Damn it, heebie, I have too much going on today to keep up with this thread. Anyone who is interested should check out this brand new report on the Obamacare premiums.
Yesterday, I student said to me: "Well, now that Obamacare is in the drink, they might finally let me have more hours at JoAnn's."
I wanted to ask her where she got the idea that Obamacare was in the drink,* but she went on to talk about what she's been doing to make ends meet, since JoAnn's Fabric only pays minimum wage and won't let her work full time. She gets DJ work sometimes in the clubs where she used to take off her clothes when she was younger and more svelte. I think that actually pays pretty well, since she gets paid out by the dancers.
In any case, there is one person who has perfectly good reason to be not excited by the roll out of Obamacare.
*Even though I know it's probably Fox News.
And right now she gets health care coverage?
All these years, Jo Ann Fabrics has been keeping employees away from full-time status because of Obamacare. Now for the first time in decades, we will live in a world without Obamacare. Watch freedom reign.
And check out this new premium calculator with state- and zip-code-specific estimates.
I like how they ask if your children use tobacco.
Can I complain about the concept of "tobacco"? Our new plan for a $1200/year surcharge if you don't take a physical and get basic blood work done (free of charge) was cancelled abruptly because of nebulous fears. But the $1200/year surcharge for using "tobacco" remains. This explicitly includes electronic cigarettes. Come on!
8: In the exchanges (not I guess with your employer) if you're in some kind of cessation program you don't get the penalty.
How long can you be in a cessation program? Because it took me something like five years on nicotine replacement to quit.
And right now she gets health care coverage?
Probably not. But right now she doesn't have health care bills but does have to buy food and pay the mortgage.
I'm basically pro-Obamacare. I just thought this was a fair example of one of the downsides.
I have to admit I'm not too clear on what electronic cigarettes are and what they do. I assume they suck because come on Stephen Dorff is your pitchman?
I thought e-cigarettes WERE a cessation program.
I'm basically pro-Obamacare. I just thought this was a fair example of one of the downsides.
The part where she will find paying premiums a burden is a real downside. The part where Jo-Ann's is claiming they aren't giving her more hours because Obamacare seems less grounded in actual problems with Obamacare.
11: I still don't buy it. Not having health coverage and staying healthy isn't an upside in any real sense. It's gambling and winning. Also, I don't think it is reasonable to blame the increase in part-time only jobs on Obamacare. It's the recession, being used as an excuse to argue against Obamacare, mostly by people who opposed anything real to fix the recession.
13: The people I've seen with them clearly regard them as a replacement. Which seems fine with me as long as nobody shows they are more dangerous than smoking/dip.
10: Not sure. Might be indefinitely. I'll see what I can find.
17: It's just idle curiosity on my part. I'm quit for five years now and have employer-provided coverage.
I know at least one major employer in this area has devoted many person-hours to being sure that no adjuncts teach enough classes to qualify as full-time under Obamacare. I can't imagine we are the only one who is dicking our part time employees like this.
And did any of the adjuncts get health coverage before Obamacare?
19: That's the part that was all delayed until next year, correct?
The question is whether they got more hours.
15
Yeah. These people are opposed to anything that improve life for workers, because it hinders "job creation," but are actively against anything creating jobs, because it shrinks the pool of desperate workers willing to work in increasingly demeaning conditions. Marx actually described this very well in one section in Capital.
Thinking about job creation always reminds me of one point about 10 years ago when I lived in Beijing, AFAICT there was a woman at the supermarket whose sole job was to put yogurt in your basket. She just hung out in the yogurt section, hassling you to buy yogurt if you walked by. She didn't obviously work for a specific company because she didn't seem to care what brand you bought. If you tried to put the yogurt in your basket yourself, she snatched it out of your hands and put it in your basket for you. I haven't seen a similar position since, so maybe it was just a one off. Or maybe, despite her valiant attempts to make sure no shopper's hands touched the yogurt before it went in the cart, the supermarket realized her position was redundant and reassigned her to the filing out receipts in triplicate department.
