OBAMA PASSED HEALTH INSURANCE REFORM / REPUBLICAN REPEAL ATTEMPTS SITE

SITE CONTENTS:



NEWS (here) about Promises of Republican Congressional Members and Candidates to repeal. the passed-in-2010 effective-in-2014 pre-existing-condition Obama reforms, which, if the Republicans succeed, will keep pre-existing-conditions medical-financial-wipeout risks for non-independently-wealthy people (below Medicare age 65) forever.

And, yupper, additional Republican challenges to the passed Obama Reform at the state level have gone to the Supreme Court--yet an additional hurdle. (Arguments have been heard at the court, as reported here. Decision expected late June 2012. You can even listen to or read the court proceedings here, though, if your not a person particularly legally focused by virtue of career, there might be better ways to use your time to develop an understanding of the technical problems in the health care issue. That is, the people involved, including the 9 justices, are a bunch of lawyers, and though undoubtedly quite distinguished in something more substantial than the lawyerly manipulation of juries of average citizens, I expect they have little of the background and innate skill at the scientific and quantitative/economic issues needed to help with the technical health care delivery and financing problems. Their function in society is instead to keep the particular social institutions that are contained within the "rule of law" relatively well defined, which is supposed to provide basic somewhat-predictable rules to allow productive social and economic transactions to take place, as well as to keep utter social chaos from breaking out without the need for a military-style police state. Some other developed countries manage to have sound "rule of law" with only about a third as many lawyers per-capita, but that is a side issue (p. 13 here and I wonder what the social benefit is from and who's paying for the 998 U.S. law journals you can find on this page). )


Presumed Republican Presidential Candidate Mitt Romney promises to repeal the Obama Reform (in March 2012) (Source: CBS News here).



and in June 2011, Romney promised to repeal it in the first day of his administration (YouTube video here).



Throwing a monkey wrench into any reputatiotion of truthfulness for Romney, on 4/12/2012 the Obama campaign celebrates the 6th Anniversary of Massachusetts RomneyCare, and points out that Romney was proud of that Massachusetts plan, which is the model for the main provisions of the Obama plan (video here).



March 20, 2012: Republicans are still creating uncertainty and danger for everyone by going after the repeal as a part of the brand new Mar 2012 Ryan Budget proposal. (The timing of this new attempt is more than two years after the law was passed, and more than half way through the period when the major provisions kick in at the start of 2014, for Pete's sake.) (Source: US News and World Report here). March 29, 2012:Ryan Budget proposal passed by House Republicans, as indicated here



"By the time I am sworn in, [Congress] will have repealed Obamacare," [former Republican Presidential Candidate Newt] Gingrich said,
explaining that he would ask Congress to get to work on the repeal beginning January 3, 2012, after its Christmas recess.

(Source: CBS News here).



ASSESSING YOUR OWN (BY-STATE) RISK OF MEDICAL FINANCIAL WIPEOUT / ILLNESS NON=TREATMENT
Due to Pre-Existing-Conditions Issues (People Under 65):

(These risks remain until the passed-in-2010 Obama/Democratic reform provisions kick in in 2014, at which time they go away. If Republican efforts to repeal (as here with House Member voting record here) and court-obstruct (as here) the Obama law succeed, the risks remain beyond 2014, (including post-issuance policy recision). If the Republican proposed "Ryan plan" succeeds, or some similar Republican plan passes in the future, the risks to people under 65 remain, and similar pre-existing-conditions medical/financial wipeout risks extend to people over 65 starting in 2021.)

To: By-State information and DANGERS

Directly to State In That Table: AL AR AK AZ CA CO CT DE DC FL GA HI ID IL IN IA KS KY LA MA ME MD MI MN MS MO MT NE NV NH NJ NY NC ND OH OK OR PA RI SC SD TN TX UT VT VA WA WV WI WY Non-US



The Republican Ryan Medicare Plan (click here). Full privatization of Medicare (for people over 65), where seniors have to worry about not being able to afford health insurance if they have pre-existing medical conditions.

[U.S. Government Debt-Spiral Note: The author of this site is aware of the looming government debt crisis, and wants to be clear that he supports the tough, painful decisions that need to be made (a la Bowles-Simpson) and which indeed the special-interest-infested political system and electorate are not making.

