OBAMA: "No longer will you be without health insurance, even if you lose your job or change jobs"

[kpete]

THE WHITE HOUSE

Office of the Press Secretary
For Immediate Release
July 18, 2009

WEEKLY ADDRESS: President Obama Says Health Care Reform Cannot Wait


First, the same folks who controlled the White House and Congress for the past eight years as we ran up record deficits will argue – believe it or not – that health reform will lead to record deficits. That’s simply not true. Our proposals cut hundreds of billions of dollars in unnecessary spending and unwarranted giveaways to insurance companies in Medicare and Medicaid. They change incentives so providers will give patients the best care, not just the most expensive care, which will mean big savings over time. And we have urged Congress to include a proposal for a standing commission of doctors and medical experts to oversee cost-saving measures.

...............

Finally, opponents of health reform warn that this is all some big plot for socialized medicine or government-run health care with long lines and rationed care. That’s not true either. I don’t believe that government can or should run health care. But I also don’t think insurance companies should have free reign to do as they please.

That’s why any plan I sign must include an insurance exchange: a one-stop shopping marketplace where you can compare the benefits, cost and track records of a variety of plans – including a public option to increase competition and keep insurance companies honest – and choose what’s best for your family. And that’s why we’ll put an end to the worst practices of the insurance industry: no more yearly caps or lifetime caps; no more denying people care because of pre-existing conditions; and no more dropping people from a plan when they get too sick. No longer will you be without health insurance, even if you lose your job or change jobs.

more:
http://www.whitehouse.gov/the_press_office/Weekly-Address-President-Obama-Says-Health-Care-Reform-Cannot-Wait/

Video:
http://www.youtube.com/watch?v=83FvLjsUOJg

[Eric J in MN]

1. Is the idea that someone who gets insurance through his job and gets fired...

...would sign up for the public plan, and then when he gets another job which provides insurance, drop out of the public plan?

[Hutzpa]

4. You guys need to pay more attention

to what the President says, you find a plan you like you keep it irregardless of job change
how difficult is that to understand(?)

:banghead:

[Eric J in MN]

8. So the private insurance company would be obligated to sell you their insurance after you got fired

...which you had been getting through your job?

[backscatter712]

11. Yes, and under the new bill, if you lose your job and collecting unemployment, you get subsidized.

Subsidies go up to 4x FPL, and would drop your health insurance costs to sane levels - double-digits for a person like me on unemployment, if my back-of-the-napkin estimates are correct.

No, health care isn't free, but it's a hell of a lot more affordable under this bill.

[enlightenment]

19. Insurance. Health insurance would be more affordable.

What sort of care the insurance covers is another element of the issue.

[ibegurpard]

36. No INSURANCE might be more affordable

who knows what the actual cost of healthcare is...insurance/pharmaceutical company and provider tug-of war has ballooned healthcare costs to insane heights.
Any actual HEALTHCARE PRICE CONTROLS in these insurance company bills?
Other than the market-based model "exchange" which is supposed to allow compettion to keep the price down?

[Hutzpa]

12. You get the government option

if you don't want your previous plan from your previous job.

[cascadiance]

20. I've already picked my old plan for COBRA...

... which I get free for a while and then pay a third of the rate for a while before it kicks in at around $500 / month. And I have a procedure that I may or may not want to have happen where I will get it 80% covered if I go through with it now with my current plan. I don't NEED to do it now, and it has a slight chance of complications, but should I do it now if:

1) In the future I have a job with NO insurance...
2) In the future I have a job but insurance doesn't like this "pre-existing" condition.
3) In the future I have a job that has an insurance plan looks at my urologist as being "in-network" instead of out of network and actually covers it BETTER than 80%.
4) Somehow this public option plan kicks in and then:
- can I switch to this option from being under COBRA now?
- what limitations are under this option that I don't have with my current plan?
- would it cost more or less to be covered with this newer plan?
- would it complicate coverage of this procedure?
5) Perhaps go back to what I and my plan had felt was recommended approach which was to hold off and not do this procedure, and wait to see if I need separate procedures if and when stones don't pass through my system normally.

