Thursday, July 12, 2012

Obamacare Is No Longer So Unpopular

Yesterday, Texas Democratic Party Chairman Gilbero Hinojosa said,

Two days after Rick Perry said he would turn down billions of federal dollars that would boost our economy and help insure millions of Texans, Congressional Republicans have scheduled their thirty first vote to repeal your health care rights.

Today Republicans like Quico Canseco and Pete Sessions are voting to give lifetime guaranteed government health care to other Members of Congress while they take away health care rights from their constituents. They should be ashamed!

Republicans propose to further hurt sick people by going back to the days when people with pre-existing conditions couldn’t get health care at any price. They propose to hurt our seniors by re-cutting the donut hole in Medicare part D and forcing them to pay more for their prescriptions.

They propose to hurt young people by shoving young adults off their parents’ policies. They care about no one but themselves. They propose to hurt millions of Texans and Americans by reinstating lifetime caps on health benefits—which pretty much assure that a catastrophic disease means you die bankrupt.

The Atlantic: Obamacare Is No Longer So Unpopular:

One of the most accurate polling outfits in the country found this week that President Obama's signature achievement is no longer unpopular with the majority of the country.

The Affordable Care Act, according to a Washington Post/ABC News survey, is now backed by 47 percent of Americans, up from 39 percent in April 2012. Opposition to the law in the wake of the Supreme Court decision upholding it is also down, from 53 to 47 percent.

As well, "just one-third of all Americans favor repealing the legislation in its entirety or in part," a number that's been pretty consistent in these polls since 2010. The Republican-controlled U.S. House yesterday made its 33rd failed attempt to repeal part or all of the law.

Romney has made "repeal and replace" into a campaign mantra, promising to undo the law. But that vow is a promise to his base voters and to partisans rather than an appeal to the majority of the country: "Thirty-eight percent of Americans consider Romney's support for repeal a major reason to vote for him, compared with 29 percent who say it is a major reason to vote against him."

The top-line conclusion The Post put out is that opinion on the law remains deadlocked, which is very much the case. But another way of looking at it is that support or opposition to the law is increasingly partisan, which is what pretty much every survey shows, including the Post's most recent poll.

One of the first bills brought to the floor for a vote after Republicans took over control of the House of Representatives in January 2011 was the repeal the Patient Protection and Affordable Care (Obamacare) Act of 2010.

When the DBN wrote about that January 19, 2011 vote to repeal Obamacare we included a partial list of health insurance industry reforms that Republicans want to repeal. The list is given here, again, after the "more" jump.

  1. No lifetime limit on coverage for 105 million Americans.

  2. Up to 17 million children with pre-existing conditions can no longer be denied coverage by insurers.

  3. 6.6 million young adults up to age 26 have taken advantage of the law to obtain health insurance through their parents’ plan.

  4. Free coverage for comprehensive preventive services for millions of women starting in August.

  5. 86 million Americans, including 32 million seniors in Medicare, have already received free preventive services.

  6. 5.3 million seniors have already saved $3.7 billion on their prescription drugs.

  7. Since the health care law was enacted in March 2010, 4.2 million private sector jobs have been created – many of them in the health care industry.

  8. The Small Business Health Care Tax Credit has already been used by 360,000 small businesses to help insure 2 million workers.

  9. $1.1 billion in rebates from health insurance companies this summer will benefit nearly 13 million Americans.

  10. The health care law reduces the deficit by $124 billion over the next 10 years and over $1 trillion over the following decade.
Any of the thirty-three Republican bills to repeal Obamacare brought to the House floor since January 2011, if passed by the Senate and signed by Pres. Obama, would add roughly $230 billion to the deficit by 2021 and leave about 54 million non-elderly Americans uninsured by 2019, according to CBO projections.

Here are some of the private health insurance industry reforms mandated in the legislation that Republicans want to repeal:

  • Health Insurers cannot deny children under age 19 health insurance because of preexisting conditions. (Reference) A ban on preexisting condition exclusions for adults will take effect in 2014.
  • Small businesses will get tax credits covering up to 50% of employee premiums for 2009 and 2010. (Reference)
  • Seniors will get a rebate to fill the so-called "doughnut hole" in Medicare drug coverage, which severely limits prescription medication coverage expenditures over $2,700. As of 2012, 50 percent of the doughnut hole will be filled. (Reference)
  • The cut-off age for young adults to continue to be covered by their parents' health insurance rises to the 27th birthday. (Reference)
  • Lifetime caps on the amount of insurance an individual can have will be banned. Annual caps will be limited, and banned in 2014. It says that health insurance companies can no longer tell customers that their health care coverage will be terminated because they have hit a "lifetime limit" on claims. And there are now restrictions on yearly spending limits. too. (Reference)
  • Adults with preexisting conditions may buy into a temporary national high-risk pool, at different rates than people without them, until health insurance exchanges come online. While high-risk coverage will not be cheap, it is still better than total exclusion from health care access. And the high-risk pools provide some cost benefit from a wider pool of insured adults. This is a way to phase out the old "preexisting conditions" exclusions insurance companies use to use to deny health care coverage. Health insurance exchanges will eliminate the program in 2014. (Reference)
  • Free preventative care - New plans must cover checkups and other preventative care (mammograms, colonoscopies, etc.) without co-pays. All plans will be affected by 2018. (Reference)
  • No more rescission. Effective immediately, insurance companies can no longer cut someone when he or she starts filing claims for high treatment cost diseases like cancer. (Reference)
  • Insurers have less ability to change the amount customers have to pay for their plans. (Reference)
  • Authorizes early funding of community health centers in all 50 states. Community health centers provide primary, dental and vision services to people in the community, based on a sliding scale for payment according to ability to pay.
  • Insurers must now reveal how much money is spent on overhead - All insurers must post their balance sheets on the Internet and fully disclose administrative costs, executive compensation packages, and benefit payments. (Instead of just "administrative fee", they have to be more specific).
  • Any new plan must now implement an appeals process for coverage determinations and claims. Insurers need to have an appeals process for when they turn down a claim, so customers have some manner of recourse other than a lawsuit when a claim for coverage is denied. (Reference)
  • This tax will impose a ten percent tax on indoor tanning services. This tax, which replaced the proposed tax on cosmetic surgery, would be effective for services on or after July 1, 2010. (Reference)
  • New screening procedures will be implemented to help eliminate health insurance fraud and waste. (Reference)
  • Medicare payment protections will be extended to small rural hospitals and other health care facilities that have a small number of Medicare patients. (Reference)
  • Non-profit Blue Cross organizations will be required to maintain a medical loss ratio -- money spent on procedures over money incoming -- of 85 percent or higher to take advantage of IRS tax benefits.
  • Chain restaurants will be required to provide a "nutrient content disclosure statement" alongside their items, so people can have an easier time making choices to eat healthy. Expect to see calories listed both on in-store and drive-through menus of fast-food restaurants sometime soon. (Reference)
  • The bill establishes a temporary program for companies that provide early retiree health benefits for those ages 55-64 in order to help reduce the often-expensive cost of that coverage.
  • The Secretary of Health and Human Services will set up a new Web site to make it easy for Americans in any state to seek out affordable health insurance options The site will also include helpful information for small businesses. (Reference)
  • A two-year temporary credit (up to a maximum of $1 billion) is in the bill to encourage investment in new therapies for the prevention and treatment of diseases.
  • The Medical Loss Ratio Provision of the Act requires health insurance companies to spend 80% of the consumers’ premium dollars they collect — 85% for large group insurers — on actual medical care rather than overhead, marketing expenses and profit. Failure on the part of insurers to meet this requirement will result in the insurers having to send their customers a rebate check representing the amount in which they under-spend on actual medical care. (Reference)
  • The Act allows the Food and Drug Administration to approve more generic drugs (making for more competition in the market to drive down prices) (Reference)
  • The Act establishes a non-profit group, that the government doesn't directly control, PCORI, to study different kinds of treatments to see what works better and is the best use of money. (Reference)
  • Insurance companies can no longer deny insurance coverage because of a "preexisting" disability, or because they are, or have been, a domestic abuse victim. (Reference)
  • People in a "Medicare Gap" get a rebate to make up for the extra money they would otherwise have to spend. (Reference)
  • For people who make over $200,000 a year, taxes go up less than 1 percent after January 1, 2013. (Reference)
  • High preexisting condition insurance coverage rates are totally eliminated. Everyone pays the same rate the same regardless of their medical history beginning on January 1, 2014. (Reference)
  • Beginning on January 1, 2014, if you can afford insurance but do not get it, you will be charged a fee. If you opt to not buy insurance, you'll have to pay a penalty fee on your tax form, unless you just can't afford it. The Supreme Court ruled this mandate is Constitutional, as long as it's considered a tax on the uninsured and not a penalty for not buying insurance. (Reference)
  • Medicaid can now be used by everyone up to 133% of the poverty line (basically, a lot more poor people can get insurance) (Reference)
  • Businesses with over 50 employees must offer health insurance to full-time employees, or pay a penalty.
  • Insurers now can't do annual spending caps. Their customers can get as much health care in a given year as they need. (Reference)
  • The Act limits how high of an annual deductible insurers can charge customers. (Reference)
  • The Act establish health insurance exchanges and rebates for the lower and middle-class, basically making it so they have an easier time getting affordable medical coverage. (Reference)
  • The Act requires Congresspersons and Congressional staff to use the same insurance offered to people in the insurance exchanges, rather than Federal Insurance. Basically, we won't be footing their health care bills any more than any other American citizen. (Reference)
  • If any state its own health insurance that gives citizens the same level of care at the same price as the Affordable Care Act, they can ask the Secretary of Health and Human Resources for permission to do their plan instead of the Affordable Care Act. So if they can get the same results without, say, the mandate, they can be allowed to do so. Vermont, for example, has expressed a desire to just go straight to single-payer (in simple terms, everyone is covered, and medical expenses are paid by taxpayers). (Reference)
Only one in four Americans said they support full repeal of the reforms, according to a January 2011 Associated Press-GfK poll, and 30 percent strongly opposed the law, the lowest figure since September 2009. The drop is particularly notable among Republicans. Forty-nine percent said they're against the law, down considerably from 61 percent just after the November 2010 elections.

ObamaCare Is Winning the Fight on Fraud and Abuse

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