Why do the poor and uninsured refuse to sign up for Obamacare?

[Redfairen]

We can all remember that the ACA was sold to us as the healthcare solution for the 50 million people who were previously uninsured. We're now getting somewhat close to the end of the signup period. By all accounts, the number of people enrolled to date is but a tiny percentage of that 50 million. Why have so many of the disadvantaged not rushed to claim their benefits?

I've just happened across an editorial which had a comment about this state of affairs. It was published near the end of January and I discovered it only belatedly, so forgive me if it's slightly out of date. The following paragraph laid it out.

"Now, as February draws near, things don't look much better. Far fewer than half the number needed by March 31 have signed up. And, as it turns out, most of the people signing up for Obamacare aren't the uninsured for whom it was supposedly enacted, but people who were previously insured (many of whom lost their previous insurance because of Obamacare's new requirements). "At most," writes Bloomberg's Megan McArdle, "they've signed up 15% of the uninsured that they were expecting to enroll. ... Where are the uninsured? Did hardly any of them want coverage beginning Jan. 1?" It looks that way."

http://www.usatoday.com/story/opinion/2014/01/26/obamacare-numbers-health-exchanges-insurance-obama-column/4913341/


Perhaps the answer is simple. Perhaps the threat of a tax penalty is no incentive to sign up when you already cannot afford to pay your bills. The ACA will give you a hefty subsidy but no matter which plan you choose you have to find the extra money to pay that last small percentage of the premium.

What if you just don't have that money? Those suffering that kind of financial hardship would most likely be paying little or no taxes to the federal government and probably receiving a refund. Therefore, a tax penalty would be no incentive to sign up.

I'm probably not the first person to make this suggestion. That said, we're somewhat late in the game here and the lackluster enrollment numbers are looming large. Who is going to face facts and speak the truth out loud?

We need single payer more than ever.

[hobbit709]

1. There are many people that even $10/mo extra means something else has to give.

[leftyohiolib]

55. 10 dollar is 2-3 gallons of milk. i think alot of people think that way

[Wounded Bear]

137. Or 2-3 gallons of gas to drive to work...

Or even bus fare for the month (though it probably wouldn't cover that in a major met area).

It all adds up.

[Fumesucker]

2. There don't seem to be many on DU who understand what having *no* money is like

A lot of lip service about helping the poor but remarkably little understanding of the overall issues facing those who are really struggling financially.

[KG]

3. i saw posts suggesting poor folks get a second job. oy.

[adirondacker]

79. Or they go on a diet of beans for a year. Empathy abound here. nt

[lunasun]

9. I agree it is lack of understanding. There is a good willl wish but no reality check

[shaayecanaan]

46. Definitely agree

Probably a lot of those folks don't have the time to educate themselves on what is quite a labyrinthine system as well.

[PowerToThePeople]

60. Many (myself included) view insurance as a scam

You pay and pay and pay, but get nothing in return. You can not do that if you are poor. Heck, you shouldn't do that if you are not poor.

If they are that low income, the could probably get some expanded Medicaid. But, then again, I live in Washington and our State's public assistance programs are probably a lot better than much of the Country.

[Xithras]

123. Insurance isn't a scam. It's gambling.

You're betting money month after month against the odds that you'll one day get sick, and that the value of your medical bills will exceed the total amount of money you've paid in premiums.

Of course, the reality is that most people lose that bet. If everybody (or even a majority) of people actually accrued more health debt than they paid in premiums, the entire system would collapse. It's just like a casino...it's only financially viable if most of the gamblers LOSE.

For the overwhelming majority of people, having health insurance is a losing financial proposition. For a minority, it's a lifesaver. Your premium is your bet for the latter.

[dreamnightwind]

198. Which is why insurance is the wrong model for healthcare

It should be a zero-sum, nonprofit government-run system taken from the general tax revenue. No gambling. Nobody needs to sign up. Come on in, we'll treat you, anytime, anywhere, anyone.

[TexasTowelie]

201. +1

[DesertDiamond]

61. Well said, Famesucker. I have found that those who have never done without just live in a reality

where there is no such thing as no extra money. I have changed that karma, but there were many years where, for instance, people would tell me I would look so much better if I wore makeup, and I sometimes would say I had no extra money for makeup. So they would say, quite helpfully, "Well they sell makeup at the 99 cent stores." Uh huh. Even 99 cent stores are for people with a little money. Not for people with NO money. But they just can't get the concept of NO EXTRA MONEY.

[ladyVet]

209. I see this attitude over and over here.

And not just here, actually, but on any forum where people discuss money. $0 x $0 = $0. I'm not good at math, but I get this equation. And it's not a matter of doing without the morning cup of java from Starbuck's.

The clueless tell people to move to cities with public transportation if they don't have cars, or move closer to their jobs, or whatever oddball thing they come up with, with no understanding at all that these things cost money. Which we don't have.

They tell us to eat rice and beans. Many of us are already there. What do we stop eating next? The rice, or the beans?

[QC]

109. Do you remember those old DU polls about members' incomes

that used to get posted from time to time.

According to those, DUers tend to be a pretty affluent group--and affluence more often than not makes people pretty clueless about how the rest of us down here are living.

[Yo_Mama]

144. Yes. Yes.

There's not a lot of understanding about people who know they will spend months without money to keep the lights on or have to struggle to eat and pay to get to work. It is very unlikely that these people will buy insurance even for very small premiums, because they don't have money for the copays, and they don't have the confidence that they will be able to come up with the small premium month after month. They are going to wind up at the free clinic anyway, so why pay extra for the privilege?

A LOT of citizens are completely out of touch with the lives of millions of people. I do think society is more segmented on all levels now than it was when I was young. And DC is truly, truly out of touch.

I get frustrated when I talk or write on public policy issues. Telling people that they should spend ten bucks on an LED light bulb when ten bucks is what they have to feed themselves for a week. Sometimes I get depressed into silence.

[Myrina]

126. +1 brazilion

Thank you.

[liberal_at_heart]

136. +1

[Egalitarian Thug]

147. +++ Hardly a day goes by without some

, seriously moment here.

[Doctor_J]

159. And many others who have convinced themselves that ACA is actually health care

and if you don't agree you're a racist libertarian Paulite hater

[30cal]

195. I have noticed that

Today in fact I mailed out last months bills.

I get paid on Friday , I have 9 dollars in my pocket until then.
I have enough food in the fridge , gas in my car and and food for my dog.

That's it

Some just don't understand living like this. I wish I didn't live like this.

Right now it's tough , maybe better days ahead . I'm trying to get into a local mill
that pays pretty good.

[Fumesucker]

203. Welcome to DU!

We aren't all clueless privileged fucks here even if it might look that way sometimes.

Good luck with that job upgrade..

[daleanime]

4. K&R....

[Shivering Jemmy]

5. You are citing Megan McArdle?

Why?

[Redfairen]

15. Even our political enemies can speak the obvious truth.

The ACA enrollment numbers are a complete disappointment in every way. You don't have to be a progressive to see it. Someone needs to speak the truth out loud. I take McArdle's observation as truth and then take it a step farther than she ever would.

We need single payer to solve the enrollment problem she recognized. I mean Hell, everyone can see these enrollment numbers are terrible. Face the plain facts that even our enemies can see. Then demand single payer because nothing else will work.

[ProSense]

146. There is no "truth" in the OP, but thanks

giving this asshat exposure: http://www.dailykos.com/story/2011/09/30/1021638/-New-right-wing-attack-on-Elizabeth-Warren-All-taxes-are-rape

[Turbineguy]

6. It's also a choice between the abstract and the concrete.

You need to buy food. You need to fix your car to get to work. On the other hand, you might get sick.

A guy where I work dropped his insurance last June. Too expensive. Shortly after Thanksgiving he had a heart attack, was taken to the hospital and got a bypass operation. The taxpayers are picking up the tab. He already has single payer.

Insurance is for people who have something to lose.

[antiquie]

69. I can't figure out what else I can cut to pay the premium.

Then I will not be able to get medical care because of the 30% I would still have to pay which is beyond my reach.

I have tried to sign up on coveredca but have not been able to due to various site errors. This is the latest one:

javax.xml.ws.soap.SOAPFaultException: oracle.iam.identity.exception.UserCreateException: Orchestration process with id 3837713, failed with error message Queue:not found.

I live on Social Security and will pay for ACA for one year until I am on Medicare. I know many people in my position, as well as others who are facing the second round of 25% increases in their private insurance and have no ACA option. I am thrilled for the people who have been helped; please don't dis me because it has not helped me.

[Turbineguy]

139. I suspect

that the rates will not settle until the system is fully functional. The insurance companies must be in a pickle to determine their expected costs. They used to be able to control those by kicking people out when they got sick or keeping them out for pre-existing conditions.

It's a brave new world.

[cbdo2007]

141. What did they say when you called??

I have heard from a handful of people who blame not signing up on "that darn website won't work."

[mrmpa]

7. They might be like me................

they may have checked the healthcare.gov site, inputted their information & found they were unable to afford it. Or like me found tjat under Federal guidelines they were eligible for Medicaid, but their state did not expand Medicaid and they would have to pay full fare for insurance.

[Mnemosyne]

35. This^^^ nt

[independentpiney]

53. That's our situation as well

I'm on ssdi and have medicare, but without the medicaid expansion I can't afford to get a policy for my wife and daughter.

[winter is coming]

103. +1000. I'm taking my kid to the doctor today. Pretty sure she has atypical pneumonia.

