Luna del'Corvo

A lot of people whose opinions I respect are actually quite furious that the PPACA/Affordable Care Act/Obamacare was upheld. Their chief complaint seems to be the objection to only one thing: that the government requires individual citizens to purchase a product form a corporation, and can penalize that citizen for failure to do so.

This is also accompanied by the concern that there are no minimum standards for that product, and no protections from things like price-gouging, and corporate abuse of a 'captive market.'

Well, no, not really. There ARE standards and protections, as well as expetions and subsidies for low income Americans. There are also provisions that make employer-provided care easier for small companies to offer, and which make basic care co-pay-free and therefore far more accessible. Here's what it REALLY does:

1. Guaranteed issue and partial community rating will require insurers to offer the same premium to all applicants of the same age and geographical location without regard to most pre-existing conditions (excluding tobacco use). This means that while all Americans are required to purchase coverage, they cannot be denied coverage for pre-existing conditions. This is HUGE.
2. A shared responsibility requirement, commonly called an individual mandate, requires that all persons not covered by an employer sponsored health plan, Medicaid, Medicare or other public insurance programs, purchase and comply with an approved private insurance policy or pay a penalty, unless the applicable individual is a member of a recognized religious sect exempted by the Internal Revenue Service, or waived in cases of financial hardship. Insurers must be approved, and exemptions will exist for those in financial distress.
3. Medicaid eligibility is expanded to include all individuals and families with incomes up to 133% of the poverty level along with a simplified CHIP enrollment process. This expanded eligibility means that many who can't afford coverage, even under the ACA, will still be covered.
4. Health insurance exchanges will commence operation in each state, offering a marketplace where individuals and small businesses can compare policies and premiums, and buy insurance (with a government subsidy if eligible). Again, there will be assistance with coverage, and active steps toward fostering actual market competition to offer better services.
5. Low income persons and families above the Medicaid level and up to 400% of the federal poverty level will receive federal subsidies[27] on a sliding scale if they choose to purchase insurance via an exchange (persons at 150% of the poverty level would be subsidized such that their premium cost would be of 2% of income or $50 a month for a family of 4). Can we really argue that $50 for a family of four is abusive, especially when set against the grim realities of the millions of uninsured who have no coverage at all?
6. Minimum standards for health insurance policies are to be established and annual and lifetime coverage caps will be banned. Minimum standards, there they are. These standars mean that no, companies will not be able to offer pointless 'compliance only' policies that do not actually provide for health care. (I wish auto insurance had the same standards!)
7. Firms employing 50 or more people but not offering health insurance will also pay a shared responsibility requirement if the government has had to subsidize an employee's health care. This will help more people get coverage through employers, reducing the number forced to purchase health coverage privately.
8. Very small businesses will be able to get subsidies if they purchase insurance through an exchange. As above.
9. Co-payments, co-insurance, and deductibles are to be eliminated for select health care insurance benefits considered to be part of an "essential benefits package" for Level A or Level B preventive care. It's a no brainer that basic preventive care is essential to cutting costs of lifelong health care AND improving overall health and quality of life; this will make that basic care much more easily accessible to those who need it most.
10. Changes are enacted that allow a restructuring of Medicare reimbursement from "fee-for-service" to "bundled payments."
11. Additional support is provided for medical research and the National Institutes of Health.

I do understand the concerns about government forcing private citizens to purchase a product, but I think that to argue that this is the first step towards any corporation or industry being able to obtain similar positioning is a massive slippery slope. The ACA is NOT the first step towards 'government mandated' purchase of sneakers, cigarettes, or anything else.

(No, the icon has no relevance except *pretty!*)

Nebraska lawmakers on Monday gave final approval to a first-of-its-kind measure requiring women to be screened for possible mental and physical problems before having abortions.

The measure is unusual, however, in spelling out what factors doctors must consider when doing the screenings. [Greg] Schleppenbach [of the National Catholic Conference] said that’s because doctors otherwise would turn to other abortion providers to set the standards for the medical community.

The bill requires a doctor or other health professional to screen women to determine whether they were pressured into having abortions. The screenings also would assess whether women have risk factors that could lead to mental or physical problems after an abortion.

http://www.religiondispatches.org/blog/religiousright/2458/you’re_crazy_

Read the article. I can't really comment coherently on this, as I am too stunned. I mean, this passed? This is a law now? What year is this again?

....is you keep demanding that you get screwed and then, not surprisingly, you keep getting screwed.

(Reposted from Slacktivist. This is his work, not mine. But it's important, so I'm reposting, with full credit.)

Hey you. You there in the Glenn Beck T-shirt headed off to the Tea Party Patriot rally.

Stop shouting for a moment, please, I want to explain to you why you're so very angry.

You should be angry. You're getting screwed.

I think you know that. But you don't seem to know that it doesn't have to be that way. You can stop it. You can stop it easily because the system that's screwing you over can only keep screwing you over if you keep demanding that it do so.

So stop demanding that. Stop helping the system screw you over.

Look, you can go back to yelling at me in a minute, but just read this first.

