Obamacare in complete disarray

[Greenbeard]

And to top it all off, as I already pointed out, the centerpiece of the insurance market reforms (the insurance exchanges) will be designed and operated by states to meet the unique needs of their populations and market conditions. A triumph of federalism.

I like you Green, you are reasonable, but this is an outright lie.

If they take Federal Dollars they play by Ferderal Rules....I expect better of you.

And, as has become this administration's custom in many respects, the federal rules are designed to give states as much flexibility as possible to figure out what will work best for them.

States Given Flexibility for Health Law Marketplace Rules - Businessweek
States get 'substantial flexibility' in running health law exchanges - The Hill's Healthwatch
States given flexibility on new health insurance exchanges - Los Angeles Times

Which is the same point Bill Frist was making earlier.

 

[Amazed]

SEC. 201. ESTABLISHMENT OF HEALTH INSURANCE EXCHANGE; OUTLINE OF DUTIES; DEFINITIONS.

a) Establishment- There is established within the Health Choices Administration and under the direction of the Commissioner a Health Insurance Exchange in order to facilitate access of individuals and employers, through a transparent process, to a variety of choices of affordable, quality health insurance coverage, including a public health insurance option.
(b) Outline of Duties of Commissioner- In accordance with this subtitle and in coordination with appropriate Federal and State officials as provided under section 143(b), the Commissioner shall--

(1) under section 204 establish standards for, accept bids from, and negotiate and enter into contracts with, QHBP offering entities for the offering of health benefits plans through the Health Insurance Exchange, with different levels of benefits required under section 203, and including with respect to oversight and enforcement;
(2) under section 205 facilitate outreach and enrollment in such plans of Exchange-eligible individuals and employers described in section 202; and
(3) conduct such activities related to the Health Insurance Exchange as required, including establishment of a risk pooling mechanism under section 206 and consumer protections under subtitle D of title I.

c) Exchange-participating Health Benefits Plan Defined- In this division, the term `Exchange-participating health benefits plan' means a qualified health benefits plan that is offered through the Health Insurance Exchange.

Bill Text - 111th Congress (2009-2010) - THOMAS (Library of Congress)

 

[Amazed]

And to top it all off, as I already pointed out, the centerpiece of the insurance market reforms (the insurance exchanges) will be designed and operated by states to meet the unique needs of their populations and market conditions. A triumph of federalism.

I like you Green, you are reasonable, but this is an outright lie.

If they take Federal Dollars they play by Ferderal Rules....I expect better of you.

And, as has become this administration's custom in many respects, the federal rules are designed to give states as much flexibility as possible to figure out what will work best for them.

States Given Flexibility for Health Law Marketplace Rules - Businessweek
States get 'substantial flexibility' in running health law exchanges - The Hill's Healthwatch
States given flexibility on new health insurance exchanges - Los Angeles Times

Which is the same point Bill Frist was making earlier.

1) The State-based Health Insurance Exchange must demonstrate the capacity to and provide assurances satisfactory to the Commissioner that the State-based Health Insurance Exchange will carry out the functions specified for the Health Insurance Exchange in the State (or States) involved, including--

A) negotiating and contracting with QHBP offering entities for the offering of Exchange-participating health benefits plan, which satisfy the standards and requirements of this title and title I;

Tell me what a QHBP is?

Tell who dictates coverages in order for a plan to BE a QHBP?

You should read the Bill, NOT what others say about it.

 

[Greenbeard]

SEC. 201. ESTABLISHMENT OF HEALTH INSURANCE EXCHANGE; OUTLINE OF DUTIES; DEFINITIONS.

a) Establishment- There is established within the Health Choices Administration and under the direction of the Commissioner a Health Insurance Exchange in order to facilitate access of individuals and employers, through a transparent process, to a variety of choices of affordable, quality health insurance coverage, including a public health insurance option.
(b) Outline of Duties of Commissioner- In accordance with this subtitle and in coordination with appropriate Federal and State officials as provided under section 143(b), the Commissioner shall--

