HomeLatest ThreadsGreatest ThreadsForums & GroupsMy SubscriptionsMy Posts
DU Home » Latest Threads » Forums & Groups » Main » General Discussion (Forum) » When does ACA become a &q...

Thu Mar 13, 2014, 10:17 AM

When does ACA become a "failure"?

The right-wing/Republicans, of course, have carped about ACA being a "failure" since the day it was signed into law. According to them ACA is forcing businesses to cut worker hours, lay off workers, forcing people out of the (junk) insurance plans they supposedly love and want to keep en masse, forcing doctors to quit, killing jobs, and, basically everything bad you can think of short of ushering in the apocalypse foretold in the Book of Revelations (though I'm sure they will be accusing ACA of that as well eventually).

However, for those of living in reality (or some iteration thereof) and recognizing that much of what is occurring is more attributable to long-standing employment trends and/or insurance company shenanigans, what I am curious about is, when is ACA considered a "failure"? What are the signs and symptoms that the law is failing and might possibly need to be repealed? The right-wing/Republicans and the MSM are talking up the fact that ACA is unlikely to meet its projected enrollment by the end of this month, which may be the case but if so, then what? Is it over? Does ACA go into that much vaunted "death spiral" that analysts have previously discussed? From what I have been hearing, there are likely already enough enrollees to prevent that, so then what? The end of March comes and go and then what's the next big test for the law? At what point do critics think the the law will inherently crash and burn because of its design and structure? For me, I just don't see it happening and, frankly, I can't think of lot of things that can't be administratively or legislatively fixed for smaller issues. I can't really see the law collapsing under its own weight like the right-wing/Republicans think is likely (they hope) to happen at some point.

Opening for discussion.

39 replies, 2366 views

Reply to this thread

Back to top Alert abuse

Always highlight: 10 newest replies | Replies posted after I mark a forum
Replies to this discussion thread
Arrow 39 replies Author Time Post
Reply When does ACA become a "failure"? (Original post)
Proud Liberal Dem Mar 2014 OP
frazzled Mar 2014 #1
Proud Liberal Dem Mar 2014 #5
frazzled Mar 2014 #7
Proud Liberal Dem Mar 2014 #14
joeglow3 Mar 2014 #10
functioning_cog Mar 2014 #27
sendero Mar 2014 #2
Puzzledtraveller Mar 2014 #6
Proud Liberal Dem Mar 2014 #15
riversedge Mar 2014 #3
Proud Liberal Dem Mar 2014 #4
unblock Mar 2014 #31
rgbecker Mar 2014 #8
functioning_cog Mar 2014 #24
Romulox Mar 2014 #9
functioning_cog Mar 2014 #23
Romulox Mar 2014 #30
functioning_cog Mar 2014 #32
Romulox Mar 2014 #33
functioning_cog Mar 2014 #35
Fumesucker Mar 2014 #11
PasadenaTrudy Mar 2014 #12
functioning_cog Mar 2014 #21
PasadenaTrudy Mar 2014 #29
Jesus Malverde Mar 2014 #13
functioning_cog Mar 2014 #20
1000words Mar 2014 #16
functioning_cog Mar 2014 #19
1000words Mar 2014 #22
JoePhilly Mar 2014 #26
Arkana Mar 2014 #17
functioning_cog Mar 2014 #18
HereSince1628 Mar 2014 #25
functioning_cog Mar 2014 #28
pnwmom Mar 2014 #36
HereSince1628 Mar 2014 #38
pnwmom Mar 2014 #39
Rex Mar 2014 #34
snooper2 Mar 2014 #37

Response to Proud Liberal Dem (Original post)

Thu Mar 13, 2014, 10:20 AM

1. Let's not argue on their terms at all

This should not even be a discussion. We must stop being suckered into responding to their false arguments, using their terms (such as "failure".

At what point was Social Security or Medicare a "failure"? Never. So let's just not go there.

Reply to this post

Back to top Alert abuse Link here Permalink


Response to frazzled (Reply #1)

Thu Mar 13, 2014, 10:37 AM

5. I'm not trying to be/sound defeatist

it's just the concern trolling on the ACA is just so bad out there- trotting out new polls every five seconds showing how people still don't like the law/think that it has harmed them

Reply to this post

Back to top Alert abuse Link here Permalink


Response to Proud Liberal Dem (Reply #5)

Thu Mar 13, 2014, 10:56 AM

7. Look, Social Security was famously called "a fraud on the workingman"

by Alf Landon. And there was criticism from the left as well: "“In our opinion, the Wagner bill is not designed to provide social security for the masses of the people. In our opinion this bill is designed, rather, to provide security for the rich who dominate the country."

See http://billmoyers.com/content/deja-vu-all-over-a-look-back-at-some-of-the-tirades-against-social-security-and-medicare/

Its constitutionality was challenged in 1937 (and Roosevelt tried to pack the court).
And while polls showed that people liked the idea of "old age insurance," a vast percentage of the population did not understand the law at all.