My objection to the Ryan Medicare plan is not that it inflicts pain, is austere, etc., but rather that it supplies pre-existing-condition-screened insurance to people over 65. (You observe this if you read the bill--here--carefully. The pages about Medicare are 255-337, and I guide you to more specific details within those pages on my Ryan Plan page here.) Pre-existing-condition-screened insurance is just lousy insurance, which leaves people who have worked and saved to go bankrupt if they get sick for a long time. I would accept austerity of a "premium-support" plan like the Ryan plan if the associated insurance is not pre-existing-condition dependent. Indeed, there needs to be pain in the measures necessary to control the U.S. debt, but the point is to act sensibly, and not have the pain be mainly by personally bankrupting say 10% of people over 65. The author of this site is not opposed to the necessary austerity -- indeed there will need to be some extra physical discomfort and a bit of earlier death and cutting back on luxuries for the over-65-crowd, but the author wishes to avoid excessive risk volatility amd punishments on people who work and save. This is the apparent consequence of much in our current health care system and state/Federal financing, and many of the Republican proposals, including much of the means-testing (only when such means testing is poorly crafted).]




To Understand Why The Reform Was Needed, and Get a Grip on the Economic Mechanisms Surrounding Pre-Existing-Health-Conditions (In Particular: Why the Mandate to Carry Coverage is Critical to Make the Pre-Existing-Health-Conditions-OK Insurance Work without an increasing-without-bound Coverage Cost Death-Spiral), You Can Click here for my explanations.

ANOTHER GOOD SOURCE OF SIMPLE EXPLANATIONS ABOUT THE PLAN: (graphic book form) from an MIT health economist who helped create of the Federal Obama Law (and a person who advised Mitt Romney on his construction of the Massachusetts blueprint for the Federal Obama law--the Massachusetts "RomneyCare" blueprint being very close to the Obama law including in the mandate to purchase coverage that all the Republicans are now complaining about: for example, Rick Santorum and Newt Gingrich in this video of debate confrontations of Romney.



"I mean, people have access to health care in America. After all, you just go to an emergency room.".
-G.W.Bush, 7/10/07.

(Quote Source: Official Bush White House U.S. Government Archives, Paragraph 16, here).



NOTE: Some problems with the emergency-room approach that Republicans are trying to keep in place forever:

--My undersanding is the hospital can go after you for the cost unless you have no money or assets to lose

--It makes people who do have any money to lose and manage to get away with it freeloaders

--My understanding is the emergency room only has to stabilize you

--The care is given when you become really sick and could have been much cheaper for the country if you got treated earlier.

(Some sources for this info below on this page.)


Republican Senator expresses contentment with the emergency-room system:

"People have -- people got health care before. They had to go to emergency rooms, but they got it."

-Republican Senator Orrin Hatch 2/28/11.

(Source: PBS Newshour Transcript, Last "Sen. Orrin Hatch" section, here).




INSURANCE RECISION Based On Known or Unknown Pre-Existing Condition

(Recision problem temporarily relieved under temporary in-effect provisions of the Obama reform, and go away completely when the full law kicks in in 2014. But, recision problems come back full scale if the law is repealed or rejected by the court. Further, I see no reason why post-claim insurance recision based on comments about feeling sick or emotionally down you made on publically available Facebook and Twitter posts can't happen after the Obama law is repealed. Recision perhaps even decades after your internet post was made, with that post having hung around on Facebook, Twitter, or somewhere else on the internet, or on insurance industry magnetic archive disks, for all of those decades.)



Is Employer Coverage Secure if the Obama Reform Gets Repealed or Rejected by the Supreme Court? No, Not In This Age of Corporate Cost-Cutting Pressures. See The Walmart Memo



General Information on Health Insurance and Pre-Existing Conditions


Another Brazen Republican Deception on their Health Insurance Proposals

"BENEFIT PARITY WITH MEMBERS OF CONGRESS" as a bold heading in their bill, to trick you.

