How to Protect Yourself From Obamacare

[Townsend]

In case you've depended on political ads for information about medical care...a refresher:

http://finance.yahoo.com/news/8-biggest-mix-ups-about-health-care-reform.html


8 Biggest Mix-Ups About Health Care Reform

The public remains sharply divided toward President Barack Obama's historic health care reform legislation, according to polls that show few are undecided. Most people think they know whether they like or dislike the law. But when it comes to knowing what's actually contained within this mammoth retooling of our health insurance system, most of us may not be smarter than a failing fifth grader.

A recent online quiz on the main provisions of health care reform by the Kaiser Family Foundation found that participants, on average, answered just 5 out of 10 questions correctly.

It's understandable. The ambitious law runs to 2,700 pages, some of its regulations have yet to be written, and the benefits that have already taken effect have been overshadowed by the recently resolved Supreme Court challenge. The barrage of political advertising surrounding November's presidential election has further clouded, rather than clarified, things.

Now that the Supreme Court has upheld the health care overhaul law, perhaps it's time to acquaint ourselves with the changes that have already occurred and those soon to come.

[Related: ObamaCare's new price tag: A guide]

Here are the facts to dispel eight fictions that have grown up around the Affordable Care Act.

1. Mandate muddle

Fiction: Everyone must purchase health insurance beginning in 2014, no exceptions.

Fact: While most uninsured Americans will be required to buy health insurance or pay a penalty (or tax, if you like) beginning in 2014, several groups are exempt from the so-called individual mandate.

They include those whose income is so low, they don't file federal tax returns; anyone who would have to spend more than 8 percent of their income on health insurance; undocumented immigrants; people who are incarcerated; members of Native American tribes; and those who qualify for a religious exemption.

There's also one other large set of people who won't need to buy health insurance.

"Everybody who is eligible for Medicaid or Medicare does not have to purchase additional coverage," notes Deborah Chollet, a senior fellow at Mathematica Policy Research in Washington, D.C., who is helping states set up the new health exchanges where consumers will shop for insurance.

Private researchers have found that only a very small percentage of Americans will be subject to the individual mandate penalty, maintains Kathleen Stoll, director of health policy for the health care consumer group Families USA.

2. Misplaced worker apathy

Fiction: If you're insured through your employer, health care reform won't affect you.

Fact: On the contrary, many new consumer protections under the Affordable Care Act are already benefiting people with job-based health insurance.

For example, the health care reform law bars insurers from placing lifetime limits on what they will pay for a worker's medical care, plus there are new restrictions on annual benefit limits, says Brian Chiglinsky, spokesman for the Centers for Medicare & Medicaid Services. "Insurers are no longer able to arbitrarily cancel your insurance policy when you get sick, except in cases of fraud," he adds.

Other new features for job-based policies include: no more copayments or deductibles for preventive health services, including cancer screenings; the right to see obstetricians and gynecologists without a referral; better access to out-of-network services in an emergency; protections against unfair administrative fees; and the right to keep dependents younger than 26 on your policy.

[Related: What health care ruling means for consumers]

3. New government insurance?

Fiction: The Affordable Care Act creates a new government-run insurance plan.

Fact: The health care reform law includes no such provision.

Rather than centralize health insurance, health care reform accomplishes many of the goals of so-called universal coverage through its interwoven expansion of the existing Medicaid program, increased federal regulation of the health insurance industry and tax credits to make private insurance more affordable.

The law does call for the creation of new insurance plans, but the government won't run them, Chollet says. "The federal Office of Personnel Management is required to contract with at least two private insurance carriers, including at least one nonprofit, to offer coverage in every market nationwide," she explains. "They can contract with more than two, and some of these nonprofits are consumer-owned and operated health plans called co-ops."

4. Business befuddlement

Fiction: All businesses will be required to provide employee health insurance.

Fact: The Affordable Care Act does not require employers to provide health coverage.

However, it does impose a penalty on larger employers that either do not offer a plan or offer unaffordable coverage.

"The law specifically exempts all firms that have fewer than 50 employees -- 96 percent of all firms in the United States, or 5.8 million out of 6 million total firms -- from any employer responsibility requirements," says Chiglinsky. "More than 96 percent of firms with 50 or more employees already offer health insurance to their workers. Less than 0.2 percent of all firms (about 10,000 out of 6 million) may face employer responsibility requirements."

