Daily Obamacare Thread: Good and Bad

[Dirty Penguin]

If we see government created incentives to become less employed, I see that as a negative thing.

It depends on our perspective. I see one person working two part-time jobs to make ends meet and maybe be able to have some level of healthcare but still living below the poverty line. Now I see that same person working less hours, still have healthcare and maybe able to go to a vocational school. Then again....many of the people who are working aren't really trying to work less hours especially if they're getting paid by the hour. Many of their personal financial situations won't allow that so they will continue to work more than one job and/or continue to seek full-time employment or employment with health benefits.

It is equivalent to killing jobs, with the death just spread around more broadly.

Not really. We're talking about the working poor...which this report seems to focus on. Many of the working poor can't afford to simply opt out and stay afloat...at least not long term. So many of them will continue to work. Anyone opting out of work leaves the employer in a situation where he or she will have to fill that spot. This opens the door for some one else seeking employment.

 

[Revoltingest]

It depends on our perspective. I see one person working two part-time jobs to make ends meet and maybe be able to have some level of healthcare but still living below the poverty line. Now I see that same person working less hours, still have healthcare and maybe able to go to a vocational school. Then again....many of the people who are working aren't really trying to work less hours especially if they're getting paid by the hour. Many of their personal financial situations won't allow that so they will continue to work more than one job and/or continue to seek full-time employment or employment with health benefits.

Not really. We're talking about the working poor...which this report seems to focus on. Many of the working poor can't afford to simply opt out and stay afloat...at least not long term. So many of them will continue to work. Anyone opting out of work leaves the employer in a situation where he or she will have to fill that spot. This opens the door for some one else seeking employment.

I'll buy the idea that needed work could be done by having more employees working part time if Obamacare incentivizes against full time workers. But this is problematic nonetheless.
- Workers will limit income to less than they could earn because of the high marginal tax consequences.
- Employers will have more employees for a given amount of productivity, which is less efficient (due to a per-employee overhead).
- Workers working 2 part time jobs to earn a full time equivalent wage is more costly for them because of additional commuting.
- These inefficiencies incentivize replacing employees with automation.

 

[esmith]

I'll buy the idea that needed work could be done by having more employees working part time if Obamacare incentivizes against full time workers. But this is problematic nonetheless.
- Workers will limit income to less than they could earn because of the high marginal tax consequences.
- Employers will have more employees for a given amount of productivity, which is less efficient (due to a per-employee overhead).
- Workers working 2 part time jobs to earn a full time equivalent wage is more costly for them because of additional commuting.
- These inefficiencies incentivize replacing employees with automation.

But the points that you put forward in your abbreviated dissertation of the problematic issues of full-time versus part-time employment as expressed in the Congressional Budget Officer does not reflect what has been put forth as a advantage of those ideals expressed by the current administration in response to aforementioned (somewhere within this thread I assume) report. Thus those that tend to disagree with anyone putting forth contradictory synopsis of the aforementioned (I think they were aforementioned) positive aspect of the benefits of part-time versus full-time employment will find the abbreviated dissertation that reflects on the negative aspect of the aforementioned (got to be here somewhere) positive attributes of part-time versus full-time employment.

Whew, glads that's done; However, I don't think I understand what I was attempting to say. Gee, maybe I could get a position explaining the current administrations policies.

 

[Jeremy Mason]

I signed up a month ago and it was super easy and fast.

 

[esmith]

More bad news about Obama's signature legislation keeps inundating the White House.

As of 31 Dec 2013 approximately half of the enrollees in 17 states have not paid their premiums. The figures released by the administration reflect all that have signed up, not those that have paid their first month premiums.Half of Obamacare 'Enrollees' Have Yet to Pay

As of 31 Dec 2013 over half of all counties in 34 states do not have a plan that is affordable by the governments own definition. USA Today: Obamacare Plans Unaffordable For Over Half Of Counties

Numerous Democratic politicians are distancing themselves from Obama and Obamacare.
Vulnerable Dems scramble to keep distance from ObamaCare | TheHill

Yes to some fellow forum members, I will continue to bring you the information that you do not want to hear or believe. Sorry about that....No in actuality I'm not

 

[metis]

Time will tell, and the enrollment figures for January were above expectations, but that in part was probably caused by the "wardrobe malfunction" when enrollment started. Even though there's some here that couldn't care less about the roughly 27 million Americans will likely be helped, some others of us do care. Some here believe their money is more important than helping out their fellow Americans, but some of us actually feel that American lives and health are worth saving.

