Happy Anniversary to the Affordable Care Act!!


Here is a master list of some of my favorite PPACA resources, feel free to inform yourself, or help educate someone else who may have inaccurate ideas about the content or the meaning of the healthcare law.

As more and more of the legislation goes into effect, there are going to be more and more myths floating around, so bookmark this for future reference! ;)

This is my absolute favorite reference- if you only bookmark one page make it this one: http://abaldwin360.tumblr.com/post/25504467630/what-exactly-is-obamacare-and-what-does-it-change

(this one has citations to the ACA: http://www.reddit.com/r/explainlikeimfive/comments/vb8vs/eli5_what_exactly_is_obamacare_and_what_did_it/c530lfx)

The “non-partisan” (slightly right-leaning) site ProCon.org’s take is even Obamacare friendly: http://healthcarereform.procon.org/

Kaiser’s Consumer Guide: http://www.kaiserhealthnews.org/Stories/2010/March/22/consumers-guide-health-reform.aspx

How the ACA affects disabled people: http://www.healthcare.gov/news/factsheets/2010/11/affordable-care-act-americans-disabilities.html

Information on a federally sponsored exchange option (NOT A PUBLIC OPTION) http://rollingforwardwithobama.tumblr.com/post/35590678493/a-federally-sponsored-non-profit-health-insurance

Information on the Exchange Marketplace: http://www.healthcare.gov/marketplace/index.html

The HHS website developed specifically to help the public understand the law: http://www.healthcare.gov/index.html

The ENTIRE TEXT of the Healthcare Law! http://www.healthcare.gov/law/full/index.html

Also found here: http://housedocs.house.gov/energycommerce/ppacacon.pdf

The entire text of the Supreme Court decision on the constitutionality of the ACA: http://www.supremecourt.gov/opinions/11pdf/11-393c3a2.pdf

and last but not least:

The ENTIRE LIST of Obamacare myths on Snopes! 


The Supreme Court today upheld the Affordable Care Act, the health care reform law signed by President Obama in 2010, ruling 5-4 that the law was constitutional. Chief Justice John Roberts joined Justices Sonya Sotomayor, Stephen Breyer, Ruth Bader Ginsburg, and Elena Kagan on the opinion. The individual mandate, the requirement that all Americans purchase health insurance or pay a fine, was upheld as legal under Congress’ taxing ability.

Health care reform isn’t important just because it expands access to quality, affordable care, but also because rapidly rising costs and the fact that 30 million Americans don’t have insurance are weighing down the American economy. Here are four reasons why the Court’s decision is good news for the still-struggling economy:

1) Obamacare will reduce the deficit. The Congressional Budget Office estimated in 2011 that Obamacare will reduce the federal deficit by $210 billionover the next decade. The law is expected to save about $1 trillion over its second decade, according to other CBO analyses. The CBO found that repealing the law, as Republicans attempted to do in 2011, would increase the deficit by$230 billion over the next 10 years.

2) Health care costs for young Americans won’t skyrocket. More than 3.1 million young Americans have insurance thanks to Obamacare. Without the law, the cost of acquiring an equivalent health care plan would have risen dramatically at a time when young people are still struggling with the effects of the Great Recession.

3) Millions of jobs will be created. Health reform will help create roughly 4 million jobs over the next decade, according to a 2010 Center for American Progress report, by reducing the cost of health care and making it cheaper for businesses to hire. The law will create between 250,000 and 400,000 jobs a year, and they will be spread across sectors: according to the study, the law will help create more than 200,000 manufacturing and 900,000 in the service sector by 2016.

4) It will be cheaper for employers to provide health care. American businesses are under tremendous pressure thanks to rising health care costs, and these costs are often passed on to customers (one study estimates that each car sold by General Motors contains $1,200 in built-in health costs). The ACA, however, will make it cheaper for businesses to provide care, and not just by reducing the cost of care. Small businesses are already receiving tax credits contained in the law to help insure their employees, and it has already offered more than $4.7 billion in reinsurance payments to companies that are providing health care to retirees who aren’t yet eligible for Medicare.

