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    Posted: Jul 15 2012 at 12:13pm
As the presidential election grows closer, I am sure that we will hear about the pros and cons of Obamacare until we can recite them in our sleep. Until then, I am curious about the opinions of this forum’s members as they relate to “The Patient Protection and Affordable Care Act (PPACA) aka Obamacare.

To start the discussion, I want to admit the following:

1.     Typically, I am a fiscally conservative person who opposes the federal government’s involvement in anything.
2.     As the GM of a company for 25 years, I have personally witnessed the impact of the cost of healthcare on a typical small business.
3.     I am personally impacted by the legislation because both my wife and I have pre-existing medical conditions.

To start the debate……. I started looking into this topic expecting to “oppose” the legislation but, to be honest; it appears to me that it is much better than status quo. Other than a political point of difference, what is there in this legislation that is wrong for America?

GG
"If you always do what you always did, you'll always get what you always got"
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My thoughts are that Obama care won't matter as much to those that are able to afford to pay for the best doctors but for the rest of us its going wind up like Englands health care eventualy be s.o.s.
 
 
Maybe you could read all 2400 or was it 2500 pages and give us a complete analysis of it Mr. Goose,as most of us including the Congress are unaware whats really in it.
 
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Post Options Post Options   Thanks (0) Thanks(0)   Quote TonyB Quote  Post ReplyReply Direct Link To This Post Posted: Jul 15 2012 at 3:01pm
If you don't know what is in the Affordable Health Care Law, how can you be against it? Is it just because those who oppose it, oppose Obama? In other words, if Obama's for it, I'm against it? Not much logic or reasoning behind that argument.

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Post Options Post Options   Thanks (0) Thanks(0)   Quote squeemy Quote  Post ReplyReply Direct Link To This Post Posted: Jul 16 2012 at 7:58pm

One of the best explanations of the Patient Protection and Affordable Care Act comes courtesy of "CaspianX2" on Reddit. Here's a copy of the beginning:

"What people call "Obamacare" is actually the Patient Protection and Affordable Care Act. However, people were calling it "Obamacare" before everyone even hammered out what it would be. It's a term mostly used by people who don't like the PPACA, and it's become popularized in part because PPACA is a really long and awkward name, even when you turn it into an acronym like that.

Anyway, the PPACA made a bunch of new rules regarding health care, with the purpose of making health care more affordable for everyone. Opponents of the PPACA, on the other hand, feel that the rules it makes take away too many freedoms and force people (both individuals and businesses) to do things they shouldn't have to.

So what does it do? Well, here is everything, in the order of when it goes into effect (because some of it happens later than other parts of it):

(Note: Page numbers listed in citations are the page numbers within the PDF, not the page numbers of the document itself)

Already in effect:

  • It allows the Food and Drug Administration to approve more generic drugs (making for more competition in the market to drive down prices) ( Citation: An entire section of the bill, called Title VII, is devoted to this, starting on page 766 )

  • It increases the rebates on drugs people get through Medicare (so drugs cost less) ( Citation: Page 235, sec. 2501 )

  • It 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. ( Citation: Page 684, sec. 1181 )

  • It makes chain restaurants like McDonalds display how many calories are in all of their foods, so people can have an easier time making choices to eat healthy. ( Citation: Page 518, sec. 4205 )

  • It makes a "high-risk pool" for people with pre-existing conditions. Basically, this is a way to slowly ease into getting rid of "pre-existing conditions" altogether. For now, people who already have health issues that would be considered "pre-existing conditions" can still get insurance, but at different rates than people without them. ( Citation: Page 49, sec. 1101, Page 64, sec. 2704, and Page 65, sec. 2702 )

  • It forbids insurance companies from discriminating based on a disability, or because they were the victim of domestic abuse in the past (yes, insurers really did deny coverage for that) ( Citation: Page 66, sec. 2705 )

  • It renews some old policies, and calls for the appointment of various positions.

