Good news everybody

The ACA is 6 years old today.

It is potty trained, knows the alphabet and it is starting to use phonics as the 100th day of Kindergarten has passed.

Is the ACA the epitome and capstone of health care and health finance reform? No!

Is it a massive improvement over the pre-ACA status-quo where the entire system was slowly death spiraling? Yes!

Are there massive changes to service delivery that are going on underneath the radar that have and will continue to alter the US healthcare delivery sector with an aim to better quality at the same or lower costs? Yes!

Is this worth celebrating for a day? Yes

Tomorrow should we get back to work to making things a bit better wherever we have the ability to do so? Yes.






114 replies
  1. 1
    WereBear says:

    This is heartening.

  2. 2
    Baud says:

    Happy anniversary!

    Kill the bill!

    Repeal and replace!

  3. 3
    Matt McIrvin says:

    How many times has the House passed a bill to repeal it since then? Is it into the triple digits yet?

  4. 4
    raven says:

    But Hermann Cain says it’s a disaster!!!!

  5. 5

    @Matt McIrvin: I think 64 times officially

  6. 6
    OzarkHillbilly says:

    THIS TYRANNY MUST END!!!!

  7. 7
    Chris says:

    I have health insurance today bbecause of the ACA.

    If the ACA had been left intact by the Nine, I also would’ve had decent health insurance when I was in FL, instead of having to pay for a high deductible plan that was all I could afford and then getting stuck with some pricy bills when I did get sick.

    So God bless the ACA, God damn the people who watered it down, and here’s to continued improvement.

  8. 8
    WereBear says:

    @Chris: If only the people in non-covered states would send letters to Roberts, every month, detailing how badly things are going for them.

    It has a certain poetic justice.

  9. 9
    raven says:

    @Richard Mayhew:

    Will you still need me
    Will you still feed me
    When I’m 64!

  10. 10
    MomSense says:

    🎉🎉 👁❤️ObamaCare

    Had my no co-pay physical yesterday and will now have all the other tests and things that go with it.

    I’m also paying $1,362 less per month than I was when I finally had to give up health insurance due to cost.

  11. 11
    Ohio Mom says:

    All three of us in my little family have aquired fairly serious pre-existing conditions. The fact that I never have to worry about any of us losing any part of our coverage is something I never tire of pointing out to the Republicans in my life.

    I like to think one day I will trigger a massive attack of cognitive dissonance in at least one of ’em: “Gee, I love these people and yet I support legislation that will cause them pain, suffering, and maybe even death…”

  12. 12
  13. 13
    Linnaeus says:

    @Chris:

    I also have health insurance because of the ACA. I lost mine a little over four years ago when I was laid off, and I went for two years without health insurance because none of the jobs I’ve held since then offer health insurance as a benefit. I still hold two of those jobs, so I still need the ACA.

  14. 14
    The Republic, Blah Blah Blah... says:

    It is potty trained, knows the alphabet and it is starting to use phonics as the 100th day of Kindergarten has passed.

    Then it’s doing better than most of the Republicans in the House who have voted to repeal it so many times… especially the potty trained part…

    I’m covered out in CA because of it, btw…

  15. 15
    Cermet says:

    Beyond the pale that the thug noise machine can convince so many that the ACA isn’t critical to them even while they benefit both directly and indirectly; just proves robert’s is an ass wipe thinking that both corporations have free speech rights and that limiting money in politics is equivalent to limiting free speech.

  16. 16
    RobertDSC-Quad Intel Mac says:

    It’s a big Biden deal.

  17. 17
    Geeno says:

    @Cermet: Now, now. Be fair to Roberts. He’s just an evil minion doing the bidding of his evil overlords.

  18. 18
    dr. bloor says:

    It is potty trained, knows the alphabet and it is starting to use phonics as the 100th day of Kindergarten has passed.

    Yay! But there’s no fucking way I’m putting its crayon drawings on my refrigerator. Been there, done that.

  19. 19
    Hal says:

    I work in a cancer hospital and we have quite a few patients who come here now because of the ACA. Despite this I regularly have patients who will say their copay went up this year because of Obama. Their premiums went up this year because of Obama. I’ve been in employee meetings where fellow employees have blamed the face that certain insurance providers won’t cover our particular hospital on Obama.

