Have the village dolts figured out by now that you are no longer in charge of your own health care. Now the corporate parasites (campaign contributors who buy candidates every election) will decide what you get, how much you get, when you get it and how much you pay. When you get health care it will be delivered by the same dull-witted and poorly motivated lifelong bureaucrats who think working between breaks is really too much to expect from a career civil servant.
MILLIONS ARE NOW REALIZING THEY'RE TOO POOR FOR OBAMACARE
Jeffrey Young | HuffPost | 01/31/2014
Thanks to a Supreme Court ruling and staunch Republican resistance, Marc Alphonse, an unemployed 40-year-old Marine veteran who is essentially homeless, cannot get health insurance under Obamacare.
Three years ago, Alphonse learned he has a kidney disorder that will deteriorate into kidney failure, and possibly prove fatal, if left untreated. As it stands now, he suffers from bouts of nausea caused by his dysfunctional kidneys, and he's dogged by an old knee injury that limits his job prospects. He gets by on $400 a month in unemployment benefits, and his family can no longer afford housing in their home city of Miami. Alphonse's 28-year-old wife, Danielle, and three young children are staying with relatives while Alphonse couch surfs.
"I live from family to family until I'm able to get myself situated," he told The Huffington Post.
ALPHONSE IS ONE OF NEARLY 5 MILLION UNINSURED AMERICANS CAUGHT IN A CRUEL GAP THAT RENDERS SOME AMERICANS "TOO POOR FOR OBAMACARE."
Obamacare was supposed to make health coverage affordable, or even free, for low-income Americans. The law's official name is the Affordable Care Act. However, THE SUPREME COURT TOSSED A HUGE OBSTACLE IN THE PATH OF THAT GOAL IN 2012, RULING THAT THE STATES COULD OPT OUT OF ONE OF OBAMACARE'S CRUCIAL PROVISIONS: THE EXPANSION OF MEDICAID COVERAGE TO ANYONE MAKING LESS THAN 133 PERCENT OF THE FEDERAL POVERTY LEVEL, OR ABOUT $15,300 A YEAR FOR A SINGLE PERSON. SINCE THE COURT'S RULING, 24 STATES, INCLUDING FLORIDA, CHOSE NOT TO EXPAND THE PROGRAM.
Under the pre-Obamacare rules, eligibility for the program typically was limited to low-income children, pregnant women, parents caring for children at home, and adults with disabilities. Without the law's expansion, an adult without a disability who isn't living with their children -- like Alphonse -- doesn't qualify for Medicaid, no matter how poor he or she is.
For those who don't qualify for Medicaid coverage, Obamacare offers tax credits for private health plans sold through the law's health insurance exchange marketplaces. But those subsidies are available only to those making between the poverty level, or about $11,500 for an individual, and four times that amount. In states not expanding Medicaid, people who earn less than poverty wages get nothing.
In Alphonse's case, his family is trying to survive on his unemployment insurance. It amounts to $4,800 a year -- far below the poverty level, which is $27,570 for a family of five. Even the unemployment benefits will run out in March.
'PEOPLE BREAK DOWN IN TEARS'
Florida Gov. Rick Scott (R) launched his political career in 2009 as a health care reform antagonist. Originally, he opposed the Medicaid expansion, but he then changed his mind. Last year, Scott and the majority-Republican state Senate backed a plan to accept federal dollars to expand the program. The GOP-led state House of Representatives refused to go along.
Now, 764,000 low-income adults in Florida will remain without insurance because of the coverage gap, according to the Henry J. Kaiser Family Foundation. And they're beginning to understand the tragic consequences of that public battle. At Miami's Borinquen Medical Centers for low-income and uninsured patients, Jason Connor sees hopes crushed as people who thought Obamacare could help them at long last learn otherwise.
"We've had people break down in tears at our desk," said Connor, who is under contract with the community health centers to do Affordable Care Act outreach and enrollment activities through his company, Choice Returns.
