Michael Moore: ACA is both "awful" and "a godsend"

[eridani]

This actually makes sense if you read the whole article. One of the authors of the WA State single payer bill said at our last meeting that the most important thing about ACA was that it broke the logjam where everyone just assumed that nothing about our health care delivery system could change.

http://www.nytimes.com/2014/01/01/opinion/moore-the-obamacare-we-deserve.html?hp&rref=opinion&_r=0

By 2017, we will be funneling over $100 billion annually to private insurance companies. You can be sure they’ll use some of that to try to privatize Medicare.

For many people, the “affordable” part of the Affordable Care Act risks being a cruel joke. The cheapest plan available to a 60-year-old couple making $65,000 a year in Hartford, Conn., will cost $11,800 in annual premiums. And their deductible will be $12,600. If both become seriously ill, they might have to pay almost $25,000 in a single year. (Pre-Obamacare, they could have bought insurance that was cheaper but much worse, potentially with unlimited out-of-pocket costs.)

And yet — I would be remiss if I didn’t say this — Obamacare is a godsend. My friend Donna Smith, who was forced to move into her daughter’s spare room at age 52 because health problems bankrupted her and her husband, Larry, now has cancer again. As she undergoes treatment, at least she won’t be in terror of losing coverage and becoming uninsurable. Under Obamacare, her premium has been cut in half, to $456 per month.

Let’s not take a victory lap yet, but build on what there is to get what we deserve: universal quality health care.

[last1standing]

1. That sums up my feelings about the ACA very well.

It's a very bad plan that is much better than what came before it.

[gaspee]

2. Exactly how I feel about it (n/t)

[Skittles]

3. ditto

[obxhead]

29. yep

It's later. Can we fix it yet?

[etherealtruth]

36. Count me as another one in complete agreement

[Egalitarian Thug]

39. Agreed, a bad republican idea that is slightly better than nothing. n/t

[last1standing]

43. It's much better for many but far worse for some who will pay more for less coverage.

And for others it will be a cruel joke as they find they can't afford the deductibles so they can't use the insurance they're paying for to get actual healthcare.

I see this going one of two ways. Either the people demand that the problems with ACA be fixed properly or they merely give up on the programs and let the republicans dismantle it.

Based on recent events, I'm guessing it will be the latter because the number of those affected for the better are those least able to influence congress or public opinion.

[Egalitarian Thug]

44. Exactly. Look at the money flows, somebody has to pay to support the insurance industry.

The poor can't and the rich won't even be asked.

[Octoberfurst]

64. I agree

The Affordable Care Act was better than what we had before but it is FAR from perfect. Changes need to be made to it and I fear that the GOP will use the problems in the program to demand the ACA be scrapped. (And knowing how gullible the American people are I could see many going along with that.) Then we would go back to the old system that left 40 million uninsured. That would be a disaster.
What I want to see is the problems in the ACA fixed so that people get MORE coverage for less bucks. (I would prefer single payer but perhaps this will be a stepping stone to it.) But for now lets concentrate on make the ACA work better for Americans.

[FatBuddy]

4. it's a great plan if you are broke

it's terrible if you're barely scraping together a lower middle class existence.

our owners want EVERYONE to be broke.

[pnwmom]

5. I've heard from lots of people here who've gotten subsidies on the exchange

so that they are paying very little -- in some cases nothing -- for policies on the exchange. So I don't think what you're saying is true for people on the low end.

[loudsue]

10. That's what fatbuddy was saying pnwmom. "If you're broke"...

My husband and I are in the group Michael Moore is talking about...more expensive insurance. I know a couple of other families in my (rural) community who are in the same boat as we are. So, yes, there is a pool of people who are pretty much paying the premium.

Am I still glad we have ACA? You bet! And I am VERY happy that so many people have affordable coverage. I do not blame my misfortune on those people, nor am I in the least bit jealous toward THEM. I am angry that all republicans and some democrats stirred up the public so much in those "town hall meetings" that there was never a discussion about how to make it truly "affordable" for EVERYONE....because they were too busy screaming at each other.