    It’s frustrating to see so much disinformation being propagated while at the same time people are actually able to get life saving health care. Hopefully the perceptions of the aca keep improving.

  20. 20
    dww44 says:

    And, Richard, thank you for consistent effort to make us all better informed about the ACA and healthcare in general. Even though Ted Cruz and other GOP’ers will make repealing the ACA their first act upon winning the Presidential election, we need to remind ourselves that GOP efforts to move the country backwards are not new.

    Am reading Lynne Olson’s “Citizens of London” about the Americans who stood with Britain in its darkest and finest hour. The first American profiled is John Gilbert Winant who became the face in 1935-36 of the new Social Security Administration. As a widely respected former, but liberal GOP governor, he was widely revered in the Northeast. ” Because of the ferocity of the GOP opposition, FDR insisted that a prominent liberal Republican,Winant, head the 3 man Social Security board that would administer the new law.” Winant later succeeded Joseph P Kennedy as our Ambassador to Britain in 1941, much to the relief of official Britain.

    It is good to revisit history at times like these.

  21. 21
    Ohio Mom says:

    @Hal: Yeah, like the premiums, co-pays and deductibles never went up before, nor did coverage ever get cut in the good old days.

  22. 22
    japa21 says:

    A person high up in the organization at Japa Insurance was at a high power forum discussing insurance and the ACA and said that we have to try to determine why enrollment is below the 20 million expected and what can be done about it.

    Apparently the higher ups are not aware that there are a few million not covered due to states not expanding Medicaid and that the projection that employers would move to the exchanges did not happen.

    Makes me wonder.

  23. 23
    PurpleGirl says:

    I have a friend who is a respiration therapist. A few months ago she was let go by the hospital she worked at. She began doing per diem work and she went on line to find insurance through the exchanges. She found a better plan than what the hospital had offered her and it cost her less than what she had to contribute at the hospital. Thanks Obama because it really helped her

    ACA wouldn’t have helped me, being unemployed. However, living in NYC, the City hospital system has its own Options program of discounted health care. (I get my health care at a City clinic.) This will carry me til I’m eligible for Medicare next year. Thanks NYC.

  24. 24
    bemused says:

    @Ohio Mom:

    No luck getting through to even one of them so far?

    They’re like abuse victims who keep believing their abusers actually love them.

  25. 25
    Big Ol Hound says:

    My son’s pre-existing condition excluded him from all plans so thanks to ACA the last 5 years of his life were at bearable. Freakin’ cancer.

  26. 26
    Chris says:

    @Linnaeus:

    It was nowhere near as bad for me as it could’ve been, since I had a(n admittedly minimum wage) job and had no rent to pay since I was living with relatives for the entire second half of the year. But the medical bills plus the 250 a month for insurance did eat up just about all of my disposable income, and put to rest any hopes I had that I could earn enough money to not have to take out student loans for my last semester.

    Moving back to Maryland and being able to rely on Medicaid while jobless was an indescribable relief. Also the first time I’ve really felt an attachment to the state that goes beyond the generic “go Orioles” sentiment, the occasional my-state-is-better-than-your-state trash talk, and childhood nostalgia for the old suburb. Attachment in the sense of “it’s because you’re a citizen of this community that you can count on these things. You have lived in other communities and you know not everyone’s that lucky. Appreciate these things and don’t take them for granted.” It’s the sort of sentiment they tell you you’ll feel in re America vs. Random Third World Country You Just Visited, but damn if it doesn’t apply here too.

  27. 27
    MomSense says:

    @Big Ol Hound:

    Oh I’m so sorry, Big Ol Hound.

  28. 28
    A Ghost To Most says:

    @Big Ol Hound:
    Sorry to hear that, but glad ACA helped.

    Thanks Obama. My sons have coverage because of ACA.

  29. 29
    rikyrah says:

    Thanks for dropping the good news, Mayhew.

  30. 30
    OzarkHillbilly says:

    @Hal: A buddy of mine lost his health insurance “because if Obama”. I called bullshit on that. Turns out it was his union and his fellow union members (all retired cops and retired military who can get it cheaper/free elsewhere) who did it. They all decided they would rather put the HI money into their 401Ks.