  • It creates a new 10% tax on indoor tanning booths. ( Citation: Page 942, sec. 5000B )

  • It says that health insurance companies can no longer tell customers that they won't get any more coverage because they have hit a "lifetime limit". Basically, if someone has paid for health insurance, that company can't tell that person that he's used that insurance too much throughout his life so they won't cover him any more. They can't do this for lifetime spending, and they're limited in how much they can do this for yearly spending. ( Citation: Page 33, sec. 2711 )

  • Kids can continue to be covered by their parents' health insurance until they're 26. ( Citation: Page 34, sec. 2714 )

  • No more "pre-existing conditions" for kids under the age of 19. ( Citation: Page 64, sec. 2704 and Page 76, sec. 1255 )

  • Insurers have less ability to change the amount customers have to pay for their plans. ( Citation: Page 66, sec. 2794 )

  • People in a "Medicare Gap" get a rebate to make up for the extra money they would otherwise have to spend. ( Citation: Page 398, sec. 3301 )

  • Insurers can't just drop customers once they get sick. ( Citation: Page 33, sec. 2712 )

  • Insurers have to tell customers what they're spending money on. (Instead of just "administrative fee", they have to be more specific).

  • 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 they're turned down. ( Citation: Page 42, sec. 2719 )

  • Anti-fraud funding is increased and new ways to stop fraud are created. ( Citation: Page 718, sec. 6402 )

  • Medicare extends to smaller hospitals. ( Citation: Starting on page 363, the entire section "Part II" seems to deal with this )

  • Medicare patients with chronic illnesses must be monitored more thoroughly.

  • Reduces the costs for some companies that handle benefits for the elderly. ( Citation: Page 511, sec. 4202 )

  • A new website is made to give people insurance and health information. (I think this is it: http://www.healthcare.gov/ ). ( Citation: Page 55, sec. 1103 )

  • A credit program is made that will make it easier for business to invest in new ways to treat illness by paying half the cost of the investment. (Note - this program was temporary. It already ended) ( Citation: Page 849, sec. 9023 )

  • A limit is placed on just how much of a percentage of the money an insurer makes can be profit, to make sure they're not price-gouging customers. ( Citation: Page 41, sec. 1101 )

  • A limit is placed on what type of insurance accounts can be used to pay for over-the-counter drugs without a prescription. Basically, your insurer isn't paying for the Aspirin you bought for that hangover. ( Citation: Page 819, sec. 9003 )

  • Employers need to list the benefits they provided to employees on their tax forms. ( Citation: Page 819, sec. 9002 )

  • Any new health plans must provide preventive care (mammograms, colonoscopies, etc.) without requiring any sort of co-pay or charge. ( Citation: Page 33, sec. 2713 )

1/1/2013

  • If you make over $200,000 a year, your taxes go up a tiny bit (0.9%). Edit: To address those who take issue with the word "tiny", a change of 0.9% is relatively tiny. Any look at how taxes have fluctuated over the years will reveal that a change of less than one percent is miniscule, especially when we're talking about people in the top 5% of earners. ( Citation: Page 837, sec. 9015 )

1/1/2014

This is when a lot of the really big changes happen.

  • No more "pre-existing conditions". At all. People will be charged the same regardless of their medical history. ( Citation: Page 64, sec. 2704, Page 65, sec. 2701, and Page 76, sec. 1255 )

  • If you can afford insurance but do not get it, you will be charged a fee. This is the "mandate" that people are talking about. Basically, it's a trade-off for the "pre-existing conditions" bit, saying that since insurers now have to cover you regardless of what you have, you can't just wait to buy insurance until you get sick. Otherwise no one would buy insurance until they needed it. You can opt not to get insurance, but you'll have to pay the fee instead, unless of course you're not buying insurance because you just can't afford it. (Note: On 6/28/12, the Supreme Court ruled that this is Constitutional, as long as it's considered a tax on the uninsured and not a penalty for not buying insurance... nitpicking about wording, mostly, but the long and short of it is, it looks like this is accepted by the courts) ( Citation: Page 164, sec. 5000A, and here is the actual court ruling for those who wish to read it. )

Question: What determines whether or not I can afford the mandate? Will I be forced to pay for insurance I can't afford?

Answer: There are all kinds of checks in place to keep you from getting screwed. Kaiser actually has a webpage with a pretty good rundown on it, if you're worried about it. You can see it here.

Okay, have we got that settled? Okay, moving on...

