Healthcare going forward

[smokeshadow]

interesting analysis of what happens if the Donald succeeds in overturning the ACA

https://news.yahoo.com/q-overturning-obamacare-during-pandemic-035853437.html

 

[Kulindahr]

Couldn't decide whether this should go into the Deplorables thread...

In the middle of a pandemic, with nearly 40 million people unemployed in the US, the Trump Administration is trying to kick 24 million people off Obamacare. If they are successful, this would also mean that insurance companies would be able to use pre-existing conditions to deny you coverage.

Trump administration asks Supreme Court to invalidate Obamacare [CNN]

The Supreme Court lately has been unpredictable in what cases it will even take, denying cert to cases where lower courts have taken utterly incompatible positions that need to be resolved. I can see the Court just shrugging and ignoring this.

 

[smokeshadow]

the Donald is getting scorched for bragging that he will be issuing Executive Orders in the upcoming days mandating insurance companies cover pre-existing conditions

https://www.thenewcivilrightsmoveme...pre-existing-conditions-which-is-already-law/

something that the ACA has been doing for over 10 years

 

[gsdx]

something that the ACA has been doing for over 10 years

And something that Trump is bragging about never having been done before.

 

[TX-Beau]

Has anyone asked if that's even legal?

 

[Kulindahr]

Has anyone asked if that's even legal?

It can't be. Executive orders only apply to government activity, and even then only to the executive branch. The only possible way he could have leverage for this would be to withdraw federal dollars from any company not complying, but that would be void if it contradicts any existing law. Since Congress holds the power of the purse, Trump doesn't have a leg to stand on with this.

 

[smokeshadow]

4 or so years later and all we get from the Donald are a couple of executive orders that A) proposes to work with Congress to pass a law that would prohibit surprise billing and B) declares that insurance companies can not discriminate against people with pre-existing conditions

https://www.thenewcivilrightsmoveme...-which-is-really-a-toothless-executive-order/

Doesn't the PPACA already accomplish both???????

 

[KaraBulut]

4 or so years later and all we get from the Donald are a couple of executive orders that A) proposes to work with Congress to pass a law that would prohibit surprise billing and B) declares that insurance companies can not discriminate against people with pre-existing conditions

https://www.thenewcivilrightsmoveme...-which-is-really-a-toothless-executive-order/

Doesn't the PPACA already accomplish both???????

B) yes, A) no

 

[KaraBulut]

There's another thread on the forum that was started in 2011 that discusses the some of the Republican's 71 attempts to repeal the Affordable Care Act (aka ACA aka Obamacare). Ten years. Ten years.

This was the 3rd attempt to get SCOTUS to do what Republicans couldn't get the votes to do. SCOTUS left the ACA in place and dismissed the latest suit for plaintiffs' lack of standing. They did not rule on the merits of the case, which leaves the door open for more attempts.

Supreme Court dismisses challenge to Affordable Care Act, leaving it in place [CNN]

The justices noted that there is no harm to opponents from the provisions that they are challenging because Congress has reduced the penalty for failing to buy health insurance to zero.

"For these reasons, we conclude that the plaintiffs in this suit failed to show a concrete, particularized injury fairly traceable to the defendants' conduct in enforcing the specific statutory provision they attack as unconstitutional," Breyer wrote. "They have failed to show that they have standing to attack as unconstitutional the Act's minimum essential coverage provision."

The Department of Health and Human Services released a report earlier this month that shows a record 31 million Americans have health coverage through the Affordable Care Act, including 11.3 million people enrolled in the Obamacare exchanges as of February and 14.8 million newly-eligible, low-income people enrolled in Medicaid expansion as of December.

 

[Kulindahr]

^
Useless defense of a useless Act. I know a dozen people with ACA coverage, and none of them can afford to use it -- so basically the government is handing insurance companies money for policies they know will never be used because the deductibles are too high.

 

[KaraBulut]

^
Useless defense of a useless Act. I know a dozen people with ACA coverage, and none of them can afford to use it -- so basically the government is handing insurance companies money for policies they know will never be used because the deductibles are too high.

Tell them to call the hospital to ask for a price without insurance. Walking in the door with an insurance card gets you about a 40-50% discount off the charge master price before your deductibles get applied.

In other words, if you don't have insurance a heart catheterizaton will cost between $20,000 to $40,000. With insurance, you will get a discounted price between of between $10,000 to $24,000.

 

[Kulindahr]

Tell them to call the hospital to ask for a price without insurance. Walking in the door with an insurance card gets you about a 40-50% discount off the charge master price before your deductibles get applied.

In other words, if you don't have insurance a heart catheterizaton will cost between $20,000 to $40,000. With insurance, you will get a discounted price between of between $10,000 to $24,000.

When they can't afford the deductible in the first place, discounts are useless. These are people to whom a $300 traffic ticket means skipping meals for a couple of months; a visit to urgent care tends to be about that same price (my last was $340).

 

[Sausy]

The ACA is far from perfect, but it has saved lives. Republicans back "skinny plans" and market shit, as if they will stop people from going bankrupt or still facing severe financial pressures. Build on the ACA, bring in a public option and hopefully eventually an improved Medicare for All over time. The rest of the developed industrialized world has some form of public health insurance and the usual general cost to the patient is quite small. We think we're a great country? Not where it comes to access and availability to all of quality basic health care.

