57% of those visiting exchange websites could not find a plan they could afford.

[eridani]

http://www.commonwealthfund.org/publications/issue-briefs/2015/sep/to-enroll-or-not-to-enroll

Exhibit 2. Just under half of the adults who have visited the marketplace enrolled in a marketplace plan or Medicaid

52% - Did not select a private plan or enroll in Medicaid

30% - Selected a private health plan

15% - Enrolled in Medicaid

2% - Don’t know/refused


Exhibit 6. Among market-place visitors who didn’t enroll, more than half said they couldn’t find an affordable plan

Can you tell me why you did not obtain a private health insurance plan or Medicaid coverage when you visited the marketplace? Was it because…?

Percent of adults ages 19-64 who visited the marketplace but did not select coverage

57% - Could not find a plan you could afford

51% - Obtained health insurance through another source

43% - Not eligible to enroll in Medicaid or for financial assistance

38% - Found the process of enrolling in a plan difficult or confusing

32% - Could not find a plan with the type of coverage you need

15% - Decided you did not need health insurance

14% - Did not know where to get help to sign up

23% - Some other reason

Affordability was a key reason people did not enroll in plans. More than half (57%) of adults who visited the marketplaces but did not enroll said they could not find a plan they could afford. Excluding the adults who also said they gained coverage elsewhere, the majority of those who did not enroll because they couldn’t find affordable plans had lower incomes. More than half (54%) had incomes in the range that made them eligible for subsidies (i.e., from 100 percent to 400 percent of the federal poverty level, or $11,670 to $46,680 in annual income for an individual). Thirty percent had incomes under 100 percent of poverty. An estimated 26 percent (and thus nearly all of those with incomes under 100 percent of poverty) were likely in the so-called Medicaid coverage gap. That is, they were living in states that had not expanded eligibility for Medicaid at the time of the survey and had incomes under 100 percent of poverty and thereby not eligible for marketplace subsidies. About 11 percent had incomes that exceeded the threshold that made them eligible for subsidies (i.e., 400 percent of poverty).

Comment by Don McCanne of PNHP: Is the Affordable Care Act a misnomer? Although half of the individuals who visited the insurance exchanges and did not enroll obtained coverage outside of the exchanges, the other half did not enroll because they found the plans unaffordable.

Making health care affordable for everyone was the primary goal of reform. It didn’t happen. But it would if we were to enact a single payer national health program.

[GoneFishin]

1. This was a completely predictable outcome of allowing the health care companies to extract

profits from ACA. The hunger for profits will always drive these vultures to seek out every loop hole, every weasel tactic, and every ploy to extract more profit, with no regard whatsoever for the good of the country or the health of the U.S. people. They cannot be trusted to operate in good faith.

They should have been shown the door from day one.

[Enthusiast]

4. Every weasel tactic must become a thing of history.

[URL=.html][IMG][/IMG][/URL]

[raouldukelives]

17. That is why they were concern one.

Whatever shareholders demand, shareholders get. To the chagrin of the health, wealth and liberty of every organism on the face of the planet.

We all live in the most democracy Wall St shareholders cannot afford to block.

[hughee99]

19. This was completely predicted as well.

Nt

[GoneFishin]

78. How timely. I just found out my barely "affordable health care" just went up 300%.

[Enthusiast]

2. A universal single payer system with no insurance industry influence is the only answer.

New rule: If you do not contribute directly to the health care of the citizenry, no money for you!

[Angleae]

3. It's actually 29.6% that couldn't find a plan they could afford (57% of 52%)

[striegl]

11. Good point but...

It's actually 21%. 15% of the 52% selected Medicaid

[Major Nikon]

23. Not only that, it's asking the opinion of someone as to whether or not they can afford it

Someone who makes $80K may not be able to afford a plan due to other considerations, but someone else who makes $80K may very easily afford a plan.

[Hortensis]

37. Excellent points, all. Opinions are extremely subjective. I'm a little bemused

over these responses.

57% could not find a plan they could "afford," even plans with lower coverages with government subsidies? As already pointed out, though, 37% of these are unfortunately not eligible for subsidies. But 51% found cheaper free market coverage? Let's compare coverages. The free market isn't in the charity business.

38% found it difficult or confusing? That over a third! I've applied 2 years now, and it doesn't get simpler. A possible reason that occurs may be that half our population reads at dysfunctional levels, but the text is very simply written and as short as possible for this reason.

32% could not find the TYPE of coverage needed? Oh, come on.

[pnwmom]

44. Good catch.

[jwirr]

103. Okay. I am not up on how to work with these statistics but

Medicaid is misplaced in this group is it not? Medicare and Medicaid were used to take those in ACA to other programs they were eligible for.

Shouldn't those people be taken out of this study? They did get a program they could afford.

[striegl]

123. They fudged the numbers

http://www.democraticunderground.com/?com=view_post&forum=1002&pid=7211787

[hobbit709]

5. A plan you can barely afford with a $5,000 deductible is no plan at all.

It takes money that one can't afford to spend and gives you nothing for it.
If you can't even afford the copay, how can you afford the $5K deductible.

[Major Nikon]

20. I disagree

The true purpose of any form of insurance is to keep you and your family from going bankrupt. All ACA plans accomplish this. Besides that if you are healthy and generally don't go to the doctor, a plan like that makes good sense because otherwise one is paying for something they probably won't use anyway.

[Orrex]

25. A $5000 deductable is enough to drive some families into bankruptcy, alas

[Major Nikon]

32. I can't imagine that being too many

The reason most people file bankruptcy is because they are being sued, they are facing the threat of having things repossessed, or their wages are being garnished.

