Affordable Care Act Reconciliation Elimination of Unintended Healthreform

This question violently misjudges the costs and benefits for Quora and the President.As far as I can tell, the Barack Obama account has not violated any of the policies or terms of services that apply to anyone else who signs up. So for the most part, the President could have done this without any assistance from Quora at all. Quora's only real contribution was designing adding a pretty blue check-mark to his name to indicate that it is really him.In exchange, Quora gets The President of the United States to use its product, at least for a few days, with all the extra media coverage that comes with that.The President and his advisors, on the other hand, had to think through every conceivable ramification of using a new tool to communicate with constituents, develop a strategy, write the answers, etc. etc.In exchange, they signNow Quora's relatively small user base, many of whom they were likely already signNowing through Facebook, etc.It's neat that he felt this was worth his time, but if you want to make something sinister of it, ask instead how much Quora is paying him.

Let me clarify your question. The ACA is federal law, and a federal law cannot simply be opted out of by states. What the Act specified was some tasty incentives to states for expanding Medicaid, and a big stick - denying existing federal matching Medicaid funds to states who refused the expansion.At the time, it was assumed that states could not pass up free federal money, and they sure couldn't afford to replace existing funding, so this was a way to ensure states aligned their Medicaid rules to the Act. One example is expanding coverage to include childless adults. The SCOTUS ruled (Kaiser family foundation briefing here: http://kaiserfamilyfoundation.fi... ) that states couldn't be forced to accept the expansion - they were free to keep things the way they were before the Act and keep getting their money. This allowed red states to avoid expansion of Medicaid and still keep the existing money flowing.From where I sit, this position is entirely political. Most folks who oppose the Medicaid expansion in their state say they want to avoid a larger government spending increase. But remember the ACA is budget-neutral; it's already paid for, mostly with provider offsets and a variety of taxes such as  a medical device tax. Plus the federal government pays 100% of the expansion cost for a few years, when it goes to 90%. That small state burden is more than offset by the economic benefit to hospitals, doctors, pharmacies, and so on.Some states with Republican Governors (example: Iowa, Pennsylvania) (edit: clarified that these states are not truly "red states" but do have Republican governors driving ACA policy in their state) are expanding Medicaid with 1115 waiver programs that allow them to perform the expansion with some accommodations, for example requiring recipients to pursue healthy behaviors or pay a small monthly fee for coverage. This lets them get the money and still show their supporters that they are spending the money responsibly.

