Lawmakers/Aides try to get out of Obamacare

[ninjadude]

I think the point is that assume a person gets cancer. Up till that point the person can get by without insurance. But then after getting cancer, they will need it, right? Too bad then that they chose to take the Penalty instead? NOPE, due to not being able to discriminate about pre-existing conditions, the person with cancer gets insurance and gets their cancer paid for. And at a reasonable rate.

Thus the arguement is why get insurance till you need it? If you can immediately get insurance whenever you need, what is the motivation to have it at all times?

You know better than this. It doesn't work that way. You can't sign up for it when you get sick. This has been discussed here on UM many times.

[ninjadude]

LMAO. I am glad you are so out of touch you actually believe SS is in good shape. .

You can LMAO all you want. SS needs a very minor adjustment. It was already setup to handle the increase in usage by Baby Boomers. It is the only program anywhere than can assure payment that far into the future. It will currently pay full benefits for quite some time and partial after that - if there are no changes. It is amongst the most popular government program in existence. What exactly is your "problem" with SS? Or are you going to parrot more lies and inuendo.

No one should be forced to buy health insurance.

Why?

[ninjadude]

You mean the same type of "free enterprise" that was supposed to keep the media from being owned by all these corporations back during Reagan's term, and now there are only a handful of corporations who own the media now? The whole "free enterprise" backfired then, too.

So now you're not for free enterprise and capitalism? You want socialism or totalitarianism? is that it?

[Merc14]

You can LMAO all you want. SS needs a very minor adjustment. It was already setup to handle the increase in usage by Baby Boomers. It is the only program anywhere than can assure payment that far into the future. It will currently pay full benefits for quite some time and partial after that - if there are no changes. It is amongst the most popular government program in existence. What exactly is your "problem" with SS? Or are you going to parrot more lies and inuendo

I don't discuss things with you as you are a totally irrational person. I use your posts as examples of all that is wrong with the progressive ideology and the zealots that follow it.

Edited May 26, 2013 by Merc14

[+DieChecker]

You know better than this. It doesn't work that way. You can't sign up for it when you get sick. This has been discussed here on UM many times.

I must have missed it. Is the discussion in this thread?

What about not being able to discriminate against pre-existing conditions? Your tests and appointments to establish you have cancer are probably like 20,000 dollars, but then you get insurance and the rest of the 4 million dollars for treatment is covered. Lifetime limit anyone?

Edited May 26, 2013 by DieChecker

[Merc14]

I must have missed it. Is the discussion in this thread?

What about not being able to discriminate against pre-existing conditions? Your tests and appointments to establish you have cancer are probably like 20,000 dollars, but then you get insurance and the rest of the 4 million dollars for treatment is covered. Lifetime limit anyone?

I honestly don't think he has a clue on how insurance works so you are probably wasting your time. The pre-existing conditions change along with the initial low penalties for not being insured will drive most insurers out of the business creating a crisis which will allow the government to enact single payer.

[+DieChecker]

I honestly don't think he has a clue on how insurance works so you are probably wasting your time. The pre-existing conditions change along with the initial low penalties for not being insured will drive most insurers out of the business creating a crisis which will allow the government to enact single payer.

I'm not too worried about it. The Republicans will come to power and have another decade, and hopefully if they get a super-majority like the Dems had back in 2009, we'll see a real Do-over of all the crap laws that were pushed though for the sake of partisan politics.

I'm kind of interested how a decade of Federal Health Insurance would look being guided by the Republicans.

[F3SS]

I don't think that is the case, because people can get insured immediately upon begining a new job (If there is no probationary period) and so people get insured constantly year round. Changing your Existing insurance is only done at Open Enrollment, AFAIK, but starting a new insurance can be done at any time.

If we are talking about the ACA, then they have set a Open Enrollment of October 2013, which is basically when the Market Exchanges are opening for business. But..... I highly doubt that the ONLY time that people will be able to sign up for a Marketplace insurance plan is in October. What if someone gets a job in November and has no existing insurance? Does he have to wait till the next October? No... that is idiotic. And if that IS the way it is going to work, then it simply is NOT going to work.

