Obamacare Update: affordable premiums, more competition, stabilized costs

Reblogged from The Secular Jurist:

By Robert A. Vella

Here’s the latest news on the Affordable Care Act (a.k.a Obamacare):

From The Washington PostFederal insurance exchange subsidies cut premiums by average of 76%, HHS reports

The 28-page report, by the Department of Health and Human Services, is the government’s first effort to gauge the affordability and availability of health plans under the Affordable Care Act, now that the first insurance sign-up period has ended.

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The health officials said they have not yet analyzed the incomes of people who qualified for the subsidies. But overall, the report shows, the average monthly tax credit this year is $264. Without the federal help, the average premium chosen by people eligible for a tax credit would have been $346 per month, and the subsidy lowered the consumers’ premiums, on average, by 76 percent. The result is that four out of five people with subsidies are paying premiums of no more than $100 a month — although that does not include money they might need to spend for insurance deductibles and other out-of-pocket costs.

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On average, the analysis found, people buying in the federal exchange had a choice of 47 health plans, offered by an average of five different insurance companies. The level of competition is slightly below what was found in late September, days before the federal insurance exchange opened, when HHS issued a report saying that the typical American would have a choice of 53 health plans from eight different insurance companies.

From Daily KosObamacare’s very good week

Chart showing surge of insurers joining exchanges in several states.


More insurers means, as Kaiser Family Foundation President Larry Levitt says, potentially lower premiums and thus lower costs overall—less the government is paying in subsidies, more consumer choice, and “marketing muscle” from big insurers that will help boost enrollments. More insurers being willing to enter the market helps prove another point which was reinforced this week—these are paying customers. If there was a huge problem with people paying their premiums, insurers would be staying away.

From The Huffington PostMillions Get Obamacare For $100 Or Less

Premiums are likely to rise for most consumers next year, as they typically have for decades. Health insurance companies already are submitting widely varying proposals for next year’s rates to state regulators. Some have requested hikes of 10 percent or more, while others aim to lower prices. Premiums for people who don’t get health insurance from their jobs rose an average of 10 percent a year prior to the Affordable Care Act, according to an analysis published by the Commonwealth Fund this month.

People who receive tax credits largely should be shielded from premium increases, however. The Affordable Care Act caps their monthly costs based on income, and uses tax credits to fill the gap between that cutoff and the price of the health insurance plan.

Obamacare Update: The Numbers are Undeniable

Reblogged from The Secular Jurist:

By Robert A. Vella

Today is the last day of the Affordable Care Act’s initial open enrollment period.  People who log-in before April 1, 2014 will be granted an additional grace period to complete the process.  Despite the botched website roll-out on October 1st, a generally uninformed public, and systematic sabotage efforts by Republicans, Obamacare enrollment numbers are poised to meet or exceed the original projections.

The Los Angeles Times has reported the following:

  • Individual enrollments through the various private health insurance exchanges will at least come close to the 7 million figure forecast by the Congressional Budget Office.
  • The Rand Corporation has estimated that 4.5 million people have signed up for the Medicaid expansion, and an additional 3 million adults under the age of 27 have received coverage through their parents’ health plans (a provision of the ACA).

Those figures represent a minimum of 14 million Americans now enrolled in Obamacare.  Even considering that some of these enrollments were just switching to better plans, that still leaves roughly 10 million more people with health care coverage who didn’t have it before implementation of the ACA (myself included).  In 2009, the United States Census Bureau listed 48.6 million people in the U.S. (15.7% of the population) who were without health insurance.  Extrapolating that percentage of uninsured to 2014 (the U.S. population has increased by approximately 12 million since 2009 from 305 million to 317 million), there would have been an additional 1.2 million (49.8 million total) uninsured Americans today under the previous system.  Therefore, Obamacare has reduced the uninsured rate by about 3% to 12.7% overall (based on 9.5 million newly insured).

The Times article also responded to criticism from conservatives who insist these enrollment numbers don’t address:

  • The number of new enrollments which remain unpaid.
  • How many of the new enrollments already had health insurance.
  • How many of the new enrollments are “young invincibles” (aged 18-34).
  • How many individuals with existing plans were cancelled without recourse (a factual inaccuracy).
  • The White House arbitrarily manufactured the enrollment numbers for political gain (a factual absurdity).