It's just a matter of priorities.

 

[esmith]

Time will tell, and the enrollment figures for January were above expectations, but that in part was probably caused by the "wardrobe malfunction" when enrollment started. Even though there's some here that couldn't care less about the roughly 27 million Americans will likely be helped, some others of us do care. Some here believe their money is more important than helping out their fellow Americans, but some of us actually feel that American lives and health are worth saving.

It's just a matter of priorities.

It is not that I do not support taking care of those that need help. It is that I consider what is commonly called Obamacare to be the wrong way to address the problem. It also seems that a considerably large number of people within the US that agrees with me. I think the figures are now around 31% that approve. Yes, I agree that many like some aspects of the law, others see that it hasn't gone far enough, then there are those that think it can be fixed, and others that just want it repealed. I am in the camp of keeping what is good in the law (for example per-existing conditions, not dropping an insuree for medical reasons, no lifetime cap and a few others) but do not like the mandate that everyone have insurance, and telling people what kind of insurance they have to have and a few other misguided concepts.

 

[metis]

It is not that I do not support taking care of those that need help. It is that I consider what is commonly called Obamacare to be the wrong way to address the problem. It also seems that a considerably large number of people within the US that agrees with me. I think the figures are now around 31% that approve. Yes, I agree that many like some aspects of the law, others see that it hasn't gone far enough, then there are those that think it can be fixed, and others that just want it repealed. I am in the camp of keeping what is good in the law (for example per-existing conditions, not dropping an insuree for medical reasons, no lifetime cap and a few others) but do not like the mandate that everyone have insurance, and telling people what kind of insurance they have to have and a few other misguided concepts.

First of all, people are not told what kind of insurance they have to have, as they shop and select what best suits them. Yes, there are basic guidelines, but to me those guidelines are there to create a package that can work and prevent freeloading.

Secondly, not to mandate all people having insurance creates a couple of problems, with one of them be that it would encourage people to flood emergency rooms with maybe something no more severe than having a hangnail. And guess who will pay for their milking the system, as we have been seeing?

Thirdly, what you propose above would cost a lot of money, so how do you propose paying for this? Please try to be as specific as possible and not say something like "Well, we'll cut unnecessary costs somewhere else"-- that's a non-starter for rather obvious reasons.

BTW, I was going to post something else before reading your post, and that is that on one of the news programs yesterday, they said they're seeing a gradual shift taking place with Republicans whereas "Repeal Obamacare!" is being replaced with "We can fix Obamacare to make it better!". The point they were making is that even many Republicans now realize that it's a done deal that can't be reversed because doing so will alienate millions that have already signed up, plus it would unleash the insurance industry to jack up rates as we saw before the ACA was passed. As more and more companies raised co-pays or dropped their employees, leaving them with nothing, can you begin to imagine the outcry? Do you think the Republican leadership wants to be blamed for that?

As the old adage goes, "be careful what you wish for".

 

[esmith]

First of all, people are not told what kind of insurance they have to have, as they shop and select what best suits them. Yes, there are basic guidelines, but to me those guidelines are there to create a package that can work and prevent freeloading.

Wrong, there is a minimum standard prescribed by the ACA that mandates the minimum insurance that a person must have. If there is no chance that I do not need coverage for something, say like maternity coverage, why should the government tell me I have to have it. If I didn't have this coverage would I be, in your words, freeloading. The answer is no. What it is, is that some bureaucrat has decide that to get the program to work they must force people to purchase something they do not need or want.

Secondly, not to mandate all people having insurance creates a couple of problems, with one of them be that it would encourage people to flood emergency rooms with maybe something no more severe than having a hangnail. And guess who will pay for their milking the system, as we have been seeing?

Let see this program was to insure that everyone in the US had health insurance and there were approximately 30 million that did not. Guess what, even with this boondoggle there will still be 30 million without insurance. So what was the point.
CBO: Obamacare Will Leave 30 Million Uninsured | CNS News

Thirdly, what you propose above would cost a lot of money, so how do you propose paying for this? Please try to be as specific as possible and not say something like "Well, we'll cut unnecessary costs somewhere else"-- that's a non-starter for rather obvious reasons.

Not sure what you mean by "cost a lot of money". Exactly what did I imply that you consider cost a lot of money?

