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  1. #1
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    Obama care

    I live in MA, were i am required to have health insurance.

    i am also a bit drunk at the moment... so bear with me.

    but if Obamacare is popular, and so needed (as many would say) why wasnt it mandated at the state level?

    or at least heavily encouraged?

    I've been laid off once in my carreer, and being forced to either pay for COBRA or pay the penaly dam near bank rupted me. that being said, i am ok with the idea that was the healthcare law in MA.'

    So back to my question.... why havent stated been pressued to adopt policies that would cover people living in there states, and that way, each state could taylor the laws and requiments to what best suited them.

    Why did everyone one that wanted Obamacare wait for a federal mandate as opposed to being more proactive at the state level?

  2. #2
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    One reason would be that some states would refuse. Several Republican governors have recently stated they weren't going to participate in the program or at least drag their feet in doing so. So a national mandate which at least forces them to confront an issue which they would have never given another thought to.

  3. #3
    Senior Contributor DOR's Avatar
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    West Virginia sues Federal Government for trusting West Virginia.

    by Brainwrap


    Opinion for the Court filed by Senior Circuit Judge SILBERMAN.

    SILBERMAN, Senior Circuit Judge: This is rather an unusual case. West Virginia has sued to challenge the President’s determination not to enforce certain controversial provisions of the Affordable Care Act for a transitional period. That decision, implemented by a letter from the Secretary of the Department of Health and Human Services, left the responsibility to enforce or not to enforce these provisions to the States, and West Virginia objects to being put in that position. We conclude that West Virginia, not having suffered an injury in-fact, lacks standing.

    So, what's this all about? The Transitional Policy Brouhaha. To summarize:

    2009-2010: During the contentious debate over the ACA prior to it being passed/signed into law, President Obama reassures people that "If You Like Your Plan, You Can Keep It."

    March 2010: The ACA is signed into law; health insurance carriers are given notice that they have over 3 years to make sure that their policies are brought up to ACA standards by January 1, 2014.

    2010-2013: Very few carriers bother updating their policies to ensure that they're compliant with the new provisions prior to the deadline.

    October 2013: The ACA exchanges launch (with a whole mess of technical glitches), and several million people receive notices that their existing, non-compliant policies are being cancelled effective 12/31/13.

    October-November 2013: Millions of people freak the f*ck out (or, as the actual Court decision puts it):

    Millions of cancellation notices were sent out in the fall of 2013, warning policyholders their plans would be illegal once the new regulation took effect. All hell broke loose as policies were cancelled, leading to Congressional promises to modify the law to prevent cancellations.

    November 13, 2013: In response to the backlash, President Obama and HHS announce that they're going to allow noncompliant policies which people enrolled in after March 2010 but before October 2013 to remain in effect for up to 1 extra year (ie, through 12/31/14). However, they're leaving this decision up to the individual states.

    Some states stick to the original 12/31/13 cut-off date, but most decide to take HHS up on the 1-year "transitional" extension period. In turn, some of the insurance carriers within those states decide to stick with the original cut-off date while others decide to bump the deadline out another year.

    West Virginia decides to stick with the 2013 cut-off date.

    March 2014: The HHS Dept. decides to say, "to heck with it" and bumps out the transitional period by another two years, eventually allowing noncompliant plans to remain in effect as late as 12/31/17.

    West Virginia changes their minds and decides to let carriers bump out their noncompliant plans for another couple of years after all (although only on the small group market, since the individual market enrollees had presumably all been shifted to compliant plans by this point anyway).

    Presumably, WV's initial decision to enforce the 2013 cut-off pissed off a bunch of West Virginians...and, presumably, their later decision to change their minds and allow the extensions after all pissed off a bunch of other West Virginians.

    At this point, the Attorney General of West Virginia, a Republican named Patrick Morrisey, apparently decided to sue the HHS Dept. over allowing the states to decide whether to extend the deadline in the first place.