Many Americans had better insurance before the ACA than they have now. I am no longer subject to it, but I had insurance-as-a-benefit through an employer and went through several intense years with a covered family member in a severe health crisis. The deductible was low enough and the cap high enough that we saw a half a million dollar set of medical bills get picked up and paid. If I were in the same state covered by the ACA the deductibles would be much higher. Out of pocket expenses would be greater. It would be devastating. I would not have worked for us. But employers are always looking for a way to pay less out, and one way they historically have done it has been to cut expenses for health insurance. Refusing to cover preexisting conditions was standard. As a result, people like us were able to have a group policy the company could support. Now, with the new rules, they cannot. So to get those pesky preexistings covered, everybody got less coverage, because the company still spent the same amount for coverage as before.I had a friend who was always low income. He and his wife were getting up in years, and he worked as a security guard. He had a heart attack. The ER bill was staggering and there was no insurance for him. We helped negotiate the available resources. We found some state aid, we found some charitable hardship case funds in the home town, and we negotiated a settlement with the hospital. One reason why hospitalization was so unavailable to the poor before had nothing to do with government mandates. It was because people who had insurance had insurance companies that negotiated special rates with “in-network providers.” In one case a hospital charged the insurance company only $92,000 for a $240,000 surgery. An uninsured person did not get the special rate. We were successful covering our poorer friend, and he recovered and went back to work. These are things we did that rarely are reported in the news. The media seems to think that we all sucked before Obama saved us. No, we got by. Even the poor often got by better. In fact, the ACA encourages people with health problems to stay on welfare and below the poverty line to get the government handout. More crazy socialism trapping people in untoward circumstances. I know Obama’s goal was to move toward a single payer system, and he was willing to totally break the system and rebuild it from the ground up.This debate is full of lies on both sides. I am telling it as it was, and now is. It was imperfect before, it is worse now, and what the Republicans will do next will not be a finished product. We have to have a revolution in this area where we do not fight each other, but instead we fight the problem. We need an American system. not a Democrat or Republican system. We need the door to be open to health care regardless of ability to pay. We need it accessible, affordable and smart.My own idea isBasic GP service: Medical card. All employers and wage earners contribute through taxes and everyone can see any doctor that will have them.Specialists would be partially covered. A person could buy health insurance for the extras (its time we tell the insurance companies that they can no longer take so much of the health dollar and put it toward their bottom line. They have as close to a Trust where a few companies divide up the pie in each area, and companies or individuals just shell out.Catastrophic health care can be covered in a couple of ways. For the truly impoverished, we take care of them. For those able to afford it, they can buy the best extra insurance they can afford, and the system takes care of the rest. Some assets tests can keep it fair.Get the monkey off of businesses to provide health insurance. They offered it long ago voluntarily to attract much needed workers to the mines and factories, offices and businesses. Now we have taken what was voluntarily offered to cover something the government was not touching and turned it into a forced mandate that strangles the very life out of small business and startups, and inspires companies like Walmart to hold people to 28 hour weeks with no benefits at all, and lower than the hourly wage paid to full time workers, just to control costs. How many businesses, usually union shops, has Walmart’s agressive practices closed down all over America. Good paying jobs were sacrificed on the altar of low prices, but these displaced workers can take the pittance Walmart offers or stay home and starve. What a country! Where everyone will cut everyone else’s throat if they can save a buck on a bottle of dish soap.If all companies could compete on a level playing field without having to pay out staggering health insurance invoices, these abuses would stop favoring those who have driven out competitors with predatory practices.If we do it right, we do not trap people in poverty. We give all but the most idle people hope to improve their lives, drive better cars, live in better homes, and actually learn how to save and invest and start sending their offspring to universities and break the back of ever-expanding poverty in the homeland.

Edit: I tried to answer this question at first on my phone and didn't get down to the details of your question. First of all, let me say that I'm sorry to hear about your son's medical problem and I wish him and you all the best.My concern for you is to find out if your son's doctors and hospital are a part of the medical network you can purchase through the exchange. If so, you may find that the premium is reasonable but the deductible is much higher. That may be okay. If not, your out of network costs may be unaffordable.If that is a problem, you might consider finding or changing jobs where you could get your insurance through an employer. Those plans tend to have a choice of several plans with broader networks of doctors and hospitals. The deductible should be much less and you will have some out of network coverage. This may  be important if your son needs to go to a specialty center that's outside your geographic area like Children's Hospital Los Angeles. Good luck.As to why this is happening?The hundreds of thousands of cancellations including 300,000 from Florida Blue and 160,000 in Kaiser California are being terminated as required by law.The ACA requires a comprehensive coverage for everyone that includes things like maternity care (even if you are a 50 year old woman who has had a hysterectomy, or a 35 year old mother of 3 who's husband has had a vasectomy). Thousands Of Consumers Get Insurance Cancellation Notices Due To Health Law Changes

According to a February 7, 2017 New York Times article by Kyle Dropp and Brendan Nyhan:A sizable minority of Americans don’t understand that Obamacare is just another name for the Affordable Care Act.This finding, from a poll by Morning Consult, illustrates the extent of public confusion over a health law that President Trump and Republicans in Congress hope to repeal.In the survey, 35 percent of respondents said either they thought Obamacare and the Affordable Care Act were different policies (17 percent) or didn’t know if they were the same or different (18 percent).One-Third Don’t Know Obamacare and Affordable Care Act Are the SameSo… 35% at that point. Amazing, isn’t it?The article goes on to say that 45% either didn’t know that repealing Obamacare would repeal the Affordable Care Act or were sure that it wouldn’t.

