Sorry for the length, but I didn't have time to write a short blog.

Monday, October 14, 2013

Since It Is the Law of the Land

One of the explainers of the Affordable Care Act that I saw said  that the problem of explaining the ACA or Obamacare is because some guy who understands eight percent of the ACA explains to someone who understands five percent of the plan. The plan is huge, but the problem is not that you need to read the law in order to use it any more than you need to read the Medicare law or the Medicaid law or any of the hundreds of laws that are as complex.  What you need to do is go to the websites and look.

The U.S. website is a mess.  Welcome to any government program that is set up by government officials.  I don't care what party your elected official is from, someone who knows someone who helped someone will inevitably get employed because of it.  It has been done that way since governments were invented.  Unfortunately, it is also why some of the programs have dismal disasters.  Under George W. Bush the FEMA director, Michael Brown was hired by his long time friend the then FEMA Director Joe Albaugh who ran Bush's campaign in 2000.  See how it works? Neither man was prepared to handle an emergency like Katrina because neither were trained for disasters.  I also suspect this is true with the roll out for the ACA.

State sites are doing much better with the issues because most hired honest to goodness technical specialists. Yes, even they had glitches but the good news is most of them are up and fixed. The other good news is that the government is not responsible for the insurance, just the enrollment to the insurance.  The bad news is that a number of red states have done, like congressional Republicans, everything they can to keep the ACA from working.  Anyone remember the time that when laws were passed the other party tried to fix it so it worked better rather than destroy it by holding 42 meaningless votes? So in an effort to make sure it doesn't work, many red states have refused to expand Medicaid, which would actually save their states money and opted not to set up state run sites for enrollment forcing people who would get much better coverage if they only had Medicaid to flock to the badly run Federal site.  The irony is that many of these states have the largest number of uninsured of any of the states in the nation. According to a New York Times economic blog "The Urban Institute, a nonpartisan research group in Washington, performed a similar, detailed analysis of new costs and cost savings. It ran the numbers for all 50 states and the District of Columbia. It estimates that 21 to 45 states would save money by taking the Medicaid expansion." Several states that have embraced the full law are actually saving money and helping to make sure the poor receive coverage too.

What do the uninsured rely on when they get hurt or sick? The most expensive form of medical treatment, emergency care, and since they don't have insurance, guess who gets to cover the cost? That's right, you, and I do. That is why the law carries the individual insurance mandate.  The theory is that by adding the healthy to the insurance pool, we lower cost. Oddly that works. If you choose to risk having everyone else pay for your uninsured emergency procedures, then you will pay a penalty in taxes for not getting coverage. This penalty, the individual mandate, is what helps to fund the law.   So delaying it or making it optional would actually end up costing money in the long run. That's why delaying it as offered in one of the Republican CR's was not really an option.  It was really the same as the defund the ACA offer was just with a slightly different hair style. The other thing that many folks don't realize is that people in low and lower middle income brackets will receive immediately tax credits which will greatly reduce their insurance costs.  Roughly 26 million folks will be eligible for various levels of these credits based on up to something like 400 percent of the Federal Poverty line.  The lower the income the more help one receives.  So the little memes about some poor guy being penalized or the story about the guy fined while signing up for the ACA are not true. Not even remotely.

So why was the law delayed for businesses? Well there are several reasons.  First it effects a very small number of people.  Second, it quickly became clear that it would give the businesses a better chance to get their ducks in a row.  The fact is that the requirement for insurance to be offered by a business is only on businesses employing 50 or more people.  Something like 92 percent of all business employs less than that.  The delay was done because a number of businesses who employ over 50 complained that the law was too complicated.  Organizations like the National Retail Federation praised the move.  It was also a wise political move to help shore up support from small businesses for Democrats.  Yes, there was also a purely political move. Duh.

So will the cost of insurance go up for some people. Yes.  Particularly for people who don't have insurance. It will also go down for a number of people.  Will medicine cost go up for some? Yes.  It will also go down with the medicare expansion for many.  The fact is that seniors take far more medications than any other group and those on medicare will reap the best benefits.  If you want to read the actual numbers go here.  This is Fact Check not some Republican site that uses bad figures to pump up the numbers or some Democrat site that use too narrow of numbers. It will affect different folks in different ways.

Here are two pretty good videos that explain the cost of health care. The first is the cost. The next is about the ACA or ObamaCare. If you really want to learn and not be lead around by some right or left winger, take the time to watch the videos. I think you will be amazed.

So here it is. Most know that the ACA let's you keep kids on the insurance until 25.  It covers all people even with pre-existing conditions. There are no lifetime caps on insurance.  Medicare recipients are already enjoying some of the benefits.  A woman's insurance will be the same price as a man's.  It is the law of the land. It may succeed.  It may not. A politician has his own agenda.  A Facebook friend probably knows about as much as you do.  We have never done this before.  What we do know is something must be done and this is something.  Health care in other countries is controlled and far cheaper than our country and often far better, and, as the video shows, we're not just talking a difference of a little but a difference of a lot.  The only way you and I will know what to do is to go on to the sites, state ones if you have one, and see.

It's here and it's time to deal with it.  If there are parts you do not like or think we can improve, contact your Senator and Congressperson and tell them to do what they are suppose to do.  Get on the stick and work to make it better and not take meaningless votes.  The problems need to be fixed and can be fixed just as Medicare was worked on and Social Security was worked on in a time when politicians did what they were suppose to do. Taking votes and closing the government and theatening the national credit is stupid and playing politics.

We can do better than hateful memes or uninformed opinions from agenda driven web sites. Change is always difficult.  It is the law, and it is here.  Time to quit whining and become informed.  That's what I intend to do; how about you?