Even a judge who was a finalist for appointment to the Supreme Court under George W. Bush agreed that striking down health care would have had disastrous consequences for the American economy. 

h/t: Travis Waldron at Think Progress Economy

“What the Court did not do on its last day in session, I will do on my first day if elected President of the United States, and that is I will act to repeal Obamacare.”

— Mitt Romney, June 28, 2012video source

What EXACTLY is Romney Vowing to Take Away from You and Your Family?

The Patient Protection and Affordable Care Act (aka PPACA, ACA or ObamaCare) forces insurance companies to play by the rules, prohibiting them from dropping your coverage if you get sick, billing you into bankruptcy because of an annual or lifetime limit, or, soon, discriminating against anyone with a pre-existing condition. 

All Americans will have the security of knowing that they don’t have to worry about losing coverage if they’re laid off or change jobs.  And insurance companies now have to cover your preventive care like mammograms and other cancer screenings. 

ObamaCare is already making a difference by:

1) Increasing Access to Affordable Care

Millions of Americans have gained new access to more affordable health coverage and care.

  • Coverage for young adults until age 26: 3.1 million young adults who were uninsured have gained coverage by being able to stay on their parent’s health plan, giving their families peace of mind.
  • Access to free preventive services: 54 million additional Americans now receive coverage through their private health insurance plan for many preventive services without cost sharing such as copays or deductibles. That means that more Americans will receive wellness visits, cancer screenings and other services that will help them get and stay healthy. Women can now get coverage— without cost-sharing—of even more preventive services they need.  Approximately 47 million women now have guaranteed access to additional preventive services without cost-sharing for policies renewing on or after August 1, 2012.
  • Coverage for people with pre-existing conditions: 82,000 Americans with pre-existing conditions have gained coverage through the Pre-Existing Condition Insurance Plan. This temporary program makes health coverage available and more affordable for individuals who are uninsured and have been denied health insurance because of a pre-existing condition.
  • Investing in primary care: The health care law invests in training and supporting thousands of new primary care doctors and nurses by providing bonus payments, scholarships and loan repayment, and new training opportunities.
  • Community Health Centers: Community Health Centers improve the health of the nation and assure access to quality primary health care services at more than 8,000 service delivery sites around the country. Since the beginning of 2009, health centers have increased the total number of patients served on an annual basis by 2.4 million.

2) Making Care More Affordable

The health care law is bringing down health care costs and making sure health care dollars are spent wisely.

  • 80/20 Rule: The health insurance companies of 76 million Americans now have to meet the 80/20 rule, or Medical Loss Ratio, where they must spend at least 80 cents of your premium dollar on your health care or improvements to care. If they fail to meet this standard, they must provide a rebate to their customers. Already, the 80/20 rule is helping deliver rebates worth $1.1 billion to nearly 13 million consumers – an average rebate of $151 per household.
  • Reviewing premium increases: For the first time ever in every State, insurance companies must publicly justify any rate increase of 10% or more. And the law gives States new resources to review and block these premium hikes. To date, rate review has helped save an estimated $1 billion for Americans and 42 States have used their rate review grant funds to make the rate review process stronger and more transparent.
  • Small business tax credits: Small businesses have long paid a higher price for health insurance – often 18% more than larger employers. Tax credits for small businesses will benefit an estimated two million workers who get their insurance from an estimated 360,000 small employers who received the credit in 2011. In 2014, small business owners will get more relief with tax credits and affordable insurance choices in the new competitive health insurance marketplace in every State.
  • Supporting early retiree coverage: The Early Retiree Reinsurance Program (ERRP) has provided $5 billion in reinsurance payments to employers so they can continue to provide benefits to their retired workers who are not yet eligible for Medicare. This program has reduced premiums or cost sharing for at least 19 million early retirees, workers, their spouses, surviving spouses and dependents.

3) Strengthening Medicare

Nearly 50 million seniors and Americans with disabilities depend on Medicare every day. The health care law makes Medicare stronger and extends the life of the Medicare Trust Fund by eight years.