BTW, I was going to post something else before reading your post, and that is that on one of the news programs yesterday, they said they're seeing a gradual shift taking place with Republicans whereas "Repeal Obamacare!" is being replaced with "We can fix Obamacare to make it better!". The point they were making is that even many Republicans now realize that it's a done deal that can't be reversed because doing so will alienate millions that have already signed up, plus it would unleash the insurance industry to jack up rates as we saw before the ACA was passed. As more and more companies raised co-pays or dropped their employees, leaving them with nothing, can you begin to imagine the outcry? Do you think the Republican leadership wants to be blamed for that?

As the old adage goes, "be careful what you wish for".

It seem you are running on speculation. You have no proof in many of the situations that you put forth. When you come up with proof, feel free to present it. Until then you have nothing but hyperbole.

 

[metis]

Wrong, there is a minimum standard prescribed by the ACA that mandates the minimum insurance that a person must have.

And what exactly do you think I just had posted, which is the same as above?

If there is no chance that I do not need coverage for something, say like maternity coverage, why should the government tell me I have to have it.

Most people get their insurance through where they work, and with most of those programs the coverage tends to be broad whereas the insured can't pick and choose which coverage they want or don't want. When I was younger, I worked at various jobs whereas I had insurance, and never was I asked which items I wanted. Essentially it was a package deal arranged by the employer through the insurance company they selected.

You might not need maternity now, but someone else does. Over and over again all I get from you is this selfish "me-ism" whereas you refuse to recognize the fact that in any civilized country, we need to watch out for and help each other and not be as self-centered as your approach is.

Let see this program was to insure that everyone in the US had health insurance and there were approximately 30 million that did not. Guess what, even with this boondoggle there will still be 30 million without insurance. So what was the point.

As I have posted before, I only have viewed the ACA as a step in the right direction, and I was quite disappointed that it was not universal and that the roll-out was terribly flawed. Hopefully in the near future, coverage will be extended to all.

Not sure what you mean by "cost a lot of money". Exactly what did I imply that you consider cost a lot of money?

You honestly don't know this? Your gotta be kidding? If you are so totally unaware of the costs involved that you have said you'd keep with the ACA, your credibility is totally shot. Totally.

It seem you are running on speculation. You have no proof in many of the situations that you put forth. When you come up with proof, feel free to present it. Until then you have nothing but hyperbole.

It's beyond hypocritical for you to post the above. I said in a previous post that we don't know how all this is going to play out in the long run, but then you come back with this nonsense. BTW, nothing seems to have ever stopped you from posting speculation on top of even more speculation, so maybe you should take your own advice.

As I said before, some of us actually care about our fellow Americans to want to help them out, but then there's those who are too selfish to care, and it's rather obvious which camp you're in. With all the posts that I've seen you write, not once have I ever seen you admit that you're even at least somewhat pleased that uninsured Americans will finally get some help by the ACA. No, with you, it's all about the almighty $.

 

[Revoltingest]

I wonder how widespread this effect is...
Fourth Georgia hospital closes due to Obamacare cuts | The Daily Caller

The federal government has historically made payments to hospitals to cover the cost of uninsured patients seeking free medical care in emergency rooms, as federal law mandates that hospitals must care for all patients regardless of their ability to pay. Because the Affordable Care Act’s authors believed they’d forced all states to implement the Medicaid expansion, Obamacare vastly cut hospital payments....

 

[Dirty Penguin]

I wonder how widespread this effect is...
Fourth Georgia hospital closes due to Obamacare cuts | The Daily Caller

The Daily caller left out some important info. (as usual)

Fourth Georgia Hospital Shuts Down As The State Continues To Refuse Medicaid Expansion | ThinkProgress

The Lower Oconee Community Hospital, a so-called “critical access” hospital in southeastern Georgia with 25 beds, will close down and possibly re-open as an urgent care center that provides services that aren’t quite serious enough to necessitate an emergency room visit. Patients in the Wheeler County region who need more extensive medical care after the hospital closes will need to travel upwards of thirty miles in order to receive it.





“We just did not have sufficient volume to support the expenses,” said CEO Karen O’Neal in an interview with local CBS affiliate WMAZ. “It’s a terrible situation, and it’s tragic, the loss of jobs and the economic impact.”

Had Georgia expanded Medicaid and built an exchange like some of the others then they might not be in this situation.


The source aboves continues....

Last fall, Bloomberg reported that at least five public hospitals in Georgia, North Carolina, and Virginia — including three in Georgia alone — were cutting staff and services in the wake of their refusal to expand Medicaid. These hospitals are so-called “Disproportionate Share Hospitals” — providers that serve a disproportionate number of poor and uninsured Americans, and as such don’t always receive payments for the care they give patients.