Seventy-eight percent of the 50,000 patients that Borinquen Medical Centers treat every year are uninsured, Connor said. About 20 percent of those who visit their facilities looking to apply for benefits fall into the coverage gap, he added.
"Folks are frustrated and they're angry, and they'll curse at you even though you have nothing to do with it," he said.
When the Supreme Court ruled that states could opt out of the Medicaid expansion, Florida, Texas and nearly the entire South turned away billions in federal dollars offered for broadening the program, citing budgetary concerns and resistance to Obamacare itself. The federal government will pay the full cost of the Medicaid expansion through 2016, after which its share will be no less than 90 percent.
These decisions by governors and legislators essentially consigned a huge swath of the very poor to a life of extreme insecurity.
"It's very frustrating," said Alphonse, who last worked as a security guard until being laid off 10 months ago. "It's kind of odd where an individual that has an opportunity to help millions of people in their own state, and they just totally refuse to do it."
Florida's legislature is poised to take up the Medicaid expansion again during this year's session, but the political dynamics don't appear to have changed much since last year. Meanwhile, one-quarter of Florida's population (under the age of 65) is without health insurance -- the second-highest of all the states behind Texas. In Miami-Dade County, where Alphonse lives, the uninsured rate was an astonishing 34 percent in 2011, the most recent year county-level data were available.
Where Are The Uninsured? This map shows the percent of uninsured in each U.S. county in 2011. The data includes all incomes, races, and both sexes for people under age 65. Source: U.S. Census Bureau
'I JUST TRY TO LIVE EVERY DAY'
Unable to afford medical care or insurance, Alphonse hasn't followed up on the warning he received about his kidneys from a doctor treating a knee injury he suffered in 2011 while working as a security guard. Alphonse was told he needed to see a kidney specialist and start getting treatments, or he'd risk the condition worsening to the point he'd need dialysis or a transplant.
"It's extremely scary, but I try not to think about it. I just try to live every day because it's what you have to do to survive," Alphonse said.
A few years ago, Alphonse broke his hand and faced a $1,000 emergency room bill that destroyed his credit. He's afraid to rack up medical bills now. Even copayments as low as $20 at community health centers, which charge low-income patients on a sliding scale, are unaffordable, he said. He's applying for health benefits through the Department of Veterans Affairs, but he may not meet the program's eligibility rules.
While hospitals can't turn away patients in need of emergency treatments, they aren't required to provide the kind of comprehensive care needed for someone with a serious medical condition.
"If you're really sick, you can fall through the cracks of the safety net system," said Lise Federman, a health policy specialist at Florida Legal Services in Miami. "People who have chronic conditions who need specialist services do suffer." (Florida Legal Services referred HuffPost to Alphonse.)
TAXPAYERS STILL FOOT THE BILL
Keeping people like Alphonse off the Medicaid rolls doesn't shield American or Floridian taxpayers from the cost of whatever treatments he eventually may receive, like at a hospital emergency room or a government-funded community health center. Unpaid medical bills totaled $57.4 billion in 2008 -- and taxpayers picked up about three-quarters of the tab, according to a study published in the journal Health Affairs. Expanding health coverage via Obamacare was supposed to reduce that burden, but the patchwork Medicaid expansion limits the law's reach.
And if Alphonse's condition deteriorates into what's known as end-stage renal disease, or permanent kidney failure, he automatically would qualify for Medicare coverage paid for by the federal government. Although Medicare mainly is for people over 65 or those with disabilities, people who need dialysis or a kidney transplant are eligible under a special rule enacted in 1972.
For those too poor for Obamacare in Miami, watching neighbors who make more money receive subsidized health insurance makes the experience even more painful, said Mayte Canino, a field and volunteer coordinator for Planned Parenthood of South Florida and the Treasure Coast. Uninsured people are skeptical of Obamacare and unaware of many provisions, and only 49 percent know that states have the option to expand Medicaid, according to a poll conducted by the Kaiser Family Foundation this month.
