Obamacare.

[tednlou2]

President Obama does a mock talk show interview with Zach Galifianakis, for Funny or Die.  So, Funny or Die? 

Does this kind of thing work?  I found myself FWDing through it.  Even though there were some funny lines, it still just seemed like one of those late night infomercials, where they pretend to be doing a real interview, but it is way too rehearsed.  I suppose even if younger folks roll their eyes, it may still get them to think about signing up. 

http://www.upworthy.com/president-obama-burns-a-rude-celebrity-and-then-teaches-him-how-to-get-it-treated?c=ufb1

[Dan0]

Funny you should mention this...I just saw this over at JoeMyGod

[mitch777]

Obama announced today in a press conference that 8 million people have signed up and 35% of those were under 35 years old.

Seems like it's working as planned. Now if the Republicans could finally admit it they could focus their energy on fixing any flaws and attend to more important issues facing our country but I know that won't happen before November. Hell, I bet they vote to repeal the ACA another few times in the coming months. So sad.

He also mentioned in his PC that the Governors who didn't allow Medicaid expansion are denying another 5 million people healthcare purely for political reasons. Obvious to me but the people that live in these states are the only ones with the power to vote them out. I wish them the best.

[mecch]

Rachel Maddow reported this week (?) that the Republicans voted a minor fix for Obama Care, very very quietly.

[mitch777]

Rachel Maddow reported this week (?) that the Republicans voted a minor fix for Obama Care, very very quietly.

Details? Or was it SO quiet that it will never be heard?

Edited to add:
Or does the "minor" fix come at the cost of another social program. Sorry, I'm jaded.

[leatherman]

Details?

Edited to add:
Or does the "minor" fix come at the cost of another social program. Sorry, I'm jaded.

Color yourself Jade.

"At the urging of business organizations, House Republicans quietly secured a recent change to Obamacare to expand coverage choices
....
No member of the House GOP leadership has publicly hailed the fix, which was tucked, at Republicans’ request, into legislation preventing a cut in payments to doctors who treat Medicare patients."
http://freakoutnation.com/2014/04/06/house-republicans-quietly-support-a-change-in-obamacare-to-expand-coverage/

Rachel's vid:
https://www.youtube.com/watch?v=KwWX80RBA8s

[mitch777]

Color yourself Jade.

"At the urging of business organizations, House Republicans quietly secured a recent change to Obamacare to expand coverage choices
....
No member of the House GOP leadership has publicly hailed the fix, which was tucked, at Republicans’ request, into legislation preventing a cut in payments to doctors who treat Medicare patients."
http://freakoutnation.com/2014/04/06/house-republicans-quietly-support-a-change-in-obamacare-to-expand-coverage/

Rachel's vid:
https://www.youtube.com/watch?v=KwWX80RBA8s

Interesting. Reform due to pressure from the business community. Why bury it? (rhetorical question)

[BT65]

He also mentioned in his PC that the Governors who didn't allow Medicaid expansion are denying another 5 million people healthcare purely for political reasons. Obvious to me but the people that live in these states are the only ones with the power to vote them out. I wish them the best.

I live in one of those states and I can tell you that Indiana is pretty conservative.  Pretty typical Nascar fans, beer-drinking, gun-toting rednecks.  Not that everyone who likes one of those activities is a redneck. But typically, well, they are.

I wish these people would realize they're being screwed.  But, they don't.  You would think with Indiana University (IUSB), Notre Dame, and St Mary's, it would be more liberal.  And they do have liberal groups on these campuses and do lots of community service.  But, you are correct M, they need to vote these fuckers out.  Too many people being untreated.  I just talked to one today whose shoulder is dislocated.  She cannot get it fixed due to no health coverage.  MADDENING!

[mitch777]

I live in one of those states and I can tell you that Indiana is pretty conservative.  Pretty typical Nascar fans, beer-drinking, gun-toting rednecks.  Not that everyone who likes one of those activities is a redneck. But typically, well, they are.

I wish these people would realize they're being screwed.  But, they don't.  You would think with Indiana University (IUSB), Notre Dame, and St Mary's, it would be more liberal.  And they do have liberal groups on these campuses and do lots of community service.  But, you are correct M, they need to vote these fuckers out.  Too many people being untreated.  I just talked to one today whose shoulder is dislocated.  She cannot get it fixed due to no health coverage.  MADDENING!