But it is true....there is at least one pool of people that I know of, like Michael Moore pointed out, that is paying a lot.

[questionseverything]

14. our premium plus out of pocket

would be 33% of our pre tax income...whoever thought that would be "affordable" has a serious disconnect

hopefully with someone like moore pointing it out something will change

[loudsue]

15. It's going to be up to us talking about it to make it happen. You know as well as I do

that the squeeky wheel gets the oil, so we're going to have to make some noise....NOT about voting to do away with Obamacare, as the republicans act like is the only solution, but to push for our well-paid, very comfortable politicians to sit up and take notice, and FIX the problems.

It's going to take groups like DU, DailyKos, MoveOn, and folks like Rachel & Ed to make a fuss on our behalf.

[pnwmom]

32. I'm glad you're still supportive of the program then, despite all its flaws.

And I'm sure you realize that the insurance you have now is an improvement in a couple of ways. Neither of you can be dropped if you develop an expensive condition. And they can't impose an annual or lifetime limit on in-network costs.

[Coyote_Bandit]

54. My premium exceeds my income

as a sole unpaid caregiver for a paren wih dementia. My state opted not to expand its Medicaid program. Since the little income I di have is nsufficient to generate a tax liability those tax credits are worthless to me.

Once again I am left to feel like a throw away second class citizen.

The one thing ACA did do for me was to insure that I could get coverage provided I could afford the premium and that coverage cannot be cancelled and I cannot be priced out of the market if I am diagnosed with a chronic health condition. That is not insignificant.

But it does not mean that I can afford care. Or my premium. Or that ACA has financially benefitted me.

[pnwmom]

56. Thats terrible. But it's your state's fault, not the ACA's.

I don't know anyone, even the single payer advocates in Congress, who expected states to turn down free Medicaid money. They thought there would be more support from states' rights people if they had that clause in. Obviously they were wrong -- because they underestimated the depth of the evil in the other party.

[Coyote_Bandit]

60. Medicaid expansion by the states was not mandated by the ACA

Which means ACA made it possible for some citizens to be treated differently than others. Short-sighted of those who drafted the legislation not to anticipate that just might happen given the current state of politics and government

You could not fault the states for opting not to expand Medicaid if the ACA did not make that an option.

The states may have made the choice not to expand Medicaid but they made that choice because he ACA permitted them to make that choice.

I am not saying the states are not to be faulted for heir choice. But the sole responsibility does not rest there. ACA clearly made it possible for states to make the choice to throw some of us away and treat us as less equal and less deserving than oher citizens in simlar circumstances.

[pnwmom]

61. The states had to file a lawsuit in order to turn down the Medicaid money.

It was the Supreme Court that made that decision, not the legislators who never expected the bill to be interpreted that way.

http://kff.org/health-reform/issue-brief/a-guide-to-the-supreme-courts-decision/


On June 28, 2012, the U.S. Supreme Court issued its decision in the case challenging the Affordable Care Act (ACA). The Court upheld the constitutionality of the ACA’s individual mandate, which requires most people to maintain a minimum level of health insurance coverage beginning in 2014. A majority of the Court also found the ACA’s Medicaid expansion unconstitutionally coercive of states, while a different majority of the Court held that this issue was fully remedied by limiting the Health and Human Services (HHS) Secretary’s enforcement authority. The ruling left the ACA’s Medicaid expansion intact in the law, but the practical effect of the Court’s decision makes the Medicaid expansion optional for states.

[Coyote_Bandit]

62. And I m still a second class throw away

The Supreme Court does not legislate - they interpret legislation.

In any event, what is important to people in my position is meaningful access to affordable healthcare. We don't really give a damn about finger pointing and political posturing.

