Governors Befuddled by Obamacare

[Amelia]

The states would not have leverage. They could complain all they want but once they've let Obama into their house it will be a futile struggle to make any demands on him. The most they could get is extra time to accomplish what he wants them to do.

And as noted already, that will just make them accomplices in the budget-busting boondoggle which is already projected to cost three times as much money as Obama said it would, with no end in sight.

You and others on the right are such blind partisans, you can’t even accept the truth being told you by a fellow conservative.

Hence the schism within the GOP now. Some of them have taken sort of a New Federalism approach, recognizing it's better to have an exchange under state control and customized to the state's preferences and environment. Holtz-Eakin's piece is especially interesting because he takes it even further, arguing that by turning their state markets over to the federal exchange they're actively, if unwittingly, supporting the creation of a framework for a hypothetical future single-payer system.

The other train of thought seems to be a vestige from the days when these governors (and apparently most of the Republican party) thought the ACA wouldn't even exist come 2013 because 1) the SCOTUS would throw it all out, and 2) when that failed, the election of Mitt Romney would put the final nail in the ACA's coffin. What a slam dunk that was. And when all that failed, they were left just sort of spinning their wheels and handing their exchanges over to the federal government by default, partly in a pouty way but partly because there's just no intellectual energy left among them to figure out what they should do. Which leaves them in the odd position of embracing and talking up a federal role.

It's fascinating to watch. I suspect some of these decisions will be useful fodder in the 2014 state-level elections.

"embracing and talking up a federal role"?

Who's embracing? Who is talking up?

I'm saying let Obama have it so that it's all on him when the sh*t hits the fan and the accounting comes and his lies are exposed. That's not embracing or talking up.

 

[Amelia]

Obama violated this nation with all the lies he told to cram the ACA through.

Some of us aren't going to roll over and pretend the violation didn't happen, much less help cover for the perp.

 

[C_Clayton_Jones]

The states would not have leverage. They could complain all they want but once they've let Obama into their house it will be a futile struggle to make any demands on him. The most they could get is extra time to accomplish what he wants them to do.

And as noted already, that will just make them accomplices in the budget-busting boondoggle which is already projected to cost three times as much money as Obama said it would, with no end in sight.

You and others on the right are such blind partisans, you can’t even accept the truth being told you by a fellow conservative.

Hence the schism within the GOP now. Some of them have taken sort of a New Federalism approach, recognizing it's better to have an exchange under state control and customized to the state's preferences and environment. Holtz-Eakin's piece is especially interesting because he takes it even further, arguing that by turning their state markets over to the federal exchange they're actively, if unwittingly, supporting the creation of a framework for a hypothetical future single-payer system.

The other train of thought seems to be a vestige from the days when these governors (and apparently most of the Republican party) thought the ACA wouldn't even exist come 2013 because 1) the SCOTUS would throw it all out, and 2) when that failed, the election of Mitt Romney would put the final nail in the ACA's coffin. What a slam dunk that was. And when all that failed, they were left just sort of spinning their wheels and handing their exchanges over to the federal government by default, partly in a pouty way but partly because there's just no intellectual energy left among them to figure out what they should do. Which leaves them in the odd position of embracing and talking up a federal role.

It's fascinating to watch. I suspect some of these decisions will be useful fodder in the 2014 state-level elections.

Very true, and it is fascinating to watch.

In essence, if republican opposition to their own plan isn’t partisan simply because it was implemented by a democratic president, then the only other rationale is republicans simply wish millions of Americans to go without health insurance, and consequently without healthcare – which is just as reprehensible.

 

[dblack]

Hence the schism within the GOP now. Some of them have taken sort of a New Federalism approach, recognizing it's better to have an exchange under state control and customized to the state's preferences and environment. Holtz-Eakin's piece is especially interesting because he takes it even further, arguing that by turning their state markets over to the federal exchange they're actively, if unwittingly, supporting the creation of a framework for a hypothetical future single-payer system.

Yes. They're essentially rationalizing surrender. Maybe they're right. Maybe it's better to give up our rights with the hopes of regaining them later. But history really doesn't bend that way much.

I think what you fail to recognize is that the rest of us, those of us who see no point in surrendering, are rejecting more than an overreaching health care bill. We're rejecting the kind of government embodied in concepts like corporatism and 'New Federalism'. Under corporatism, government wheels and deals playing all 'vested interests' against the middle. The problem with playing along with that game is that it directly undercuts your ability to defeat it. Some of us - some of those stubborn governors perhaps - are coming to understand this. You can't fight oppressive government if you make yourself a willing ward of the state.

