Affordable Care Act (AKA Obamacare)

[Joe Shlabotnik]

The only thing I can come up with is spite. When people in these states realize their legislators refused hundreds of millions of free money that would have made life better for thousands of working people for no better reason than spite, I hope there is hell to pay.

I think it's generally spite for Obama. (the governor/state legislature has to agree to set up the state exchange)

The thing is, the expansion is really necessary for how the exchanges work, because it will cover the most needy/risky profile people, which then makes the other plans offered through the exchanges more affordable, since they don't have to worry about covering those people.

If your state has no medicaid expansion, then the plans offered through the exchange have to take into account that they need to cover these higher-risk people, so premiums go up.

Right. I think a year down the road when people can compare how it is working between states that fully implemented ACA and those that resisted, it will be obvious how much worse people in those resisting states have it. I am hopeful that will translate into changes in the legislatures of those states. But hey, Somalia exists too so I'm not holding my breath.

[AWvsCBsteeeerike3]

I'd be curious what the 10% of expanded coverage would cost the states? Honestly, it seems like a no-brainer to accept it. But, I remember the Governor in Arkansas talking about how it was difficult to project the costs and figure out where to cut accordingly as they have to balance the budget every year.

[IMADreamer]

sorry if it has been discussed, but what is up with MO (and other states) not accepting the medicaid expansion??

Missouri (and those other states) voters obviously have no morals, and are perfectly happy to let people die. These same people label themselves "right to lifers" when it fits their psychopathic agenda.

Move or die......... those will be the options for the people in those states at some point. The Republican leaders thank you for your vote.

Pretty much this. Although to be fair Illinois decided not to set up it's own exchange and I remember our Governor and my local State Senator giving some reason about having faith in the federal exchange. Not saying that's the case with Missouri because I'm pretty sure the Missouri Senate is Republican.

It boils down to the right wanting Obamacare to fail and doing anything they can to make that happen. The federal govt was just throwing money at the states for this so those that didn't accept it were just stupid.

[AWvsCBsteeeerike3]

I agree that states should have picked it up. Here is a quip from the healthcare.gov website.

https://www.healthcare.gov/what-if-my-s ... e=arkansas

If your state isn’t expanding Medicaid for January 1, 2014

Some states aren’t expanding their Medicaid programs effective January 1, 2014. If you live in one of these states, you may not have as many options for health coverage. It will depend on where your income falls.
•If your income is more than 100% of the federal poverty level -- about $11,500 a year as a single person or about $23,500 for a family of 4 -- you will be able to buy a private health insurance plan in the Marketplace and may get lower costs based on your household size and income.
•If you make less than about $11,500 a year as a single person or about $23,500 for a family of 4, you may not qualify for lower costs for private insurance based on your income. However, you may be eligible for Medicaid, even without the expansion, based on your state’s existing rules.

Why this coverage gap exists

When the health care law was passed, it required states to provide Medicaid coverage for adults between ages 18 and 65 with incomes up to 133% of the federal poverty level, regardless of their age, family status, or health.

It also provides tax credits for people with incomes between 100% and 400% of the federal poverty level to buy private insurance plans in the Marketplace.

In short and if I understand correctly, it expanded Medicaid to cover people at and under 133% of the poverty level instead of just 100% and it further extended tax credits to those not covered but between 100% and 400% of the poverty level.

The fed government picked up the tab for 3 years then agreed to cover 90% going forward.

That's a good deal for the states, but as I mentioned it's not free and states actually have hard budget constraints. I'd argue cuts should be made elsewhere if need be. But....you know, republicans want people to die and stuff.

[Leroy]

http://washingtonexaminer.com/kathleen- ... le/2531097

“I would suggest, sir, that, again, this is an incredibly agonizing situation where someone lives and someone dies,” Sebelius replied. “The medical evidence and the transplant doctors who are making the rule — and have had the rule in place since 2005 making a delineation between pediatric and adult lungs, because lungs are different that other organs — that it’s based on the survivability [chances].”

I hope when my day for transplant need arrives, I'm in the 'lives' category, but whatever.

[Jocephus]

http://washingtonexaminer.com/kathleen- ... le/2531097

“I would suggest, sir, that, again, this is an incredibly agonizing situation where someone lives and someone dies,” Sebelius replied. “The medical evidence and the transplant doctors who are making the rule — and have had the rule in place since 2005 making a delineation between pediatric and adult lungs, because lungs are different that other organs — that it’s based on the survivability [chances].”

I hope when my day for transplant need arrives, I'm in the 'lives' category, but whatever.

thats from june 4th.

june 5th a federal judge ordered the gal to be on the list: http://washingtonexaminer.com/update-ju ... le/2531241

on june 12th she had the transplant - http://washingtonexaminer.com/article/2531754

additionally, according to the sebelius quote included in this thread, the rule was enacted in 2005...so im not sure why its relevant to ACA. and while kathleens quote seems awfully harsh, and perhaps it is, i dont think eligible lungs are readily available so it seems logical to give them to those with the highest probability of survival.

[Joe Shlabotnik]

There are hard and fast limits on any policy. You can find a harsh anecdote from someone on the wrong side of an insurance company's decision no matter what the policy.

[lukethedrifter]

http://washingtonexaminer.com/kathleen- ... le/2531097

“I would suggest, sir, that, again, this is an incredibly agonizing situation where someone lives and someone dies,” Sebelius replied. “The medical evidence and the transplant doctors who are making the rule — and have had the rule in place since 2005 making a delineation between pediatric and adult lungs, because lungs are different that other organs — that it’s based on the survivability [chances].”

I hope when my day for transplant need arrives, I'm in the 'lives' category, but whatever.

Well now that the little girl got them, maybe you aren't aware of this but someone else didn't.

[Joe Shlabotnik]

My girl has Down Syndrome. If she ever needed a transplant - no matter what the insurance or the hospital - she'd be triaged below other, 'normal' individuals. There are harsh realities anytime limited health care resources need to be rationed. Why are 'death panels' all the sudden blamed on Obamacare? They've always 'existed' as triage decision makers and insurance actuaries.

[Leroy]

Show me where I blamed Obama. I just think it is a stupid thing to say. Now back to our regularly scheduled death panel discussion.