Tag Archives: Obamacare

“She Didn’t Ask”

Tennessee Gov. Haslam, who refuses to expand the state’s Medicaid program, preferring to let the state’s poor get sick and die (I suppose), while also claiming to have some kind of super-secret non-existent Tennessee plan that he’s supposedly “negotiating” (wink wink), and who recently was in the news asking HHS Secretary Kathleen Sebelius “to come up with a proposal that would give Tennessee more flexibility to expand Medicaid coverage,” could have asked Sebelius for an update on said plan today. Because today, Secretary Sebelius was in Nashville urging people to sign up for ObamaCare:

Sebelius was joined by Amy Speace, a 46-year-old singer-songwriter who was able to find insurance on the exchange for $30 a month with a $500 deductible, thanks to a tax credit. Speace said she did not at first think she would be eligible for insurance on the exchange because she already was covered by a high deductible plan through a musicians group. Despite that coverage, she nearly had to declare bankruptcy a few years ago when she developed laryngitis and ended up owing $5,000 in medical bills. She was only saved from bankruptcy by the help of a charity.

So, did Gov. Haslam meet with Sebelius for an update on that counterproposal? What do you think?

The governor told a reporter that he had no plans to meet with Sebelius when she came through Nashville on Thursday.

“She didn’t ask,” Haslam said.

I guess he just doesn’t give a shit.

Every day thousands of Tennesseans who lack health insurance face bankruptcy and worse. Gov. Haslam certainly doesn’t seem unduly concerned about those folks.

Good to know.

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Filed under Gov. Bill Haslam, health insurance, healthcare, Nashville, Obamacare

Best Healthcare In The World, V. Eleventybillion

Have you seen this video making the rounds?

When it comes to wait times for healthcare, I would just like to point out that not only is it correct that until Obamacare, millions of Americans died or sickened because they couldn’t get insurance and access the best healthcare system in the world, but also even ordinary, well-insured people such as myself have to deal with wait times. For example, today I called my doctor and was told her next appointment was at the end of May, over two months away. However, if I want to see her daughter, who is not a doctor but a nurse practitioner, I can get an appointment in April. That’s still a few weeks but it’s not a few months.

Let me remind everyone what happened last time I had to go to the doctor (and yes, I’m starting to think she’s avoiding me, foisting me off on her non-doctor daughter.)

Our system is not wonderful. Anyone who uses it knows that. My insurance company is now sending me quarterly marketing materials that look like warmed-over Cosmopolitan and Marie Claire magazine articles, reminding me to eat my vegetables and to exercise and get enough sleep. They even include recipes, as if the internet hasn’t been invented and I can’t find a damn recipe on my own.

This is what BlueCross BlueShield is spending its money on. But I don’t need that. I already know that stuff. I’d really prefer they stop with the patronizing PR/marketing bullshit. Let me be clear: the absolute last thing I want is a “relationship” with my insurance company. What I really want is for them to just basically do their jobs and otherwise leave me the fuck alone. That shouldn’t be too hard.

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Filed under healthcare

Obamacare Boosts Wages, Tennessee Proves

What’s that you say? It’s true, according to Dean Baker:

This is the “job loss” that has gotten opponents of the ACA so excited. But there is another aspect of this picture that should get other people excited. Back in intro economics we teach students about supply and demand. Other things equal, we expect a reduced supply – in this case of workers – to lead to a higher price or wage. In other words, a reduction in labor supply associated with the ACA might lead to some increase in wages.

We have an opportunity to test this proposition since Tennessee effectively did Obamacare in reverse, eliminating health insurance subsidies for low and moderate income adults without children in 2005. If the resulting change in labor supply has an impact on the market, then we would expect to see a drop in wages in Tennessee relative to other states.

That is in fact what we see. The figure below shows the median real wage for workers with high school degrees or less (the workers most likely to be affected) in Tennessee since 2000 compared to the workers without high school degrees elsewhere in the South.

btp-2014-02-20

Interesting idea. Also ironic that Tennessee kicked its low and moderate income folks in the teeth 9 years ago and saw a decline in wages as a result. It stands to reason that lifting up these folks will see a rise in wages. It’s sorta what people like Krugman have been saying since forever, but don’t expect the Republican’ts to start listening.

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Filed under healthcare, Obamacare, Tennessee, wages

Yet Another Anti-Obamacare Story Falls Apart

The Tennessean committed an act of journalism and actually looked into the claims of Emilie Lamb, a Tennessee woman who has become the “national posterchild” for the anti-Obamacare crowd, appearing in Americans For Prosperity ads and mentioned in an op-ed by that harpy Marsha Blackburn.