Isn't there a provision where companies are being evaluated on the number of Full-Time-Equivalent workers, and not just full-time workers? I keep hearing about the cut-their-hours way of being an asshole employer, but I'm not sure how that pays off.
(In other words, one possible answer is that if you're over 50 FTE employees, you have to provide health care...but only to your full-time employees. Is that actually the case?)
My stereotype-o-meter says that there's not much overlap between people who are stringing together minimum wage jobs and DJ'ing in strip clubs and people who use the golf metaphor "in the drink" to describe something, but my meter may need to be recalibrated.
I've probably asked this before, but can anybody explain to me why the business community still supports this weird, Rube Goldberg system of employer-provided health insurance, instead of single-payer? I mean, wouldn't it be much easier for companies not to have to pay people in HR to research which insurance plan to offer, or to have to pay bean counters and managers to calculate whether the increased benefit to the company of having an employee work more hours offsets the cost of having to offer health insurance? Wouldn't it be easier for companies that are not actually in the insurance business to not have to be in the business of offering insurance?
"In the drink" is a golf metaphor? I thought it was a off-the-wagon metaphor.
26: Because it makes it harder for people to switch jobs meaning they can pay employees less. Plus, the employer contribution is a tax-deduction for them.
26: Wasn't the business lobby* pro-universal healthcare until HRC in the early 90s, at which point the AMA pressured them to switch sides?
*the big main one whose name I'm blocking.
It does seem insane, but then insurance and related entities are themselves businesses, so that also muddles things.
"In the drink" is a golf metaphor? I thought it was a off-the-wagon metaphor.
I thought it was a WWII RAF pilot metaphor.
Chamber of Commerce! The chamber of commerce was pro-universal-healthcare until it wasn't.
I think someone here once posted a link about it.
I guess I've also heard the term "the drink" used by sailing type people.* I thought "in the drink" was specifically about you hitting your little golf ball into one of those lakes, and then your ball is lost, by analogy to whatever else is "in the drink." I dunno, I hate golf and am very glad I have no social or professional reason to play it.
I think it's mostly because employers want people to be more afraid to lose their jobs.
I meant I thought people were extending the phrase "in the drink" by analogy to golf. OK BORING DIVERSION OVER, you can proceed to play "the back nine."
I've never heard the phrase before, which isn't surprising, because there isn't a JoAnn's Fabrics in Heebietown.
All I know about Joann's is why golfers wear two pairs of pants.
I only know that phrase from golf too.
I have to admit I'm not too clear on what electronic cigarettes are and what they do
Portable vaporizers and specially prepared nicotine-containing liquids that are vaporized by thus.
28 and 35 get it right, I think.
6: Many thanks to Minivet for the updated Kaiser premium calculator! Woo-hoo! My health insurance premium should be reduced by 45%. (This is chiefly because my current plan amounts to 17% of my income, and Obamacare caps what's reasonable and affordable at 9.5%.)
Thanks, Obamacare!
Also, what is this "it must be middlebrow", "should be deriding it" thing in the OP? Did I miss something?
Did I miss something?
Only Ted Cruz becoming America's greatest hero ever.
I should put this on the table while we're on the topic: I confess I've now become confused about the nature of the subsidies.
They're repeatedly referred to as tax credits, but that suggests that one must pay one's premium at full price and then be reimbursed, so to speak, the following April 15th when federal taxes are filed. Surely not. I'd thought it had been clarified that this was incorrect: rather, you have your credit in hand, and the insurance company deducts it from the full price premium each month. It's not a tax credit, in other words, but a, well, subsidy.
I'd thought this had been asked and answered, but I see now that the HHS document Kermit linked in 1 refers again, in the very first paragraph, to "tax credits."
42: This post and here down on this comment thread.
Isn't there a provision where companies are being evaluated on the number of Full-Time-Equivalent workers, and not just full-time workers? I keep hearing about the cut-their-hours way of being an asshole employer, but I'm not sure how that pays off. (In other words, one possible answer is that if you're over 50 FTE employees, you have to provide health care...but only to your full-time employees. Is that actually the case?)
