01 Apr

More people will be able to sign up for healthcare throughout the year, which I’d wondered about

Millions of people losing jobs or changing jobs, moving to freelance, will be able to sign up for ACA all throughout the year. That’s in addition to the 6 or so million who signed up over the last months. I also have an article somewhere that pointed out we still have no idea how many people signed up for ACA outside the exchanges. In Oregon that doubled the signups.

“The ACA’s state Marketplaces, in contrast, provide a non-discriminatory home for those losing their insurance coverage. In many cases, the loss of insurance coverage is what is known as a ‘qualifying event’ that allows individuals to purchase insurance on their state Marketplace even after the open enrollment deadline. And for those seeing a sharp drop in income due to job loss, the tax credits available through the ACA exchanges can provide a much more affordable option than COBRA; in about half of the states, Medicaid will also be available for those suffering the largest income losses.

The number of Americans that will eligible for these qualifying events is large. In 2012, for example, 7.6 million people lost coverage and became uninsured. Almost half of this group, or 3.4 million, cited loss of job as the reason for losing insurance; another 600,000 cited loss of student insurance upon graduation or due to aging out of parental coverage; another 200,000 cited divorce as the source of insurance loss; while 60,000 lose insurance because they move. All of these are qualifying events that would trigger a special enrollment period for people who are currently insured but who lose access to coverage over the course of a year. These figures suggest that roughly 4 million Americans who previously faced the harsh reality of life without insurance can now access fairly priced and often subsidized insurance through state and federal exchanges, or, in many states, expanded Medicaid coverage.”

(Via Obamacare Enrollment Is Far From Over.)

ACA Sign Ups puts the number of people who became covered, as a result of finding out about Medicare/Medicaid when trying to sign up for ACA, kids put under parents’ plans, is somewhere between 14.6 to 22 million.

NewImage

03 Jan

ACA Signups: the 538 of the ACA political newscape

ACASignups is like the 538 of the ACA roll out political landscape (the graph in particular makes me swoon):

“What about the big guns?

Why is ACAsignups.net being run by Charles Gaba and other volunteers, including myself? Why hasn’t a major media outlet made an endeavor to keep a running, daily (or at least weekly) total of ACA enrollments? Why is news routinely reported uncritically and without context? When HHS announced that there had been 1.1 million signups through HealthCare.gov as of December 24th, many news organizations didn’t bother to emphasize that this was only half the picture (or more accurately, 55.5 % of the picture). There was little mention of the fact that 14 states running their own exchanges and accounting for 44.5 % of the CBO’s enrollment targets had close to a million enrollments – with California alone accounting for 400,000.

Just the facts

However, in the months ahead, at least you can look to ACAsignups.net for one thing: an honest and accurate state-by-state tally and running total of ACA enrollment data, where you can check every data point for yourself. We’ll also examine the trends and look behind the scenes at what this data really means.”

(Via Welcome to a Healthier Year! (Guest Post) | ACASignups.net.)

The swoon-worthy graph:

NewImage

01 Oct

American healthcare was already socialized by Reagan, we’re just fighting about how to pay for it

Today the US government shut down. Ostensibly by Tea Party Republicans to try and stop socialized medicine from becoming a reality. In fact, false equivalence reporting has lent an air of respectability to the effort (they might be fighting a losing battle, and the polls are low for congress and Republicans, but they’re fighting for their minority opinion).

By the way, false equivalency is when you’re a news organization and someone says ‘our party believes the world is round’ and you have someone on saying ‘the world is flat’ and the reporter says ‘opinions differ’ and offers you poll results about what people believe after the two talking heads hash out why the world may or may not be flat.

So here we are.

But the fact is, US medicine has been socialized since the year 1986.

1986.

In 1986, President Ronald Reagan passed a bill called the Emergency Medical Treatment and Active Labor Act, or EMTALA.

See, up until 1986, hospitals and doctors could turn people away if they didn’t have the money. So could emergency rooms.

Let’s repeat that.

Up until 1986, in the USA, hospitals could turn a dying person away at the door if they didn’t have money, or refuse to treat.

As you can imagine, costs were kept down.

In 1986, Republicans passed EMTALA. What did EMTALA do? It socialized healthcare and made emergency rooms just like police, or firemen, or roads. It said people showing up on a door step of an ER dying *could not be refused* treatment.