Last night, I was telling her what today would probably be like and she said something like, "and then you'll probably get it from me and have to go to your doctor," and all I could think was no, I probably wouldn't be seeing the doctor because we can't afford it. I'm grateful that she, at least, has insurance.

[CottonBear]

129. This is the reallity for many in red states.

I am a middle aged, unmarried parent who lost my job in 2008 when my child was an infant. The job market in my field has not recovered. I have 2 jobs now. Neither offer insurance. I do not qualify for Medicaid or a subsidy.

It sucks. I miss my great job with full benefits. I worked for 25 years in my career field.

[DocMac]

131. I was just on the gov. site

and chatted with Sarah. I haven't worked for 7 years and my brother takes care of me...a place to live and food. He is an IT contractor and makes too much for a subsidy, even though he claims me as a dependent. My home residence is PA, so no Medicaid expansion.

Sarah said that my brother could buy me insurance, but he still makes too much for a subsidy and the cost for me she didn't know.

So, even though I make $0, the household income is still near $100k/year. I was told that I would have to go to a local clinic, have my brother pay even much more to care for me, or wait until PA expands Medicaid.

I need the medicaid to see a doctor and build a case for disability. I'm 54 and worried about how i'm going to figure all this out.

[Hippo_Tron]

165. Tom Corbett is about to to be unemployed, hopefully PA Medicaid expansion is soon to follow...

Kasich was smart enough to do it in Ohio and he might survive re-election because of it. But Corbett was stupid enough to follow the lead of the Tea-Nuts on this one and he'll go down in flames. Not expanding Medicaid may fly in the dark red states (for the time being) but it's going to destroy the Republicans in swing states if they keep resisting it.

[TheFrenchRazor]

187. yep. so i guess we get fined for being poor. and get work cut below 30hrs/wk

so employers won't have to provide coverage. now we're even poorer.

[30cal]

197. I couldn't afford it , I wanted to

Mine was $167 a month with the subsidy.

I don't have that left at the end of the month after paying my bills.

[ladyVet]

210. I don't qualify for ACA.

I have no income, so I got shunted to the state Medicaid site. NC didn't expand Medicaid, and I don't qualify for it anyway because I'm no longer fertile. I'm waiting for a reply from the federal Medicaid thing, which the nice lady from our Medicaid office has referred my application to.

It's possible I would qualify as a dependent of my son, but he's run the numbers and the premium would be too high for us. He works part-time retail, and can't even afford his own insurance premiums.

Our solution: don't get sick, and if we do, treat it ourselves or wait it out.

[newfie11]

8. If your living on the street and homeless

How would you sign up? Sorry I don't know much about the procedure but I've seen people refer to doing it on line. If that's the case then most poor and all homeless have no computer. Are there street offices?

I am on Medicare and Champva so not familiar with sign up procedures for ACA.

[bravenak]

128. If you are living on the streets and homeless you can go to your local DPSS and sign up.

Or at the hospital if you are sick now, and don't have time to jump through hoops. Unless your state did not expand Medicaid, like mine.

The hospital can sign you up.

[newfie11]

207. Glad to know it's easier than I thought for them

Thanks for the answer.

[bemildred]

10. Why the Hell not just give them care if we want to give them care?

Why must they "get insurance" to "get care"?
Isn't this just clever bullshit to dissemble the fact that we don't provide free health care?

[MannyGoldstein]

22. Because that would cut out the insurance companies nt

[Heather MC]

26. Exactly, The ACA is a for profit Insurance racket

Why do we need an insurance company to get Federal health insurance.

It should have been simple. If you have a ss# you can go to any Dr. or Hospital participating in the Federal program. If you have private insurance keep it.

Unfortunately, Our country only sees us as comodities to take as much from us as possible.

[zeemike]

41. "Our country only sees us as commodities"

Yep, to be exploited.

[TexasTowelie]

202. ...and disposed of after being used! nt

[winter is coming]

110. We don't want to give them care. We want to sell them insurance.

Receiving care is an incidental and random side effect.

[merrily]

11. Money? Just a wild guess.

[santroy79]

12. why do people have to sign up by March?

why cant they sign up whenever?

[merrily]

13. The idea is that uninsured people have been costing society money by

showing up at emergency rooms and getting free care.

Of course, they've also been costing health insurers profits by not buying health insurance, but I'm sure that had nothing to do with anything.

[raven mad]

32. "Free" care in the ER? Where do you live?

The first thing our ER does is send a rep around to collect your "deductible" - or whatever is in your pocket at the time.

Then you start getting the bills a week later.

[Ed Suspicious]

72. I am currently being sued by the ER doc who treated my daughter (the 500 dollar bill became

a 654 dollar bill as I continue to be unable to pay it). This bill was separate from the ER facilities bill that my insurance picked up much of (left me with $350.00 -which I was able to pay finally) and the ambulance bill (four mile trip (suspected suicide attempt by taking too many of her pharmacuticals while at school - 5 fluoxitine when only one was prescribed) that cost $750.00.

I am fully insured by blue cross blue shield through my wife's employer. Free ER care does not exist. $1600 out of pocket plus whatever the insurance company actually paid all for a ride and an hour in the ER. Fuck those who say ER is in any way an acceptable delivery system for routine health care.

[shaayecanaan]

80. Jesus...

Those costs are ridiculous. I assume all they did was monitor her since four Prozac aren't going to kill you. Believe me I know.

Seems like the hospitals are just as complicit in the whole racket as the insurers.

[Ed Suspicious]

89. They did make her drink a charcoal slurry of some sort, but yeah, charcoal, water and observation.

[840high]

124. If neeed in future -

get yourself some Charco-tabs. They do the same thing.

[Ed Suspicious]

91. And how my in network hospital is staffed by out of network Doctors is beyond my comprehension.

[merrily]

199. Where were you during the 2008 Presidential campaign, when

Obama and McCain were discussing this and the following year, when the Congressional Budget Office was rating Obamacare and everyone was discussing why a mandate was necessary?

BTW, my saying, "The idea is," does not equal my saying that my local hospital, one of the most expensive in the world, is offering free ER treatment to everyone. However, ERs are obligated to treat you, even if you don't have health insurance and are unable to pay. And that was a big talking point 2008-10.

[alc]

66. then you could wait until you're sick to sign up

This way you have to pay for insurance before you use it. And it's a pool of people sharing risk (i.e. insurance) rather than a pool of other people's money that you can pull from for a small fee when you expect large medical expenses.

Of course, lots of people will wait anyhow since there was a lots of talk of the "no pre-existing conditions" rules but little talk of enrollment periods so many people think you can sign up when you need it.

[jeff47]

111. Because insurance only works when the healthy are paying.

Health insurance works by spreading the costs over the sick and the healthy.

If the healthy can sign up anytime, they won't sign up until they are sick - why pay for it when you don't need it? Just wait until you're sick, and buy it on your way to the doctor. And then cancel once you're healthy again.

Enrollment periods are designed to fix that. The healthy have to buy in during the enrollment period so they are covered when they become sick.

Yes, single-payer is a far better way of accomplishing the same goal. We'll get there, and the ACA gives us a great framework to do so.

[rhett o rick]

171. The ACA is a first step, when will we start seeing some action on the next step? nm

[jeff47]

176. States can go single-payer or public option in 2018. (nt)

[rhett o rick]

191. Yes but we can guess how well that will go over. What is the next step nationally?

[jeff47]

194. To advance it in blue states.

The national effort runs into the problem where red states are ovderrepresented in Congress.

So you advance in the blue states. VT is already laying the groundwork to go single-payer. Public options should be relatively easy to pass in CA, OR, NY and several other blue states. With no need to profit, public options should do quite well against private insurance. Success in those states will encourage other blue and some purple states to follow suit.

Once those systems are up and running, the lack of dead bodies will make it hard to keep shoveling the FUD to stop national efforts.

[DocMac]

133. By March 15th.

That's what lady said at gov. website chat. I guess in order for it to kick in by the 31st.

[Thor_MN]

14. There are those that can't afford even the smallest premium and those that want it to fail

Those are not mutually exclusive groups. But some percentage are letting their hate stand between health insurance and themselves. Likely they would call it their pride that keeps them from accepting any assistance in obtaining heath insurance.

[demwing]

16. Anyone applying for Food Stamps

WIC, or GA should be automatically enrolled. Anyone already receiving benefits should be enrolled. Any student filling out a FAFSA with 0 estimated family contribution, should be automatically enrolled.. Anyone in Section 8 housing... etc.

[Bluenorthwest]

42. That's how it is done in Oregon, where our website does not work at all!

We had a fast track provision approved which allowed the State to send 'you have heath insurance' notices, sign and return was all it took for those getting other benefits you mentioned. A friend of mine who is often dubious of Obama told me 'I got put on Oregon Health Plan' and I told him that's Obamacare to which he said 'then I love Obamacare'.
Why wouldn't he love it? It will save him tons of money. Includes dental.

[davidpdx]

17. I agree it's what we need to continue to push for

The ACA was a start. I think it's going to take awhile to get there as we have to get large majorities in the House and Senate.

We have universal care here in Korea and I love it. Last year I had to go to the hospital on a holiday for an allergic reaction because my face had swollen up like a balloon. I walked in and there was no paperwork or waiting, they sat me down and started taking my vitals and finding out what was wrong (although they had a hard time pinpointing it exactly, the treatment was to give me the equivalent of Benadryl through and IV).

