Funny thing is Globe has steered away from the issue the last couple of days -- as predicted.
"Was Mitt Romney right about US health overhaul?" by Tracy Jan | Globe Staff, December 07, 2013
WASHINGTON — The warning resounded through the 2012 presidential campaign. Massachusetts’ groundbreaking health reform, Republican nominee Mitt Romney said, would never work for the country as a whole.
Democrats widely dismissed Romney’s comments as politically opportunistic, an effort to distance himself from the plan he backed as governor. Now, given the epic scale of problems that have bedeviled the rollout of President Obama’s plan, some state legislators, insurance and hospital executives, and others around the country are returning to Romney’s refrain.
Was the Massachusetts plan, in hindsight, really the best blueprint for the nation?
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While the Massachusetts model may work for some states, Massachusetts state Senator Richard Moore, a Democrat and key architect of the state’s health reform law, said, imposing a uniform standard across the country was folly because it did not take into account the unique dynamics of local insurance markets, regional variation in health care delivery, and even the political and social culture of other states.
Obama and other Democrats in 2009 and 2010, when they were drafting their law, Moore added, would have been better served to use the Massachusetts model as a flexible framework for states to adopt over time, rather than a blueprint for a mandatory national plan....
That's what Republicans say!
Andrew Dreyfus, chief executive of Blue Cross Blue Shield of Massachusetts and another supporter of the Massachusetts and national health care plans, said, “In some ways, we may see the Affordable Care Act evolve into a more state-based system.”
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These are the sorts of assessments that were thrust to the forefront this week at an annual meeting of the National Conference of State Legislatures in Washington, where the organization’s health reform task force examined how states are responding to the mass public confusion caused by the law’s botched rollout. “It’s the most daunting challenge I’ve faced in 20 years as an elected official,” said Alabama state Representative Greg Wren, the task force’s Republican cochairman. “The feds passed something the states did not have involvement with, and yet we’re being forced to implement a patchwork of federal ideas, and now we’re being asked to help in saving the health law.”
Like Massachusetts, the federal plan mandates that most Americans buy insurance in 2014 or face a tax penalty; requires insurance plans to be sold through an online marketplace where consumers could make comparisons; provides insurance subsidies for low-income individuals; and fines larger companies that don’t offer insurance to their employees.
Already, the unified sweep of the federal law has splintered considerably. Following a Supreme Court ruling in 2012 that made Medicaid expansion optional for states, 25 of them, including Maine and New Hampshire, have opted out of that portion of the law.
And because of widespread Republican resistance to the law from governors and state legislators, 36 states, including Maine and New Hampshire, have not launched their own online insurance portals, leaving it to the federal government to oversee those marketplaces.
That's a LIE! Some Democrats have also declined to join.
Consumers living in states that set up websites have had a much smoother shopping experience overall.
Wrong, as you shall soon see below!
As Obama attempts to weather wave after wave of controversy, he continues to move back deadlines and give states increasing flexibility to adapt.
For example, seeking to recover politically from his broken promise that all people could keep their health care plans, Obama gave individual states the option of allowing noncompliant plans to remain in place for another year. About two dozen states, including many that have embraced health reform such as Massachusetts, Washington, and New York, have said no. The other half, including Florida, New Hampshire, and Maine, will allow the renewals of such plans.
Does one ever really recover from such a thing politically?
“There are now four or five variations of what state markets could look like,” said Dreyfus, whose company, Blue Cross Blue Shield of Massachusetts, was the only individual insurance plan in the country that filed a friend of the court brief backing the Affordable Care Act during the Supreme Court case.
Several Democrats in Congress, including those who have sponsored bills to amend the federal law, say they are not ready to dismiss the Massachusetts blueprint despite their misgivings about the law’s implementation. “We looked at the Massachusetts-type model because it’s based on a competitive, Republican-style market-based plan,” said Representative Diana DeGette, a Colorado Democrat and member of the Energy and Commerce Committee that drafted the House version of the health bill.
Say what?
The bill that passed with only Democrat support was a Republican-style plan?
An aide to Senator Mary Landrieu, a Louisiana Democrat who is pushing a bill to allow consumers to keep their noncompliant insurance plans indefinitely, said the problems with the rollout are inexcusable but in states willing to embrace the health overhaul, the Massachusetts plan is working.
Senator Edward Markey of Massachusetts, who was a senior member of the committee that drafted the House version of the health bill, said it is the federal government’s responsibility to ensure a right to health care rather than leaving it up to each state to create a patchwork of policies.
“Every American should have access to quality, affordable health care just as Medicare and Social Security provide vital benefits that millions of Americans depend on, regardless of the state in which they live,” Markey said in a prepared statement. Still, it is difficult for Republicans not to gloat.
