Obama Health Care

By January 14 of 2014, states will either offer health insurance through state-run exchanges, or default to federal control under Obama health care.  As the Boston Herald says, American consumers will be the guinea pigs in the experiment to see whether the “feds” or state will do the best job in getting those individuals in the U.S. who currently do not have health insurance coverage.

According to the article, at the current time the U.S. is fairly evenly split between states that defaulted to federal control (mostly Republican-led states), and those which chose to have state-run exchanges (mostly Democrat-led states).  The states which have chosen to “default” to federal control essentially do not want to participate in Obama health care.

Purchasing health insurance isn’t an easy task for individuals who don’t have the money; the article goes on to say that under Obama health care, buying coverage through exchanges will make the experience similar to shopping on sites like Amazon.com.  Additionally, it is predicted that individuals who are not covered by their employers will flock to the health exchanges, and that the government will assist those in the middle-class with payment of premiums in many cases.

Obama health care will also send low-income individuals who cannot buy coverage in the direction of Medicaid and other programs considered “safety nets.”

Robert Krughoff, president of Consumers’ Checkbook, says that essentially, the health care exchange component of Obama health care is “an experiment between the feds and the states, and among the states themselves.”  Krughoff has serious doubts that either will make the selection of health care coverage as easy as choosing a hotel and travel package.

Come October 1st of this year under Obama health care, consumers will being signing up regardless of whether all of the kinks get worked out.  Coverage will take effect January 1, 2014, the same day that two other provisions of Obama health care take effect – the rule that insurers must provide coverage regardless of individuals’ health or pre-existing conditions, and the mandate that nearly all Americans have health coverage or face a penalty.

So far, 26 states have defaulted to the feds, and 23 states in addition to Washington, D.C. have chosen either state-run exchanges or are partnering with the Obama administration to run their own markets.  Already, states which have chosen to set up their own exchanges are taking very different paths; while some have chosen to open their markets to nearly all insurance providers and let consumers choose which one they prefer, others have chosen to “drive bargains” by offering only a limited selection of insurance providers.

According to a recent AP poll, 63% of Americans prefer state-run exchanges versus 32% who would rather yield to federal control.  Spokeswoman for Governor Rick Perry, Lucy Nashed, stated that “Texas is not interested in being a subcontractor to Obamacare.”

It will be interesting to watch over the next year to see how Obama health care fares in regard to health exchanges, and the differences between states which choose their own state-run markets, and those which default to the feds.  Will choosing insurance coverage really be as easy as going to Amazon.com and buying a book?  Only time will tell.  One thing is certainly clear; the confusion doesn’t seem to be subsiding, but hopefully as the changes are implemented it will become easier for Americans to understand, choose, and afford the coverage they need.

Roughly 25% of the U.S. population have benefited over the past year because of a federal law that many of those 25% despise – Obama health care.  According to Bloomberg Businessweek, last year approximately one of four Americans received free medical care including flu shots, colonoscopies and mammograms.

Other bright spots thus far under Obama health care are also evident, including the fact that 2.5 million young adults under the age of 26 were able to stay on their parents’ health insurance plans.  In addition, those who receive Medicare saw the gap in their prescription drug coverage begin to close as many saved over $600.  While Obama health care has received a bad rap since it was signed into law on March 23, 2010, it is evident that there have been advantages.

Dr. David Longworth, chairman of the Medicine Institute at Ohio’s Cleveland Clinic, stated that “This is probably the most transformative period I’ve lived through.”  As Republicans continue to fight Obama health care, consumers have clearly benefited; in fact, the health care market is being reshaped as doctors, insurers and hospitals continue to adopt new procedures and form alliances.  If Obama health care remains intact, it is estimated that by the year 2018 30 million Americans who are now uninsured will be covered.

Regardless of whether Obama health care keeps going forward or is considered unconstitutional because of the mandate that Americans purchase coverage or be penalized, one thing is clear:  health care may never be as it was prior to March of 2010 again.