(1) under section 204 establish standards for, accept bids from, and negotiate and enter into contracts with, QHBP offering entities for the offering of health benefits plans through the Health Insurance Exchange, with different levels of benefits required under section 203, and including with respect to oversight and enforcement;
(2) under section 205 facilitate outreach and enrollment in such plans of Exchange-eligible individuals and employers described in section 202; and
(3) conduct such activities related to the Health Insurance Exchange as required, including establishment of a risk pooling mechanism under section 206 and consumer protections under subtitle D of title I.

c) Exchange-participating Health Benefits Plan Defined- In this division, the term `Exchange-participating health benefits plan' means a qualified health benefits plan that is offered through the Health Insurance Exchange.

Bill Text - 111th Congress (2009-2010) - THOMAS (Library of Congress)

What you're quoting is from the House health reform bill that did not get signed into law. That bill was based on a single national exchange that was indeed operated out of a hypothetical "Health Choices Administration" (which is not something that exists under the Affordable Care Act).

Under the actual reform bill that passed, the Affordable Care Act (which was designed in the Senate), the single national exchange was replaced with the idea of 51 state-based exchanges.

The easiest-to-read version of the ACA is here: http://housedocs.house.gov/energycommerce/ppacacon.pdf

Tell me what a QHBP is?

Tell who dictates coverages in order for a plan to BE a QHBP?

You should read the Bill, NOT what others say about it.

Again, you're going to want to use the text of the Affordable Care Act. "QHBP" is something out of previous iterations.

The ACA uses language about qualified health plans (the cool thing about dealing with an actual law, instead of just various bits of proposed or failed legislation, is that you can link right to the U.S. Code when considering a particular piece of law), which basically means any plan certified by the state exchange--certification remains a state prerogative--and offering at least the essential health benefits package, which under the Obama administration's regulations will be defined by the states.

Again, very state-focused.

 

[Oldstyle]

Oldstyle:

Come 2016 I hope the thing's you fear end up working themselves out somehow. B/c neither of us really knows what's going on, and both current presidential candidates have enough power and money to not have to care if things end up working themselves out. Good luck to all of us haha.

Let's stop kidding ourselves that we can continue on this way and not have the entire house of cards come crashing down, OldSchool. It's a fact that we're spending too much money. It's a fact that our government has become so bloated that it's sucking the private sector dry. It's a fact that we've reached a tipping point where more people will be getting money FROM entitlements than there are people paying into them. We either smarten up right now or it's going to get really ugly just a short time down this road. We're not Greece...some small economy that can be bailed out by Germany...we're the largest economy in the world and if we continue this insanity then there will be nobody to save us and we'll probably take the rest of the world down the toilet with us.

All I'm asking for is a little fiscal sanity...

 

[Murf76]

"
The Obama team is woefully behind its own schedule for implementing features of the legislation. The critical regulations outlining what the Obamacare insurance benefit will look like was supposed to be out more than six months ago. Now it looks like this regulation won't be dropped until after the election. This is just one key aspect of the program that is way behind the administration's own timeline.

These facts alone should give proponents of the law pause. But the early experience with the elements of Obamacare that have already kicked in is downright dismal.
The core of Obamacare doesn't get started until 2014, when state-based exchanges are supposed to be formed as places for consumers to buy the legislation's tightly regulated, subsidized coverage. But early features of Obamacare are already failing."
RealClearMarkets - The Emerging Obamacare Truth Is Disarray

Everything about Obamacare is screwed up anyway. Check it... now that the government is all up in the electronic records business... doctors have found it much simpler to "up-code", which means they're billing more to Medicare as well as private insurance companies. Yay Obama.

When the federal government began providing billions of dollars in incentives to push hospitals and physicians to use electronic medical and billing records, the goal was not only to improve efficiency and patient safety, but also to reduce health care costs.

But, in reality, the move to electronic health records may be contributing to billions of dollars in higher costs for Medicare, private insurers and patients by making it easier for hospitals and physicians to bill more for their services, whether or not they provide additional care

cont... http://www.nytimes.com/2012/09/22/b...ecords.html?smid=tw-share&pagewanted=all&_r=0

 

[francoHFW]

Also makes it EASIER to fix THAT problem...