We should just be concentrating on the ACA's benefits and future potential, and probably ignore the obviously political railings against it. It's the law, it's not going to be rescinded. It's already passed its constitutionality test; it's in its infancy still. I think the more we try to rebut their crazy accusations, the more average people believe there is something to the accusations.

Reply to this post

Back to top Alert abuse Link here Permalink


Response to frazzled (Reply #7)

Thu Mar 13, 2014, 01:35 PM

14. I didn't really know all of the historical parallels

but it does make me feel a little better. I'm mostly worried about ACA being killed in its infancy- without really being given a chance- though I think that Republicans and their "base" are the ones the most problems with ACA but it's the polling that bothers me and them being able to use those poll numbers to hammer Democrats in the upcoming elections. I will have to say that- despite being a bit "mousy" at times about their support for the law- there are almost no Democrats in the House and/or Senate whom have committed to a full repeal of the law.

Reply to this post

Back to top Alert abuse Link here Permalink


Response to frazzled (Reply #1)

Thu Mar 13, 2014, 11:27 AM

10. I don't like this mindset

 

This is not related the government, our president or this bill. We should ALWAYS evaluate how something is working to determine its effectiveness. This applies in business, our homes, every facet of life, etc. It is this mindset that has led trillions in military equipment.

Reply to this post

Back to top Alert abuse Link here Permalink


Response to joeglow3 (Reply #10)

Thu Mar 13, 2014, 01:58 PM

27. Evaluating effectiveness is not the same as declaring

 

Failure, packing up your tent, and going home. There will be positive effects and negative effects of this law going into force.

Those should be evaluated and acted upon.

Reply to this post

Back to top Alert abuse Link here Permalink


Response to Proud Liberal Dem (Original post)

Thu Mar 13, 2014, 10:21 AM

2. We really won't know..

.... if the ACA is a success or failure for many years. And that could also depend on whether some tweaks are made here and there.

The ACA is very complex. Lots of assumptions were made. Some of them are not bearing out at this time, but they still might.

If we can just keep the GOP from killing it, it might be a reasonable success someday.

Reply to this post

Back to top Alert abuse Link here Permalink


Response to sendero (Reply #2)

Thu Mar 13, 2014, 10:49 AM

6. Most sensible appraisal I have seen here

Two opposing sides, one calls it an unmitigated disaster, they other calls it a unparalleled success. It has to be somewhere in the middle. I can say from my experience from doing HBE applications, I'm a medicaid caseworker, that it is somewhere in between. Like you said, I think some assumptions were made that are not bearing true and other miscalculations. One in particular that both co-workers and clients agree with is there was is a conflation that wanting health care equates to having the ability to pay for it, even when payment assistance is available. I have had some clients who were over the limit for expanded medicaid yet were approved for a tax credit who declined to enroll in a plan because they couldn't even afford a bronze plan after subsidies were applied. I also do SNAP, and many of the families in my caseload do not have an extra dime to spare. In the plus side, medicaid expansion in my state has made it possible for many people to get coverage who previously were not eligible.

Reply to this post

Back to top Alert abuse Link here Permalink


Response to sendero (Reply #2)

Thu Mar 13, 2014, 01:37 PM

15. It's too bad that there aren't many (any?) people in the House/Senate speaking so sensibly

It would be wondrous to see an "outbreak of sanity" like prevail this in Congress.


Reply to this post

Back to top Alert abuse Link here Permalink


Response to Proud Liberal Dem (Original post)

Thu Mar 13, 2014, 10:24 AM

3. If America is stupid enough to elect a Republican as President--it

will most likely fail.

Reply to this post

Back to top Alert abuse Link here Permalink


Response to riversedge (Reply #3)

Thu Mar 13, 2014, 10:35 AM

4. Of that we can be certain

though the right-wing/Republicans believe that it will fail (or they will make it fail) before 2017- pretty much the only time that they *might* have fully have the ability to get a repeal through (though I would argue by then, assuming the best, it will be a moot point for most people).

Reply to this post

Back to top Alert abuse Link here Permalink


Response to riversedge (Reply #3)

Thu Mar 13, 2014, 03:05 PM

31. in rhetoric only. they'll rebrand it as their own.

officially, they'll repeal obamacare and while they're stomping gleefully on its grave, they'll replace it with something barely different and celebrate it as the greatest thing since sliced bread.

Reply to this post

Back to top Alert abuse Link here Permalink


Response to Proud Liberal Dem (Original post)

Thu Mar 13, 2014, 10:57 AM

8. To repeal the law it will take the House, the Senate and the President.

Or, if the president vetoes a repeal, it will take an override of the veto.