[Orrex]

33. $5000 could certainly do that

It would easily have done it to my family just a few years ago, and I'm not sure that it wouldn't do it today.

And I'm better off than a sizable chunk of society.

[Major Nikon]

36. Probably harder than you think

Most medical debt can be discharged by making zero interest payments over time. $41 per month will pay a $5000 debt in 10 years. Bankruptcy is not automatic. If a judge decides you can pay, they won't let you write off the debt. It's not hard to imagine this happening to some people, but not all that many because those in that situation probably couldn't afford the policy to begin with.

[Hortensis]

39. That $5000 deductible is often chosen by people of limited means

who may not see a medical professional for years or even decades because they feel they can't afford the bills, and "it'll probably go away anyway."

The purpose of healthcare coverage is not just to stave of bankruptcy but, first, to make healthcare available to people who need it. Most diabetics and people with chronic kidney disease are first diagnosed after they become symptomatic, as is the case for many other irreversible and progressive diseases.

I used to work in insurance, and it's clear to me that in the age of the medical revolution the very term insurance has become obsolete for healthcare. The goal is no longer just to cover unforeseen expenses. Today's insurers have become administrators of lifetime healthcare maintenance programs.

But in a world of constant, soaring healthcare cost inflation, high deductibles mean failure of the plans for millions whose income today may be lower in real terms than it would have been in the 1970s.

[Major Nikon]

46. It's also chosen by healthy people who generally don't go to the doctor

While it's true that insurance may have many purposes, the primary purpose is to keep one solvent. As such said policy is not worthless.

[Hortensis]

53. Yes, and then many get sick and still don't go to the doctor. NO to primary purpose.

That was the past.

Now and in future, most individuals, even those who do not develop chronic conditions in middle age, can REASONABLY EXPECT medical costs over decades to completely outstrip their ability to pay. The NEW PRIMARY PURPOSES OF HEALTHCARE COVERAGE are to keep people healthy, productive and independent for as long as possible and to allow them to live anywhere from 10 to 30 and more years longer than they would without healthcare.

Secondary is to keep people from being broken economically. Even though this is also a huge benefit, it doesn't trump life itself.

[Major Nikon]

65. The definition of the word "insurance" hasn't changed

All of the things you mentioned are certainly laudable goals and well worth perusing, but it doesn't change the reality of an insurance plan that insures one against catastrophic loss is certainly not worthless.

[Hortensis]

69. No, but the reality of it has changed. We live in the Medical Age now.

[Orrex]

58. Bully for them.

If it works for the healthy people who don't go to the doctor, then that's super-duper. Until they fall down the steps or accidentally slice their hand with a table saw.

It's a mistake to pretend that the $5000 deductible is reasonable if the claimed justification is that people won't need it, because that ignores the reality of people who do need it, which is frankly the bigger problem.

It's like the financial advice (offered by pretty much any media outlet including NPR) that boils down to "set aside a few thousand dollars of your discretionary income each month," as if that's even possible for more than half of the population.


I'm not worried about people of good health and secure finances, because they can take care of themselves.

[Major Nikon]

71. I'm not pretending anything

I'm challenging the notion that such a policy is worthless. Auto insurance policies don't cover preventative maintenance. Does that make them worthless? Homeowner's insurance policies don't cover replacing worn out carpet. Does that make them worthless? Flood insurance policies don't pay for gutters for your home. Does that make them worthless? For just about any type of insurance you can name it works just this way. Not everyone can afford insurance unless it's universal.

[Orrex]

80. Those examples are not relevant.

Auto insurance policies don't cover preventative maintenance. Does that make them worthless?

They are worthless for preventative maintenance, yes.

Homeowner's insurance policies don't cover replacing worn out carpet. Does that make them worthless?

They are worthless for carpet maintance due to wear and tear, yes.

Flood insurance policies don't pay for gutters for your home. Does that make them worthless?

They are worthless for covering the cost of gutters, yes.

You're arguing a tautology: a thing is not worthless if it can be demonstrated to have any worth at all.

Well no kidding, and no one is claiming otherwise. But that's not even the point. The more relevant argument is this: A thing has no worth if it cannot be used by the people who need to use it. For people who can't afford a tidy $5000 deductible, the service that requires a $5000 deductible is worthless.

Chances are pretty good that your gutter and your carpet won't go bankrupt if your insurance policy fails to cover their maintenance, not least because your insurance has nothing to do with them. That's very different from a mandated insurance policy that can't be used by the low-income people who are forced to maintain it.

[Major Nikon]

92. Neither is pointing out some may not be able to personally benefit

When I'm countering the assertion that such policies are worthless.

Furthermore those examples are all perfectly relevant in demonstrating the purpose of insurance is to insure against catastrophic loss. Financing health care is not the primary purpose of health insurance. The only reason it became part of health insurance is because employers and unions were given tax benefits for including it.

The more relevant argument is this: A thing has no worth if it cannot be used by the people who need to use it.

That's not much of an argument. I've already pointed out that millions of people actually do both need and want such policies. Furthermore even if they can't personally benefit from it, the policy still has worth. People don't personally benefit from their own liability coverage either, yet it's still actually mandated as a condition of operating a vehicle on public roads, unlike ACA which has no actual forced mandate to anyone other than employers.

[Orrex]

102. We're simply arguing different points

You are argung that the ACA has value because it helps some people. I have no interest in discussing this because I don't disagree with it.

I am arguing that the ACA has no value for people whom it does not help because they can't afford to use it. You seem to have no interest in discussing this because the ACA has value for people whom it does help (a fact that, incidentally, I do not dispute).