 

[dblack]

In essence, if republican opposition to their own plan isn’t partisan simply because it was implemented by a democratic president, then the only other rationale is republicans simply wish millions of Americans to go without health insurance, and consequently without healthcare – which is just as reprehensible.

Yes, of course. It's really the only other explanation. People opposed to ACA are bitter, hateful souls who want to maximize suffering in the world. It's so obvious now that you point it out!

 

[tap4154]

Mitt was wrong. The Heritage plan was put forward as an alternative to Hillarycare, and was only about requiring "catastrophic" HC policies, aka high-deductible HC policies (with premium subsidies or tax credits for the poor). Not the expensive comprehensive HC policy mandate that Obamacare has.

It was more like state's minimum liability auto insurance requirements, which are designed to protect others, not you. By everyone having at least a high deductible HC policy, if they get very ill they will be covered after the $3-5K deductible, rather than having taxpayers or hospitals eating the rest.

All explained here:

Don't blame Heritage for ObamaCare mandate

 

[WillowTree]

Obamacare was conceived and given birth to, in the bowels of the uber-conservative Heritage Foundation.
But gosh Willow, are you saying I should trust what you have to say about the birth of Obamacare over what a rightwing ideologue that happened to be employed by the Heritage Foundation at the time they conceived the most controversial part of Obamacare? Jeez tough choice but now-----but now at least, you know.

​

You're welcome!​

How the Heritage Foundation, a Conservative Think Tank, Promoted the Individual Mandate - Forbes


Avik Roy
10/20/2011

James Taranto, who writes the Wall Street Journal’s excellent “Best of the Web” column, put forth a lengthy and informative discussion yesterday on the conservative origins of the individual mandate, whose inclusion in Obamacare is today its most controversial feature on the Right.


This came up at Tuesday’s Western Republican Leadership Conference Debate, where Mitt Romney and Newt Gingrich tussled on the question:

ROMNEY: Actually, Newt, we got the idea of an individual mandate from you.


GINGRICH: That’s not true. You got it from the Heritage Foundation.


ROMNEY: Yes, we got it from you, and you got it from the Heritage Foundation and from you.


GINGRICH: Wait a second. What you just said is not true. You did not get that from me. You got it from the Heritage Foundation.


ROMNEY: And you never supported them?

GINGRICH: I agree with them, but I’m just saying, what you said to this audience just now plain wasn’t true.
(CROSSTALK)


ROMNEY: OK. Let me ask, have you supported in the past an individual mandate?


GINGRICH: I absolutely did with the Heritage Foundation against Hillarycare.


ROMNEY: You did support an individual mandate?


ROMNEY: Oh, OK. That’s what I’m saying. We got the idea from you and the Heritage Foundation.


GINGRICH: OK. A little broader.


ROMNEY: OK.
​

(Romney was prepared to go on, but Michele Bachmann, in her usual role as the person who makes the debates less useful, interjected and changed the subject. Here’s a YouTube video of the entire debate. The Gingrich-Romney exchange begins at the 27:38 mark.)
.

Dearest Star. bamie care was written by the democrats and passed into law by the demoncraps, not a single solitary Republican voted for it. It's a clusterfuck and you demoncraps own it. Nice try but your bulldog don't hunt.

“Whatever the particular differences, the Heritage mandate was indistinguishable in principle from the ObamaCare one. In both cases, the federal government would force individuals to purchase a product from a private company—something that Congress has never done before.” ~ James Taranto


I agree that the Dems own Obamacare, but the rest of your message is delusional. Are you calling Mitt Romney a liar? or are you calling Newt Gingrich a liar? Both?




ROMNEY: Actually, Newt, we got the idea of an individual mandate from you.


GINGRICH: That’s not true. You got it from the Heritage Foundation.


ROMNEY: Yes, we got it from you, and you got it from the Heritage Foundation and from you.


GINGRICH: Wait a second. What you just said is not true. You did not get that from me. You got it from the Heritage Foundation.

<snip>


ROMNEY: Oh, OK. That’s what I’m saying. We got the idea from you and the Heritage Foundation.



But-----but I like the idea that righties disdain a program that every new poll shows is gaining in popularity with voters. Another group of voters the Republican party is throwing under the bus-----cool-WTG.

.

Hey! Twafflelips! Did the so called original idea steal 716 Billion dollars from the old people? bamie care did.