O-care is just fine, dupes. These imaginary Pub horrors strangely never actually happen, and it's working. Teddycare proves it.

 

[buckeye45_73]

Yes the Republicans have been pretty successful in undermining the ACA.

Yeah government programs are known for their efficiency and accuracy from initial forcasts......do you really believe that?
Oh wait this is the guy that doesnt know much about politics or current events......doesnt even know who Chavez is....or cares........

 

[Greenbeard]

Yes the Republicans have been pretty successful in undermining the ACA.

Yeah government programs are known for their efficiency and accuracy from initial forcasts......do you really believe that?

The thread isn't about any "forecasts," it's about the speed of implementation of this law. As usc points out, some of the delays have been due to partisanship. Much of implementation is happening at the state level, requiring state-level decisions to tailor the reforms to their environments and officials in some--not all--red states have been intentionally dragging their feet. Similarly, Congressional Republicans have attempted to hamstring some of the federal-level implementation.

That said, it's a big undertaking. Those who wondered why 2014 was the start date for most of the coverage expansion now have their answer: getting ready isn't easy and it's time-consuming. From the onset, some thought the deadlines for starting in 2014 were too tight.

Next year will be an interesting year.

 

[AmericanFirst]

Yes the Republicans have been pretty successful in undermining the ACA.

The ACA, or obamaturdcare, is a bad idea from the get go. But then the left loves stupid.

 

[P@triot]

Obamacare Spends More Than a Trillion in Taxpayer Dollars and Still Leaves 30 Million People Uninsured

Obamacare Spends More Than a Trillion in Taxpayer Dollars and Still Leaves 30 Million People Uninsured

 

[mex]

It's really pretty simple --- Do you understand the difference between state and federal government?

Even the OP noted that the exchanges are state-based, just like the Commonwealth Connector in Massachusetts. The feds will only step in to run one for a state as a last resort. Here's former GOP Senate Majority Leader Bill Frist writing a few months ago on the wisdom of that design:

Why both parties should embrace ObamaCare's state exchanges - The Week

State exchanges are the solution. They represent the federalist ideal of states as "laboratories for democracy." We are seeing 50 states each designing a model that is right for them, empowered to take into account their individual cultures, politics, economies, and demographics. While much planning has yet to be done, we are already seeing a huge range in state models. I love the diversity and the innovation.

Want a more conservative, small-business focused exchange that bans abortion coverage in all its plans? Try Utah and its state exchange, originally founded under Gov. Jon Huntsman. Think that President Obama missed a huge opportunity to steer the nation towards a single payer system? Try Vermont, which plans to ultimately transform its state exchange into a single payer system, Green Mountain Care, that will offer coverage to all state residents. With soaring health care costs one of, if not the most, dangerous threats to America's greatness, a new round of national health care experimentation is exactly what we need.

that's all fine and dandy and all... but the question still begs... where do all these states, MOST OF WHOM ARE IN THE RED, get the money to pay for universal care?

UTAH'S BUDGET WOES

Vermont is also in debt.

My question is, do they start taxing now, before coverage begins, to fraudulently hide the true costs... like they did with obamacare?

The only diversity you're seeing in any state-mandated healthcare plans is the debt they are running up.

 

[Greenbeard]

Everything about Obamacare is screwed up anyway. Check it... now that the government is all up in the electronic records business... doctors have found it much simpler to "up-code", which means they're billing more to Medicare as well as private insurance companies. Yay Obama.

What you're identifying right there is the fundamental problem with the way we (not just Medicare, virtually every insurer in the country) pay for health care: more stuff equals more revenue for providers, independent of the quality of the 'stuff' they're providing or its impact on patient health. The amount of money they have flowing in is independent of the quality of the product they're providing, it's affected by how much they can bill for (or fraudulently over-bill for, as the case may be).

That problem goes much deeper than just a bunch of wasted money on excess volume we don't need. That fee-for-service system deeply impacts the actual way care is delivered--the organization of service delivery and its relation to patients.