[liberal N proud]

18. Ever been down to your last dime?

My guess is there are more people in that situation than anyone wants to admit or anyone can fully understand.

[Uben]

19. Some may not like being tracked

Every damned thing you do these days, there's someone tracking your every move. WTF? 1984? I think a lot of folks just want to be left alone to do as they please without any government or other interference. Why have we allowed these mega-corporations the ability to track our every move? I do whatever I can to make it difficult to be tracked, but that in itself is inconvenient and I shouldn't have to do it. We need to have a program that will let people surf the net without being tracked, sorta like the do not call list for telephone numbers.

[quaker bill]

20. single payer is no cure

It still costs everyone something, the fees are just collected as a tax.

It does get rid of the problem of voluntary sign ups as everyone is just enrolled whether they like it or not. It would probably lower costs a bit, but it will still cost dollars some people don't have.

[shaayecanaan]

47. it will lower costs a shitload more than that

The average health spend for countries with single payer is 10% of GDP. Currently US spending is 16% of GDP.

[newfie11]

62. +1

[bornskeptic]

127. Healthcare costs in mandatory insurance systems are about the same as in single-payer systems.

Mandatory insurance systems include Germany, France, Switzerland, Belgium and the Netherlands. The high cost of healthcare in the US has many causes, most of which are at the provider level. Actually, health insurance company profits only constitute about 1% of US healthcare costs. Single Payer would expand coverage, but there's no reason to think that it would reduce costs appreciably.

[shaayecanaan]

162. Theres a world of difference between Obamacare and the Swiss system

I actually had high hopes that ACA would come to resemble the Swiss system. The Swiss system is far simpler than Obamacare, and mandates a straightforward weight-for-age system requiring Insurers to offer the same coverage and pricing to everyone of equal age. It gives much greater power to government to set prices than Obamacare.

Bear in mind that the Swiss/German system is still not as good as pure single payer in reducing costs. German/Swiss/French healthcare costs are about 15% higher than UK costs. The point is that single payer gives the government monopsony power. A monopsony means a system in which there is only one buyer. Typically, this gives that buyer far greater power in setting prices than a system in which there are multiple buyers.

[grahamhgreen]

189. Primary care is non-profit only in these systems

[quaker bill]

170. OK then

Let's go with your figures. Then the subsidized $100 a month premium falls to $62.50, still well short of being free.

[shaayecanaan]

196. But its funded from general tax revenues

You don't have to pay for it in order to get it. Its the same as the police service, the fire department or any other public utility, you qualify as a consequence of being human.

[quaker bill]

205. There is no free lunch

All the general tax revenues are already spent and more is borrowed every year.

So, if we are going to increase expenditures, other things need to be cut or more money needs to be raised. I have no problem with raising taxes and am good with certain cuts (in particular defense). The question with taxes is always where do you raise them?

Now if the notion is to raise taxes on the well off to fund healthcare for the poor, I have no problem with that. It would be roughly the same as increasing the subsidy, so the poor would pay nothing under ACA. I would have no problem with that either.

The real question is that somewhere along the income scale the taxes collected must start to substantially exceed the average cost of healthcare delivered or you don't have money to fully subsidize the poor. Where does that point fall?

At some point far further down the income scale, taxes kick in and start collecting some portion of the healthcare cost back. Where does that point fall?

It is the same as police, fire service, and the public schools, I do qualify as a consequence of being human, but I also pay taxes to fund them, and in my case moved to a better neighborhood so I could pay more taxes and get better services.

Healthcare does not grow on trees, taxes or premiums will need to be paid to fund it. Who pays, and where does the free ride start?

[shaayecanaan]

206. remember

You are already paying for the healthcare of old people, children, veterans, public servants, certain sectors of the poor, and various other ad hoc health schemes (eg the first responders health bill). Most of those people are amongst the most expensive to insure, the elderly particularly.

The US govt is already paying about two thirds of the money that it would need to pay for single payer, and is basically pissing it away on inefficient ad hoc schemes (tricare, medicare medicare part d, va, schip, medicaid etc).

[Redfairen]

56. OK then, tell us the real cure.

I'm genuinely interested since I'm the one who started this whole damn thread. Tell us the answer to this problem. I really want to hear it.

[quaker bill]

173. A different social contract entirely

We can futz around the edges patching this bit or that bit forever. Yes, single payer would be an improvement, but the family will still be short money, and a bit more so as with single payer the ability to opt out goes away.

We patch low wages with subsidized housing, food, education, healthcare... There is always another need to be patched. It is far better to patch them then not. It would be far better still that they not exist. Higher wages is what are really needed.

It is way past time that the worker quit being seen as the enemy to be conquered, disciplined, developed, taught to expect and accept less. Workers are how things get done.

[jeff47]

113. Paying for it via taxes lets you use graduated taxes.

So the poor pay little or nothing, while the wealthy pay more. Just like our income tax system.

[quaker bill]

179. The subsidy does more

because instead of reducing the taxes they are charging you for it, they simply take tax money from farther up the wage scale and buy you insurance with it (it largely never comes out of your check) If you are poor enough to get the maximum subsidy, the existing ACA program is a massive wealth transfer in your direction (not as cash but as paid insurance), but if you cannot afford the 10% match, you are hosed.

If what you are arguing for is a more progressive rate structure, we agree, I am all for it, but it is only a Band-Aid.

[jeff47]

181. It's the same whether you call it a subsidy or not

The government buying insurance (single-payer) or paying a subsidy to buy private insurance (the ACA) really doesn't make a difference to the person getting the insurance. In either system, they're paying little to nothing themselves.

It's not like they see the subsidy check.

[quaker bill]

214. exactly, so why do they not sign up?

to circle back on the OP. If it is basically the same, the only real difference is whether the sign up is voluntary or not.

[jeff47]

215. There's another difference

If you just sign everyone up for a single-payer plan, no one is deciding which insurance to buy. They're all getting the same thing.

Which insurance is best massively varies between people. Even if we define "best" as "least expensive", the various parts mean "least expensive" in some cases is bronze, and in other cases it's silver. There isn't a nice, hard-and-fast rule that's easy to apply.

That tends to result in paralysis - doing nothing means not choosing the wrong one.

[cbdo2007]

142. Wait, you mean "single payer" won't be magically free for everyone?? lol

The poor will be hurt more by single payer than anyone else because they'll still have to pay that 5% tax for it, or whatever the rate is.

[quaker bill]

169. If you connect it to a large increase in minimum wage

Then you are getting somewhere.

[Doctor_J]

143. o.....m.....g

Please, stop it. Single payer is indeed the cure, which is why everyone in the world has it, except us. Honest arguments accepted. Bald-faced lies, not so much.

[Egalitarian Thug]

148. Simply stunning, isn't it? n/t

[quaker bill]

168. It is not the cure for having too little money

The cure for that is higher wages.

Think about it seriously for just one moment. Plans through the exchanges require 80% of the premiums collected be spent on healthcare. Now with a fully public system, you could boost that to perhaps 90%. This adds up to a lot of money nationwide, but what does it do to premiums? It takes a currently subsidized premium of say $100 a month down to $88 dollars a month.

People who cannot spend $100 a month, are just as unlikely to be able to afford $88.

The answer is to get them higher wages.

[Doctor_J]

175. You could boost that to 97%, which is what Medicare operates at

ACA gives Big Insurance 600 billion dollars per year. Those 600 billion are more than enough to provide health care for those who can't afford insurance.

1. We are the only rich country that spends a half trillion of our health care dollars on bonuses for executives
2. We are the only rich country that leaves 1/7 of its citizens without

[quaker bill]

182. But single payer does not fix thar

It just has the checks all coming from the same source going into a private run system.

Socializing the healthcare system would handle the problem. These are different concepts. I am all for laying off those who profiteer from sickness. Single payer does not necessarily do that. A national healthcare system does.

I have actually lived poor and without insurance, I do not need the lecture, thanks.

[Le Taz Hot]

21. Oh, the Party Faithful don't want to hear that here.

I and many others have raised the alarm about this. How many times have I heard, "But it's only $19.00 a month! Who can't afford $19.00 a month?" The answer is a lot of people. Nineteen dollars a month buys food for several people for several days if you know how to shop and cook from scratch.

Personally, I finally decided on the shittiest insurance I'll never be able to use for $300.00 a month AND I lose my free meds because -- TA DA -- I have "insurance" now. Guess who will be without medication again?

Too many people around here either have never been REALLY REALLY poor or they're the pull-yerself-up-by-yer-bootstraps kinds "Democrat."

[hobbit709]

24. +1000

[antiquie]

96. This^

I do get subsidized so I will only pay $115 for insurance I cannot afford to use.

[ladyVet]

211. Seriously.

How many times have I heard, "But it's only $19.00 a month! Who can't afford $19.00 a month?" The answer is a lot of people. Nineteen dollars a month buys food for several people for several days if you know how to shop and cook from scratch.

For real. $19 would feed the four of us for at least four days, at least. I cook plain, simple meals from scratch or we'd have food-less days.

Oh, and my son's premium, when he was figuring out if he should switch from his crappy company plan, was way more than $19 a month.

Too many people around here either have never been REALLY REALLY poor or they're the pull-yerself-up-by-yer-bootstraps kinds "Democrat."

I don't call those latter types Democrats.

[lancer78]

212. Dunno

With the subsidy, I could have gotten a bronze plan for $0 per month.