 

[cityboy-stl]

The ACA is far from perfect, but it has saved lives. Republicans back "skinny plans" and market shit, as if they will stop people from going bankrupt or still facing severe financial pressures. Build on the ACA, bring in a public option and hopefully eventually an improved Medicare for All over time. The rest of the developed industrialized world has some form of public health insurance and the usual general cost to the patient is quite small. We think we're a great country? Not where it comes to access and availability to all of quality basic health care.

The ACA was built on Romneycare. The only thing republicans don't like about Obamacare is Obama. It's all about "sticking it" to Obama. If everthing else were the same, but the ACA was called Trumpcare, they'd think it was sent from heaven. They're idiots.

 

[Kulindahr]

The ACA is far from perfect, but it has saved lives. Republicans back "skinny plans" and market shit, as if they will stop people from going bankrupt or still facing severe financial pressures. Build on the ACA, bring in a public option and hopefully eventually an improved Medicare for All over time. The rest of the developed industrialized world has some form of public health insurance and the usual general cost to the patient is quite small. We think we're a great country? Not where it comes to access and availability to all of quality basic health care.

"Market" solutions that prohibit people from using a service are not market solutions anyway, they're corporate welfare.

But between the GOP and the ACA IMO things are too screwed up for market solutions any more, with one exception: a law that would help not-for-profit organizations start their own insurance companies. Some of the best insurance plans in the country are run by churches for employees of their denominations and by fraternal organizations for their members, and their costs are generally lower, so encouraging more such would help drive prices down. Include in that law a "free" (i.e. covered by Medicare-like plan) annual physical, dental check-up, and vision check-up, and four "free" doctor visits. And yes, the point is partially to force for-profit insurance companies to become much more effective or go out of business.

I had an example of the stupidity of the U.S. approach to health care this last weekend: a guy who got injured in the job got switched from employer's insurance to the Oregon Health Plan -- and due to the switch he had to go in and get every single X-ray, MRI, whatever done over because of switching coverage! That's just insanity.

 

[KaraBulut]

"Market" solutions that prohibit people from using a service are not market solutions anyway, they're corporate welfare.

Healthcare is not a market-driven service. Healthcare tends to be an on-demand service. People don't decide one day to go out and get an appendectomy. When you need an appendectomy, you go to a hospital emergency room and you don't consider the price.

Until the ACA, you could not get a price estimate from a healthcare provider. Under the ACA, prices are now published publicly. This helps somewhat if you're making a decision about where to deliver a baby but in non-elective cases, you don't have the luxury of shopping around. You select from a list of preferred providers that are contracted with your insurance company.

I had an example of the stupidity of the U.S. approach to health care this last weekend: a guy who got injured in the job got switched from employer's insurance to the Oregon Health Plan -- and due to the switch he had to go in and get every single X-ray, MRI, whatever done over because of switching coverage! That's just insanity.

It's also against the intent of the ACA. There's a whole set of interoperability rules in the ACA that set standards for healthcare providers to electronically exchange information. If you show up to an emergency room, they can do an electronic query to retrieve your records from other helathcare providers. There is no reason why tests should be repeated. Oregon Health Plan is a participant in OCHIN and all data in OCHIN is exchanged automatically through a data exchange.

 

[smokeshadow]

now Texas AG Paxton is suing the U. S. government over guidance issued by HHS regarding someone receiving medical care and/or advice based upon their gender assigned at birth or gender identity. HHS is basically stating that denying care would result in loss of federal funds under PPACA

https://www.thenewcivilrightsmoveme...s-investigations-of-trans-childrens-families/

 

[KaraBulut]

So, you know how your insurance pays 100% of the cost of screening colonoscopies, cancer screenings, PrEP, immunization and other preventative healthcare?

A judge in Texas just threw all of that out. If his ruling stands, your insurance company will begin charging you for ordinary deductible and coinsurance and you will be paying out of pocket for those services.

Federal judge in Texas strikes down key ACA provision regarding preventive care services

A federal judge in Texas found the appointment of the volunteer body issuing preventive care requirements, unlawful.

www.texastribune.org

 

[cityboy-stl]

So, you know how your insurance pays 100% of the cost of screening colonoscopies, cancer screenings, PrEP, immunization and other preventative healthcare?

A judge in Texas just threw all of that out. If his ruling stands, your insurance company will begin charging you for ordinary deductible and coinsurance and you will be paying out of pocket for those services.

Federal judge in Texas strikes down key ACA provision regarding preventive care services

A federal judge in Texas found the appointment of the volunteer body issuing preventive care requirements, unlawful.

www.texastribune.org

The words "evil incarnate" come to mind. This is nothing but these fascists taking out their hate for Obama on helpless patients. People will die if this stands.

 

[Kulindahr]

So, you know how your insurance pays 100% of the cost of screening colonoscopies, cancer screenings, PrEP, immunization and other preventative healthcare?

A judge in Texas just threw all of that out. If his ruling stands, your insurance company will begin charging you for ordinary deductible and coinsurance and you will be paying out of pocket for those services.

Federal judge in Texas strikes down key ACA provision regarding preventive care services

A federal judge in Texas found the appointment of the volunteer body issuing preventive care requirements, unlawful.

www.texastribune.org

It's a surprising basis for a ruling though it does make sense given how powerful the committee is, and it's easily solvable:

if his ruling stands Biden will just appoint new committee members and ask the Senate to confirm them, and they can make the same recommendations over again. Or Biden could acknowledge the ruling and appoint committee members; though that wouldn't make it a legal requirement by legislation, it would make it the de facto legal requirement because the president would be acting on an action by a federal court.