  • Reducing prescription drug costs in Medicare: Nearly 5.4 million seniors and people with disabilities have saved more than $4.1 billion on prescription drugs thanks to the Affordable Care Act. These savings include a one-time $250 rebate check to seniors who fell into the prescription drug coverage gap known as the “donut hole” in 2010, and a 50% discount on brand-name drugs. Seniors in the “donut hole” have saved an average of $768. 
  • Medicare preventive benefits: The Affordable Care Act makes many key preventive services available with no co-pay or deductible to help ensure that seniors don’t have to skip a potentially life-saving cancer screening because they can’t afford it. More than 32.5 million seniors have already received one or more free preventive services, including the new Annual Wellness Visit. During the first seven months of 2012, the health care law has helped nearly 18 million people with original Medicare get at least one preventive service at no cost to them.
  • Saving money for seniors: The average person with Medicare will save approximately $4,200 from 2011 to 2021, while those with high prescription drug costs will save much more – as much as $16,000 over the same period. This is especially good news for people with chronic conditions such as diabetes and high blood pressure who must take their medication every day for many years.
  • Fighting fraud and saving taxpayer dollars: The health care law helps stop fraud with tougher screening procedures, stronger penalties, and new technology. Total recoveries over the last three years were $10.7 billion and prosecutions are up too. Learn more about these efforts at StopMedicareFraud.gov.

4) Holding Insurance Companies Accountable

Under the law, patients have more rights and protections – and more security that their coverage will be there for them when they need it. For example:

  • No more pre-existing condition denials for children: The parents of over 17.6 million children with pre-existing conditions no longer have to worry that their children will be denied coverage because of a pre-existing condition.
  • No more lifetime dollar limits on coverage: 105 million Americans no longer have a lifetime dollar limit on essential health benefits. Annual dollar limits are set at increasingly higher amounts until January 1, 2014 when most plans issued or renewed are banned from having an annual dollar limit on coverage.
  • Insurance companies can’t drop your coverage when you get sick: You no longer need to fear that your insurance company can rescind or take away coverage when they get sick because of an unintentional mistake on an application.
  • No more coverage denials without appeal: Many Americans with private coverage now have the right to appeal an insurance company’s coverage decision and the Affordable Care Act provides you with information and assistance to give you more control over your health care decisions.
  • Helping consumers understand their coverage: The Health Insurance Finder on HealthCare.gov gives you information about the health plan choices in your community. Starting in September 2012, health plans will provide you with clear, consistent and comparable information about their health plan benefits and coverage. The Summary of Benefits and Coverage forms will enable you to easily understand your health coverage and determine the best health insurance options for your family.

5) Laying the Foundation for 2014

Starting in 2014, a new competitive health insurance marketplace will make it easy for you to compare qualified health plans, get answers to questions, find out if you are eligible for tax credits for private insurance or health programs like Medicaid and the Children’s Health Insurance Program (CHIP), and enroll in a health plan that meets your needs.

  • Building the Health Insurance Marketplace: The Affordable Care Act gives States the resources and power to build and run their own competitive health insurance marketplace, sometimes called an Exchange. Thirty-four States, including the District of Columbia, are on their way, having received at total of nearly $850 million in Exchange Establishment Grants.
  • Ensuring Health Insurance Choices: The Affordable Care Act creates a new type of non-profit health insurer, called a Consumer Operated and Oriented Plan (CO-OP). These insurers are run by their members. CO-OPs are meant to offer consumer-friendly, affordable health insurance options to individuals and small businesses. Already 20 non-profits intending to offer coverage in 20 states have been awarded more than $1.5 billion in loans to get up and running.
  • Banning the Worst Insurance Practices: Starting in 2014, the Affordable Care Act will prohibit health insurers from charging more or denying coverage to people because of pre-existing conditions. It will also make charging women more for health insurance a thing of the past.
Get the FACTS at Healthcare.gov

 had my annual physical exam this week, and since I had to take time off work to do it, I figured I’d at least get a little bit of research done since I knew I wanted to do some kind of essay about it today, given the exchanges open for business in two days. So I queried my doctor about what he’s hearing from patients when they talk to him about Obamacare. Do they have questions? Are they confused by any particular part of it?

