Obama’s Health Law: Who Was Helped Most

[Scuba]

http://www.nytimes.com/interactive/2014/10/29/upshot/obamacare-who-was-helped-most.html?rref=upshot&abt=0002&abg=1&_r=2

We know that about 10 million more people have insurance coverage this year as a result of the Affordable Care Act. But until now it has been difficult to say much about who was getting that coverage — where they live, their age, their income and other such details.

Now a large set of data — from Enroll America, the group trying to sign up people for the program, and from the data firm Civis Analytics — is allowing a much clearer picture. The data shows that the law has done something rather unusual in the American economy this century: It has pushed back against inequality, essentially redistributing income — in the form of health insurance or insurance subsidies — to many of the groups that have fared poorly over the last few decades.

The biggest winners from the law include people between the ages of 18 and 34; blacks; Hispanics; and people who live in rural areas. The areas with the largest increases in the health insurance rate, for example, include rural Arkansas and Nevada; southern Texas; large swaths of New Mexico, Kentucky and West Virginia; and much of inland California and Oregon.

...

That state boundaries are so prominent in the map attests to the power of state policy in shaping health insurance conditions. The most important factor in predicting whether an American who had no insurance in 2013 signed up this year was whether the state that person lives in expanded its Medicaid program in 2014. (Just consider the contrast between Kentucky, which expanded Medicaid, and Tennessee, which did not.)

The map, which I couldn't paste into this post, is highly illustrative. My state, Wisconsin, appears to be among the worst-served in the nation. Thanks Governer (sic) Walker.

Love the part about how the ACA reduces inequality. The law isn't perfect, but perfection is the enemy of progress. We've made substantial progress under this law.

[joeglow3]

1. Cant even see Illinois or Pennsylvania

[IADEMO2004]

2. and a married self-employed couple in SW Iowa she has cancer he takes care of her.

living on her SS disability and savings. ACA saving over $800/mo. with ACA exchange health insurance. Don't feel like a winner but we have insurance we need. Vote for Democrats

[treestar]

3. People not quite poor enough for Medicaid

But slightly above that. Self employed or with job not good enough to provide a good policy. Anyone whose employer won't provide a policy or provides only a chintzy one.

[freebrew]

15. It doesn't help those with chintzy policies...

if your employer offers anything at all...no supplement.

[treestar]

18. That's a drag

It's because of people afraid of change, who were so worried they had to be placated with keeping what they have. A good next step would be that you can choose the marketplace over your employer's policy. IMO one of the best things we could do it divorce it from employment. Why we have insisted that only employers can provide health insurance is beyond me. It's so stupid. We had that silly reform about how you can take over the payments if you leave your employer!

Employers no longer have loyalty, we are told over and over again we must reinvent ourselves and not depend on lifetime employment with one employer. That's been so since the 80s. Why haven't we divorced health coverage from employment then?

It's like they are saying you don't deserve health care unless employed!

[freebrew]

19. ^^THIS^^

One of the best arguments for universal care.

[redruddyred]

23. and sick people are not employed,

and therefore don't deserve health coverage either.

tho one could've made the same argument with that pre-existing conditions bullshit.

[Doctor_J]

44. you didn't know this?

That probably explains some of the simple-minded swooning over heritage/Gingrich/Romney/Obamacare. Yes we wage slaves are as usual getting clobbered.

[treestar]

55. FFS

Then fight to change it - it was the people who didn't want change. Meanwhile, be happy for people it did help. People above poverty but below having a good plan.

Besides, the idea was you could keep it if you wanted, so I'd like to see the actual law saying you have to settle for your employers plan if you don't want it but would rather get a policy under the ACA.

People praise it as a step, no one praises it on its own. The conservatives and Lieberman made it impossible to get more.

[truedelphi]

4. I am glad that some people will be getting helped.

It offers great peace of mind to have insurance.

However, it is when you actually try and use the insurance, should the need come up, that you may be in for a shock.

A family friend signed up on the California Covered Exchange. Part of why he signed up was the website of the Big Insurer that was on the Exchange had posted photos of doctors he knew and trusted, with bits of blurb suggesting those doctors actually worked on that network.

Then he fell and injured his ankle. None of the doctors who had been presented as being part of his Big Insurer's network really worked for that Big Insurer. For some reason, in California, the Big Insurers can make it seem your doctor is on the network, even if he or she is not. (Several Bay Area TV news stations have covered this travesty, but nothing has been done. Is Senator Boxer in the House? Paging Barbara Boxer.)