It IS maddening. I hear reports from MNSBC (ya, I know, liberal media) that it is estimated 17,000 people will die this year in the states that refused to expand Medicaid. Wonder what "death squad" Michelle Bachman has to say about that. Wait... I don't want to know.

I'm sure your story is repeated countless times over across those states. I honestly think it's all about education. A tough job ahead.

[mecch]

I have a question. The oft touted 8,000,000 people on "Obama Care" first year out. Is there a breakdown yet how many people signed up for state run and how many to the national?  How many people from states that didn't expand Medicaid, signed up for national plans?
Isn't there a way to fund the poor who might have been eligible for state medicaid, had it been offered, to next year somehow get enough funds to buy plans on the national exchange? 
I realise its a nation with state powers and independence. But it maybe not be constructive or realistic to expect the banana-republic 3rd world mentality states to put their legislatures in order. 
Its seems like a long slow slide to destitution and in 20 years there will be failed States peppering the country.  At that point, its going to be even more expensive to fix and that means one or two decades of people suffering, with poor country standards of living, in one of the so-called "richest countries in the world".   

[buginme2]

I have a question. The oft touted 8,000,000 people on "Obama Care" first year out. Is there a breakdown yet how many people signed up for state run and how many to the national?  How many people from states that didn't expand Medicaid, signed up for national plans?
Isn't there a way to fund the poor who might have been eligible for state medicaid, had it been offered, to next year somehow get enough funds to buy plans on the national exchange? 

What do you mean by how many people signed up for state run versus national?

I thought the 8 million were people who signed up for private insurance on the exchanges.  I don't think it includes people who signed up for Medicaid.  But I could be wrong.

In states that didn't expand Medicaid the poor are still offered subsidies to purchase insurance, but if you still can't afford it your shit out of luck.

I have a friend who got on Medicaid with the expansion.  She hasn't been to a doctor in years.  She got coverage on the exchange through Medicaid, she got a phone call two days later from a medical clinic in her neighborhood to set up an appointment, was seen two weeks later.  Was amazing how quick and easy it was.

[leatherman]

In states that didn't expand Medicaid the poor are still offered subsidies to purchase insurance, but if you still can't afford it your shit out of luck.

not quite. if you're so poor that you would have been eligible for Medicaid Expansion,  then you are too poor to qualify for any subsidies from get-go. Subsidies are for people who are not quite as poor and make too much to qualify for ME in the first place.

If you make less than about $11,490 a year as a single person or about $23,550 for a family of 4, you may not qualify for lower costs for private insurance based on your income. You may be eligible for Medicaid, even without the expansion, based on your state’s existing rules. But if you aren’t, you won’t qualify for either of the affordability options under the health care law.

https://www.healthcare.gov/what-if-my-state-is-not-expanding-medicaid/

[leatherman]

How many people from states that didn't expand Medicaid, signed up for national plans?

Medicaid Expansion and getting insurance through the exchanges (either state- or federal-administered, and with or without subsidies) are different issues.

Isn't there a way to fund the poor who might have been eligible for state medicaid, had it been offered, to next year somehow get enough funds to buy plans on the national exchange?

SC has started up it's own program to help the poor - the Healthy Outcomes Plan. Instead of using the federal tax dollars that could have come back to our state through ME, our Governor tasked the Director of Health and Human Services (tony keck) to create a whole other plan, funded by SC, to fill in the gap.

TONY KECK: My fear is, in the states where there’s Medicaid expansion that hospitals and doctors and other health care providers take the path of least resistance, which is instead of going and finding the people who need the most help, they take the healthy folks who just come on into their door, easy dollars, easy to treat. And it’s not really solving the big problems that a state like South Carolina needs to focus on.