He just sort of shook his head and sighed. Understand that this is Idaho, and he’s a doctor. So he’s pretty much a Republican. But he’s a very frustrated Republican who keeps hearing his patients recite back to him Fox News talking points. They think government is going to dictate what kind of care they can get. They think they’re losing their freedom. And don’t get him started on death panels. Yes, death panels. Still. He talked to me about the real death panel experiences he’s had. The ones with the insurance companies. Like last year when he had a patient in her sixties with early stage liver cancer. She was a fantastic candidate for a relatively new, very effective treatment in which the tumor is cauterized in a minimally invasive procedure. Nope, her insurance company said. It’s not an approved procedure, so she didn’t get it. And she didn’t make it.

We all know those kinds of stories. Presumably, even the people who are duped in to believing that there really are death panels in Obamacare either have been or know someone who has been screwed over by their insurance company. And yet, this new law that will rein in some of the worst abuses of those insurance companies is scarier to them than the status quo. Because they just keep hearing the myths. So let’s go through it one more time, those persistent myths that just won’t go away. Because in just a few days the exchanges open, everybody’s talking about it, so that makes now a really good time to inject some truth.

Let’s head below the fold and talk it out.

Almost all of the big lies are aimed at, as usual, the people who are the “haves.” That’s why the people my doctor has been talking to are so scared. That’s why they’ve been talking about losing “freedom.” They’ve been listening to Fox News and hearing that Obamacare is going to take what they already have away from them.

Obamacare will take the insurance I have away.

Let’s just get this straight: If you already have insurance, Obamacare is not taking it away. If you do lose it, it’s because your employer has dropped your coverage. It’s true that some employers might drop it, either to make a political point or because it would cost them less to pay the penalty for not providing coverage than to continue to carry it. But that’s not something Obamacare is forcing them to do.

Obamacare won’t let me see my doctor anymore.

Trust me, the government doesn’t care what doctor you see. If you have insurance, and you have a primary doctor, that won’t change unless your insurance company decides it will change. The power to force you to find a new doctor is something insurance companies have always had, and still do.

The IRS will control my health care.

That’s a persistent and difficult one to shake. Everyone hates the IRS, so it’s easy to believe the worst here. The IRS has a big role: It’s going to be verifying how much of a subsidy you’re going to be getting to help pay for insurance if you purchase it on the exchange. If you already have health insurance, the IRS will have nothing to do with it, with you, with your health care. They don’t know who your doctor is. They won’t see your medical records. They don’t care about your medical records.

It’s taking Medicare money away from me.

Scaring old people is the easiest and favorite thing for Republicans to do. Obamacare will not make you pay more for your Medicare, it will not take it away, and if you’re on Medicare, you don’t have to do anything at all on Oct. 1. But if you are on Medicare, you will see some additional benefits from Obamacare: more preventative care services and more savings on prescription drug coverage.

Obamacare is going to ration my health care (a corollary of death panels).

Your insurance company already rations your health care, but much of that’s changed with Obamacare: you can now get preventive care services without having a copay; you don’t face annual or lifetime caps on how much your insurance company will pay out for you if you get seriously, chronically ill; your insurance company can’t deem a condition “pre-existing” and refuse to cover it.

The Independent Payment Advisory Board, the supposed death panel, is prohibited in the law from rationing health care. It’s right there in black and white: It cannot make "any recommendation to ration health care … or otherwise restrict benefits or modify eligibility criteria."

This is a government take-over of health care in America.

We should be so lucky. Your insurance company won’t be going out of business, turning all your records over to the government. The insurance industry will continue to flourish, albeit with some new regulations that even the people propounding this one like, number one being no more pre-existing conditions.

There are a lot more, really crazy, chain-email type ones like “you won’t get cancer treatment after age 76,” or “government workers will force their way into your home to inspect it,” or “this is the biggest tax increase in the history of the world,” or “Obamacare creates a database of people’s sex lives.” Occasionally, PolitiFact is useful debunking lies. They do a good job with these and a handful of others.

