“Anyone who calls the Affordable Care Act (ACA), Obamacare, is trying to deceive you or is deceived themselves. The ACA was written by Corporations for Corporations, Period! It’s Corporatecare…not Obamacare!” – T.D.P. Admin.
“The ACA wasn’t written to fix a broken system – it was written to ensure that the broken system would be kept in place!”
In all, 1,750 corporations or other groups reported lobbying on health care reform legislation at some point during 2009. That is, 11 percent of all groups that lobbied the federal government last year lobbied on health care reform
These groups include: the American Wind Energy Association, Comcast, Qwest Communications, Yahoo!, the Gap, the National Rifle Association, Northrop Grumman, Raytheon, the Knights of Columbus, the Professional Golfers Association of America, the office of the governor of Indiana, 1-800 Contacts and Hormel Foods […]
NOTE: All Web Pages with complete or partial Corporate Lobby Lists for the ACA have been removed from the internet. This small sampling and (2) other Corporations, were all that we could find. – T.D.P. Admin.
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Obamacare or Corporate-care: The Writing of the Affordable Care Act
The Obama administration presented the Affordable Care Act (ACA) as a victory for health care over the corporations and their profits. In fact, not only does the ACA maintain the profits of the big insurance and drug companies, but it was written for the Obama administration with the help of these very same companies.
If the goal of health care is to keep people healthy, the health care system in this country is broken. Forty-six million people, 15.4 percent of the country, have no medical coverage. For those who are currently working, one in five have no insurance. The U.S. spends over $7,000 per year per person on health care, nearly double what Canada, Austria, or France spend with their national health care plans. All that extra money isn’t going towards better care but towards the profits of companies in the health care industry.
The ACA was written to supposedly address this crisis, not by changing it, but by making it a law, ensuring even more profits for the health care industry, which spent over 380 million dollars to support the ACA. The health care companies have always been against any sort of national plan, or a “public option” in which tax dollars would pay for a basic health insurance program because any program like that would eliminate the privately-run health insurance programs and the billions of dollars in profits they create for the health care companies.
In the 1993, the Clinton administration proposed a health care reform bill similar to the ACA in that it required bosses to provide some sort of minimum coverage to their workforce, but it also proposed to increase funding to cover people who were too poor to afford insurance. But this was shot down by the pressure of the big health care companies because they claimed it regulated too much their ability to charge outrageous prices. Out of this debate, a proposal emerged from the right wing think tank, the Heritage Foundation: rather than increasing public funds for health insurance, individuals should be required by law to buy insurance. The insurance would be subject to minor regulations, but the health care companies profits would be further guaranteed.
In 2008, the Obama administration wrote the ACA in collaboration with all the major players in the health care industry, the drug and insurance companies, the major hospital chains, and lobbyists representing the largest employers in the country.
Essentially the bill is the same as the Heritage Foundation plan from the 1990s. Under the ACA, all individuals must either buy insurance, get it from their employer or pay a fine every year. Health care companies will be able to make billions more off of the millions of people who will now be forced to buy health insurance. The original plan proposed a so-called “public option” plan to compete with private insurance plans. But quickly the public plan was eliminated to protect the private insurance companies from competition. The ACA also imposed no price controls on prescription medications, guaranteeing that drug companies could continue to charge outrageous prices for prescription drugs.
Essentially, the ACA was designed to write the for-profit health care system into law, increase corporate profits, and to discourage people from demanding a health care system that would actually provide real health care coverage for all. The ACA wasn’t written to fix a broken system – it was written to ensure that the broken system would be kept in place. After all, from the standpoint of the health care industry, the system is working just fine for their profits.
SOURCE:
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Medical Debt: A Weapon of Class War
The price of for-profit medical care is increasing at a relentless pace while quality is declining. Fifty million people have no insurance and 77 million have trouble paying medical bills (Rukavina). Despite these inequities, the US spends more on care than any other wealthy country in the world. The for-profit health care industry sucks up 18% of Gross Domestic Product, more than twice what countries that have publicly-financed health care spend. Despite the high cost, Americans are sicker and die earlier than people in other developed nations (“Shorter Lives”).
People without insurance must privately finance health care. Less well understood, however, is that medical debt is not only a problem for those without coverage. One in five adults who are privately insured struggles to pay medical bills. Even more scandalous is the fact that Americans are paying more for weaker coverage (“Shorter Lives”). According to the Commonwealth Fund, the cost of insurance has outpaced wage increases for the last ten years. Employers are shifting these costs to employees and their families. Premiums increased 62% from 2003 to 2011 (“State Trends”). For at least ten million Americans, deductibles are so high that their insurance plans are little more than scams, providing a false sense of security in hard times (Young).
Medical Debt and Bankruptcy: The Insurance Hoax
Bankruptcy is often presumed to be the result of profligate living by consumers who overspent on luxury items. Don’t live beyond your means is common advice, as if personal responsibility is the only thing that matters in an economy that almost collapsed only 5 years ago. In fact, people are being forced into bankruptcy in America because they had the audacity to get sick without millions of dollars in the bank. Or, they believed their private health plan would protect them from the worst. By the time many realize that for-profit health care is a hoax, it’s too late. The crisis is gaining steam. Just 30 years ago, debtors rarely filed for bankruptcy as a result of a medical problem. Today, an astonishing 62% of personal bankruptcies are linked to medical debt.
The link between medical debt and bankruptcy also shatters the myth of personal responsibility that makes many of us feel as if we are to blame if we can’t afford basic needs. According to a report in the American Journal of Medicine, most people who declare bankruptcy as a result of medical debt had insurance at the time they incurred the debt (Himmelstein). Furthermore, the majority of medical debtors who declared bankruptcy attended college, owned their own home, and had middle-class jobs. They did everything “right,” yet they were still financially devastated when a member of their family got sick or had an accident.
Won’t Obama’s Affordable Care Act Reduce Medical Debt?