And then, if I do go through this procedure, when should I do it, to minimize the effect it has on me in looking for newer jobs and other things I have to do with my life during my "transition times".

With this being argued out now, and many of us without jobs and health conditions NOW, this is really making things complicated to plan for now! If congress could get their act together and get something passed soon, that would deliver decent and well spelled out public option/single payer coverage, then I might look to factor that in. But for now, it seems only like a distant possibility at this time that I can't plan for. I have a feeling many people like me are in the same boat and perhaps worse off when they have more serious ailments like cancer, etc.

If this public option were available within the next few months, and it's as good as my current insurance plan under COBRA or likely as good as any I might get with a full time job, I might be more apt to look at contract jobs too to work on in the interim, instead of waiting for a good full time opening. That might also help others too with similar situations and getting the unemployment numbers down by doing so. Though perhaps that might be an incentive for employers to offer just contract jobs moreso now too, if they figure they can get more people to fill those that might otherwise wait for full time openings to be available. So perhaps congress should look at the same time for ways to incentivize American industry to do more full time employment of domestic workers rather than contract work (which they tend to abuse more).

I think I heard Obama say something like, at present the current plan doesn't provide public options to those already working for big companies that provide an insurance plan to all of its employees, though it sounded rather nebulous if those plans had bigger copays, etc. How that would affect COBRA options, etc. didn't seem to be clear.

[lumberjack_jeff]

31. No. Hold on.

This is a complicated subject, but here goes;
Joe gets fired from his company. He has the option of using COBRA to purchase the coverage he had, or he can purchase insurance from the exchange. Since insurers are prohibited from excluding people with preexisting conditions, and since the exchange will give you affordability credits to purchase insurance from them, there is little reason to use COBRA.

Since Joe is unemployed, his income is probably far below the upper threshold of subsidy. (Effectively) Joe's premiums will be set on a sliding scale based on his income, (the bill describes this process as a subsidy, credits offsetting his premiums above a percentage of his income) and he will have an upper limit of annual costs.

When he goes back to work, he can keep his existing policy, or he can accept the one from his new employer. Since the bill requires employers to offer plans which meet minimum quality and service criteria, and since employers are required to pay for something like 65%- 75% of the minimum conforming plan's premiums, it will usually make more sense to opt into the employer's plan.

[blondeatlast]

44. I'm liking this--it sounds like it will allow me to get out of my miserable marriage.

I have insulin-dependent diabetes and he is working overseas and living with his new girl. He's agreed to no divorce untiul I can get my own health coverage.

I want out so desperately but jobs are so very scarce that it looks like a year or more before I can get out. I'm really desperate. I want single-payer and have been advocating it for a decade, but right now I just nrrd some affordable coverage.

[lumberjack_jeff]

45. The biggest problem with the bill is the fact that it doesnt take effect until 2013. n/t

[blondeatlast]

64. Ouch. I'll keep my head up and hope the job prospects improve.

Since I am going after paralegal cert, my prospects are likely to improve greatly once the economy heats up.

[Honeycombe8]

54. You could stop the public plan and go to new employer's plan, if you want.

I don't see why not.

[lumberjack_jeff]

24. When you get rehired, you have the option of taking the new job's plan

or keeping your public plan.

As the law is right now, there's usually not a good reason to reject the employer plan because, with the new mandates on employers their plan would meet quality standards and usually be cheaper to you.

Ron Wyden has offered an amendment which requires employers to offer workers a voucher allowing them to purchase a standalone plan from the exchange in lieu of the insurance offered.

[cascadiance]

30. If the public option were properly done it shouldn't cost anything, and would ALWAYS be cheaper!

That is the potential problem where one continually gets "locked in" with something that's more expensive. If the public option does cost more than a new job's insurance plan, but that newer insurance plan says, "Oops, but you have a pre-existing condition. Sorry, but you need to take a hike!", then you're stuck with a "more expensive" public option plan that hasn't been properly priced to truly be a decent option for universal care.