Yes, in essence. The liability for the penalty is triggered by having 50 full-time equivalents, but the amount of the penalty is a function of the number of full-time employees. It's complicated. The stories about companies cutting back hours to avoid the mandate are not all bullshit. OTOH, in many cases, Obamacare is better and cheaper (after subsidies) than the employer-sponsored plan.
44: The legal mechanism is a refundable tax credit, but the flow of funds works like a subsidy (in most cases; if you wanted, you could choose to pay the full premium and claim your tax credit on the back end on your 1040).
I gotta say Kermit you are amazing on this stuff.
I'm still trying to decide whether or not I should switch from COBRA to an exchange plan. From a financial perspective it's a no-brainer; the exchange plan was cheaper even before the COBRA rates went up for next year. But I can't quite wrap my brain around the notion of the exchanges actually being a real thing I can rely on.
45: Ah, thanks. I'd totally missed that. I hope heebie's not actually defensive about middlebrowedness, in any event.
47: Right, I had a feeling it was something like that (if only because SCOTUS made a big deal of framing things in terms of taxation) -- thanks. Not sure what advantage there might be in taking the full tax credit at year's end, but I imagine it's moot for most.
49: Mmm, I'd do it in a heartbeat. You're in CA? Dude, do it. If I were in a reddish state with an exchange run by the feds, I might be a bit more careful in assessing options (the feds are just seriously overloaded in what they can do for the 27 or so state that have abdicated their responsibilities), but I can't possibly imagine CA is going to fall on its face here.
Freedom! Seriously, folks, this is so good.
Confidential to Apo: I know you're probably grumbling, but friend, single-payer didn't happen, and this is a great, great improvement over the status quo ante.
Except for the Medicaid gap. And a couple of other lacunae which should be fixed.
I hope heebie's not actually defensive about middlebrowedness, in any event.
She does keep mentioning it. Seriously Heebs, we think your brows are great.
54: Well, I'm really neither here nor there about it at this point, except that anything that makes Ted Cruz unhappy is a net positive. The employer-based private insurance system is still crumbling, and the ACA doesn't really address that. It's an improvement in the near term, yes, and has maybe put off the reckoning by several years.
I never expected single-payer to pass, FWIW. My primary objection was that if we were going to mandate coverage, there had to be a public option. Otherwise, we're just propping up a predatory industry inside a somewhat better regulatory system.
Maybe there will be a way to leverage the new system into something better once the still-existing systemic problem comes to a head.
What are the chances our system morphs into something like the German system? I gather that the big difference is that the German sicknessfunds are nonprofit? But they still compete with each other?
I also assume the German system is a model of effciency.
What apo said. While this thing seems to improve things substantially, the system is still deeply flawed. Some of the flaws have been papered over, but a lot of them haven't, and the opportunity for a real fix is probably gone for another generation.
My primary objection was that if we were going to mandate coverage, there had to be a public option. Otherwise, we're just propping up a predatory industry inside a somewhat better regulatory system.
Every time I hear a conservative say that Obamacare, which has no public option, represents a "government takeover of healthcare", a few more of my neurons explode in frustration. At this point, I'm lucky I have any neurrrrons lefft in myy brainnnnocfyradksabl
57, 60: Well, don't let the perfect be the enemy of the good.
The position of Enemy of the Good is currently filled, and there's a long list of applicants, so I doubt if The Perfect can even get its resumé looked at, let alone get an interview scheduled.
The perfect can always get an interview, because of the 4.0. References who won't use codewords for "smug asshole" are the problem.
60: the opportunity for a real fix is probably gone for another generation.
I understand this thought (though disagree at the Eeyorism), but I'm afraid I find this glib: understand that many, many people have been unable to procure health insurance coverage, and will be able to do so now. Many people have been paying exorbitant sums for coverage, and will find relief now. It's not a small thing, and it's a tad irritating to listen to handwringing from people who have no skin in the game.
57.3: Maybe there will be a way to leverage the new system into something better once the still-existing systemic problem comes to a head.