The fact that many liberals greeted the passage of the Obama administration’s health reform law with such delight is downright shocking when we consider its glaring inadequacies. In 2014, states will be required to create exchanges in which people can purchase private insurance. But, as PNHP physician Margaret Flowers has explained, the majority of these plans will not offer full coverage. And people who purchase insurance through an exchange will end up with plans that cover 70% or less of the cost of health care. Since even a short hospital stay can cost tens of thousands of dollars, the math is not on the side of people who don’t already have huge bank accounts. Insurance companies profit by denying coverage. Now, thanks to the Affordable Care Act, that strategy will be codified into law. Insurance companies will also gain access to a whole new market for their products while offering worthless umbrellas in return.
It gets worse. The federal subsidy that is supposed to help people purchase health insurance under the new law only applies to individuals, not families. So, depending on your income level, if you want to purchase coverage through an exchange, you’ll be left with two options: pay market rate for private insurance or go without. The people who will benefit from an expansion of our market-based insurance system are not patients. Instead, the 1%, who already control the profit-driven health care system, will get a payout every time the rest of us see a doctor. Most appalling, however, is that more than 20 million people will not be covered under the new law (Babcock).
Life or Debt?
For-profit health care kills.
It’s not your fault if you’re in debt and it’s particularly not your fault if you’re in debt because of a medical problem. This is unfair. No other developed nation forces people to go into debt because they get sick (“Time To End”).
The situation we face is not our fault, but it’s our job to take a stand together. The only real solution is a bottom-up, grassroots movement that puts people before profits. It will not be given to us by benefactors or by politicians who depend on Wall Street funding for reelection. It’s up to us. The time is now. It’s life or debt.
SOURCE – Read Entire Article/Post Here: [ strikedebt.org/medicaldebtreport/ ]
Types of Debt (2013)
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Affordable Care Act (ACA):
A.C.A. BASIC(S): Deductions / Maximum Insurance Coverage / Monthly Premiums
BRONZE: Ded.: $5,000 / Max. Ins Cov.: 60% / Prem.: $110 p/m
SILVER: Ded.: $2,900-$2,000 / Max. Ins Cov.: 70% / Prem.: $177 p/m
GOLD: Ded.: $2,000-Or Less / Max. Ins Cov.: 80% / Prem.: Age 30/$336 Age 40/$378 Age 50/$525 Age 60/$801
PLATINUM: Ded.: $243 / Max. Ins Cov.: 90% / Prem.: Age 30/$345 Age 40/$388 Age 50/$543 Age 60/$825 p/m
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WHAT’S THE DIFFERENCE BETWEEN BRONZE, SILVER, GOLD And PLATINUM PLAN’S?
Who is this for?
If you’re shopping for your own health coverage, this will help you compare your options by explaining what makes each metal tier unique.
To make shopping for health insurance easier, plans you purchase for you and your family are divided into metal tiers: bronze, silver, gold and platinum. We all know gold costs more than silver, and silver costs more than bronze.
But when it comes to health plans, metal tiers tell you more than just price.
Coverage and costs
The Affordable Care Act requires each metal tier to cover a certain percentage of your health care costs.
* Bronze plans cover about 60 percent
** Silver plans cover about 70 percent, unless you’re eligible for cost sharing reduction. We explain what this is below.
*** Gold plans cover about 80 percent
**** Platinum plans cover about 90 percent
What does that mean for you? If you choose a bronze plan, overall you’ll pay about 40 percent of your health care costs, and your insurance company will pay about 60 percent. If you choose a gold plan, overall you’ll pay about 20 percent, and your insurance company will pay about 80 percent.
Silver plans are a little different. You may be eligible for a cost sharing reduction subsidy. Depending on your income, this subsidy means you could qualify for a silver plan that covers about 73, 87 or 94 percent of your health care costs.
* Payments and out-of-pocket costs
Metal tiers will also give you a general idea about monthly payments and out-of-pocket costs, like deductibles and copays.
* Bronze plans: lower monthly payments, but higher out-of-pocket costs.
** Silver plans: monthly payments lower than a gold plan, but more than bronze. Your out-of-pocket costs will be less than a bronze plan, but more than a gold plan, unless you’re eligible for cost sharing reduction.
*** Gold plans: higher monthly payments, but lower out-of-pocket costs.
**** Platinum plans: highest monthly payments, lowest out-of-pocket costs.
The Advanced Premium Tax Credit subsidy can lower your monthly payment. If you’re eligible, you can apply it to any bronze, silver, gold or platinum plan.
Metal tiers and HSAs
Another way metal tiers differ from each other is whether they pair with an HSA, or health savings account. An HSA is a bank account you use to pay medical expenses. You can save on taxes with an HSA because the money you put in and take out is tax-free or tax-deductible. These plans pair with an HSA:
Blue Cross® Partnered, Select, Preferred and Premier Bronze
Blue Cross® Premier Silver
Blue Cross® Silver, a Multi-State Plan
[ www.bcbsm.com/index/health-insurance-help ]
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HealthCare.gov (U.S.)
FEES/PENALTIES
The fee you pay if you don’t have health coverage
If you can afford health insurance but choose not to buy it, you must have a health coverage exemption or pay a fee. (The fee is sometimes called the “penalty,” “fine,” “individual responsibility payment,” or “individual mandate.”)
* The fee for not having coverage in 2015
If you don’t have coverage in 2015, you’ll pay the higher of these two amounts:
2% of your yearly household income. (Only the amount of income above the tax filing threshold, about $10,150 for an individual, is used to calculate the penalty.) The maximum penalty is the national average premium for a bronze plan.
$325 per person for the year ($162.50 per child under 18). The maximum penalty per family using this method is $975.
The fee for not having coverage in 2014
If you didn’t have coverage in 2014, you’ll pay the higher of these two amounts:
1% of your yearly household income. (Only the amount of income above the tax filing threshold, about $10,150 for an individual, is used to calculate the penalty.) The maximum penalty is the national average premium for a bronze plan.
$95 per person for the year ($47.50 per child under 18). The maximum penalty per family using this method is $285.