The health care law features a variety of incentives meant to encourage small businesses to insure their employees, including tax credits and access to more affordable plans through new Small Business Health Options Programs, or SHOPs, that will be part of the state insurance exchanges.

The SHOPs will give small businesses "the clout that big businesses already enjoy when purchasing insurance," Chiglinsky adds.

5. Immigrant inaccuracy

Fiction: Undocumented immigrants will receive federal aid to purchase health insurance.

Fact: Undocumented immigrants are excluded from health care reform.

And not only that, but they also are ineligible to receive Medicaid insurance for the poor or to purchase health insurance with their own money in the state exchanges when those open in 2014.

Legal immigrants who have resided in the United States for less than five years are similarly ineligible for federal assistance, though the states have the option of extending coverage to pregnant women and children while they await legal status.

"Undocumented immigrants are still in the same difficult situation they have always been in," says Chollet.

6. 'Death panels' notion lives on

Fiction: Health reform creates a "death panel" to make decisions about end-of-life care for seniors.

Fact: Early drafts of health care reform would have allowed Medicare to reimburse physicians for time spent talking with older patients about advance care planning. But these provisions were eliminated in subsequent revisions.

"Given some political space, (the reimbursement) would have been something that families and their doctors would have appreciated having. But it became so politicized so fast that it just threatened to sink the entire bill, so it was struck," says Chollet.

Stoll says savvy Medicare-eligible consumers who want to have these discussions already have discovered a cost-free workaround provided by a previous president.

"In 2003, President George W. Bush signed into law the Medicare Modernization Act, which allows Medicare to cover advance care planning as part of the Welcome to Medicare physical exam," she explains. "Also, if you visit your doctor, for example, to check your diabetes and you also discuss your end-of-life care preferences during that visit, Medicare will cover the appointment."

7. Medicare scare

Fiction: Health care reform will reduce Medicare benefits to all seniors.

Fact: Traditional Medicare benefits will be unaffected by the law, and some seniors will even enjoy better coverage.

"It improves prescription drug coverage for people with Medicare Part D by gradually closing the coverage gap, or 'doughnut hole,'" Stoll says. "Seniors with high drug costs who fall into the doughnut hole are now receiving 50 percent discounts on their brand-name drugs at the pharmacy and other discounts on generics. These discounts will increase each year until the gap is completely closed in 2020."

Health care reform does reduce payments to privately-administered Medicare Advantage plans and requires them to spend at least 85 percent of premiums directly on patient care in order to bring their costs more in line with the average cost of traditional Medicare. These plans may then charge higher premiums and reduce added benefits such as eye and dental care, but all plans will still be required to provide all benefits currently covered under traditional Medicare.

8. States on the sidelines?

Fiction: States that don't set up health exchanges will be exempt from the Affordable Care Act.

Fact: If states fail to establish a health exchange, the federal government will set up and run one for them.

"On Jan. 1, 2014, consumers in every single state will have access to private health insurance options on an Affordable Insurance Exchange, regardless of whether that exchange is run by the state, the federal government or a partnership between the two," says Chiglinsky.

But the Supreme Court's ruling on the Affordable Care Act said states may, in fact, opt out of another part of the health care reform law: its expansion of Medicaid, which is designed to make health insurance affordable for an additional 16 million Americans.

States that do decide to opt out would be turning down millions of dollars in Medicaid funding, because the federal government plans to foot the entire bill for expanding Medicaid in the first few years. After that, states will be expected to pick up 10 percent of the costs.

Oh, and I forgot to add, here's where Oklahoma is...

States that do decide to opt out would be turning down millions of dollars in Medicaid funding, because the federal government plans to foot the entire bill for expanding Medicaid in the first few years. After that, states will be expected to pick up 10 percent of the costs.

[Hoss]

In case you've depended on political ads for information about medical care...a refresher:

http://finance.yahoo.com/news/8-biggest-mix-ups-about-health-care-reform.html


8 Biggest Mix-Ups About Health Care Reform


Oh, and I forgot to add, here's where Oklahoma is...

To be fair, I thought Governor Failin' hadn't made a decision regarding that..or at least said she 'would wait until after the election'.

[Townsend]

To be fair, I thought Governor Failin' hadn't made a decision regarding that..or at least said she 'would wait until after the election'.