That's my hope. Employer-based health insurance should end, in my view. Providing independently based options is a step forward.
I guess my concern is that this isn't The Good. This is The Somewhat Less Shitty.
That's going to be a tough distinction to make.
68: Hogwash. It's far better than just Somewhat Less Shitty, and I repeat that it's annoying that you'd think otherwise. Feel free to spell out just how barely less shitty you think it is, if you like.
Kermit, are we colleagues or peers or counterparts or something and don't realize it? This is the first thread in a while that I REALLY WANT to participate in but I have to go run into a meeting to find out if we're going live on 10/1, so...
ALL PEOPLE who want to participate in this thread really should, please. The more information, the better.
I myself have stopped being crotchety about it, so no worries there.
I, for one, suggest that those playing a constructive role in bringing things live, please do so rather than discussing with us.
Sitting in a room running through all the critical and non-critical technical defects for go live and the lights suddenly go out. Not that anyone should be nervous or anything.
By the way: if you ever see an Avik Roy piece -- he writes chiefly at Forbes -- proclaiming doom and gloom for health insurance rates come Obamacare, take it with a handful of salt. Don't believe it. He screws with the numbers. It's bullshit spinning. Do not trust.
It will be a total clusterfuck if there's a shutdown on Oct 1, right? (And over Obamacare to boot!) Can all of HHS be declared exempt?
It is true that Avik Roy is full of shit.
77: Though that should be the baseline assumption for anybody employed by Steve Forbes.
76: ACA roll-out will be mostly okay, it's said: HHS funding for it has been previously secured. Some federal employees involved might could be furloughed, but a lot of activity is happening at the state level. In the end: no past government shutdown has lasted more than 17 days, I believe, so it's not like the gov't shuts down forever.
In the case of shutdown -- which seems likely -- it's all going to be about what kinds of "compromises" (a polite term for shitty options) will be needed to get things up and running again.
Bear in mind also that while the exchanges go live on 10/1, that is only to enroll in plans beginning 1/1/14. So while issues in October (shutdown-related or otherwise) would be bad, there is time for them to be corrected.
Right, spelling out Osgood's point, people have between Oct. 1 and mid-December to enroll in an exchange mediated plan beginning 1/1/14.
And then until the end of March to enroll in a plan for the rest of the year, with a short waiting period.
Feel free to spell out just how barely less shitty you think it is, if you like.
I could. I do have quite a few reasons and remarks I could make about it - and you probably have some idea of what those arguments might be.
But damn, the topic is tiresome, and I'm really not interested in re-litigating the issue. It will be nice, 5 years from now, when we are all enjoying our still somewhat shitty relationships with insurance companies, at least the topic will have changed.
Kermit, tell me you called out the mob for the Shah in '53 by offering them somewhat better health insurance?
84: Nah, we got them on the streets with a deft combination of behavioral "nudges" and targeted tax incentives. Plus, there was this thing the boys back in the black ops department at Langley used to call "The Individual Mandate".
85.last: Hey, I had one of those just the other night!
Speaking of Iran (or maybe that was a different thread), one good thing about Cruz's bullshit is it kept most of the assclown league occupied rather than having them 24x7 whining about Obama's speech re: Iran.
On a completely superficial note, I'm kind of fascinated by Ted Cruz's hair.
When he announced he was going to speak "until he could no longer stand," all I could think was "Please hit your head on the podium when you collapse, you dick."
That almost never happens since the podium airbag was invented.
88: It is something out of a '70s movie or TV show.
He may have been conceived during one.
the podium airbag
That should be his new nickname.
I am super excited and terrified and overwhelmed by the exchanges starting. But mostly because I am right in the thick of working as an actuary for a health plan participating in the exchange and having spent the last 6 months working on our rate filing and implementation plan. There are definitely going to be some hiccups but basically i think it will work...
It's clear that many of the gripes and ill-feelings about the current system will migrate over to become gripes about the ACA (and already have to some extent). And not completely unfairly as it leaves intact so much of the current patient/insurance/health provider dance. But I dread the constant chorus of attacks and whinging that this will engender from the bozo brigade. Can't see a UPMC doctor under your Highmark plan? that's ACA for you, and on and on and on.