And then insurance companies will have less pressure to take on the more expensive members into their plans, and those with bigger problems with health care conditions would get dumped into the public plan, making it look like it costs a lot more to implement (to help justify tearing it down later).

It's kind of like measuring the effectiveness of public school (which must take everyone) versus private schools, who are more selective, and arguably take kids with parents that care more about their kids' education, since they are willing to pay extra for it.

[lumberjack_jeff]

34. Excluding pre existing conditions is outlawed by this bill.

The exchange doesn't allow insurers to cherry pick.

It is my understanding that every insurer who participates in the exchange must take any customer who comes to the plan seeking coverage. It is only unclear to me if insurers can charge different rates based on actuarial criteria (age, etc.)

[SpartanDem]

52. Rates can vary by age, area and family enrollment

all other variance are not allowed accroding sec 113 of the bill.

(a) IN GENERAL.—The premium rate charged for an
3 insured qualified health benefits plan may not vary except
4 as follows:
5 (1) LIMITED AGE VARIATION PERMITTED.—By
6 age (within such age categories as the Commissioner
7 shall specify) so long as the ratio of the highest such
8 premium to the lowest such premium does not ex9
ceed the ratio of 2 to 1.

(2) BY AREA.—By premium rating area (as
11 permitted by State insurance regulators or, in the
12 case of Exchange-participating health benefits plans,
13 as specified by the Commissioner in consultation
14 with such regulators).

15 (3) BY FAMILY ENROLLMENT.—By family en16
rollment (such as variations within categories and
17 compositions of families) so long as the ratio of the
18 premium for family enrollment (or enrollments) to
19 the premium for individual enrollment is uniform, as
20 specified under State law and consistent with rules
21 of the Commissioner.

[lumberjack_jeff]

60. Thanks for doing the heavy lifting.

a 1000 page bill is intimidating. :hi:

[cascadiance]

57. Can they still charge deductibles or only cover a percentage of some hospital procedures...

that can be more if you are "out of network"?

Unless they get rid of all of these restrictions, then it really isn't an equal set of options... And I'm wondering how these insurers will compete without trying to gouge you someplace else (if they can't limit things like pre-existing conditions).

[lumberjack_jeff]

62. In the lower tier plans, there are still co-pays.

... and I just explained the status of pre-existing conditions. If you're disinclined to believe me when I tell you once, why ask me again?

[dflprincess]

67. Yes - only now out-of-pocket with be called "cost sharing"

It's defined on page 8 of the bill:

COST-SHARING.—The term ‘‘cost-sharing’’ includes deductibles, coinsurance, co payments, and similar charges but does NOT include premiums or any network payment differential for covered services or spending for non-covered services.

http://docs.house.gov/edlabor/AAHCA-BillText-071409.pdf

this is where the $5,000 (single) and $10,000 (family) numbers come in. If you're single and make more than $43,000 (gross) you will be expected to pay a premium (or share the premium cost with your employer) plus up to $5,000 for covered services (more if there are any uncovered services). This is not unlike a plan many employers currently have and evidence shows that when out of pocket expenses get this high, costs go up because people are still hesitant to go to a doctor until they absolutely have to. High copays and deductibles usually result in higher ER & inpatient costs as more people wind up admitted to the hospital and stay longer.

[Coyote_Bandit]

2. "...just as long as you make your mandated premium payments...."

Subsidized premiums are worthless to those who cannot afford to make their portion of the premium payments. And there are millions of those folks. We'd rather forget about them though. Not pretty to consider the millions of hungry, food insecure and homeless among us who are being put in an even worse position.

[Hydra]

16. Yup

I can't afford even another $15 going out the door right now per month. That's why I'm uninsured.

As always, wait and see before I judge.

[WI_DEM]

27. did he actually say that?

[Bill McBlueState]

3. nice in theory

But when someone loses a job, how much of a lag will there be between the end of the employer coverage and the beginning of the public coverage?

When my private coverage ended in Massachusetts, there was a two-month period of administrative back-and-forth before I could get into MassHealth. MassHealth required evidence that my private coverage had actually ended before they would even consider my application.