Oh c'mon

[Hoss]

Oh c'mon

Need to make sure she's 'not taken out of context'.   

[Conan71]

Curious, under the part of people for whom their insurance cost would be more than 8% of their total income, are they eligible for Medicaid?

[Townsend]

Curious, under the part of people for whom their insurance cost would be more than 8% of their total income, are they eligible for Medicaid?

What have the guidelines been?

[Conan71]

What have the guidelines been?

No idea.  I suppose that falls to state-by-state programs like Soonercare.

[Teatownclown]

No idea. 

that's right.

[Townsend]

Your pizza is about to bump up $.20.

http://www.politico.com/politico44/2012/08/papa-johns-obamacare-will-raise-pizza-prices-131331.html

Pizza chain Papa John's told shareholders that President Obama's health care law will cost consumers more on their pizza.

On a conference call last week, CEO and founder John Schnatter (a Mitt Romney supporter and fundraiser) said the health care law's changes — set to go into effect in 2014 — will result in higher costs for the company — which they vowed to pass onto consumers.

"Our best estimate is that the Obamacare will cost 11 to 14 cents per pizza, or 15 to 20 cents per order from a corporate basis," Schnatter said.

"We're not supportive of Obamacare, like most businesses in our industry. But our business model and unit economics are about as ideal as you can get for a food company to absorb Obamacare," he said.

"If Obamacare is in fact not repealed, we will find tactics to shallow out any Obamacare costs and core strategies to pass that cost onto consumers in order to protect our shareholders best interests," Schnatter vowed.

Schnatter is not the first pizza magnate to bemoan proposed or actual changes to federal health care. In 1993, future presidential candidate Herman Cain charged that Bill Clinton's proposed health care reform law would cost his company Godfather's Pizza money and jobs.

"For many many businesses like mine, the cost of your plan is simply a cost that will cause us to eliminate jobs," Cain told Clinton in a famous exchange.

[carltonplace]

Like Poppa Johns was providing health care to their drivers. Of course they weren't, very few service industries offer health care to their employees, especially their tipped employees.

[nathanm]

Curious, under the part of people for whom their insurance cost would be more than 8% of their total income, are they eligible for Medicaid?

I believe they're eligible for federal tax credits to the extent that health insurance costs more than the 8% amount, presuming they're not eligible for Medicaid because of low income.

[Hoss]

Your pizza is about to bump up $.20.

http://www.politico.com/politico44/2012/08/papa-johns-obamacare-will-raise-pizza-prices-131331.html

Doesn't really matter to me.  Papa John's sucks.  Much like Chick-fil-a.  Didn't boycott them because of what their moron CEO said, I boycotted them since day one because I think their food sucks.

[TulsaRufnex]

Like Poppa Johns was providing health care to their drivers. Of course they weren't, very few service industries offer health care to their employees, especially their tipped employees.

Well, alot of their employees are under age 26 and would likely be covered under their parents' insurance... and some of their employees over age 26 would be covered under a spouse's insurance, since most other employers have better benefits than those offered to full time fast food employees...

Otherwise, the little industry trick I remember from retail and fast food was to work people a part time schedule of less than 32 hours per week... so they can force their employees who NEED health insurance to pay out the wazoo on the individual market... and then there's CRAP health insurance that is only offered to save face.....

Health Care's Uneven Road to a New Era
By DAVID LEONHARDT
Published: October 5, 2010
http://www.nytimes.com/2010/10/06/business/economy/06leonhardt.html?_r=1&src=me&ref=business

McDonald's offers its hourly workers two different health care plans, which are known as "mini-med" plans. In one, workers can pay about $730 a year for benefits of up to $2,000. In the other, they can pay about $1,660 a year for benefits of up to $10,000, The Journal reported.

In a memo to federal regulators, McDonald's executives argued that their version of health insurance "positively impacts" the almost 30,000 workers who are covered. And that's true. A plan with a $2,000 or $10,000 cap can cover some modest health problems and is better than being uninsured.

But should the litmus test for American health care really be better than nothing?

Mini-med plans force people to drain their savings accounts for dozens of common medical problems. They also force hospitals to let some bills go unpaid, which drives up costs for everyone else.

Senator Charles Grassley, Republican of Iowa, has previously criticized AARP for marketing similarly limited plans to its members. "It's not better than nothing," Mr. Grassley argued, "to encourage people to buy something described as 'health security' when there's no basic protection against high medical costs."