But the lies directed toward the uninsured are the ones that really expose just how immoral Republicans are. They are trying to convince people, particularly young people, that it’s better to go without the protection of health insurance to make a political statement.

h/t: Joan McCarter at Daily Kos

The Challenges that come with Obamacare

about-hortense replied to your post: Great, lots more people are about to have insurance.

i don’t understand the meaning of that BUT. This topic intrigues me a lot and, as a non-american, I’d like you to stretch out ya point of view which, obviosuly, lingers behind that opening adversative.

What I was referring to is that there’s a huge deficit of primary care doctors in this country, and our system does not do a very good job of encouraging trainees to go into primary care.  

Putting it simplistically, billing in the American medical system is based on procedures, tests, and the complexity of diagnoses. Doctors bill a certain amount for different things, and insurance companies generally pay a higher percentage of what doctors charge than government programs like Medicare and Medicaid pay. So the more patients you have with private insurance, the better your reimbursement rates.


The problem is that things like preventive care and regular follow-ups for chronic conditions (things which should theoretically save the system money by preventing conditions that require expensive procedures and tests) are not considered complex enough to warrant decent pay from government payor sources (Medicare/Medicaid). And guess what takes up the majority of primary care docs time? You guessed it, preventive care and follow up visits. 

Read More

When what happened today, happened.

I was sitting with a bunch of co-workers in a conference room, eyes and ears tuned to CNN and watching Wolf Blitzer talking to their correspondent at the Supreme Court, waiting for the chyron to change, indicating that their producer inside the building got word of the Justices’ ruling.

And when that lower-third flashed — that SCOTUS had killed the individual mandate — my heart sank. I pounded once on the table in frustration and anger and sadness and caught my colleagues off guard. I admittedly have a dog in this fight — community health providers who I’ve worked with for a long time — and just to be sure we were all on the same page, I gave them a call.

But no sooner than they answered the phone did I see a Reuters post on my Dashboard: the Supremes had UPHELD the law. I let my friends know that CNN had reported that the individual mandate was dead — but now Reuters was saying something else. I put them on hold, grabbed the remote and desperately went to find MSNBC. Heaven knows I wasn’t going to Fox.

And there it was, right there on screen: the Court ruled that the Patient Protection and Affordable Care Act, years in the making, was constitutional after all. Well, the main guts of it: the individual mandate. It was intact. We didn’t know the breakdown but Chief Justice John Roberts, a conservative appointed by George W. Bush, had apparently sided with the liberals on the bench.

It was at that moment I pounded the table again and let out a whoop, along with just about everyone else in the room: we were going to have universal healthcare in our lifetimes.

My heart’s still racing now, at the thought of it. Every American will have access to healthcare insurance, and access to quality care. And while I have no illusion that the Republicans won’t fight this tooth and nail all the way to 2014, what we’ve witnessed here is the endgame of a President who saw what needed to be done and who, with his fellow lawmakers, carried the ball into the end zone.  Principled men and women who spent political capital and made personal sacrifices to see to it that tens of millions of our fellow citizens were now on a level playing field.

It’s a historic day for our nation, and I am proud, so proud, to call Barack Obama my president.

Thank you, sir.

That’s a scandal—those people are guilty of murder in my opinion. Some of those people they persuade are going to end up dying because they don’t have health insurance. For people who do that to other people in the name of some obscure political ideology is one of the grossest violations of our humanity I can think of.
—  Angus King (I-ME), on conservatives’ attempts to dissuade uninsured people from enrolling in PPACA [Obamacare]

Chris Collins (R - NY), unsympathetic idiot extraordinaire.

All the conservatives whining about “free birth control” need to sit the fuck down and learn how insurance works. 

You pay a premium, plus copay when you get the actual service. The only thing that has changed is THERE IS NO MORE COPAY FOR BIRTH CONTROL. You still pay the insurance company a premium in the first place. Birth control is fully covered by the insurance company, but you’re still paying for the plan. THEREFORE IT IS NOT FREE. YOU ARE STILL PAYING FOR YOUR OWN BIRTH CONTROL BY PAYING FOR HEALTH INSURANCE. 

Apparently this is a difficult concept for people. 


Sen. Mitch McConnell has some explaining to do.