 

[Amelia]

Mitt was wrong. The Heritage plan was put forward as an alternative to Hillarycare, and was only about requiring "catastrophic" HC policies, aka high-deductible HC policies (with premium subsidies or tax credits for the poor). Not the expensive comprehensive HC policy mandate that Obamacare has.

It was more like state's minimum liability auto insurance requirements, which are designed to protect others, not you. By everyone having at least a high deductible HC policy, if they get very ill they will be covered after the $3-5K deductible, rather than having taxpayers or hospitals eating the rest.

All explained here:

Don't blame Heritage for ObamaCare mandate

Interesting. Don't expect anyone here to change their narrative based on the additional information. But I sure appreciate the link.

 

[tap4154]

Mitt was wrong. The Heritage plan was put forward as an alternative to Hillarycare, and was only about requiring "catastrophic" HC policies, aka high-deductible HC policies (with premium subsidies or tax credits for the poor). Not the expensive comprehensive HC policy mandate that Obamacare has.

It was more like state's minimum liability auto insurance requirements, which are designed to protect others, not you. By everyone having at least a high deductible HC policy, if they get very ill they will be covered after the $3-5K deductible, rather than having taxpayers or hospitals eating the rest.

All explained here:

Don't blame Heritage for ObamaCare mandate

Interesting. Don't expect anyone here to change their narrative based on the additional information. But I sure appreciate the link.

The Obama Julias have their many Internet memes implanted, and stick to them no matter what. You can post facts all day long, and they'll still stick to their KOS/MoveOn memes. Been my experience at least. When they disappear from a thread it means you probably convinced them, so they run and hide, and usually find another false meme to parrot.

 

[Greenbeard]

Mitt was wrong. The Heritage plan was put forward as an alternative to Hillarycare, and was only about requiring "catastrophic" HC policies, aka high-deductible HC policies (with premium subsidies or tax credits for the poor). Not the expensive comprehensive HC policy mandate that Obamacare has.

It was more like state's minimum liability auto insurance requirements, which are designed to protect others, not you. By everyone having at least a high deductible HC policy, if they get very ill they will be covered after the $3-5K deductible, rather than having taxpayers or hospitals eating the rest.

High-deductible plans will be available in the exchanges, and they're likely to become even more common (particularly when paired with an HSA) in the group markets under the ACA.

 

[tap4154]

Mitt was wrong. The Heritage plan was put forward as an alternative to Hillarycare, and was only about requiring "catastrophic" HC policies, aka high-deductible HC policies (with premium subsidies or tax credits for the poor). Not the expensive comprehensive HC policy mandate that Obamacare has.

It was more like state's minimum liability auto insurance requirements, which are designed to protect others, not you. By everyone having at least a high deductible HC policy, if they get very ill they will be covered after the $3-5K deductible, rather than having taxpayers or hospitals eating the rest.

High-deductible plans will be available in the exchanges, and they're likely to become even more common (particularly when paired with an HSA) in the group markets under the ACA.

My understanding is that they will not be allowed. I have a $5K HD plan by choice, and have been informed by Kaiser that they will have to cancel it on Dec 31, 2013, then will offer me new plans to choose from that meets the specifications of the ACA. It will be much more expensive as well.

Since the ACA was passed my premiums have been hiked 4 times, and I never go to the doc!

Obama lied about the ACA saving us money AND about being able to keep our current plan. Of course, those were only two of many lies he told as he and Pelosi forced it on the nation, against the will of the majority of the public, with no bipartisan support, and with legislative tricks

 

[usmcstinger]

No member of Congress ever read the entire Bill and it is more probable than not that they don't understand Those who are charged with it's implementation are clueless.

As Pelosi so stated, "we had to pass it so we could see what was in it".

 

[tap4154]

No member of Congress ever read the entire Bill and it is more probable than not that they don't understand Those who are charged with it's implementation are clueless.

As Pelosi so stated, "we had to pass it so we could see what was in it".

Actually it's impossible to know what's in it, even if you do read it. MUCH of it is left to the discretion of HHS, and many references to other documents and laws makes trying to decipher it impossible. It basically was a bill that said "just trust us", and they forced it on the nation. Most of it will be written after the fact, and as they go along. Unprecedented in American history that a law of such major consequences, taking over 17% of the economy, has ever been allowed. I still think it will be knocked down eventually, at least in large part, by SCOTUS.

 

[Greenbeard]

My understanding is that they will not be allowed. I have a $5K HD plan by choice, and have been informed by Kaiser that they will have to cancel it on Dec 31, 2013, then will offer me new plans to choose from that meets the specifications of the ACA. It will be much more expensive as well.

