It’s finally here. The one thing Americans won’t shut up about.
And no, I’m not talking about Sandra Bullock and George Clooney floating around in outer space in 'Gravity.' I’m talking about the mammoth, complex, and potentially intimidating new healthcare law, the Affordable Care Act, also known as Obamacare.
Here are two things we know about Obamacare. Number one, it’s the single most significant form of social legislation since Lyndon Baines Johnson signed Medicare into law in 1965. And number two, most people couldn’t explain it to you if you offered them a million dollars. Some of the blame lies at the feet of Barack Obama and his administration who’ve done a lousy job of explaining to the American people what it is. And some of the blame lies at the feet of our corporate media who, instead of explaining to the American people in clear and concise terms just what Obamacare is, would much rather tell you what the Democrats say Obamacare is, and what the Republicans say Obamacare is, and let our highly partisan electorate draw their own befuddled conclusions.
So I decided to take a break from listening to the new album from Miley Cyrus. I’ve put away my foam finger and my teddy bear. No more twerking! Time to explain to my readers just what the hell the Affordable Care Act is.
Here it is, in basic laymen terms.
About half of us get health insurance through our jobs. About a third get coverage through the government (Medicare and Medicaid). And about one in 10 will buy insurance themselves.
So let’s begin in the workplace. Many Americans are already covered through their employers. For them, not a whole lot will change. There will be some new advantages, like caps on how much you have to pay out of pocket, and free preventative care.
The bigger changes are for those who work for larger companies. That is because the government is going to require that companies who have 50 or more employees to cover their full-time workers, or else they'll have to pay a penalty. So, more workers may find themselves covered (this portion of the law goes into effect in 2015).
Smaller employers won’t face the same penalty for refusing to buy insurance. But they’ll be encouraged to do so. The government will be setting up special marketplaces to make it easier for small employers to take the plunge. Some will be offered temporary tax breaks if they do. And insurers can’t inflate prices if some of the employees are sick.
So many of us will be covered through work. A lot of us will be covered with help from the government. Not much will change for seniors on Medicare. The law has already started helping with prescription drugs and better preventative care.
On the other hand, Medicaid is expanding to help poor adults, many of whom weren’t eligible before. If your income is low (below $15,000 for a single person), Medicaid will cover you, most likely in a private insurance plan.
But there’s a catch. Last year, the Supreme Court, in its infinite wisdom, gave states the option to opt out of the Medicaid expansion, an expansion that will cost the states a whopping $0 for the first three years, and only 10 percent of the total cost each year after. So far, 26 states, all led by Republican governors and Republican legislatures have opted out, thereby denying healthcare to a jaw-dropping 30 million Americans.
For those of us who are not covered, or who find our insurance through work too expensive, we can shop for it ourselves on the open market at Healthcare.gov. It’s like walking into a strip club. You've got a bunch of one dollar bills in your pocket, now all you gotta do is find the exotic dancer that you most want to do business with. So instead of choosing Candie with the big boobs and severe daddy issues, you're choosing Anthem Blue Cross and Blue Shield. It's the same principle.
You'll find private insurers competing for your business. You can pick out how much coverage you want, and how much you want to pay - from cheaper, high deductible bronze plans, to more expensive platinum plans. Still, all plans will cover a comprehensive set of services like: hospital visits, doctor visits, maternity care, mental health care, and prescription drugs.
One big advantage to buying insurance in these marketplaces is that the federal government will provide most people with a tax credit to make insurance more affordable, especially if you don’t have any other options, and your income is below a certain level ($78, 000 for a family of three).
In fact, most people buying insurance on their own will be eligible for a tax credit and won’t have to pay the whole premium themselves. And the marketplaces will make sure insurance companies operate fairly under strict rules. They’ll have to offer everyone insurance, even if they’re sick. And they won’t be able to charge more for preexisting conditions. Men and women will pay the same price. And prices for older people will come down. Young people will have to pay more. To keep costs down, young folks can stay on their parent’s plan until they turn 26, and buy low-budget catastrophic plans until they’re 30.
All these changes still won’t mean insurance will come cheap. Most people buying their own coverage will end up paying less with their new tax credit. But some people will have to pay more. Even though many of them will be getting better and more secure insurance.
Not everybody is going to run out and buy insurance. Some people will say, “hold on a minute. If I can’t be turned down, or charged more, why not just wait until I get sick or injured to buy insurance?”