This kind of thing is my main concern about a hybrid public/private system.

[Hutzpa]

5. You keep your health plan if you lose your job n/t

[KittyWampus]

6. HELLO! If I'm sick I want health CARE not fucking health insurance.

[SammyWinstonJack]

7. +1

:thumbsup:

[Curtland1015]

9. What?

What does that even mean?

[Fumesucker]

10. Health care means that you will be appropriately treated for whatever ails you..

By the proper medical personnel.

Health insurance on the other hand means that some entity may or may not pay for you to be appropriately treated as above.

Without 100% guaranteed payment you have no guarantee that you will be appropriately treated for whatever ailments you may have.

[stray cat]

13. You get health care from medical professionals - what you also need is a way for someone to pay

health care usually costs money for supplies, tests and doctors, nurses etc. - so there has to be a way to pay and can not be achieved without some source of funds.

[RaleighNCDUer]

17. And that is why more rational societies invented single-payer. nt

[nebenaube]

25. No doubt...

Single payer reduces the overhead of the provider, moves paper pushers into more productive work and opens the field to more care providers entering the field. You don't need to do back flips to get claims reimbursed. The level of complexity in this bill is just ridiculous.

[dflprincess]

68. +1

[Hepburn]

15. +1....exactly. n/t

[liberalhistorian]

18. Amen! We need health CARE reform, NOT

"insurance" reform. Insurance companies are a large part of the reason we're even in this mess. Having insurance does NOT guarantee coverage or care, not at all, especially if you have a major or chronic illness. And mandatory insurance is NOT REFORM.

[kath]

39. +100

[Frank Booth]

26. Well, then move to the UK.

We're not going to get single payer in this country in the foreseeable future.

Obama's trying to change a system of built-in greed that's been established over decades, against a minority party that will do anything to see him fail and a substantial portion of the majority party that's willing to help them. The insurance industry and their representatives still have control over the process. It will be a major victory if legislation with any effective public option is passed.

[ibegurpard]

29. Would that it were that easy

I'm sure the UK is handing out visas right and left to Americans unhappy with healthcare in this country.
:eyes:

[Frank Booth]

37. It's less ridiculous than demanding single payer or bust,

cuz no matter how much we whine, we ain't getting single payer.

[ibegurpard]

40. nice to know you consider it whining

enjoy your insurance company written shit bill.

[Frank Booth]

48. If there's 0% chance we'll get single payer, but those who want it won't support a plan

with an effective public option, yes I consider it senseless whining.

[ibegurpard]

49. There's a bill with an effective public option?

sorry, haven't seen that one yet.

[Frank Booth]

51. Not yet, but there's a chance that there will be.

And I'll take a step in the right direction over a "principled" stand with the status quo any day.

[Raineyb]

63. Where the chance is certainly 0% if you don't bother to try to insist on it

Perhaps you'd be more comfortable in a totalitarian system where you just take what's given without bothering to fight for more.

[ipaint]

65. I haven't seen a plan with an effective public option.

The public option offered so far has no cost controls on the for profit medical industry. Nor does it include enough people to give it bargaining power or even a slight chance of effectively competing on a fair playing field.

[Deja Q]

61. Insurance pays for the care, but the care needs to be controlled too...

That $20 aspirin when I could just as well smuggle in a friggin' case of it from Sham's Club and get only 3600x the quantity for the same price... that's asinine and out of control.

[Bluenorthwest]

14. But how much will it cost?

And is my family to be treated as strangers to each other, each judged by our individual incomes, or as a household, a family? Who decides? Do we have 'an income' as we actually do, or will they insist that I have one and he has another? Will we be a family when is serves the Government, and strangers when it serves them for us to be strangers?
No one is saying a word about any of this stuff. When. How much do we have to pay. And how unfair will the treatment be that heterosexuals will insist upon for their GLBT neighbors and family members?
The more advance the notice, the better the chances we can survive this new burden. We will have to forgo all dentistry, which is what is most pressing, to pay this mandated coverage. Frightened.