In general, out-of-pocket limits for insurance policies are tagged to the existing limits for high-deductible plan-HSA pairings that have been on the books for a decade. For 2013 that translates into a minimum deductible of $1,250 and maximum of $6,250 for a policy covering a single person, and minimum deductible of $2,500 and a maximum of $12,500 for a family.

So in the individual markets (primarily the exchanges) you're going to see deductibles of several thousand dollars, and in the large group market there will be new incentives to migrate toward higher-deductible plans.

Which is why HR-oriented resources like Workforce Management that are focused on the impact the ACA will have on benefits have produced articles like "Reform Could Accelerate Shift to High-Deductible Plans":

Beginning in 2014, once the health insurance exchanges are established, employers will have an incentive to keep employees’ premium contributions below 9.5 percent of their adjusted gross income if workers earn less than 400 percent of the federal poverty level, Savan says. Otherwise, the employer will have to pay a penalty—typically $3,000 annually per such employee who receives coverage through a health exchange—for surpassing that premium ceiling.

That’s a relatively low bar, Savan says. For a family of four, 400 percent of the federal poverty level is $88,200 annually. If that penalty were in effect today, that employee couldn’t pay more than nearly $8,400 annually toward health coverage.

“The plans that are most likely to allow the employer to stay under that [premium] threshold are going to be high-deductible health plans,” Savan says. “Whether they are HSA-compatible or not, it’s going to be those plans, by virtue of simple mathematics.”

The exception is in the small group market (which consists of employer groups that have fewer than 100 employees or fewer than 50 employees, depending on a choice your state made), where the maximum deductible comes down to $2,000 for an individual plan and $4,000 for family plans (except in cases where a small group plan is on a relatively low actuarial tier and needs a higher deductible to keep the actuarial value down). That's still within the range for HDHP-HSA pairs but lower than the maximums allowed for individual market plans and for larger employer groups. Presumably you're in a small employer group and that's the problem you're running into, though if your plan qualifies as a grandfathered plan there isn't any reason Kaiser can't continue to offer it to you.

 

[Star]

.[/quote]

Hey! Twafflelips! Did the so called original idea steal 716 Billion dollars from the old people? bamie care did.[/QUOTE]


Wrong again!
Are you following the Republican mantra, expressed so eloquently by Herman Cain; "Ahh don' have facks ta back this up, but..."



Do try to keep up -- Politifact sez:

​

Our ruling

Ryan said Obama "funneled" $716 billion out of Medicare "at the expense of the elderly." This gives a very misleading impression.

In fact, the law limits payments to health care providers and insurers to try to reduce the rapid growth of future Medicare spending. Lawmakers said they hoped the measures would improve care and efficiency. Those savings, spread out over the next 10 years, are then used to offset costs created by the law (especially coverage for the uninsured) so that the overall law doesn't add to the deficit. Ryan’s statement is exaggerated and we rate it Mostly False.



Mostly False, but thanks for a good ol' afternoon giggle!
.

 

[Meister]

No shit, that's why Holtz-Eakin is urging state governors to design and operate their own exchanges instead of ceding that responsibility to Barack Obama and Kathleen Sebelius. What you're saying is exactly his rationale:

It is an illusion that the states would be able to control their destinies. Obama's administration wouldn't allow that. The states would never be more than puppets implementing the neverending restrictions coming down the pike. Obama wants the states to have their hands dirty so that he can minimize his exposure to recriminations when the full costs of his deceptions become apparent.

Very well put....the extinction of federalism.


1. Obamacare was intended to have one national exchange to regulate all health insurance, and to distribute subsidies. Forced to back down on that idea, he got fifty instead! Under Title I, state officials are instructed that they “shall” establish an “American Health Benefit Exchange, “ (AHB) in each state. The secretary of HHS will make grants to each state to set them up, determining the amount of money, whether or not to renew depending on whether the state is “making progress” in meeting the new federal insurance requirements, and other “benchmarks” that the secretary may see fit to establish. And the secretary has the power to decide if the state exchanges are “qualified,” as of January 1, 2013.

a. These exchanges will be the central vehicle for the federal government to control and regulate the health insurance market. Washington will dictate exactly how they work, and step in and set them up if not satisfactory. PPACA, Public Law 111-148, section 1321(c) (1)

b. Rather than co-equal with the federal government, as is the character of American federalism, the state becomes nothing more than a distal agency of Washington.