  • Medicaid can now be used by everyone up to 133% of the poverty line (basically, a lot more poor people can get insurance) ( Citation: Page 198, sec. 2001 ) (Note: The recent court ruling says that states can opt out of this and that the Federal government cannot penalize them by withholding Medicaid funding, but as far as I can tell, nothing is stopping the Federal government from simply just offering incentives to those who do opt to do it, instead)

  • Small businesses get some tax credits for two years. (It looks like this is specifically for businesses with 25 or fewer employees) ( Citation: Page 157, sec. 1421 )

  • Businesses with over 50 employees must offer health insurance to full-time employees, or pay a penalty. ( Citation: Page 174, sec. 4980H )

  • Insurers now can't do annual spending caps. Their customers can get as much health care in a given year as they need. ( Citation: Page 33, sec. 2711 )

  • Limits how high of an annual deductible insurers can charge customers. ( Citation: Page 81, sec. 1302 )

  • Cut some Medicare spending

  • Place a $2500 limit on tax-free spending on FSAs (accounts for medical spending). Basically, people using these accounts now have to pay taxes on any money over $2500 they put into them. ( Citation: Page 820, sec. 9005 )

  • 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. ( Citation: Page 107, sec. 1311 )

  • Congress and Congressional staff will only be offered 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. ( Citation: Page 100, sec. 1312 )

  • A new tax on pharmaceutical companies.

  • A new tax on the purchase of medical devices.

  • A new tax on insurance companies based on their market share. Basically, the more of the market they control, the more they'll get taxed.

  • Raises the bar for how much your medical expenses must cost before you can start deducting them from your taxes (Thanks to Redditor cnash6 for the correction!).

1/1/2015

  • Doctors' pay will be determined by the quality of their care, not how many people they treat. Edit: a_real_MD addresses questions regarding this one in far more detail and with far more expertise than I can offer in this post. If you're looking for a more in-depth explanation of this one (as many of you are), I highly recommend you give his post a read.

1/1/2017

  • If any state can come up with their own plan, one which gives citizens the same level of care at the same price as the PPACA, they can ask the Secretary of Health and Human Resources for permission to do their plan instead of the PPACA. 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). ( Citation: Page 117, sec. 1332 )

2018

  • All health care plans must now cover preventive care (not just the new ones).

  • A new tax on "Cadillac" health care plans (more expensive plans for rich people who want fancier coverage).

2020

  • The elimination of the "Medicare gap"  "
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greygoose View Drop Down
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Post Options Post Options   Thanks (0) Thanks(0)   Quote greygoose Quote  Post ReplyReply Direct Link To This Post Posted: Jul 17 2012 at 12:35am
Squeemy,

Thanks for sharing this summary. It does a great job of explaining the legislation in a simple, easy to understand, format.

GG
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Originally posted by greygoose greygoose wrote:

Squeemy,

Thanks for sharing this summary. It does a great job of explaining the legislation in a simple, easy to understand, format.

GG
Gee, Squeemy and greygoose, I guess that greygoose can thank you for "explaining the legislation in a simple, easy to understand, format," but every time I clicked on one of the citation links you provided all that I found was a bunch of gobbledygook within the thousands of pages of legalese that I would need two or three lawyers to help me understand.
 
If this is a "simple, easy to understand format" then AJ Smith and Anne Mort are Rhodes scholars on the verge of solving cold fusion and David Schiavonne and Lawrence Mulligan are honest politicians with only the people's best interests in mind.
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Post Options Post Options   Thanks (0) Thanks(0)   Quote greygoose Quote  Post ReplyReply Direct Link To This Post Posted: Jul 17 2012 at 10:37am
Richard,

Read my post again Mr. Saunders. I stated that the "summary" was easy to understand. Do you have "anything" to contribute other than an attitude? I happen to support the legislation and I am curious if those that oppose it have any justification other than they oppose "anything" that Obama supports. In short.... is this good legislation or bad legislation? Try to provide some justification to your opinion and try to leave the attitude behind.

GG
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Hermes Quote  Post ReplyReply Direct Link To This Post Posted: Jul 17 2012 at 12:17pm
I see Obama Care as very dangerous.First of all that traitor supreme court justice John Roberts declared Obama Care a tax,what does that mean exactly ? My definition is this,a tax is something everyone has to pay meaning you have no choice so since you have no choice you will be forced to take Obama Care whether you want it or not and what does this mean for employers ? I think you will see employer provided health care vanish.Sooner or later every American will be forced to accept the government version of health care with no options.And since it will be forced upon us and since it's a tax and with government run a muck quality of health care will eventually also vanish which makes this very dangerous.Case in point take a look at health care provided to veterans by the VA.
No more democrats no more republicans,vote Constitution Party !!
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Post Options Post Options   Thanks (0) Thanks(0)   Quote greygoose Quote  Post ReplyReply Direct Link To This Post Posted: Jul 17 2012 at 2:20pm
Hermse,

I assume that you referred to Justice Roberts as a “traitor” because he was appointed by a conservative republican President but ruled in favor of legislation sponsored by a liberal President. Do you truly want our Supreme Court to make rulings based upon party affiliation or political ideology? Wouldn’t you prefer that they make their decisions based on our constitution? I, for one, am sick of seeing votes strictly along party lines (both parties). It tells me that they put their power above the needs of our country and it is shameful.