The First Lady wants to know what we’re thankful for this Thanksgiving holiday, so here’s my answer

Reblogged from The Secular Jurist:

By Robert A. Vella

First Lady Michelle Obama sent out an email asking people what they are thankful for this Thanksgiving holiday.  Here is the response I sent her:

Dear Mr. President and First Lady,

I am thankful for getting healthcare coverage, under the Medicaid expansion provision of Obamacare, for the first time in six years.  Now, I won’t be one illness or injury away from financial ruin or perhaps something even worse.

On a sadder note, I am also thankful I’m old enough that I may not have to witness the final destruction of American democracy which is inevitable – in my opinion – if current trends continue.  Our nation cannot survive under the current circumstances.  When money rules at the exclusion of everything else, a republic becomes a plutocracy.  When amoral and self-serving business interests subordinate the larger interests of the people, corporatism replaces democracy.  When growing economic inequality stratifies society to a critical point, it collapses under its own weight.  The failure of America’s leadership to address this imminent crisis is not just the result of political obstructionism.  It is also due to a lack of courage within the socioeconomic establishment to speak directly to the nation about this incredibly serious problem.  Yesterday, Pope Francis wrote of the “tyranny” of unfettered capitalism and the “idolatry of money.”  His sentiments were profoundly accurate, bravely delivered, and long overdue to an increasingly desperate world.


I am not a religious person, but the Pope’s apostolic exhortation really grabbed my attention.  In it, he also wrote:

In this context, some people continue to defend trickle-down theories which assume that economic growth, encouraged by a free market, will inevitably succeed in bringing about greater justice and inclusiveness in the world,” Pope Francis stated in reference to the supply-side economic theory promoted by conservative ideology and popularized as “Reaganomics” in the 1980′s.  “This opinion, which has never been confirmed by the facts, expresses a crude and naïve trust in the goodness of those wielding economic power and in the sacralized workings of the prevailing economic system,” he emphatically added.

The reasons why some existing health insurance plans are being cancelled through Obamacare

Reblogged from The Secular Jurist:

By Robert A. Vella

Conservatives are in an uproar over the cancellation of some existing health insurance plans because of Obamacare.  They are reiterating their charge that President Obama “lied” when he repeatedly said people would be able to keep their existing health insurance.  Is this true?  In a narrow superficial sense, yes this is true.  But like most things, the complete truth cannot be assessed without a thorough examination of the underlying facts.

The plans being cancelled are referred to in the industry as “junk” health insurance and are primarily in the individual (non-employer) market.  They have abnormally low premiums because the policies were written to severely limit insured benefits and to exclude coverages that would impact the insurers’ financial liability.  In other words, it is health insurance in name only.  The Affordable Care Act set minimum standards for benefits and coverage much higher than these junk plans.  Indeed, this was the whole point of health care reform – to establish a base level of quality care and to reduce aggregate costs by expanding the number of insured individuals.

Let’s unpack this further.  From:  Obama administration knew millions could not keep their health insurance

Four sources deeply involved in the Affordable Care Act tell NBC News that 50 to 75 percent of the 14 million consumers who buy their insurance individually can expect to receive a “cancellation” letter or the equivalent over the next year because their existing policies don’t meet the standards mandated by the new health care law. One expert predicts that number could reach as high as 80 percent. And all say that many of those forced to buy pricier new policies will experience “sticker shock.”

None of this should come as a shock to the Obama administration. The law states that policies in effect as of March 23, 2010 will be “grandfathered,” meaning consumers can keep those policies even though they don’t meet requirements of the new health care law. But the Department of Health and Human Services then wrote regulations that narrowed that provision, by saying that if any part of a policy was significantly changed since that date — the deductible, co-pay, or benefits, for example — the policy would not be grandfathered.

So, if insurers hadn’t modified those plans they wouldn’t have been cancelled.  Hmm…

Now, let’s get back to President Obama’s “lie.”

Buried in Obamacare regulations from July 2010 is an estimate that because of normal turnover in the individual insurance market, “40 to 67 percent” of customers will not be able to keep their policy. And because many policies will have been changed since the key date, “the percentage of individual market policies losing grandfather status in a given year exceeds the 40 to 67 percent range.”

