Jun 28, 2012 09:45 AM kayb wrote:
Good day indeed! Moving forward, health care reform can be refined. This step was critical to allowing the changes to begin.
Posted on: Jun 28, 2012 09:28 AM
This is a good day for Americans, and especially we cancer patients! Now hopefully there will be no more heartwrenching tales of woe, from sisters and brothers with this devastating disease who can't afford their treatments. Thank you Justice Roberts! Without his yea vote the ACA would have gone down.
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Jun 28, 2012 09:45 AM kayb wrote:
Good day indeed! Moving forward, health care reform can be refined. This step was critical to allowing the changes to begin.
Jun 28, 2012 09:48 AM yorkiemom wrote:
Kayb, yes indeed. The act needs a lot of tweaking, but we had to start somewhere.
Jun 28, 2012 09:49 AM 1openheart wrote:
Like! My husband and I both have pre existing conditions and we are self employed. No insurance company would write us a policy, not even a major medical with us paying for the day to day things.
Yes, this law is not perfect, but it is a start.
Jun 28, 2012 10:01 AM peggy_j wrote:
You know you're a cancer patient when reading news like this makes you weep with relief. (seriously, tears are streaming down my face as I write it.) I was 46 at the time of my Dx and while my DH's company has fantastic health insurance coverage, knowing that I now had a serious pre-existing condition made me worried that I could one day be without. I never thought John Roberts would be the one to help me. Thank god! Really. (agreed, it's not perfect but a big step forward in the right direction).
Jun 28, 2012 12:30 PM Jules59 wrote:
Many republicans in congress, as well as Mitt Romney vow to pass legislation to do away with the ACA. Here's hoping they don't succeed.
Jun 28, 2012 12:39 PM yorkiemom wrote:I don't think they will. They're just bloviating to rile up their base!
Jun 28, 2012 02:08 PM Chickadee wrote:
That's why we should never let one party control both house and the presidency. The more they gridlock, the less damage they do. Until they can learn to work together for the country and not their own greedy benefactors, gridlock it is.
Jun 28, 2012 02:17 PM 3monstmama wrote:
I think I would have been happy-happy today even if I weren't a cancer patient but as a cancer patient, as a woman who did "everything" right, I am so much happier.
No one goes into life thinking they will get cancer (or any other major illness) and yet so many get whacked with the cancer stick and find themselves dealing with insurance and financial issues in ways that keep them from focusing on their cancer and getting well. Then there's that whole preexisting condition thing and what to do about your young adult children who don't have insurance.
As for those claiming its a "bad law," I'll listen to their views as soon as I see the signed sworn statements of each giving up their own federal insurance.
Jun 28, 2012 02:31 PM bevin wrote:
I am not sure this is good news. They upheld it as a tax. So it will be one more tax we all have to pay. I'm not sure this will make me happy.
Jun 28, 2012 02:46 PM, edited Jun 28, 2012 02:46 PM by CindylIt's only a tax you have to pay if you choose not to carry insurance. So if you are covered by your employers plan, or can join a high risk pool you don't pay the tax. (which I understand is 1% of your income) So if you make 50,000 a year and choose not to carry insurance you will be taxed $500. I think that is not unfair at all. The folks who choose to gamble and go without insurance frequently end up costing the system money when they end up in the ER. But this plan should assure that there are affordable options for those of us who have lost/never had insurance.
Jun 28, 2012 03:06 PM 1Athena1 wrote:
Today is a great day that finally brings our country into the club of truly civilized nations which regard healthcare as a fundamental right. IMO, the fact that SCOTUS labels it a tax sort of reaffirms healthcare's position as a cornerstone of our society, like roads, bridges and schools. And that is exactly where it belongs. Millions of American will feel more security, and far fewer people will have to make the choice between food and medicine.
Proud to be a member of a truly developed nation.
And now for some frivolity: Give a hand to Linda Greenhouse, NYT columnist, who observed Roberts's deference for federal power and fully predicted today's decision in today's paper....and give a thumbs down to Fixed Noise and Cretin News Network, both of whom got the news wrong for the first few minutes and reported that the law had been struck down because the court rejected the government's central argument defending the mandate under the Commerce Clause. See here: tpmdc.talkingpointsmemo.com/20...
Jun 28, 2012 03:11 PM 1Athena1 wrote:
bevin: the health care law doesn't change one iota based on how SCOTUS upheld it - although the SCOTUS arguments could affect other legal rulings on other issues. I am actually glad the court rejected the Commerce Clause argument - I always found it to be a flimsy one.