MARY JO BROOKS: Keck has launched a pilot program that he thinks could do just that. It’s called the Healthy Outcomes Plan, and it’s really a series of 40 different experiments, each one developed by hospitals in the state to reach out to uninsured people who are chronic users of their emergency rooms

http://www.pbs.org/newshour/bb/in-a-state-without-medicaid-expansion-uninsured-south-carolinians-mind-the-gap/

the problem with Keck's plan (besides the huge cost to SC w/o any federal reimbursement) is, as the SC HIV Task Force pointed out in our one-on-one meeting with Mr. Keck, is that the hospitals which he believed would reach out to the poor and disenfranchised have sat on the funds and reached out to no one. Millions of dollars earmarked for health care for those who would have received ME are sitting idle in hospital bank accounts - while the dozen ASOs in SC could have used those funds to treat financially poor PLWH.

Its seems like a long slow slide to destitution and in 20 years there will be failed States peppering the country.  At that point, its going to be even more expensive to fix and that means one or two decades of people suffering, with poor country standards of living, in one of the so-called "richest countries in the world".   

I would venture to say that we're already in that slide you mention and that 20-yrs could be wishful thinking. SC, Mississippi and Alabama (for example) with their low quality education issues, high STI rates, high teen pregnancy, poor overall health, poor access to health care, poverty.....well with all those issues and more, some states are already on the verge of failing right now.

[mecch]

Medicaid Expansion and getting insurance through the exchanges (either state- or federal-administered, and with or without subsidies) are different issues.
SC has started up it's own program to help the poor - the Healthy Outcomes Plan. Instead of using the federal tax dollars that could have come back to our state through ME, our Governor tasked the Director of Health and Human Services (tony keck) to create a whole other plan, funded by SC, to fill in the gap.
http://www.pbs.org/newshour/bb/in-a-state-without-medicaid-expansion-uninsured-south-carolinians-mind-the-gap/

the problem with Keck's plan (besides the huge cost to SC w/o any federal reimbursement) is, as the SC HIV Task Force pointed out in our one-on-one meeting with Mr. Keck, is that the hospitals which he believed would reach out to the poor and disenfranchised have sat on the funds and reached out to no one. Millions of dollars earmarked for health care for those who would have received ME are sitting idle in hospital bank accounts - while the dozen ASOs in SC could have used those funds to treat financially poor PLWH.
I would venture to say that we're already in that slide you mention and that 20-yrs could be wishful thinking. SC, Mississippi and Alabama (for example) with their low quality education issues, high STI rates, high teen pregnancy, poor overall health, poor access to health care, poverty.....well with all those issues and more, some states are already on the verge of failing right now.

First of all,yes,I understood that the exchanges and medicaid are two different issues.  I was asking is there a way to reach these US citizens who won't get qualified within state for medicaid and don't have the funds to pay for their state exchanges.


Maybe a mega foundation needs to step in.  After all, that suits the Randian/Victorian politics of charity being the recourse for "poor cases". 

If I understand correctly, the idea of government paying for a social safety net such as healthcare is too big a leap of consciousness for these state legislatures.  Even if it wasn't going to be their own state monies......lts the world view that the poor don't deserve government "handouts".   So would they be OK with say, a Clinton or Gates or Rockefeller foundation handout?

[zach]

leather specifically, but anyone that has knowledge. how difficult is it to move to another state with programs like adap and ryan white? i understand the difference in federal and state funding and administering, but have no experience with it.

say from georgia to north carolina? (out of the fire, into the pan i know). would i be making it more difficult for myself to access healthcare in north carolina than i have now in georgia? would ryan white and/or adap be affected? access to medicaid?

i know you live in south carolina, but i think the south is generally roughly equivalent in its hateful politics. i have noticed before you seem very knowledgeable in the healthcare access. is this something you're politically or professionally involved in? i do want to thank you for educating me now and in the past. i've lurked on most of these threads, but am starting to feel more politically motivated in this area

[leatherman]

how difficult is it to move to another state with programs like adap and ryan white? i understand the difference in federal and state funding and administering, but have no experience with it.

say from georgia to north carolina? (out of the fire, into the pan i know). would i be making it more difficult for myself to access healthcare in north carolina than i have now in georgia? would ryan white and/or adap be affected? access to medicaid?

everytime I read of someone moving to another state the first thing I warn them to do is check on the availability of services. Every state has different eligibility requirements and different services. Not too long ago, several states even had waiting lists for ADAP so if you moved there and needed ADAP, you would simply not have it - nor have any meds. Right now, no one using ADAP should be moving to Utah, because they currently have a waiting list. Also, Medicaid, because it is another federally-funded state-administered program, pays differently in different states. (SNAP benefits are different too but that's another story).