Why did this happen. Because patients were being, literally dumped, by hospitals to prevent having to assume the expense of treating them:

Congress passed EMTALA to combat the practice of “patient dumping,” i.e., refusal to treat people because of inability to pay or insufficient insurance, or transferring or discharging emergency patients on the basis of high anticipated diagnosis and treatment costs. The law applies when an individual has a medical emergency “and a request is made on the individual’s behalf for examination or treatment for a medical condition.”

Here’s what that looked like on the ground:

Ron Anderson, M.D., president and CEO of Parkland Memorial Health and Hospital System in Dallas, was the medical director of the emergency department at Parkland in the early 1980s, and he knew all about dumping. “I would see patients transferred with knives still in their backs, or women giving birth at the door of the hospital, simply because they were uninsured.”

These, and many other shocking incidents, caught the attention of the CBS investigative show 60 Minutes, which, on March 17, 1985, broadcast an episode titled “The Billfold Biopsy,” about the dumping of unstabilized patients at Parkland.

So basically, Ronald Reagan set up hospital emergency rooms as socialized healthcare, and then…

…didn’t fund them.

It’s an unfunded mandate.

So it’s illegal to let patients die on your doorstep. A step forward in society (Reagan at the time said it allied with American’s Christian principles and his own). But the Republicans of the time never paid for it. They kicked that particular can down the road.

As a result, hospitals saw emergency room visits drastically increase. Insurance companies, because many of the uninsured used emergency rooms as care (to which they’re legally allowed, it’s how to collect the payment later that’s in issue), try to refuse to pay for the increase. Hospitals got clever at burying costs into healthy patient’s procedures, or anywhere else.

The system gets distorted.

So we already have socialized healthcare, it’s just that the hospitals, the government, and the insurance companies are all putting their fingers on their noses and saying ‘not it!’ due to that single fact: the 1986 bill was an unfunded mandate.

The thing is, one way or another, we do pay for it. Via taxes. Via higher costs of procedures. Via too much red tape caused by this giant game of ‘not it.’

Because of EMTALA.

Hillary Clinton tried to create a way to pay for it, so that all citizens chipped in. It looked too socialized. The Heritage Foundation suggested that all citizens just be forced to carry health insurance, and that if it cost too much for poor people the government chip in a little. Much like using the road (only, because the road is ‘being alive’ everyone has to have car/health insurance because you can’t get off the road, except for by dying), everyone has to have insurance. Massachusetts adopted this model, and it’s not perfect, but it’s way better than the current situation.

Obamacare imitates the Heritage and Massachusetts model. But it’s being fought by anti-Obama Tea Party folk because it’s socialism.

No son. Socialized medicine arrived in 1986.

What is being fought out is a case of ‘will we now be fiscally responsible about the socialized medicine that Ronald Reagan signed into law or will we continue using the expensive, unfunded mandate via emergency room payment system that has been a mess since 1986?’

The current House Republicans claim to be fighting socialized healthcare. If they were, I’d respect their ideological position. But none of them are filibustering or trying to repeal EMTALA. I haven’t seen a single attempt to repeal EMTALA by any of them.

So stopping the government, all the fits thrown this week, all this misery and the high, high cost of this shutdown to the economy, will come merely because Republicans refused to pay for a mandate their party created in 1986. (also, if you’re a Republican or Tea Party and not campaigning against EMTALA, I don’t take you seriously if you say you’re fighting socialized medicine, because you’re not, you’re just fighting to not have to pay for it).

Right now, ACA lets freelancers and people in between jobs get healthcare. It lets people outside of large corporations get healthcare. It lets small businessmen get healthcare.

It makes the practice of insurers dumping people with preexisting conditions illegal.

It makes it easy to find a healthcare package.

It has already been shown to be slowing down the rising cost of healthcare in studies.

And people want to try to stop it. Because it might help people not have to wait until they’re hurting in front of the emergency room to get the benefit of that 1986 law, it’ll let people start taking care of themselves ahead of time.

It’s been working in one state very well for a long time. It works well in other countries. We know how the ground game goes.

One group is doing everything they can to stop it, because this refinement of how the 1986 law is handled society-wide is coming from someone they didn’t vote for. That’s not a reason to hurt millions. It’s the biggest, saddest, childish thing I’ve seen.

Remember it come the next round of elections.

Remember well.

Here is Healthcare.Gov.

12 Aug

Florida strips insurance commissioner of power negotiate lower health plan rates

Slick. Refuse to negotiate lower rates or make the health insurance companies compete like in the other exchanges. When ACA exchange rates are announced for Florida, they’ll be crazy high. Prediction: lots of conservatives announcing ‘failure.’