[div class="excerpt]

The more relevant argument is this: A thing has no worth if it cannot be used by the people who need to use it.

That's not much of an argument. I've already pointed out that millions of people actually do both need and want such policies.And that's not much of a refutation, because it's irrelevant to my point that the ACA offers no value to people who can't use it, regardless of the "millions of people actually do both need and want such policies."

[Major Nikon]

104. If you had no interest in discussing it, why did you reply to post 20?

I have all sorts of interest in discussing ACA improvements and do so. I also have interest in correcting false assertions regarding ACA.

And that's not much of a refutation, because it's irrelevant to my point that the ACA offers no value to people who can't use it, regardless of the "millions of people actually do both need and want such policies."

Now you are moving the goalposts.

The more relevant argument is this: A thing has no worth if it cannot be used by the people who need to use it.

That's not the same thing as saying it has no worth to them personally. The policy still has worth regardless.

[Orrex]

108. Perhaps you should read reply #25, in which I answered that question

I have all sorts of interest in discussing ACA improvements and do so. I also have interest in correcting false assertions regarding ACA.

Bravo. When I make false statements about the ACA, I will be happy to enlist your noble service in correcting them.

And that's not much of a refutation, because it's irrelevant to my point that the ACA offers no value to people who can't use it, regardless of the "millions of people actually do both need and want such policies."

Now you are moving the goalposts.

No, you've simply realized at long last that your goalposts are not my goalposts.

An argument need not be static, and if the argument expands beyond the original point, so much the better.

You off-handedly dismissed my original point that $5000 can easily bankrupt an economically challenged family, despite the reality that directly contradicts your dismissal. I then moved on to a second point (consistent with the first) that the ACA offers no value to people who are for all practical purposes unable to use it.

The more relevant argument is this: A thing has no worth if it cannot be used by the people who need to use it.

That's not the same thing as saying it has no worth to them personally. The policy still has worth regardless.

Please explain the worth of the policy to the person who has no way to use it. That's like insisting that a freshwater lake has value for the person dehydrating in a desert 10,000 miles away.


You're still arguing that the ACA has worth for those who find worth in it. Lovely. And I don't care, because no shit it does.

I maintain that the ACA has no worth for people unable to use it, and you've responded by saying, in essence, "it still has worth." If you would care to offer a different summation of your position, then please do so.

Regardless, I'm getting bored of going through this with you.

[hobbit709]

41. $41/mo is laughable when you have $2 in your pocket on payday morning-if that much.

Some people can't even afford to file bankruptcy-the lawyers want cash up front.
If you have no house, no car, why bother.

[Orrex]

52. Forgive me, but I've walked this road

I'm not speaking from theory or from guesswork. Not long ago I was staring down the barrel of bankruptcy, even consulting an attorney about it. The situation is grim unless you're a billionaire who bankrupts his companies and then runs for president.

The problem isn't just the $5000 deductible that threatens to crush a family's finances; it's the avalanche that follows it.

Sure, some hospitals might discharge some of your debt, but it's more likely that they'll put you on a payment plan that you can't afford, either. Then you get to choose between paying your medical bills or paying your rent/mortgage, your student loans, your utilities, gas for your car and/or making your car payments, any one of which is more than happy to throw you into default in a merry cascade. And if you've been lucky enough to lose your job as a result of the medical condition that caused you to miss work in the first place, you're even more thoroughly fucked.

For a large fraction of society, a $5,000 annual deductible, on top of copays, coinsurance, and out-of-pocket costs, might as well be a $500M bill. It's simply an impossible target.

[Major Nikon]

74. You are arguing against something I didn't claim

My claim is that such a policy is most certainly not worthless. In order to understand the worth, you have to understand what we had before ACA. Before ACA, most policies did not include a catastrophic maximum, which means that even if you could afford a policy, you had zero insurance against bankruptcy which is kinda the whole idea behind insurance to begin with. I would argue that before ACA, virtually all non-group policies were truly worthless because the chances you would ever get more out of them than what you paid in were virtually nil.

[Orrex]

75. A policy that one cannot use is a worthless policy

It doesn't matter if the policy has a catastrophic maximum if your finances are too weak to bear eve the non-catastrophic minimum. For all practical financial purposes, one is exactly the same as the other: unattainable.

[Major Nikon]

77. A policy that one can potentially use is not a worthless policy

An equally true statement which renders my original assertion valid. Exceptions do not make the rule. The reality is that people are buying these policies because they do have worth to them, which before ACA was not the case.

[Orrex]

81. I disagree

A policy that one can potentially use is not a worthless policy.

I disagree. A policy that one can potentially use but which cannot be used in practical reality is indeed a worthless policy in practical reality.

But let's get back to your irrelevant tautology:

The reality is that people are buying these policies because they do have worth to them,

i.e., they do not have zero worth for people find them to have non-zero worth. Well that's super, and once again I'm not concerned with people who can afford the policy, because they're not the issue.

[Major Nikon]

82. You keep pretending the exception makes the rule

The great part about ACA is regardless of whether you care or not for people who lost everything to health care bills prior to ACA, people still derive benefit from theses policies. Millions of people didn't buy health insurance prior to ACA, not because they couldn't afford it, but actually because the policies they could afford were no-shit worthless. So not only do such policies provide a benefit to those who buy them, they provide a net benefit to society which was effectively insuring them all along with or without insurance. That's why ACA has tremendous value even with its obvious flaws.

There is no question that some people are still left out in the cold who need to be covered, but the idea that these policies are of no benefit to anyone is very far afield from reality. So you are either trying to contradict me on that point and falling quite short, or you are trying to contradict a point I never made and am in complete agreement.