[Le Taz Hot]

213. Right.

And your deductible is $6,000 a year and they only pay 60% of the bill and you pay 40%. If those amounts aren't a problem for you then I'm happy for you. They're a problem for me and millions of others because it amounts to an insurance that we pay for but won't be able to use. I don't call that health care.

[raven mad]

23. "What if you just don't have that money?"

And it has to be paid "up front"? What is the difference between no insurance (where you pay the doctor up front) and this?

[Le Taz Hot]

27. Answer:

You don't go to the doctor until it's critical at which point you go to emergency and the taxpayers pick up the tab anyway.

[raven mad]

29. Exactly. It's a no-win situation.

My dentist will not accept insurance, period. He will file so that you can recoup some (or little, in my case) funds, but is independent and just flat refuses to take insurance.

He treats a large number of patients "pro bono".

I have to save pennies - literally - to get to see him, but it's worth his care, he's excellent. I do feel for those without insurance at all - they do wind up in the ER where the care, here, is at best very poor. I did go about the "sign up" deal for Obamacare, only to find out it would cost more than what we're paying per month, anyway. Sigh.

Damned if you do, and damned if you don't! I still think the program is the best bet so far for folks with no coverage at all - but the fact that Big Insurance, Big Pharma and Big Med are running it makes me sick.

[antiquie]

76. This is not true for all of us.

I have not been to a doctor in seven years.
My husband has not been in thirty.
We are in our sixties.
We can't pay.
We don't go.

We are not evil takers.

[Le Taz Hot]

90. Oh, jesus!

Is that how I sounded? That SO didn't come out like I meant it. Allow me to apologize. I've long been an advocate for Single Payer and what I MEANT was people should be able to seek medical care (not insurance) when they need it, regardless of ability to pay.

That's what I get for posting at 4:00 in the morning when I can't sleep.

[antiquie]

99. Oh gosh, I've over-reacted, sorry.

The concept of the OP and the usual dismissing of poor people really got my rage going again. So sorry, I took it out on you. You are one of the Good People.

[Le Taz Hot]

102. I re-read what I wrote

and it was easily mistaken. We're good, antiquie, and I COMPLTELY understand your rage because I've seen the same dismissive posts you have (there's a couple in this very thread as a matter of fact).

[retread]

25. They live in a state that refused to expand Medicaid?

[Le Taz Hot]

28. Even in states where medicaid was expanded

the premiums are unaffordable to many people. Yes, some insurance offers the policyholder "free" insurance (i.e. 100% subsidized premiums) -- the 60/40 kind with a $6,000 per person per annum deductible.

[ProSense]

63. Not true.

Enrollment is strong even in states that didn't expand Medicaid.

Why NC (surprisingly) is a national leader in Affordable Care Act enrollment

Posted by : Adam Searing

Last week I was meeting with other health advocates from around the country. Many of them had one question for me – with our state’s refusal to expand Medicaid or set up a state exchange under the Affordable Care Act, how is it that NC is enrolling twice the percentage of its uninsured people in private health plans than any other similar state? In response I wrote this op-ed in today’s News and Observer:

While North Carolina has refused to expand Medicaid under the Affordable Care Act and many politicians continue to complain about the federal health exchange, the roll-out of Obamacare in N.C. tells a far more positive story.

North Carolina is enrolling uninsured people at a rate at least twice that of any other state that has refused to set up its own health exchange and refused to expand Medicaid. In short, among states that are dragging their feet on the Affordable Care Act – no advertising campaigns, no speeches by the governor on how important it is for everyone to have access to health care, no Medicaid expansion that guarantees the lowest income workers coverage – North Carolina is by far leading the pack in private plan enrollment.

Even with the federal health exchange’s shaky start, N.C. has already enrolled 107,778 uninsured people in private health plans. Compare that with Virginia (44,676 enrolled), South Carolina (24,116), Georgia (58,611), and Tennessee (36,250). Only states like Florida and Texas with many more uninsured people than North Carolina are enrolling anywhere near our raw numbers, and they are far behind us in the percentage of uninsured getting coverage. (Read more)

http://pulse.ncpolicywatch.org/2014/01/29/why-nc-surprisingly-is-a-national-leader-in-affordable-care-act-enrollment/

More: http://www.newsobserver.com/2014/01/28/3572241/how-nc-surprisingly-became-a-leader.html

http://www.democraticunderground.com/10024493554

[BlueCaliDem]

83. Uh-oh. The PUMAs on this board don't want to hear that.

(borrowed and paraphrased that line from that very poster, by the way).

[ProSense]

84. It's hate. When RW distortion (How to kill Obamacare)

is given crediblity while the positive news about the law is attacked or ignored, it's hate. Yeah, some are just jumping on the bandwagon, but there is definitely hate here. I mean, the same people who like to scream Third Way/DLC shills and accuse Obama of being center right are pushing RW drivel from the likes of Glenn Reynolds and Jennifer Rubin. The irony is thick.

It's hate. There is no frigging way around it.

[Le Taz Hot]

94. Yeah, I'm a right-winger

hate machine I am. Well, me and a couple hundred thousand other DUers but don't let the facts get in the way. I suppose blind loyalty makes life much easier when one doesn't have to actually think critically.

[BlueCaliDem]

114. I totally agree. It's amazing how much hate the word "Obama" can conjure

on a Democratic Party supporting site. And he's a Democrat, which is something I can't say for the ObamaHaters infesting this Democratic Party supporting community. It's just mind-blowing.

On the other hand, some of those anti-Obama "DUers" are honest and upfront, and admit to being Libertarians. Some still skulk behind the disingenuous, "I campaigned for him, signed people up for him, donated a gazillion dollars to his campaign, and voted for him - twice - and thus I'm immunized against anyone who dares to call me out when I criticize him as if I'm a true-blue Republitarian" excuse.

[Le Taz Hot]

87. Who's a PUMA?

I can't stand Hillary and that's where that term comes from -- Hillary supporters who were pissed that Obama won the primary. And for the record, I've NEVER used that term so you're pretty much wrong all the way around. And one more thing, anytime you have something to say about me, say it TO me instead of this chickenshit passive/aggressive bullshit.

[BlueCaliDem]

115. No. The acronym stands for "Party Unity My Ass".

Which you, and a few other ObamaHaters here fall under.

So what Party do you really support, Le Taz Hot? The Republitarian or Liberaltarian Party? I'm guessing the Liberaltarian, judging by the few posts I've read of yours that were of "meh" interest to me.

[Le Taz Hot]

118. Yes, I know what it stands for

and where it originated -- after the 2008 primaries were over the Hillary supporters were being asked to support Obama in the name of party unity and whose response was, "Party Unity My Ass," a.k.a. "PUMA."

You might want to educate yourself on the subject matter before you try and educate others or you might look uninformed.

[BlueCaliDem]

174. Yeah. That's because I just explained it to you.

You knew it originated during the 2008 primaries, but it appeared that you had no clue that the acronym has a stand-alone definition that transcends Democratic primaries. I'm glad you've learned something new.

As for accusing someone of being uninformed? You'd have more credibility had you not asked such a stupid question. That's the definition of uninformed, Le Taz Hot.

And nice dodge-work in your feeble attempt not to expose yourself, by the way. But it's okay. My mind, and most likely every other DUer - on your side as well as mine - already know the answer.

[Le Taz Hot]

185. The "transcendence" is purely in the mind

of the Party Faithful. I've no idea what the rest of your post is about.

[Doctor_J]

180. Here's an idea - if you want party unity, try acting like Dems

instead of moderate or far right republicans. Edit: and what most of us hate are republican policies like ACA

[Le Taz Hot]

92. Which has NOTHING to do with what I posted.

[ProSense]

93. It has everything to do with what you "posted"

The fact is in all states, whether or not they expanded Medicaid, people are signing up.

You knew what I meant.

[Le Taz Hot]

95. No, actually, I don't.

But then again, I've never understood blind loyalty so there is that.

[rhett o rick]

217. If you've never understood blind loyalty I recommend you read "The Authoritarians."

Blind followers have most likely been raised to bow down to their authoritarian leaders their whole life. Never taught or encouraged to think for themselves. And if you think about it, it is sooo much easier for them. Although they seem to spend a lot of time trying to rationalize their naive positions.

[uponit7771]

154. PS, FUD and wingers have been using the word "many" to obfuscate your point.. many could mean

... any nebulous number

For instance - "many people die from having sex in the morning"....

These guys are out in full force these days

[uponit7771]

152. +1

[uponit7771]

151. Winger position - no concrete evidence on "many" just conjecture

[uponit7771]

150. ***************SCREW FACTS!!!!!!!***************

[Ms. Toad]

30. Well - subtract the roughly 50% of the poor

who would have to pay full price for insurance in states where Medicaid was not expanded, and that should give you a pretty good idea of why the haven't signed up.

[TheFrenchRazor]

188. yep.

[JoePhilly]

31. The tax penalty wasn't created to incent people who don't pay taxes.

The subsidies, and the Medicare expansion, target those folks.

The mandate is intended to create an incentive for those who can afford insurance but have generally thought they didn't need it. That is, young healthy folks.

That said, the correct next step is to encourage states to add public options to their exchanges. Then have the federal exchanges add a public option.

The GOP Governors have helped make this easier by not setting up their own exchanges and relying on the Federal exchange.

[magical thyme]

33. time and money

I haven't taken the time to look through the site; I worked in high tech for a couple decades, so knew to wait. I deliberately planned to look in late Feb/early March when the bugs would be ironed out. Possibly on superbowl day (has that happened yet?) if I wasn't working that day.