    “I’m sorry your union and your fellow union brothers decided to fuck you, Dave.”

  31. 31
    Cermet says:

    @Big Ol Hound: So very sorry and hope he gets better!

  32. 32
    Punchy says:

    This is terrible news for auto-reactive T-cells targeting the beta cells in the Islets of Langerhans.

  33. 33
    raven says:

    @Cermet: Uh, you better read that comment again.

  34. 34
    Yutsano says:

    @Big Ol Hound: A) fuck cancer.
    B) glad he’s doing well.
    C) I wonder if people even know how universal health care even gets started in most countries. Going from scratch is usually the worst way. Even Canada took years to make it formal.

  35. 35
    MattF says:

    I hope (and expect) that most Republicans will continue their die-hard opposition to the ACA– the repetitive attempts to repeal the ACA combine futility, ignorance, and heartlessness in a brew that’s deeply toxic to their hopes for the future– and all I can do here is cheer them on. At this point, the damage to their future will only increase– it’s no accident that Ted Cruz their hero.

    And this Republican behavior offers an unmistakeable hint that what they really object to about the ACA is the color of Obama’s skin. Does that make any sense? Do any of them actually care about the health of their constituents? Do they have a clue about how to fix the real problems of heath care in this country? No, no, and no.

  36. 36
    Chris says:

    @OzarkHillbilly:

    The willingness to go “because Obama” even in the most blatant cases like this is just mind boggling.

  37. 37
    ruemara says:

    @Big Ol Hound: So sorry.

    Without the ACA, I’m not sure how things would have gone for me. I’m now chronically ill despite looking fit and healthy. My meds were going higher & higher. I’m very thankful.for the ACA. I want to see it expanded and improved. It should cover the undocumented & tourists. We’ll see if Americans can grow up like the law does.

  38. 38
    EriktheRed says:

    Let’s not forget the added schadenfreude benefit, folks!

  39. 39
    Bill Arnold says:

    @Geeno:

    Be fair to Roberts.

    Roberts took/is taking a lot of flak from the right, and made a lot of enemies on the right preserving the core of Obamacare; He deserves credit for that.

  40. 40
    gene108 says:

    @MattF:

    I hope (and expect) that most Republicans will continue their die-hard opposition to the ACA– the repetitive attempts to repeal the ACA combine futility, ignorance, and heartlessness in a brew that’s deeply toxic to their hopes for the future– and all I can do here is cheer them on. At this point, the damage to their future will only increase– it’s no accident that Ted Cruz their hero.

    As long as the media treats them “as responsible adults” with ver serious, well thought out, policy positions, and not like the bomb throwing radicals that they are, we will have no repercussions for Republicans.

  41. 41
    Ruckus says:

    @ruemara:
    We’ll see if Americans can grow up like the law does.
    A healthy thing to do would be to not hold your breath.
    Old saying, “He refuses to grow up.” Today’s conservatives seem to refuse to not regress to infancy.

  42. 42
    ruemara says:

    @Ruckus: I’m going forward with a plan to have the worst offenders hold their breath.

  43. 43
    OzarkHillbilly says:

    @Chris: I should have mentioned that the union and his company were blaming it on the ACA. You here it everywhere, nonstop from every conservative talking head who garners a spot on a talk show. He works around diehard conservatives so he gets fed this stuff from his workmates constantly. I was probably the first person other than his wife to tell him “BS.”

    We’ve known each other for more than 40 years but I don’t see him near enuf to counter all the baloney he gets.

  44. 44
    Ruckus says:

    @gene108:
    Worse still is that as bomb throwing radicals they fail to realize that they are the radicals.

  45. 45
    Ruckus says:

    @ruemara:
    Now that’s a plan!

  46. 46
    JMG says:

    Any belief the Republicans will ever adapt to the ACA is illusory. The suffering of unworthy Others, and by definition anyone suffering is unworthy, is the core of their political belief system. Nobody believes the trickle-down, bootstraps crap. Meanness is its own reward.

  47. 47
    Bruce K says:

    I suspect that one of the major problems is that the policy-makers in the modern GOP have seen what happened next, and they still don’t believe it, which is why they insist that the ACA is having effects that are, to put it politely, counter-factual.