Paul Keckley, Deloitte Center for Health Solutions executive director, believes that regardless of whether the individual mandate fails or passes, the more popular coverage improvements will remain.  For instance, many children with pre-existing medical conditions are now able to get treatment regardless of insurance coverage.

Now that it’s election year and the president is involved in campaigning, what would it do to his chances of winning if the individual mandate portion of Obama health care were to be found unconstitutional by the Supreme Court? This is a question in the back of the minds of many voters – and most definitely in the mind of Barack Obama.

The cost of reverting back to how things were before Obama health care came along is likely too prohibitive for things to go back “the way they were,” so to speak.  As Jonathan Gruber stated, “The early deliverables are on the way and hard to reverse.”  Gruber is an economist with the Institute of Technology in Massachusetts, and was instrumental in the creation of both the 2006 health care law in Massachusetts and the Obama health care law signed in 2010.

One area of the law that is particularly promising is that doctors will be paid on an improved quality of care which results in a good outcome for the patient, rather than for x-rays, treatment, tests and other fee-for-services that have been the tradition for decades.  While this may not be the case in every situation, this is how UnitedHealth Group intends to handle the issue, according to a statement the health insurer made in February.

Love it or hate it, Obama health care is a topic that is still hotly debated, and likely will be for some time to come.

Recent polls have demonstrated that Obama health care is no more popular today than it was when his plan was signed into law.  In fact, a poll taken by ABC News and the Washington Post recently proved what we were already fairly certain of:  Obama health care has sunk to new low levels in regards to popularity.

The poll, taken in early April, revealed that the hearings held in March on whether or not health care reform is constitutional had no impact on improving support of Obama health care.  The biggest concern people seem to have with President Obama’s signature domestic legislation is the individual mandate, requiring even those who cannot afford insurance to buy coverage, or be penalized.

Today, only 39% of Americans support Obama health care overall; a full 53% are strongly opposed to it.  Polls have shown that it seems to be younger Americans, those age 18 to 29, who are the biggest supporters of Obama’s health care reform law.  A poll produced by Langer Research Associated for ABC revealed that those who were strongly against Obama health care outnumbered those who strongly support the law by almost 2 to 1.

Many people (about 38%) want the Supreme Court to throw out the entire Obama health care law, while 29% would like to see the mandate requiring most individuals to buy coverage or be penalized taken out.

Not surprisingly, most people believe that politics will play a greater role in what happens with Obama health care in the Supreme court than the law plays. A full 50% of all Americans think that the ruling will be based on politics, with the highest percentage of those being Democrats.  Republicans are the lone political party that believe that the outcome will be based on the law; Independents side fairly evenly with Democrats, leaning toward the opinion that politics will be the persuading factor.

Even while the overwhelming majority of Americans are against Obama health care, most feel that the President can handle the health care policy better than Mitt Romney, who is presumed to be the GOP nominee.  In fact, of those who support the Affordable Care Act, 81% prefer the current President over Mitt Romney.

And outside of Obama health care, more and more Americans are becoming concerned regarding the huge deficit, as Washington goes on about the business of spending money like there was no tomorrow.  Will the health care mandate be upheld, will it fall, will the entire law be struck down?  These are the questions everyone is asking, but when will we have answers regarding whether and how Obama health care will affect our lives?

With oral arguments set to begin in March in front of the Supreme Court for yet another challenge to its existence, the Obama Health Care overhaul continues to cause waves. At issue is the current directive that Americans will be required to buy health insurance or pay a fine. Arguments pertaining to that concern the Anti-Injunction Act, a Federal law. There is disagreement as to whether not the fine Americans would pay if they didn’t buy health insurance is actually considered a tax; if it is, that tax can only be challenged after it’s imposed, not preemptively. The Supreme Court agreed to hear arguments specific to that question beginning March 26 of 2012.