One other thing to consider when moving between states is the time-lag of applying and being approved in the new state. Some people have found the paperwork change to be smooth and easy, and others have had to battle the bureaucracy. A pozzie changing states needs to make sure they have enough "backup meds" to weather through the changeover in a worse case scenario.

Looking back, I had more services and higher benefits in Ohio than I do in SC. The only saving grace for where I live in SC is that there is an ASO here (Catawba Care) which fills in the gaps and pays for a lot of services for it's clients (we are part of the Charlotte metro area and are the only SC county that receives NC ADAP and CDC for the clients we care for who cross the the state line). Yet even with this ASO, it still took the state of SC 3 long months to get everything transferred properly for my case and benefits.

i have noticed before you seem very knowledgeable in the healthcare access. is this something you're politically or professionally involved in? i do want to thank you for educating me now and in the past. i've lurked on most of these threads, but am starting to feel more politically motivated in this area

When I moved back to SC, I attended an ADAP funding rally and realized that 20 yrs earlier I had been at a rally in Cleveland - both times advocating for meds. In 1990, I was advocating for the development of meds; and in 2010, I was advocating for access to meds. It seemed not much has changed, except the meds were finally working for me, so I began volunteering for my ASO doing prevention/education work. for the last 3 yrs, I've been the Communications Chair for the volunteer SC HIV Task Force (http://schtf.com).

The Task Force was formed in 2006 when 4 people died in SC while they were on the ADAP waiting list. We had another Waiting list in 2010 and one person died. Thankfully, we have been able to persuade enough State Legislators to fund ADAP and they agreed to 4 yrs worth of recurring funding. (we have just about a yr and a half left before we'll have to be advocating for ADAP again). Over the last 2-3 years we've been advocating for Medicaid Expansion (and hence why I know all I do, and more than I wanted to know LOL, about the ACA, the exchanges, and ME  ).

We're working towards becoming a stand-alone non-profit this year, and I've got my fingers crossed because I want to the be not just the first Exe Director of the independent Task Force; but I want to be the first HIV+ person leading the Task Force. (I think it's going to be very important to grab this leadership spot as the ASOs in my state are having to follow the money and turn into Community Health Centers expanding to serve more than just HIV+ people. As HIV is recognized more and more as a "chronic" illness, our fight for resources is changing. but that really is another story for another time)

[mitch777]

I know the ACA has had it's problems but this latest attempt to squash it without any replacement (once again) by the repubs will piss millions off. Kinda makes me smile in a way. It's funny how they describe the liberals as "elite" but seem to have no idea how elite they are themselves.

I'm STILL wondering if Wumpy ever found a policy through the ACA that was beneficial for him. Not picking on you if your listening, just wondering.

I have another link to post but granny doesn't seem to know how to post 2 links in one thread yet. lol.

http://thinkprogress.org/health/2014/10/08/3577518/republicans-threaten-another-shutdown-over-obamacare/

[mitch777]

Looks like we hiv+ folks are a huge portion of enrollees in Obamacare. No surprise to me. Not to mention Medicaid expansion, at least in the states that have more compassionate politicians.
http://mobile.nytimes.com/2014/10/08/business/health-law-drug-plans-are-given-a-check-up-.html?referrer&_r=0

[tednlou2]

Interesting that HIV patients are making up such a huge number. 

I continue to hope for a Medicare-For-All system, btw.  Did the CBO ever do a study on the effect of that?  It would seem Medicare would have huge buying power, if allowed to negotiate drug prices-- even with the current Medicare beneficiaries and much more so, if opened to millions more. 

[buginme2]

Ya if Medicare were allowed to negotiate drug prices, that would be huge.

[AusShep]

Interesting that HIV patients are making up such a huge number. 

The numbers are misleading.  It's based on number of Rx's, not enrolees.  If it were the number enrolled, it would more than the total HIV population of the US.  Also, based on the expense to the insurance companies it isn't nearly as far off from the employer plans.