  48. 48
    Ruckus says:

    @Bruce K:
    Reality will never trump their beliefs.

    See what I did there?

  49. 49
    Sister Rail Gun of Warm Humanitarianism says:

    @WereBear:

    If only the people in non-covered states would send letters to Roberts, every month, detailing how badly things are going for them.

    They can start with this letter.

    And to pivot to a related subject, do health coaches really accomplish anything? NCHealthSmart has been ringing my phone off the hook and just can’t understand why I don’t want to sign up for their program. I frankly can’t figure out what they’re supposed to do that my doc isn’t already doing.

  50. 50
    D58826 says:

    OT but the campaign just got more depressing

    Another, more self-interested, reason for Jeb to back Cruz: His son. George P. Bush, the 39-year old Texas land commissioner is now considered the Bush family’s next best hope to reclaim the White House, but he cannot expect to easily advance in Texas state politics without Cruz’s support

  51. 51
    Amaranthine RBG says:

    ACA is a joke. The most touted achievement is a 5% reduction in the overall uninsured rate. There aren’t any solid studies in yet, but I haven’t seen any data suggesting noticeable declines in morbidity rates.

    We need a single payer system. 8nfortunately no Republican president is going to support that and, if History is any guide, Clintons main concern will be protecting insurer profits.

  52. 52
    Kylroy says:

    I think the biggest thing the ACA does is provide a functioning insurance market for people who don’t have employer-based coverage but can afford to pay for insurance. This situation accounts for a single-digit percentage of the population currently, but the employer based system is slowly unraveling. I expect it to do so faster now that an employer can drop insurance without leaving it’s employees without options: “we’re dropping coverage, here’s some cash, figure your own health insurance out”.

    In short, the ACA will allow the U.S. to transfer to a more functional healthcare market as the existing employment-based model dissolves.

  53. 53
    singfoom says:

    Amen to the ACA. People without a chronic illness had/have no idea what it was like having to make sure you’re insured EVERY single day despite job losses / changes and worry about being rejected for coverage because you went uninsured for 1 day.

    As for the copays and premiums, is there a good source for the rate of change? Used to be a benefits administrator years and years ago, and I remember premiums going up on the order of 12% a year (this was early 2000s)

    I wonder if the ACA slowed that down at all.

  54. 54
    OzarkHillbilly says:

    @Sister Rail Gun of Warm Humanitarianism: Justify their existence, something your doctor will never do for them.

  55. 55
    amygdala says:

    Here’s a perspective from the other side of the gurney. Working as I did in a safety net hospital, where many of our patients were uninsured, I used to cringe when folks came in with a major new neurologic diagnosis. And not just for knowing how radically their lives would change with medications, physical therapy, doctor visits, fear, uncertainty, and the rest.

    It also meant they would never be able to get private health insurance unless they recovered enough to work, preferably for a large employer, or had a spouse with bombproof work-related insurance. The only other options were being (or becoming poor enough to qualify for Medicaid, which is underinsurance where I worked, or getting permanently disabled or turning 65, in order to be eligible for Medicare.

    It was such a depressingly well-worn path, where a seizure, mild to moderate traumatic brain injury, early multiple sclerosis or some other thing that shouldn’t throw a person down a greased Teflon economic slide did just that. People who had mortgages and a toehold in middle class life could find themselves living in a shelter, in a matter of months.

    I took care of a lot of HIV patients in my practice and the first few years after combination antiretroviral therapy came out could be a real headwhip. Patients with brain infections that were usually fatal went into remission–how amazing is that? But then they’d get well enough to lose their disability and hence the coverage that was paying for the very medications that helped them get better. Fortunately there were local programs that filled the gap nearly all of the time, but still, it was such unnecessary grief for everyone. ETA: And if you happened to live in a state that didn’t have such programs, well, start getting your affairs in order.

    Yes, the ACA needs more fixes to make it better. What big program designed to help people hasn’t? That’s why there are policy wonks. Getting rid of the pre-existing condition clause was, and remains, huge. So is being able to keep people hooked up with the treatments that are keeping them alive.

    Thanks, Obama? Hell, yes.