Good points but it's likely that what I was parroting was in reference to me, a self employed person and my employees who are not insured. At a later time I was also given a link showing that the IRS will have no authority to penalize with jail or put liens on property for failure to pay the fine. However, they will just take the fine out of your tax return. I then asked what about a guy like me who pays quarterly taxes on my own will. What if I just don't write the check for the fine? I never get a tax return as I'm always spot on or owe money so how they gonna get my money if there is no real consequence? I asked all this to the resident Obamacare aficionado, Startraveller, and as informing as he is I never got an answer. My guess is because there is no other answer and if I choose not to pay I won't really have anything coming to me and if it's as simple as that he probably didn't want to affirm that just so I'd feel compelled to participate in this stupid law. But the link he showed me looked like a legit reference to the law and if that's the case then anything else is just a scare tactic to get me to participate but the majority of people who get tax returns will not have a choice unless they opt out of there W2 deal and pay their own taxes if that's even possible,

[Startraveler]

I find that very hard to believe Star. Its no coincidence that just months before 0bama care is fully implemented that the prices have litteraly shot through the roof. Just as predicted.

What are you suggesting is actually raising your prices?

I hate insurance companies with a passion! They do the same thing to elderly people all the time. They keep going up on them, knowing no one else is going to take them at that advanced age...and they are living on a fixed income.

That's exactly why the reforms include age rating requirements that kick in for next year's plans.

Um...HOW?

Oh, do you mean Medicaid? That program all you liberals think is so wonderful?

I believe he was talking about private insurance available through the new marketplaces. Medicaid is part of the coverage expansion (a smaller part now than was expected when the law passed), the rest is about getting people access to private insurance plans.

I don't think that is the case, because people can get insured immediately upon begining a new job (If there is no probationary period) and so people get insured constantly year round. Changing your Existing insurance is only done at Open Enrollment, AFAIK, but starting a new insurance can be done at any time.

If we are talking about the ACA, then they have set a Open Enrollment of October 2013, which is basically when the Market Exchanges are opening for business. But..... I highly doubt that the ONLY time that people will be able to sign up for a Marketplace insurance plan is in October. What if someone gets a job in November and has no existing insurance? Does he have to wait till the next October? No... that is idiotic. And if that IS the way it is going to work, then it simply is NOT going to work.

Open enrollment in the exchanges is going to work very much like it works right now in the small group market (or in Medicare, for that matter). You can't just buy a plan any time you like because you happened to get hit by a bus or had a heart attack and need someone to pick up the tab. After the initial open enrollment period this year when the exchanges open for the first time--which will last for six months--there will be an annual open enrollment every for seven weeks starting in October. You buy it then or you don't buy it and take your chances.

The exception is that (like in the small group market serving employers today) there are certain special circumstances when you have a major life change where you can get a new plan. If you leave your job and thus lose access to the employer-based health plan or you have a child that needs to be added to your coverage, etc you can change or join a plan; you get 60 days from the qualifying event to buy insurance, otherwise you have to wait until the next open enrollment period.

You can't sign up for coverage just because you've become sick or injured.

[ I never get a tax return as I'm always spot on or owe money so how they gonna get my money if there is no real consequence? I asked all this to the resident Obamacare aficionado, Startraveller, and as informing as he is I never got an answer. My guess is because there is no other answer and if I choose not to pay I won't really have anything coming to me and if it's as simple as that he probably didn't want to affirm that just so I'd feel compelled to participate in this stupid law.

I'm not a tax lawyer, but I imagine it won't affect you. That said, if you ever do have a tax return, you'll have wracked up quite a backlog of money owed.

As I've said, the mandate penalty and its enforcement are weak.

[F3SS]

I'm not a tax lawyer, but I imagine it won't affect you. That said, if you ever do have a tax return, you'll have wracked up quite a backlog of money owed.

As I've said, the mandate penalty and its enforcement are weak.

That's what I'm thinking now. Soloing as I'm self employed all I need to do is not pay more than I owe because if I do I still don't get a return. Instead I just get a credit toward next year or if I don't have insurance they'll just eat that and I get no credit.

[ninjadude]

I don't discuss things with you as you are a totally irrational person. I use your posts as examples of all that is wrong with the progressive ideology and the zealots that follow it.

back at you for showing everything wrong with a TEA party ideology and the zealots that follow it.

[Merc14]

back at you for showing everything wrong with a TEA party ideology and the zealots that follow it.

You haven't the slightest idea what the tea party wants or what it stands for. You are the single most uninformed individual I have ever seen on any forum.

[ninjadude]

You haven't the slightest idea what the tea party wants or what it stands for. You are the single most uninformed individual I have ever seen on any forum.

Nor have you ANY idea what Progressive or Liberalism wants or stands for. You are quite SIMILAR to the uninformed few that make up the the TEA party and have no idea what they are talking about.

How long do you want to hurl insults?

