Thread: What's in the Affordable Care Act?

Okay, here's some MUCH overdue information on what the Affordable Care Act actually does, including the changes that have already taken effect and the ones that will later. As you'll find, the main aspect of it, the massive expansion of Medicaid coverage, takes effect on January 1st, so that is not yet in place, but is coming down the pipeline fairly quickly. That's the measure that will ultimately reduce the ranks of the uninsured in this country by tens of millions. (Medicaid is the program that subsidizes the poor...and beginning next year also most low-income people...to purchase health insurance on the market. In other words, the program underwrites the cost of purchasing insurance for said groups of people.) But lots of other benefits are already in place, including ones that have benefited my mom and myself directly. My family has a history with breast cancer, for example. My mom is now enabled, as a result of this law, to get mammograms for free. That's a real benefit. So was the rebate check she recently received because her insurance company spent less than 80% of its revenues on actual health care. Neither of those things would have happened without the new law. One measure that will likely benefit me took effect yesterday: the provision covering contraception for free. (No co-payments, no deductibles.) And, needless to say, the measure to take effect at the start of 2014 requiring that insurance companies stop charging women higher rates just because we're women will also likely benefit us both. And so when I hear politicians (such as presidential candidate Mitt Romney, who ironically HIMSELF authored the state-level legislation in Massachusetts that inspired the "Obamacare" law in the first place) proclaiming that they'd like to see all this repealed and prevent the rest of it from ever taking effect, I'm rather unsympathetic to it.

Some on the left have criticized the ACA on the grounds that it doesn't go far enough. That's obvious. It leaves the private, for-profit insurance industry intact and it virtually doesn't cover immigrants at all. The former of those things is particularly problematic in that it guarantees that actual health care costs will ultimately continue to rise, and very substantially, even while insurance coverage will increase. The current regime of things, even with this new law in place, cannot be sustained. It's too expensive and inefficient. Eventually we're going to have to socialize our insurance system at minimum because that will be the only way to keep rising administrative costs under control (not to mention that it's only way to actually cover everyone). The successful passage of the ACA, however, has created an added momentum in that direction. My native Vermont, for example, subsequently passed a law implementing a socialized medical insurance system in this state, which will take effect in the coming years. Montana is in the process of doing the same now as well. And momentum for socialized insurance regimes is building in many other states now too.

Feminists have often criticized the ACA's failure to cover abortion procedures for free, or even to ALLOW women to have abortion procedures covered on the same insurance plans that they receive their ACA benefits from. Those are serious and justified criticisms since the latter aspect of that in particular actually hurts access in a significant way. HOWEVER, it's clear that the ACA benefits women overall, including in many ways that are specific to women and women's reproductive rights. I've highlighted the provisions covering mammograms and requiring that insurance companies charge women the same rates as men, for example. Concerning reproductive rights, this law is a net gain for women in that it provides free coverage for contraception, which the vast majority of women would prefer over the abortion option anyway. Women tend to recourse to abortion only when contraception has not been an option. The measure of the ACA that took effect yesterday will massively help ensure that it is an option for many more women.

In short, there is no good reason to actually oppose the Affordable Care Act. There are lots of shortcomings to it that are worthy of criticism and there is much yet to be done in the way of getting from here to a system of socialized medicine, but I believe that such criticisms should be offered within the framework of fundamentally supporting the ACA. Just saying.

Originally Posted by Polly Minx

In short, there is no good reason to actually oppose the Affordable Care Act.

I can give you one good reason to oppose ObamaCare, Polly: the individual mandate.

The mandate is what pays for it. One may justly oppose it if they are opposed to balanced budgets, to the public having the maximum possible price bargaining power possible, etc., but not if they are serious about insuring the maximum number of people in any way short of nationalizing the health care system (which, as stated previously, would be my preference anyway).

The Medicaid expansion is elective, states can and will likely opt out. Of course now there are options some states might ask for a partial expansion in example cover disabled persons based in the income guideline up to the poverty line which would make getting on faster. And you could require basic medical evidence of at sufficient medical issues to be considered disabled. In fact other options exist cover people up to the poverty line and the ones at and over go into an exchange. It depends what states decide to do. If they do not expand Medicaid the only option the Feds have is expanding the exchanges to include those at the bottom in the 0-100% of the povety line.

But overall the mandate is fine one way or another people must be in insurance plans for this to work as far as that can be done.

Originally Posted by Talon

I can give you one good reason to oppose ObamaCare, Polly: the individual mandate.

Thank Romney and the republicans for that one. They forced Obama to replace the public option with the mandate.

The individual mandate that Republicans complain about today was, in fact, originally their idea in the first place. It was proposed by none other than Newt Gingrich and the Heritage Foundation in the '90s as an alternative to the Clinton plan of an employer mandate. The individual mandate was first put into place by Republican governor, and now party nominee for president, Mitt Romney. But suddenly, now that the president has signed such a measure into law as part of a "Romneycare"-esque national health care reform package, its all his possession: "Obamacare". You see how that works?

The Supreme Court decision allows the States to opt out of the expansion of Medicaid, without jeopardizing their participation in "regular" Medicaid, so I don't think it's going to do nearly as much to cover people as originally predicted.

States now have options for Medicaid that is good, for example they could ask for funds for people earning at the poverty line and have one or more serious chronic conditions with a clear list of what counts paid for with a penny more on state sales tax. Or could expand it to those earning 138% of the poverty line based on income but charge for this say 5% of the persons income and more out of pocket costs over those on for disability. The fact is the decision is not all doom and gloom look at it as I do giving states choices they didn't have before the all or nothing of the ACA.

Why is this bad I thought Republicans wanted states to have their rights now its all on them to make expansions or not and how they want.

Originally Posted by polly

.....to get mammograms for free.

That's as far as I got. Nothing is "free". The machines, the staff, the building, the electricity, the doctors.....None of that is "free".

Irish politician kicks the ass off a Tea Bagger:


http://www.upworthy.com/a-tea-partie...t-go-so-we?g=4


This is how liberals and other patriots should always answer to right wing critics who hate America and who love to see Americans die due to the right wing terrorism of the lack of health care.