Like every other one of these stories, it doesn’t add up:

Her beef? The health coverage she had received for years — and liked — under a state program known as CoverTN ended last year because it was deemed substandard under the health care law. Now she pays seven times more for a plan she says is more than she needs.

Supporters of the law who have examined CoverTN say the coverage Lamb had under the state plan was the very kind of junk policy the health care law was meant to replace.

There were restrictions on the number of times she could see a doctor or specialist. Emergency room visits were limited. Financial help for prescriptions was capped. But the real danger of CoverTN, they said, was that it covered a maximum $25,000 in medical bills a year— an amount a moderate hospital stay could easily eat up.

Even BlueCross BlueShield of Tennessee, which administered the program for the state, warned consumers on its website that CoverTN benefits “are very limited compared to traditional insurance.”

[…]

Advocates for the health care law say Lamb was lucky to avoid financial ruin under her old plan, especially because of the long-term expenses associated with lupus.

And they said she could have opted for a much less expensive option that covers hospitalization — including a plan costing $159 per month — among the 37 plans offered on the federal HealthCare.gov health exchange serving Tennessee residents.

Basically, Lamb is an idiot. As I wrote last November,

If you liked insurance that is basically ripping you off then you’re a moron. You’re probably one of those people who thinks a Nigerian prince wants to send you a million bucks. Guess what, that’s a scam, too.

Okay, it’s not fair to say CoverTN was ripping people off but let’s remember who and what it was designed for: it was a program Gov. Bredesen created to cover all of those people who were uninsured because of pre-existing conditions and those who got kicked off TennCare, our state Medicaid program. It was,

[...] designed to offer stripped-down medical coverage to the uninsured at a steep discount.

Denying coverage because of pre-existing conditions is now against the law — remember, this is the part of the Affordable Care Act everybody likes — so you can see how an insurance program designed to cover a group of people who no longer exist might be a tad superfluous.

CoverTN was also created for the unemployed and self-employed — it was designed for portability. Again, this is a key part of the Affordable Care Act (and the part that the media completely missed when it erroneously reported the “Obamacare kills 2.5 million jobs” lie): with health insurance tied to your employment, people didn’t have the freedom to leave jobs, retire, stay home with the kids for a while, start a new enterprise, be self-employed, etc. etc. If you, your spouse or child had a health condition, you were trapped in your job by your need for health insurance. Under Obamacare this is no longer the case. As a self-employed person let me say: this is wonderful.

Also, CoverTN was created for low-income people who made too much money to be eligible for TennCare but not enough money to be able to afford traditional insurance. Emilie Lamb paid $52 a month, but that was just one-third of the actual premium’s cost: the rest was paid by employers ($50) and the state ($50). Seems like if Gov. Haslam would get off his ass and accept the federal help to expand Medicaid here, people like Lamb wouldn’t be complaining.

And finally,

The entire Cover Tennessee plan will “sunset” in 2010, at which time it will be re-evaluated by the legislature.

It was going to go away anyway.

CoverTN was created as a stop-gap measure for a marketplace which no longer exists. People are no longer denied insurance for pre-existing conditions. The unemployed and self-employed no longer have limited options for obtaining health insurance. Low-income people — at least, those in states which don’t have recalcitrant Republican governors who’d rather hurt the poor than defy the Tea Party — have expanded state Medicaid programs to turn to.

I just can’t take Emilie Lamb’s complaints seriously.

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Filed under health insurance, healthcare, Tennessee

Rand Paul Is Lying

Stop the presses: Rand Paul claims when his son signed up for Obamacare, he was “forced” onto the Kentucky Medicaid rolls:

The senator briefly flashed a blue-and-white insurance card before launching into a diatribe about his son’s travails: “We didn’t try to get him Medicaid…They automatically enrolled him in Medicaid,” Paul said. “For a month they wouldn’t talk to us because they said they weren’t sure he existed. He had to go down to the welfare office, prove his existence, then, next thing we know, we get a Medicaid card.”

Paul then extrapolated from his son’s experience to make a general point about Kentucky’s health exchange: “Most of the people in Kentucky are getting automatically enrolled in Medicaid.”

Paul is lying.

The Affordable Care Act allowed states to automatically add residents who already receive other social services, such as food stamps and other health programs, to the Medicaid rolls. But Kentucky chose not to take advantage of that provision of the law. The state is notifying some residents of their eligibility for Medicaid, but Paul’s son would have needed to actually apply for Medicaid in order to receive a Medicaid card.

Midkiff couldn’t discuss the Paul family’s specific troubles due to confidentiality laws. But her general description of the state’s exchange clearly contradicts Paul’s story. When a Kentuckian visits Kynect, the state’s health insurance website, she’s asked to provide basic information about herself—age, location, income, number of dependents, etc.—to determine whether she qualifies for the Medicaid expansion or other insurance subsidies. The website is designed to encourage people who are eligible for Medicaid to apply, but it doesn’t force anyone onto the Medicaid rolls. The applicant would still have to actively choose to enroll in a specific Medicaid plan.