[Orrex]

89. No, that's not what I'm doing.

Nowhere have I ever asserted that the ACA as a whole is worthless, because clearly that is not the case. However, I am arguing that the ACA is indeed worthless for people who can't afford to take advantage of it.

There is no question that some people are still left out in the cold who need to be covered, but the idea that these policies are of no benefit to anyone is very far afield from reality.

I agree, and in fact that's exactly the opposite of the argument I am making.

[rusty fender]

97. People are buying them because

they are required, by law, to buy them! Medical insurance, by and large, is a legalized scam.

[Major Nikon]

101. Nonsense

For one thing, nobody is required by law to buy them so your assertion fails right out of the gate.

For another, the extra tax one would have to pay as a result of not buying insurance is less than the cost of the insurance itself. So anyone buying a policy solely for the tax benefit wouldn't be very smart.

[Humanist_Activist]

118. What about those with chronic conditions, that 5,000 dollar deductible renews annually...

for most plans, so they get hit with 5,000 dollars in debt every year.

Sure you can pay 41 dollars a month(or whatever is the minimum you negotiate the who provides medical care) but you might as well not since you can never pay it off.

[Major Nikon]

119. There's all sorts of "what about"s when there is no right to basic healthcare

We still have thousands of people dying each year from easily treatable chronic conditions because they can't afford it.

[hobbit709]

38. I have friends who are barely making enough to get by.

$400/wk gross doesn't leave money for even a copay much less the $5K deductible.

[Major Nikon]

49. Those people probably wouldn't buy the policy in the first place

The known flaw in ACA is that it's not universal and we can only thank the GOP for that.

[hobbit709]

50. Not just the GOP, It wasn't an R that said single payer was off the table.

[Major Nikon]

56. Single payer was off the table because of the GOP was unified against it

That's just the political reality.

[hobbit709]

62. Then why cave before negotiations even start.

As soon as that statement was made I knew the public was going to get screwed.

[Major Nikon]

66. Because there is no negotiating with the GOP

[tkmorris]

67. This is nonsense

The GOP was unified against ANY health care reform bill, not just single payer. Single payer was blocked by Blue-dog Dems, including the one whose name became synonymous with the final bill.

[Major Nikon]

72. It would have been blocked with or without them

Regardless, single payer =/ universal coverage.

[lumberjack_jeff]

88. Use the Kaiser calculator

Please tell us how much their premium would be.

If we're not discussing real numbers, all we're doing is (like the op) waving our arms.

The ACA is a huge improvement over the alternative.

[hobbit709]

93. Given the values for a friend's age and income here in TX it's $53/mo

Of course that doesn't do squat since he never has more than $20 a month left over after basic expenses.

It's easy to say things if you're not below the poverty level.

[lumberjack_jeff]

98. a) it's not the ACA's fault that Texas didn't expand medicaid.

b) the ACA is written such that he can wait to buy that $53 insurance when he inevitably does become sick.

[WinkyDink]

45. "The true purpose of any form of insurance is to" make money for the insurance company. FIXED!

[Major Nikon]

48. Pretty much all private enterprises are in the business of making money

It would be pretty naive to believe otherwise.

[canoeist52]

64. Absolutely! And by denying as much care as they can get away with, to make their profit!

[lumberjack_jeff]

87. "No plan at all" leaves you bankrupt.

$5000 is inconvenient, not disastrous.

For all its flaws, the ACA has ended medical bankruptcy.

[hobbit709]

91. To some people $500 is disastrous.

[lumberjack_jeff]

94. Life threatening illness is disastrous.

$500 or $5000 is comparatively trivial.

There is of course room for improvement but ACA is several orders of magnitude better than the previous situation.

Health care should cost 7% of GDP not 17%, but until it does, it's going to be expensive for us individually as well as collectively.

[hobbit709]

95. and the ACA is not HEALTHCARE.

Must be a nice view up there at that altitude on your horse.

[lumberjack_jeff]

100. Prior to ACA, "ruination" meant people dying because they lacked access to health care.

Today, "ruination" means they have to drive 25 miles to see an orthopedic specialist.

Not sure why I responded because you're in ad-hominem mode and therefore apparently done.

[eridani]

134. $5000 is disastrous for a lot of people. ACA has reduced medical bankruptcy--

--not ended it.

Consumers still struggling with medical debt

http://www.usatoday.com/story/news/2015/02/01/consumers-still-struggling-with-medical-debt/22587749/


Still, some numbers suggest a decline in people facing medical debt. About 64 million Americans struggled to pay medical bills in 2014, according to a survey by the Commonwealth Fund — that's a drop of about 10 million since 2012. Experts have celebrated the decline but cautioned that high-deductible insurance plans could put a damper on those gains.

Of the 64 million the authors said were struggling to pay for care, 38 million, or 59%, were insured the whole year.

There's been some improvement: The same report found 29% of the insured had medical debt or difficulty with medical bills, a drop from 33% in 2012 — while the pool of insured adults grows larger. But analysts cautioned that, absent a significant change in industry or policy, even this group will likely continue to face the prospect of medical debt.

Deductibles keep growing. Last year, work-sponsored insurance plans had an average deductible of about $1,200 — in 2009, the average deductible was $826. And this year, the silver plans sold through the federal marketplace require people to pay on average more than $2,500 or about $3,500 before they get coverage. Whether it is the higher or lower amount is determined by whether the plan groups medical visits and drug costs in a single deductible or two separate deductibles. Bronze plans, known for being cheaper but less generous, have average deductibles of about $5,300.