Dr. Aaron Carroll, an Indiana University pediatrics professor who studies health policy, says of mini-med plans: "They're great if you're healthy, because you feel like you're covered. But if you ever need them, they're so skimpy, they provide very little." Gary Claxton of the Kaiser Family Foundation adds, "They really just shouldn't be considered health insurance."

The plans' skimpiness is the main reason they ran into legal jeopardy. Under the new law, most plans must spend at least 85 percent of their revenue on medical care, rather than administrative overhead. The McDonald's plans aren't generous enough to clear the hurdle.

At the same time, it's probably unrealistic to expect McDonald's to give workers decent health insurance. Many of those workers make less than $20,000 a year. A typical family insurance plan would raise their total compensation by more than half, destroying the McDonald's business model.

The workers, for their part, cannot afford to buy insurance in the so-called individual market. Plans are even more expensive in that market, because it is dominated by people who desperately need insurance — which is to say, sick people.

This is where health reform comes in. It tried to solve the problem by creating what policy experts call a three-legged stool.

First, people will be required to buy insurance, to spread costs among the sick and the healthy. Second, insurers will be prohibited from cherry-picking only the healthiest customers, again to spread costs. Finally, the government will give subsidies to people, like McDonald's workers, who can't afford insurance on their own.

[Townsend]

Universal Healthcare: A Conservative Reform

http://www.thedailybeast.com/articles/2012/08/08/universal-healthcare.html

he Romney campaign appears on the verge of pivoting and re-embracing the candidate's most important achievement as governor. Some conservatives are already expressing dismay. They should not. To accept the ideal of universal health coverage is not to accept Obamacare in its present form. From a conservative point of view there are many, many changes that need to be made to Obamacare. The most important from my perspective (as I've often argued here) are to change the financing mechanism so that it does not entirely fall on a few people, to rely less on Medicaid, and to accelerate cost controls. (It would also be desirable to end the distinction between Medicare and health insurance for those under-65s, but that' s another story.)

For now, let's just recall why the ideal of universal coverage—Romneycare—fits well and rightly into mainstream modern conservative politics:
1) It saves money. Every other advanced democracy covers virtually all of its people at a cost relative to national income of something like 60% of what the United States pays. That's just wasted money—money that could buy other things.
2) It protects the defense budget. As we saw during the debt ceiling debate of 2011, when the pressure to save money rises, Democrats protect domestic programs as their first priority and Republicans hold the line on taxes. Defense becomes the budget-cutters' target of opportunity.
3) It supports entrepreneurship. People who don't worry about losing their healthcare are more likely to risk quitting a job with an established firm to start something of their own.
4) It provides support to the middle class in a time of anxiety. Globalization has thus far tended to enrich the rich and squeeze the middle, not only in the United States, but in almost every developed country. Many ideas for securing the middle that we hear from e.g. President Obama threaten the whole free-enterprise system. Health security puts a floor under the middle class without radical change to the rest of the economic system.
5) It enhances national unity. The existing health system disproportionately leaves ethnic minorities exposed to risks of premature death, disability, and illness. Universal health coverage makes all feel in this one respect at least equally part of society and nation.
6) It's the right thing to do. "To make men love their country, their country ought to be lovable," wrote Edmund Burke. The United States will be a better country without this unnecessary fear pressing on millions of its people—and a better country will be a stronger country.

[TulsaRufnex]

Obamacare = slavery?
http://blog.beaumontenterprise.com/bayou/2012/07/31/beaumont-biz-owner-obamacare-slavery/

Hmmm.  If Obamacare = slavery, shouldn't there be a plantation somewhere.... oh, wait... here we go...


Location: Stonegate Road, Louisville, KY
Square Feet: 40,000

This 40,000 square foot mega-mansion is owned by John Schnatter. Schnatter is the founder, chairman, and CEO of the Papa John's pizza chain. The castle-like mansion was designed by Don Evans, an Orlando architect. It also has a multilevel subterranean garage with 22 parking spaces, an office for valet parking, a built-in car wash and a giant motorized turntable to help move limousines. It is divided into 14 parking spaces for the family on one level and eight spaces for guests on another, with an elevator between the two floors. John had a net worth of $402.6 million back in 2006, a figure that has definitely risen over recent years.