But read just a little farther, and read carefully. : Bottom on this Page



Yes, indeed, honesty forces me to admit that Barack is a Pol and thus no Angel of Truth. One of his most flagrant cases of not going straight for the truth is his proposed "Buffet Rule" proposed by billionaire Warren Buffet -- taxing incomes over a million dollars at the 30% rate (instead of say the 16% that say Romney pays on his huge income because it is mostly dividends and capital gains from investments which are now-- due to the 2001 and 2003 George W. Bush tax cuts -- taxed for the very wealthy at a much lower rate than salary-income from jobs -- those rates for capital gains and dividends for the wealthy were 28% and 35% or so before those GW Bush tax cuts brought them down to 15%). The Buffet Rule is reasonable and probably increases the fairness of the system to make it more like the fairness before GW Bush was President, but Barack's deception is in trying to let the less quantitative of the people believe it will help in a large way with our budget problems, when it's only about $5 billion a year out of a $500 billion dollar a year problem. Though I'd rather see more courage to be truthful with the bad news on his part, it seems all of the current bunch of Pols are massively deceptive -- Romney asserts Obama has wrecked the country in his 3 years in office, when in fact Obama seems to have been able to keep us out of a full depression that might have been the consequence of the 2007 financial meltdown, and Obama's health care reform is very similar to what Romney did in Massachusetts (where I live) as Governor. That Massachusetts health insurance reform is working out well for me, and I a feel noticeably more financially secure here due to it than I would in any other state. In fact, I won't move out of the state until and unless the Obama Reform goes into effect in the other 49 states.


Oy, oy, oy. Scientists and doctors have created a Monster of Resource Consumption (e.g.) that the country is having real problems coming to grips with. The better of the politicians pander (e.g. Obama asserting no sacrifice at all in his healthcare plan or that raising taxes only on the rich will solve our problems), while the Republicans seem unable to think of any solution more effective than the fully market-based one of having us all pay cash for all medical and hospital services, like we do now at the dentist. The Republicans organize an orgy of deception geared at manipulating the least mentally able ("rationing" cries, etc.). It's enough to make me drag out my dismal Walter Lippmann quotes.



COMMENTS ON A QUOTE

"I mean, people have access to health care in America. After all, you just go to an emergency room.".
-G.W.Bush, 7/10/07.

(Quote Source: Official Bush White House U.S. Government Archives, Paragraph 16, here).



One thing the former president didn't mention is that, if you're not low enough in both assets and income to qualify for Medicaid-for-the-poor (and in some states, even just being a childless adult can disqualify you no matter how poor you are), the emergency room can bill you for full cost of services, and you are legally responsible. (To check me on this, see here or especially here.)

So, if you are and want to stay middle class, Mr. Bush's emergency room system may not work out so well for you. But if you don't mind dropping to having no wealth or savings, and if you don't mind getting all of your treatment only in emergencies, from the emergency room, then it would seem to work, based on the "the hospital can't get blood from a rock" principle.

And, of course, people who do "just go to an emergency room" and manage not to pay for their care, wind up freeloading on people with and without insurance who do pay, because of cause the hospital has to pass the cost on of that unpaid for care to people who do pay.

For some other information on the "just go to an emergency-room system", including the Federal Government ENTALA law, which makes that system possible by forcing emergency rooms to treat people who it knows can not pay, click here.



BENEFIT PARITY WITH MEMBERS OF CONGRESS (my ass)


If the complexity of the economic mechanisms involved has had you missing the outrageousness of Republican efforts to undermine secure health insurance for Americans, you should be able to catch it here if you read carefully, in this particular instance from the text of the Ryan Medicare bill.

I have extracted the relevant page of the Ryan Bill here. (It is page 11 of the full Ryan bill, verify my link from Ryan's own page here).

Now, on the extracted page we have this:

"BENEFIT PARITY WITH MEMBERS OF CONGRESS.—With respect to health insurance issuers offering health insurance coverage through the State Exchange, the State shall not impose any requirement that such issuers provide coverage that includes benefits different than requirements on plans offered to Members of Congress under chapter 89 of title 5, United States Code." .

Certainly the heading "BENEFIT PARITY WITH MEMBERS OF CONGRESS" will satisfy those taking a superficial look at the bill, but those reading carefully will see that what it says means only that the government can't prohibit an insurance company from giving you the same coverage as members of Congress get if the insurance company is so inclined. (Well, since the Ryan plan offers seniors insurance where insurance companies can charge more for seniors with pre-existing-medical conditions, I'm pretty damned sure the insurance companies won't be inclined to offer people with serious medical conditions the same benefits as members of Congress get, unless they charge them a humongous unaffordable premium to cover costs and profit on those medically expensive people.)

To accompany the deceptive language of the bill, in promotions of it such as this PBS Newshour interview, Ryan misleadingly indicates that seniors on Medicare will be getting coverage like "Members of Congress" under his plan.

(Besides the section quoted above being intended to mislead, I suspect it might be tied to an additional purpose of actually limiting requirements on the quality of the Medicare insurance. For those interested in going through these details, here is a link to Chapter 89 of title 5.)