GG
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Hermes Quote  Post ReplyReply Direct Link To This Post Posted: Jul 18 2012 at 11:05am
greygoose.....I refer to Roberts as a traitor because he agrees with Obama Care and declared it a tax which is wrong.What Roberts did went against the constitution and our basic rights.
As for Bush picking Roberts that is not even true.Roberts is the only supreme court justice to ever be chosen by a non-attorney and was recommended to Bush by Karl Rove.That in itself makes Roberts suspicious in my book.
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Post Options Post Options   Thanks (0) Thanks(0)   Quote greygoose Quote  Post ReplyReply Direct Link To This Post Posted: Jul 18 2012 at 1:12pm
Interesting........

A Constitutional schlolar made a decision contrary to the laws of our Constitution..... Isn't more likely that this adhered to the Constitution but it was contrary to what you wanted? This is what I am trying too determine. What is the "real" reason that some folks oppose this legislation. What is in it that they don't like or think is bad for our country? I'm looking for specifics. An answer like "it goes against the Constitution" says to me that you really don't have a good reason to oppose it.

Also... I didn't know that Karl Rove had the power to appoint a Supreme Court nominee. I guess that I had better brush up on my civic lessons.
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Bocephus Quote  Post ReplyReply Direct Link To This Post Posted: Jul 18 2012 at 5:04pm

heres a link that tells some negative side affects

 
 
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Post Options Post Options   Thanks (0) Thanks(0)   Quote TudorBrown Quote  Post ReplyReply Direct Link To This Post Posted: Jul 18 2012 at 9:23pm
egardless of my own political leanings, I take exception to this ruling because it amounts to a legal comedy of contradictions and blatant fallacies that cannot be reconciled with reality. And by blatant fallacies, I don't mean matters of opinion. Demonstrable, actual, factual fraud has been perpetrated upon the American people.

I read the 180+ page decision. In addition, I also read and re-read the Roberts opinion and the 70+ page dissent twice. Had this law been upheld on sound legal ground through the legitimate application of the constitution, then I would come to accept the result. However, this is simply not the case—and no argument can be made to the contrary. Unfortunately, winning trumps the truth every single time (especially in politics and law).

I'm not going to delve into the legalese too much, but in simple terms there are three glaringly obvious misstatements of fact  which ultimately preserved the individual mandate of the ACA (The affordable care act) as a constitutionally permissible tax.

(1)   On the first day of oral arguments, solicitor general Verrilli argued that the individual mandate was not a tax. On day two, he argued that it was a tax. When Justice Alito questioned Verrilli as to whether the Supreme Court had ever ruled that an aspect of legislation is a tax for one purpose while simultaneously not being a tax for another, Verrilli answered in the negative.  Yet, that is the crux of the Roberts opinion. On page 15 of the Roberts opinion he plainly states that the individual mandate is not a tax while on page 35 he opines the EXACT opposite. Throw in the following facts: Obama has repeated ad nauseum that the individual mandate is not a tax, the Federal Government argued in more than one of the district court cases which led to the SC showdown that the bill was not a tax and that the bill was RENAMED and restructured prior to its passage to purposely remove the tax label in an unsuccessful effort to shield Congressional Democrats from the 2010 midterm onslaught.

(2)   Even the liberal justices on the court DISSENT from Robert’s mindless theory that the individual mandate is a tax.

(3)   By legal definition and the plain statutory language of the ACA, the individual mandate is penalty and NOT a tax.  Page 18 of the dissenting opinion says in relevant portion: “In a few cases, this court has held that a “tax” imposed upon private conduct was so onerous as to be in effect a penalty.  But we have never held—never-- that a penalty imposed for violation of the law was so trivial as to be in effect a tax. We have never held that any exaction imposed for violation of the law is an exercise of Congress’ taxing power—even when the statute calls it a tax, much less when (as here) the statute repeatedly calls it a penalty.”