Edited May 27, 2013 by ninjadude

[+DieChecker]

Open enrollment in the exchanges is going to work very much like it works right now in the small group market (or in Medicare, for that matter). You can't just buy a plan any time you like because you happened to get hit by a bus or had a heart attack and need someone to pick up the tab. After the initial open enrollment period this year when the exchanges open for the first time--which will last for six months--there will be an annual open enrollment every for seven weeks starting in October. You buy it then or you don't buy it and take your chances.

The exception is that (like in the small group market serving employers today) there are certain special circumstances when you have a major life change where you can get a new plan. If you leave your job and thus lose access to the employer-based health plan or you have a child that needs to be added to your coverage, etc you can change or join a plan; you get 60 days from the qualifying event to buy insurance, otherwise you have to wait until the next open enrollment period.

You can't sign up for coverage just because you've become sick or injured.

I see that one of the Qualifiers of a Special Enrollment is marriage. I can imagine people using that as a work around the Yearly Enrollment. Having a child is way to hard to use to get around the yearly enrollment, unless maybe being a Foster Parent qualifies? Then there is losing a job, that could be abusable too. Friends or family could hire someone give them insurance for a month and then "fire" them, thus allowing them to get access to the Exchanges. I can see ways to work the system if someone really wanted to. There is probably going to be too many people involved for those who are managing the system to find people trying to enroll fraudulently. Medicare and Medicaid (IMHO) are good examples of programs where the policing of enrollees is lax.

http://www.mbaileygr...exchanges-work/

And if the Enrollee just happens to have been diagnosed with Cancer a week or two before being married, well, that is simply a coincidence, right?

Edited May 27, 2013 by DieChecker

[Wickian]

I thought this article was funny describing a few of the new regulation in Obamacare.

Obamacare will require doctors to use roughly 122,000 new medical diagnostic codes to inform the federal government of injuries sustained by Americans, so says Kentucky Senator Rand Paul.

The new codes, Sen. Paul explained, include classifications for "injuries sustained from a turtle," "walking into a lamppost" and "injuries sustained from burning water skis."

"Your government just wants to take care of you," he added, criticizing the new law's 9,000-plus pages of new regulations. "They don't think you're smart enough to make these decisions."

...

"Included among these codes," the senator continued, "will be 312 new codes for injuries from animals; 72 new codes for injuries just from birds; 9 new codes for 'injuries from the macaw."'

"The macaw?" he asked. "I've asked physicians all over the country, 'Have you ever seen an injury from a macaw?"'

[Kowalski]

You don't know whether to laugh or cry....

[+DieChecker]

Well look at all the ways a Macaw might injure someone... There are at LEAST 9....

Beak, Talons, choking on feathers, allergys, macaw flu, falling poop....

(SARCASM)

Also the dangerousness of turtles is very underrated...

[Kowalski]

Well look at all the ways a Macaw might injure someone... There are at LEAST 9....

Beak, Talons, choking on feathers, allergys, macaw flu, falling poop....

(SARCASM)

Also the dangerousness of turtles is very underrated...

LOL...

[F3SS]

I for one am glad there are another one hundred and twenty two thousand new ways for the hospital to screw up your insurance claim.

[Kowalski]

I for one am glad there are another one hundred and twenty two thousand new ways for the hospital to screw up your insurance claim.

I know, right?

[Wickian]

I for one am glad there are another one hundred and twenty two thousand new ways for the hospital to screw up your insurance claim.

Government micro-management at it's best.

[Silver Surfer]

I read this today... i know nothing about Obamacare and I am not from America... Just thought you guys could read it and argue about it. Cheers

http://www.forbes.com/sites/rickungar/2013/05/24/unexpected-health-insurance-rate-shock-california-obamacare-insurance-exchange-announces-premium-rates/

[F3SS]

I read this today... i know nothing about Obamacare and I am not from America... Just thought you guys could read it and argue about it. Cheers

http://www.forbes.com/sites/rickungar/2013/05/24/unexpected-health-insurance-rate-shock-california-obamacare-insurance-exchange-announces-premium-rates/

Gee thanks.

$276 a month for a mediocre insurance plan is still $276 a month ripped from my wallet that I don't want taken. That's $3312 a year and if I live to be only 70 that'll come to $119,232 in my life. Most people will opt for the crap ass bronze plan and who's going to ever afford gold and platinum, aka good insurance. And what happens to the people who never buy and are swamped in IRS fines? Where they gonna go? Ohh yea, the government and that'll cost tax payers how much more? No administration in history has ever cost present and future generations so much money. Screw these guys. They get a big middle finger and their pictures on a dart board and as much defiance as I can offer.