[bernmobile2016]

137. Well the thing is this...

Medical insurance was never meant to cover routine doctor visits. It was meant to cover catastrophic events. But as proof of the new America... we got lazier, cheaper, and we simply didnt give a crap so go to a doctor who now charges a minimum of $100 (and thats in rural-ville) for a doctor visit with no treatments and expect to pay only $20 with insurance. So multiply that $80 difference by 100 million people every month... and then you tell me where the system was headed?

[treestar]

141. The deductibles are not like that

That was what it was like BEFORE the ACA. My deductible is 750 but the doctor visits are only a copay whereas before I just had to pay because I had a huge deductible. This is BS people are spreading, trying to discourage others from using the ACA.

[hobbit709]

144. And prescriptions, etc. are just copay too?

There's quite a few people where even a $25 copay would put a real bind on their finances.

[treestar]

145. Yes, $10.

I pay that for three prescriptions. If that puts a bind on your finances, you qualify for Medicaid.

[hobbit709]

146. don't bet on it here in TX.

Luckily all my medical is covered by the VA but I know people that are screwed since they have no regular job and no regular place to live.

[treestar]

147. Yes, you are right about the red states not cooperating

Hopefully the poorer people in those states aren't voting for Republicans because of abortion and gay rights. Or guns or whatever else the right uses to get them to vote against their own interests.

[lonestarnot]

6. We need it and we are going to get it and my hat is on its way!

wooodamnwhoo!

[leftofcool]

7. ACA bad. Got it.

[Javaman]

8. no, not bad, just certainly not the best. and in some ways, greately flawed.nt

[blackspade]

9. The actual number is around 30% not 57%

Exhibit '6' .... The percentages do not equal 100.
Could people select more than one choice?

[crystal dawn]

10. Is this place infiltrated with right wing

talking points? We all knew that Obamacare wasn't going to magically be the best thing ever and solve all of our health care problems, but it was a start. Medicare and Social Security didn't start out as good of programs that they are today either.
That aside, seems to be yet another hit piece in favor of Bernie (or anyone other than Hillary). We know Bernie will just say we should have single payer and Hillary will support Obama's policies.

[alarimer]

31. It is not a right-talking point to criticize the badly flawed ACA

I think it is fatally flawed myself and we will face consequences down the line.

Yes, more people are "insured" but what good is insurance if you can't actually afford to use it. The ACA was and is nothing but an insurance company giveaway.

[crystal dawn]

83. so far

all of the dire predictions that right wingers have been espousing since its implementation (such as "face consequences down the line&quot haven't panned out as they said it would. It's easy to make predictions without any solid analysis or real data to back it up. The cherry picking on the percentages in the OP proves my point. "Insurance giveaway" is a vacuous statement, too. It was the best we could get at the time with a divided congress and strong industry opposition. We can improve on it and make it better as we did with Medicare, but instead the doom and gloom crowd seem to want to eliminate it, thus throwing millions of poor people off the rolls in the process.

[geek tragedy]

114. "Nothing but an insurance company giveaway" This is a zombie lie that just won't die.

Not an opinion, a lie. An unambiguous misstatement of provable facts.

1) Getting rid of pre-existing condition exclusions was not a give-away to insurance companies.
2) Enforced medical loss ratios were not a give-away to insurance companies
3) Medicaid expansion was not a give-away to insurance companies
4) banning lifetime caps was not a give-away to insurance companies

It would help if progressive critics of the ACA behaved more intelligently and more honestly than their counterparts in the Republican party.

[Hydra]

73. Umm...the ACA is a Republican program

Disagreeing with it is now a RW talking point??

[geek tragedy]

112. it's completely dishonest to call it a Republican program.

Only Democrats voted for it, and Republicans have done nothing but try to repeal it and use the courts to get rid of it.

There were ELEMENTS in it that Republicans at one time or another supported, but the bulk of the legislation was always based on Democratic policymakers and preferences.

Those who wish it had never been enacted fall into two groups:

Republicans
the Republicans' useful idiots on the left

[Hydra]

125. So it wasn't the Romneycare/Gingrich/Heritage/Nixon plan?

The fact that the Republicans felt safe to completely disown and vote against their own policies while having the WH get it done for them was a MASSIVE political failure from our "Moderate Republican&quot his own words, mind you) President.

It was especially funny when Obama asked why Mitt didn't like it, since it was his program.

[geek tragedy]

126. No. It was not the Heritage Plan.

As anyone familiar with the actual Heritage plan would know.

Mitt Romney was not the author of the Massachusetts plan--the very liberal and Democratic Massachusetts legislature did.

Your shrill rhetoric is detached from reality.

[Hydra]

128. Disputing the word of the President?

http://www.politifact.com/truth-o-meter/statements/2010/apr/01/barack-obama/obama-says-heritage-foundation-source-health-excha/

Obama told host Matt Lauer that "when you actually look at the bill itself, it incorporates all sorts of Republican ideas. I mean a lot of commentators have said this is sort of similar to the bill that Mitt Romney, the Republican governor and now presidential candidate, passed in Massachusetts. A lot of the ideas in terms of the exchange, just being able to pool and improve the purchasing power of individuals in the insurance market, that originated from the Heritage Foundation. ..."

If you're trying to make the claim that the Centerist policies, policymakers and preference were the basis of it, then yes, we can call it a "Democratic" program.

BTW, How's Liz Fowler doing lately?

[geek tragedy]

130. Subsidies and Medicaid expansion and regulations

were not in the Heritage plan.

[Omaha Steve]

12. Medicare part E

For Everybody.