A bumpy road

Originally signed into law on March 23, 2010, the plan was originally set to change the landscape of American health insurance forever. As it was originally intended, the plan was meant to allow those who would otherwise not be able to get healthcare to finally have access to it, if necessary through a public option. It’s been challenged every step of the way, and these arguments are the latest development in what has been a difficult road to success.

Although originally much more robust than it is now, the Obama Health Care plan may still do much of what it was originally intended to do, even with the concessions that have taken place. It’s set to take effect in 2014, and will still provide insurance coverage to more than 30 million people who may otherwise not have been able to get health insurance. It will give subsidies to those with low or modest incomes so that they are able to buy private insurance. In addition, consumers who must buy individual insurance policies can get help through insurance exchanges.

Under Obama Health Care, insurance companies can no longer deny coverage to people with preexisting conditions. Medicare is also being revised in terms of how it’s managed. A panel of experts will oversee Medicare, and Medicare reimbursement will only cover treatments that are considered currently effective for medical conditions. Providers are highly encouraged to limit charges on an individual procedure basis and to engage in “bundling” of services, to save money.

Cost and savings

The plan is expected to cost about $938 billion over the next decade, and will simultaneously reduce the deficit by about $138 billion.

Continued stumbling blocks

The plan has already been challenged in court numerous times, and these arguments concerning the Anti-Injunction act are just the latest to be heard. The plan’s implementation is further complicated by the fact that previous court challenges to Obama Health Care have sometimes had conflicting appellate court rulings that will need to be worked out.

Current changes likely to stay in place

Even with these continued stumbling blocks, though, Obama Health Care has brought about significant changes already that are likely to stay in place. For example, health insurers are under new, strict oversights, and young adults previously not able to get insurance can continue to be covered under their parents’ plans. The existence of the plan has also caused a sometimes unpleasant analysis of the current health care system and its rising costs.

Does Congress really have the power?

Another question yet to be resolved asks whether or not Congress can actually enforce the mandate that Americans must buy insurance or pay a fine. Although the mandate was meant to require everyone to have health insurance, opponents to that directive say that it violates one’s right to choose.

It’s interesting to note that insurance companies actually like this mandate. They argue that if healthy individuals must buy insurance, the insurance companies will have the resources to cover those with chronic conditions, who are more expensive to treat. It may very well be that the insurance companies are only in this for profit, but regardless, Obama Health Care seeks to give everyone insurance coverage across the board, instead of only offering this privilege to a select few as seems to be true now.

The mandate that individuals carry health insurance has been the topic of hot debates in the past few weeks, as it becomes more and more questionable whether Obama health care will survive, or plummet to its death. In particular, justices have been posing skeptical questions regarding the mandate, which in theory is an effective method of getting more people into the insurance pool. The penalty that would be imposed upon those who do not buy health coverage if the mandate passes is relatively mild; 2.5% of household income, or $695 per year, which ever amount is greater.

Still, many feel that the Obama health care mandate is unconstitutional; it has been compared on television recently to citizens of the U.S. being forced to buy broccoli, because it is for the greater good of the nation’s health.  Even the presidential debates have touched on the subject many times, as candidates accuse former governor of Massachusetts Mitt Romney of devising the actual program that Obama health care is modeled after, known as “Romney care.”  In fact, the health care plan has worked very well in the state of Massachusetts.  Bloomberg Businessweek will be reporting in next week’s issue about the work being done by health policy experts and economists in an effort to find alternatives to the mandate that would help avoid legal issues while enticing healthy individuals to buy insurance.

Basically, individuals earning $30,000 would pay more than $2,000 annually for coverage, even considering the generous government subsidies.  Should individuals choose not to buy individual coverage, they would not be subject to penalties above the $695/2.5% of household income, nor would they face criminal prosecution.  Because $2,000 is still out of range of many individual’s budgets, it is believed that healthy people may choose to pay the fine rather than buy coverage, according to Helen Darling, president of the National Business Group on Health.