Rand Paul is lying.

Of course, it wouldn’t be the first time.

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Filed under health insurance, healthcare, Rand Paul

Identity Theft Memory Hole

It’s very amusing that people have suddenly discovered the identity theft issue, but it’s really annoying that they only seem to care about it in relation to Healthcare.gov. It’s not like your private insurance company doesn’t have all of this same information, folks, and it’s not like they are any less vulnerable to theft than Obamacare.

Let’s take a trip into the memory hole and go waay back to 2009. Oh lookie here: BlueCross BlueShield of Tennessee had 57 hard drives containing unencrypted client identity information stolen from a closet at its Chattanooga office.

Or how about back in 2007, when thieves stole laptops containing the Davidson County voter rolls — which include everyone’s social security numbers?

We’re always hearing about data breaches at places like Amazon.com and PayPal. I need look no further back than October 2013 when the State of Tennessee, which processes my paychecks, lost all of my information — not just social security number and passport number but also my freaking bank account number, because I signed up for direct deposit. All of it … gone. Not only did I not get paid for an entire month but now I have to worry about what the hell happened to this sensitive information. Probably nothing, but should I take this risk?

Wingers are going nuts about the Obamacare website exposing people to identity theft, but it’s not like everyone’s information isn’t available to thieves in a thousand other ways, too. Identity theft isn’t new, and it isn’t something Obamacare has brought on.

I find this incredibly annoying.

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Filed under Blue Cross, health insurance, healthcare, Obamacare

Julia Hurley Lost Her Insurance

That’s pretty much all you need to know about the former Republican state rep/dog surfer, who has written an Obamacare op-ed (excerpted here).

In it, Hurley states that since she lost her job and got dumped by her insurance company, she is rethinking Obamacare. As so often happens with Republicans, all bets are off once the plight of the plebes lands on their doorstep. Suddenly the social safety net isn’t the “hammock” they thought it was.

Hurley makes one good point:

I am a conservative Republican who believes in providing a future for myself without government involvement. I have been unemployed for nearly 14 months. Unable to collect unemployment and unwilling to take government assistance, I have spent nearly all my savings and, unless an employment option arrives, soon will be spending my retirement savings as well.

[...] If the Republican Party continues to fight Obamacare without offering an alternative, I fear the failure of my party is inevitable. The expectation of personal responsibility is being outweighed by the overwhelming number of unemployed voters, uninsured voters and, to be honest, voters without hope who are tired of being told to just hang in there a little longer because things will get better.

Well, join the club, honey. Yes, we’ve all been dying to know what the Republican healthcare plan is. Cue the *crickets*, right?

Then she says this:

If the Democratic Party continues to provide everything for a voter without encouraging some personal responsibility, I fear a gap between taxpayers and beneficiaries will open so wide that our government will not be able to repair the financial damages.

While I do not support the premise of Obamacare, I can fully understand the frustration of the unemployed, uninsured American. I cannot judge those who choose to use the program, for I know exactly what it is like to need it.

Gosh, I’m so old, I remember when Republicans sold the individual mandate as a “personal responsibility provision.” I mean seriously, Julia?

I still think Julia Hurley is an idiot, but she’s the kind of idiot who’s slowly starting to realize that Obamacare sure beats “I don’t care.”

9 Comments

Filed under health insurance, healthcare, Tennessee, Tennessee politics

Death Of Another RW Talking Point, v. Twentygazillion

Obamacare is lowering healthcare costs, not increasing them:

Even as coverage efforts are sputtering, success on the cost front is becoming more noticeable. Since 2010, the average rate of health-care cost increases has been less than half the average in the prior 40 years. The first wave of the cost slowdown emerged just after the recession and was attributed to the economic hangover. Three years later, the economy is growing, and costs show no sign of rising. Something deeper is at work.

The Affordable Care Act is a key to the underlying change. Starting in 2010, the ACA lowered the annual increases that Medicare pays to hospitals, home health agencies and private insurance plans. Together, these account for 5 percent of the post-2010 cost slowdown. Medicare payment changes always provoke fears — in this case, that private plans would flee the program and that the quality of care in hospitals would suffer. Neither of these fears has materialized, however. Enrollment in private plans is up since the ACA changes.

The law also emphasized that payments should be based on the value, not the volume, of medical care. In a value-based system, compensation is made for the patient as a whole, not for specific services provided. As a result, eliminating services that are not needed is financially rewarded. The reaction to this change has been rapid: Hospital readmissions, which used to bring in substantial dollars, are now penalized.