[LiberalArkie]

14. Medicare with the supplemental stuff, still isn't very cheap.

[Omaha Steve]

15. Sometimes called "premium-free Part A

https://www.medicare.gov/your-medicare-costs/costs-at-a-glance/costs-at-glance.html

Most people don't pay a monthly premium for Part A (sometimes called "premium-free Part A&quot . If you buy Part A, you'll pay up to $407 each month. Calculate my premium.

[LiberalArkie]

28. Oh, I don't pay for the Part A and my B is 104, but when you tack on the

supplemental and part d it starts adding up pretty quick. And it is almost time to start playing the game of roulette again on the medicare supplements. The only decision this year is changing the part D provider. All my supplements are about 10% higher because I live in a rural county. If I walk 200 ft and cross into Pulaski county everything drops 10% per month.
Oh well such is life. No one every said being retired would be easy.

[Recursion]

132. That's almost $900 / month for a $1000 deductible and 20% copays for everything

We need to lower provider prices more than we need to once again reform insurance.

[Vinca]

13. This is why we needed the public option.

There is no real competition for big insurance.

[Keep-Left]

16. "57% - Could not find a plan you could afford "

But can afford cable TV & cell phone plans with 20 gigs of data

[xmas74]

22. Got proof of that?

Seems pretty generalized.

I know plenty of people in that group. They don't have cable, if they even have a tv and they have cheap prepaid cell plans just to have a phone. Missouri is not an expansion state so those same people who would qualify for Medicaid in another state don't qualify here. They're stuck in the middle and it's not fun.

[Doctor_J]

35. that's a right wing talking point

"The poor in the US are not really poor". That poster won't be around long.

[xmas74]

99. I recognized it immediately.

That's why I chose to confront, though nothing was ever said to back up the claim.

[jwirr]

105. But you just gave the reason for what he is talking about.

MO is not an expansion state. And now that you bring it up how many of those 26% polled are from expansion states?

[xmas74]

109. It doesn't say.

What I do get tired of hearing is that the poor would rather spend money on expensive electronics instead of on (name it-health insurance, food, etc). The talking point is that they can afford it if they'd only budget their money instead of spending it on electronics/fast food/tattoos/drugs/pit bulls on a chain in the front yard or whatever else is mentioned. I know too many who are working poor that do not have cable or satellite and do not have data plans. They also don't have tattoos, expensive electronics or any of the other things mentioned.

He started the lead up to how they could afford it if they didn't spend their money on "x". I hear the right wingers say this shit all the time in my state. It's untrue.

[jwirr]

116. On that I totally agree with you. I have been classified as

poor my entire life. They shame themselves when they are so petty to think that things show if we are poor or not. Have they never heard of used stores and rummage sales? Or even gifts?

[xmas74]

117. That doesn't matter.

If you are poor you should dress in rags and sell all your gifts.

[Keep-Left]

139. Im sure there are a lot that can not afford it

but with Obamacare they take into account your salary.

A lot of people just choose not to get it like Ins. is something not that important but yet they have cell phone ( the newest iphones) they have cable TV with DVR's - HD. Have high car payments - They spend on things that aren't as important and then turn around and say they cant afford Ins.

If you think that doesn't go on your living in a fantasy world.


Look Im with most of you. Im 100% behind single payer and argue for it all the time. But a lot of those 57% could pay for Ins. if they choose to

[xmas74]

142. If you live in an non expansion state

you can be stuck in a crack: you make too much for Medicaid but not enough for the ACA marketplace.

Missouri is one of those states. You can only make around $250 a month for a family of two to qualify for Medicaid. If you make less than 100% poverty line you will not qualify for ACA subsidies, since expansion means you'll get Medicaid. They are stuck in the middle with no insurance or the means to afford it.

In some areas cars are a necessity. In my area they are-no public transportation and it's very common to commute. If you commute you need a decent car and unless you have very good credit your payments will be outrageous. Damned if you do, damned if you don't.

Also, in my area on Facebook we have different groups that sell various items, including used cell phones.For cheaper than you can get a phone new from the cell company or for a prepay you can buy a newer model that someone used for a year. I also know of more than a few who have received phones as gifts from family. It's $60 a month for a home phone in my area, before taxes.I can get a Straight Talk with unlimited talk and text and a data plan for $45.

I honestly know many who no longer have cable/satellite. It's too expensive and that was one of the first things they cut.

[tkmorris]

70. I bet those fuckers have refrigerators too

[striegl]

18. Your subject line doesn't match what you posted.

Last edited Tue Sep 29, 2015, 06:08 PM - Edit history (1)

Please change it. It wasn't 57% of those that VISITED the website couldn't afford it. The article states it was 57% of those that did not SELECT a plan.

Exhibit 2
52% - Did not select a private plan or enroll in Medicaid

This is misleading because 15% of the 52% went on Medicaid according to Exhibit 2 So actually 37% that visited didn't select a medical option. While 45% selected a private plan or Medicare.

Exhibit 6 - How do they make the numbers work on this? 57% couldn't afford while 51% obtained through another source...That's 108% then 43% - Not eligible to enroll in Medicaid....now we're at 151%

The Commonwealth Fund did some slight of hand in how they reported their findings to make some things look worse than they are. I don't say they are 100% off on their findings but they aren't playing around with the numbers.

[Ms. Toad]

21. Math is your friend. 57% of 52% is 29.64%, not 57%. n/t

[DhhD]

24. What happens when, all at once a very few, sign up for a Plan for the coming year?

Insurance companies would collapse unless congress intervenes with affordable public plan options. I think Sanders will be President in 2017.

[Orrex]

26. Unusual number of brand-new DU members in this thread.

Welcome!