* DO YOU OWE THE FEE FOR NOT HAVING COVERAGE IN 2014? YOU MAY STILL BE ABLE TO ENROLL IN 2015 COVERAGE IF:
You didn’t know until after Open Enrollment ended on February 15, 2015 that the health care law required you and your household to have health coverage, or you didn’t understand how the requirement would impact you and your household
You owe the fee for not having coverage for one or more months in 2014
You aren’t already enrolled in 2015 coverage through the Health Insurance Marketplace or outside the Marketplace
If all of these apply to you, you can enroll in a 2015 plan between March 15 and April 30, 2015. Select the button below to apply for coverage with this Special Enrollment Period.
* The fee in future years
If you don’t have coverage in 2016, you’ll pay the higher of these two amounts:
2.5% of your yearly household income
$695 per person ($347.50 per child under 18)
In future years, the fee is adjusted for inflation.
SOURCE: [ www.healthcare.gov/fees-exemptions/fee-for-not-being-covered/ ]
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11 STATISTICS ON AVERAGE HOSPITAL COSTS PER STAY
Written by Bob Herman | December 12, 2013
In 2011, hospital stays cost a cumulative $387.3 billion, which averages out to about $10,000 per stay, according to a new statistical brief from the Agency for Healthcare Research and Quality.
AHRQ’s Healthcare Cost and Utilization Project has issued several reports breaking down the costs and finances of the country’s healthcare system. The most recent brief breaks down costs for U.S. hospital stays in 2011.
Here are 11 statistics on average hospital costs per stay in 2011, based on the AHRQ and HCUP statistical brief.
Mean hospital cost per stay by age
85 or older: $9,900
65 to 84: $12,600
45 to 64: $12,500
18 to 44: $7,400
1 to 17: $8,400
Younger than 1: $4,500
Mean hospital cost per stay by payer
Medicare: $11,900
Medicaid: $8,000
Private insurance: $9,200
Uninsured: $8,300
Other: $10,700
http://www.beckershospitalreview.com/finance/11-statistics-on-average-hospital-costs-per-stay.html
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SILVER PLAN:
Enter Information About Your Household
1.Select a State: [Maryland]
2.Enter income as: [$ Dollars]
3.Enter annual income: [$44,000 Dollars]
4.Is coverage available from your or your spouse’s job??: [No]
5.Number of people in family?: [1]
6.Number of adults (21 to 64) enrolling in Marketplace coverage? [1]
Age? [52] Uses Tobacco? [?]
7.Number of children (20 and younger) enrolling in Marketplace coverage: [0]
Results:
You are likely eligible for financial help:
Based on the information you provided, your income is equal to 377% of the poverty level. This means you are likely eligible for financial help through the Health Insurance Marketplace. An estimate of your cost for coverage and amount of financial help in 2015 are provided below. To find out your actual amount of financial help and to get coverage, you must go to Healthcare.gov or your state’s Health Insurance Marketplace.
Estimated financial help: $0 per month ($0 per year)
as a premium tax credit. This covers 0% of the monthly costs. (Although your income would qualify you for help, insurance premiums in your area may not be expensive enough for this help to kick in. For more information, see the FAQ). Your cost for a silver plan: $177 per month ($2,125 per year)
in premiums (which equals 4.83% of your household income). The most you have to pay for a silver plan: 9.56% of income for the second-lowest cost silver plan Without financial help, your silver plan would cost: $177 per month ($2,125 per year)
OTHER LEVELS OF COVERAGE
The costs above are for a silver plan in your area. Silver plans are one of four levels of coverage that you can buy with financial help. These levels – bronze, silver, gold, and platinum – tell you about how much financial protection the plan will offer you if you get sick. Bronze plans have the lowest monthly costs, but when you need medical care, you will pay more for your care. Gold and platinum plans offer more financial protection if you get sick, but these plans have higher monthly costs. You can receive financial help to purchase any of these levels of coverage.
For example, you could enroll in a bronze plan for about $119 per month ($1,430 per year), which is 3.25% of your household income, after taking into account $0 in subsidies). For most people, the Bronze plan represents the minimum level of coverage required under health reform. Although you would pay less in premiums by enrolling in a Bronze plan, you will face higher out-of-pocket costs than if you enrolled in a silver plan.
OUT OF POCKET COSTS
Although your insurance company may cover most of the cost of your medical care, you generally have to pay something when you go to the doctor or have a hospital stay. These costs – which are in addition to the amount you pay each month – are called your “out-of-pocket” costs. The health reform law sets limits on the amount you have to pay out-of-pocket each year. Your out-of-pocket limit for a silver plan can be no more than $6,600 in 2015. Whether you reach this maximum level will depend on the amount of health care services you use. Keep in mind that this only protects you when you go to doctors and hospitals that are in your insurer’s network. If you go to a doctor or hospital that is not in the network, you could end up paying much more.
You are guaranteed access to a silver plan with an actuarial value of 70% . This means that for all enrollees in a typical population, the plan will pay for 70% of expenses in total for covered benefits, with enrollees responsible for the rest. If you choose to enroll in a bronze plan, the actuarial value will be 60%, meaning your out-of-pocket costs when you use services will likely be higher. Regardless of which level of coverage you choose, deductibles and copayments will vary from plan to plan, and out-of-pocket costs will depend on your health care expenses. Preventive services will be covered with no cost sharing required.
OTHER COVERAGE OPTIONS
Children and young adults under age 30 are eligible to purchase catastrophic coverage. With a catastrophic plan, you would pay out-of-pocket for most health services until you reach the annual limit on cost sharing ( $6,600 in 2015). However, preventive services are covered with no cost sharing required.
…
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Silver plans by far the most popular insurance option – USA …
www.usatoday.com/story/news/…/almost…aca…/7735239/
USA Today
May 1, 2014 – WASHINGTON — Almost two-thirds of the 8 million Americans who enrolled in health insurance through the Affordable Care Act picked the Silver Plan…
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What Are The Silver Plan’s Out-of-Pocket Costs?
Based on an average person’s expected use of healthcare services, Silver Plans have the insurance company pay 70% of covered healthcare expenses. The remaining 30% of expenses are paid out-of-pocket by the policyholder. These out-of-pocket expenses include deductibles, copayments, and coinsurance. However, the plan’s monthly premium is not included as one of these out-of-pocket costs.
