Obamacare

About

Obamacare is the colloquial name for the Patient Protection and Affordable Care Act (aka ACA, PPACA) enacted in 2010 in response to reform initiatives in 2009. It requires all health insurance plans to cover ten essential benefits:

1. Outpatient care
2. Emergency services
3. Hospitalization
4. Maternity and newborn care
5. Mental health and addiction treatment
6. Prescription drugs
7. Rehabilitative services and devices
8. Laboratory services
9. Preventative services, wellness services, and treatment for chronic diseases such as emphysema, MS, or cancer.
10. Pediatric services

It also prevents insurers from refusing coverage on the basis of "pre-existing conditions", which insurers were free to define however they liked (and could equate to basically anything ever recorded on your medical chart, such as a hangnail).

It has been attacked by the political Right, especially free market libertarians, since it was first proposed – despite being heavily based on a plan created by the right-libertarian Heritage Foundation think-tank and supported by the political right as an alternative to the Clintons' universal healthcare proposal in the 1990s. Attacks included:

• distortions and misrepresentations (many people now believe popular myths about it)
• fighting various provisions of the law so as to make it less effective:
  • the Medicaid expansion mandate (successful, see NFIB v. Sebelius); result:
    • states no longer have to accept it
      • leaving millions (who would otherwise have been covered) without healthcare...
        • ...because they fall into the gap between those who can benefit from tax subsidies and those poor enough to receive Medicaid
  • the individual mandate (unsuccessful, see NFIB v. Sebelius); results would have been:
    • eliminating a major revenue source for insurers
      • ...forcing them to raise insurance prices even more
  • tax credits to insured individuals outside of states which accepted the Medicaid expansion (unsuccessful, see King v. Burwell); results would have been:
    • many more individuals in Republican-controlled states who could not afford health insurance, thus:
      • deepening criticism against it (the law itself is blamed for the problems caused by damage to it)
      • removing a source of funding for it, increasing insurance costs
      • creating many more uninsured emergency room visits, increasing healthcare costs overall
  • screwed around with the "risk corridors" mechanism
    • causing difficulties which resulted in further rises in the price of insurance
  • see also Constitutional challenges to the Patient Protection and Affordable Care Act
  • further attempts to screw around with how insurers are reimbursed for high-risk loads (House v. Burwell, currently unresolved)
    • ...which would similarly increase insurance prices

Pages

• /myths

Links

Reference

• Wikipedia
• ACA Signups: data
• official:
  • timeline: when each provision takes effect
• reports:
  • 2014-02-21 Report to Congress on the impact on premiums for individuals and families with employer-sponsored health insurance from the guaranteed issue, guaranteed renewal, and fair health insurance premiums provisions of the Affordable Care Act (PDF)
    • John Boehner used the report as a basis for criticism of the ACA:
      • 2014-02-25 ObamaCare: Bad for Small Businesses, Worse For Their Employees (press release)
        • Obama administration: Health law’s new rules will increase costs for most small businesses
          • discussion/analysis