[Ilsa]

27. I'm hearing this from a few friends, and they

are not conservatives. One friend has a son who needs coverage. The first year was affordable. Now it's doubled in price and he can't afford it any more. He makes too much for Medicaid and his state (southern) isn't expanding.

The insurance companies have us over a barrel as they drive up premium costs, offer less coverage, and make billions off of us.

[Scuba]

29. Medicare for all, including dental, optical, hearing aids and mental health services.

And yes, we can afford it.

[bread_and_roses]

30. Quibble over the exact % and ignore the point

It doesn't surprise me around here. Many of us said from the start this was not "affordable." What was it people were supposed to pay out? Was it 8% of income for premiums? Whatever. With wages what they are, with costs for basics - food, energy, housing - what they are, it was totally unrealistic.

And of course we have the predictable authoritarians around here mocking lower-income people who have internet and cell phones - as if it was even possible to function these days with them. You have to go online even to file for unemployment, for goddess sake.

A market-based system cannot make health care "affordable." It screws us one way or another. Not to mention the horrible waste, the stress individuals experience trying to figure out future unknowns. Health care can only be "affordable" as a common good.

It is pathetic to see people still defending this monstrosity, which was only ever crafted to preserve the rapacious vampire insurance industry, not the people's health.

[pnwmom]

42. The number is off by a half. That's not a quibble. 3/4 of visitors who fail to enroll

say they have another reason for not enrolling.

[bread_and_roses]

90. Missing the point entirely (n/t)

[historylovr]

106. ^^This.^^

[leftstreet]

121. +1

[Doctor_J]

34. I want to see their tax returns!!!$@!@11!1

Secretary Clinton wants to "expand" heritage care - I.e. make everyone be a health insurance consumer. Just say no.

[pnwmom]

40. No, the real number is about a FOURTH. The 57% is based on the 52% who did NOT enroll.

So what this means is that of the 52% who did not enroll, 57% of them said they couldn't afford a policy.

IOW, of the half who didn't enroll, a little more than half said they could not afford it -- a half of a half is a quarter of the total.

[hobbit709]

47. Even 26% is way too high of a number, no matter how much one wants to quibble.

[stevenleser]

51. And that 1/4 number is pretty close to the percentage of folks living in states that did not expand

medicaid. In other words, not a function of the ACA, but of the Republican governors in those states.

http://familiesusa.org/product/50-state-look-medicaid-expansion

[hobbit709]

55. Bottom line. Insurance is NOT healthcare.

If we had healthcare, no one would worry about being able to afford care.

[stevenleser]

57. Bottom line, slogans are not policies or policy suggestions. nt

[City Lights]

59. Exactly right!

[pnwmom]

110. excellent point

[pnwmom]

54. When you're off by half, it's not a quibble.

And as someone above pointed out, it's even lower than a fourth. Since the 52% included people who opted for Medicaid, OF COURSE those people couldn't afford an exchange policy. By definition.

Accounting for those people results in 21% overall saying they couldn't afford an exchange policy. And without knowing more about those people it's hard to know how concerned to be. For example, some of them are cigarette smokers, who have to pay higher premiums. If they stopped smoking they would save both on cigarette purchases and on insurance premiums.

If your budget puts a pack a day of cigarettes as a higher priority than health insurance, does that really mean you can't afford the insurance, even with a subsidy?

[hobbit709]

61. Better than one in five is NOT acceptable-period.

Some of the people I know, a pack of cigarettes a day would be unaffordable-even if they smoked.

[mythology]

76. Except you haven't presented any real evidence that 1 in 5 can't

You presented some biased numbers and when called on that, moved the goalposts. There are any number of reasons people might say they can't afford insurance that don't actually mean can't. In my experience, people often say can't when they mean don't want to.

You would have to be able to actually analyze the individual finances of the individuals to see which is the case.

As for insurance companies being inherently negative, the Netherlands gets by just fine with having health care run through insurance companies. They even ranked number one in the world on heath care last year.

[pnwmom]

111. It's not the fault of Obamacare that people in states without expanded Medicaid

can't afford it.

Why should anyone be surprised that there are a significant number who can't get insurance, when there are millions living in states without expanded Medicaid?


Blame the governors who refused expanded Medicaid.

[City Lights]

43. I just received notification from BCBS that the plan I purchased in March of 2014

is being cancelled on December 31st.

I am going to be very angry if I have to find a new doctor again.

[JoePhilly]

60. What % of ACA attack OPs get the math right??

Like this one, most don't.

[tabasco]

63. Learn math. Thanks.

21%

[Orrex]

138. But it's 100% of 21%

[dembotoz]

68. i went on the site a number of times and did not enroll

couple times just research

live in walkerstan so if you income is low but would be covered by extended medicaid your rates are not good

ultimately she got a job with group insurance so went that route

[brush]

79. Isn't this OP misleading?

Other posters pointed out that actually it's 52% of the cited 57% who couldn't find affordable coverage which really translates to only 29% of coverage seekers.

And another poster takes it further by pointing out that some of those 57% chose Medicaid, thereby reducing the number who didn't find affordable coverage to 21%.

What is the agenda behind this misleading post?

Of course most progressives want single payer but it's not here yet. Let's give the ACA it's due. Although flawed, it's provided coverage to many millions who had nothing at all before. It's a start that can be improved upon.

[ProgressiveCheese]

84. Couple things

A) Read carefully. It's not 57% of everyone.
B) The subsidies aren't sufficient and never were.

[lumberjack_jeff]

86. Health care is 17% of GDP.

If your personal healthcare costs less than 17% of your gross income, you're doing better than most.

People have a distorted view of "affordable" because they're unaware of the real costs - most of those costs are externalized onto government or the company they work for.