Below are the average out-of-pocket cost-sharing expenses for medical services and prescription drugs found across silver plans for 2015.
Cost-Sharing Category Average for a Silver Plan
Deductible for an individual enrollee $2,927
Deductible for a family $6,010
Doctor Visit $29
Specialist visit $57
Generic drugs $13 (2014 data)
Preferred brand drugs $47 (2014 data)
Non-preferred brand drugs $89 (2014 data)
Specialty drugs 31% of specialty drug expense charged to patient as coinsurance fee (coinsurance fees used for specialty drugs in 62% of 2014 plans studied)
Annual cap on out-of-pocket costs for an individual $5,775
Annual cap on out-of-pocket costs for a family $11,555
[ SOURCE ]
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Seventy-four percent of 2015 silver level plans’ out-of-pocket spending caps are below the $6,600 spending limit allowed for individual plans and $13,200 maximum for family plans, according to Avalere, a consulting firm.
The average out-of-pocket maximum for 2015 individual silver plans will be $5,853, says Caroline Pearson, a vice president at Avalere. Silver was the most popular plan type this year, selected by about two-thirds of enrollees.
After a policyholder reaches the out-of-pocket spending limit during the year, the insurer pays all the bills, unless, for example, they involve doctors and hospitals not in the health plan’s network.
SOURCE: [ kaiserhealthnews.org/news/many-obamacare-plans-set-out-of-pocket-spending-limits-below-the-cap/ ]
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Out-of-Pocket Costs for Gold Plan Enrollees
In Gold Plans, the insurance company pays 80% of covered healthcare expenses based on an average person’s expected use of healthcare services. The remaining 20% of expenses are paid out of pocket by the policyholder. Below are the average out-of-pocket cost-sharing expenses for medical services and prescription drugs found across gold plans.
Cost-Sharing Category Average for a Gold Plan
Deductible for an individual enrollee $1,198
Deductible for a family $2,626
Doctor Visit $23
Specialist visit $45
Generic drugs $11 (2014 data)
Preferred brand drugs $39 (2014 data)
Non-preferred brand drugs $85 (2014 data)
Specialty drugs 28% of specialty drug expense charged to patient as coinsurance fee (coinsurance fees used for specialty drugs in 52% of 2014 plans studied)
Annual cap on out-of-pocket costs for an individual $4,298
Annual cap on out-of-pocket costs for a family $8,986
The specifics of deductibles, copayments, and other out-of-pocket costs will vary by Gold Plan, but we do know that for a standard population the Gold Plan should be expected to cover 80% of healthcare expenses. To illustrate how costs could differ among Gold Plans, we’ve created a table of two hypothetical Gold Plans.
Gold Plan Example A Gold Plan Example B
Consumer Out-of-Pocket Costs 20% of costs 20% of costs
Deductible $250 $2,000
Coinsurance 20% 10%
Gold Plan Premiums
Gold plans have the second highest premium rates of the four new types of metal plans since they charge the second lowest out-of-pocket costs. However, there may be instances where the Gold Plan for one insurance company may charge a lower premium than the Bronze or Silver Plan of another insurance company, as well as instances where the Platinum Plan for one insurance company may charge a lower premium than the Gold Plan of another insurance company. Comparing plans is essential for anyone trying to minimize their healthcare expenses. HealthPocket’s health insurance comparison tool allows people to compare all the plans available in their area.
Below are the average monthly premiums found for 30, 40, 50, and 60-year-old individuals in Gold plans across 34 different states.
Age 30 Age 40 Age 50 Age 60
$336 $378 $528 $801
http://www.healthpocket.com/individual-health-insurance/gold-health-plans#.VQ7jfPzF9vo
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Platinum Plan Out-of-pocket Costs
Below are the average out-of-pocket cost-sharing expenses for medical services and prescription drugs found across platinum plans.
Cost-Sharing Category Average for a Platinum Plan
Deductible for an individual enrollee $243
Deductible for a family $489
Doctor Visit $18
Specialist visit $29
Generic drugs $7 (2014 data)
Preferred brand drugs $31 (2014 data)
Non-preferred brand drugs $61 (2014 data)
Specialty drugs $126 (copay used for specialty drugs in 54% of 2014 plans studied)
Annual cap on out-of-pocket costs for an individual $1,971
Annual cap on out-of-pocket costs for a family $3,942
Since the Platinum Plan has the most generous cost-sharing for enrollees, it is expected that these plans will typically have the highest premiums when compared to the Bronze, Silver, and Gold plans. However, this is a generalization. It will be important to compare premiums among different insurance companies offering Platinum Plans. Moreover, deductibles and copayments will also differ among Platinum Plans. This is perfectly acceptable as long as the Platinum Plan covers 90% of healthcare expenses for a standard population. Below is a hypothetical example revealing how cost-sharing could differ among Platinum Plans.
Platinum Plan Example A Platinum Plan Example B
Consumer Out-of-Pocket Costs 10% of costs 10% of costs
Deductible $250 $2,000
Coinsurance 10% 5%
Insurance companies are not obligated to offer a Platinum Plan. To participate in a State Insurance Exchange they are only required to offer Silver Plans and Gold Plans.
Platinum Plan Premiums
Platinum plans have the highest premium rates of the four new types of metal plans since they charge the lowest out-of-pocket costs. However, there may be instances where the Platinum Plan for one insurance company may charge a lower premium than the Bronze, Silver, or Gold Plan of another insurance company. HealthPocket’s health insurance comparison tool allows people to compare all the plans available in their area.
Below are the average monthly premiums found for 30, 40, 50, and 60-year-old individuals in Platinum plans across 34 different states.
Age 30 Age 40 Age 50 Age 60
$345 $388 $543 $825
http://www.healthpocket.com/individual-health-insurance/platinum-health-plans#.VQ72yvzF9vo
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HEALTH INSURANCE PREMIUMS RISING AFTER ACA
ObamaCare Insurance Premiums – ObamaCare Facts
obamacarefacts.com/obamacare-health-insurance-premiums/
Why Are Health Insurance Premiums Rising Under ObamaCare? The primary cause of the insurance premium rate hikes under ObamaCare is the requirement …
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Cost of Coverage Under Affordable Care Act to Increase in …
www.nytimes.com/…/cost-of-coverage-under-afforda…The New York Times
Nov 14, 2014 – Many Americans with health insurance bought under the Affordable Care … The Times analysis found that premiums had increased much more …
.