Even if the Obama health care mandate lives, it is estimated that in the year 2016 approximately 26 million Americans would remain uninsured, according to Congressional Budget Office estimates.  This number would be made up of primarily those who are exempt due to a low income level, those who choose to pay the penalty rather than buy coverage, and undocumented immigrants.

While there are many alternatives being discussed that would replace the Obama health care mandate, many individuals would likely remain uncovered regardless.  Might Obama health care be heading toward the dreaded death spiral?  While supporters hope that the mandate passes, if it falls it is still to be seen whether the other aspects of the health care law remain in place.

The ongoing debate concerning Obama health care continues, as key issues are now before the Supreme Court.  It has yet to be determined if Obama health care will “stick,” as legal battles continue regarding the law’s fate.

At the current time, two of the most controversial issues surrounding Obama health care are the individual insurance mandate and the expansion of Medicaid.  In regards to the individual insurance mandate, the issue revolves around whether Congress went above and beyond its power by requiring that all Americans either purchase health insurance or be subject to penalties.  Obama health care aims to provide over 30 million Americans who did not have coverage with insurance.

The Obama administration argued that Congress could enact the individual mandate under the regulation of interstate commerce in the U.S. Constitution. Currently, the individual insurance mandate is set to take effect in 2014.  Twenty-six of the fifty states in the U.S. are opposed to the individual insurance mandate, arguing the Congress exceeded its power.  Obama health care has been a highly controversial issue ever since the President signed the bill into law on March 23rd of 2010.

Opponents of the mandate state that the provision should be struck down, that it is unconstitutional and that the federal government’s power was drastically expanded.  The National Federation of Independent Business strongly feels that without the individual mandate, regulations and other provisions in Obama health care will not survive, as the individual mandate is at the center or core of the law.

The expansion of Medicaid is another spot of contention in the Supreme Court, as states have challenged the forced expansion of the government supported program that provides health care to Americans who are poor.  These states are arguing that by threatening to withhold billions of dollars in funding, Congress is attempting to force states to cooperate with Medicaid expansion.

Obama health care is likely to be in the headlines for months to come; it will likely be March of 2012 before arguments begin, and a ruling on the issues is not expected until the end of June.

In recent months, news reports have been focused heavily on the extreme costs of Obama health care.  Can the nation afford it?  Essentially, the cost will be substantial primarily for government plans, as nearly half of the citizens in the U.S. are covered by these plans.  While it may not impact individuals severely, Obama health care will definitely cost the nation, some estimate to the tune of half a trillion dollars over the course of a 10-year time period.

Ironically, the president touted in the beginning that the new health care law would reduce the cost of health care, bending the cost downward.  Recent reports show that Obama health care will do just the opposite in fact, bending the cost upward.  The report, “The Fiscal Consequences of the Affordable Care Act,” Charles Blahouse predicts that over a 10 year period, federal healthcare spending will increase the deficit tremendously.

Other reports claim that Obama health care will affect most individuals very little, because of the fact that approximately half of the residents in the U.S. are covered by Medicaid, Medicare or through employment with local, state and federal government.  As the nation continues to age, it is thought that a large majority of the population will be protected under a plan that is sponsored by the government in coming years.  More people will have coverage through Medicare, as the retirement population continues to grow.  When it comes to discussing the pros and cons of Obama health care, there never seems to be steady ground that everyone can agree on.

In addition, many students who attend college will be covered through universities and other government-sponsored agencies.  It’s easy to understand why the topic of Obama health care has been and still is such a hotly debated topic.

Many individuals and families are covered through their employers; self-employed individuals typically pay for their own coverage.  Under Obama health care, much of this would remain the same, other than those who are self-employed may be open to additional options, particularly if the idea tossed out by Republicans that the self-employed may buy insurance across state lines is approved.

Jeanne Lambrew, White House health adviser, called Blahous’s analysis “new math” and claimed the Blahous’s statements regarding Obama health care costing billions over a 10 year time period fit the old pattern of mis-characterizations about Obama health care.  Lambrew wrote on the White House blog that official estimates demonstrate that the health care law does reduce the deficit.