In fact, he would have had to travel out of the county to get help, as there was not a single doctor in tht network in his county. But since it was his foot that was hurt, he couldn't handle being on a bus (the stairs up to the seats) nor could he drive. He ended up paying out of pocket.

He lives on a marginal income Had he not had "California Covered," then he would have qualified for either a charity payment of his bills, or else MediCaid. But once you obtain the insurance, you can't have either of those two possibiities help you - you are excluded.

[taught_me_patience]

9. The reason is that the Covered California plans reimburse 30% less than comparable insurance

A 30% loss in revenue can easily mean a 50-75% loss in income. Thus, there are not many doctors willing to take that insurance. The doctors who are taking it are seeing a drop in income. When that doctor's patient panel fills up, you'll find that if you are CC, you'll be at the end of the line to be seen.

[truedelphi]

11. Exactly.

I have found that even on pro-Democratic websites like this one, the biggest enthusiasts of the new ACA provisions are rather wealthy people. I remember one such person telling me how great the ACA is - she and her family had been paying over $ 50K a year, and now they pay only around $ 32 K a year.

It is also helpful for some people who have Corporate-benefits in terms of health insurance.

And of course, I am glad tht someone somewhere is benefitting.

But for everyone else, well, you may not get any service, or your health care service comes after you have sat or stood at the end of the line. Standing or sitting at the end of the line after I have paid out every single penny of disposable income I possess is not my notion of a "decent health insurance situation."

[PasadenaTrudy]

14. Exactly n/t

[Andy823]

5. I couldn't agree more Scuba

"The law isn't perfect, but perfection is the enemy of progress."

Without ACA there would be little hope of actually getting to some kind of a real universal health in this country. It's the foundation to build on, and it will take time, but it will happen someday.

[zipplewrath]

6. Prove it

We heard the same things about Medicare and Medicaid too back in the day. It was only a matter of time before these programs would expand to effectively "everyone". It hasn't happened in 50 years.

Now the insurance companies are in charge. You really think they're gonna give that up?

[area51]

13. +1, thank you for the dose of reality that some on this board need. n/t

[IronLionZion]

22. What was it like before Medicare and Medicaid?

And who gets rich off of Medicare and Medicaid? I suppose in the last 50 years they didn't change these programs at all, no adding parts B, C, or D, no End Stage Renal Disease program, no CHIP for children, no Medicaid expansion, no subsidies, no exchanges, no new nonprofit insurers, just 50 years of government run very slowly and inefficiently with no progress.

You think that message will help move our country towards universal medicare for all?

[zipplewrath]

24. It hasn't for 50+ years

In fact they've RAISED the age of medicare to 67 for people below a certain age. Kinda moving in the wrong direction.

[IronLionZion]

25. So government is slow and inefficient and won't help you?

I've heard that somewhere before.

[zipplewrath]

26. Wow

How ridiculous.

Single payer doesn't come from not passing single payer. Universal doesn't come from trying NOT to pass universal health CARE. Universal health care doesn't come from passing some warmed over GOP proposal that was originally designed by the GOP to avoid single payer/universal health care and instead put the insurance companies in the drivers seat.

And wishing it to be otherwise doesn't change 60+ years of history.

[IronLionZion]

28. Then do something to change it

Forward. not back

[zipplewrath]

29. I'll ask again

What is the political path from here to single payer? What about the ACA makes it anymore possible than prior to the existence of the ACA?

[IronLionZion]

32. The same reason why GOP is not going to take away Medicare or Social Security

As more people benefit, you build a larger constituency of supporters. You think Medicaid isn't single payer? The ACA expanded this to cover millions more. And strengthen Medicare's funding after misguided reforms during Bush that left a gap in coverage. A lot of Democrats lost their elections to bring us that much.

You need enough supporters to elect enough representatives who will vote for it. Whining about the ACA won't get you single payer.

[zipplewrath]

33. That didn't work for Medicare

It didn't work for Medicaid. It didn't work for Schip or WIC, or any of the other alphabet soups. This assertion that some how ACA is going to magically lead to single payer is completely unsupported by history.

[IronLionZion]

35. Medicare and medicaid are single payer

why do those programs exist?

And nothing is magic. What's your plan to get single payer?

[Doctor_J]

37. especially since it INCREASES the presence of big insurance

This is what happens when people fall in love with someone who is supposed to work for them. The middleman multiplication and profit protection act is a travesty. There is no way the insurance industry will ever let it be repealed.