Related

• 2015/02/24 [L..T] Arkansas, Kentucky See Most Improvement in Uninsured Rates "Of the 11 states with the greatest reductions, 10 expanded Medicaid and established a state-based marketplace exchange or state-federal partnership. Montana, which is tied for 10th, is the only exception."
• 2015/02/05 [L..T] 3 Male Lawmakers Propose Eliminating Obamacare's Maternity Coverage "In their quest to repeal and replace Obamacare, three Republican lawmakers have offered an alternative proposal to the health reform law that would roll back some of its major consumer protections, including maternity care for pregnant women."
• 2014/07/22 [L..T] An "unfortunate political stunt" goes awry «Earlier this year, Sen. Ron Johnson (R-Wis.) thought he'd come up with a great idea: he'd file a lawsuit against the Affordable Care Act in the hopes of making coverage more expensive for Capitol Hill staff. Rep. Jim Sensenbrenner, a Republican from Johnson's home state of Wisconsin, conceded the senator's lawsuit was "frivolous" and an "unfortunate political stunt."»
• 2014/07/22 [L..T] Appeals court swings a sledgehammer at the ACA «There's one last court case that we've been following that, in theory, could still destroy much of the federal health care system. At a distance, it's a genuinely ridiculous case, but as Adam Serwer reports this morning, its absurdity didn't stop Republican-appointed judges from making the wrong call this morning.»
• 2014/07/01 [L..T] Hobby Lobby Made Fight a Matter of Christian Principle
• 2014/05/26 [L..T] I.R.S. Bars Employers From Dumping Workers Into Health Exchanges
• 2014/05/13 [L..T] The Totally Misleading Way The GOP Plans To Attack Obamacare Next "But they left out one crucial piece of information: Obamacare is designed to protect enrollees against year-to-year price fluctuations. Warning about higher premiums leaves an impression that people will pay more, and the GOP surely won't hesitate to push that line again whenever news of rising premiums breaks."
• 2014/05/07 [L..T] U.S. Women Saved $483 Million On Their Birth Control Pills Last Year "Compared to the data from 2012, about 24 million more birth control pill prescriptions were filled without a co-pay in 2013. That means each of the women filling those prescriptions ended up saving an average of $269."
• 2014/05/05 [L..T] Rand Paul says 40 times more Kentuckians have gotten health-insurance cancellation notices than signed up for Obamacare Rand Paul email: "Since the implementation of Obamacare, hundreds of thousands of Kentuckians have received cancellation notices from their current health care providers. For every Kentuckian that has enrolled in Obamacare, 40 have been dropped from their coverage." Rated pants-on-fire.
• 2014/05/05 [L..T] Tennessee State Senator Compares Obamacare To The Holocaust "A brief post published at the blog of state Sen. Stacey Campfield (R) read: "Democrats bragging about the number of mandatory sign ups for Obamacare is like Germans bragging about the number of manditory [sic] sign ups for 'train rides' for Jews in the 40s.""
• 2014/05/02 [L..T] GOP Went Fishing For Bad Obamacare News And Came Up Empty "Perhaps the most interesting thing about the House GOP's Obamacare survey, which an insurance industry source dismissed as "incredibly rigged" when sharing it with TPM, is the question that it didn't manage to answer: How many of the law's enrollees were previously uninsured?"
• 2014/04/29 [L..T] Rick Scott bombs with this crowd of seniors on Obamacare
• 2014/04/24 [L..T] GOP can't even win the healthcare argument in the South «As new polling from the New York Times and the Kaiser Family Foundation suggests, even in the deep South, voters aren't actually buying what Republicans are selling on health care.»
• 2014/04/23 [L..T] Six Studies That Show Everything Republicans Believe is Wrong "The great 20th-century economist John Maynard Keynes has been widely quoted as saying, "When the facts change, I change my mind. What do you do, sir?" Sadly, in their quest to concentrate economic and political power in the hands of the wealthiest members of society, today's Republicans have held the opposite position – as the evidence has piled up against them, they continue spreading the same myths."