Per the original wording of the Q:There never were "death panels" as a result of Romney Care.* Ergo, there are precisely zero (0.00) "Citizens killed by Obama Care Death Panels."*Details Matter: So named, accurately, because the State he was governor of passed it, he vetoed 8 sections of it (notably, one was the Public Option), then the Legislature and the Citizens rose up to ram it all down his throat. It wasn't until the campaign that he started lying to claim it as "his" "accomplishment."Any way... the PPACA, as badly and loudly as it sucks because corporate bribers had the Public Option removed (very quietly), the Law specifically prohibits denial of care to the aged and those with pre- existing conditions. Sadly, insurance companies kill people via denial of service daily and weekly anyway.So, where did this meme about the PPACA come from? Answer: Follow the money and look to the classic Republican Party Brass "debate" manual.Rule 1: If you're afraid your opponent is going to slam you with something you actually did, blame them for it or accuse them of doing it. This time they chose the latter. So, Ms. Palin, in her typical, spectacularly unrestricted by Fact, style spouts off and...Viola! *waves hands vehemently in air* *Poof!* I give you... "Obama Care" death panels. *crowd applauds*Now, if We want to find out who and where the real Death Panels actually are, all We have to do is follow the money; and ask very loudly "Who F'ing Profits From This?!"Be careful what you ask for, here's the answer: The REAL Death Panels are found in the mafia style US Health "Insurance" Corporations which bribe our Congresscritters. (Remember that Rule 1 from the Republican "Debate" Manual?)Like this:http://mediamatters.org/research...Twelve-Year-Old Died In 2007 From Abscessed Tooth After His Family's Medicaid Lapsed. In 2007, as The Washington Post reported:Deamonte Driver, a 12-year-old homeless child, died Sunday in a District hospital after an infection from a molar spread to his brain.At the time he fell ill, his family's Medicaid coverage had lapsed. Even on the state plan, his mother said, the children lacked regular dental care and she had great difficulty finding a dentist. [The Washington Post, 3/3/07]Seventeen-Year-Old's Insurance Revoked After He Tests HIV Positive. According to Huffington Post, in 2009:The South Carolina Supreme Court has ordered an insurance company to pay $10 million for wrongly revoking the insurance policy of a 17-year-old college student after he tested positive for HIV. The court called the 2002 decision by the insurance company "reprehensible."[...]Mitchell learned that he had HIV when, while heading to college, he donated blood. Fortis then rescinded his coverage, citing what turned out to be an erroneous note from a nurse in his medical records that indicated that he might have been diagnosed prior to his obtaining his insurance policy.Before the cancellation of the policy, an underwriter working for Fortis wrote to a committee considering whether or not to rescind his policy: "Technically, we do not have the results of the HIV tests. This is the only entry in the medical records regarding HIV status. Is it sufficient?" The underwriter's concerns were ignored and the rescission went forward. [Huffington Post, 9/17/09]Woman Denied Coverage For Breast Cancer Because She Wasn't Diagnosed At Correct Clinic. From The Wall Street Journal: In June 2003, Shirley Loewe went to Good Shepherd Medical Center here with a softball-size lump in her breast and was diagnosed with a rare form of breast cancer. She didn't know it, but she had just made a big mistake.Ms. Loewe was uninsured. Under federal law, she could have gotten Medicaid coverage -- and saved herself a lot of hardship -- if she'd gone to a different clinic less than a half-mile away. But by walking through Good Shepherd's doors, Ms. Loewe unwittingly let that opportunity slip and embarked on a four-year journey through the Byzantine U.S. health-care system.It was an odyssey that would take her to five hospitals, two clinics, two charitable organizations and two nursing homes in two states. She was denied assistance or care at least six times along the way, for reasons that ranged from not being poor enough to not being sick enough.Ms. Loewe eventually got treatment, but at personal cost and great aggravation. [The Wall Street Journal, 9/13/07]Woman's Double Mastectomy Denied Over Disputed Acne Treatment. CNN reported that in 2009:Robin Beaton found out last June she had an aggressive form of breast cancer and needed surgery -- immediately.Her insurance carrier precertified her for a double mastectomy and hospital stay. But three days before the operation, the insurance company called and told her they had red-flagged her chart and she would not be able to have her surgery.The reason? In May 2008, Beaton had visited a dermatologist for acne. A word written on her chart was interpreted to mean precancerous, so the insurance company decided to launch an investigation into her medical history.Beaton's dermatologist begged her insurance provider to go ahead with the surgery.