Jun 28, 2012 03:41 PM, edited Jun 28, 2012 04:01 PM by kayb
Jun 28, 2012 04:03 PM Chris13 wrote:
I also heard a commentator say that the "tax" is unenforcable, ie the IRS is prohibited from garnishing wages, etc. to collect it, as they can do for other tax deadbeats (or those who sadly are in such terrible financial shape they skip paying taxes to buy food.)
Now that we all have a pre-existing condition, as least we know (after 2014) we cannot be denied coverage. And oh, how insurance companies love to deny coverage.
Jun 28, 2012 04:19 PM yorkiemom wrote:
Lol! Reminds me of that famous picture of Truman who, after winning the presidency, held up a newspaper with the headline "Dewey Defeats Truman." That paper was of course prematurely released. The editor was a die hard Dewey supporter.
Jun 28, 2012 04:29 PM DucorpsToo wrote:I'm also happy about nixing the pre-existing condition clauses as well as the lifetime caps on insurance. The ACA is a very good first start. However I'm somewhat concerned about the ACA financing. Theoretically, if everyone "chips into the pool" so to speak, then healthcare costs should be lower. But as it stands, who's to say that the insurance companies won't jack up the prices -and still make the premiums unaffordable? In an event like this, we "technically" cannot be denied coverage due to a pre-existing condition, yet we still wouldn't be able to afford premium. Are there any provisions in the ACA that regulate how much these companies can charge?
Jun 28, 2012 04:41 PM yorkiemom wrote:
DucorpsToo, I just read that under ACA insurance companies cannot raise rates on JUST people with pre-existing conditions. However, they can raise rates in general. Of course they already can do that. It's a big improvement that they can't just screw the sick anymore.
Jun 28, 2012 04:48 PM DucorpsToo wrote:
So if they can raise rates on the general poplace, just as they're doing currently, then that certainly doesn't ensure that such rates would be affordable to the general population. As we well know, there are plenty of folks out there with no pre-existing condition that cannot afford the rates that these companies are charging. That's why I think that another major tweak to the ACA should be some sort of regulation to these companies. I remember a couple of years ago that Anthem Blue Cross (here in California) had hiked up rates as much as 30%! -however they were "called on the carpet" for that move...
Jun 28, 2012 04:53 PM yorkiemom wrote:
I don't know if this is relevant, but under ACA insurance companies are required to apply 80% of premiums to medical care only. 20% goes to administrative costs and profits. If they don't spend all of the 80% they must issue refunds to their policy holders. That money cannot be pocketed by the companies.
Jun 28, 2012 05:08 PM Trisha-Anne wrote:
Hope you ladies don't mind an Aussie chiming in here.
Our health system is based on tax. We all pay 1.5% of our income towards Medicare. That comes out of our paypacket along with our income tax. This entitles all Australians to go to a hospital and be treated, tested, operated on etc at no personal cost at all.
We can also pay for private health insurance, and if we earn over a certain amount and don't have private health insurance we are taxed at a higher rate because of it. The Australian Government also pays a subsidy of 30% of the cost of the private health insurance. The private health insurance means that we can choose our own doctor and go into a private hospital to shorten waiting times in the public system. I pay private insurance and for a couple it is around $190 per month. I don't pay for "extras" insurance that covers dentists, glasses or chiropractors etc. No private insurer can charge you more for insurance with pre-existing conditions - there may be a waiting period of up to a year though (for new joiners) where they aren't covered for a pre-existing condition. But everyone gets charged the same amount.
I used a private hospital for my mx and my port placement and deporting (lol) and my health insurance paid all the hospital accommodation costs. Doctor's bills rebates are a bit more difficult to explain, but there was still some out of pocket costs - and it depends on the doctor you choose and how much they charge as to how much out of pocket you are. But Medicare and the health insurer pay some of their costs.
I use the public system for my oncology visits and scans etc. They cost me nothing at all - everything is covered by Medicare. So MUGA scans, mamograms, u/s, brain scans etc are all free for me.
It's a great system - it does have it's flaws, all systems do - but no-one is denied good quality care. Women who can't afford health insurance (because they don't have a high enough income) can get a mx, and pretty much all the treatment and scans they need without paying a cent.
I hope you ladies benefit from the changes in your health system - it's worked so well for many countries, and cancer patients will be the big winners I hope.
Jun 28, 2012 06:06 PM o2bhealthy wrote:
I just hope we can afford the rates...yeah, they cannot deny us coverage, but there is currently no cap to what they can charge for the coverage...
Jun 28, 2012 07:11 PM, edited Jun 28, 2012 07:11 PM by bevin
Well, all I know is nothing is free, so all those coverages and payments for them will need to come from somewhere; our government will tax us to pay for it. Well, I geuss they will tax those of us who work. Those who don't work, since they pay no tax, and since the IRS (as stated above) cant enforce it, those people I assume will get free health care; paid for by the taxes of those who do work.