    Let me repeat that: West Virginia sued the federal government for ALLOWING West Virginia the authority to make the decision.

    http://www.dailykos.com/story/2016/7...-West-Virginia

  4. #4
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    Know what? The actual lawsuit was "PAY FOR YOUR GODDAMNED SHIT!"
    Chimo

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    Some background as the GOPers seek to strip healthcare from millions of Americans

    Obamacare and Part-Time Work, Part 1: Voluntary Part-Time Employment
    Written by Nick Buffie
    Published: 06 December 2016

    http://cepr.net/blogs/cepr-blog/obam...ime-employment
    Highlights—
    In 2013, shortly before the main provisions of the Affordable Care Act (ACA) went into effect, critics warned that the law might have dire effects on working hours… There is reason to believe that many workers are employed full-time only because they need health care insurance…While voluntary part-time employment is up 10 percent, involuntary part-time employment has declined 24 percent since the fourth quarter of 2013.

    = = = = =

    Obamacare and Part-Time Work, Part 2: Involuntary Part-Time Employment
    Written by Nick Buffie
    Published: 07 December 2016
    http://cepr.net/blogs/cepr-blog/obam...ime-employment
    Highlights—
    Maria Bartiromo, Robert Samuelson, and Fox News all argued that firms would move workers from full-time to part-time status due to the law’s “employer mandate”. And while most critics have since shifted to other arguments against the ACA, Fox News has continued pushing this particular line…the discussion surrounding the employer mandate paints a rather incomplete picture of the ACA’s effect on involuntary part-time work, for two reasons. First, the discussion often lacks empirical evidence about the potential size of the mandate’s impact. To the extent that economic analysts have looked into this particular issue, they have generally found that the mandate caused little to no increase in involuntary part-time work, with even the largest purported increases being completely invisible in the aggregate national data.

    Obamacare and Part-Time Work, Part 3: Part-Time Employment & Unemployment
    Written by Nick Buffie
    Published: 12 December 2016

    http://cepr.net/blogs/cepr-blog/obam...t-unemployment
    Highlights—
    This post simply examines the changes in different types of part-time employment over the past couple of years. Regardless of whether we believe that Obamacare is behind these positive changes, it’s clear that the forecasts made by the law’s critics simply haven’t come true…And even the very slight decline in the number of part-time workers masks a positive story: since 2013, voluntary part-time employment is up, while involuntary part-time employment is down. Unemployment among workers seeking part-time jobs has fallen as well.

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    Senior Contributor DOR's Avatar
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    Don't ask questions you don't want to know the answers to ...

    Republicans ask Dems: Where's your healthcare plan?
    By John Bowden - 07/05/17 11:54 AM EDT, The Hill

    Dems response:

    124 STAT. 119
    PUBLIC LAW 111–148—MAR. 23, 2010
    Public Law 111–148
    111th Congress
    An Act
    Entitled The Patient Protection and Affordable Care Act.
    Be it enacted by the Senate and House of Representatives of
    the United States of America in Congress assembled

    https://www.gpo.gov/fdsys/pkg/PLAW-1...m_medium=email

  7. #7
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    lol, reading back to the OP...I gotta ask the big question...bfng, if you are a bit drunk, your impulse is to log onto WAB and post a question about state vs federal implementation of the ACA? :-) that is true dedication to debate and knowledge indeed!
    There is a cult of ignorance in the United States, and there has always been. The strain of anti-intellectualism has been a constant thread winding its way through our political and cultural life, nurtured by the false notion that democracy means that "My ignorance is just as good as your knowledge."- Isaac Asimov

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    Quote Originally Posted by astralis View Post
    lol, reading back to the OP...I gotta ask the big question...bfng, if you are a bit drunk, your impulse is to log onto WAB and post a question about state vs federal implementation of the ACA? :-) that is true dedication to debate and knowledge indeed!
    2012.... it was a rough year.

    I think the question still stands though.

    you can get the legalization of Pot put onto a ballot question and voted on by the people within the state, you can get the 'millionaires tax' put on a ballot and voted for, why cant states that really want mandated health insurance put it on a ballot and vote on it?

    why do some states need the federal government to step in and mandate it?

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    Quote Originally Posted by DOR View Post
    by Brainwrap


    Opinion for the Court filed by Senior Circuit Judge SILBERMAN.

    SILBERMAN, Senior Circuit Judge: This is rather an unusual case. West Virginia has sued to challenge the President’s determination not to enforce certain controversial provisions of the Affordable Care Act for a transitional period. That decision, implemented by a letter from the Secretary of the Department of Health and Human Services, left the responsibility to enforce or not to enforce these provisions to the States, and West Virginia objects to being put in that position. We conclude that West Virginia, not having suffered an injury in-fact, lacks standing.

