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ACA Running Thread

Excellent long Politico article about how Mississippi became the only state in which the percentage of uninsured Americans went up under Obamacare.
http://www.politico.com/magazine/story/2014/10/mississippi-burned-obamacare-112181.html

Gary didn’t have health insurance either, not that she hadn’t tried. When the Affordable Care Act mandated that Americans buy coverage, she didn’t want to be a lawbreaker: She had gone online to the federal government’s new website, signed up and paid her first monthly premium of $129. But when her new insurance card arrived in the mail, she was flabbergasted.
“It said $6,000 deductible and 40 percent co-pay,” Gary told me, her timid drawl giving way to strident dismay. Confused, she called to speak to a representative for the insurer Magnolia Health. “‘You tellin’ me if I get a hospital bill for $100,000, I gotta pay $40,000?’” Gary recounted. “And she said, ‘Yes, ma’am.’”

Never mind that the Magnolia worker was wrong—Gary’s out-of-pocket costs were legally capped at $6,300. She figured that with a hospital bill that high, she would have to file bankruptcy anyway. So really, she thought, what was the point?
“This ain’t worth a tooth,” she said.
She canceled her coverage.


.
...

By the time the federal government offered the required coverage on its balky HealthCare.gov website, 70 percent of Mississippians confessed they knew almost nothing about it. “We would talk to people who say, ‘I don’t want anything about Obamacare. I want the Affordable Care Act,’” remembered Tineciaa Harris, one of the so-called navigators trained to help Mississippians sign up for health care. “And we’d have to explain to them that it’s the same thing.”


...

It is difficult to untangle the state’s dismal health from its past. For African-Americans, even going to a doctor can be a fraught historical act in Mississippi. There are the practical reasons that come from being poor and uninsured, but there is also a toxic legacy: the Jim Crow laws of living memory that barred blacks from most doctors’ offices, the widespread practice of sterilizing black women as a form of birth control, a practice so common it became known as “Mississippi appendectomies.” Perhaps it’s no surprise then that Mississippians today are less likely than the rest of the country to seek primary care for chronic conditions and more likely to turn to hospitals when those ailments become more serious and expensive.

...

Now he was keen to take up the conservative think tank’s ideas for how to aid one portion of those without health insurance: “The largest group of the uninsured in Mississippi when I was governor were the employees of small businesses,” Barbour told me. He tasked Chaney with laying out how Mississippi could set up an online marketplace where the state’s many small businesses could pool their purchasing power to shop for medical coverage.
The idea, at the time, was seen as a conservative one. It was part of the health reform law Republican Governor Mitt Romney had signed in Massachusetts in 2006, and Barbour was touting it as an economic development measure. “I went from not liking it to really falling in love with it,” Chaney told me. “You know, like you didn’t like the girl in the third grade and you ended up marrying her?”
By 2010, when Congress passed the Affordable Care Act, planning was well underway for a state-based, small-business exchange in Mississippi. “We had no elected officials who were against what we were doing,” Chaney insists today.



...

But the Affordable Care Act had descended on Mississippi like so many prior federal edicts: as an invasion from the North that fractured along racial lines, stoking long-held grievances against the federal government. In June 2012, after the U.S. Supreme Court upheld the law’s core principle—requiring most Americans to obtain health coverage or pay a penalty—Mississippi Tea Party co-founder Roy Nicholson issued a florid order to the ground troops: “To resist by all means that are right in the eyes of God is not rebellion or insurrection, it is patriotic resistance to invasion.”

An anti-abortion activist who recently lost a bid for alderman in his hometown east of Jackson, Nicholson had founded the Mississippi Tea Party in 2009 with a fiery call “to resist the Socialist agenda” of the Obama administration, and the health law became his Exhibit A. (He would eventually resign as chairman of the group in 2013 after referring to the president as “Hussein Obama” and accusing him of “branding patriots, Christians and veterans as potential domestic terrorists that must be spied on, harassed and vilified.”) Obamacare was a perfect issue for the Tea Party, of a piece with its self-declared mission to scale back the government and slash federal taxes, a call that resonates strongly with Mississippians, who have the lowest per capita income—$33,073—in the nation. (Mississippi conservatives don’t tend to mention that Mississippi receives $3 for every $1 it sends to Washington; nearly half of the state’s annual budget depends on federal disbursements. “If you cut that out, we would cease to be a going concern,” says political scientist Marty Wiseman.)


...

Soon after Bryant was sworn in, the Obamacare fuse was lit by the Mississippi Center for Public Policy, a member of a national network of think tanks that reportedly receives funding from the billionaire Koch brothers. As Mississippi’s plan for a state exchange garnered national press and became something of an embarrassment for the conservative faithful, the think tank’s president, Forest Thigpen, seized the moment to come out against the idea. The insurrection urged by Tea Party founder Nicholson was on, and those seen as helping to put the law into place were now to be considered traitors.
Mike Chaney didn’t see the ambush coming.