Fuckers.

“Florida lawmakers have left the state vulnerable to unreasonably high insurance premiums in an effort to undermine Obamacare, say the state’s U.S. House Democrats.

Gov. Rick Scott and the Legislature cynically stripped Florida of its ability to review rates for the law’s rollout, U.S. Rep. Ted Deutch writes in a letter signed by all 10 of the state’s Democratic representatives.

The letter, which appeals to the federal government to step in on Floridians’ behalf, blames a law Scott signed at the end of May for refusing to allow the state insurance commissioner to ‘negotiate lower rates with companies or refuse rates that are too high.'”

(Via PolitiFact | Democrats say Florida stripped insurance commissioner of power to set health plan rates.)

Dear small business people and freelancers of Florida. You have an honest-to-goodness actually enemy that doesn’t want you to be able to buy healthcare. Just an FYI.

06 Aug

Andrew Sullivan on freeloading

Andrew Sullivan on the encouragement of Freedomworks and other types to get young Americans of a Certain Political Persuasion to refuse healthcare:

“since 1986, hospitals have been legally required to treat anyone seriously ill who presents himself at an emergency room, with clear medical needs. In the most fundamental way, that was the moment the US socialized medicine – and Ronald Reagan signed the bill. Alas, like so many Reagan domestic initiatives, there was no federal money provided to pay for this. And we all know what happened next: all those extra costs for the uninsured drove up premiums for everyone else, drove up hospital costs, giving them a reason to raise prices even further, and played a role in rendering healthcare unaffordable for many others.

What Obamacare does, like Romneycare before it, is end this free-loading.

The law is telling these young adults that if you want to go without insurance, you are not going to make everyone else pay for it if your risk-analysis ends up faulty. You have to exercise a minimum of personal responsibility to pay for your own potential healthcare. In other words, rights come with responsibilities in a liberal democracy. At least that is what I always understood the conservative position to be.

So why is an allegedly conservative organization actively encouraging personal irresponsibility?”

(Via Since When Was Free-Loading A Conservative Value? « The Dish.)

25 Apr

Congress and ACA exchange provisions?

Fuuuckkk. This is not a good sign:

“Congressional leaders in both parties are engaged in high-level, confidential talks about exempting lawmakers and Capitol Hill aides from the insurance exchanges they are mandated to join as part of President Barack Obama’s health care overhaul, sources in both parties said…”

(Via Will Congress exempt itself from ACA exchange provisions?.)

If Congressional aides don’t want to have to use the exchanges, it’ll mean they have no incentive to make sure they’re good for the rest of us proles.

ACA is the only way I’d be able to get health insurance in this country as a freelancer if I was the sole earner. If these jackholes fuck up exchanges, my choices are to move to New York to access freelance healthcare, Vermont, or Connecticut.

Or move to the EU (I have a passport) or Canada.

My heart defect knocked 3 years out of my writing career, but I’m coming back (seen some announcements around here showing what I’ve been up to) of late. And I’m just getting back to the place I was in 2008.

At some point this is going to have a big impact on the how and where trajectory part of my life.

I’m keeping a close eye on this.

12 Apr

David Farland’s lack of insurance due to refusal of insurers to let him sign up for a plan

By 2050 40% or so of the US workforce is expected to be flexible or freelance. Despite the legions of vitriol against health care reform of any kind, right now things like this happen, when freelancers with preexisting conditions can be denied healthcare by companies and thus put their families at risk:

“Through no fault of his own, Farland cannot obtain medical coverage due to pre-existing health conditions. His wife did have a job that allowed them to carry group health insurance, but got laid off during the worst of the recession. When asked how authors survive these kinds of disasters, Farland answered, ‘It’s only through people working together. People are amazingly kind in times like this.'”

(Via Army of Friends Rally Around Best-Selling Author David Farland.)

The current system is due to change next year, due to the reforms that are coming down the pipe. Alas, this happened a year too early for Farland’s family.

This wasn’t a case of someone just not getting health insurance and gambling his family’s life, according to the story above, but a horrible and unique creation of the existing system that conservatives are fighting hard to keep in place, one that forces us to depend on employers and fear being laid off lest things just like this happen.

Consider helping however you can.

By the way, this could have been me. My genetic heart defect means American companies can, until 2014, refuse to even take my offered money if I wanted to get healthcare. Current we’re insured via my wife, but even if I made enough for her to leave her job, I couldn’t get covered due to the same issue.

Outraged?

You should be.