I have several days off from work next week, which is when I currently plan to look. The calculator I looked at showed my income is so low that I can get a bronze plan for free. In that case, I will get the bronze plan. If the calculator was wrong (and I was estimating my income at the time, plus the calculator didn't make clear whether to enter gross or agi) and it costs $$, I will get what is cheapest, either insurance or fine.

I expect that people that are barely getting by working multiple low-pay jobs, and taking care of errands and whatever in between, simply don't have ACA as a high priority. I've lived most of my adult life without insurance. When I had it, I got seriously ill and the insurance companies left me to die anyway. So I spent a couple thousand dollars on worthless insurance and my life was saved by my dentist when he saw how ill I looked (dropped from my normal slender 110 pounds to skeletal 83 pounds within weeks) and put me on "prophylactic" antibiotics (if you're already septic, it's not prophylactic, it's treatment) for a month before taking out my wisdom teeth.

Face it: healthcare reform was a #1 priority for some number of people for some time, but after the economy collapsed, healthcare reform dropped down on the priority list below jobs for many, many people, and health insurance was never a high priority for anybody except the health insurance industry. 6 years later, for most people any job and jobs that pay a living wage continue to be a top priority for most people who lack health insurance. After 2008, the #1 priority of the administration should have shifted to the economy (specifically cracking down on and cleaning up the corruption and thievery that led to it) and always it should have been on climate change and the environment.

Personally, I saw it as a last chance wake-up call -- all those bailout trillions could have been spent rebuilding our infrastructure to eliminate energy waste (eg something like 40% of electricity is lost between the generators and the recipients) and build in resiliance, foster alternative clean energy where practicable, putting people back to work at the same time. Then we would be ready for the rest of it.

But hey, the banksters go trillions, we got ACA, gay marriage in a lot of states and pot in a few, so its all good, right?

[Snarkoleptic]

34. Why do the poor and uninsured refuse to sign up for Obamacare?

Because Faux Newz is free on basic cable?

I mean, who would want the Obamacare microchip implanted as well as to contribute to the downfall of mom, apple pie and the American way.

[shaayecanaan]

49. maybe they can't put down their moonshine jugs

long enough to log in to dat dang gubnment website? Great to see poor-bashing is still such great sport on DU.

[svpadgham]

82. Poor people generally don't have cable.

[Le Taz Hot]

106. So, poor people aren't signing up

because they're too stupid?

Let's put our thinking caps on now, shall we? Would there be any other reason that people might not sign up? Any reason at all.

Oh, and the swipe at the mentally ill had an especially classy touch.

[hollowdweller]

36. I know 2 types of people who haven't signed up.

First have several friends who make decent money but have always been healthy. Any medical bill that they have had they generally pay out of pocket and they really like money.

2 of my friends told me that Obamacare was "too expensive", that it was going to cost them a little over 200 a month each, which is lower than the cost of insurance thru my job and seems low to me. Said since they are healthy premiums were "wasted money" since they are healthy.

They would rather just pay the fine, pay anything out of pocket and then if they got really sick they could sign up then. These are people who were for Obama care, very liberal but when it comes to then to sacrifice some money they don't want to do it.

2 of my other friends who haven't are poor. They would almost certainly would get free insurance thru Medicaid expansion but they are just lazy and put off everything including paying bills till the very last minute. I suspect they will pay the fine even though they could get the free insurance just because they are too lazy to set down and do it.


By far the largest segment of friends I know who have signed up are the ones who are poor but are unemployed or underemployed thru no fault of their own, have medical problems. A bunch of them have signed up for the Medicaid expansion and are thrilled to be able to have needed operations.


I know this is going to sound awful. Really though unless you make it universal coverage that is taken out of taxes or your paycheck and your employers money and done automatically there is only 1 way to make people sign up.

You change the law so doctors and hospitals can refuse service to anybody who doesn't have insurance. I don't even think the threat of potentially dying would motivate some of the poorer and lazier ones I know but it would get better than half.

[shaayecanaan]

64. uh...

You change the law so doctors and hospitals can refuse service to anybody who doesn't have insurance.

I'm going to make the ACA work even if it kills me! Or someone else, preferably.

[winter is coming]

98. "change the law so doctors and hospitals can refuse service to anybody who doesn't have insurance"

So people wouldn't be able to get medical care even if they paid up front? That's both stupid and callous.

[jeff47]

117. The first group gets covered by the escalating fine.

The first year the fine is trivial.

The second+ year, the fine goes up. It costs more than insurance.

[a kennedy]

38. I copied and printed this out: "Being poor is knowing exactly how much everything costs."

http://www.democraticunderground.com/10024401512

[karadax]

39. Enrollment penalties are not harsh enough.

For many people in the poor and uninsured category it's probably cheaper to pay the penalty than to dish out the $$ they may or may not have for coverage. It's an easy economic choice.

2016 is when we will truly find out as families will be dishing out nearly $700 a person and half that for kids that are uninsured. My bet is that there are more people in this category than people wanted to admit when this law was signed.

[Coyote_Bandit]

57. pfft

My monthly premium is about $515.

My annual income as an unpaid caregiver to a parent is about $6000. My state opted not to expand Medicaid.

My expected annual out of pocket in network medical expenses (including premium paymnts but excluding costs associated with vision and dental care) is about $12,000.

I am fortunate to have savngs hat I can deplete to absorb these costs. Most poor people don't. A $700 penalty is a financial catastrophe for them. But that doesn't mean coverage under ACA is an affordable option - especially in states hat hve opted not to expand Medicaid. They face a cruel situation.

Then there are people lke me. I qualify for Medicaid but cannot get it - and prefer to secure a private off market polcy rather than have to repay the government for Medicaid coverge. If my income were higher I would qualify to tax subsidies - which are useless to me at my current income level. At some point I will leave my role as caregiver and return to the workforce. A transition that will bring a reduced ncome from my previous employment and costs associated with returning to the workforce. Why the hell can't people like me have a tax credit that we can carry forward for a few years o appl against future earnngs? Seems fair.

ACA has lots of inequities and needs significant improvement. Single payer would be a vast imprvement. The single biggest reform enacted by ACA so far as I can tell is the fact that pre-existing conditions no longer exclude someone from coverage or produce rating surcharges. People who have assets to secure coverage can do so. Unfortunately, lots of poor people are still denied meanngful access to healthcare. Unfortunately, I do not see that changing anytime soon.

[Walk away]

107. I don't understand how a state can be so stupid as to....

literally kill their own working poor. Is it possible that they hate us so much?

[Coyote_Bandit]

192. ACA is federal law with

the expansion of state Medicaid programs almost entirely funded by federal tax dollars.

This raises an issue of equal protection under the Constitution because poor people in one state are treated differently than poor people in another state. That would be ok if we were not talkng about a federal law primarily funded by federal tax dollars.

The US Supreme Court decides cases on the narrowest possible issues and they have not been presented with any cases challenging ACA on an equal protection basis.

Somebody in DC needs to grow a spine and insist that all our nations poor people have access to the same healthcare options regardless of whether they reside in a red state (opted out) or ablue state.(opted in).

Blaming individual states is a cop out. If ACA were properly drafted, litigated and enforced then red states would not have the ability to opt out.

Maybe some legal genius that works for a civil liberty group with resources to pursue clients and long-term litigation will figure this out and have both the skill and the guts to pursue it.

[Coyote_Bandit]

192. ACA is federal law with

the expansion of state Medicaid programs almost entirely funded by federal tax dollars.

This raises an issue of equal protection under the Constitution because poor people in one state are treated differently than poor people in another state. That would be ok if we were not talkng about a federal law primarily funded by federal tax dollars.

The US Supreme Court decides cases on the narrowest possible issues and they have not been presented with any cases challenging ACA on an equal protection basis.

Somebody in DC needs to grow a spine and insist that all our nations poor people have access to the same healthcare options regardless of whether they reside in a red state (opted out) or ablue state.(opted in).

Blaming individual states is a cop out. If ACA were properly drafted, litigated and enforced then red states would not have the ability to opt out.

Maybe some legal genius that works for a civil liberty group with resources to pursue clients and long-term litigation will figure this out and have both the skill and the guts to pursue it.

[azurnoir]

40. This is a Glenn Reynolds hit piece actually entitled How Americans can kill ObamaCare

now as to why the 'poor' do not sign up for ObamaCare the article gives figures based enrollment in one state only and leads the reader draw their 'own' conclusions

what it does not do is tell us just who these 'poor' are or if they have opted for Medicaid instead

myself I suspect many of the poor who have not signed up and do not qualify for medicaid are very young, single, and childless

[Redfairen]

51. You're right. My whole point is that our enemies also speak the truth.

The puny number of people enrolled to date is a total disaster. No one on any side of the political aisle can ignore this fact.

This is the time to stand up and speak out for single payer. What other option remains?

[azurnoir]

70. I agree about single payer

that said there just are not enough facts in the article to make the conclusion that ACA is failing

especially on the 2 points I mentioned how many have enrolled in Medicaid and a demographic break down of just who the poor that have not signed up are

[jeff47]

119. The ACA is how we get to single payer.

It's a lot easier to roll out single payer in "blue" states than nationally. A public option in California will be much easier than the nation overall. Heck, Vermont is working hard to get single-payer in place as soon as possible.

And public options, without the need to turn a profit, will be cheaper. That'll draw more people in, and drive the private insurance out of the state. You're left with de-facto single-payer.