Until that happens, the ACA is the law of the land. Insurance companies will have to provide health insurance to anyone who applies and pays the premium, including those with pre-existing conditions.

If the Insurance companies insist on raising rates or going out of the business, the ACA will become a mute point as Health care insurance won't be available to many who want it. At that point, it will be back to what we had, or forward to single payer, government administered Medicare for all. How bad would that be?




Reply to this post

Back to top Alert abuse Link here Permalink


Response to rgbecker (Reply #8)

Thu Mar 13, 2014, 01:54 PM

24. Under no formulation are we going back. In fact, expect this to

 

Move forward with public option and employers getting out of the insurance equation. In next five to ten years.

Reply to this post

Back to top Alert abuse Link here Permalink


Response to Proud Liberal Dem (Original post)

Thu Mar 13, 2014, 11:24 AM

9. If the ACA doesn't meet the projected actuarial standards, it will need an infusion of $$$$$.

As early as this year.

Reply to this post

Back to top Alert abuse Link here Permalink


Response to Romulox (Reply #9)

Thu Mar 13, 2014, 01:52 PM

23. No. By next year. Resets to rates happen for following year starting Dec.

 

So the bulk of any increase in subsidy payments by US gov. will happen throughout 2015.

You can bet DHS will be paying attention to how much insurance companies spend vs. what they projected to spend.

Reply to this post

Back to top Alert abuse Link here Permalink


Response to functioning_cog (Reply #23)

Thu Mar 13, 2014, 02:45 PM

30. Rate increases aren't the only source of ACA funding. Insurers are entitled to gov't subsidy any

time certain actuarial standards are not met (the so-called "risk corridors".

I'm talking about an infusion of cash from the US Congress, not rate-payers.

Reply to this post

Back to top Alert abuse Link here Permalink


Response to Romulox (Reply #30)

Thu Mar 13, 2014, 03:06 PM

32. link please. they don't get wads of cash from the US government up front just because.

 

they have to prove their case. What actually happens is at each state exchange level, insurers who pay out less than anticipated, they kick money back in to the government program. Insurers who pay out more would receive money from the government.

There is a possibility that the people signing up across states will end up representing a variety of risk pools and will even each other out. We shall see. The penalties that kick in will also go toward payment. There is also a slight tax on all plans sold under the exchange which also creates a resevoir of cash for possibly higher risk pools.

http://www.csmonitor.com/USA/DC-Decoder/2013/1205/Obamacare-What-if-not-enough-young-healthy-people-enroll-video

Reply to this post

Back to top Alert abuse Link here Permalink


Response to functioning_cog (Reply #32)

Thu Mar 13, 2014, 03:29 PM

33. I said they may require a cash infusion this year. Your link confirms it. What are you arguing?


If the market ends up imbalanced, how does Obamacare address that?

The ACA provides for what are called the “three R’s” – reinsurance, risk corridors, and risk adjustment. Reinsurance is a pot of money, funded by a tax on every health plan, that helps insurers cover the costs of expensive claims. Under a recent rule change, reinsurance would pay 80 percent of the cost of claims over $45,000, down from $60,000. The ceiling is $250,000.

The program called risk corridors, available only to insurers on the new exchanges, exists to even out premiums. If an insurer takes in more than it ends up needing, it gives some of the excess to the government. If its premiums end up being too low, the government will cover some of the losses.

The risk adjustment program takes money from insurers that had healthier-than-average customers and gives it to insurers with more-expensive customers. That removes the incentive by insurers to recruit only healthy customers.

The first two risk mitigation programs are in effect for three years, 2014 to 2016. Risk adjustment is permanent.

Reply to this post

Back to top Alert abuse Link here Permalink


Response to Romulox (Reply #33)

Thu Mar 13, 2014, 03:31 PM

35. my bet is that any net loss across all states and all insurers will be immaterial

 

Reply to this post

Back to top Alert abuse Link here Permalink


Response to Proud Liberal Dem (Original post)

Thu Mar 13, 2014, 11:30 AM

11. Tha ACA cannot fail it can only be failed n/t

Reply to this post

Back to top Alert abuse Link here Permalink


Response to Proud Liberal Dem (Original post)

Thu Mar 13, 2014, 11:31 AM

12. Something that makes me nervous

is this - - lately I've been seeing a few new specialists ( a dermatologist, an ENT) and when I call to make an appt, they ask if my blue shield plan is through Covered CA. When I say no, they then say okay then we can see you. My boyfriend has a Covered Ca plan so this worries us.

Reply to this post

Back to top Alert abuse Link here Permalink


Response to PasadenaTrudy (Reply #12)

Thu Mar 13, 2014, 01:49 PM

21. Sounds like some greedy fucks who don't want to

 

Treat at ACA negotiated rates. They are the next ones to go after in this unholy money pit of U.S. health care.

