**UPDATE** New Obamacare Reality Setting in: 8M in exchanges, 35% are < 35 yrs old

[Texashiker]

I was not referring to you TH but I find it funny that you answered. Nice one

Thank you.

I find working in the garden and watching the chickens very relaxing.

Perhaps too much fertilizer then?

Maybe.

When I was raking soil up around the potatoes I threw down some 13-13-13 as a side dressing. Hopefully the extra fertilizer will not kill the plants.

 

[fskimospy]

That's an untrue statement and you know better. The test and control populations were determined by random lottery drawings thus there has never bee a more rigorously controlled demographics and it would be unethical to create one more rigorous. Trying to argue otherwise is acting in bad scientific faith because you'd be setting an impossible threshold to meet.

You should know how to read better? My first paragraph was not referring to the Oregon study.

And is that really your argument, that after hundreds of billions of taxpayer dollars spent you can't demonstrate any significant difference between having Medicaid and being uninsured? Is that really how you want to roll with this, that you can say as a point of pride "you can't prove that Medicaid is worse" rather that you presenting evidence that it's better and a policy we should even continue, much less expand further?

You are now mashing different studies together. The Oregon one did not say that Medicaid was worse than no insurance, in fact it showed results that were better, just not good enough to meet standards of statistical significance.

As for what my argument is, it has nothing to do with these studies. You appear to think that the study not producing statistically significant results indicates that Medicaid is ineffective. I just read the study and note that with the small sample sizes for those groups that statistical significance would be almost impossible to achieve. If you're actually reading these studies to be informed then you would know better than to draw your conclusions like that. I for one sincerely doubt you read them to be informed, which makes what you're saying about people viewing the results objectively kind of funny.

EDIT: I also just noticed that you complained about 'acting in bad scientific faith' due to your incorrect presumption that I was setting impossible thresholds. Then of course you set a basically impossible threshold for Medicaid to meet in the next study. Bad scientific faith indeed! lol.

 

[ccchr]

Well doesn't look good for saving money. Probable not a shock to most.

http://www.cbo.gov/publication/45159

And more good news coming soon.

http://www.thefiscaltimes.com/Columns/2014/04/03/Coming-Obamacare-Shock-170-Million-Americans

 

[michal1980]

You still want me banned because I disagree with you. Where is your outrage for jhhnn?

The side claiming to be for free speech and tolerance is always calling for bans. They dont want other opinions and other ideas, just their own. If you disagree with them, then you should be banned, or are accused on 'not compromising'.

 

[Incorruptible]

The side claiming to be for free speech and tolerance is always calling for bans. They dont want other opinions and other ideas, just their own. If you disagree with them, then you should be banned, or are accused on 'not compromising'.

They never actually believed in free speech. Pathetic pieces of crap who have no respect for freedom.

 

[glenn1]

You should know how to read better? My first paragraph was not referring to the Oregon study.

You are now mashing different studies together. The Oregon one did not say that Medicaid was worse than no insurance, in fact it showed results that were better, just not good enough to meet standards of statistical significance.

As for what my argument is, it has nothing to do with these studies. You appear to think that the study not producing statistically significant results indicates that Medicaid is ineffective. I just read the study and note that with the small sample sizes for those groups that statistical significance would be almost impossible to achieve. If you're actually reading these studies to be informed then you would know better than to draw your conclusions like that. I for one sincerely doubt you read them to be informed, which makes what you're saying about people viewing the results objectively kind of funny.

EDIT: I also just noticed that you complained about 'acting in bad scientific faith' due to your incorrect presumption that I was setting impossible thresholds. Then of course you set a basically impossible threshold for Medicaid to meet in the next study. Bad scientific faith indeed! lol.

Okay, so you agree that Medicaid produces at best "no statistically significant result" of improved health outcomes versus no insurance. Yet you argue this doesn't show the program is ineffective despite the government spending ~ $450B annually on Medicaid.

Given the above statements, how could anything possibly *NOT* meet the definition of being an "effective" program? Again, thanks for proving my point that you really don't give a shit about actually improving things for the recipients of programs, only that the program continues regardless.

 

[Pens1566]

They never actually believed in free speech. Pathetic pieces of crap who have no respect for freedom.

If you knew what the concept meant, you wouldn't be posting this.

 

[fskimospy]

Okay, so you agree that Medicaid produces at best "no statistically significant result" of improved health outcomes versus no insurance. Yet you argue this doesn't show the program is ineffective despite the government spending ~ $450B annually on Medicaid.

What the government spends has no bearing on the results of this study or its explanatory power. The study was simply too limited in size and duration in order to measure those things. By the way, if anything the Oregon study showed that Medicaid recipients were healthier than non-recipients. The sample sizes just weren't large enough to meet the standard of significance. EDIT: So, 'at best' I would say that this study provides a small amount of evidence that Medicaid works.

These studies are not new, and had you read them carefully you would have seen what I quoted. Needless to say, your statements about what the studies showed were highly misleading. I'm not sure if this was intentional or not, but I do suggest in the future that you take your own advice on reading these studies to become better informed, not for an ideological outcome.

Given the above statements, how could anything possibly *NOT* meet the definition of being an "effective" program? Again, thanks for proving my point that you really don't give a shit about actually improving things for the recipients of programs, only that the program continues regardless.

Your arguments aren't making much sense. You were the one attempting to state that Medicaid was ineffective based on these studies, not me.

If you were arguing that more rigorous studies should be undertaken to see how effective Medicaid is at improving health outcomes I would agree with you! For the metrics that we do have reliable data on with significant enough sample sizes, Medicaid correlates well with improved outcomes. This is present in that Oregon study, by the way. In almost every metric for which there were large sample sizes (like quality of life, mental health, etc) Medicaid had statistically significant positive effects.