  56. 56
    Cacti says:

    @Amaranthine RBG:

    ACA is a joke. The most touted achievement is a 5% reduction in the overall uninsured rate. There aren’t any solid studies in yet, but I haven’t seen any data suggesting noticeable declines in morbidity rates.

    We need a single payer system. 8nfortunately no Republican president is going to support that and, if History is any guide, Clintons main concern will be protecting insurer profits.

    Your arguments are novel and fascinating.

  57. 57
    Miss Bianca says:

    @Chris: And so say all of us.

  58. 58
    Chyron HR says:

    @Amaranthine RBG:

    Since the 2016 primaries aren’t going the way you wanted them to, you’re going to re-fight the ACA battle instead? Good luck with that; please let us know if it turns out differently this time.

  59. 59
    Amaranthine RBG says:

    @Cacti: You’re not being helpful.

  60. 60
    satby says:

    @Big Ol Hound: Condolences on your son’s passing . I can’t even imagine the pain of a son with a terminal disease who might not have gotten care either.

  61. 61
    OzarkHillbilly says:

    @Amaranthine RBG: Hello Pot, I’m Kettle. You’re black.

  62. 62
    Chyron HR says:

    @OzarkHillbilly:

    THAT’S NOT HELPFUL!

  63. 63
    Amaranthine RBG says:

    @Chyron HR: unlike you, I’m more concerned with doing what’s right rather than just cheering for the home team

    Praising the ACA is a bit like saying that it’s wonderful that public lynchings have decreased this century in America. Why, yes it is, but thats no excuse not to be outraged by the systemic racism that still exists.

  64. 64
    japa21 says:

    @Amaranthine RBG: But then, neither were you. Would help if you had some ideas as to what could be done to improve things from a practical point of view.

  65. 65
    Cacti says:

    @Amaranthine RBG:

    You’re not being helpful.

    Kill the bill and wait for the new progressive super majority to write a better one in 2010!

  66. 66
    Chris says:

    @JMG:

    Any belief the Republicans will ever adapt to the ACA is illusory.

    I mean, they still haven’t adapted to Social Security.

  67. 67
    burnspbesq says:

    @Amaranthine RBG:

    Would a hearty “fuck you” from someome who is only alive because of beimg able to get insurance through an exchange while self-employed suffice to get you down off your high horse?

    If yes, then “fuck you.”

    Visit the real world some time. It’s a bit different than your fantasies.

  68. 68
    japa21 says:

    @Amaranthine RBG: Now that is a novel argument, comparing the ACA to a decrease in lynchings.

    BTW, you do realize there is probably not a person here who views the ACA as the perfect solution.

  69. 69
    Cacti says:

    @Amaranthine RBG:

    unlike you, I’m more concerned with being philosophically pure than attaining any sort of tangible progress in a real world setting.

    Fixed.

  70. 70
    Just One More Canuck says:

    @Amaranthine RBG: What is more important, universal coverage or single payer? You seem to be arguing that the means is more important than the end itself. Your goal of single payer doesn’t seem to be a realistic possibility in the short term.

    Or you’re just a troll.

  71. 71
    Ampersand says:

    I’m sure that the ACA has helped many people, but I still don’t have health insurance. I don’t qualify for subsidies and can’t afford it. I have a few decades to go before I’m retirement age, so my only shot at getting any form of health insurance is if we switch to universal coverage. I’m hoping it happens, but, with my luck, it’ll probably be passed the day before I turn 65…

  72. 72
    the Conster, la Citoyenne says:

    @Amaranthine RBG:

    How disgustingly easy it is for you purity types to dismiss a 5% reduction, or any reduction, as if those people who have coverage now and didn’t before, just simply don’t matter. If I ever hear the word “progressive” again after this primary season from anyone, considering the complete disregard and dismissiveness of actual progress it requires to tout oneself as holier than thou, well, they better hope they have medical insurance.

  73. 73
    satby says:

    @Amaranthine RBG: And in a thread where many people (and I’m another) are talking about how the ACA allows them health care coverage for the first time in years, or prevents them from losing coverage when they get a chronic illness, you are being an obtuse dick to say the only benefit was to insurance companies.

  74. 74
    Cacti says:

    @Just One More Canuck:

    What is more important, universal coverage or single payer? You seem to be arguing that the means is more important than the end itself. Your goal of single payer doesn’t seem to be a realistic possibility in the short term.