-----------

That's just from the first 2 of 5 pages. Very good read.
 
PH - I'll read the whole article when I get time but from reading what you quotes I can tell you that isn't merely an AA problem. My farm employs close to 40 people and we brought in 2 Humana reps to come in and sign everyone up by hand (so no one had to try and go online).

We handle all the premium payments in house and we keep getting letters saying that coverage has been cancelled. Out employees go to buy medicine and they have basically no coverage. I am wake forest educated. My feather in law is vandy/nyu tax law, my uncle is millsaps/Harvard business, my other uncle is Texas/Texas MBA. And we are still having issues getting proper coverage.

Perhaps it is a Humana issue but for me I attribute it to ACA because we didn't have nearly these many problems until we were basically forced to switch.

The large majority of our employees are AA due to the demographics of our county and I can tell you that ACA is not fractured among racial lines among our crew. It is almost unanimous among our workers that they hate it and that it is causing more difficulty on their life than before it was implemented.

Thanks for sharing. I'll read later.
 
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The article mentions the racial divide, but it's mostly about the Mississippi problems overall. I've read a few articles recently how bad things are in Mississippi. Not sure if Ole Miss and Miss St. are drawing more attention to how bad Mississippi is at everything but college football.
 
Here is a good blog post that addresses the Mississippi situation. It points out that in order to address the real human cost of the health care crisis in Mississippi, both sides of the aisle need to bend - conservatives in their stiff-necked anti-Obamacarism, sure, but also liberals who insist that all 50 states adopt Medicaid expansion in exactly the same way. Even a slimmed-down, stingier Mississippi version of Medicaid would be better than no care at all.

The hospital closures are probably the saddest issue. It is very possible that the hospital in my little rural NC hometown may have to shutdown if Medicaid expansion doesn't happen soon. The closest alternatives are all 45 minutes away over twisty mountain roads, treacherous in winter, and of course there is 0 public transit. That's millions of dollars in infrastructure going to waste, and a real cost to the quality of life of rural Americans.
 
I wonder how many ACA problems in Mississippi are actually due to the provisions of the bill versus administrators in the state and within the exchange who don't want to comply with what the law actually is.
 
The article mentions the racial divide, but it's mostly about the Mississippi problems overall. I've read a few articles recently how bad things are in Mississippi. Not sure if Ole Miss and Miss St. are drawing more attention to how bad Mississippi is at everything but college football.

Healthcare is really poor in MS in general...I agree. We glorify unhealthy lifestyles, we have a very poor infrastructure, and the culture in general is very anti-preventative care (when I say culture I am not limiting that to either race). IN the end what we have is people who are unhealthy and don't go to the doctor until they are having a heart attack. It is a bad cycle (much like many other ones in MS) that I am not sure how to break.
 
I wonder how many ACA problems in Mississippi are actually due to the provisions of the bill versus administrators in the state and within the exchange who don't want to comply with what the law actually is.

I spent 2 hours on the phone with the exchange trying to tell them I was not going to be paying them any money, and they passed me around 5 times until I eventually hung up. It was almost as though they didn't want me to officially unsubscribe. After about 6 months of sending me mountains of paperwork with no response I guess they eventually go the hint.

But to answer your question, I am not sure there is a quantifiable method to judge that. The infrastructure is really bad from my experience, and I am not sure what state lawmakers could have done to better that.
 
Provide infrastructure?
 
I spent 2 hours on the phone with the exchange trying to tell them I was not going to be paying them any money, and they passed me around 5 times until I eventually hung up. It was almost as though they didn't want me to officially unsubscribe. After about 6 months of sending me mountains of paperwork with no response I guess they eventually go the hint.

But to answer your question, I am not sure there is a quantifiable method to judge that. The infrastructure is really bad from my experience, and I am not sure what state lawmakers could have done to better that.

Yeah I'm not disputing that administratively this is a great program as far as government employees are concerned, but most states in the south have literally done nothing to provide any infrastructure whatsoever to understanding or aiding people to receive the service. Just providing any infrastructure would be nice for southern states.
 
Kentucky may have created the best ACA implementation structure of any Southern state and McConnell still wants to repeal it, but keep the website(?).

Of all the political gaffes out there this one has to be one of the worst. The minority leader of the Senate indicated that he actually had no idea what the law was when he said he wanted to keep the exchange and website but repeal the ACA. HE DIDN'T EVEN KNOW THAT THIS WAS THE ACA. I mean this just goes to show you how willfully ignorant most of the Republican party is about anything Obama does just because it's Obama.