[...]

Before he was criticized for his statements about insurance continuity, President Obama was lambasted for his forecasts of cost savings. In 2007, Obama asserted that his health-care reform plan would save $2,500 per family relative to the trends at the time. The criticism was harsh; I know because I helped the then-senator make this forecast. Yet events have shown him to be right. Between early 2009 and now, the Office of the Actuaries at the Centers for Medicare & Medicaid Services has lowered its forecast of medical spending in 2016 by 1 percentage point of GDP. In dollar terms, this is $2,500 for a family of four.

Looking ahead, there is every reason to believe that costs will continue to grow slowly, maybe even more slowly. A study in Massachusetts showed that ACO savings increase over time as organizations move into more areas that can slow cost growth. An analysis of exchange premiums estimated that insurance costs in the exchanges are 16 percent below what was forecast two years ago; the lower costs were attributed to competition from new entrants in the market.

If cost growth continues at its low pace, the cumulative savings to the federal government would be more than $750 billion over the next decade. Such savings are likely to dwarf anything that comes out of Congress this year.

Every time Republicans fearmonger about Obamacare, facts prove them wrong. Yes, the website was a problem. But the underlying fundamentals of Obamacare are working. Costs are slowing. And Republican governors have lost their main excuse for not expanding Medicaid.

Yet I just saw the Republican former governor of Virginia Jim Gilmore on my TV repeating about a hundred times that “there are no cost savings in Obamacare” and “costs are going up.” It’s simply not true. Just because you repeat something over and over again does not make it true, Republicans.

This is what I don’t understand about Republicans. This fact-free bubble in which they live and breathe, where they seem to think if they say something enough times it will magically become true? It’s not working for you guys. Facts are facts, wishing they weren’t so doesn’t change them. And none of these facts has anything to do with a crappy website.

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Filed under healthcare

Today’s Moment Of “Huh”?

Tennessee Senator Lamar Alexander joins the chorus of Republicans — all of whom have been trying to destroy Obamacare for the past three years — in calling for the resignation of HHS Secretary Kathleen Sebelius over the website’s faulty launch.

Let that one sink in for a moment. The people who have voted to defund Obamcare eleventybillion times and shut down the government for two weeks over this very law they despise want the person who botched the rollout to resign.

Dudes. She should be your 2016 front-runner.

I see absolutely no reason to take these folks seriously, ever. It’s just more Kabuki.

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Filed under health insurance, Sen. Lamar Alexander, Tennessee

Obamacare War Is Over (If You Want It)

Republicans, you can end the Obamacare War if you want. You’ve already lost. It’s a free-market program, you know it is. You can get on board and implement it and let the free market do its thing, or you can continue to drag your feet and have whiny-baby fits, driving up costs with your inaction and obstruction. That’s not exactly how you tell us conservativism is supposed to work, but you know, the choice is yours. Be the principled free market conservatives you claim to be or continue to be this recalcitrant caricature of a political party. Your choice. If you choose the later your party will die, because reality is a potent neutralizer of fear.

Obamacare is working where it’s allowed to work.I give you this headline:


California Man Get Health Insurance For $1 A Month Through Obamacare

And here’s the story:

This is California, where the state didn’t attempt to sabotage the law. There weren’t efforts to obstruct, defund, misinform the public or prevent them from signing up. They didn’t dig their heels in and say, “fuckitall, we’ll just let the Feds set up our exchange, we don’t want to do it.” There wasn’t a rejection of Medicaid expansion, or this ridiculous notion that people could just go to emergency rooms and somehow the rest of the state wasn’t paying for it.

No, in California the state created its own website and was able to roll out its exchange, tailored to its specific needs. It worked on this for months and everything is going well. California is the nation’s largest market, and the rollout here, while not perfect, is also not plagued with the glitches seen elsewhere. It works here because people wanted it to work. Amazing what can happen if you have your want-to.

The war is over, Republicans. Do not be like the lone Japanese sniper living in a tree who still doesn’t know, decades later, that the Empire lost the war.

I find it really interesting that Republicans are working off a 50-year-old playbook when it comes to Obamacare. Today, Medicare is so widely popular, you even have Tea Partiers saying “Hand off my Medicare.”

Cognitive Dissonance Alert

Cognitive Dissonance Alert

Obamacare can work if you want it to. California proves it. If you’re unfortunate enough to live in a state governed by Republican’ts, whose guiding theology is government can’t work and government is the enemy, then it won’t. Simple.

[UPDATE]:

Oregon cuts number of uninsured in its state by 10% in less than two weeks. This thing nobody wanted .. people want! And Blue States are able to implement it nicely.

Imagine what we can do when we work together.

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Filed under California, health insurance, healthcare