[Startraveler]

I see that one of the Qualifiers of a Special Enrollment is marriage. I can imagine people using that as a work around the Yearly Enrollment.

As I said, this (the enrollment period bit) is how it works now for people with employer-sponsored insurance (i.e. the vast majority of people with private insurance). Has there been an epidemic of people marrying to gain access to their new spouse's company insurance plan? I have no idea. I suspect not.

I thought this article was funny describing a few of the new regulation in Obamacare.

Except it's false. Believe it or not, not all things are an artifact of Obamacare. In 1996, Congress passed HIPAA, which moved to simplify the administration of health care by requiring providers who billed the public payers (and effectively the private insurers, as well, who moved to follow the government's lead) to bill using a code set called ICD-9 (i.e. the International Conference for the Ninth Revision of the International Classification of Diseases). Here's the thing: ICD-9 was developed in 1975. The United States is currently set up to bill for health services as they were delivered in 1975. Medicine changes over the course of 40 years.

In 2008, the Bush administration released regulations to push us forward a bit and move to ICD-10, which was finished in 1992.

FOR IMMEDIATE RELEASE

Friday, August 15, 2008

Contact: CMS Office of Public Affairs

(202) 690-6145

HHS Proposes Adoption of ICD-10 Code Sets and Updated Electronic Transaction Standards

Proposed Changes Would Improve Disease Tracking and Speed Transition to an Electronic Health Care Environment

The Department of Health and Human Services (HHS) today announced a long-awaited proposed regulation that would replace the ICD-9-CM code sets now used to report health care diagnoses and procedures with greatly expanded ICD-10 code sets, effective Oct. 1, 2011. In a separate proposed regulation, HHS has proposed adopting the updated X12 standard, Version 5010, and the National Council for Prescription Drug Programs standard, Version D.0, for electronic transactions, such as health care claims. Version 5010 is essential to use of the ICD-10 codes.

Notice the effective date there? The Bush administration said that providers have to upgrade to ICD-10 by 2011.

One of the first things the Obama administration did (back in 2009) was push that date back by at least two years to give providers a chance to adjust:

HHS announces intent to delay ICD-10 compliance date

As part of President Obama’s commitment to reducing regulatory burden, Health and Human Services Secretary Kathleen G. Sebelius today announced that HHS will initiate a process to postpone the date by which certain health care entities have to comply with International Classification of Diseases, 10th Edition diagnosis and procedure codes (ICD-10).

The final rule adopting ICD-10 as a standard was published in January 2009 and set a compliance date of October 1, 2013 – a delay of two years from the compliance date initially specified in the 2008 proposed rule. HHS will announce a new compliance date moving forward.

Rand Paul can chuckle all he wants, the update to ICD-10 has nothing to do with Obamacare and in fact has been in the works since the Bush administration. The real joke is that we're using code sets from 1975 to catalog what medicine is being delivered in 2013. Our health system has a lot of work to do to move into the 21st century.

Edited May 28, 2013 by Startraveler

[Merc14]

As I said, this (the enrollment period bit) is how it works now for people with employer-sponsored insurance (i.e. the vast majority of people with private insurance). Has there been an epidemic of people marrying to gain access to their new spouse's company insurance plan? I have no idea. I suspect not.

Except it's false. Believe it or not, not all things are an artifact of Obamacare. In 1996, Congress passed HIPAA, which moved to simplify the administration of health care by requiring providers who billed the public payers (and effectively the private insurers, as well, who moved to follow the government's lead) to bill using a code set called ICD-9 (i.e. the International Conference for the Ninth Revision of the International Classification of Diseases). Here's the thing: ICD-9 was developed in 1975. The United States is currently set up to bill for health services as they were delivered in 1975. Medicine changes over the course of 40 years.

In 2008, the Bush administration released regulations to push us forward a bit and move to ICD-10, which was finished in 1992.

Notice the effective date there? The Bush administration said that providers have to upgrade to ICD-10 by 2011.

One of the first things the Obama administration did (back in 2009) was push that date back by at least two years to give providers a chance to adjust:

Rand Paul can chuckle all he wants, the update to ICD-10 has nothing to do with Obamacare and in fact has been in the works since the Bush administration. The real joke is that we're using code sets from 1975 to catalog what medicine is being delivered in 2013. Our health system has a lot of work to do to move into the 21st century.

Marx referred to westerners, deeply engrossed with the socialist ideal and its huge "successes" in the Soviet Union, with the pejorative term "Useful idiot". Karl would be proud of you sir.