    Or you’re just a troll.

    There is a door #3 here: Doesn’t know that universal coverage and single payer aren’t interchangeable terms.

  75. 75
    satby says:

    @Cacti: most of them don’t know that, and their revolutionary hero doesn’t bother to educate them, since it doesn’t advance his narrative.

  76. 76
    burnspbesq says:

    At the risk of getting a 15-yard penalty for piling on, I do wonder what sort of health insurance Mr. Or Ms. Amaranthine has and what he/she pays for it. It’s easy to lack compassion when one is well taken care of.

  77. 77
    Thoroughly Pizzled says:

    Eat shit, Joe Lieberman. Enjoy retirement, Bart Stupak. Go sit in the corner for a decade, Martha Coakley. RIP, Arlen Specter and Ted Kennedy.

    @Ampersand: Do you qualify for expanded Medicaid? You can also try looking for an ACA Navigator. In-person assistance can be significantly more helpful than just using the website.

  78. 78
    amygdala says:

    @Amaranthine RBG:

    unlike you, I’m more concerned with doing what’s right rather than just cheering for the home team

    Question for you: since the votes did not exist to pass a public option, much less full-on single payer, would have it been better, in your view, to let the old system, which included pre-existing condition clauses, stand?

  79. 79
    the Conster, la Citoyenne says:

    @Amaranthine RBG:

    The ability for purity holier than thou types to dismiss a 5% reduction, or any reduction in the number of people covered as simply not mattering to them is why after this primary season I never want to hear the word “progressive” again, since it seems to require wholesale dismissiveness of actual progress, and the hard legislative work it takes to create it. .

  80. 80
    Brachiator says:

    The ACA is 6 years old today.

    I keep hoping that the Democratic candidates will include a Keep It “Simple Stupid” challenge in their campaign.

    “The ACA is 6 years old. The ACA is a success. It has reduced the number of uninsured. It has helped people get and keep medical insurance.

    Over this same 6 year period, the GOP has insisted that they will repeal ACA and replace it with a better plan. But they have never offered a plan. Never. Not the GOP in Congress. Not any of the GOP presidential candidates from 2008, or 2012, or 2016.”

  81. 81
    japa21 says:

    @the Conster, la Citoyenne: Many are those who call themselves progressives who decried Obama agreeing to extend the tax cuts for the wealthy by one year despite the fact that was the only way to get extended unemployment insurance and other safety net measures also extended.

    We always talk about the GOP as being the “I got mine, fuck you” party, but I think the phrase also applies to some on the left.

  82. 82
    magurakurin says:

    @Cacti: lot of space dust out there right now. Some big guns were banned over at KOS last night. Probably better put on the radiation googles for a couple of days in this bunker.

  83. 83
    Ampersand says:

    @Thoroughly Pizzled:

    My state did expand it, but, no, I don’t qualify.

    I did try calling, and they gave me a list of prices that I can’t afford.

    “Luckily,” I don’t make enough to have to pay the fine for not having insurance.

  84. 84
    magurakurin says:

    @Amaranthine RBG:

    Praising the ACA is a bit like saying that it’s wonderful that public lynchings have decreased this century in America.

    Yeah, it’s exactly like that. Damn, boy, you’re like Mark Twain with your wit. Impressive.

  85. 85
    magurakurin says:

    @burnspbesq:

    At the risk of getting a 15-yard penalty for piling on, I do wonder what sort of health insurance Mr. Or Ms. Amaranthine has

    I guess that depends on what the Cruz campaign is offering its employees.

  86. 86
    ArchTeryx says:

    @magurakurin: Who got banhammered last night? I’m on the GOS and didn’t hear about this.

  87. 87
    the Conster, la Citoyenne says:

    @japa21:

    It’s actually worse – it’s I got Mine due to other people’s hard work and think I’m special so I can disparage and dismiss others’ hard work by sniping from the sidelines because I’m too pure to get my own hands dirty.

  88. 88
    magurakurin says:

    @ArchTeryx: GeeBeeBee got the “bojo” as they like to call it over there. It seems he got caught with his pants down and his hands on his sock puppet.