2. The feds will require the ‘state’ exchanges to perform a dozen or so “minimum functions”
Section 1311(d)(4) of the PPACA requires all Exchanges to perform certain minimum functions:

Certify, recertify and decertify health insurance plans as “qualified health plans” to be offered through the Exchange,

Operate a toll-free hotline for consumer assistance,

Maintain a website providing standardized comparative information on health plans,
Assign price and quality ratings to plans,

Present plan benefit options in a standardized format,

Provide information on Medicaid and CHIP, determine eligibility for applicants, and enroll eligible individuals in these programs,

Provide an electronic calculator to allow applicants to determine the actual cost of coverage, taking into account premium tax credits and cost sharing reductions for which they are eligible,

Certify individuals who may be exempt from the individual responsibility requirement,

Provide information to the Treasury Department and to employers on certain employees who are eligible for premium tax credits, and

Establish a Navigator program that provides grants to entities to conduct outreach and education, as well as assist consumers in enrolling in qualified health plans through the Exchange.


a. While states cannot accept any insurers who offer policies that provide fewer benefits than those ordered by the federal government, they may offer plans that include more benefits. This, of course, obviates the kind of competition that lowers cost or favors the consumer. The state must them subsidize the additional benefits, which requires extensive invasion of privacy of the individual.

b. While mandating additional benefits, the PPACA imposes restrictions that one would expect in a free market system, i.e., more benefits results in higher premiums. On the contrary, this law gives the secretary of HHS the ability to remove the company if the increases are 10% or more.
Questions and Answers: Keeping the Health Plan You Have: The Affordable Care Act and ?Grandfathered? Health Plans

Bump

 

[dblack]

High-deductible plans will be available in the exchanges, and they're likely to become even more common (particularly when paired with an HSA) in the group markets under the ACA.

My understanding is that they will not be allowed. I have a $5K HD plan by choice, and have been informed by Kaiser that they will have to cancel it on Dec 31, 2013, then will offer me new plans to choose from that meets the specifications of the ACA. It will be much more expensive as well...

Most likely existing HSA/high-deductible plans won't qualify under newly concocted regulations. We can be sure that any options that deny insurance company profits and empower consumers will be disallowed.

 

[WillowTree]

.

Hey! Twafflelips! Did the so called original idea steal 716 Billion dollars from the old people? bamie care did.[/QUOTE]


Wrong again!
Are you following the Republican mantra, expressed so eloquently by Herman Cain; "Ahh don' have facks ta back this up, but..."



Do try to keep up -- Politifact sez:

​

Our ruling

Ryan said Obama "funneled" $716 billion out of Medicare "at the expense of the elderly." This gives a very misleading impression.

In fact, the law limits payments to health care providers and insurers to try to reduce the rapid growth of future Medicare spending. Lawmakers said they hoped the measures would improve care and efficiency. Those savings, spread out over the next 10 years, are then used to offset costs created by the law (especially coverage for the uninsured) so that the overall law doesn't add to the deficit. Ryan’s statement is exaggerated and we rate it Mostly False.



Mostly False, but thanks for a good ol' afternoon giggle!
.[/QUOTE]

Hey twafflelips he stole 716 Billion dollars from the old people.

 

[tap4154]

The exception is in the small group market (which consists of employer groups that have fewer than 100 employees or fewer than 50 employees, depending on a choice your state made), where the maximum deductible comes down to $2,000 for an individual plan and $4,000 for family plans (except in cases where a small group plan is on a relatively low actuarial tier and needs a higher deductible to keep the actuarial value down). That's still within the range for HDHP-HSA pairs but lower than the maximums allowed for individual market plans and for larger employer groups. Presumably you're in a small employer group and that's the problem you're running into, though if your plan qualifies as a grandfathered plan there isn't any reason Kaiser can't continue to offer it to you.

No, I'm just a self-employed one man operation. Single guy as well, so I'm just covering myself. I'd like to keep the plan I have, but I know that won't happen. I will be forced to buy a lower deductible plan, which I don't want. I'd rather pay out of pocket for any small stuff, and just have the high deductible insurance there in case of a serious illness.

I would have been grandfathered in but my old Blue Shield plan kept raising my premiums after Obamacare was passed (about 40%), so last year I shopped around and got a similar plan under Kaiser with much lower monthly premiums (almost one half what BS was charging). BUT that plan is not grandfathered in because it began after the law was forced down our throats.

I just wish I wasn't being FORCED to buy a HC insurance plan that is MANDATED and as SPECIFIED by the federal gov't. Never thought that would happen in America...

 

[Meister]

Just got back from my dermatologist, seems that starting Jan. 1 there is going to be procedures that won't be covered any longer by insurance companies.
Go figure....yay obamacare.