a vocal opponent of ObamaCare from the start, maintains “the whole thing is collapsing like a house of cards.”

“Now that the law is unraveling, it’s no surprise that Democrats are clamoring for a so-called ‘public option,’” McCain recently told FoxNews.com in a statement. “If anything is clear about this failed law, it’s that more government intervention is the wrong solution to fixing our health care system.”

Cato Institute scholar Jeffrey Singer believes the public option is nothing more than a sleight of hand and “would eliminate competition, not increase it.”

“Few things are more frightening for the future of American health care,” he wrote. “ObamaCare’s critics were right to predict that it would enter a death spiral; Arizonans are now experiencing it firsthand. Now we must ensure that its death spiral doesn’t take us down an even darker road.”

Asked Tuesday about what might have been driving Bill Clinton’s critical comments, Donald Trump backer and ex-GOP primary rival Mike Huckabee said the former president is “telling it like it is.”

“The breaking news here is a Clinton is telling the truth,” Huckabee told Fox News. “And it’s kind of refreshing.”

troung
04 Oct 16,, 22:47
Ailing Obama Health Care Act May Have to Change to Survive

By ROBERT PEAROCT. 2, 2016
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President Obama’s signature domestic achievement will almost certainly have to change to survive. The two major parties agree that for too many people, health plans in the individual insurance market are still too expensive and inaccessible. Credit Al Drago/The New York Times

WASHINGTON — The fierce struggle to enact and carry out the Affordable Care Act was supposed to put an end to 75 years of fighting for a health care system to insure all Americans. Instead, the law’s troubles could make it just a way station on the road to another, more stable health care system, the shape of which could be determined on Election Day.

Seeing a lack of competition in many of the health law’s online insurance marketplaces, Hillary Clinton, President Obama and much of the Democratic Party are calling for more government, not less.

The departing president, the woman who seeks to replace him and nearly one-third of the Senate have endorsed a new government-sponsored health plan, the so-called public option, to give consumers an additional choice. A significant number of Democrats, for whom Senator Bernie Sanders spoke in the primaries, favor a single-payer arrangement, which could take the form of Medicare for all.

Donald J. Trump and Republicans in Congress would go in the direction of less government, reducing federal regulation and requirements so insurance would cost less and no-frills options could proliferate. Mr. Trump would, for example, encourage greater use of health savings accounts, allow insurance policies to be purchased across state lines and let people take tax deductions for insurance premium payments.
Continue reading the main story

In such divergent proposals lies an emerging truth: Mr. Obama’s signature domestic achievement will almost certainly have to change to survive. The two parties agree that for too many people, health plans in the individual insurance market are still too expensive and inaccessible.

“Employer markets are fairly stable, but the individual insurance market does not feel stable at all,” said Janet S. Trautwein, the chief executive of the National Association of Health Underwriters, which represents more than 100,000 agents and brokers who specialize in health insurance. “In many states, the individual market is in a shambles.”

Mr. Obama himself, while boasting that 20 million people had gained coverage because of the law, acknowledged in July that “more work to reform the health care system is necessary.”

“Too many Americans still strain to pay for their physician visits and prescriptions, cover their deductibles or pay their monthly insurance bills; struggle to navigate a complex, sometimes bewildering system; and remain uninsured,” Mr. Obama wrote in The Journal of the American Medical Association.

The marketplace faces a major test in the fourth annual open enrollment season, which starts on Nov. 1, a week before Election Day. In many counties, consumers will see higher premiums and fewer insurers, as Aetna, Humana and UnitedHealth have curtailed their participation in the exchanges, and many of the nonprofit insurance cooperatives, created with federal money, have shut down.
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Senator Jeff Merkley of Oregon, Democrat of Oregon, has introduced a resolution calling for a public option on the insurance exchanges that now has 32 co-sponsors. Credit Rachel La Corte/Associated Press

Mr. Trump has said that Congress must “completely repeal Obamacare,” and Republicans in Congress have repeatedly tried to do so. But parts of the law appear to be here to stay. One such provision, now widely accepted, says that insurers cannot deny coverage because of a person’s medical condition or history.

For their part, many Democrats are clamoring for a public insurance option, as they did nine years ago.

“Supporters of the public option warned that private insurance companies could not be trusted to provide reliable coverage or control costs,” said Richard J. Kirsch, who led a grass-roots organization that fought for passage of the Affordable Care Act in 2009 and 2010. “The shrinking number of health insurers is proof that these warnings were spot on.”