About one in four people in Wheeler County, where the latest hospital is shutting down, is uninsured. About one in ten residents are unemployed and over 40 percent of children live in poverty.


As the Albany Herald reports, experts agree that offering higher Medicaid reimbursement rates for rural hospitals and accepting Obamacare’s Medicaid expansion, which would extend health benefits to all Americans who make up to 138 percent of the Federal Poverty Level (FPL), would provide major financial security to hospitals in lower-income regions.


Approximately five million working poor Americans who live in states refusing Obamcare’s Medicaid expansion will fall into a coverage gap where they make too much money to qualify for existing state Medicaid programs but too little money to qualify for the ACA’s insurance subsidies. Nearly 500,000 Americans in this coverage gap reside in Georgia.

 

[Revoltingest]

I don't see the point of this little guy, since you seem to support the article I linked.

New Obamacare news:
#1 son just had his premium raised, has his non-smoking status questioned again,
& finds difficulty resolving differing info among the various Obamacare outfits.
It's amateur hour.
I'm convinced that Obama outsourced design & management to the Vogons.

OK, DP, now it's your turn to defend Obamacare.

 

[Dirty Penguin]

I don't see the point of this little guy, since you seem to support the article I linked.

Not really. The headline of your article and its content suggest that hospitals are closing due to Obamacare but the information from the hospital officials suggest the closures are due to the fact that they aren't able to make money because many of the patients are low income, unemployment rate in the state is high and that the state itself, run by a Republican governor, has refused the Medicaid expansion. Other more reliable news sources shed more light on the situation and puts things into proper context. Daily Caller left most of the important information out and proceeded to give a critique that wasn't germane to the actual reasons these hospitals are closing.

Another rural hospital closed | Albany Herald

The Wheeler County area had a 23 percent uninsured rate, and 10 percent of citizens are unemployed, according to the County Health Rankings from the University of Wisconsin and the Robert Wood Johnson Foundation.

Forty-one percent of the county’s children live in poverty.

“We just did not have sufficient volume to support the expenses,” O’Neal told WMAZ. “It’s a terrible situation, and it’s tragic, the loss of jobs and the economic impact.”

It’s a crisis for rural health care, Lewis said, and ‘‘if left unattended, will create a Third World nation’’ system of medical care in these areas of Georgia.

Georgia’s spending per capita on Medicaid is among the lowest of the 50 states, Lewis noted.

Another possibility is Medicaid expansion, which would help rural hospitals by turning many of their uninsured patients into paying patients. The federal Affordable Care Act calls for expansion, providing subsidies for it, but the decision is up to the individual states.

Gov. Nathan Deal and Republican lawmakers have rejected expansion in Georgia, citing the cost to the state. And this week, GOP leaders went further, introducing a bill that would require legislative approval of any Medicaid expansion in the state.


“I think it’s an effort to add another barrier to expansion,’’ said Tim Sweeney, health policy director for the Georgia Budget and Policy Institute.

So as you can see the factors surrounding the closure are far deeper than the limited biased information provided by the Daily Caller. As usual when you and others post "news" from right wing sources such as the Daily Caller and Breitbart I have to cross reference your sources with actual news sources to get the full picture. As mentioned above they actually welcome the Medicaid Expansion and fault the local government for not taking it given the obvious need to service the poor and they suggest the local legislature is purposely making it harder on them by implementing more restrictive (regulations) that would make it harder for their state to expand Medicaid.

 

[Revoltingest]

Not really. The headline of your article and its content suggest that hospitals are closing due to Obamacare but the information from the hospital officials suggest the closures are due to the fact that they aren't able to make money because many of the patients are low income, unemployment rate in the state is high and that the state itself, run by a Republican governor, has refused the Medicaid expansion. Other more reliable news sources shed more light on the situation and puts things into proper context. Daily Caller left most of the important information out and proceeded to give a critique that wasn't germane to the actual reasons these hospitals are closing.

Spluh! Of course this is the reason. It's the reason because under Obamacare, they're no longer compensated for the overhead of serving non-paying patients....which is the claim in the article.

So as you can see the factors surrounding the closure are far deeper than the limited biased information provided by the Daily Caller. As usual when you and others post "news" from right wing sources such as the Daily Caller and Breitbart I have to cross reference your sources with actual news sources to get the full picture. As mentioned above they actually welcome the Medicaid Expansion and fault the local government for not taking it given the obvious need to service the poor and they suggest the local legislature is purposely making it harder on them by implementing more restrictive (regulations) that would make it easy for their state to expand Medicaid.