[xchrom]

21. well i'm glad to see insurance companies making out in an economy where the rest of us

are subject to job losses at something like half a mil a month.

this is fuckin NUTS.

[kestrel91316]

22. I hate to tell you this, but I don't want health "insurance". I want a

guarantee of health CARE.

[ibegurpard]

23. yes

sorry, but I'm not interested in keeping our broken system.
Insurance companies are a BIG part of the problem.

[OmmmSweetOmmm]

28. +2!

[niceypoo]

32. I have insurance, but I am underinsured

And next year our benefits will be cut in half......again. What does this do for me, if anything?

[lumberjack_jeff]

42. The bill creates three tiers of service level.

and describes what is offered in each tier. The lowest tier is still pretty good coverage.

Employers will be required to pay 65-75% of the cost of insurance conforming to the lowest tier.

[Lorien]

47. I'm self employed and without work

so I see no benefit with this plan.

[lumberjack_jeff]

58. If your income is below 133% of FPL, your coverage is free.

I feel like I'm playing whack-a-mole.

[Kansas Wyatt]

33. Obama & the Democratic Congress have already BLOWN it.

Their FAILURE was due to:
Their thinking that you could negotiate this country's Health Care with the Insurance Industry. "Insurance" does NOTHING for Health Care. It NEVER has and NEVER will, and in fact, hinders Health Care. If you are looking to improve anyone's Health Care, you must first pry off the parasite that is sucking the life out of that person... Which would be the Insurance Industry.

Jesus Fucking H Christ... It doesn't require very much intelligence to figure out that a for profit Insurance Industry will never do anything beneficial for anyone's Health Care. Yet we are to believe, that we finally have the more "intelligent" Party running Congress and the White House. I call it for what it is... Bullshit!

[kath]

43. That's right - pry off the parasites and kill 'em dead - it's way past time for them to go.

All the proposed plans I've seen are just insurance co. protection rackets. they suck.

[shadowknows69]

35. How about if you just haven't had a job for like five years

Except for your own failed small business? Any bones being thrown our way yet? How many corporations today actually provide decent health insurance these days? Certainly none of the ones my friends have worked for. Why would you just want to trade shit for shit, or just be able to keep your shit?

[lumberjack_jeff]

38. The house bill forces large (over 20 employees) to provide good insurance...

... and to pay most of the cost.

Those of us who make more than 133% of FPL and are self-employed, or employed by small non-profits, or unemployed can get subsidized coverage.

[shadowknows69]

41. Cool. Too cynical to be hopeful until I get an official letter lol.

[Lorien]

46. I don't want insurance. Insurance is what stands between the patient and

their doctor/ treatment. Single payer is the only ethical way to go here. Save billions and save lives; CUT OUT THE MIDDLE MAN!

[Better Believe It]

50. President Obama's statement indicating you or your employer can choose the public option is false

Reply #20

http://www.democraticunderground.com/discuss/duboard.php?az=view_all&address=132x8534596#8534777

[Hutzpa]

53. You're either here working

for some organization or deliberately trying to mislead folks, your blatant description of the President misleading us, is in it self misleading, you sure do sounded like someone desperate
for attention.

[ibegurpard]

55. read the bills

He is correct

[Better Believe It]

56. Read the bill. Facts are facts. Do you want me to present the hard facts in this string?

I can do that if you'd rather not check out the link.

What would you like me to do?

[lumberjack_jeff]

59. It is the intent of the bill that employers be allowed to eventually participate in the exchange.

Employers of over 20 employees will undoubtedly particpate at some point. The problem is that something needs to be done to prevent large employers with oppressive healthcare costs from simply dumping their problems on the public all at once. Opening the exchange up to big employers incrementally is good policy.

[Wednesdays]

66. K&R

:kick:

[eridani]

69. Fuck insurance. What about CARE?

What is your recourse if your insurance company denies your claims?

[strategery blunder]

70. +1

The ONLY reason why a health insurance company should EVER deny a claim is because it is prepared to prove fraud in a court of law.

Fuck arbitrary denials.