"That even affects them more, when they see that other people are getting help and they're not," said Canino, who helps people sign up for insurance. "Many of them are very unhappy. They blame the law, some of them, for it. They just walk away from it, and they think that's it. They're defeated."
Sentiment: Strong Buy
OBAMACARE DEATH PANEL ORDERS FIRST EXECUTION
86-Year-Old Diabetic Grandmother to Face Firing Squad
The Daily Currant | Jan 20, 2014
The death panels set up under Obamacare ordered their first execution today.
At a hearing this morning in Chicago, the president's Patient Resource Efficiency Board (PREB) ruled that 86-year-old Dorthy Zborknak has outlived her usefulness and sentenced her to death by firing squad.
Zborknak, a grandmother of four, had worked at Fleur de Lis Florist on the city's North Side for 40 years before retiring in 1998. Since then she has struggled with diabetes, high blood pressure and kidney failure.
"Unfortunately the cost of her care just became too expensive," says Peter Johnston, a member of the Chicago PREB who voted to kill the woman. "Her diabetes medicine alone costs the taxpayers thousands each month. And in a few years she'll need a new kidney.
"Kidney transplants can run into the hundreds of thousands of dollars. Bullets only cost a few cents apiece. Under the Affordable Care Act, we have the power to make choices about end of life care and I stand by our ruling.
"I know it will be hard for the family to accept what's going to happen. It will be a rough few days emotionally. But from a financial standpoint, this was a very easy decision."
Death panels have always been one of the more controversial parts of Obamacare. First noticed by health care policy expert Sarah Palin, the unelected "efficiency boards" allow the government to kill anyone they deem too costly to insure.
Conservative groups bravely warned against the dangers of the system, decrying both its lack of accountability and the immorality of killing senior citizens to save money.
Tea Party leaders such as Sen. Ted Cruz of Texas and Sen. Mike Lee of Utah led an effort late last year to defund Obamacare and stop the death panels once and for all.
Unfortunately their efforts weren't enough to save Zborknak, an active member of her local knitting club who would have celebrated her 87th birthday next month.
In the coming days a team of FBI agents will escort her to the execution site in Springfield, where she will be shot by a group of federal agents. The government promises the process will be as humane as possible.
"It will be quick and painless," Johnston assures. "We're planning on doing around 20,000 of these a year so speed and efficiency are critical."
For her part, Palin has vowed to continue fighting the practice. In a Facebook post this morning she lambasted the Obama administration for its actions and gloated that her prediction had come true.
"Dear liberals I TOLD you this would happen. When Obama said 'If you like your grandmother, you can keep her,' did you really trust him?" she wrote.
Sentiment: Strong Buy
ACA SIGNUPS: KY UP 19%; MD UP 10%; CO UP 20% & CONFIRMS NEW MEDICAID ENROLLEES
Brainwrap | Daily Kos | JAN 17, 2014
KENTUCKY: (h/t to deaconblues)
Not much to say here, just steady improvement. Kentucky's Private QHP Enrollments have gone up from 33,289 to 39,771, a 19% increase since January 2nd. Medicaid Enrollments are up from 100,359 to 122,328, a 22% increase. Kentucky is now up to 18% of their absurdly high CMS projection level.
MARYLAND: (h/t to dadadata)
Maryland's private QHP enrollments went up about 10% in the first part of January, to 22,512, but the Medicaid numbers are confusing. According to the HHS report, as of 12/28 Maryland had 43,065 people enrolled in Medicaid via the exchange, but this update from the Maryland Health Connection states the number as only 29,517. However, they did also enroll a couple thousand more people via the automatic Primary Adult Care program, which cancels out some of this loss.