Well, you can only get coverage during the special enrollment period (October 1 - March 31). So if you snooze, you lose. And second, thanks to something called the Individual Mandate, if you’re not insured you may have to pay a fine.
Still, if you really can’t afford to buy in, and can’t get insurance anywhere else, the government will waive the penalty.
And where will the money come from to pay for this new government-subsidized form of healthcare?
It’ll come from higher taxes, many of them targeted at the health industry. For instance, tanning salons will have to pay more to Uncle Sam. Individuals will pay more too (mostly the rich who will be paying more into Medicare).
So that means the Speaker of the House, John “Jack-O-Lantern” Boehner, will be taxed twice – one because he’s rich, and two because he spends more time in a tanning salon than a Hollywood starlet.
I mean seriously, the man looks a pumpkin!
Now, memorize everything you just read and explain to your Republican grandparents why Obamacare isn’t socialism, isn't welfare, isn’t going to bankrupt America, and isn’t a jobs killer.
Hey, speaking of things that aren’t true about the Affordable Care Act, here’s a few more talking points brought to you by the right wing's own curious brand of truthiness.
“Obamacare will lead to death panels.” – Sarah Palin
“Thanks to Obamacare doctors will be forced to ask patients about their sex lives, even if it has nothing to do with the medical treatment that they are seeking at the time.” – Ainsley Earhardt on “Fox and Friends”
“What we now have is the biggest tax increase in the history of the world. Obamacare is just a massive tax increase. That’s all it is.” – Rush Limbaugh
Wait a minute. Rush Limbaugh said something that was blatantly false?
Wow! That almost NEVER happens!
Yes, Obamacare is deeply flawed. It provides big subsidies to the health insurance industry, it’s a bonanza for lobbyists, there is no public option, and the glitches that have plagued the site has been an epic embarrassment.
The Congressional Budget Office has calculated that by 2018, after the law has been fully implemented, 7 million people will be dropped from their employer health plans and 5 million people will shift out of private plans. Meanwhile, the number of people without insurance will decrease by 25 million, a cut of more than 45 percent. This week Oregon announced that the state’s uninsured rate has already been cut by 10 percent since Oct 1, when people were first able to sign up for Obamacare.
In other words, there are pros and cons. But I would rather we have the Affordable Care Act than to have the Republicans’ alternative plan, which is to give every uninsured sick person the finger!
I would respect their point of view a lot more if they at least had their own healthcare plan. But they don’t. All they have are a bunch of talking heads who want you to believe that Obamacare is the worst thing to happen to this country since slavery.
Oh, I’m not joking. Respected neurosurgeon, and Conservative Flavor Of The Week, Dr. Ben Carson, stood two weeks ago before a bunch of white people at the Values Voter Summit and said this.
“Obamacare is the worst thing to happen to this country since slavery.”
Did I happen to mention that Dr. Ben Carson is an African American?
It’s hilarious that the conservative ideology can make even a neurosurgeon sound about as smart as Homer Simpson.
Not segregation, not the Great Depression, not the attack on Pearl Harbor, not the assassination of President Kennedy, not the resignation of President Nixon, not 9/11, not Hurricane Katrina, not the Wall Street shenanigans that brought down our economy, none of that.
In the eyes of Dr. Carson, idiot savant and the world’s worst historian, Obamacare is the most awful thing we’ve seen in America since slavery. That’s a breathtakingly stupid thing to say, and because he said it, it provides racist white people with the cover to say the exact same thing.
The most shocking thing about Carson’s comment was that it wasn’t shocking. Carson was simply obeying commandments that are chiseled on a stone tablet somewhere in a dark corner of Lucifer’s Lair, also known as Rupert Murdoch’s basement.
Thou shalt not understate;
Thou shalt not be thoughtful;
Thou shalt not make a lick of sense.
Expanding Medicaid, the joint federal-state program for the poor, is critical to the Affordable Care Act’s goal of covering the nation’s 48 million uninsured. Hospitals and insurers are counting on more Medicaid patients to make the economics of the law work.
But in June 2012, the Supreme Court ruled that states could opt out of Medicaid expansion. The ruling opened the door for conservative opponents of the law (i.e. Americans for Prosperity) to run aggressive campaigns aimed at gutting the Medicaid expansion.
Here in Virginia, where one million residents lack health insurance, AFP is paying youth church groups to knock on doors, and spread misinformation about the law. Think about that for a second. Churches (and their pastors) are engaging in a fight to deny poor people health insurance, which is the exact opposite of what Jesus would do.