My bottom line is that ACA did very little to make affordable healthcare more accessible to me. I am depleting my meager savings to have health insurance. And I don't even get a tax credit that I can carry forward and apply against future income. Is that the state's fault as well? I don't think so.

And I am far more fortunate han most who find themselves in my situation. I have the ablity to make that premium payment. Most others don't.

Those who want to win the support of folks in my situation would do far better to fight for equal benefits under the ACA for all citizens than to wash their hands of the matter and fault the states.

I am not so sure there is not a Constitutional argument under he Equal Protection Clause. ACA is after all federal legislation and the expansion of hose state Medicaid programs is being funded by federal tax dollars.

All I see from my iwndow is a world where lower standards and different rules apply to
me. And ohers eiher want to enforce or excuse that double standard. I am less than equal.

[joshcryer]

9. Depends on whether your state has expanded Medicare.

And where they set poverty levels. Some Southern states admittedly fuck over the consumer, but there's not a lot that can be done about that at the Federal level thanks to the SCOTUS. Those people in those states will need to elect people who will protect them as opposed to shit on them.

[Motown_Johnny]

21. Can you please put a dollar amount on that?

Exactly what do you think of as "barely scraping together a lower middle class existence".

[former9thward]

41. Those are the premiums. It says nothing about the deductible.

[last1standing]

52. What age brackets does that graph cover?

As we all know, the cost of insurance for those over 50 jumps so I'd be very interested in knowing if they're included in the graph you've posted.

[dotymed]

22. If you are broke and jobless,

living in a state that refused to open Medicare rolls, you are still without health insurance...no hope of being healed and worried that you will be fined for being poor.
I know too many people like this in Tn.
They are suffering and dying when, with some medical help, they could become contributing citizens.

[pnwmom]

33. They've already announced they won't be fining people in that situation

in those states.

[Egalitarian Thug]

40. The people that are broke while employed, people that are toward the right of that

graphic above, but live in very expensive places, and people that are living beyond their means as well, these are some of the groups for whom there is significant hardship imposed for very little benefit. Like the poor that live in the dumber states that will not have access to medicaid, these are separately small groups that, taken together, add up to large numbers of the most vulnerable that are still screwed even though the rest of are going to be paying more. Even the people that live beyond their means have a right to health care.

It is better than nothing, but all the rest of us received in exchange for guaranteed profits for and control over American health care by the health insurance companies, was this. Just a little better than nothing. And no, it was not the best we could have done, that's the key to the problem, IMO.

[cheapdate]

47. If you're broke and jobless in Tennessee,

you have my sympathy. But, you can buy private health insurance in the federal exchange and the federal government will pay a portion of the cost, which can be almost the entire cost depending on your household income as a percent of the federal poverty level.

There are quite a number of participating plans in the exchange marketplace for Tennessee, at least there are for Rutherford County, where I live.

[dotymed]

66. I hope you are right.

I have invited 2 people over to try and get insurance. They do not have computers (never have) and are in desperate need of health insurance. Is it too late?

[cheapdate]

67. I don't know.

Healthcare.gov says:

"Open enrollment for 2014 coverage ends March 31, 2014. If you haven’t enrolled in coverage by then, you generally can’t enroll in 2014 coverage until the next open enrollment period, which begins November 15, 2014."

So, maybe. I'm not an expert in the legal language of health insurance.

Good luck.

[pnwmom]

6. You'd think Michael Moore would know the difference between

a deductible and total out-of-pocket costs.

But aside from that, he's right that the ACA is deeply flawed. But it has paved the way for the next steps -- a public option and, hopefully, more and more states following Vermont's path to single payer.

[dflprincess]

48. It has also come to light that, at least until 2015, the cap on out of pocket expenses only applies

to who your insurer deems to be "in network".

http://www.democraticunderground.com/101681567

-- and --

http://www.democraticunderground.com/111643792#post57


If you need specialized treatment you may either go without or find yourself declaring bankruptcy. The more things change, the more they stay the same.