“I do think that one of the fundamental problems we’re seeing now is that the Obama administration was attempting to federalize something that ultimately cannot be federalized,” said Lanhee Chen, Romney’s policy director during the 2012 campaign. “Governor Romney’s criticism turns out to have been quite accurate.”
What worked in Massachusetts will probably not work in all 50 states, each with its own political dynamics, he said — not to mention that insurance has always been regulated at the state level. “If you try to impose a one-size-fits-all framework, you’re going to run into some difficulties, and I think the administration is learning that the hard way,” Chen said. “So what the Obama people wanted — a single federal system — will never come to pass.”
The Massachusetts law had distinct advantages, having evolved over nearly two decades and building on practices that were already in place, such as insurers not being allowed to deny coverage to people with preexisting medical conditions. The state law also garnered bipartisan support, as well as industry buy-in.
John McDonough, a Harvard public health professor who helped craft the Massachusetts and federal laws, said he cannot conceive of another health reform model that would have achieved a similar level of progress and gotten through Congress in 2010. The law was a compromise cobbled together with conservative ideas such as the individual mandate and having a competitive market-based plan to appease those wary of a single-payer government-run system some Democrats had advocated.
I don't want to refight what I blogged tirelessly about almost five years ago. I couldn't find the links through a search, and even if I could why bother? Politics is all $hit-show fooleys for you folks, this "argument" over health care being the latest manifestation.
“The Massachusetts model was the worst possible framework for federal reform,” McDonough said dryly, “except for all the alternatives.”
What we are left with, huh?
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The answer to my question is supplied by my very own representative:
"Now required to shop at exchange, many lawmakers see premiums rise" by Mattias Gugel | Globe Correspondent, December 07, 2013
WASHINGTON — As millions of Americans grapple with the confusion and complexity of President Obama’s national health care overhaul, they have company in Congress. Many lawmakers, including most members of the Massachusetts delegation, are facing hefty premium increases.
We were told those weren't going to happen, but what is one more broken promise? Now I need Obamacare to help heal my broken heart -- but I can't sign up for it because of the continuing problems at the website.
As a symbolic political move to ensure that members of Congress and their staffs participate in the insurance changes they adopted in the Affordable Care Act in 2010, the law, starting in 2014, strips them of their federal employee health insurance. Instead, they are required to choose a plan from among the options on the District of Columbia health insurance marketplace, one of the local health care exchanges the act created to help Americans purchase affordable coverage.
I'm so sick of the symbolism, imagery, and illusion of the world as presented by my jewsmedia, sorry.
With the switch, they are exposed to stricter underwriting rules that are used to set premiums, especially those based on age. As a result, older lawmakers are getting socked, with monthly costs expected to more than double for some.
“I’m going to be paying significantly more than I paid under the Federal Employee Health Benefits Program,” said Representative Jim McGovern, 54, a Democrat from Worcester. “But it is what it is, and we’re going to do our homework and try to make the best choice for our family.”
Think about that for a minute. The lawmaker says it is what it is. People who are allegedly paid to look out for our interests, who respond to events and write laws to correct, prevent, or right the wrongs that have occurred is saying it is what it is. Just accept this stinky, smelly, swirler we have plated to you. They can't do anything about it. And yet they want, what, climate change taxes and such to respond to that alleged problem? Gun control? Is what it is?
Honestly, I'm a little turned off by the indifference my own man is showing the American public.
With the exception of 33-year-old Representative Joseph P. Kennedy, a Brookline Democrat, all of Massachusetts’ lawmakers are older than 51 — a key age threshold for more expensive premiums.
Senator Elizabeth Warren and Representative William Keating are the only Massachusetts lawmakers who will not be enrolling through the D.C. exchange, according to a Globe survey of the Massachusetts delegation. Warren will remain on the plan of her husband, Bruce Mann, a professor at Harvard Law School. Keating, a former state lawmaker and Norfolk County district attorney, will continue to draw benefits from the Commonwealth of Massachusetts’ Group Insurance Commission as a retiree.
Most of the remaining lawmakers are facing increases because they are losing what is known as “community-rated’’ employer-based insurance, in which everyone in an insurance pool pays the same individual or family premium. On the Affordable Care Act exchanges, factors that increase risk of illness like age and smoking are taken into account when setting premium rates.
“What happens to the Congress is that the older ones will wind up paying double or more the current premium, and younger ones less,’’ said Walton Francis, a Washington health insurance consultant who advises the government and federal employees.
For Representative Richard E. Neal, the higher premiums he will see when he signs up for his new plan are just a fact of life. “Well, at this stage of my life, I deplore age-rating,” said the 64-year-old congressman from Springfield, chuckling. “Insurance is shared risk. It’s based on actuarial realities.”
In 2014, most federal employees will contribute $190.28 for individual coverage toward their total $616.52 monthly premium for the Blue Cross Blue Shield standard option for individual coverage through the government employee health program.