[...]Still, the insurance carrier decided to rescind her coverage. The company said it had reviewed her medical records and found out that she had misinformed them about some of her medical history.Beaton had listed her weight incorrectly. She also didn't disclose medication she had taken for a pre-existing heart condition -- medicine she wasn't taking when she originally applied for coverage. [CNN, 6/16/09]9/11 Responders Without Insurance Face Inferior Coverage For Sustained Injuries. From The New York Times:The largest health study yet of the thousands of workers who labored at ground zero shows that the impact of the rescue and recovery effort on their health has been more widespread and persistent than previously thought, and is likely to linger far into the future.The study, released yesterday by doctors at Mount Sinai Medical Center, is expected to erase any lingering doubts about the connection between dust from the trade center and numerous diseases that the workers have reported suffering. It is also expected to increase pressure on the federal government to provide health care for sick workers who do not have health insurance.[...]There should no longer be any doubt about the health effects of the World Trade Center disaster," said Dr. Robin Herbert, co-director of Mount Sinai's World Trade Center Worker and Volunteer Medical Screening Program. "Our patients are sick, and they will need ongoing care for the rest of their lives."Dr. Herbert called the findings, which will be published tomorrow in Environmental Health Perspectives, the journal of the National Institute of Environmental Health Sciences, "very worrisome," especially because 40 percent of those who went to Mount Sinai for medical screening did not have health insurance, and will thus not get proper medical care. [The New York Times, 9/6/06] Thousands Of Americans Have Been Denied Health Coverage And CareTwenty-Five Percent Of Adults Under 65 Say They Or A Family Member Have Been Denied Coverage Or Charged More For Having Pre-existing Condition. According to a June 2013 survey from the Kaiser Foundation, one quarter of respondents under 65 "say that they or a family member has ever been denied insurance or had their premium increased because of their pre-existing condition":Americans with pre-existing medical conditions often face problems in getting and retaining good health insurance coverage, an issue dealt with directly by ACA in its "guaranteed issue" provision, which prohibits insurance companies from denying coverage to individuals on the basis of health status or pre-existing medical conditions beginning in 2014. The June survey finds that roughly half (49 percent) of adults under age 65 say they or someone in their household has a pre-existing condition, and many of them report problems related to getting and keeping insurance.One quarter (25 percent) of these individuals (14 percent of all non-elderly adults) say that they or a family member has ever been denied insurance or had their premium increased because of their pre-existing condition. Further, nearly one in ten (9 percent) of these individuals say that in the past year, they or someone in their household has passed up a job opportunity, stayed at a job they would have quit otherwise, or decided not to retire in order to maintain their health coverage. [Kaiser Foundation, 6/19/13]Forty-Five Thousand Americans Die Every Year Due To Lack Of Insurance. In September 2009, a Harvard Medical School study found that a "lack of coverage can be tied to about 45,000 deaths a year in the United States," The New York Times reported. The paper explained:Researchers from Harvard Medical School say the lack of coverage can be tied to about 45,000 deaths a year in the United States -- a toll that is greater than the number of people who die each year from kidney disease.[...]The Harvard study found that people without health insurance had a 40 percent higher risk of death than those with private health insurance -- as a result of being unable to obtain necessary medical care. The risk appears to have increased since 1993, when a similar study found the risk of death was 25 percent greater for the uninsured.The increase in risk, according to the study, is likely to be a result of at least two factors. One is the greater difficulty the uninsured have today in finding care, as public hospitals have closed or cut back on services. The other is improvements in medical care for insured people with treatable chronic conditions like high blood pressure. [The New York Times, 9/17/09]Study Found That In 2010, Three Americans Died Every Hour From Lack Of Coverage.  According to a June 2012 report from Families USA, "Across the nation, 26,100 people between the ages of 25 and 64 died prematurely due to a lack of health coverage in 2010," which works out to "three every hour." The report also found: Between 2005 and 2010, the number of people who died prematurely each year due to a lack of health coverage rose from 20,350 to 26,100.Between 2005 and 2010, the total number of people who died prematurely due to a lack of health coverage was 134,120.Each and every state sees residents die prematurely due to a lack of health insurance. [Families USA, June 2012]Over 7.5 Million People Denied Medical Care By Health Plans In First Six Months Of Bush's First Term.  According to data from the Census Bureau and a report from the Henry J. Kaiser Family Foundation analyzed by Families USA, "[M]ore than 7.5 million people experienced a problem with their health plan that resulted in a denial or delay of health care" in the month from President George W. Bush's inauguration to June 2001. Families USA wrote:[A]pproximately 18.1 million Americans per year between 18 and 64 years of age experience a problem with their health plan that results in a denial or delay of medical care. [Families USA, 6/21/01]These greedy bastards are the real Death Panels. These are also the same greedy bastards who also murdered the Public Option in its birth (three times now) so that US Citizens wouldn't have the choice to opt out of their rigged Mafia style corporate fascist games... and I guarantee that I damned well would have opted in to that public option in a heartbeat.