Where Obamacare comes into this discussion is in its efforts to start reforming that payment system, moving us incrementally away from the deeply flawed system you're rightfully jabbing at here. But, ironically perhaps, you know what will be important for moving away from that broken system and toward one that holds providers accountable and makes sure we're getting what we pay for? Technology like electronic health records.

that's all fine and dandy and all... but the question still begs... where do all these states, MOST OF WHOM ARE IN THE RED, get the money to pay for universal care?

The costs of the coverage expansions by and large aren't being paid for by states. The only cost of the coverage expansion they're on the hook for is one-tenth of the Medicaid expansion (which has now become optional for the state) a decade from now. Since roughly half of the newly insured folks will be covered through Medicaid, that means the state's share of the costs if one-tenth of a half of it all.

And again, that's at the end of the decade. For the first three years (2014-16), the federal government pays for all of the Medicaid expansion. After that, the state's share of the additional Medicaid costs goes up a little each year: 5%, 6%, 7%, until in 2020 (and every year after that), it's 10%.

 

[Political Junky]

"
The Obama team is woefully behind its own schedule for implementing features of the legislation. The critical regulations outlining what the Obamacare insurance benefit will look like was supposed to be out more than six months ago. Now it looks like this regulation won't be dropped until after the election. This is just one key aspect of the program that is way behind the administration's own timeline.

These facts alone should give proponents of the law pause. But the early experience with the elements of Obamacare that have already kicked in is downright dismal.
The core of Obamacare doesn't get started until 2014, when state-based exchanges are supposed to be formed as places for consumers to buy the legislation's tightly regulated, subsidized coverage. But early features of Obamacare are already failing."
RealClearMarkets - The Emerging Obamacare Truth Is Disarray

What kind of doctor would allow himself to be bought by the AEI?

 

[GoneBezerk]

I'm not surprised liberals are screwing up Obamcare, they usually can't get anything done correctly or on time. Don't worry, they will waste even more money on studies of what went wrong, plans to get it done, etc. The entire cost will be over $2T if Romney isn't elected to stop it.

 

[Listening]

It's really pretty simple --- Do you understand the difference between state and federal government?

Even the OP noted that the exchanges are state-based, just like the Commonwealth Connector in Massachusetts. The feds will only step in to run one for a state as a last resort. Here's former GOP Senate Majority Leader Bill Frist writing a few months ago on the wisdom of that design:

Why both parties should embrace ObamaCare's state exchanges - The Week

State exchanges are the solution. They represent the federalist ideal of states as "laboratories for democracy." We are seeing 50 states each designing a model that is right for them, empowered to take into account their individual cultures, politics, economies, and demographics. While much planning has yet to be done, we are already seeing a huge range in state models. I love the diversity and the innovation.

Want a more conservative, small-business focused exchange that bans abortion coverage in all its plans? Try Utah and its state exchange, originally founded under Gov. Jon Huntsman. Think that President Obama missed a huge opportunity to steer the nation towards a single payer system? Try Vermont, which plans to ultimately transform its state exchange into a single payer system, Green Mountain Care, that will offer coverage to all state residents. With soaring health care costs one of, if not the most, dangerous threats to America's greatness, a new round of national health care experimentation is exactly what we need.

Then let the states choose.

You bastards are so thinly veiled it's amazing you bother at all.

 

[Greenbeard]

Then let the states choose.

That's the strategy, yes.

 

[Misty]

...they're not implementing it fast enough for you?

I guess that makes two of us!

No. And what a loser you must be if you are so in favor of government health care

And you know that is not the meaning of her op so address the issue not deflect with innuendo.

 

[Greenbeard]

...they're not implementing it fast enough for you?

I guess that makes two of us!

No. And what a loser you must be if you are so in favor of government health care

And you know that is not the meaning of her op so address the issue not deflect with innuendo.

I agree with the OP. Ideally they would indeed be going faster.

 

[Big Black Dog]

No matter how much sugar you put on it, and no matter how many times you stir the pot, shit stew is still shit stew.