That means the administration knew that more than 40 to 67 percent of those in the individual market would not be able to keep their plans, even if they liked them.

Yet President Obama, who had promised in 2009, “if you like your health plan, you will be able to keep your health plan,” was still saying in 2012, “If [you] already have health insurance, you will keep your health insurance.”

Were the President’s statements lies, half-truths, or just the usual political rhetoric designed to conceal inconvenient facts?  You decide, but I believe it was the latter.

What remediable options are available to those individuals who had their health insurance policies cancelled?  First, they should shop for available plans through their state exchanges (or the national exchange if their state opted not to setup its own);  and secondly, see what subsides they qualify for to offset potentially higher premiums.  Anyone choosing not to explore these options, and instead relying on their previous insurer to offer them a replacement plan, is well… not exercising wise financial judgment.

The White House does not dispute that many in the individual market will lose their current coverage, but argues they will be offered better coverage in its place, and that many will get tax subsidies that would offset any increased costs.

“One of the main goals of the law is to ensure that people have insurance they can rely on – that doesn’t discriminate or charge more based on pre-existing conditions.  The consumers who are getting notices are in plans that do not provide all these protections – but in the vast majority of cases, those same insurers will automatically shift their enrollees to a plan that provides new consumer protections and, for nearly half of individual market enrollees, discounts through premium tax credits,” said White House spokesperson Jessica Santillo.

Oh, and here’s a final note to those people who would rather pay the individual mandate fee (scheduled to begin next year) than to purchase a new health insurance policy.  The ACA law specifically prevents the IRS from taking measures to actually collect those fees.  From:  Lawrence O’Donnell says the IRS cannot pursue ‘either civil or criminal remedies’ for people who don’t purchase health insurance

“No one ever really has to pay the fine in the individual mandate,” O’Donnell said, “because the IRS has been specifically forbidden, in writing, in law, in the Affordable Care Act, from ever actually pursuing either civil or criminal remedies to collect those fines from anyone. The individual mandate is the only provision in the tax code that was written deliberately to be essentially unenforceable.”

Don’t believe him? On air, O’Donnell pointed to page 131 of the law, which more or less states exactly what he said about IRS enforcement, or lack thereof, of the mandate. (He actually read the key sections aloud.)

In 2014, uninsured taxpayers will pay a pro-rated fine of either 1 percent of annual income or $95, whichever is greater. It goes up each year, and there are more costs for uninsured dependents. There are some exemptions for religious beliefs, prisoners, Indian tribes, certain low incomes and undocumented immigrants.

The final bill President Barack Obama signed into law in 2010 included two requirements that essentially yanked out the agency’s teeth in enforcing the mandate penalty. The IRS cannot pursue criminal charges against someone who does not pay the penalty and is supposed to. The agency also cannot file a notice of lien or seize property.

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Our ruling

Experts said O’Donnell’s point is pretty accurate: The IRS cannot use its most effective collection weapons — the threat of jail time or seizing of property — for the individual mandate penalty. But the law did not take away its power to pursue lawsuits against delinquent taxpayers, though experts say it isn’t likely given the small size of the penalty and current difficulty of filing suit outside of tax court. Plus, for taxpayers who overpay their income taxes and don’t pay the fine, the IRS could extract the penalty from a taxpayer’s refund. We rate the claim Mostly True.

New polls show majority of Americans support Obamacare or want it expanded

Earlier this week I wrote a column here relating the surprising—to some—results of a new CNN poll. Although conservatives and many reporters and pundits declare, as if proven fact, that Obamacare is “very unpopular” or “most Americans oppose it because it goes too far,” progressives have long claimed that this is not really true, because many on the left have always felt it didn’t go far enough (no public option, or single-payer or Medicare-for-all) and this swells the “against” numbers in surveys.

That CNN poll, in fact, showed that 53 percent actually either support the ACA—or want it expanded.

Still, that number was disputed by critics of the new law, and the poll, in any case, was taken just before criticism of the tech problems with the rollout of the ACA truly ignited.