[tammywammy]

96. Like a lot of the complaints about COBRA.

People are shocked when they get a COBRA notification with the payment amount thinking the company is jacking it up, when in reality it's just the full premium plus admin fees. Most don't know how much their employer pays toward their health insurance.

[Recursion]

133. That's on this next W2, though, isn't it? (nt)

[Zorra]

107. Obamacare helped some, but not nearly enough. And private insurers will render Obamacare

less and less effective with each passing year by jacking their premium costs so high that fewer and fewer people will be able to afford insurance from one year to the next.

Access to genuinely affordable healthcare is a right, just like access to clean water is a right.

"Making health care affordable for everyone was the primary goal of reform. It didn’t happen. But it would if we were to enact a single payer national health program".

[lumberjack_jeff]

115. Due to ACA, health care inflation (0.55%) is slower than it has been in 50 years.

Yet something appears to have changed. America is experiencing its slowest growth in health spending in five decades. In 2013 the share of GDP devoted to health care was the same as it was in 2009. Some of this is due to the recession and its aftermath—when Americans lose their jobs, they often lose their health insurance, too. But the Affordable Care Act of 2010, better known as Obamacare, may also have helped to curb costs. As the Supreme Court considers whether to strike down a crucial pillar of that law (see next article), economists are furiously debating how big that effect has been. By one estimate the economic downturn accounted for 77% of the dip in health-care inflation; by another, it was only 37%.

Obamacare sought to fix two problems: coverage and cost. To extend coverage, the law made it compulsory for Americans to have health insurance, on pain of a fine. It also offers subsidies for those who cannot afford it and bars insurance firms from charging people more if they have “pre-existing conditions”; ie, they are already ill. Before the exchanges arrived in 2013 some 41.3m Americans lacked health insurance. That has fallen to 30m (of whom 48% are eligible for assistance).

Curbing costs is more complicated. Traditional American health care is inefficient and wasteful. Costs vary enormously from provider to provider—sometimes by an order of magnitude—and until recently were largely opaque. Medical bills were long paid by third parties, such as insurers, so patients neither knew nor cared whether one option was cheaper than another. Under the “fee-for-service” system every blood test, bandage or X-ray triggers a payment. Doctors are tempted to order lots of unnecessary procedures to pay for a new yacht or their children’s education.

http://www.economist.com/news/united-states/21645855-growth-americas-health-care-spending-slowing-will-obamacare-cut-costs

[GoneFishin]

122. Anyone else recently get slammed with a several hundred % premium increase under ACA?

I just went from an ok, but not great premium, to one that is totally unaffordable again.

WTF?

[colsohlibgal]

124. Health Care Should Not Be For Profit.

We are rather unique among non backwater countries in allowing it.

The companies want to profit. We want to stay well, alive, and solvent. That is a real conflict of interest.

Real for profit sprang out of HMOs in the 80, talk of it coming is in the Nixon tapes. Nixon liked the idea, not a surprise.

[Recursion]

131. Every exchange has not-for-profit insurance providers available (nt)

[ablamj]

127. something about a

POSUCS?

[jfern]

129. That's 57% of 52%, or about 28%

[bernmobile2016]

135. The one thing I sure as hell don't want to hear from any of you....

is that BS "argument" of "oh just allow people to be able to buy any plan from any insurance company in any state" Yeah... ok, roll with that and in 9 months, hundreds of health insurance companies would merge away into a handful and thus no true competition to drive down rates.

[bernmobile2016]

136. Affordability? LOL! Try this example:

My coworkers in-laws from Japan who moved to the US 3 years ago (not citizens yet) and now have insurance.. they are in their 70's, in good shape (not overweight at all, and active) BUT they are both smokers. They pay for Obamacare, (BRACE FOR IT!) $1,600 EACH a month, or $3,200 a month for both! $38,400 a year for medical insurance, and their plan ain't all that either!

[xmas74]

143. IN their seventies and smoke?

Yeah, insurance will be sky high.

Hell, my insurance through work charges another $75 per week as a surcharge for smokers and that's per person on a group policy.

Age and smoking together will make it very expensive. Quit smoking and it'll drop quite a bit.

[bernmobile2016]

148. Yeah smoking aint good

My job we are finding out for our open enrollment next month will require everyone to have a physical done at the company's selected doctor. We pay $87 a month single no dependents, $140 single with children, $148 married no children, and $230 married and family. They will go up $30 across the board for this year... BUT, after your physical, if you smoke, you will be hit with a $75 a month penalty, if your obese, its $45 a month, if you have high blood pressure due to being obese its another $45 a month. They will allow people to go and enroll in company/insurance paid weight loss and quit smoking programs and if enrolled with improvement, they half it in 6 months. If your smoke free in a year, they drop the premium. If you get your weight loss below "obese" standards after a year, that penalty drops as well. Also, if they determine your a regular drinker (yeah we have to do a kidney urine test strictly to detect something alcohol related) they charge $75 a month penalty. However I am 50/50 on the penalties. But despite my feeling that it is wrong, I do have to put myself in their shoes from a corporate/efficiency mindset. healthier workers are more productive and take less time off and don't cost as much to employ. In the end, its all about money. For me, I am about 15 lbs overweight and I have tossed out all the sugars from my diet and in 3 weeks I have shaved off 28 lbs with virtually no extra exercising...just adjusting my diet and the weight is still falling off.

[treestar]

140. Bullshit

They said they could not afford it does not mean they can't. The subsidies cover it. My plan is worth more than I pay for it. It is right there how much it is worth and my income determines how much I pay for it. These people are lying, or stupid, or won't even pay their share of it with the subsidy.