95: True. I just had the most bizarre and time-consuming health care coordination problem, and I'm tempted to blame ACA. It's convoluted, but in short, IUDs used to be ordered by doctor's offices upon patient request. The doc would bill either the patient or their insurance. This time, I got a paper prescription and instructions to fill it at a pharmacy. The pharmacy said it wasn't covered but they could order it for $900. I called BCBS,who explained that it's not a prescription; it's medical equipment. The doctor's office needed to order it from a single approved distributor. I let the doctor's office know, and they told me I'd need to come back to sign paperwork and return the original script (?). It all got worked out in the end, but I can totally see blaming ACA if I didn't know better. Out of pocket cost $0, time and aggravation medium-high.
Can't see a UPMC doctor under your Highmark plan? that's ACA for you, and on and on and on.
The eminently sensible Aaron Carroll has an eminently sensible take on the "narrow network" issue. Interested parties can follow his eminently sensible healthcare blog.
And for some more pointless whining on the state of politics and media: Remember when for years the Obama administration the Republicans kept talking about how "uncertainty" was a big drag on the economy and the insipid political media pretended to take them seriously?
That was awesome.
Out of pocket cost $0
For that you really can thank the ACA, at least until the Opus Dei devotees on the Supreme Court have their say.
It all got worked out in the end, but I can totally see blaming ACA if I didn't know better.
Or if your doctor told you to blame ACA.
Right. In the event that was absolutely the way it was already heading sans ACA.
UPMC/Highmark isn't a normal network issue. UPMC is trying to use its local near-monopoly on health care provision to become a local near-monopoly in local health insurance and, apparently, rehabilitate Frick's reputation by showing that you can do everything he did except shoot people and still keep non-profit status.
But--not to belabor a dead horse--all of that will turn out to have been the fault of the ACA.
Repubs are waist deep in a Big Muddy of their own making, trying to see if they can climb out on the backs of the citizenry.
99: Actually, the last one was completely covered by BCBS, too! So, as promised, nothing has changed for me. (Smart insurance - birth control is cheaper than a baby.) Not that I'm not an ACA fan.
not to belabor a dead horse
Tie the plow on if you want, that field ain't gettin' tilled.
Jim DeMint has been all, "We fucked up, we nominated the wrong guy, someone who implemented this stuff."
But as Steve Benen points out: I suspect he'd prefer that we forget, but in 2007, DeMint, then a U.S. senator, endorsed Mitt Romney's presidential candidacy, citing -- you guessed it -- Romney's successful health care reform law in Massachusetts.
Smart insurance - birth control is cheaper than a baby.
Actually, the smarter thing for an insurer to do is to decline to cover maternity care, which is what nearly all individual insurers did pre-ACA. Contraception is only covered because the ACA requires that, too. It's covered without consumer cost sharing (your $0 co-pay) because the U.S. Preventive Services Task Force says it saves money in the long term, so the ACA requires that, too. Left to their own devices, individual insurers historically gave a rat's about saving money with preventive care, because their entire book of business turned over every two to three years on average.
THANKS, OBAMACARE!
Tie the plow on if you want, that field ain't gettin' tilled.
IYKWIMAITYD.
83: It will be nice, 5 years from now, when we are all enjoying our still somewhat shitty relationships with insurance companies, at least the topic will have changed.
I actually agree with this: the topic will have changed from "Why can I not get health insurance at all due to my preexisting condition? (or due to unaffordability)" to -- once many more people have coverage -- "Why is this health insurance so shitty?"
I'm reminded of a conversation I strayed into a few years ago about women's rights. This will sound like a banned analogy, but it's a thought experiment: some commenters had worked themselves around to averring that now that women can relatively freely join the workforce, they've realized how shitty it often is to be a member of the workforce: it's not an improvement at all!