On Sept. 15, Senator Jeff Merkley, Democrat of Oregon, introduced a resolution calling for a public option. The measure now has 32 co-sponsors, including the top Senate Democrats: Harry Reid of Nevada, Chuck Schumer of New York and Richard J. Durbin of Illinois.

“You need competition to make the exchanges successful,” Mr. Merkley said in an interview. “A public option guarantees there’s competition in each and every exchange around the country.”

As they did before the Affordable Care Act was enacted, insurance lobbyists are mobilizing to kill the public option. The main trade group for the industry, America’s Health Insurance Plans, says it would do nothing to stabilize the exchanges, and in an urgent “action alert,” the group asked member companies to lobby against Mr. Merkley’s resolution.

Senator Lamar Alexander, Republican of Tennessee and chairman of the Senate health committee, said the Democrats’ public option plan would compound the problems it seeks to solve.

“Obamacare exchanges are collapsing because of federal mandates and a lack of flexibility,” Mr. Alexander said. “We need to give states more flexibility and individuals more choices so more people can buy low-cost insurance.”

Mr. Trump would replace the Affordable Care Act with an assortment of conservative policies, including some that are similar to ideas favored by House Republicans and by think tanks like the Heritage Foundation or the American Enterprise Institute. But Democrats and some Republicans say that Mr. Trump has not laid out a comprehensive, coherent alternative to the Affordable Care Act.

Mr. Trump would eliminate the requirement that most Americans carry health insurance. He would encourage the sale of insurance across state lines, in a bid to increase competition. And he would convert Medicaid, now an open-ended entitlement, into a block grant, giving each state a lump sum of federal money to provide health care to low-income people.
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Congressional Republicans, like Senator Lamar Alexander of Tennessee, are pushing for less government involvement in health care. “Obamacare exchanges are collapsing because of federal mandates and a lack of flexibility,” Mr. Alexander said. “We need to give states more flexibility and individuals more choices so more people can buy low-cost insurance.” Credit Gabriella Demczuk for The New York Times

The basic structure of the Affordable Care Act looked promising to private insurers. The government, in effect, required consumers to buy their products and provided subsidies to help defray the cost, under an arrangement that had few precedents in other industries.

A public option could take market share from private insurers, so it is no surprise they would oppose it. But insurers say the public option would not hold down medical costs, which they describe as the main engine driving up premiums. Moreover, insurers say that the government would have an unfair advantage if it both regulates and competes with private plans.

For some people, the subsidies have proved inadequate. People with annual incomes less than two and half times the poverty level (less than $29,700 for an individual) receive the most generous subsidies and have signed up in large numbers.

But enrollment figures suggest that higher-income people who receive smaller subsidies or none at all have not seen insurance as such a bargain.

“The insurance exchanges have enrolled more than 80 percent of the potential exchange population with incomes below 150 percent of the federal poverty level,” said Caroline F. Pearson, a senior vice president of Avalere, a health policy consulting company. But, she added, they have enrolled only 17 percent of potential customers with incomes from three to four times the poverty level ($35,640 to $47,520 for an individual).

Andrew M. Slavitt, the acting administrator of the Centers for Medicare and Medicaid Services, said the administration was taking steps to ensure “a stable, sustainable marketplace” — by increasing payments to insurers for “high-cost enrollees” and by curbing any abuse of “special enrollment periods” by people who sign up for coverage after they become sick. In addition, federal officials are redoubling efforts to sign up young adults.

Dr. John W. Rowe, who was the chief executive of Aetna from 2000 to 2006 and the president of Mount Sinai Medical Center in New York before that, predicted that “the insurance market will stabilize in two or three years.”

“We are not in a death spiral,” Dr. Rowe said. “If this were a patient, I would say that he’s not in intensive care, but he’s still in the hospital and requires careful monitoring.”

But that does not mean the act will heal on its own, said Sara Rosenbaum, a professor of health law and policy at George Washington University.

“Even the most ardent proponents of the law would say that it has structural and technical problems that need to be addressed,” she said. “The subsidies were not generous enough. The penalties for not getting insurance were not stiff enough. And we don’t have enough young healthy people in the exchanges.”http://www.nytimes.com/2016/10/03/us/politics/obama-health-care-act.html

astralis
05 Oct 16,, 01:10
regular crappy Fox headlines, Dems weren't happy about the ACA -even when it passed- because it had no public option.

Paul Krugman, for instance, was already talking about the drawbacks of the ACA back in October of 2013.

http://www.nytimes.com/2013/10/28/opinion/krugman-the-big-kludge.html



Why did this thing have to be so complicated in the first place?