The Republican Plans are effectively non-existent. They want to repeal health insurance for people who have it now but some of them like the ban on pre-existing condition denials of coverage. This is morally reprehensible.Clinton's plan is vague but I think it is in general the right way of thinking. There are many things wrong with the ACA, in particular the high deductible plans that don't cover anything other than catastrophic issues, which in reality should be the Government's responsibility but the Democrats in Congress shot it down. The lack of Medicare being able to negotiate drug prices (the VA can).Rising insurance costs (some people's premiums went up a lot)Health savings accounts shouldn't have to exist. All health expenditures should be tax deductible New plans caused some people to lose their doctorsEtcAnd Clinton's plan is to fix these things. Doctors don't like the ACA because it is resulting in DRAMATIC reimbursement reductions for our services. One treatment I do got cut 66% THIS YEAR. A few types of sight saving/restoring surgeries I do got reduced 20-30% (some of which takes hours and require extensive follow up within the 90 day window that is included in these payments). That really sucks for me and will probably cost me around $50,000 this year (before taxes), which is a lot of money to me because my dad can't just "give me a small loan of $1 million." So ultimately it means we will hire 1 less person in our practice. But all that being said, I Ike the ACA. I think people should not be prevented from having health insurance because of a pre-existing condition and I think MedCaid needed expansion. The Sanders plan is Medicare for all. What he doesn't seem to understand is that it will quickly turn into Medcaid for all. It will not make the private insurance market disappear (just like it didn't in the UK), so many people's costs will go up because they will be paying taxes for the new system but will demand that their work provide private insurance which will allow them to see their doctor. It will make basically all doctors who don't work for the government drop Medicare, because they will be reimbursed less than their costs. The government will have to spend a Trillion dollars building new hospitals and buying medical real estate to provide doctors for all of the patients. The British have this system and their doctors are striking. Basically doctors can't get a steady job for 10 years after residency and get forced to work slave labor until a government job opens up. Also the Republican house and Senate will never agree to this. They will scrap the ACA and not replace it. It's funny because Sanders claims to be a democratic socialist like Europe but they don't all have a single payer system. Some have a universal insurance system like we do under the ACA, but I think most have a public option, which we should as well.

Yes. Under the Affordable Care Act you will be able to opt out of your employer's coverage and enroll in a plan through your State's Exchange. The law can actually penalize the employer if you decide to do this, as a means of discouraging employers from offering 'bad' insurance. Below is a summary of the section of the law that answers your question:Summary of Section 1513 of the Affordable Care Act: ObamaCare: Penalties on Employers Failing to Offer Coverage (Post 33)

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