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Well, a funny thing happened on the way to Obamacare losing much of its popular backing. A new CBS poll came out last night and, guess what, it shows virtually the same numbers that the CNN survey produced—even though it was taken amid that explosion of criticism this week. Where is the surge against the Obamacare from the right?


My personal experience with Obamacare enrollment

As an uninsured individual, I’ve been following the Affordable Care Act (Obamacare) pretty closely since its inception.  Even though I’m probably more knowledgeable of the law than most people, it became evident during the enrollment process that I still had much to learn.  Without doubt, the ACA is complicated and it will take time for the public to become familiar with it.  But when they do, I think most people will be as pleasantly surprised with it as I am now.

First off, I had assumed that I wouldn’t be eligible for the ACA’s Medicaid expansion provision due to my financial assets (I’m close to retirement age living off savings and investment earnings).  So, I was anticipating purchasing a low cost private insurance plan through the new health care exchanges.  However, that assumption proved incorrect.  The ACA removed the existing asset limitation, and Medicaid eligibility is now based on the following requirements:

  • Age must be 19-65.
  • Income must be below 138% of the federal poverty level ($1322/month or $15864/year).
  • Must not be entitled to Medicare.
  • Must not be incarcerated.
  • Must meet citizenship requirements.
  • Must be a resident of the state you’re applying in.

I had this experience with the online application process:

Day 1 – I couldn’t access the website because the shear volume of users had crashed their servers.

Day 2 – I filled out the reasonably-sized questionnaire in short order, but couldn’t submit the application due to a software glitch.

Day 3 – I submitted the application, and it was approved later that same day.

One of the many faces of Obamacare

One of the many faces of Obamacare

The Medicaid expansion plan I’m enrolled in is called Washington Apple Health – No Cost Adult Coverage.  There are no monthly premiums associated with this plan, although I’m not sure yet about co-pays and other potential costs.  Also, I won’t know the exact spectrum of benefits until I receive the official documentation in the mail.

In any event, this is a huge load off my shoulders.  No longer will I have to worry about an illness or injury wiping out my financial resources.  In 2009, I supported Congressman Alan Grayson’s (D-FL) Medicare Buy-In plan and the widely debated Public Option.  Both of those legislative options failed to pass Congress, but the now enacted ACA still appears to be a very beneficial law for millions of Americans.  And, I’m one of them.

Obamacare vs. The Affordable Care Act (Yeah, They’re The Same Thing)



Rachel Maddow talked about some bewildering results of a recent survey on people’s feelings about Obamacare on her news show. CNBC has reported about it as well:

29% of the public supports Obamacare compared with 22% who support the Affordable Care Act.

46% oppose Obamacare and 37% oppose Affordable Care Act.

So what’s going on? Well, it’s all in the name, of course!

The strange results are due to two things. The first is that the respondents didn’t know that Obamacare and the Affordable Care Act are the same thing (Obamacare is simply a derisive nickname given to the Affordable Care Act by those who don’t support it, whereas the Affordable Care Act is its official name). The second is that the respondents were swayed by the name used in the survey. When the term “Obamacare” was used, the results were different than when the term “Affordable Care…

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10 Reasons to Love Obamacare

Photo courtesy of drexel.edu

Photo courtesy of drexel.edu

About Pres. Obama’s new health care plan, Care2 says:

“The Patient Protection and Affordable Care Act is called that for a reason. Otherwise known as Obamacare, it protects patients from HMOs’ common abusive tactics and makes health insurance more affordable.”

Here are 10 reasons why you should feel good about Obamacare (and not listen to Republicans) –

1) Everyone will have access to health care coverage

2) Pre-existing conditions will no longer affect your coverage

3) Sick patients will no longer be dropped by their insurance 

4) Young adults can stay on their parents’ plans

5) Free preventive care

6) Regular check-up with a gynecologist will be free for women

7) Free birth control

8) You will save money on medical bills

9) The whole country will save money (Obamacare will reduce the national deficit by two hundred billion dollars in its first ten years)

10) The Medicare “donut hole” will close (Seniors on Medicare  who experience this donut hole often pay up to $4,550 out of pocket for prescription medication. Obamacare will seal up the hole by 2020)

For more details, go to Care2.com.