• 2014/04/21 [L..T] Kansas Governor Ensures His State Won't Expand Medicaid Anytime Soon "On Friday, Brownback signed House Bill 2552, which removes his authority to accept Obamacare's Medicaid expansion and requires the legislature to approve the policy. Since lawmakers have already concluded their session for the year, that means the state won't be able to move on Medicaid expansion in 2014. And even if a Democratic governor is elected in the fall, the Republicans in the legislature could continue to block expansion."
• 2014/04/14 [L..T] CBO: Affordable Care Act getting even more affordable «The report found that coverage is likely to cost less thanks to premiums being lower than expected through the exchange marketplaces. In other words, take pretty much everything you've heard from congressional Republicans lately and believe the opposite. [..] And as part of the same review, of course, the CBO added that the Affordable Care Act will also continue to reduce the federal budget deficit, which is also the opposite of critics' claims.»
• 2014/04/11 [L..T] Dems run on, not from, the ACA «The conventional wisdom on the politics of health care is so widely accepted, it usually goes unchallenged. Democrats – especially vulnerable, red-state Democrats – will be desperate to avoid the Affordable Care Act this election year, eager to talk about anything but the health care law.»
• 2014/04/09 [L..T] [[2014/04/09/Tea Party Republicans Publish Op-Ed Slamming Obamacare|]]
• 2014/04/09 [L..T] Koch Brothers Received Millions In Obamacare Subsidies
• 2014/04/08 [L..T] Maddow: Obamacare "Armageddon" for Republicans in November Midterms (Video) "MSNBC anchor Rachel Maddow investigates this swing of public support in favor of Obamacare, and describes a political scene where the Affordable Care Act's success converts into a literal Armageddon for the conservative party – and not just temporarily."
• 2014/04/08 [L..T] Survey Estimates Net Gain of 9.3 Million American Adults with Health Insurance "Using a survey fielded by the RAND American Life Panel, we estimate a net gain of 9.3 million in the number of American adults with health insurance coverage from September 2013 to mid-March 2014."
• 2014/03/31 [L..T] Obamacare fails to collapse. Time to move on, folks.
• 2014/03/30 [L..T] Obamacare has led to health coverage for millions more people "At least 9.5 million previously uninsured people have gotten health insurance since Obamacare started, surveys and reports show."
• 2014/03/26 [L..T] Poll: Keep Obamacare, fix it, and shut up about it! "Enough already with talking about Obamacare, 53 percent of America (and 47 percent of Republicans!) says. Keep it, fix it and move on to other things, says 60 percent. That's according to the Kaiser Family Foundation poll for March."
• 2014/03/25 [L..T] Sebelius v. Hobby Lobby Stores, Inc.
• 2014/03/12 [L..T] Americans Stick With Obamacare as Opposition Burns Bright
• 2014/03/11 [L..T] A Major Victory for Obama: House Republicans Introduce 3 Bills That Improve Obamacare In what is a major victory for the president, House Republicans will vote on three bills next week that correct small issues and unintended consequences in the ACA.
• 2014/03/08 [L..T] Republicans Want to Replace Obamacare With...Obamacare-Lite? Ever since Barack Obama signed the Affordable Care Act on March 23, 2010, the Republicans in Congress have tried to repeal it. This week's vote was their 50th attempt.
• 2014/03/08 [L..T] Republicans Must Make A Choice About Obamacare: Repeal Or Relent The number of uninsured Americans has dropped by three to four million since Obamacare coverage took effect Jan. 1, according to a new Gallup survey. How much of the drop can be precisely attributed to the health care law is a matter of debate, though there are signs that enrollment among the uninsured is picking up.
• 2014/03/07 [L..T] Yet another ACA "horror story" draws scrutiny «After all the recent troubles conservatives have had with "Obamacare victims" in attack ads that turned out to be wrong, the Koch-financed Americans for Prosperity wouldn't push its luck with another dubious commercial, would it?»... further results