I'm not positive what to make of the 60,000 number, but the footnote certainly makes it look like this may be the true number of new Medicaid enrollees after separating out Medicaid renewals. This appears to account for the drop of 13,548, and suggests that (not including the PAC transfers), roughly 32% of all Medicaid enrollees were renewals. Assuming this is the case, these have now been separated out, and like Washington State, Maryland's Medicaid numbers should now be "clean" going forward (I think).
COLORADO: (h/t to Sacramento Dem)
The latest Colorado update is significant not just because of the solid numbers (private QHP enrollments up 20% from 12/31 through 01/15, to 63,407; Medicaid/CHIP enrollments up 17.6% to 101,730), but also because the second report devoted to Medicaid expansion specifically states that the 101K does not include redeterminations (ie, renewals of existing Medicaid recipients).
Also note that these Medicaid applications may include more than one person each.
Colorado is now at about 69% of their CMS projection number with 59% of the enrollment period passed.
Sentiment: Strong Buy
SO MUCH FOR THE OBAMACARE APOCALYPSE
Obamacare Logistical Apocalypse Nowhere To Be Seen
Jeffrey Young | 01/03/2014 | HuffPost
The first days of Obamacare enrollment were a mess. The first days of Obamacare benefits, on the other hand, went quietly. The health care industry expects that to change soon.
More than 2 million people signed up for insurance under the new law by year's end. Those people have yet to flood pharmacies, hospitals and community health centers surveyed by The Huffington Post.
The White House and health care companies are nevertheless bracing for a flood as soon as people who lacked health insurance coverage begin to take advantage of their new access to health care.
"At this point, we've seen only moderate activity," Jim Cohn, a spokesman for the Deerfield, Ill.-based pharmacy chain Walgreens, wrote in an email to HuffPost. "We are anticipating a surge in activity beginning next week, following the holiday period."
The White House views January, the first month of new coverage, as a critical moment for President Barack Obama's signature domestic policy achievement. The Obama administration has put in place measures to ease the transition for both those new to the insurance market and those switching from old policies, which have have been discontinued at year's end, into new plans purchased via the exchange marketplaces.
HealthCaregov, the federal portal to the health insurance exchanges in 36 states, and most of the state-run insurance marketplaces, have mostly recovered from major technological failures that hampered signups during October and November. Still, some of those who enrolled before the December deadlines for January coverage may find their benefits aren't in place. The enrollment period runs until March 31.
Health insurance companies are scrambling to process the hundreds of thousands of last-minute enrollments, even as they continue to sort through faulty data about some customers provided by the exchanges. Premiums for January coverage aren't due in most states until next week, after insurers agreed to accept late payments for the first month of Obamacare benefits. Many customers haven't received invoices, while others who have paid don't yet have insurance cards.
Health care providers, led by drugstores, also are taking steps to smooth over problems. Major retail chains such as Walgreens, Walmart, CVS, Rite Aid and Kroger are offering patients whose enrollments are in doubt supplies of prescription drugs for up to 30 days. Smaller, independent pharmacies also are assisting patients who run into trouble confirming their health insurance coverage.
Pharmacist Robert Frankil spent about a half-hour Friday trying to track down the correct insurance information about a patient without his new insurance card at Sellersville Pharmacy, which Frankil owns in suburban Philadelphia.
"I believe I've received one Affordable Care Act plan come in, and the insurance was not accurate," Frankil said. "So we're 0 for 1." After several telephone calls, Frankil confirmed the patient's coverage, he said.
On the other side of Pennsylvania, Tim Davis of Beaver Health Mart Pharmacy in Beaver also hasn't see many Affordable Care Act enrollees. Davis encountered some problems with a few patients who believed they had new plans. In one case, the trouble was cleared up with a phone call. In another, Davis sent a patient home with medicine at no charge and will bill the insurer when the issue is resolved.