Now There Can Be No Doubt: Obamacare Has Increased Non
www.forbes.com/…/now-there-can-be-no-doubt-obamacare-will-i…
Forbes
Oct 23, 2014 – This state-by-state analysis shows that premiums will increase in 45 … up by a large amount, so what’s happening under Obamacare is no …
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Key Study On Obamacare 2015 Premium Rates Is Out And …
www.forbes.com/…/key-study-on-obamacare-2015-premium-rate…
Forbes
Oct 31, 2014 – When was the last time we saw insurance premiums experience an annual increase of less than 5 percent? I cannot remember such a time and …
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Here’s What’s Going On With Obamacare Premium Increases
www.huffingtonpost.com/…/obamacare-premiums-2…
The Huffington Post
Aug 21, 2014 – Rick Scott (R) says health insurance premiums will go up 13.2 percent on … Under the Affordable Care Act, 24 states have opted not to expand …
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Health insurance costs are skyrocketing under Obamacare …
www.politifact.com/…/health-insurance-costs-are-skyrocke…
PolitiFact.com
Sep 29, 2014 – Health insurance costs are skyrocketing under Obamacare, Republican Party … When the policies had to change, premiums were likely to rise.
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Obamacare sends health premiums skyrocketing by as …
www.washingtontimes.com/…/obamacare-sends-h…
The Washington Times
Oct 28, 2014 – Obamacare premiums soar as much as 78% to help cover ‘essential health benefits’ …. “Attendant to that would be an increase in premiums to be able to … Under our worthless drug addled President, we are less free, less …
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For consumers whose health premiums will go up under …
www.washingtonpost.com/…premiums…go-up-und…
The Washington Post
Nov 3, 2013 – Americans who face higher insurance costs under President Obama’s health-care law are angrily complaining about “sticker shock,” …
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All ages see higher premiums under Obamacare …
www.washingtonexaminer.com/…premiums-under-obamacare/…/25555…
Nov 3, 2014 – “While the degree of increase varied by age and sex, the occurrence of an increase did not.” Average premium increases ranged from a low of …
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PEOPLE ARE LOSING HEALTHCARE COVERAGE UNDER ACA
Under Obamacare, Americans Will Continue To Lose …
www.usnews.com/…/under-obamacare-ameri…
U.S. News & World Report
Sep 22, 2014 – There’s another wave of Obamacare health plan cancellations on the … will mean changing doctors, interrupting coverage and losing continuity …
How many people are poised to lose 2014 ObamaCare …
hotair.com/…/how-many-people-are-poised-to-lose-2014-obama…
Hot Air
Sep 16, 2014 – The next group of people won’t lose their coverage, but could lose the ….. http://nypost.com/2014/09/08/er-visits-skyrocket-under-obamacare/.
CBO: 10 million will lose employer-based coverage under …
hotair.com/…/cbo-10-million-will-lose-employer-based-coverage…
Hot Air
Jan 28, 2015 – Not only did ObamaCare force millions of people out of their plans in the ….. 10 million losing coverage under ObamaCare by 2021 is a failure …
Herman Cain says more losing insurance through …
www.politifact.com/…/herman-cain-says-more-losing-insu…
PolitiFact.com
Nov 4, 2014 – “More people are losing their insurance (due to Obamacare) than are … staying under 50 employees to avoid the coverage mandate).
Another 25 million ObamaCare victims | New York Post
nypost.com/2014/…/another-25-million-obamacare-victi…
New York Post
Jan 14, 2014 – It now looks like ObamaCare will hurt twice as many people as it helps … the only option for most people who lose on-the-job coverage — are a …
Millions of Americans Are Losing Their Health Plans …
www.weeklystandard.com/…/millions-americans-ar…
The Weekly Standard
Oct 23, 2013 – Jindal: Under My Obamacare Repeal, You Can Keep Your . … The U.S. individual health insurance market currently totals about 19 million people. … letters from their carriers saying they are losing their current coverage and …
Almost 80 million with employer health care plans could …
www.foxnews.com/…/evidence-shows-obama-adminis…
Fox News Channel
Nov 26, 2013 – Almost 80 million people with employer health plans could find their coverage … would lose their existing coverage due to the Affordable Care Act.” … are getting sticker shock at the new, higher prices under ObamaCare.
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The YouToons Get Ready for Obamacare
Kaiser Family Foundation
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OBAMACARE: THE BIGGEST INSURANCE SCAM IN HISTORY
The Affordable Care Act (ACA), also called “Obamacare,” may be the biggest insurance scam in history. The industries that profit from our current health care system wrote the legislation, heavily influenced the regulations and have received waivers exempting them from provisions in the law. This has all been done to protect and enhance their profits.
In the meantime, the health care crisis continues. Fewer people, even those with health insurance, can afford the health care they need because of out-of-pocket costs. The ACA continues that trend by pushing skimpy health plans with low coverage and restricted networks.
This is what happens in a market-based system of health care. People get only the amount of health care they can afford, rather than what they need. The ACA takes our failed market-based system to a whole new level by forcing the uninsured to purchase private health plans and using the government to sell and subsidize them.
Sadly, most Americans are being manipulated into supporting the ACA and do not even know they are being bamboozled. That is how scams work. Even after the con is completed, victims do not know they have been manipulated and ripped off. They may even feel good about being scammed, thinking they made a deal when they really had their bank accounts picked. But it is the insurance companies that are the realizing windfall profits from the Obamacare con even as it falters.
The mass media is focused on the technical problems with getting the insurance exchanges up and running. These problems result from the complexity of the law and outsourcing of services to corporations that are often more costly and less effective than government. In comparison, in 1965 when Medicare started, everyone 65 and over was enrolled within six months – using index cards.