Video

• 2014/04/08 [L..T] Maddow: Obamacare "Armageddon" for Republicans in November Midterms (Video) "MSNBC anchor Rachel Maddow investigates this swing of public support in favor of Obamacare, and describes a political scene where the Affordable Care Act's success converts into a literal Armageddon for the conservative party – and not just temporarily."

Projects

• Saving the American Dream: the current alternative proposal from The Heritage Foundation

to file

• 2012-12-18 Aetna CEO Bertolini: Get Ready for 'Rate Shock' as Some Health Insurance Premiums to Double in 2014 by Avik Roy
• 2013-01-07 Obamacare Guarantees Higher Health Insurance Premiums -- $3,000+ Higher by Sally Pipes
• 2013-02-09 State lacks doctors to meet demand of national healthcare law
• 2013-02-13 Drop Coverage or Cut Hours? Big Companies Grapple With Obamacare "For large retail and restaurant chains the big unknown in the year ahead is how much more they'll pay for health coverage. Employers with 50 or more workers who put in 30 hours a week will be required to provide health care coverage or pay a fine..."
• 2013-03-26/SOA ACA-Driven Changes in Individual Market Composition Could Lead to 32 Percent Average Increase in Cost; Wide Variability among States: the SoA "predicts that expected changes in member composition of the individual health care market could drive up underlying claims costs by an average of 32 percent nationally by 2017"
• 2013-03-26 Health insurance rates to double as Obamacare fully kicks in: this site seems to be a woo-peddler
• 2013-03-27 Obamacare not so "Affordable," study finds by M.D. Kittle: report on 2013-03-26/SOA. (This was the only link I was able to find to that report in nearly an hour of searching.)
• 2013-04-23 PPACA's Impact on Affordability refers to 2013-03-26/SOA
• 2013-05-14 Who will pay more under Obamacare? Young men
• 2013-05-23 California Obamacare premiums: No "rate shock" here by Ezra Klein
• 2013-05-24
  • Unexpected Health Insurance Rate Shock-California Obamacare Insurance Exchange Announces Premium Rates by Rick Ungar "The jolt that I was experiencing was not the result of the predicted out-of-control premium costs but the shock of rates far lower than what I expected – even at the lowest end of the age scale."
  • California Will Be Spared the Obamacare Apocalypse No sticker shock here – just affordable insurance premiums by Jonathan Cohn
• 2013-05-26 The Obamacare Shock by Paul Krugman
• 2013-05-28 California's health-care exchange: Proof ObamaCare works? by Keith Wagstaff
• 2013-05-30/F Rate Shock: In California, Obamacare To Increase Individual Health Insurance Premiums By 64-146% by Avik Roy
• 2013-05-30 Obamacare drives up insurance premiums by up to 146 percent in California: promotes 2013-05-30/F
• 2013-06-01:
  • 2013-06-01/WP The shocking truth about Obamacare's rate shock Ezra Klein criticizes 2013-05-30/F
  • discussion: Tau-Mu Yi, Woozle, and others
  • Forbes Fight responds to 2013-05-30/F: "Avik Roy wrote an extremely misleading article on Obamacare in California. [...] Basically Roy compared Obamacare exchange rates (without subsidies) to the teaser rate from a web site which has received many extremely unamusing negative reviews for baiting and switching."
  • We Are Not Having A Serious Discussion, Obamacare Edition by Paul Krugman
• 2013-06-02 Forbes Tells The Truth, Then Lies About Obamacare by karoli responds to 2013-05-30/F in a bulleted list
• 2013-06-03
  • Conservative economics fraud re: ObamaCare
  • Anatomy of a Bogus Obamacare Argument How an irresponsible Forbes writer distorted the debate by Jonathan Cohn responds to 2013-05-30/F
• 2013-06-04 Will ObamaCare double your health insurance premiums? by Peter Weber
• 2013-06-05/NR Un-rigging the Rate-Shock Debate The truth about what those healthy 25-year-olds will pay by Jonathan Cohn
• 2013-06-05 Higher Health Insurance Premiums: The Obamacare Debate We Didn't Have by Peter Suderman "that still leaves roughly three quarters of the market who will see far higher rates." -- not clear at all how he figures this.
• 2013-06-06/ODI Health Insurance Costs to Increase Significantly Under Affordable Care Act
  • as of 2013-06-11, there is no request listed here for 2013 that is anything over 23%. The most recent request was March 31.
  • the 88% figure is apparently derived by comparing 2013-03-26/SOA with rate-hike proposals submitted to the ODI.
  • Analysis: Woozle
• 2013-06-06
  • Obamacare Insurance Exchanges Creating Roadblocks To Enrollment While Wasting Millions In Taxpayer Money? by Rick Ungar: responds to 2013-05-30/F, but brings up a new criticism
  • Debunking The Myths of Obamacare Rate Shock: discussion of 2013-06-05/NR
• 2013-06-10
  • Ohio Dept. Of Insurance: Obamacare To Increase Individual-Market Health Premiums By 88 Percent by Avik Roy - reporting on 2013-06-06/ODI
  • Obamacare costs soaring in recent rate checks by M.D. Kittle: reporting on 2013-06-06/ODI
• 2013-06-22 Even With Obamacare, Health Inflation Falls To Historic Lows ...although some people will still see their premiums go up
• 2013-10-24 Original 1989 document where Heritage Foundation created Obamacare's individual mandate
• 2013-11-12 Is the ACA the GOP health care plan from 1993? "The bill she had in mind did have a strong roster of Republicans behind it, and it did share many major features with the Affordable Care Act. There were some significant differences but in a side-by-side comparison, the similarities dominate. [..] However, to call it the Republican plan, as though a majority of Republicans endorsed it, goes too far."
• 2013-12-06 The ACA v. the Heritage Plan: A Comparison in Chart Form: argues that Obamacare and the Heritage healthcare plan have only one thing in common: an insurance requirement. This is clearly wrong in at least one regard: they both specify an individual mandate, the very feature most objected to by the GOP and other opponents of Obamacare.
• 2014-02-14 New GOP health-care plan is a starting point for a conversation, not a replacement