Ugh, so not on board yet. I agree the commerce clause was wrong and I'm glad that wasn't allowed to be used as the bases for law.
Jun 28, 2012 08:31 PM CLC wrote:
It is very rare that I feel proud of the decisions made by our government. Today, I feel proud. The ACA is not ideal. It is not the plan I wanted at all, but it is finally a real attempt to get decent health care for all Americans, even those who are poor. It is unconscionable that poor families don't get decent preventative care. It is even just plain old stupid, because we have all been paying for the follow up care that results from the failure to prevent. It is about time that we all carry the responsibility for the welfare of all our fellow human beings. It is just the right thing to do.
Jun 28, 2012 11:56 PM kayb wrote:
Bevin - people who don't have insurance now still get health care of some sort through emergency rooms. It's been said many times that each of us who has insurance pays an extra $1000.00 a year to cover their care. The whole point of requiring a mandate is to shift that burden to a larger group - thus LOWERING the costs overall. It's also the mandate that broadens the market so that people with pre-existing conditions can buy insurance at the same price as everyone else. Really - its all good.
Also - insurance companies will have to provide justification for any premium increases over 10%. In the past two years many companies have jacked prices 25% or more each year to beat the deadline for this clause. The great news of the AHA is that these things will be regulated so that insurance companies won't have the freedom to screw us like that in the future. By insuring thatat least 80 cents of every dollar must go for your care, insurance company CEOs (like the guy who ran UHC) won't be able to get 100 million+salaries each year.
Jun 29, 2012 01:43 AM riverhorse wrote:
When you control prices (limit premiums) and expand demand (heathcare for everyone) eventually you reduce supply. Doesn't matter if it is health care or potatoes. In this case when supply becomes limited the government will need to either raise prices (allow increases in premiums) or allocate available supply by some criteria (regulate what insurance companies must provide and what they cannot provide). It seems unlikely that the government regulators will allow much in the way of price increases.
It wiil be most sensible to apply cost effectiveness to determine which treatments benefit the largest number. IMHO that will mean reduced availability of expensive treatments that benefit only a small percentage of patients. Of course it is also likely that there will be fewer expensive treatments around as the incentives to develop specialized treatments will be gone as the ACA will dictate what insurers can cover. Hope I am wrong!!
Jun 29, 2012 09:59 AM Chickadee wrote:
Perhaps now would be a good time to look closely at Massachusetts (w/o the political spin) and determine what has worked well and what needed attention. I knew one person who lived in Mass. and worked, like me, as a FEMA reservist with no insurance until this came along. She was very glad of it and had no complaints.
I would expect the states to be looking at the structure and determining their setups
I personally feel this a good thing.
Jun 29, 2012 10:07 AM yorkiemom wrote:
I think a lot of the costs will be contained when people without insurance stop using the ER for medical care.
Jun 29, 2012 10:45 AM, edited Jun 29, 2012 11:27 AM by riley702
Sorry to jump in late, but I read the most thorough explanation on reddit. It's pretty long, so I'll just put a link, but they include lots of reference links for everything they say. It's also purposely NOT written in confusing terms (I think the asker said "explain it to me like I'm 5.")
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.
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.
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.
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...
Small businesses get some tax credits for two years.
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.
Limits how high of an annual deductible insurers can charge customers.
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.
(my favorite - riley) 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.
The amount you can deduct from your taxes for medical expenses increases.
Doctors' pay will be determined by the quality of their care, not how many people they treat. (includes a link to a more thorough discussion of this - riley)
All health care plans must now cover preventative care (not just the new ones).
A new tax on "Cadillac" health care plans (more expensive plans for rich people who want fancier coverage).
Not sure why it did the wonky thing with the italics, lines and bullet points not lining up. It's not there when I try to edit. Sorry.
Jun 29, 2012 11:29 AM alexandria58 wrote:
So pleased about this decision! The law isn't exactly what I'd have chosen - I'm a big fan of single payer - but it's a huge step in the right direction. Way to go, Roberts. Actually upholding the rule of law!!!
On cost the most expensive type of care is emergency room care. There are people with conditions and illnesses that are not treated until it's an emergency situation because they don't have insurance. Getting those people into doctors' offices alone will be a big cost reduction.
Here's my other 2 cents on reducing costs. Prevention. Get people moving. Get people on proper diets. And let's tax sugar products - the way we tax tobacco. If we can just cut back on the number of people with preventable diseases, such as diabetes 2, our health care costs will go way down - without cutting back on any of the care for cancer or any other disease.
Jun 29, 2012 11:38 AM 1Athena1 wrote:
A great site on the law and how you can find out what is available in your state is:
www.healthcare.gov - it also has a timeline.