The Obama administration decided that members of Congress and their staff will still receive employer contributions from the federal government. The taxpayer contribution toward members’ insurance is calculated as a percentage of the premium, reaching a maximum of $420.14 per month for individual coverage.
That means taxpayers who are getting cancellation notices or whose premiums are skyrocketing are subsidizing federal employees health care costs -- all for your own good.
According to a Globe sampling of plans on the D.C. exchange, lawmakers over 59 looking to stay with CareFirst Blue Cross Blue Shield will see a potential increase in their contribution of 102 percent, to $384.57 a month. Members younger than 39 should see their premiums cut at least in half in comparison with the standard plan.
The D.C. exchange will have a wider selection of plans from which to choose. Lawmakers are now choosing between 112 gold-tier options from insurance providers Aetna, CareFirst Blue Cross Blue Shield, Kaiser Permanente, and United Healthcare.
How many options are you being given?
Before, they could choose from 10 to 15 health insurance plans available to them from a total of 256 plans through the Federal Employees Health Benefits Program, according to the Congressional Research Service.
Francis said that, based on his analysis of the exchanges’ gold plans, most were comparable in coverage to the federal workers program with the exception that “the lower-priced gold plans generally have much higher deductibles.”
Neal said his new plan’s coverage would be “not really” different from what is now.
Representative Niki Tsongas, 67, a Lowell Democrat, said going to the Affordable Care Act exchanges for her health coverage is part of empathizing with constituents who will rely on the marketplace to find their insurance.
“I do think it is appropriate for members of Congress to be experiencing that which so many Americans will be experiencing,” she said. (The D.C. exchange rules say that Medicare-eligible members of Congress, like Tsongas, must purchase a primary plan through the exchange; Medicare serves as their secondary insurance.)
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Oh, yeah, about those smooth state websites:
"Problems continue to plague Mass. health marketplace" by Chelsea Conaboy | Globe Staff, December 07, 2013
With three weeks left in the year, not one of the thousands of Massachusetts residents who need to enroll in new health insurance plans by Jan. 1 has been able to do so through the state insurance marketplace that was revamped to comply with the national Affordable Care Act.
HealthCare.gov ruined the state's website, huh?
Un-f***ing-believable!
About 126,000 people enrolled in health plans subsidized by the state have until March to choose a new plan and can keep their current coverage until then. But thousands of others are depending on a new plan to start on the first of the year, and some worry that their coverage will not be ready in time. Their anxiety has only been heightened by stubborn technical problems, such as a snag this week that blocked many people from signing in to the website....
And who does the Globe use as an example? A gay woman.
The Connector Authority will mail invoices starting next week, said executive director Jean Yang....
The $69 million website was built by CGI, which helped develop the much-maligned federal health insurance site, HealthCare.gov. The Health Connector website, by communicating with federal databases and the state Medicaid program, was meant to give users a place where they could find out which insurance subsidies they qualify for. But that function of the website has not worked.
Oh, the horror, the horror!
Many people who applied for a subsidy are in a holding pattern, waiting for the Connector Authority to verify their eligibility so they can shop for a plan. Yang said Health Connector staff and contractors are working to find the fixes necessary to make online verification possible and, in the meantime, to identify applicants who need coverage starting Jan. 1.
That health problem you have that needs attention? Put it in a holding pattern!
Many people already receiving state insurance subsidies — through Commonwealth Care, the Medical Security Program for people who are unemployed, and the Insurance Partnership for small business employees — must re-enroll in a new plan, but the state extended the deadline for that group from Dec. 23 until March 24, giving them three more months on their current plans.
As many as 15,000 people who have completed applications do not fall into that category, and an unknown number of them could be uninsured on Jan. 1 if they are not enrolled through the Health Connector.
Yang said CGI has increased the number of people working on the website, and the Connector Authority plans to boost the number of customer service representatives to as many as 190 by the end of December, up from about 65 last month.
Which will cost the state's taxpayers how many more millions?
“We are not happy with the situation; there’s no question about it,” Yang said. “We look at the vendors critically. We look at ourselves critically. We ask ourselves every day how fast can we make things better.”
You can only imagine how we feel, and not happy is mild.
Nationally, insurers have expressed frustration that the enrollment records sent by the federal website have been inaccurate.
And THAT CONCERN WILL NOT be put into a holding pattern.
Yang said the state is preparing a back-up plan to deliver data in a spreadsheet or a similar format if the state’s website fails on that front, too....
But the state may already be short on time, said Bill Fields, a business consultant who works with companies on insurance compliance....
“This is a mess,” Fields said. “The sad thing is that the people who are going to get hurt are the people that they’re trying to help.”
That's happens when the legislation is written of, by, and for in$urance companies, and sadly that is what government now does best. Even when they have good intentions it never works out, and often their is an ulterior motive to their good intentions.
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Also see: 23andMe to halt health-related genetic reports
Business and government already got all your DNA?