  89. 89
    ArchTeryx says:

    @magurakurin: Whoa. Link to this event?

    They can go to the subreddit and go back to doing the Rights work for them.

  90. 90
    japa21 says:

    @the Conster, la Citoyenne: Yeah but IGMDTOPHWATISSICDADOHWBSFTSBITPTGMOHD is just too long to work with.

  91. 91
    magurakurin says:

    @ArchTeryx: they are talking about it in Lysys’ Hillary News and Views diary. I am on my tablet and linking is a chore. It is on the wreck list now though.

  92. 92
    Thoroughly Pizzled says:

    @Ampersand: Rats. Well, hang in there, I guess. Once we have a functioning government again your story will be a compelling reason for further reform.

  93. 93
    Chyron HR says:

    @Amaranthine RBG:

    Unlike you

    It’s amazing how well you’ve come to know all the blog’s readers since you first showed up yesterday afternoon.

    I’m more concerned with doing what’s right

    How many people get single payer health insurance every time you post “Waaaah me hate ACA”?

    None?

    Well, gosh, then I guess you’re not actually doing “what’s right”. Tough break.

  94. 94
    Ken says:

    Richard, first, I appreciate all of your articles, especially the health care topics. My wife and “bridged” over (via ACA) on NYS Health Exchange, prior to me enrolling in Medicare. I feel that President Obama has more than fulfilled his obligation to “national security” with his initiative on the ACA.

  95. 95
    Sister Rail Gun of Warm Humanitarianism says:

    @Ampersand: Wow, that’s a hell of a donut hole, too much for a subsidy and not enough to trigger a fine.

    None of us expected the ACA to be perfect out of the gate. Nothing ever is. Social Security had some appalling gaps, too, when it was first passed. I think our biggest fault was expecting to have a chance to fix the parts that didn’t work out.

    Richard’s posts have been essential in keeping my hopes up that a lot of the subtler things in the ACA are actually working. I couldn’t imagine something like this price comparison tool existing seven years ago. That is was needed, yes. That it would ever happen? No.

  96. 96
    StellaB says:

    I do taxes as an AARP volunteer (need your taxes done? Google AARP and see if there’s a program in your area. It’s free. It’s a fun way to volunteer, too, if you have the time.) A client was sitting in front of me whining that she lost her insurance because of O’care. I had all of her financial data in front of me. I could see that she had Medicare in 2014. Some people watch too much TV.

  97. 97
    p.a. says:

    B B b but single payer! (pls n.b. this is a song I sang too)
    How has Obama failed to fail today!?

  98. 98

    @Sister Rail Gun of Warm Humanitarianism: yes good health coaching is a very good thing

  99. 99
    Mnemosyne says:

    @Ampersand:

    That sounds … weird. You make too much money for expanded Medicaid and too much to receive a subsidy, but not enough to have to pay a fine? I think you’re getting bad advice somewhere along the line, but I can’t figure out where. Are you willing to say what state you’re in?

  100. 100
    Ampersand says:

    @Mnemosyne:

    Sure, I’m in Montana.

    I’m a single white male with no disabilities and no kids, and I was told that I don’t qualify for subsidies. Likewise, when I do my taxes every year, my accountant asks me if I have health insurance, I say no, and he tells me that I don’t have to pay the fine.

    Obviously, this is a big issue, one that I usually vote on…but I won’t be voting on it this year. I’ll be ignoring it so I can vote for Hillary.

  101. 101
    jon says:

    @Amaranthine RBG: A 5% reduction means fifteen million more people have insurance coverage. That’s a big deal.

    Wanting more isn’t a problem, really. Wanting more so much you can’t see how much the law has improved the lives of so many? That’s a problem you have. Like many others, I’m interested in hearing how privileged your life is that you don’t really think fifteen million people’s lives getting more financial and medical security matters.

  102. 102
    Mnemosyne says:

    @Ampersand:

    Okay, rural state. That makes more sense — even with Medicaid expansion, you guys have higher premiums because you have fewer providers. I went to the Montana HELP plan site and it looks like their waiver is relatively new (July of 2015), so it may be worth it to apply again if your previous application was before that date. It looks like they have their own exchange page, too with a calculator (link on the upper right-hand side). They also have a directory of people you can talk to face-to-face, not just on the phone.