    So, what's this all about? The Transitional Policy Brouhaha. To summarize:

    2009-2010: During the contentious debate over the ACA prior to it being passed/signed into law, President Obama reassures people that "If You Like Your Plan, You Can Keep It."

    March 2010: The ACA is signed into law; health insurance carriers are given notice that they have over 3 years to make sure that their policies are brought up to ACA standards by January 1, 2014.

    2010-2013: Very few carriers bother updating their policies to ensure that they're compliant with the new provisions prior to the deadline.

    October 2013: The ACA exchanges launch (with a whole mess of technical glitches), and several million people receive notices that their existing, non-compliant policies are being cancelled effective 12/31/13.

    October-November 2013: Millions of people freak the f*ck out (or, as the actual Court decision puts it):

    Millions of cancellation notices were sent out in the fall of 2013, warning policyholders their plans would be illegal once the new regulation took effect. All hell broke loose as policies were cancelled, leading to Congressional promises to modify the law to prevent cancellations.

    November 13, 2013: In response to the backlash, President Obama and HHS announce that they're going to allow noncompliant policies which people enrolled in after March 2010 but before October 2013 to remain in effect for up to 1 extra year (ie, through 12/31/14). However, they're leaving this decision up to the individual states.

    Some states stick to the original 12/31/13 cut-off date, but most decide to take HHS up on the 1-year "transitional" extension period. In turn, some of the insurance carriers within those states decide to stick with the original cut-off date while others decide to bump the deadline out another year.

    West Virginia decides to stick with the 2013 cut-off date.

    March 2014: The HHS Dept. decides to say, "to heck with it" and bumps out the transitional period by another two years, eventually allowing noncompliant plans to remain in effect as late as 12/31/17.

    West Virginia changes their minds and decides to let carriers bump out their noncompliant plans for another couple of years after all (although only on the small group market, since the individual market enrollees had presumably all been shifted to compliant plans by this point anyway).

    Presumably, WV's initial decision to enforce the 2013 cut-off pissed off a bunch of West Virginians...and, presumably, their later decision to change their minds and allow the extensions after all pissed off a bunch of other West Virginians.

    At this point, the Attorney General of West Virginia, a Republican named Patrick Morrisey, apparently decided to sue the HHS Dept. over allowing the states to decide whether to extend the deadline in the first place.

    Let me repeat that: West Virginia sued the federal government for ALLOWING West Virginia the authority to make the decision.

    http://www.dailykos.com/story/2016/7...-West-Virginia



    West Virginia sues Obama over the “like it, keep it” fix




    August 12, 2014 at 7:30 am

    Nicholas Bagley




    Remember the “like it, keep it” fiasco and the Obama administration’s effort to fix it? West Virginia certainly does. Two weeks ago, it filed a lawsuit challenging the legality of the administrative fix.

    Here’s the background. The ACA imposes a bunch of new rules on insurers. Among other things, they can’t decline to cover you or charge you more because you have a preexisting condition. That’s great news for those who’d been priced out of the insurance markets because of poor health. But it’s not such good news for those who had really cheap health plans before the ACA took effect. Those plans were so cheap in large part because insurers could refuse to cover unhealthy people.

    The ACA prohibited the sale of these non-compliant plans as of January 1, 2014. The preceding fall, insurers began sending out cancelation notices to people with non-compliant plans. The cancelations clashed with the President’s public commitment that, “If you like your health plan, you can keep your health plan.”

    Under intense political pressure, the administration released a letter to state insurance commissioners encouraging them to decline to enforce the ACA’s new insurance rules for a year (now extended to three years). That gave state insurance commissioners a choice about whether to allow insurers to re-issue their recently canceled, noncompliant plans. About two-thirds of the states said that insurers could re-issue noncompliant plans; the other third declined the administration’s invitation.

    West Virginia fell in the first camp. But it’s apparently not pleased that it had to make the choice at all. So West Virginia sued, arguing that the President has violated his constitutional duty to “take Care that the Laws be faithfully executed.”

    On the merits, I have considerable sympathy for the legal claim. In my judgment, the administrative fix is unlawful and sets a troubling precedent for future administrations. But what’s West Virginia’s injury? Does it have standing to sue?

    The state thinks so. Prior to the announcement of the fix, if states declined to enforce the ACA, the federal government would step in to enforce on their behalf. As West Virginia’s complaint explains:


    [U]nder the regime provided by the ACA, the States lacked the authority to determine whether individual health plans made unlawful by the ACA would be sold within their borders. Whatever a State decided to do, the sale of non-compliant plans would be punished—either by the State or by HHS.