Reply to this post

Back to top Alert abuse Link here Permalink


Response to functioning_cog (Reply #21)

Thu Mar 13, 2014, 02:43 PM

29. I agree

It must be greed. The ENT I went to didn't even take my blue shield PPO. Something about contracts between the doctors and the ins. company. Great.

Reply to this post

Back to top Alert abuse Link here Permalink


Response to Proud Liberal Dem (Original post)

Thu Mar 13, 2014, 11:36 AM

13. I'd give it a year and see if people are getting the health services they need.

All the talk is about insurance, we need to focus instead on the benefits that insurance provides.

The limited doctor selection on these full price plans is the first failure or rip off.

Reply to this post

Back to top Alert abuse Link here Permalink


Response to Jesus Malverde (Reply #13)

Thu Mar 13, 2014, 01:46 PM

20. Limited choice is better than no choice

 

Which is what was far too common in the U.S. prior to Obamacare.

Reply to this post

Back to top Alert abuse Link here Permalink


Response to Proud Liberal Dem (Original post)

Thu Mar 13, 2014, 01:41 PM

16. For the loyalists, never.

 

Your "racist hatred" for the President is being noted and logged for future reference.

Reply to this post

Back to top Alert abuse Link here Permalink


Response to 1000words (Reply #16)

Thu Mar 13, 2014, 01:45 PM

19. Your mischaracterization is also being noted

 

Reply to this post

Back to top Alert abuse Link here Permalink


Response to functioning_cog (Reply #19)

Thu Mar 13, 2014, 01:51 PM

22. Rah, rah ... Go team!

 

Reply to this post

Back to top Alert abuse Link here Permalink


Response to 1000words (Reply #16)

Thu Mar 13, 2014, 01:57 PM

26. For my neice, who's life will be saved by the ACA ... never.

Her view of what failure would mean, is far more important than yours will ever be.

Reply to this post

Back to top Alert abuse Link here Permalink


Response to Proud Liberal Dem (Original post)

Thu Mar 13, 2014, 01:42 PM

17. It doesn't.

They think it's good politics to keep screeching about it being one, however.

Reply to this post

Back to top Alert abuse Link here Permalink


Response to Proud Liberal Dem (Original post)

Thu Mar 13, 2014, 01:44 PM

18. Ludicrous position. The ship has sailed. There is no "fail".

 

If, after the first year the risk profile for insurance companies goes up because of the makeup of people in marketplace, their premiums will go up. Because no one will be required to pay more than 9% of income on premiums, the government portion will often go up.

The federal government will be monitoring insurance companies to ensure they ate providing adequate percentage of revenue toward care.

This thing needs tweaks, and Republicans would be insane not to eventually relent, but this baby is here to stay.

Welcome to industrialized society that provides healthcare to all.

Reply to this post

Back to top Alert abuse Link here Permalink


Response to functioning_cog (Reply #18)

Thu Mar 13, 2014, 01:55 PM

25. Question on that 9% of income cap

Isn't that only going to be for folks at or above poverty, or who live in states with medicaid expansion?

Reply to this post

Back to top Alert abuse Link here Permalink


Response to HereSince1628 (Reply #25)

Thu Mar 13, 2014, 02:02 PM

28. I'm not sure. But that is one tiny fraction of the population which

 

Which can have a fix implemented by Congress to address if they'd get off their black president hating asses.

Reply to this post

Back to top Alert abuse Link here Permalink


Response to HereSince1628 (Reply #25)

Thu Mar 13, 2014, 03:37 PM

36. The cap applies to middle income families, too

as defined as a family of four with an income of approximately 92K. Those families will get subsidies to keep them within the cap of 9%.

But families who make more than the subsidy level of 92K won't pay more than whatever the standard amount is for a policy.

Reply to this post

Back to top Alert abuse Link here Permalink


Response to pnwmom (Reply #36)

Thu Mar 13, 2014, 03:41 PM

38. Yes, I think so, as I understand it goes into effect for people at or above the poverty level.

It's a bludgeon to those below it.

Reply to this post

Back to top Alert abuse Link here Permalink


Response to HereSince1628 (Reply #38)

Thu Mar 13, 2014, 03:44 PM

39. It's not a bludgeon to people below poverty level. They're on Medicaid.

It's actually not a "bludgeon" to anyone, even those in states that didn't expand Medicaid.

Reply to this post

Back to top Alert abuse Link here Permalink


Response to Proud Liberal Dem (Original post)

Thu Mar 13, 2014, 03:29 PM

34. Never, it is a WIN WIN.

 

nt.

Reply to this post

Back to top Alert abuse Link here Permalink


Response to Proud Liberal Dem (Original post)

Thu Mar 13, 2014, 03:38 PM

37. When we have Sarah Palin standing in front of a death panel

 

LOL

Reply to this post

Back to top Alert abuse Link here Permalink

Reply to this thread