If all US residents were in one plan, Medicare for all, rather than the ACA’s tiered system that institutionalizes the class divides in the United States, not only would the health system be fairer and improve health outcomes, but it would be less bureaucratic, less costly and easier to implement. The Medicare-for-all approach considers health care to be a public good, something that all people need, like schools, roads and fire departments.
Rather than being distracted by the problems of the exchanges, the more pressing issue is whether we want to continue using a market-based approach to health care or whether we want to join the other industrialized nations in treating health care as a public good. This conversation is difficult to have in the current environment of falsehoods, exaggerations and misleading statements coming from both partisan directions, echoed by their media supporters and nonprofit organizations.
Of course, the Republicans attack Obamacare for partisan reasons. And they are often blatantly dishonest in their criticism. Their foundational claim, calling Obamacare socialized medicine, is the opposite of reality. And, the Obama administration and its allies in the nonprofit world also have their fair share of falsehoods about the ACA. We will describe these farther below.
A Primed Public
In reality, the US health care system is the worst of the wealthy nations. We spend the most per person, have the lowest percentage of our population covered and have poor health outcomes. Forty-five thousand adults die each year merely because they do not have insurance, and 84,000 Americans die each year of preventable illnesses that would not die in the French, Japanese or Australian health systems.
Even those with insurance find it to be inadequate when they get seriously ill. Medical costs and illness are the greatest reasons for bankruptcy, and insurance does not prevent financial ruin. Every family is touched by the failures of US health care.
The Institute of Medicine issued a report in 2013, US Health in International Perspective, that documents the failure of the US health care system. In summary: “Americans live shorter lives and experience more injuries and illnesses than people in other high-income countries. The U.S. health disadvantage cannot be attributed solely to the adverse health status of racial or ethnic minorities or poor people: even highly advantaged Americans are in worse health than their counterparts in other, ‘peer’ countries.”
The health care crisis had grown to such proportions that by the 2008 election it could not be ignored. It was a major topic of the presidential campaigns. The health industries knew this and invested heavily in the candidates. Candidate Barack Obama overwhelmingly received more in donations from health care-related industries than any of the other candidates.
The public was ready for health care reform. Knowing that the majority of the public supports a Medicare-for-all system, it was going to take serious planning to silence that majority and enact a law that protected the interests of the health industries.
Obamacare: The Insurance Scam
A scam is a fraudulent operation designed to make money. A scam unfolds over time with a team of swindlers seeking to rob the victim without the victim ever knowing they have been scammed.
In Confessions of a Confidence Man, Edward H. Smith lists the “six definite steps or stages of growth in every finely balanced and well-conceived confidence game.” Let’s go through these six steps and see how the process of selling the ACA to the public fits.
1. Develop the Foundation
The foundation of a scam is the preparation done ahead of time to set up the scheme. In the case of the ACA, the foundation began with the health law passed by Massachusetts in 2006. The template was created by Stephen Butler of the Heritage Foundation, a conservative think tank. The law was passed under a Republican governor, Mitt Romney.
The next task was to sell this idea to Democrats. The Robert Wood Johnson foundation gave a major assist when it made large grants to state health reform groups in 2008 to promote Massachusetts-style reform in their states, called the “public-private partnership” model.
To further sell the ACA, Roger Hickey, a longtime Medicare-for-all advocate of the Campaign for America’s Future (closely allied with the Democratic Party), took an idea from Jacob Hacker to create a new public insurance modeled after Medicare to ‘compete’ with private insurance. Hickey sold the model to progressive groups, and Hacker’s proposal was used by the Obama campaign.
In July, 2008, Hickey and others rallied progressive groups to create a new coalition, Health Care for America Now, which received tens of millions of dollars to build grass-roots support for the ACA. The name was similar enough to the longtime Medicare-for-all organization, Healthcare-Now, to cause confusion.
2. The Approach
The approach is the way that the con artist gets in touch with the victim. The vehicle for the ACA con was the tech-savvy political campaign of Barack Obama. The candidate promised hope and change. Obama, who had supported single payer before running for president, was able to point to all of the problems in the US health care system and excite people with the potential of a new leader who understood the crisis and would fix it.
After his election, the campaign organized Health Care House Parties in December 2008. People were encouraged to invite friends and neighbors to their homes, and the Obama transition team provided the materials. The booklet that was used was tightly scripted to build support for the ACA rather than actually elicit citizen input on what kind of health system was desired.
3. The Buildup
In this stage, the victim is excited about the prospect and is filled with anticipation so their judgment is warped and caution is thrown away, setting them up to fall for the scam.
Throughout the winter and spring of 2009, the Obama administration gave the appearance of bringing all of the “stakeholders” together to work for health reform. The president held a White House Health Summit in March 2009, which included representatives from health insurance corporations, hospitals and pharmaceutical companies. The only groups that were not included, until there was a threat of protest, were those who advocate for Medicare for all. The single-payer advocates did not speak, but the insurance spokesperson opened and closed the White House summit.
Throughout the spring, the president and allies reassured the public that if they liked their health insurance, they could keep it; that insurance would be made more affordable (not that health care would be more affordable); and that reform would aim for universal coverage.
4. The Convincer
The convincer for many who supported real health reform was “the Public Option.” The idea was that the law would force the uninsured to purchase insurance but would include the choice of a public health insurance plan. The public was told that this option would be more cost-effective than private insurance and, thus, less expensive, which would make it more attractive.
Many were convinced that a public option would become a Medicare-for-all system, that it was a “back door” to single payer. They were told that going straight to a single-payer health care system would be too difficult and that the public option was a first step. Health Care for America Now organized grass-roots groups to put their energy into fighting for a public option, and many responded.
There was real animosity directed toward those who pointed out that from a policy standpoint a public option made no sense. It was simply adding another insurance plan to an already-complex and expensive system of hundreds of insurances and that, as had occurred time and again at the state level, it would attract those with the greatest health needs and as a result would ultimately fail because of high costs.