    After the administrative fix, however, West Virginia had to make a choice about whether the ACA would apply at all in the state—and then take the political lumps for whatever choice it made. In the state’s view, that’s injury enough to get into court.

    I have serious reservations about this argument. For all practical purposes, West Virginia faced the same choice before and after the administrative fix: whether to use state resources to enforce the ACA. And it was a bona fide choice: prior to the fix, insurance commissioners in six states had announced they wouldn’t enforce the statute.

    All the administrative fix did was change the political stakes of a non-enforcement decision. But that sort of shifting-the-political-stakes claim doesn’t tend to fare well in standing analysis. It’s too speculative—too non-concrete—to license federal courts to referee what is, even in West Virginia’s telling, essentially a fight about political optics.

    The case might be different if West Virginia was begging the federal government to enforce a law that would protect the “health and prosperity” of its residents. But the complaint says that “West Virginia believes that its citizens should be able to keep their individual health insurance plans if they like them.” It’s downright weird for the state to complain about being given a choice that allows its citizens to do just that.

    The West Virginia lawsuit will thus, I think, join the scrap heap of misbegotten Obamacare cases— including the House’s lawsuit against the employer-mandate delays and Ron Johnson’s suit against the Hill fix—that ask the courts to intercede on behalf of those with a political gripe but no real injury.

    @nicholas_bagley

  10. #10
    Senior Contributor DOR's Avatar
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    Who the GOPers are targeting in their Obamacare repeal/replace/reject

    Very interesting table in the story below.
    State-by-State breakdown of where the medical insurance coverage losses will be.

    14.4% of Blue State residents are faced with losing their healthcare insurance.
    And, 20.8% in the Red States.

    It’s a two-to-one split: Two-thirds of all healthcare insurance coverage losses will be in states that voted for The Trumpet, one-third in those that voted for Hillary.

    The biggest loser is North Carolina, where 17.5% of the population (i.e., eligible voters, not total) face losing coverage.
    The other states in double-digit losses are:

    Alabama (12.8%)
    Alaska (11.7%)
    Florida (13.2%)
    Georgia (12.7%)
    Idaho (12.0%)
    Maine (11.0%)
    Mississippi (12.3%)
    Missouri (10.2%)
    Montana (10.1%)
    Nebraska (12.2%)
    Oklahoma (13.4%)
    South Carolina (12.2%)
    Tennessee (12.5%)
    Texas (12.5%)
    Vermont (10.1%), and
    Wyoming (10.9%)
    (the calculations are my own)

    Coverage Losses by State for the Senate Health Care Repeal Bill
    By Emily Gee Posted on June 27, 2017, 9:40 am

    The Congressional Budget Office (CBO) has released its score of the Senate’s health care repeal plan, showing that the bill would eliminate coverage for 15 million Americans next year and for 22 million by 2026. The CBO projects that the Senate bill would slash Medicaid funding by $772 billion over the next decade; increase individual market premiums by 20 percent next year; and make comprehensive coverage “extremely expensive” in some markets.

    The Center for American Progress has estimated how many Americans would lose coverage by state and congressional district based on the CBO’s projections. By 2026, on average, about 50,500 fewer people will have coverage in each congressional district. Table 1 provides estimates by state, and a spreadsheet of estimates by state and district can be downloaded at the end of this column.

    https://www.americanprogress.org/iss...e-repeal-bill/

  11. #11
    Senior Contributor GVChamp's Avatar
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    Quote Originally Posted by astralis View Post
    lol, reading back to the OP...I gotta ask the big question...bfng, if you are a bit drunk, your impulse is to log onto WAB and post a question about state vs federal implementation of the ACA? :-) that is true dedication to debate and knowledge indeed!
    I don't see the problem!

    I was at a friend's wedding last weekend and another groomsman and I talked about high-yield municipal bonds. Some banks are loaning Chicago Public Schools money at 6.5%, which I think is a damn good rate (and I would lend at that rate!)

    So turns out Vanguard's high-yield muni fund has only brought in like 6.7% since inception, and 5% since 2010. Their "long-term" fund has a much better distribution of credit risk (far more investment grade), gets like .2% lower over the last 6 years, .5% lower since inception (70s), and actually isn't much longer term than their high-yield. It's also not a much different duration.