I can go on and on—but the bottom line here is that this decision was upheld on an invalid and utterly dishonest legal premise.
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Post Options Post Options   Thanks (0) Thanks(0)   Quote greygoose Quote  Post ReplyReply Direct Link To This Post Posted: Jul 18 2012 at 10:29pm
Tudor,

Thank you for this insight...... its the first that I've heard of it. Do you find it surprising that this ruling came from what most would consider a conserative justice? Do you think that there is any possibility that he may have written his opinion in a way that would enhance repeal efforts after the election (should the repubs win)? It amazes me that a justice in the highest court in the land can view the same mandate differently based strictly on its "purpose". I shouldn't be surprised but I am. Thanks again.

GG
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Hermes Quote  Post ReplyReply Direct Link To This Post Posted: Jul 19 2012 at 4:00am
Originally posted by greygoose greygoose wrote:

Interesting........

A Constitutional schlolar made a decision contrary to the laws of our Constitution..... Isn't more likely that this adhered to the Constitution but it was contrary to what you wanted? This is what I am trying too determine. What is the "real" reason that some folks oppose this legislation. What is in it that they don't like or think is bad for our country? I'm looking for specifics. An answer like "it goes against the Constitution" says to me that you really don't have a good reason to oppose it.

Also... I didn't know that Karl Rove had the power to appoint a Supreme Court nominee. I guess that I had better brush up on my civic lessons.
 
 
Roberts a constitutional scholar ? I seriously doubt that.You say your looking for specifics,using the phrase "against the constitution" is no doubt a generalization and it is appropriate as no one has the time to list all the reason's and the amendment's that are violated.Were the founders also constitutional scholars when they wrote it ? Not in any sense.You maybe one of many who think you can only be ruled by an education,but an education is nothing more than someone else's understanding of the subject taught.Where is your common sense ?
 
Your line that you didn't know Rove could appoint a justice is your way of trying to make me look ignorant but doesn't work anyway,even a 2nd grader would know that.Your reading comprehension is slightly lacking,I said Rove "recommended" Roberts to Bush.And your right,brush up on your civics.
No more democrats no more republicans,vote Constitution Party !!
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Post Options Post Options   Thanks (0) Thanks(0)   Quote TonyB Quote  Post ReplyReply Direct Link To This Post Posted: Jul 19 2012 at 9:32am
You all seem to think that Justice Roberts is some kind of moron. He is not. He made this decision for political and not constitutional considerations. This gives Republicans something to run against; his labeling the individual mandate a "tax" provides ammo to the "tax and spend" mantra. If he had struck the law down, it would have energized the Democratic and progressives to elect Obama and Democrats to Congress for the purpose of having single payer health care. Now, Obama and the Democrats have to defend the law. This is one of the most politicized Supreme Courts in modern history and this is just another example of that.

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Post Options Post Options   Thanks (0) Thanks(0)   Quote Pacman Quote  Post ReplyReply Direct Link To This Post Posted: Jul 21 2012 at 9:45pm
It is always nice to hear all the good stuff, much which could have been done using other methods. 

1. tort reform
2. allowing insurance company's to sell across state lines to create larger pools
3. Allow small firms to create groups large enough to gain favorable prices and benefits
4. not take half billion dollars out medicare
5. rather than state "you can keep your doctor if you like your doctor" as Obama has done, He should have stated that "If you like your isurance you have now, you can keep you insurance". 

Instead many company's will drop their health insurance for their employees forcing millions into the government run program.  With the Employee paying the insurance premium out-of-pocket.  Someone explain to be why a company with 10's of 1000's of employees would pay the high cost of insurance when they could get by with just pay a $2000 fine per employee.

6. Company that border on the 50 or more employees would simply not hire and keep their employees under 50 or find another way around it by starting a 2nd company.

Personally, Nancy Pelosi's comment "that we must pass this bill to see what is in it..." did it in for me.  One of the most ridiculous comments in American history.

There is more but being blind makes it difficult for me to do research.  Besides, come January 2013, I'm going on MedicareLOL

PacmanCool
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Post Options Post Options   Thanks (0) Thanks(0)   Quote 409 Quote  Post ReplyReply Direct Link To This Post Posted: Jul 21 2012 at 11:13pm

I understand.........?

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