To which I could only say: Really? You think being a member of the workforce is so bad that you'd rather you weren't allowed to join it at all? Really? [One can substitute the right to vote here, to the same effect: Now that we can vote, it turns out the political system sucks. The right to vote didn't fix anything at all: might as well not have insisted on it. Uh.]
Point is that believing that an ACA that allows many more people to become insured hardly counts for anything .. is surely focusing in the wrong direction.
Thanks for the links in 97, Kermit. The breadth of network is something I'll be paying attention to when I shop the exchange -- I always did, as this isn't a new thing.
Holy fuck, I've broken the fourth wall! Commented on an ACA thread on Facebook. On a Robert Reich status update* with 500+ comments. I'm sure it's a slippery slope; I can see it now, in my dotage I will be ranting in YouTube comments and rating which Amazon reviews were helpful to me.
Thank You, Obamacare!
*Via a link from someone who is probably one of you reprobates, but I don't recognize who <common female first name> <very common American last name> is.
When I read 112, I LOLed. Thank You, Obamacare!
The thing that drew me in was the canard about the Congresional "exemption." The details of that particular lie are too tedious to relate, but it led me to get the backstory on something I had seen briefly noted on Twitter during the Douche-a-thon. Durbin and Cruz had this exchange on Cruz being covered under the Congressional health plan:
"Will the senator from Texas for the record tell us now--and those who watched this debate--whether he is protected and his family's protected?" Durbin asked Wednesday morning, repeating a question he'd been trying to get Cruz to answer.
"I'm happy to tell you now I am eligible for it and I am not currently covered under it," Cruz responded, diverting the conversation to an uninsured diabetic woman that Durbin had mentioned earlier.Turns out Cruz almost certainly gets very, very good health insurance coverage via his wife who is an exec at Goldman-Sachs.
112: Three people over there liked my comment. They really Like me!
I haven't checked into over there in a month. A friend's relative died and I didn't feel right sending condolences in a comment on a status. I figured I'd use regular mail, but then I realized I didn't have a street address. Then I dithered long enough that it seemed too late to send a Facebook message or an email because I'd clearly had long enough to write a real letter. So I dithered longer because I couldn't think of a good way to express condolences without getting into the delays mentioned above and yet I'm safe aware enough to know that it just sounds pathetic and is pointless as far as the bereaved is concerned. So I am now just avoiding Facebook so I can act like I didn't know and express condolences in person the next time I see them.
116: Knowledge truly is responsibility.
But I've done pretty much the exact same dance pre-Facebook, and have several for which any reminder of my ultimate lack of sending a note brings a flush of shame to my face even now. And by now I mean *now*.
Thanks, Moby Hick!
It wasn't a first degree relative anyway.
My experience of this is that a thoughtful supportive perhaps somewhat longer message that's two or three months late actually means a good deal more than a hallmark-ish response in with everyone else's (and actually they have other things on their mind in the immediate aftermath than a checklist of who hasn't said anything be-it-never-so-formulaic yet).
Obviously Facebook also allows the following
Them: My beloved spouse of 73 years just died!
You: *like*
119: Great, now I get to have "continued inaction guilt" in addition to "past oversight guilt."
Thanks, tierce de lollardie!
... Wait, you're not suggesting there's something I could actually do about it are you?
Maybe borrow a page from Steve Martin and get your own cards printed.
"This certifies that you have been personally comforted by me and that you found me warm, comforting, and a true support in rough times."
The link in 123 is to a great NYT Op-Ed from Kentucky's governor. Let's see if it dints the ongoing narrative of the fucktards in the national chattering classes.
Local Fucktard Can't Get "Remember personal info?" to Work Reliably.
Op-Ed title: "My State Needs Obamacare. Now."
Late to the thread, but I don't think this fabulous Onion article got linked here yet: Man Who Understands 8% of Obamacare Vigorously Defends it from Man Who Undersands 5%.
I'm dreading the next few month of glitch articles. Fucking WaPo, for instance. However, widespread problems on Tuesday, if they occur, will further fuel Republican attacks on the law's viability. Yeah, that's newsworthy. Especially because places like the WaPo will keep flogging them for all they are worth.