While it would seem that businesses and corporations would be glad to pay for health care so that their employees are a strong, healthy workforce, it seems that most would be in a position financially that would force them to provide only minimal coverage.

The fight continues on when it comes to Obama health care, depending on the perspective of whoever is talking about it at the time.  Clearly, Blahous believes that the health care plan will drive the nation into extreme debt, while others believe that the cost will actually decrease.  Many people believe that the main change that will be seen through Obama health care is that some who are not purchasing coverage today will be required to do so, or face a penalty.

Opinions continue to clash on the subject of Obama health care, and to that there seems to be no end.  What is your opinion?  Can America afford the health care plan laid out by President Obama?

Historic legislation was signed on March 23, 2010 by President Barack Obama, legislation that is intended to change the American health care system forever. After decades of wrestling with this quandary, Obama is the first American president to finally put a plan into place. In its original incarnation, it was meant to grant access to healthcare to those who had previously been unable to get it, and still does for many even with the concessions made. However, Obama health care has yet to see an easy road to success, but certain changes have already taken place that are probably permanent, changes that may yet bode well for those struggling to get health insurance coverage under the current system.

Obama health care as it stands today

The Obama health care plan intends to give insurance coverage to more than 30 million people who previously haven’t been able to access it, mostly by expanding existing Medicaid services and giving subsidies to those with low to moderate incomes so that they can buy private insurance. Those who must buy individual insurance policies will also receive help through insurance exchanges.

Another improvement is that insurance companies are prohibited from denying coverage to those with preexisting conditions. Medicare will see some changes, too. A panel of experts will be created to oversee the Medicare, and they will limit reimbursement from Medicare so that it only covers currently effective treatments; it also encourages providers to limit charges by individual procedure and instead to bundle services for cost effective savings.

The plan is expected to cost about $938 billion over the next 10 years, and reduce the deficit by about $138 billion in the same time period.

Roadblocks for Obama health care

Obama health care has already been challenged in court more than 20 times, and today, it is now awaiting a hearing by the Supreme Court. Arguments are expected to begin in March with a decision in June. The court challenges that have been filed against Obama health care are further complicated by the fact that appellate court findings in those challenges are sometimes conflicting.

Although its fate is as yet uncertain, there are certain aspects to the Obama plan that have gone into play and are unlikely to be repealed. For example, regardless of what the Supreme Court rules, health insurers are already under strict oversight as set in place by the plan, and more than one million young adults have received extended health care coverage under their parents’ insurance plans. There are more protections for workers who have preexisting conditions, and the plan has forced institutions take an unpleasant and unwelcome look at healthcare’s relentlessly rising costs.

The crux of Obama health care’s challenges, though, is the question of whether or not Congress even has the constitutional power to require that individuals either buy insurance or pay a fine. This “individual mandate” was put in place to require insurance coverage for all, but dissenters argue that it violates the individual’s right to choose. Paradoxically, insurance companies are on board with the individual mandate, since if healthy individuals must buy insurance, they argue that they will have more money to treat those with chronic conditions, those who will be more expensive for the health industry to treat. Whether that is their true focus (and not pure profit) remains to be seen.

Republicans across the board have challenged and decried it, and Democrats have not been happy with the concessions Obama has made in order to get it passed into law. Because of this, it remains generally disliked by many, with those who supported the original plan nearly as displeased as those who didn’t want its passage at all. With the removal of a true public option, many argue, the health care industry has no counterpoint to artificially inflated pricing meant for pure profit, and of no benefit to the private consumer.

Mark South
Obama Health Care

Obama health care is still a sore subject among many Americans, particularly those who are experiencing a rise in insurance premiums, which is the exact opposite of what was promised by the President in 2008. During his campaign, the President promised that Obama health care would decrease premiums for a typical family by about $2,500. In 2008, the average premium for an employer-based family plan was approximately $12,680. Now, in 2011, the average family premium is more than $15,000.