What most people did not understand at that point was that the public option was not only a non-solution to the health care crisis but that it was not even destined to be in the final legislation. Senator Max Baucus reported in March 2009 that it was a “bargaining chip” to get health insurers to accept regulations. Glenn Greenwald exposed this more fully when the Democratic leadership in the Senate actively worked to keep the public option from being included in the Senate health bill. The public option was just part of the con.
5. The Hurrah
The Hurrah phase of a con involves some sort of crisis that must be overcome. This phase started in August 2009, when the Tea Party, backed by Americans for Prosperity (a Koch brothers front group), came out very aggressively against the ACA at local town halls. They called it “government-run” and opposed its fictional “Death Panels.” This served to energize the progressive groups to rally around the president and come out strongly in favor of the law. Rallies in favor of health reform were organized across the country.
Health reform advocates were activated further to support the law as the House and Senate struggled to come to consensus. As more aspects of the law that were important to health reform supporters were jettisoned, such as coverage for immigrants and inclusion of reproductive services, and the public option was whittled down to nothing, support for the law became a partisan statement of support for President Obama.
Members of Congress who supported the Medicare-for-all approach told us that they were going to “hold their nose and vote for it.” Progressive groups and media feared that if the health bill did not become law, it would ruin the Democrats’ chance to hold a majority in Congress in the midterm elections and would destroy the president’s chance to be re-elected.
6. The In-And-In
The purpose of the final phase of the con is to make sure the victims do not realize they’ve been conned.
Obama signed the ACA on March 23, 2010. Immediately the marketing began. The three words we heard the most to describe it were universal, affordable and guaranteed. Of course, the ACA is none of those. But members told us personally that if they told the truth, they wouldn’t be re-elected.
Progressive groups started the work of explaining the advantages of the new health law to the public. The few positive aspects of the law were promoted without explaining the big picture. Overall, the ACA is similar to other neoliberal economic policies; it defunds and destroys our public health insurances and further privatizes health care.
The end goal of the ACA con, to make sure people do not realize they have been conned, is ongoing. As we will see below, salespeople, often the same nonprofits who pushed the ACA, are getting big money to sell insurance with Madison Avenue marketing manipulation tactics.
At the same time, leading single-payer advocacy groups fear further marginalization in their communities and so are afraid to tell the truth about Obamacare. The public has been so hoodwinked by the partisan debate between Republicans and Democrats, based on misinformation from both sides, that single-payer advocates are afraid if they tell the truth, their allies, many whom are Democrats, will push them away. So the truth has few emissaries, while the well-funded deceivers continue the ACA con.
The Con Continues: The Product
A fundamental problem with the ACA is that it is based on continuing our complicated private health insurance or market-based system. Despite their advertising slogans, private insurers primarily exist to create profit for their investors or, in the case of “nonprofit insurers,” to pay exorbitant salaries to their executives. They care about health as much as Big Oil cares about the environment.
Health insurers make their profits from charging the highest premiums they can and by restricting and denying payment for care. They want to take in as much money as they can, while paying out as little on health care as possible. They have many tools with which to do this, and they’ve successfully skirted regulations for decades. When they can’t make a profit, they simply pull that product from the shelf and create new products.
The public has been led to believe that the ACA has changed the behavior of health insurers. In this section we briefly explain some major areas of concern and why many of the promises of the ACA are false.
More-expensive insurance premiums: A major promise was that people could keep their insurance if they liked it, but many are finding that this isn’t working out. Kaiser Health News reported last week: “Health plans are sending hundreds of thousands of cancellation letters to people who buy their own coverage, frustrating some consumers who want to keep what they have and forcing others to buy more costly policies.” The Society of Actuaries released a report in March 2013 that showed insurance pools are set to see an average increase of 32 percent in underlying claims costs by 2017.
The Charlotte Observer reported: “Across North Carolina, thousands of people have been shocked in recent weeks to find out their health insurance plans will be canceled at the end of the year – and premiums for comparable coverage could increase sharply.”
The increase in premiums will force more people to use the state health insurance exchanges, where prices are supposed to be more affordable, but even that is not a solution. Russell Mokhiber of Single Payer Action describes the dilemma he faces in West Virginia. Mokhiber received a notice that his current insurance expires January 1, 2014. If he wants to keep his plan, it will cost twice as much. In his state only one insurance company, Highmark, will be listed on the exchange. He called Highmark to find out what his choices were and got bad news: “The skimpiest plan is going to cost me more than I’m paying now and have a higher deductible and out-of-pocket costs.”
There are reports of increased premiums from across the country. One reason for the increase in cost is, as USA Today reports: “About a third of insurance companies opted out of participating in the exchanges in states where they were already doing business, according to a recent report by McKinsey & Co. About half of states … will see a ‘material decline’ in competitors.”
Decreased coverage: The ACA will increase the number of people who have inadequate insurance that requires high out-of-pocket costs and does not cover all necessary services. The ACA significantly lowers what is considered to be adequate insurance coverage through its system of tiers. The insurance exchanges offer four levels of coverage, with the least-expensive plans paying for 70 percent and 60 percent of covered services.
These plans include high co-pays and deductibles that are barriers to care – especially when 76 percent of Americans are living paycheck to paycheck. And insurers are restricting coverage further by limiting their networks so they do not include major medical centers or adequate numbers of health professionals.
It is important to highlight that insurers pay only for covered services because people don’t usually understand that they will have to pay for uncovered and out-of-network services themselves. The use of out-of-network services is often involuntary and occurs without being known at the time of care, especially in emergency situations.
The New York Times reports:”Most of the 15 exchanges run by states and the District of Columbia do not have provider directories or search tools on their Web sites – at least not yet – so customers cannot easily check which doctors and hospitals are included in a particular plan’s network.”
People are likely to choose the least-expensive plans without fully understanding that a serious accident or illness could bankrupt them even though they have insurance. And the race to the bottom in coverage will affect everyone. It is already estimated that 44 percent of large employer-based plans will be high-deductible plans by 2014.
Tricks to mistreat those with pre-existing illness: One of the great selling points of the ACA con is that those with pre-existing illnesses will not be denied coverage. This is true, but insurers have many ways to avoid the ill. The ACA was written by an insurance company executive from Wellpoint, Liz Fowler, who went on to be hired by Obama’s HHS to implement the law and now works for a pharmaceutical giant. So, all along the way, the insurance companies had someone protecting their interests.
