Could someone with a history around here...

[busterbrown]

Please clearly and concisely state the problems with the ACA..
I realize that there have been many threads discussing this, however I find many of them confusing and I’m not so bright in these matters. The reason why is that I need to have my ducks lined up when I try to explain all the positives of the program to my friends and relatives.. The MSM is intent on bringing the ACA down and we need to let our dem reps know what these problems are.. Quickly!!!

Please feel free to have a look at my history.. I ain’t no troll.. We need to make this work with an eye on Single Payer..

Thanks.

[lumberjack_jeff]

1. 1) the medicaid hole

Because the supreme court overturned the federal direction to states to expand medicaid, republican governors turned down the money to expand medicaid to people making up to 150% of federal poverty level. The ACA was written in a way that assumed that everyone below 133% of FPL would be eligible for medicaid. When the governors refused to expand medicaid, this meant that if you were below 133% of fpl, you were ineligible to buy subsidized coverage on the exchange, but also ineligible for medicaid.

2) technical glitches. Those will get sorted out, but in the meantime it's a clusterfuck.

3) dumb promises. Obama promised that people could keep their insurance. The unstated caveat was "you can keep your insurance only if that insurance doesn't suck".

4) short attention spans. Young people and men are now surprised that changes in rating criteria, combined with mandatory levels of coverage have raised their costs.

[DURHAM D]

2. Should you use the word medicaid instead of medicare?

[lumberjack_jeff]

3. Yes. Thank you. n/t

[busterbrown]

5. What about the points some have made about..

the age group right below Medicare eligibility?.. They have insurance which is being dropped(?) and make more than what is required for subsidizes.

[lumberjack_jeff]

8. People between 50 and 65 get a good deal.

because the ACA requires premiums for the oldest to be no more than 3 times the cost of the youngest, it has the effect of displacing the cost on to younger insureds.

BUT, because people in that age bracket tend to make more, and have smaller households, they are less likely to be eligible for a subsidy.

Comparing apples to apples, older workers tend to get cheaper insurance than they would have gotten before... for equivalent coverage. If their insurance is being dropped, it is because it doesn't conform to the standards set by the ACA.

[PoliticAverse]

11. 3 times the cost for the youngest (not 4). n/t

[lumberjack_jeff]

13. thanks!

[busterbrown]

12. Thank you for that explanation..n/t

[pnwmom]

16. That group is probably better off. If they lose their insurance for

whatever reason, from now on any other insurer will have to accept them, no matter how many or how serious their preexisting conditions are. The only things that will determine a premium (other than smoking status) is age and income. (And there are only three broad categories based on age, which works to the benefit of older people.)

And if they don't like the options offered on the exchange, and know they won't get subsidies anyway, they can buy insurance OFF the exchange, just as people have always done -- except that thanks to the ACA, no insurer will be able to ban them for preexisting conditions or drop them if they get a serious illness.

[PoliticAverse]

14. Note: If you are 55+ and on Medicaid, states have the right to recover any Medicaid expenditures

from your estate when you die.

See:
http://aspe.hhs.gov/daltcp/reports/estaterec.htm
http://www.dailykos.com/story/2013/10/21/1249471/-Estate-Recovery-It-s-Worse-Than-You-Thought#

[lumberjack_jeff]

15. Wow. I guess Republican governors are for the death tax, but only on poor people. n/t

[pnwmom]

17. According to the link this applies to 26 out of 50 states,

for Medicaid in general (I'm assuming it applies in all 50 for reimbursement for nursing home care.)

I think I know why these laws were put into effect. Twenty years or so ago, the real estate agent who sold us a house left the regular agenting business. She was going to work with elderly people -- specifically people who wanted to gift their homes and other real estate to their children while they were alive so they could qualify for Medicaid nursing home care. These people weren't poor to begin with -- they made themselves poor by divesting so they could qualify for Medicaid. Since then, they changed some laws to discourage people from doing this, and the law in question is, I think, a result of those changes.

[Recursion]

20. There was a very provocative suggestion from I think Brookings to fund Medicare ...

... by making it a default claimant on all estates. I think they had the political sense never to let that get past the trial balloon stage, but I think it's a fascinating idea.

[leftstreet]

4. The 'family glitch' is a problem

WASHINGTON — A "family glitch" in the 2010 health care law threatens to cost some families thousands of dollars in health insurance costs and leave up to 500,000 children without coverage, insurance and health care analysts say.

That's unless Congress fixes the problem, which seems unlikely given the House's latest move Friday to strip funding from the Affordable Care Act.

Congress defined "affordable" as 9.5% or less of an employee's household income, mostly to make sure people did not leave their workplace plans for subsidized coverage through the exchanges. But the "error" was that it only applies to the employee — and not his or her family. So, if an employer offers a woman affordable insurance, but doesn't provide it for her family, they cannot get subsidized help through the state health exchanges.

http://www.usatoday.com/story/news/politics/2013/09/23/aca-family-glitch-issues/2804017/

It definitely needs to be fixed

[woo me with science]

6. The main problem is that it feeds and grows and entrenches predatory corporations

in the system of American healthcare. And that was the goal all along of the corporatists who wrote it.

Obama vowed repeatedly during the 2008 campaign that premiums would fall drastically as a result of the ACA. Exactly the opposite has occurred, just as many of us warned at the time.

Health Premiums Up by $3,065; Obama Vowed $2,500 Cut
http://finance.yahoo.com/news/health-premiums-3-065-obama-224300715.html

Even if everyone who needs subsidies got them (which they don't), the subsidies mask the real problem.

The real problem is that the ACA entrenches the obscene, profit-driven middleman structure of health insurance into our health care system without any serious cost controls. By the design of the corporatists who created it, it guarantees outrageous profits to the insurance companies for merely standing between us and our doctors. Yes, the subsidies help individuals, but they are still funded by our tax dollars, and every dollar that is funneled into the pockets of health care CEO's is a dollar that is not going to education and roads and community services. Or actual health care.

We need real reform that reduces costs and eliminates the middlemen and the profit motive. Health care should not exist as a profit venture for billionaires. It should be designed first and foremost for the health and well being of a country and its citizens. We need single payer.

[Enrique]

7. why do you feel responsible for advocating for the program?

and why do you feel responsible for letting dem reps know about the problems if you don't know what they are?

[busterbrown]

10. Ah, stop getting into the piling on shit.

I’m hoping that our reps will raise hell and get the stuff fixed.. Probably they have better and immediate access to the Pres.

[AnotherMcIntosh]

18. Excuse me but the questions seemed to be good ones. It also appears they were not answered.

[busterbrown]

19. Why am I so interested?

Because I desire to see AHC...Succeed!!
I want to know the answers to the negatives so I can respond when I am advocating.

[AnotherMcIntosh]

9. Interesting choice of words: "we need to let our dem reps know what these problems are" / "dem" reps

[Fumesucker]

21. High deductibles and copays is one (or two depending on how you look at it)

The purpose of which is to keep the less well off away from actual medical care while still dunning them (and the government) for premiums.