These figures were taken from the Kaiser Family Foundation, which is a foundation in support of Obama health care. While it is estimated that the health care law is contributing 2 percentage points at the most to the substantial increase, it is believed that this estimate is “covering up” the true impact on many households across the nation.

Just prior to the first mandates taking effect, insurance providers reported that Obama health care would increase premiums by as much as 30% for some consumers by this year. Following those reports, the Obama administration accused insurance carriers of misinformation – but the truth always seems to have a way of winning out in the long run.

As if this isn’t bad enough, numerous reports reveal that Obama health care news will only continue to get worse, especially in 2014 when waivers expire and the health care law takes full effect. Jonathan Gruber, health economist at MIT predicts that 6 out of 10 consumers in the individual market in Wisconsin will watch premiums increase 31% on average; he also believes that many people will see even larger increases. One of the biggest supporters of Obama health care, will Gruber be accused of spreading misinformation (he was paid as a consultant to Obama’s administration)?

Actuarial consulting firm Milliman, Inc. predicts that in Ohio, premiums will rise by as much as 55% to 85% for some consumers in the individual market. In fact, Milliman projects that premiums may increase by 90% to 130% for young healthy males, and by 150% for small businesses.

One previous provider, Principal Financial Group, responded to Obama health care by dropping completely out of the market to leave almost one million Americans grappling to find new coverage.

Not even bothering to ask whether employers dropped dependent coverage entirely after children up to age 26 were able to enroll in their parent’s coverage plans, the Kaiser Family Foundation failed to mention that Obama health care may have caused thousands of dependent children to lose their coverage.

There are no two ways about it; it doesn’t appear that Obama health care is in any way, shape or fashion lowering premiums for family coverage.

Mark South
Obama Health Care

Nearly 18 months after Obama health care was signed in to legislation on March 23, 2010, the law is still met being met by challenges.  Obama health care seeks to extend health insurance coverage to over 30 million individuals, primarily by providing federal subsidies to assist low to moderate income Americans buying private coverage, and by expanding Medicaid.  During the first two years in office, this is the largest single legislative achievement of President Obama, and overwhelmingly the most controversial.

Challenges Facing Obama Health Care
There have been more than 20 challenges thus far against several aspects of the health care law.  Most of these challenges are in regards to the individual mandate, which requires that all Americans purchase health insurance or face paying a fine.  This mandate is key to the Obama health care law’s mission of expanding coverage.  Unless healthy people have policies, insurance providers argue that they will not be able to afford to treat individuals with costly chronic conditions.

By February of this year, the mandate had been upheld by three district judges; two found the health insurance mandate unconstitutional.  The judges in favor of Obama health care had been appointed by Democrats, the two finding the mandate unconstitutional were chosen by Republicans.

This summer three federal appeals courts weighed in on the matter, which ended in a three-way tie.  One court found the individual mandate constitutional, another found it unconstitutional, and another court ruled that plaintiffs (which included the state of Virginia) had no right to challenge the mandate.  Given the varied opinions, it’s almost a certainty that the matter ends up in the Supreme Court.

If  Obama health care is sustained in the courts, President Obama is certain to take his place in history as the one president, unlike Bill Clinton and Harry Truman, who succeeded at revamping America’s health care system.  If Obama health care does in fact remain intact, 16 million individuals will be added to the Medicaid rolls.  The  majority of Americans will be required to have health coverage, and coverage for low to moderate income people will have subsidized private coverage.  Private insurers will also be monitored more closely, as they will not have the right to deny care of those with pre-existing conditions.

As soon as Obama signed the bill, challenges filed in federal court began almost immediately.  The President has stated that he is willing to amend portions of the Obama health care law.  Obama said that if states could demonstrate other methods that would allow coverage for as many people as the individual mandate, with insurance coverage that is affordable and as comprehensive without increasing the federal deficit, they can request to circumvent minimum benefit levels.  All in all, whether the Obama health care individual mandate will live or die still seems to be an unanswered question.