    Also, ya know, all tax free.

    He asked me what I invest in, I told him paying off 6.5% student loans with no risk is the only good investment I can make. :(\



    It's the fun stuff!
    "The great questions of the day will not be settled by means of speeches and majority decisions but by iron and blood"-Otto Von Bismarck

  12. #12
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    ^ hell, i even understand THAT discussion, it might profit your personal bottom-line after all. :-)

    you got the priorities right. credit card debt > student loan debt > then investments.

    the depressing realization for me was that even when i had the first two paid off and was (and still am) saving significantly in the latter, EVEN WITH a truly remarkable growth rate (7.5% through a combo of Vanguard funds), it'll be a long, long, long time before I amass anywhere close to "f*ck you money".

    so over the 4th of july weekend, after pointing that out to the wifey, we accordingly adjusted our retirement plans and bought $40 worth of lotto tickets...
    There is a cult of ignorance in the United States, and there has always been. The strain of anti-intellectualism has been a constant thread winding its way through our political and cultural life, nurtured by the false notion that democracy means that "My ignorance is just as good as your knowledge."- Isaac Asimov

  13. #13
    Senior Contributor GVChamp's Avatar
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    "When do we get retire?"

    "Never!!!!!!"

    Maybe age 50 if there are no vacations, or medical complications.... :(
    "The great questions of the day will not be settled by means of speeches and majority decisions but by iron and blood"-Otto Von Bismarck

  14. #14
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    Both Parties Agree: Medicare Projected Shortfall Improved Under Obama

    By Dean Baker, Aug 14, 2017: http://cepr.net/blogs/cepr-blog/

    Trump’s Medicare trustees recently released their report on the health of Social Security and Medicare. Trump’s trustees reported that there was a sharp improvement in the projections of Medicare’s finances during the Obama administration – this is notable because it signals bipartisan agreement that the projected shortfall is markedly smaller than what policymakers were looking at a decade ago.

    Some critics of the Obama administration questioned the validity of this projection and accused the Trustees, four out of six of whom are political appointees of the president, of manipulating the numbers for political purposes. These critics claimed that Obama’s trustees were deliberately understating the financial problems facing Medicare over its planning horizon.

    For this reason, the fact that the 2017 Trustees report largely confirms the drop in the shortfall projected by the Obama trustees is very important. In fact, the 2017 report shows an even better picture for Medicare, with a projected shortfall of just 0.64 percent of payroll over the 75-year planning period.

    This new projection implies that almost 82 percent of the projected shortfall was eliminated by economic and policy changes during the Obama years. In fact, this figure understates the true improvement since the 75-year horizon starting in 2017 includes years that are considerably worse for the program demographically than 75-year horizon that began in 2007.
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  15. #15
    Senior Contributor DOR's Avatar
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    Obamacare Scorecard III

    2016 Edition

    _ Share _ _ _ _ 2013 _ _ _ 2014 _ _ _ 2015 _ _ _ 2016 _ _ _ 2013-16 _ _ _ 2013-16 p.a.

    Got insurance? _ _ 86.7% _ _ _89.6% _ _90.9% _ _ 91.2% _ _ _ +4.6 pts _ _ _ +1.5 pts. p.a.
    No insurance? _ _ _13.3%_ _ _10.4% _ _ _9.1% _ _ _8.8% _ _ _ -4.6 pts _ _ _ -1.5 pts. p.a.

    The number of insured people rose by 20.7 million under Obamacare, an average of 6.9 million people each year. While there are still 28 million without insurance, that’s down from 41.8 million in 2003.


    In 2013, 13 states had more than 15% of their population uncovered by health insurance:
    Alaska _ 18.5%
    Arkansas _ 16.0%
    California _ 17.2%
    Florida _ 20.0%
    Idaho _ 16.2%
    Louisiana _ 16.6%
    Montana _ 16.5%
    Nevada _ 20.7%
    New Mexico _ 18.6%
    North Carolina _ 15.6%
    Oklahoma _ 17.7%
    South Carolina _ 15.8%
    Texas _ 22.1%

    In 2016, it was just one state: Texas (16.6%).

    Source: https://www.census.gov/data/tables/2...e/p60-260.html
    Last edited by DOR; 13 Sep 17, at 09:02.
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