[pnwmom]

49. Yes, that's one of the flaws. A couple of the states have laws that mandate

insurers to cover all the hospitals (Maryland is one of them.) I'm going to be pushing in my state (WA) for that.

[dflprincess]

57. Flaw? It's dishonest

and no better than the "fine print" insurers have always included in their policies as a way to avoid paying for treatment.

What happens if you live an area where there's one major cancer or heart center and your insurance company decides it's out of network? You go bankrupt or you die - just like it's always been in the U.S. And the Stephen Hemsleys will keep laughing all the way to the bank.

[pnwmom]

58. I don't think it was dishonest on the part of the legislators.

But with hindsight, it is clear the insurers can't be trusted and it was a mistake to not regulate this more strongly.

[dflprincess]

59. Oh please when could the insurance companies ever be trusted?

The legislators aren't that stupid and they know where their campaign "contributions" come from. You can bet this is a provision the insurance companies wanted.

[Scuba]

7. Perfection is the enemy of progress.

I will continue to advocate for Medicare for All, including dental, optical and hearing aids, but the ACA is way better than what we had without it.

[joshcryer]

8. ACA is a shitty 10-15 year workaround.

But it's better than fucking nothing.

It's just damn unfortunate the leading candidates in 2008 supported private health insurance mandates (yes, Obama supported mandates for parents with children, so let's get that out of the way right the fuck now).

[loudsue]

11. I totally agree joshcryer. And I'm no longer a fan of Obama...however....

I don't think he would have gotten any politician on board at all if he hadn't kissed the insurance companies asses from the start. I was pissed that he started negotiating from the middle, and then gave ground, but at least we got SOMETHING to start to work with, and it certainly will save many many American lives, and will help one helluvalot of people not to lose everything due to medical costs.

What we really need to work on is expanding medicare to everyone, and getting insurance companies out of the health care industry. At least if we expand medicare, the insurance companies can still make $$ doing the supplementals, but the policies have to have a limit as to what they can charge.

[shaayecanaan]

13. It won't last that long

Even with ACA, health care spending will exceed median incomes by about 2030 or so, and will be at a breaking point long before that. At most, it has given the US a couple of more years.

http://www.businessinsider.com.au/health-care-costs-will-exceed-average-household-income-by-2030-2012-3

[cherokeeprogressive]

12. Obviously, Moore is both a poopyhead and a genius. n/t

[valerief]

16. Bwahahaha!

[KG]

17. yeah. coz the obvious solution to the problems posed by the private HC insurance system was

mandating that everyone participate in such a system.

[FatBuddy]

18. but can't you see?!?!?!!!!

ensuring private insurance company profits through federal law means we're on the path to single payer!

capitalists are humanistic enough to decline a veritable money spigot in the interests of the public because, well, just because.

[KG]

19. the real path to single payer lies through the failure of the ACA, not its success.

a paradox many seem unable, or unwilling to grasp.

[Demo_Chris]

24. Yep. nt

[riderinthestorm]

38. I've said it before, it may also come through pressure from the business community

As more and more companies stop offering health insurance and let people get it on the exchanges, those employees - mostly middle and upper managers - will start to whinge.

There's no incentive really for companies to offer it anymore and more WILL continue to stop offering it. They get out of the pain-in-the-ass business of running everyone's health care (ka-ching!), and they get to drop off a good chunk of their human resources department that was staffed running the company health insurance (saves them $$ on personnel).

Those folks who will fall into the donut hole that Micheal Moore is talking about where that chunk of change will really hurt (couple making $65k/year having $11k in premiums/year and a $12,600 deductible) will definitely be a big complaining block. Companies will be faced with the uncomfortable reality of a large group of disgruntled employees and I predict they'll begin to open their eyes, unplug their ears going "lalalala", and discover the true value of single payer as a benefit to THEIR bottom line.