    But, yeah, rural states are in a tough spot that should be fixable with more legislation, if we can get a Democratic House and Senate again.

  103. 103

    @Richard Mayhew: This is a post I am probably writing tonight or tomorrow regarding health coaching:

    http://www.usatoday.com/story/...../82148022/

  104. 104

    @Ampersand: Makes sense, my guess is that you make more than 400% FPL which is not that hard for a single adult with no kids BUT the cheapest Bronze plan costs more than the cut-off point for your income…and expensive Bronze is not that hard to find in rural areas with big distances plus low populations to spread fixed costs and minimal competition on either the provider or insurer side of the business.

    You’re a corner case but not that unusual.

  105. 105
    Technocrat says:

    @jon:

    Wanting more so much you can’t see how much the law has improved the lives of so many? That’s a problem you have

    This. This is really the “purity pony” problem in a nutshell. Not that more wouldn’t be better (it always would) but that the bit you got was complete shit. it’s like finding a 20 in your jeans when you’re broke, and losing your shit because it wasn’t a 100.

  106. 106
    StellaB says:

    @Amaranthine RBG: You are apparently not aware of HRC’s actual history:
    https://en.m.wikipedia.org/wiki/Clinton_health_care_plan_of_1993

  107. 107
    Sister Rail Gun of Warm Humanitarianism says:

    @Richard Mayhew: I’m going to guess that the health coaches are support for people who are intimidated by their doctors and are there to fill in the gaps left when the patients don’t demand explanations? I had to play that role for my mother quite a bit over my father’s last few years.

    Other than that, I’m not sure how anything else their website claims to accomplish is possible without them constantly calling the client. “Hi, Mrs. X, it’s time to take your medicine.” “Hi, Mr. Y, how’s the stop smoking program going today?”

    I should probably mention that the only other time we’ve been contacted by a health coaching program was after my husband’s cancer diagnosis. Two years after his surgery. Six months after he was declared cancer free. I know two people, both newly pre-diabetic, whose health coaches/nutritionists pushed fad diets. (One Rice Diet, one Blood Type Diet.) So I guess can honestly say that I don’t know anyone who has ever encountered a good health coaching program.

  108. 108

    […] confidence and skill over his time in office, he defines objectives and outplays opponents* to get what he wants.   As the occupant of the bully pulpit, henails the lay-ups and he blows away the impossible […]

  109. 109

    @Sister Rail Gun of Warm Humanitarianism: the big difference between good PCP support and good health coaching is time. A PCP might get a 15 minute window to go over everything. A health coach working in coordination with the PCP can spend 45 minutes talking about good ways to prep tasty whole grain oats for someone who needs to lower their cholesterol for example.

    A health coach acting as a free agent is at best randomly useful

  110. 110
    Xantar says:

    Come on guys, at least get the math right when you respond to the purity troll.

    It’s not a 5% decrease. It’s a five percentage point decrease. Huge difference.

    The uninsured rate went down from 14% to 9% which means it was a nearly 33% decrease.

  111. 111
    What Have the Romans Ever Done for Us? says:

    “The line is going down! That means it’s failinig!” he said in his most obnoxious wingnut voice.

  112. 112
    Sister Rail Gun of Warm Humanitarianism says:

    @Richard Mayhew:

    A health coach working in coordination with the PCP can spend 45 minutes talking about good ways to prep tasty whole grain oats for someone who needs to lower their cholesterol for example.

    *blink*

    *blink*

    I’ll … have to chalk this up to being completely out of touch with the population under consideration. I would never in a million years have thought to ask a doctor or health coach for recipes.

    I can emphatically say that if someone called me up out of the blue to discuss the subject, I’d hang up in their face. That’s too intrusive.

  113. 113

    @Sister Rail Gun of Warm Humanitarianism: that is why health coaching done well is not out of the blue

  114. 114
    chris m says:

    Once again let’s remember that having insurance is NOT the same as actually getting health care. The fact remains that for many people the combination of premiums, deductibles and coinsurance exceeds 205 of gross income. The result is their health care is only useful in the event of a health catastrophe, something that is more likely because the deductibles and coinsurance make it impossible to use to prevent those health catastrophes.

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