In making its case, AFP taps into deep unease about the size and scope of the federal government. Citing a University of Virginia study that found worse surgical outcomes for Medicaid patients than for the uninsured, they contend that Medicaid coverage is worse than no coverage at all.
Of course that’s ridiculous. The uninsured cost us all money when they get routine health care from emergency rooms and show up unable to pay for crisis care. And those who are currently on Medicaid tend to be less healthy (i.e. poor folks on kidney dialysis) than the uninsured, a huge percentage of whom are young and healthy.
If one believes that healthcare is a privilege that must be earned through paid labor then they are saying that the frail, the sick, the unemployed, the very young and very old are of no value to us and might as well die.
I find it astonishing that conservatives oppose the ACA – it’s a conservative idea, "personal responsibility" to buy your own insurance in a competitive market. This is their idea, and they’ve turned against it.
It’s like the Ku Klux Klan all of sudden announcing they like black people.
Basically, what Limbaugh, Sean Hannity, and the rest of the Fox talking heads have done is tap into the anger and racism of the aging, poorly educated whites. This is not about objections to health care, this is about objections to the black man in the White House.
We saw this last week when a march for veterans was ambushed by members of the Tea Party.
Led by the Senate's reigning drama queen Ted Cruz, the man most responsible for the two week government shutdown that cost the economy $24 billion, and by historical footnote Sarah Palin, the group brought their rifles, they waved a Confederate flag, and they told the President (as they stood in front of The White House) to “put the Quran down.”
Nothing racist about that!
Interesting, isn't it, that the issue on which the historic Republican party, the party of Lincoln and Roosevelt and Eisenhower, chooses to stand or fall is not stopping illegal war, or stopping unconstitutional drone killings, or stopping mass murder, or stopping the criminal activities on Wall Street, or stopping the flow of jobs out of the country, or stopping the economic war on the middle class, or stopping the abandonment of the poor, or stopping corporate welfare, or stopping tax dodgers, or stopping the tens of thousands of annual shooting deaths, or stopping cities from going bankrupt, or stopping our public schools from collapsing, or stopping hunger and ignorance ... no, they put the entire force of their moral, spiritual, and political will behind stopping something even more heinous, more dreaded, more apocalyptic - a very watered-down form of healthcare for almost everybody, a healthcare system that they themselves designed at the Heritage Foundation, a healthcare system that they were in favor of until that colored fella in the White House decided that he was in favor of too.
There are millions of Americans who work at crummy jobs that they hate because that crummy job offers health insurance. Workers in countries that have universal healthcare (which is every country in the developed world except the US) don’t have this problem.
Because Obamacare offers affordable healthcare to all Americans who make under $80,000 a year, the death grip that these crummy jobs have on their employees is weakened. It is now easier for employees to leave their crummy jobs to start a business, or to leave for jobs that are more fulfilling, even if those jobs don’t offer health insurance.
And Obamacare is a major step towards universal healthcare. Starting in 2016 Obamacare allows states to offer a single payer healthcare system, which is Medicare for all. Vermont has already voted on this and signed it into law. I predict that once Vermont’s single payer system of healthcare proves to be successful, other states are going to do the same thing.
Obamacare will be a success. I truly believe it. And so does Barack Obama. At a recent rally, the Commander in Chief said this …
“We may not get that same level of cooperation from Republicans right now. But the good news is I believe eventually they’ll come around. Because Medicare and Social Security faced the same kind of criticism. Before Medicare came into law, one Republican warned that – ‘one of these years you and I will spend our sunset years telling our children and our children’s children what it once was like when men were free.’ That was Ronald Reagan. And eventually Reagan came around to Medicare, and thought it was pretty good, and actually helped to make it better … And once it’s really working I guarantee you they will not call it Obamacare. Here is a prediction for you. A few years from now when people are using this to get coverage, and everybody is feeling good about the competition and choices they’ve got. There’s going to be a whole bunch of folks who say, ‘you know I always thought this provision was excellent. I voted for that thing.’ ... You watch.”
He is 1000 percent correct.
Thanks for reading. I gotta go. I need a good night's sleep before I go to work. I predict that sometime tomorrow morning I will come down with a severe case of the Mondays.
That's the bad news. The good news is that thanks to Obamacare, I'm totally covered.