[ProSense]

20. The fascinating thing

"ensuring private insurance company profits through federal law means we're on the path to single payer! "

...was how many people were reportedly crying about losing their crappy plans that did nothing but increase insurance company profit-making.

New Report Undermines Claims That Millions Will Lose Coverage Due To Obamacare
http://thinkprogress.org/health/2013/12/31/3109041/10000-lost-coverage-obamacare/

Single Payer movement in the era of Obamacare
http://www.democraticunderground.com/10024090281

[FatBuddy]

25. power given or power taken

is notoriously difficult to take back. cf. the TSA.

do you honestly think the for profit private insurance industry will relinquish this revenue stream willingly?

a revenue stream granted by federal law?

[ProSense]

27. No

"do you honestly think the for profit private insurance industry will relinquish this revenue stream willingly?"

...I don't, but some people can see the writing on the wall.

Wendell Potter: Beginning of the End for Major Health Insurers
http://www.democraticunderground.com/10023796422

[Demo_Chris]

23. Insurance companies were too powerful, so lets make them more powerful. nt

[Schema Thing]

31. The ACA certainly has not made Insurance companies more powerful

It's given them more money, yes, spread over more customers and more services. But it has also wrestled a slight amount of power away from them, and inserted the tip of wedge that people (such as the people in Vermont) can use to take even more, or all, of their power away from them.

[dembotoz]

26. yep mm nails it as usual

[Benton D Struckcheon]

28. Didn't VT set up single payer using funds from the ACA?

This is the path. The point being that if a state sets up single payer and relieves its businesses of the expense of providing health insurance to its employees, it becomes hugely more competitive than a state that doesn't. This is a snowball that could easily start rolling.

[Bradical79]

34. Not yet

I think that is the plan though. I think they are setting up the exchange in such a way that will lay a foundation for single payer. If successful it would hopefully lead to a nice snowball effect, and those people who I thought were full of crap (that ACA would lead to single payer) would be proven right

[stopbush]

30. Already-Well-Insured Multi-Millionaire Michael Moore writes from a certain perspective.

I don't find a lot of sympathy with his argument.

I guess I'm one of those "lucky ducks" for whom Obamacare is a major lifeline - I'm 59, unemployed for 3 years, with a wife and two school-aged kids, living in SoCal on my wife's part-time income and our assets. We were on her COBRA until it ran out in September (it cost us $400+ a month). She has a pre-existing condition (cancer survivor). The chances of us finding AFFORDABLE insurance on the individual market were, well, nil.

Under Obamacare and the Medicaid expansion, my family qualified for Medi-Cal, ie: FREE insurance. No co-pays, no emergency room co-pay, prescriptions cost $0-$4. The only reason we qualified was because Medi-Cal did away with the means test for assets: prior to today, a family of 4 could have no more than $3300 in assets to qualify for Medi-Cal. That wouldn't have happened without the expansion of Medicaid under Obamacare. And guess what? CA Medi-Cal includes Denti-Cal and even vision insurance.

Do I have a lot of sympathy for the couple living in CT earning $65,000 a year who will pay $11,000 in premiums under Obamacare? No, I don't. At this point, I would trade places with them in an instant. I would love to be earning $65,000 a year as opposed to the $ZERO I am earning right now. If that meant paying $11,000 in premiums and having a deductible of $12,000, I would take that over being uninsured and dreading catastrophic costs if my family faced a major medical crisis (of course, having two kids under 26, I would probably qualify for an Obamacare subsidy, even in CT).

So, Obamacare isn't perfect. Well, it's more perfect than anything Michael Moore has to offer to me and my family today, because Obamacare is REAL and it's here, today, January 1, 2014. Had President Obama pushed for single-payer, we would most likely be right where we were in 2008 when it came to health insurance in this country.

My family says THANK YOU PRESIDENT OBAMA. Without your corporate-loving, half-assed compromise on health care insurance, my family would be looking at having NO insurance at all for the foreseeable future. And, that couple in CT would have a lower rate.