And when those states don't end up disasters, the FUD against single payer will become a hell of a lot weaker. That'll allow us to expand over the purple states, and finally the country as a whole.

[maindawg]

43. I tried to sign up

Twice. I was unsuccessful. I do not know why. The second time, I was supposed to get an email with a link to continue the process. There was no link. Either the system is broken or just does not work,or I suspect, the site was bogus.
And that may be why poor people cannot sign up. Bogus web sites designed to fool people and keep them from getting insurance.
Ever since the republicans discovered the internet all they have done with it is evil.

[doc03]

44. At where I live a big reason the poor don't sign up is

Faux has told them "Obamacare bad" This is the eastern Ohio, WV and western PA area where there are "Fire Obama Stop the War on Coal" signs in half the yards. All our newspapers are owned by Republicans and they print every word Bob Murray (war on coal) says. The place is inherently racist, anti gay, distrustful of any outsiders, dirt poor, hates the EPA and hates gays. How do you get through to people like that.

[gelsdorf]

75. I live in Western Pa

and I used to service grocery stores in Pa and East Ohio. WOW!!!! The stupid is very strong there. The towns look like a war movie set, a full set of teeth is a rarity, yet they praise the Repukes and Raygun!! Unreal!!! I have a friend who is laid off, UE bennies run out in March, yet he is pro-Rethug because, wait for it, he might be rich one day!!!! Give me a break! I've known him AND his family for over 40 years, and it ain't happening. But that is the propaganda that they bought into. I'm on SSDI, and I hear about it all of the time that I am a taker. Great, lets trade places, you take my pain, but no, not an option, you can still do something. Of course, he lives in the strong area of the Greensburg Tribune-Review, a tea-bag rag of a paper owned by Richard Scaife of Heritage Foundation fame. That is an issue also

[doc03]

157. The guy is a Republican and accepts UE from the govment, imagine that. n/t

[catrose]

45. The mayor of the nearest big city

recently send people into various neighborhoods to help the residents sign up for insurance. I haven't heard how it went. Given that our state didn't expand Medicaid, probably not too well.

Consequently, my son did not qualify for a subsidy when unemployed, but did qualify for a subsidy when he got a job. I'm still trying to wrap my head around that.

I was looking forward to ditching my crummy contractor insurance, but all the deductibles on the exchange in the same price range were $5000, as opposed to $2500 (up this year from $768). I'm told this was because our state didn't set up exchanges.

Excuse me, I think I have to go donate to Wendy Davis now.

[jeff47]

120. On that deductible

You might want to go through the painful effort of finding out what actually falls under the deductible in the two plans. ACA plans cover a whole lot of things without deductible.

Depending on your health and the plan, that higher deductible may be a better deal - if you're relatively healthy, virtually all health care you'll do in a typical year doesn't require meeting the deductible for the insurance to pay. Since it's likely that your "contractor insurance" requires hitting the deductible until they pay for anything, the ACA plan may work out to be a better deal.

[catrose]

218. Thanks. I'll check into that. eom

[ProSense]

48. Now, I've seen it all.

RW drivel being cited as fact:

That seems to be happening right now, in two very different areas. In one area, we have the refusal of people to sign up for Obamacare in anything like the numbers that were predicted, or needed to make it work. Writing in the Washington Post back in November, Jennifer Rubin observed:

It is a coin flip, at best, for the president as to whether his signature achievement, his only achievement, will fail. It will be repealed in essence by a popular referendum: The mass refusal of people to go along with Obama's top-down, compulsory system that was set to transform a sixth of the economy. That possibility should traumatize and probably is traumatizing the White House. ... The political implications of this are almost too enormous to calculate.

Glenn Reynolds, Jennifer Rubin and every RW distortion about Obamacare being hyped as credible.

[1awake]

50. I'm in the process of signing up and here's my experience so far...

The process is long and difficult with (felt like) over 100 questions half of which made no sense. I am very uneasy about signing up with it and I'm not sure I can tell you why. Because its the gov?

I am currently paying around $800.00 a month for health insurance for myself and my family... a price I can no longer afford. The tax incentive piece to me is irrelevant, or at least is to far off to be a prime consideration.

[OKNancy]

100. Really?

I helped my 29 year old daughter sign up. It took 15 minutes.
A little longer to pick the best plan, but only because there were so many.

She picked a zero deductible, low co-pay. With her subsidy, she pays 28.00 per month.

[1awake]

104. My family is not small lol

the more people on it, the more questions you get asked.

[shaayecanaan]

52. Ironically, the ACA is helping single payer in Vermont...

Unions, who were previously wary of Vermont's single payer plan, have now thrown their weight behind it. They would rather deal with single payer than deal with Obamacare.

http://www.timesargus.com/article/20140222/NEWS03/702229941

[jeff47]

121. That's actually the long-term plan.

The ACA moves the battle for single-payer to the states. It'll be a much easier fight in blue states.

With successful examples in blue states, the FUD against single-payer will be much harder to sustain. We'll get the blue states, and some of the purple. The lack of dead bodies piling up will destroy the FUD, and we'll get back to the national battle in a much stronger position.

[treestar]

54. People with "no money" qualify for Medicaid

The subsidies are calculated based on what a person of that income could pay. The federal government does studies on these things. How does it decide if a person is eligible for welfare or any other such benefit? They do a study to figure out how much it should be.

[Redfairen]

67. Haha, you're funny. Fully half of all states refuse to expand Medicaid.

You cannot tell people to sign up when their own state governments actively conspire to prevent it. You're telling us one of the great jokes of Obamacare.

[GoCubsGo]

78. Also, some states, like mine, require that you have children to get Medicaid.

I have no children. I have no income other than the help I get from my family. My shitstain governor and republican-dominated state legislature refused to expand Medicare or set up insurance exchanges. The cheapest insurance available to me runs $400/month. So, I continue to go without health insurance. There are thousands just like me in my state alone. At least the fine will be waived for us.

BTW, I don't think there are any jokes regarding Obamacare. The jokes are the assholes who keep trying to obstruct it.

[GoCubsGo]

86. Not true. I speak from experience.

In my state, you need to have children in order to get Medicaid. I have no money/income. I have no children. I do not qualify for Medicaid.
These are the messages I got when I went to healthcare.gov:

Is person #1 (age 53) a parent?
If so, this person may be eligible for Medicaid or CHIP

Living in South Carolina and based on a household size of one and household income of $0:
Not eligible for help paying for coverage
This person or household is probably not eligible for help paying for health coverage.

However, you can view the prices of private health plans available through the Marketplace.

Note: this isn't a final determination. You'll need to submit a Marketplace application to get an actual eligibility statement.

Have I told you lately how much I despise living in this hellhole?

[SheilaT]

58. How about simple inertia?

Think of all the people who don't have wills, people who should have them.

My brother-in-law died suddenly last year, age 63, and I was astonished to learn he and my sister had no wills. They aren't rich, just the kind of solid middle-class person who ought to have one. Plus, this was a second marriage for both. And they'd been married thirteen years. Just never got around to it.

I'm having trouble getting my 26 year old son who lives in Oregon to get around to signing up for health care. He's very healthy, but plays ultimate frisbee and is aware of the possibility of injury. Simple inertia, although I suspect the cost might be scaring him a little, since whatever it is will be out of his pocket.

I honestly think that this is going to pave the way to single payer.

[ProSense]

59. Dental Services Are Coming Back For California's Low-Income Adults

Dental Services Are Coming Back For California's Low-Income Adults
http://www.democraticunderground.com/10024538225

California Has Already Topped Its Obamacare Enrollment Goals

California has signed up more than 825,000 people in Obamacare coverage, the state reported Wednesday, topping its total enrollment goals with six weeks to go in the open enrollment period.

About 728,000 people had enrolled by the end of January, according to the state's Obamacare marketplace, and more than 100,000 additional people have signed up in the first two weeks of February.

According to a September presentation, California was expecting a little less than 700,000 enrollments by March 31.

“These enrollment numbers mean that with six weeks to go, California has already exceeded its projected base enrollment for the 2014 open-enrollment period," Covered California Executive Director Peter Lee said in a statement. "While this is a strong showing, our goal is not pinned to meeting projections, but to making sure every Californian gets covered."

- more -

http://talkingpointsmemo.com/livewire/california-obamacare-enrollment-target

Obamacare fulfilling promise to older Americans
http://www.democraticunderground.com/10024521045

[ReRe]

65. Why haven't they signed up?

Because they don't have the money? Maybe because they don't trust the website, what with all the swirl around what the NSA has been up to? They don't have a computer? They're down and out and can't put one foot in front of the other? They don't know anything about it, as they live in a world where news of the ACA never reached? Because they listen to winger radio and watch Fox "News," and call themselves Republicans?
Maybe because they are bigots?

[deutsey]

68. I worked for a while in a homeless shelter back in the late '90s

It was during the time when the market was assuming an almost godlike stature, "Survivor" and "Who Wants to be a Millionaire" were the hot shows, and lots of people seemed to believe it was just a matter of time before they were going to be wealthy, too.

It was a different world in the homeless shelter.

I remember one night when I was on duty and I saw some residents watching TV in the lounge. Lots of fancy car commercials, ads for cruise line vacations, etc. I remember thinking the TV might just as well have been beaming images from Mars or Jupiter because it seemed like the people in the lounge didn't inhabit the same world that was on TV.