You cannot dismiss the problem by impugning the sources, & ignoring the basis for the problem.

 

[Dirty Penguin]

Spluh! Of course this is the reason. It's the reason because under Obamacare, they're no longer compensated for the overhead of serving non-paying patients....which is the claim in the article.

You cannot dismiss the problem by impugning the sources, & ignoring the basis for the problem.

The problem isn't the ACA which is what the Daily Caller is suggesting. After reviewing another source it was clear that they didn't give all the proper information or proper context. The station that conducted the interview with hospital/healthcare officials sets the proper context. The problems have more to do with the fact that the various ares in Georgia have a high rate of uninsured and unemployed people, children living in poverty..and the officials cite the fact that the local legislature and the governor rejected the Medicaid expansion as well as enacting new (regulations) that would require legislative approval of the Medicaid expansion.


Another rural hospital closed | Albany Herald

Another possibility is Medicaid expansion, which would help rural hospitals by turning many of their uninsured patients into paying patients. The federal Affordable Care Act calls for expansion, providing subsidies for it, but the decision is up to the individual states.

Gov. Nathan Deal and Republican lawmakers have rejected expansion in Georgia, citing the cost to the state. And this week, GOP leaders went further, introducing a bill that would require legislative approval of any Medicaid expansion in the state.


“I think it’s an effort to add another barrier to expansion,’’ said Tim Sweeney, health policy director for the Georgia Budget and Policy Institute.

 

[Revoltingest]

The problem isn't the ACA which is what the Daily Caller is suggesting. After reviewing another source it was clear that they didn't give all the proper information or proper context. The station that conducted the interview with hospital/healthcare officials sets the proper context. The problems have more to do with the fact that the various ares in Georgia have a high rate of uninsured and unemployed people, children living in poverty..and the officials cite the fact that the local legislature and the governor rejected the Medicaid expansion as well as enacting new (regulations) that would require legislative approval of the Medicaid expansion.
Another rural hospital closed | Albany Herald

It sounds like you're admitting the claims in the articles I linked, but then inexplicably disavowing them.

 

[Dirty Penguin]

It sounds like you're admitting the claims in the articles I linked, but then inexplicably disavowing them.

Like I said in my original post on this matter....all the governor had to do was accept the Medicaid expansion. That would have provided the necessary compensation the hospital needed. The Governor and the legislature rejected the Medicaid dollars so this isn't the fault of the ACA. The ACA offered the state the dollars. The governor said they couldn't afford to take the money from the feds..:areyoucra.... even though the feds are covering 100% for three years and gradually scaling back to 90% coverage after that (so what is this guys talking about). The local government along with their new (regulation) is making it harder on hospitals and their constituents by denying the Medicaid dollars that the feds actually want to give them to cover the people of the state. The hospitals and execs welcome the Medicaid dollars but not the local government...regardless of constituent need.

 

[Revoltingest]

Like I said in my original post on this matter....all the governor had to do was accept the Medicaid expansion. That would have provided the necessary compensation the hospital needed. The Governor and the legislature rejected the Medicaid dollars so this isn't the fault of the ACA. The ACA offered the state the dollars. The governor said they couldn't afford to take the money from the feds..:areyoucra.... even though the feds are covering 100% for three years and gradually scaling back to 90% coverage after that (so what is this guys talking about). The local government along with their new (regulation) is making it harder on hospitals and their constituents by denying the Medicaid dollars that the feds actually want to give them to cover the people of the state. The hospitals and execs welcome the Medicaid dollars but not the local government...regardless of constituent need.

Another view is that Obamacare & the state create the perfect storm of hospital insolvency.
Why do you suppose the state rejects Medicaid money?

 

[Dirty Penguin]

Another view is that Obamacare & the state create the perfect storm of hospital insolvency.
Why do you suppose the state rejects Medicaid money?

As you've indicated...it was fine for them to accept federal dollars pre-ACA but now the governor is rejecting it. As I have been following the news surrounding Gov. Deal's opinions on this matter he's rejecting this on partisan lines. The people of Georgia want the Medicaid dollars and the hospitals welcome it. The perfect storm that's a challenge for hospitals solvency in poor communities, such as the many that exist in Georgia, is when you actually have the federal government willing to cover 100% of the cost for three years and 90% after that but the governor and the local legislature intentionally rejecting these dollars and enacting (regulations) making it tougher to actually get those Medicaid dollars...even though accepting federal funds wasn't an issue in the past......