[IronLionZion]

51. So what are you doing about it?

What's your plan to get us single payer?

[zipplewrath]

56. I'm afraid I'm too old

The ACA has soured the country to do anything about it for the better part of 20 years or so. By the time the opportunity comes around again, I'll probably be lucky to be aware, much less alive.

[bornskeptic]

48. Not true. The age to qualify for Medicare is still 65. n/t

[Recursion]

49. BCBS gets very rich off Medicare and especially Medicaid

They do the actual insurance provisioning, and make a killing off of it (the "low overhead" for Medicare and Medicaid just count getting the money from the trust fund to the provisioner, not to the point of delivery).

[IronLionZion]

50. Lots of DUers seem to think Medicare and Medicaid aren't single payer

they somehow assume that hospital systems and HMOs won't get rich off single payer, and they also assume single payer is going to cover lots more things that Medicare/Medicaid don't for some reason. I worry about these DUers, since I actually work in the field and am disgusted by the issues of coverage and reimbursements in these 2 government single payer programs. Both programs have tons of contractors doing various tasks.

Can you imagine medicare for all and some asshole like Bush in the white house with republicans controlling congress and the courts? They'll tell you government is bad for you, and prove it by cutting off funding to these programs.

There is no easy way to control the costs of delivery. That's a painful issue that every country that has implemented single payer does struggle with, including Canada who is culturally as close to America as it gets.

[zipplewrath]

57. And yet we pay 5 times as much as everyone else

We pay more, and get less. Every other country is "controlling the costs" except us.

[Liberal_Stalwart71]

41. The insurance companies are in charge because the Republicans passed Medicare Part B and D, remember

Has nothing to do with the original Medicare/Medicaid laws. The original programs were improved on until they DID help everyone. No thanks to the Republicans, those programs began to become corrupted when the Republicans started raiding and privatizing them. Case in point: Rick Scott--perfect example!

----

And if Republicans take over government again, we can kiss these programs "as we know them" goodbye! If Republicans take over the Senate on Tuesday, I do not believe a Democrat will win the presidency in 2016. Hillary or anyone. I truly believe that.

Republicans will destroy ALL government programs. That's their dying wish...for a dying party!

[IronLionZion]

52. Lots of DUers think Republicans will allow single payer for all

and won't destroy it. They want red state dems to lose on Tuesday as a way to punish the party for allowing red state dems.

[jtuck004]

7. "The health insurers are the most direct beneficiaries of the law" < From the same paper

As long as we know the facts, all the rest of this is just detail.

http://www.nytimes.com/interactive/2014/10/27/us/is-the-affordable-care-act-working.html?_r=0#/outcomes

[Doctor_J]

38. their stock prices are through the roof

And they haven't even sent me a thank you note.

[jtuck004]

40. Ungrateful sleazebags too. n/t

[geardaddy]

8. Self-employed and renal transplant recipient.

I save about $300 a month on my premiums under ACA and the coverage is better.

[bigdarryl]

10. Don't get to happy the stinking Supreme Court

Is thinking about hearing the case on wether people can get the subsidies.If they take the case and usual suspects on the court rule in the favor of the plaintiffs they would mean people receiving Health care would not be able.to afford it

[1monster]

12. Well it didn't help me... but that may be because I'm in Florida.

I'm paying $680.80 a month for two people, my son and myself. The info I was given when I bought the policy was that we each would have a $6,000 deductible and the policy would pay 60% after the deductible was met.

Pretty bad, but I couldn't afford a higher premium. (Got this through the online national ACA program)

A little over a week ago, I received a statement from my insurance company saying that my deductible was $12,000 for in network health care and $25,000 for out of network health care. This was not the info I was given BEFORE I bought the policy. (So far this year, we have met $78 and some odd cents for the out of network care (primary physician for 30 some odd years).

Which means I'm throwing away $680 a month that I cannot afford. (We got an unexpected windfall last year which went to much needed house repairs and a new car to replace the 20 year old car and it meant that we did not qualify for any tax credits).

Did I mention that the last claim I made on my health insurance was over 22 years ago -- and that was for when my son was born.

I'd like to see single payer like Medicare. My husband is on Medicare, and while it is not perfect, it's a heck of a lot better than what I'm getting in the system we have now.

[truedelphi]

16. But you have to admit that now you have insurance!

I mean, before this, did you even have a shiny pretty card sitting in your wallet, reminding you of how you can pay $ 680 a month for nothing!