That disconnect between the world captured in that TV set and the world those residents inhabited has only widened into galactic proportions since then, imo.

[dmosh42]

71. In the "red" states, the message is the problem,mainly from the Healthcare.gov site itself. I live..

in one of the poorer counties in NC, and have talked with some of my neighbors about this. One of my neighbors, especially, shares a home with others, and his total income($12,000) puts him where the site has him as unqualified. In most states it would put him in the Medicaid area, but the NC gov has not decided to expand the Medicaid and allow for healthcare plans for those people. They should be directed to those people available to show how they can still get a plan mostly subsidized by the gov't, which I showed him can be found on the heathcare.gov site. There needs to be more of a publicized exposure, maybe on local news that explains where to go, and that these plans are meant for everyone by law.

[Demeter]

73. Because although they are poor, and uninsured, they are NOT stupid

Nor are they math- or factually impaired. It's called VOTING WITH YOUR FEET.

And one of the dangers of letting this Administration and Govt. continue to ignore Reality is that the politicians in power are likely to find the Feet have gone elsewhere.

[ProSense]

74. Uninsurance Rate Falls To Five-Year Low As 3.3 Million Enroll In Obamacare

Uninsurance Rate Falls To Five-Year Low As 3.3 Million Enroll In Obamacare
http://www.democraticunderground.com/10024555270

[NCTraveler]

77. I have a close relationship with the Free Clinic in our area.

They are chugging right along. Many of their clients cannot afford the ACA. Many of them refuse to sign up for a government program. Some of the free clinics funds are being directed toward ACA education. The belief is, with their client base, it won't make a difference. The clinic is still investing a lot of time into educating themselves on the ACA. They work hand in hand with the local hospital. The initial view is that it won't make a difference to their client base. These are the people who need healthcare most. The clinic has already started losing donations. Many of their donors are under the impression that these individuals will now have free health care. I increased my donation to them this year. Thankfully the hospital that they have close ties with aren't using this as a way to limit their donation. They will be matching what they did the previous year. The hospital knows that most of these people will stay uninsured. That is the sad state of affairs that we call success.

[mainer]

81. Seeing it in my own family: Suspicion.

Several family members are uninsured libertarians. They went online to the ACA website, saw all the personal information they'd have to hand over, and got freaked out about their privacy. They're afraid of the government using that information. Even worse are the rumors that if you register on ACA, and then opt not to buy any insurance, the government will confiscate your driver's license. That rumor is so rampant that I've heard it from several sources.

[Doctor_J]

85. Hate radio and Fox "News" are telling them not to.

A friend works as a HC provider in an impoverished area, and the Limbeciles would rather die than go to the ACA web site, literally.

The problems with not having money for deductibles and such is also a problem obviously, and ACA is not an answer to the county's HC problems, but many who could be helped are being terrorized by Fox

[BumRushDaShow]

88. There is a reality that the media and commentators continue to miss

and it is this - regardless of a person's actual finances, there are a good chunk of people who need to be hand-held to go through any type of forms-completion process. Whether it's an income tax form, a driver's license form, or even a voter registration form. Sadly, many of these same folks struggle with completing the forms when sitting in an emergency room waiting for care.

The wealthy just pay someone to fill out forms for them. But for others, they need some sort of intervention and there are finally more outreach programs being setup to sit with the person to go through the process (via health fairs, mall kiosks, etc).

The media is just breathtaking in how much they operate in an elitist bubble world filled with esoteric political talking points and distorted reporting of policy positions. The average targeted person on the street doesn't follow politics or cares.

This has nothing to do with whether there is single-payer or nothing at all. Even with single payer, the person would need to be put "in the system" to start some sort of file and that would necessarily require forms completion.

[Autumn]

97. When you are on a tight budget there's just no money for

extras. Some people understand, some don't.

[geek tragedy]

101. same reason they don't vote, and btw fuck Megan McArdle she's a fact-challenged idiot nt

[dembotoz]

105. here is wisconsin it is just silly

paperwork done before dec 15 deadline (fam of 4-1 at college, 1 in hs)

it said we could get badger care and sent results to state

went thru navigator who said aca results were off and should try again.
looked like youngest could get badger care but rest of us not so much.

started that process
(getting the kid on care is a good deal for us because we could predate the application to include about
a thousand bucks of emergency room billing--and the hospital is pushing collection)

also did another entry in aca for the 3 or us

looking a plans for 3 of us

in the meantime contacted by state starting to certify healthcare for youngest
They say we are all eligible except for college kid--he is away at school, not member of household
seems to contradict aca law about kids being able to be on parents plan---ya they know.....

as of today
still waiting for the cards (per the emergency room billing folks collection services start march 1)
my youngest will have (supposedly) have coverage till Aug when he turns 19
college kid--who the fuck know
the two of us-coverage for one month until april first(fitting somehow) when the income standards change again and we are kicked off. At that point we supposedly have a new window of 60 days to go to the damn aca and start all over again

[sir pball]

108. I'm not even "poor" and I'd have a hard time affording it.

I actually have a job with a so-so package for $35 a week; out of curiosity I checked the NY exchange to compare and the absolute cheapest (and, frankly, shitty as hell - total out-of-pocket potential of $5000, for one thing) plan for my age and income level was well over $300/month...I'm not "poor" but at the same time that would be the majority of my surplus. The tax hit would be significantly less anyway, so if push were to come to shove I'd have to do it that way.

I'm not opposed to universal healthcare at all, or even the ACA per se...bu it's a marginal concept at best, with a horribly flawed implementation. And I suspect it's going to end up doing a lot more political harm than good, honestly.

[2pooped2pop]

112. the poor are not signing up because

1) many probably don't even know about it. All they know is that if they don't have it they will be fined. So they don't plan to check in and make it known that they are not covered.

2) they don't understand it

3) they may not have easy access to a computer.

4) they are still waiting for someone to send a letter explaining what they need to do.

5)think they can't afford it, no matter how cheap it is.

[sabrina 1]

116. That was one of the questions people asked from the beginning. But try to explain

to people who have no concept of what $10 in extra bills mean and you will get complicated explanations of how this is not a problem at all. I gave up trying, you might have better luck.

[JCMach1]

122. Had a bang your head on the wall discussion with a friend of my mother...

This is a lady who already receives foodstamps in Florida which requires an online application process.

Applying for Medicaid uses the same system. She essentially refused to do that because she "doesn't get sick"...

The woman is in her 50's and at-risk for all sorts of things.



I think this is pretty typical of the resistance. I told her she could avoid any tax issues under ACA if she simply applied for Medicaid. If she is rejected, because FL did not expand Medicaid, then she would be exempt from any penalty.

[Myrina]

125. Because a 60% copay & $6k deduc is NOT "affordable"?

Maybe??

[Egalitarian Thug]

130. Gee, if only someone could have foreseen this kind of thing...

Oh well, the important thing is that the corporations can still afford nice fat "contributions" to "our representatives".

[Tuesday Afternoon]

132. I have been told by some, it is because the fine is cheaper than the insurance.

and No, I don't argue with them. I don't have time to educate that much ignorance. It is their money and their lives. Their choice.

I just change the subject or find a reason to excuse myself from the conversation and walk away.

[hlthe2b]

134. I suspect there are many on the cusp with major job insecurity, afraid of committing to the monthly

premiums, even if they are considered comparatively "reasonable"... If you think you are losing your job soon, have no employer-provided insurance, and are single without resources, the thought of committing to that monthly premium is pretty daunting--knowing the creditors WILL come for you, along with the car loan, the utilities, rent or mortgage.

I'm glad ACA passed, but there are major gaps that may well cause some to delay signing on.

MEDICARE FOR ALL--the only real solution.

[pnwmom]

135. If, by poor, you mean Medicaid eligible, it's because so many states refused to expand. n/t

[BKH70041]

138. I asked this same question over a week ago.

I was told they were signing up.

When I pointed out that if only 3 million have enrolled (not paid yet, mind you; just enrolled, and that chances are there's a number of those who are duplicates), and for something we were told these individuals wanted yesterday and just couldn't wait any longer, the poster then decided to personally attack me. Par for the course with that particular poster as I have noted their same response to others when backed into a corner.

But that ended the conversation because I knew the one I was engaging was defeated and desperate. They were just repeating what they've been told to repeat, which is what they do.

But, people are signing up by the trillions according to them. So rest easy.

[cbdo2007]

140. Most of those poor would get free health insurance after the credits....

so i'm not sure why they don't sign up.

My Mom isn't poor....she makes about $30,000 per year and when she signed up for an ACA plan she saw her rate go from about $200 per month to $0 per month for the same coverage.

[rusty fender]

145. What are some of the reasons that people aren't signing up in NM?

1) The deductibles are extremely high, e.g., $3,000 is the most common amt. offered by the exchange. Almost all of the plans in the state exchange are "catastrophic" plans, and aren't very good for preventive health care.

2) Our Gov. has opted to expand medicaid, which is ok for those who are 0-54 years of age. Once you turn 55 and your ins. plan is Medicaid, if you get sick, the state will liquidate your personal assets to recover the cost of your illness to the state. So, you will lose your house, your car, your savings.

What is one of the reasons that ACA sucks?

1) The ACA is funded, in part, by reducing the amt. of money that is reimbursed to doctors for accepting Medicare. As it is, more and more doctors are refusing to accept Medicare because the Govt. is reimbursing less and less for every procedure/exam. This will be exacerbated by the ACA. This is the way that the Third Way and the Repukes will destroy Medicare. Clever, huh?