"I really anticipate this to be sort of a slow go at first," Davis said. His pharmacy may not notice for six months or more an upswing in prescriptions because of the coverage expansion, he said. The National Community Pharmacists Association in Alexandria, Va., arranged for Frankil's and Davis' interviews with HuffPost.
Health care facilities that treat large numbers of uninsured or low-income people also didn't report a rise in demand during the first few days of the year.
"We are not seeing any increase in patient volumes at our facilities due to newly covered ACA populations," Clay Holtzman, a spokesman for Seattle's Swedish Medical Center, wrote in an email Friday. "In a month of so, we probably will have a greater sense."
The emergency department at Los Angeles County University of Southern California Medical Center was busy Thursday, but no more than ordinary, spokesman Frank Toscano said. "So far, it's business as usual."
At Jackson Health System in Miami, administrators aren't expecting much to change because Jackson Memorial Hospital and its other hospitals and clinics already treat the area's poorest patients, spokeswoman Lidia Amoretty said Thursday. "We see people regardless of whether they have insurance or they don't. So for us, in that sense, we're not going to see any big difference or huge new service demand," she said.
Clinics operated by Salud Family Health Centers, a nonprofit chain based about 30 miles north of Denver in Fort Lupton, Colo., aren't seeing a rush of patients streaming in or trying to make appointments -- but that will change over time, said Jennifer Morse, the organization's vice president for development.
"We're seeing our regular practice still come in the door, but we do anticipate that growing," Morse said.
Community health centers are a vital source of medical care for patients who lack insurance, Morse said, so her organization will largely be treating the same people after they gain coverage. The Bethesda, Md.-based National Association of Community Health Centers put HuffPost in contact with Morse.
If enrollment in the exchanges continues to rise -- the Congressional Budget Office predicted 7 million people would sign up for private insurance and 9 million for Medicaid or the Children's Health Insurance Program -- patients without a medical home today will go looking for one, Morse said.
"We're expecting new patients," Morse said. "People are going to have access to health insurance and they're going to need a primary care provider."
Sentiment: Strong Buy
SURGE: DECEMBER SIGNUPS NEAR 1 MILLION
Obamacare Website Enrollment Tops 1 Million
By JOSH LEDERMAN 12/29/13 06:13 AM ET EST
HONOLULU (AP) — A December surge propelled health care sign-ups through the government's rehabilitated website past the 1 million mark, the Obama administration said Sunday, reflecting new signs of life for the problem-plagued federal insurance exchange.
Of the more than 1.1 million people now enrolled, nearly 1 million signed up in December, with the majority coming in the week before a pre-Christmas deadline for coverage to start in January. Compare that to a paltry 27,000 in October —the website's first, error-prone month — or 137,000 in November.
The figures tell only part of the story. The administration has yet to provide a December update on the 14 states running their own exchanges. While California, New York, Washington, Kentucky and Connecticut have performed well, others are still struggling.
Still, the end-of-year surge suggests that with HealthCare.Gov now functioning better, the federal market may be starting to pull its weight. The windfall comes at a critical moment for Obama's sweeping health care law, which becomes "real" for many Americans on Jan. 1 when coverage through the exchanges and key patient protections kick in.
"As we continue our open enrollment campaign, we experienced a welcome surge in enrollment as millions of Americans seek access to affordable health care coverage," Marilyn Tavenner, the head of the Center for Medicare and Medicaid Services, said in a blog post.
The fledgling exchanges are still likely to fall short of the government's own targets for 2013. That's a cause for concern, because Obama needs millions of mostly younger, healthy Americans to sign up to keep costs low for everyone. The administration had projected more than 3.3 million overall would be enrolled through federal and state exchanges by the end of the year.
Tavenner said fixes to the website, which underwent a major overhaul to address widespread outages and glitches, contributed to December's figures. But the problems haven't totally disappeared. Thousands of people wound up waiting on hold for telephone help on Christmas Eve for a multitude of reasons, including technical difficulties.