It’s true that the Affordable Care Act isn’t as complex as opponents make it out to be. Basically, it requires that insurance companies offer the same policies to everyone; it requires that each individual then buy one of these policies (the individual mandate); and it offers subsidies, depending on income, to keep insurance affordable.

Still, there’s a lot for people to go through. Not only do they have to choose insurers and plans, they have to submit a lot of personal information so the government can determine the size of their subsidies. And the software has to integrate all this information, getting it to all the relevant parties — which isn’t happening yet on the federal site.

Imagine, now, a much simpler system in which the government just pays your major medical expenses. In this hypothetical system you wouldn’t have to shop for insurance, nor would you have to provide lots of personal details. The government would be your insurer, and you’d be covered automatically by virtue of being an American.

Of course, we don’t have to imagine such a system, because it already exists. It’s called Medicare, it covers all Americans 65 and older, and it’s enormously popular. So why didn’t we just extend that system to cover everyone?

The proximate answer was politics: Medicare for all just wasn’t going to happen, given both the power of the insurance industry and the reluctance of workers who currently have good insurance through their employers to trade that insurance for something new. Given these political realities, the Affordable Care Act was probably all we could get — and make no mistake, it will vastly improve the lives of tens of millions of Americans.

Still, the fact remains that Obamacare is an immense kludge — a clumsy, ugly structure that more or less deals with a problem, but in an inefficient way.

chakos
05 Oct 16,, 01:16
Just copy the Australian system. It works and is cheaper than the US spaghetti attempt at medical coverage.

astralis
05 Oct 16,, 01:37
chakos,


Just copy the Australian system.

that would pretty much be single-payer, if i'm not mistaken.

absent Dems suddenly getting 1960s-style legislative majorities that won't happen.

BTW, that's the biggest difference between HRC and Sanders' respective healthcare proposals. HRC's plan, in essence, is to drop Medicare eligibility to 55 and to support state choice for a public option. then she'll essentially increase the "kludge" on the ACA to squeeze other folks into the system if possible.

Sanders' plan was to blow the ACA up and push for national single-payer.

in any case, as i mentioned, Dems have been talking about the weaknesses of the ACA (http://www.salon.com/2016/01/26/bernie_sanders_is_right_about_obamacare_heres_why_ its_time_to_talk_about_single_player/) for a long time, but not in the way a casual reader of the Fox headline would expect.

GVChamp
15 Oct 16,, 16:17
If I make $40,000 per year and am not eligible for subsidies, I am not going to sign up for one of these shitty plans. It's not worth it. But I am a young, healthy male, and the system won't survive without healthy people paying premiums into the system.

It's really simple math. Changing something to "single payer" doesn't change anything: I am not going to buy the government's shitty plan anymore than I am going to buy Aetna's shitty plan. The difference between single payer and Medicare is that I don't have a choice to pay into Medicare...and Medicare still isn't viable without regular and massive cost restructuring (most recently to take money away from hard-working Americans who paid into the system to give Obamacare to key Democratic voting groups).

The only thing the government can do is use bargaining power to drive down costs, which just means restricted formularies and denial of care. That might be the preferred course of action, but why not just ban all other insurance companies are require everyone to enroll into a HMO then?

Wooglin
15 Oct 16,, 23:23
If I make $40,000 per year and am not eligible for subsidies, I am not going to sign up for one of these shitty plans. It's not worth it. But I am a young, healthy male, and the system won't survive without healthy people paying premiums into the system.

It's really simple math. Changing something to "single payer" doesn't change anything: I am not going to buy the government's shitty plan anymore than I am going to buy Aetna's shitty plan. The difference between single payer and Medicare is that I don't have a choice to pay into Medicare...and Medicare still isn't viable without regular and massive cost restructuring (most recently to take money away from hard-working Americans who paid into the system to give Obamacare to key Democratic voting groups).

The only thing the government can do is use bargaining power to drive down costs, which just means restricted formularies and denial of care. That might be the preferred course of action, but why not just ban all other insurance companies are require everyone to enroll into a HMO then?

It's not the only thing they can do. They can get out of the market altogether.

GVChamp
16 Oct 16,, 16:44
It's not the only thing they can do. They can get out of the market altogether.
Ha, true, but not even Republicans are going to sign on to that option. Government is so heavily entrenched in the health care and health insurance sectors that it'd take the Sweet Meteor of Death to disentangle the two.