[librechik]

149. they probably just don't know they are eligible. Part of ACA signup is to locate underserved

individuals, many of them rural or otherwise isolated. If they are poor, then they can get on Medicaid.

[jwirr]

153. For the most part the poor are eligible for things like Medicaid and Medicare. I for instance cannot

sign up for ACA because I am already covered by the above programs.

[stopbush]

155. A large number probably have been turned off by Faux News & the RW onslaught against Obamacare.

Mission accomplished!

In my case, I went to sign up for the ACA in CA and found out that family was eligible of the Medicaid expansion under Obamacare. But I live in a state where Medicaid was expanded. Many people do not.

The difference is that I went and checked out the ACA. Many people won't even bother doing that because they believe the RW propaganda.

[BlueStreak]

156. I disagree with the premise of this thread. It is not a "tiny percentage"

That is either intentionally disingenuous or the OPer honestly doesn't understand the basics of this law.

1) It was new promised to cover everybody

2) We know that millions were excluded by the SCOTUS decision.

3) It was never intended to accomplish coverage in one year.

And even so, we are on track for 20-25 million people to be covered in the first year. That is almost half the uninsured, which is not my idea of a "tiny percentage".

If everybody were to have come in the first year, that would have overwhelmed the primary care end of the system. The law was designed to cover people over the next 5 years, with the penalty for non-coverage increasing every year. By 2016, assuming we can retain control of the White House, the penalty will be higher than the cost of insurance for almost everybody.

[Fumesucker]

172. I have been assured many times on DU that the "penalty" is toothless and not a serious threat

Evidently that spin is now changing.

[BlueStreak]

186. It is -- in tax year 2014. But it goes up every year.

And if you are high income and still playing the deadbeat, it is a big penalty in tax year 2014, just as it should be.

Here is a summary from the Kaiser Family Foundation:

Those without coverage pay a tax penalty of the greater of $695 per year up to a maximum of three times that amount ($2,085) per family or 2.5% of household income. The penalty will be phased-in according to the following schedule: $95 in 2014, $325 in 2015, and $695 in 2016 for the flat fee or 1.0% of taxable income in 2014, 2.0% of taxable income in 2015, and 2.5% of taxable income in 2016. Beginning after 2016, the penalty will be increased annually by the cost-of-living adjustment. Exemptions will be granted for financial hardship, religious objections, American Indians, those without coverage for less than three months, undocumented immigrants, incarcerated individuals, those for whom the lowest cost plan option exceeds 8% of an individual’s income, and those with incomes below the tax filing threshold (in 2009 the threshold for taxpayers under age 65 was $9,350 for singles and $18,700 for couples).

So if a family makes a modest $40,000 a year, the mandate this year is $400. Next year, the penalty is $800, and in 2016, it is $1000. That's $1000 and you have no insurance. Or you could buy coverage on the exchange with a subsidy probably for $1500-$2000 a year. There will be some people who still won't buy it, but that number gets smaller every year.

I don't recall anybody misrepresenting that here.

[Jackpine Radical]

158. For many, they would be hard-pressed to use the insurance

even if it cost nothing, because of the large deductibles and copays. The poorer you are, the lousier the Obamacare plan available to you.

There were times in my life when I couldn't readily afford even minimal health insurance, so I did what poor people often do in those circumstances. I took risks.

[bvar22]

160. I can't speak for the rest of the country,

...but here in rural West-Central Arkansas,
nobody is on TV telling them that this is FREE Health Insurance.

The Arkansas State Government (Republican Majorities) is trying to pass a law making it illegal to advertise the ACA on TV, Radio, or any other media
to keep too many fucking people from finding OUT about it.

Nate Bell, GOP Lawmaker, Wants To Stop Educating Arkansas' Uninsured About Obamacare
http://www.huffingtonpost.com/2014/02/18/nate-bell-health-care_n_4810739.html?utm_hp_ref=politics

If I were the occupant of the White House, or the head of the DNC, DCCC, and DSCC,
I would open the flood gates of Party Money in the South,
for buying huge blocks of TV/Radio time telling citizens in these states to:
1) Go sign up... If you cleared under $50,000K last year, it is probably FREE.

or

2) If you can NOT go sign up for the FREE Health Insurance in your state,
it is because the REPUBLICANS , all of which HAVE Free Insurance,
don't want YOU to have it too, and STILL expect YOU to pay for their Free Health Insurance.

If I were in charge, you would NOT be able to turn on your TV without seeing an ad about FREE Health Insurance sponsored BY "The Democratic Party".
I can NOT think of a better campaign focus for 2016.
I am more than a little upset that the Democratic party is NOT doing this.
WHY????
It is a sure WIN for the Party.

On a personal level, when I talk to people living in this area,
they are completely UNINFORMED about the ACA.
All they have "heard" is the stuff from FOX and those Right Wing E-Mails.
I tell them to go and get you some ObamaCare,
and when you or your kid gets sick,
you can go to the Doctor just like the RICH people do.

[Demeter]

161. Dear Bvar, it isn't FREE

it isn't even cheap. It's basically throwing money away because one will never be able to use it after the copays and deductibles. I'm waiting for the bankruptcy stories...I figure 2 years, but that could be optimistic. It could all come crashing down long before that.

[bvar22]

163. "Enrollment" in the Medicaid Expansion is FREE,

and this thread IS about enrolling for Health Insurance.

There are no Co-Pays, hidden fees, or addition charges for enrolling in the Medicaid Expansion.
The BIG change is that it is now possible to own property and STILL be eligible.
The only eligibility criteria is one's Yearly Income.

For a family of 4, the cut off line for Medicaid eligibility in Arkansas is about the mid 40s range of annual income.
The Median House Hold Income for Arkansas in 2012 was $40K.

Get the picture NOW?

Accessing actual Health CARE may or may not involve a Co-Pay ($10?) for those enrolled in the Medicaid Expansion.
Did I mention that the enrollment is FREE?... and should be Marketed 24/7 by the Democratic Party?

Applying for Health Insurance on The Exchanges is a whole different nightmare.

Note:
Arkansas is one of the few states that opted for a Private/Public Option where applicants for the Medicaid Expansion will be able to choose a private provider.
This produced unnecessary complication in the application process.
Thank Gawd, my wife had the patience to deal with it,
and is now helping others in this area with the application process.

[rhett o rick]

178. I am dumbfounded to understand why the Admin isnt pushing this.

Why arent Congress-Critters pushing this and using it as a campaign item?

[Auntie Bush]

164. because Rush tells then not to and they don't/can't think for themselves.

[Lost_Count]

166. Just to irritate you...

[dsc]

167. why did you quote this article

was Goebels busy?

[democratisphere]

177. NO $$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$

$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$

Plain and Simple.

[tnlefty]

183. We need single payer more than ever

Couldn't agree more!

[Quayblue]

184. I have poor people around me

Hell I'm fucking poor in my eyes. With turmoil I will say I've always been a reader, but I will derail your thread so I won't go there.
poor folks are not even thinking about the penalty, they simply don't know what to do. And they don't have internet and they don't vote and they don't follow politics like we do here.

We need a more efficient outreach program until we reach single payer. We have to deal with what is now and go from there.

[grahamhgreen]

190. The sign up process is long & convoluted. My GF tried to sign up over a few days and wound up

with a medical card that was 'not good for payment'.

[Bartleby73]

200. poor conservatives

would rather be without health care than sign up for "socialism"

[2naSalit]

204. Lest anyone forget...

there are millions of us who have recently lost or are about to loose our UI benefits... And nobody has decided to fix that yet.

Sooo, not having enough money for the most basic needs, and those of us in that situation who also live in a state that refused the medicaid expansion, we're not stupid, we don't have the money - ANY money. No money to pay the rent, or any other bills and many of us don't go to a doctor because we can't afford it. And just because we get sick or injured while poor and uninsured doesn't necessarily automatically mean that we go to the ER either.

And then, for some, there could also be the tracking issue, or the fact that the medical industrial complex has already taken all we are willing to let them have after being ripped off enough. And some of us don't particularly trust the MIC to do anything more than sell us the high-priced drugs that either don't do anything for our health needs but are addictive so that we can't just stop using them, if we start, when we run out of cash...

And all of that probably has nothing to do with hating Obama or listening to Fuxnooz or whomever. But signing up isn't going to help our lives either so... Personally, I'd rather keep the roof over my head and have a bed to sleep in while I do what I've been doing most of my life, take care of myself, and when I fail at that, guess I'll die. It's not like anyone sees much value in my life or willingness to contribute to society. I'm not depressed, it's just reality for me and several million others.

Got insurance, that's nice. I don't see any reason to pay rent on "just in case" I might need surgery or something one day.

[Walk away]

208. Most of the people I meet that qualify for the new Medicaid expansion..

are the housekeepers and other domestic workers at a large condo complex where many of my clients reside. They had absolutely NO PROBLEM signing up and getting covered because they got up off their butts, boarded a bus and went downtown to one of the many centers that help people register. These are the same places that help with navigating the Social Security, Medicare/Medicaid, Family Health systems in every state. Most of these women barely speak English as a second language yet they manage to sign up and they are thrilled.
I don't know what everyone else is doing but there is plenty of help out there.

[Bonx]

216. The only one of my friends eligible, but not signing up (& his wife)

are not doing so because they 1) aren't sick at the moment & 2) would much rather spend their limited $$ on beer, cigs & scratchers.