And unless you can pay around $ 1,100 a month, or have job where the employer is offering a decent plan that they pay half of, I doubt you would do any better than that in many other states. (At least, California is not any better.)

[kelly1mm]

17. Early retireees. My wife and I were able to retire in our 40's due to ACA. Pre ACA, our

insurance would have cost just under $13,000 per year in premiums alone. We were able to structure our income to maximize subsidies and so we end up paying just under $1000 total per year. That $12,000 per year subsidy allows us to retire on our dividends.

[SunSeeker]

20. K & R

[1StrongBlackMan]

21. Wait ...

The biggest winners from the law include people between the ages of 18 and 34; blacks; Hispanics; and people who live in rural areas.

Aren't those the very groups that some on the Left have been claiming President Obama's policy initiatives have done for? ... The young (per DU), Blacks and Hispanics (per West/Smiley) and rural folks (well ... that would be their republican legislators).

Thanks.

[Liberal_Stalwart71]

42. Yep. That's what liberals have been telling us--that Obama is the biggest puppet for Wall Street...

that he is "worse than Bush," that blacks and Hispanics are even worse off than they were under Bush. Yes, it's as if they actually prefer Bush. In fact, they run over to Faux News, shaking hands and laughing with the likes of Bill O'Reilly and Sean Hannity--calling them brothers, all the while they hate our black guts!

But the ONLY thing that unites them is their hatred for President Obama.

Isn't that just sick?

[Doctor_J]

45. do you have a link to someone on du saying he's worse than Bush?

Lying seems to be what unites Fox and the BOG

[Liberal_Stalwart71]

46. I'll give you a few...

Next time, do your own fucking DU research. And don't accuse me of being a LIAR, pretending as if you have NEVER heard people here on DU assert that Obama is WORSE than Bush or say the most egregious things about him. You are being completely dishonest!

Again, next time, do your own search!

http://www.democraticunderground.com/discuss/duboard.php?az=view_all&address=433x404852
http://www.democraticunderground.com/discuss/duboard.php?az=view_all&address=439x821199
http://www.democraticunderground.com/discuss/duboard.php?az=view_all&address=433x392214

http://www.democraticunderground.com/10024606703
http://www.democraticunderground.com/10025726338

By the way, I never visit BOG! I'm not even subscribed to BOG, so put a sock in it, really. You're quite annoying.

Ignoring you for good this time. Enjoy talking to yourself.

[1StrongBlackMan]

54. Strange how ...

supporting a Democratic President (or visiting/being associated with a group dedicated to positive OPs regarding the same) on a message board named DemocraticUnderground has become a purjorative.

Personally, I enoy having the diaper change from time to time.

[Doctor_J]

43. actually the times says that the insurance companies are the biggest winners

Which is exactly what "some on the left" predicted

[Hoyt]

27. It's done a lot for all of us, some directly, some indirectly.

Some may not see it until they lose their job and/or insurance, decide to work for themselves, have a kid with a serious illness, etc.

[Nevada Blue]

30. We weren't helped by it here

We're retired but slightly too young for Medicare.

Our rates for the two of us were astronomical and so we've opted to cover ourselves again this year and pay the penalty tax.

If we lived about 10 miles to the west (over the state line) rates would have been very affordable.

Not an equitable system, though I'm happy for those that it did help. No good for us, though - we're too old and not poor enough to get decent rates.

[YoungDemCA]

31. Having a Governor who was willing to accept the Medicaid expansion made all the difference

This is why electoral politics does matter.

[Doctor_J]

36. we made no progress. in fact we moved awa from actual health care. maybe one

of the fan club can help me. My annual take home pay is about $35k. Until this year my annual out of pocket in my employer provided plan was $500 for me and spouse. This year it's $8300 and will increase again next year. From whom do you think that big insurance is getting their guaranteed half trillion dollars per year in profits? And I have to spend hours on paper work and the phone to make sure they don't cheat me.

This law sucks, and we're now stuck with it forever. Some things and people make it embarrassing to be a democrat.

[Hoyt]

47. Sounds to me like your employer screwed you and blamed Obamacare.

[BubbaFett]

53. I've noticed lately

that if you make between 35k and 100k in this country, the government seems to think you are rich.

We're like a big fucking ATM to the 1%.

[Liberal_Stalwart71]

39. Scuba, you and I have gone head to head, but I appreciate this post. Thank you so much.