1. Get out your pay stub.

Or, if you have direct deposit -- you really should get direct deposit, it saves a lot of time and money (I point this out because, honestly, I'm trying to help you here, even though you don't make that easy, Mr. Angry Screamy Guy) -- then take out that little paper receipt they give you when your pay gets directly deposited.

2. Notice that your net pay is lower than your gross pay. This is because some of your wages are withheld every pay period.

3. Notice that only some of this money that was withheld went to pay taxes. (I know, I know -- yeearrrgh! me hates taxes! -- but just try to stick with me for just a second here.)

4. Notice that some of the money that was withheld didn't go to taxes, but to your health insurance company.

5. Now go get a pay stub from last year around this time, from January of 2009.

6. Notice that the amount of your pay withheld for taxes in your current paycheck is less than the amount that was withheld a year ago.

That's because of President Barack Obama's economic stimulus plan, which included more than $200 billion in tax cuts, including the one you're holding right there in your hand, the tax cut that's now staring you in the face. Republicans all voted against that tax cut. And then they told you to get angry about the stimulus plan. They didn't explain, however, why you were supposed to get angry about getting a tax cut. Why would you be? Wouldn't it make more sense to get angry at the people who voted against that Obama tax cut?

But taxes aren't the really important thing here. The really important thing starts with the next point.

7. Notice that the amount of your pay withheld to pay for your health insurance is more than it was last year.

8. Notice that the amount of your pay withheld to pay for your health insurance is a lot more than it was last year.

I won't ask you to dig up old paychecks from 2008 and 2007, but this has been going on for a long time. Every year, the amount of your paycheck withheld to pay for your health insurance goes up. A lot.

9. Notice the one figure there on your two pay stubs that hasn't changed: Your wage. The raise you didn't get this year went to pay for that big increase in the cost of your health insurance.

10. Here's where I need you to start doing a better job of putting two and two together. If you didn't get a raise last year because the cost of your health insurance went up by a lot, and the cost of your health insurance is going to go up by a lot again this year, what do you think that means for any chance you might have of getting a raise this year?

11. Did you figure it out? That's right. The increasing cost of health insurance means you won't get a raise this year. Or next year. Or the year after that. The increasing cost of health insurance means you will never get a raise again.

That's what I meant when I said you really should be angry. That's what I meant when I said you're getting screwed.

OK, we're almost done. Just a few more points, I promise.

12. The only hope you have of ever seeing another pay raise is if Congress passes health care reform. Without health care reform, the increasing cost of your health insurance will swallow this year's raise. And next year's raise. And pretty soon it won't stop with just your raise. Without health care reform, the increasing cost of your health insurance will start making your pay go down.

13. I wish I could tell you that this was just a worst-case scenario, that this was only something that might, maybe happen, but that wouldn't be true. Without health care reform, this is what will happen. We know this because this is what is happening now. It has been happening for the past 10 years. In 2008, employers spent on average 25 percent more per employee than they did in 2001, but wages on average did not increase during those years. The price of milk went up. The price of gas went up. But wages did not. All of the money that would have gone to higher wages went to pay the higher and higher and higher cost of health insurance. And unless Congress passes health care reform, that will not change.

Well, it will change in the sense that it will keep getting worse, but it won't get better. Unless the problem gets fixed, the problem won't be fixed. That's kind of what "problem" and "fixed" mean.

14. Sadly for any chance you have of ever seeing a raise again, it looks like Congress may not pass health care reform. It looks like they won't do that because they're scared of angry voters who are demanding that they oppose health care reform, angry voters who demand that Congress not do anything that would keep the cost of health insurance from going up and up and up. Angry voters like you.

15. Do you see the point here? You are angrily, loudly demanding that Congress make sure that you never, ever get another pay raise as long as you live. Because of you and because of your angry demands, you and your family and your kids are going to have to get by with less this year than last year. And next year you're going to have to get by with even less. And if you keep angrily demanding that no one must ever fix this problem, then you're going to have to figure out how to get by on less and less every year for the rest of your life.

16. So please, for your own sake, for your family's sake and the sake of your children, stop. Stop demanding that problems not get fixed. Stop demanding that you keep getting screwed. Stay angry -- you should be angry -- but start directing that anger toward the system that's screwing you over and taking money out of your pocket. Start directing that anger toward fixing problems instead of toward making sure they never get fixed. Instead of demanding that Congress oppose health care reform so that you never, ever, get another pay raise, start demanding that they pass health care reform, as soon as possible. Because until they do, you're just going to keep on getting screwed.

And it's going to be that much worse knowing that you brought this on yourself -- that you demanded it.

Thanks for your time.

P.S. -- I didn't mention this because I'm trying here to be as patient with you as I can, but you might also want to keep in mind that in addition to screwing over yourself and screwing over your family and screwing over your own children by demanding that Congress oppose health care reform so that you will never, ever see another pay raise, by doing that you're also demanding that I never, ever see another pay raise, which means that you're also screwing over me, and my family, and my children. Not to mention the millions of poor and uninsured and uninsureable people I didn't even mention above because they don't seem to matter at all to you. And for that, let me just say the only appropriate thing that can be said to someone so determined to do direct, tangible harm to the welfare of my family: Fuck you, you fucking moron.

(Reposted from Slacktivist. This is his work, not mine.)