The administration released the figures Sunday while President Barack Obama was vacationing in Hawaii. Although the president has spent most of his time relaxing with friends and family, he stepped into work mode late Friday for an update from aides on his signature domestic policy achievement. The White House said Obama told his team to focus on minimizing disruptions for those switching plans.
For Americans who successfully chose insurance plans by Dec. 24, coverage should start on New Year's Day for those who pay their first month's premium by the due date, which in most cases has been extended until Jan. 10.
But insurers have complained that another set of technical problems, largely hidden from consumers, has resulted in the government passing along inaccurate data on enrollees. The White House says the error rate has been significantly reduced. Yet with a flood of signups that must be processed in just days, it remains unclear whether last-minute enrollees will encounter a seamless experience if they try to use their new benefits come Jan. 1.
The political fallout from the website's calamitous rollout could pale in comparison to the heat that Obama might take if Americans who signed up and paid their premiums arrive at the pharmacy or the emergency room and find there's no record of their coverage. Republican critics, already on the lookout for health-law failures to exploit in the 2014 midterm elections, would be emboldened to argue that shortcomings with the law's implementation have jeopardized Americans' health.
As make-or-break January approaches, officials are also working to prevent gaps in coverage for millions of Americans whose individual policies were canceled this fall because they fell short of the law's requirements. In one of a series of last-minute tweaks, the administration in December said even if those individuals don't sign up for new plans, they won't face the penalty the law imposes on Americans who fail to get insurance by March 31.
A key indicator of whether state-run exchanges are keeping pace with the federal exchange will come next month, when the administration releases full December figures. Overall, the goal is to sign up 7 million Americans before the first-year open enrollment period closes at the end of March.
A few states offering their own updates have posted encouraging totals, including New York, where more than 200,000 have enrolled either through the state exchange or through Medicaid, a government program expanded under Obama's health law to cover more people. In California, a tally released Friday showed nearly 430,000 have enrolled through the exchange so far.
"The basic structure of that law is working despite all the problems —despite the website problems, despite the messaging problems," Obama told reporters before departing for Hawaii.
Another major unknown is whether the recent surge in enrollments skewed toward older Americans whose medical needs are expensive to cover, or whether the administration succeeded in recruiting younger and healthier people whose participation is critical to the law's success. Those details for December are expected to be released in mid-January.
Meanwhile, with the website now able to handle higher volumes without crashing or clogging up, the government plans in January to ramp up outreach to consumers to encourage more people to sign up, the administration said.
Sentiment: Strong Buy
OBAMACARE HAD LOTS OF SIGN-UPS ON DEADLINE DAY
BY SARAH KLIFF | December 26, 2013 | The Washington Post
The evidence we have so far — albeit limited — suggests that lots of Obamacare shoppers made it in just under the wire.
California estimates that 27,000 people picked insurance plans this past Monday and 29,000 the Friday prior. Just last week, the state was averaging 15,000 sign-ups per day. Washington State had 10,000 people enroll Monday, and a total of 20,000 from Dec. 20-23. That accounts for one in 10 Washingtonians picking private health insurance plans. And New York had about 20,000 sign-ups come in that same day.
Of course, these are only the three states we know about. The 36 states on HealthCare.gov do not release data on their own schedule but rather rely on the federal government's monthly data sets. We won't know December enrollment numbers until sometime in the middle of January.
Charles Gaba has been going to painstaking efforts to show the trajectory of health law sign-ups over the past three months.
By Gaba's count, we're at 5.75 million sign-ups, between those who have enrolled in private plans and those who have qualified for the Medicaid program. The balance still tips toward public plan enrollments but, as the chart cautions, this is still preliminary data. If we do see a similar December enrollment spike among the federally run state markets, that will be a pretty quick turn-around from October's dismal showing. If not, though, that's going to make the next three months of open enrollment, which runs until March 31, all the more crucial.
Sentiment: Strong Buy