What in the world did he mean last week when he told reporters that repeal of the Affordable Care Act — “root and branch,” as he has demanded many times — is “unconnected” to the future of Kynect, Kentucky’s health insurance exchange?

Asked specifically if Kynect should be dismantled, McConnell said: “I think that’s unconnected to my comments about the overall question.”


Nothing could be more connected — or should be more important to Kentucky’s senior senator — than the fates of the more than 400,000 Kentuckians who are getting health insurance, many for the first time, and the federal Affordable Care Act, which is making that possible.

Repeal the federal law, which McConnell calls “Obamacare,” and the state exchange would collapse.

Kynect could not survive without the ACA’s insurance reforms, including no longer allowing insurance companies to cancel policies when people get sick or deny them coverage because of pre-existing conditions, as well as the provision ending lifetime limits on benefit payments. (Kentucky tried to enact such reforms in the 1990s and found out we were too small a market to do it alone.)

Kentucky’s exchange also could not survive without the federal funding and tax credits that are helping 300,000 previously uninsured Kentuckians gain access to regular preventive medicine, including colonoscopies, mammograms and birth control without co-pays.

As a result of a law that McConnell wants to repeal, one in 10 of his constituents no longer have to worry that an illness or injury will drive them into personal bankruptcy or a premature grave.

Repealing the federal law would also end the Medicaid expansion that is enabling Kentucky to expand desperately needed drug treatment and mental health services.

Kynect is the Affordable Care Act is Obamacare — even if Kentuckians are confused about which is which.

And, really, it’s no wonder that polls show many Kentuckians don’t know that Kynect is a direct product of President Barack Obama’s landmark law. How can average people be expected to understand if the Senate’s Republican leader still hasn’t figured it out, or at least is pretending there’s no connection?

We asked the McConnell campaign for a clarification and were sent the usual talking points and a statement saying, “If Obamacare is repealed, Kentucky should decide for itself whether to keep Kynect or set up a different marketplace,” a suggestion that is unconnected to reality.

Kentuckians are waiting to learn if their five-term senator understands — or cares — how much is at stake.

Read more here: http://www.kentucky.com/2014/05/28/3262267/say-again-senator-aca-unkynected.html#storylink=cpy

h/t: Lexington Herald-Leader

  1. OBAMACARE IS A JOB-KILLER.   “The impartial truth squad FactCheck.org has debunked the job-killer claim so many times that in its latest update you can hear a groan of weary frustration: words like ‘whopper’ and ‘bogus’ and ‘hooey.’ The job-killer claim is also discredited by the experience under the Massachusetts law on which Obamacare was modeled.”
  2. OBAMACARE IS A FEDERAL TAKEOVER OF HEALTH INSURANCE.  “Let’s be blunt. The word for that is ‘lie.’”
  3. THE UNFETTERED MARKETPLACE IS A BETTER SOLUTION.  "I’m deeply suspicious of the claim that a health care system dominated by powerful vested interests and mystifying in its complexity can be tamed by consumers who are strapped for time, often poor, sometimes uneducated, confused and afraid.”
  4. LEAVE IT TO THE STATES. THEY’LL FIX IT.   "You’ve heard a lot about the Massachusetts law. You may not have heard about the seven other states that passed laws requiring insurers to offer coverage to all. They were dismal failures because they failed to mandate that everyone, including the young and healthy, buy in. Massachusetts — fairly progressive, relatively affluent, with an abundance of health providers — included a mandate and became the successful exception. To expand that program beyond Massachusetts required … Barack Obama.”
  5. OBAMACARE IS A LOSER. RUN AGAINST IT, RUN FROM IT, BUT FOR HEAVEN’S SAKE DON’T RUN ON IT.  "If the Obama campaign needs a snappy one-liner, it could borrow this one from David Cutler: ‘Never before in history has a candidate run for president with the idea that too many people have insurance coverage.’"

The Pre-Existing Condition Insurance Plan is a state-by-state owned plan that covers adults with pre-existing conditions and cannot afford insurance until the ACA is fully implemented in 2014. 

Please pass this along—it might save a life!

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