It's like those poll from a couple years back asking Republicans if they supported the ACA and then asking if they supported Obamacare and Obamacare polled something like 25% worse. I'll see if I can find it.

These two examples are perfect examples of having no idea what's going on and simultaneously destroying something based solely on whose name is on it.
 
Yeah I'm not disputing that administratively this is a great program as far as government employees are concerned, but most states in the south have literally done nothing to provide any infrastructure whatsoever to understanding or aiding people to receive the service. Just providing any infrastructure would be nice for southern states.

I agree in some respects but there are a lot of pubs that are hoping for repeal in a few. years and providing infrastructure would be working against that. They disagree philosophically with a government run healthcare system so it is pretty difficult to ask them to work to promote it.
 
Did you read the article? Republicans were actively working on "government run health care" in Mississippi until Obama proposed it.

And ACA is more popular than Obamacare. That has nothing to do with philosophy.
 
I agree in some respects but there are a lot of pubs that are hoping for repeal in a few. years and providing infrastructure would be working against that. They disagree philosophically with a government run healthcare system so it is pretty difficult to ask them to work to promote it.

Except ACA isn't government run healthcare. All they have done is set minimum care levels. You can buy more than that if you so choose.

Calling it government run healthcare when private companies overwhelmingly deliver, it is a RW brainwashed, talking point lie.
 
I put this on the other health care thread but I am so pissed off that I am putting it here too. Fucking bastard.

The Community Organizer can suck my dick. The employer-side premium on our "non-compliant" HDHP plan (that everybody loved before the ACA shitshow sent it into a tailspin) went up 9.8% if we want to keep it another year. We can switch into a compliant plan, which drops the employer-side premium in theory, but it doubles the damn out-of-pocket for the employees, and pushes it up over their maximum allowed HSA contribution, so not only are they paying more, but they have to do so with after-tax dollars. So if I then try to be nice and gross up their pay by the amount to keep the effect of their out-of-pocket consistent with what it was under the non-compliant plan, then the net effect is that the employer-side premium that I am paying goes up 30%. For essentially the same damn coverage. Fuck you, you unqualified hack.
 
I can't believe Obama would do that to you. You should try Humana or BCBS instead of letting the President of The United States of America personally manage your healthcare. He's probably so busy with his day job that he doesn't have much time to find you the best rates.

While we're talking about Barack, I would like to personally thank him for lowering the price of regular unleaded at the Kangaroo station next to my house.
 
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Except ACA isn't government run healthcare. All they have done is set minimum care levels. You can buy more than that if you so choose.

Calling it government run healthcare when private companies overwhelmingly deliver, it is a RW brainwashed, talking point lie.

It is private insurance thats heavily regulated, from pricing, to whats covered to how its covered to where its covered to how its administered. There are literally thousands of pages of regs on how to administer this.

Of course, its also massively subsidized. Over 75% of the average exchange premium is paid for by Uncle Sam.

Its a bit more than setting minimum care levels.
 
Here is a good blog post that addresses the Mississippi situation. It points out that in order to address the real human cost of the health care crisis in Mississippi, both sides of the aisle need to bend - conservatives in their stiff-necked anti-Obamacarism, sure, but also liberals who insist that all 50 states adopt Medicaid expansion in exactly the same way. Even a slimmed-down, stingier Mississippi version of Medicaid would be better than no care at all.

The hospital closures are probably the saddest issue. It is very possible that the hospital in my little rural NC hometown may have to shutdown if Medicaid expansion doesn't happen soon. The closest alternatives are all 45 minutes away over twisty mountain roads, treacherous in winter, and of course there is 0 public transit. That's millions of dollars in infrastructure going to waste, and a real cost to the quality of life of rural Americans.

Who are these liberals? Do they have names? Influence? Pretty sure Arkansas has been able to get a waiver for a Medicaid "private option" with basically no fuss from the left. It's the right that tried to kill it and will be trying to kill it next year.
 
It is private insurance thats heavily regulated, from pricing, to whats covered to how its covered to where its covered to how its administered. There are literally thousands of pages of regs on how to administer this.

Of course, its also massively subsidized. Over 75% of the average exchange premium is paid for by Uncle Sam.

Its a bit more than setting minimum care levels.

Because of how badly the industry treats its customers and how much they rip us off.
 
Because of how badly the industry treats its customers and how much they rip us off.

We can certainly discuss the good & bad of how the insurance industry acts. That wasn't what I was addressing though rip off is not a terribly compelling argument given the current margins of carriers.

I was merely suggesting that the ACA is in fact a pretty big federal take over of health care. I forgot to mention the individual mandate, employer shared responsibility (i.e. play or pay), Medicaid expansion, etc. Not judging good or bad, but it is a huge regulatory action.
 
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