One way to avoid the sick was mentioned above: excluding hospitals where people with serious health problems go, like major medical centers. Another way is by providing poor service to people who have a lot of claims so they change insurers. And a third has to do with the fact that insurance companies are allowed to charge more in geographical areas where health costs are higher. If a plan in a particular area is not making enough profit, the insurance company can simply stop selling in that area.
Insurance companies also can charge three times as much based on age. Because most pre-existing illness comes with age, this greatly undermines the protection of those with pre-existing illness. Insurance companies are excellent at gaming laws and regulations, so we can expect more creative avoidance of people who actually need health care.
Almost no reduction in youths without insurance: One of the highly touted claims of the ACA con was that youths would be covered on their parents’ insurance until they are 26 years old. While this is true, the percentage of 19- to 26-year-olds without insurance has merely fallen from 48 to 41. Why? Most parents cannot afford the increased premiums that are required when more family members are covered. As a result this promise has been one of little value, except to the wealthy – and to those selling the Obamacare con.
No cap on out-of-pocket spending: One of the selling points of the ACA con was that it would limit how much people pay out of pocket for health care. Of the thousands of waivers granted by HHS, one was the limit on out-of-pocket spending. The insurance companies claimed that their computers were not set up to handle this change. HHS took this absurd rationale seriously and gave them a waiver on this important provision.
The Con Continues: The Dealers
The most egregious aspect of the ACA is the individual mandate that those without health insurance who do not qualify for public insurance such as Medicaid must purchase private insurance or pay a penalty for being uninsured. The public is being led to believe that the solution to the health care crisis is to increase the number of people who have insurance. This ignores the fact that having insurance does not mean that patients will have access to or will be able to afford the health care they need.
The ACA required states to create new marketplaces for insurance called exchanges or else the federal government would create the exchange. In essence, the federal government is using billions of public dollars to finance the exchanges, hire people to sell insurance and subsidize the purchases. Imagine what a benefit it would be if those billions of dollars were used instead to hire health providers and pay for actual care.
The federal government plays a big role in running 26 of the state health exchanges but is funding all of them. The annual cost of operating the exchanges will be $15 million to several hundred million per state. In the end, consumers will pay the cost through monthly surcharges tacked on to their premiums.
Part of the federal spending will be on “navigators” and “assisters,” people whose job it is to help people buy insurance. The Obama administration announced in 2013 that it would be directing $200 million to states, private groups and local health centers so that they can hire workers, called navigators, to sell insurance to Americans.
How are navigators paid? A House Committee on Oversight and Reform issued a report on September 13, 2013, that examined how navigators will be paid. One problem is that many are paid based on the number of people they enroll. Obviously this could lead navigators and assisters to not merely “facilitate” enrollment but to persuade people to enroll. And navigators are not required to disclose this incentive.
This payment structure is just one problem, the House report summarizes, warning of scammers:
“… the training to be Navigators and Assisters will last only five to 20 hours and there is no requirement for a background check of Navigators and Assisters who will have access to highly sensitive personal information, such as Social Security numbers, dates of birth, and income for everyone in an applicant’s household. Given the stories about how scammers are gearing up to take advantage of the tremendous confusion caused by ObamaCare, Americans are at an increased risk of being the victim of fraud and identify theft because of the Administration’s poor development of its outreach programs.”
The official navigators and assisters are only one part of the continued conning of America. The groups that advocated for Obamacare have evolved into Enroll America. The group (whose logo is incredibly similar to insurance giant Wellpoint) not only includes advocacy organizations but also interests that profit from the market-based US health care system, e.g. insurance companies, hospitals and pharmaceutical companies. The president of Enroll America, Anne Filipic, served in the Obama White House, the HHS, the Democratic National Committee and in Obama’s 2008 campaign.
Information on the budget of Enroll America has been vague. In June Reuters reported: “In a conference call with reporters, Filipic declined to answer repeated requests for details on the group’s budget. In January Congressional Quarterly reported they were eyeing a $100 million budget and quoted founder Ron Pollack, who led an NGO that lobbied for Obamacare, saying: “We keep on saying it’s got to be in the significant tens of millions of dollars, and hopefully we reach another digit.” Reuters reported that the cost of the public outreach campaign would range into the tens of millions of dollars, with “at least seven figures” going to paid advertising. In a press release they described the advertising campaign:
“Enroll America plans to organize a massive public education/advertising campaign about coverage eligibility and the ways people can enroll in coverage. We expect to involve well-known athletes and celebrities in the campaign. The advertising campaign will be segmented so that it effectively reaches different demographic groups, such as young adults, people in communities of color, low- and moderate-income families, etc. Depending on the availability of resources, we may be able to tailor ads to specific states.”
The campaign is expected to spend tens of millions of dollars on polling, focus groups, paid advertising and running its operations with a staff of a few hundred people. Americans will be subjected to all of the tools of Madison Avenue marketing through Enroll America along with sales by navigators, assisters and the insurance industry.
How is Enroll America raising money? Secretary of Health and Human Services Kathleen Sebelius has been one of the fundraisers for the organization. According to the New York Times, her fundraising has caused a political uproar, with some Republicans claiming it was illegal and two House committees investigating the activity. They report: “Senator John Barrasso of Wyoming and Representative Jack Kingston of Georgia, both Republicans, said Ms. Sebelius appeared to be ‘shaking down’ businesses and other potential donors.” The Hill echoed this, reporting that insurance companies felt like they were being pressured by the administration to donate to Enroll America. One concern is that HHS has a lot of power over insurers as the agency can delay or deny approval of their health-insurance plans for federally approved exchanges.
Sebelius is seeking funds from groups like Robert Wood Johnson Foundation and H&R Block. And the Hill noted “Obama himself made a vague but personal appeal for a close partnership with insurers, which some in the industry saw as a precursor to direct fundraising pitches.” In April 2013, “Obama reportedly sat in for an hour-long meeting he was initiall