Sorry, but I'm going to be selfish on this one, though no more selfish than that couple in CT wishing they had a lower rate.

[L0oniX]

35. It's so nice that we can have a corporate government health care system.

That's what democracy is all about ain't it? Corporations for the people ....because they are compassionate caring humanists ever so ready to assist the poor, sick and elderly. Corporations are people too my friends. We here do not qualify for ACA and do not have Medicaid because of Sick Rott ...and from what I am hearing you wouldn't want Medicaid if you ever expect to have money ...because you will have to pay Medicaid back.


On the other hand if you do have enough money and you have been turned down for a pre existing condition ...ACA is a good thing.

[bonzaga]

37. I wish everybody had and would listen to this man

He was right about GM in Roger & Me, he was right about guns and gun culture in Bowling For Columbine, he was right in Sicko, he was right in Fahrenheit 9/11, this man has always been on the side of truth and he has always been right.

And yet the bullshit persists.

[Poll_Blind]

42. K&R! nt

PB

[indepat]

45. We cannot have universal quality health care while stuffing a gorged MIC, a

7% effective corporate income tax rate, and the der Mittens of our world paying an effective Federal income tax rate of 14% on an annual income of $20 million. The MIC, large corporations, and the uber-wealthy will continue to slop mightily at the public trough while the infrastructure rots, cuts are being made to the safety net, and the long-term unemployed no longer will get unemployment benefits. Meanwhile, some estimate the makers of a crashed and trashed economy have been bailed out to the tune of $6 trillion. Welcome to this right-wing fashioned 'murikan century.

[snot]

50. That couple paying $11,800 in annual premiums

must have been living on a different planet than the one I'm on. Because that's about what my spouse and I will be paying, but it'll be $400/mo. LESS than what we'd have paid otherwise (even though we're younger than that couple), and the coverage will be better.

[soryang]

65. not really

my spouse and I are paying that amount and we don't have children. our rates went up 60 percent effective Jan 1, 2014. ironically going to the exchange would cost more for similar coverage. without the employee contribution, the rate is really the same whether going with the employer sponsored plan or the same insurer's similar plans on the exchange. what a coinkydink? No cost control effect whatever. Instead of cheaper premiums, they cost more.

[snot]

69. Um, I'm just saying,

we're paying $400 less than we'd have had to pay w/o Obamacare.

There is cost control insofar as insuring co. exec pay is limited to a percentage of insuring co. income. This was not the case before; previously there was NO cost control.

I'm not saying it's perfect or that NO ONE is paying more; just saying that, for us, even in a state that rejected the Medicaid expansion, it's a huge improvement over the way things were before. Not ONLY are we paying less, but we're getting a lot better coverage.

[merrily]

51. So, is everyone besieging his or her state legislators for state medicare for all?

Because, you know, all it takes is letting them know how you feel. Unlike the rest of us, state dnd federal governments have no access to those polls that say 2/3 of Americans want medicare for all. Only we know about those polls. Of course, if they knew, they would pass Medicare for all in every single state.

So call them and "make your voice heard." Or start an internet petition. Or a chain letter. Any of those is just bound to work.

ETA: As long as the 99% sees no real need to unite and pool their money and efforts, plutocrats have nothing to worry about.

[MADem]

53. A much more accurate headline than the other thread on this same topic. nt

[Raine]

55. Agree ... nt

[Stellar]

63. As Nancy Pelossi says...

embrace the suck...it can get better. LOL!

[otohara]

68. Newsmax Left Out "Godsend"

I guess Newsmax pays for their standing right column of headlines over at Raw Story, but the headline was...
Michael Moore says ObamaCare is AWFUL.

and that was the case at other sites too.

[iamthebandfanman]

70. we can always hope that the plan is

that the ACA was designed to be terrible to some people... in order to help us push full universal as the solution to its woes ...

that way we can say 'hey, we just tried the republican private insurance plan to fix health insurance.. now lets try ours'