Overall, Medicaid provably improves access to care, mitigates catastrophic health expenditures, and appears to improve quality of life. All those are good things. Whether or not our current Medicaid structure is the best way to do that is open for debate, of course. We would need to have that debate with both eyes open though, not looking for ways to justify our ideological bias through selective interpretation of study results.

 

[werepossum]

Well doesn't look good for saving money. Probable not a shock to most.

http://www.cbo.gov/publication/45159

And more good news coming soon.

http://www.thefiscaltimes.com/Columns/2014/04/03/Coming-Obamacare-Shock-170-Million-Americans

First, welcome to the forums. We need more like you.

Second, I think only the foamiest of the far left ever believed this would save money - that's merely a useful political lie. The real question is are we getting sufficient value for our money. I don't think anyone can yet answer that, although we can all agree that the implementation has been brutally inept.

A federal government takeover is by far not my preferred solution, but it's here, and for some people it's a Godsend. Almost certainly more people have been significantly helped than have been significantly hurt, even if that number is close. For instance, Obamacare costs me an extra thousand bucks a year because of the higher minimum deductible for HSAs, but that's a comparatively minor effect compared to someone who was uninsurable but now has health insurance, or a twenty-something pursuing an advanced degree who now has health insurance. I'm all for repealing Obamacare, but only if you can show me something better; there's no point in simply changing the ACA's winners into losers and vice versa.

My own preference would be for each state to develop the plan that best suits its citizens, with each state competing in the marketplace of ideas so that good ideas are adopted and bad ideas are identified and dropped. However, doing that by repealing Obamacare just means a second round of great societal upheaval on the hope that these implementations are not as abysmally bad as was Obamacare's. Much better at this point to make a change allowing states to opt out if they can show a credible plan to reach near-100% health insurance coverage OR health care access at non-ruinous cost. Don't leave it up to Obama or the bureaucracy, make it something that must pass that state's voter referendum, preferably with a 60% or 67% majority to avoid inflicting another upheaval on people merely because one side was more motivated. If a plan works well, other states will be motivated to try it and its politicians will be rewarded. If a plan works poorly, other states will be motivated to avoid it and its politicians will be punished.

Okay, so you agree that Medicaid produces at best "no statistically significant result" of improved health outcomes versus no insurance. Yet you argue this doesn't show the program is ineffective despite the government spending ~ $450B annually on Medicaid.

Given the above statements, how could anything possibly *NOT* meet the definition of being an "effective" program? Again, thanks for proving my point that you really don't give a shit about actually improving things for the recipients of programs, only that the program continues regardless.

Do we really need a study to tell us that Medicaid is better than no health insurance at all? I'm very suspicious of studies nowadays as I think the vast majority know their conclusion in the beginning and are only studying what justification they need to develop to support that conclusion, but c'mon. For everyone without health insurance there is a band of medical treatment between what one can afford and what must be provided without regards to ability to pay, and if one qualifies for Medicaid the level of medical treatment one can afford is pretty low. This mid-range of medical treatment certainly has value or it would not exist, so Medicaid has to be better than no health insurance. It's literally a question of whether a set of desirable services and products is better than a much smaller subset of the same desirable services and products; mathematically that's a given.

 

[shortylickens]

Well doesn't look good for saving money. Probable not a shock to most.

http://www.cbo.gov/publication/45159

And more good news coming soon.

http://www.thefiscaltimes.com/Columns/2014/04/03/Coming-Obamacare-Shock-170-Million-Americans

Its basically a tax, and a welfare system.

Its a tax because the law requires you to pay it whether you want it or not, whether you benefit or not.
Its welfare cuz it takes a lot of money from many people to help a handful. Also welfare because being a large complex system it wastes a good portion of the money it collects.

See Also: Michelle Obamas Sorority.

 

[rockyct]

It's way too early to say that premiums won't spiral out of control. In fact there's already evidence that they are. Premiums certainly are not going down $2500 like Obama said so many times.

Furthermore I disagree with you that goodies such as free birth control needed to be included. Why only BC? Why not add free beta blockers or insulin? There's no reason it needs to be free.

Want to know how Republicans can become heros? They can remove much of the regulation of Obamacare and make it possible for people like me to buy a plan that does NOT include free BC, colonoscopies, kids dental, Mammograms and preventatives. Then those policy premiums would drop by hundreds if not thousands of dollars. Relieve voters pocketbooks=political success

There's no evidence that premiums in the new insurance pools are going to spiral out of control, mainly because they went over their total enrollment estimate and the percentage of young people signing up is close to where they wanted it. Premiums in general skyrocketed before Obama was elected and continue to go up. Welcome to the private insurance model, but at least with Obamacare they have to refund everyone a portion of their premiums if the insurance company doesn't spend at least 80% of the premiums they collect on paying for health services. That didn't exist before.

Sorry, certain things should either be cost shared or made free to incentivize their use. Free birth control barely costs anything when averaged over every insurance plan in the country and yet it could do a lot to reduce the birthrate with low income people, which then means that unborn child doesn't have to get that free dental plan. One annual checkup and preventive care should be free to even the bronze plans because at least even the barebone plans should try to get people to see a doctor before they get very sick. The goal is to ultimately reduce some of the expensive parts of health care if they can. The free annual checkup may not save any money in the end, but free birth control could really save state/federal government a lot of money.

 

[Sea Ray]

There's no evidence that premiums in the new insurance pools are going to spiral out of control, mainly because they went over their total enrollment estimate and the percentage of young people signing up is close to where they wanted it. Premiums in general skyrocketed before Obama was elected and continue to go up. Welcome to the private insurance model, but at least with Obamacare they have to refund everyone a portion of their premiums if the insurance company doesn't spend at least 80% of the premiums they collect on paying for health services. That didn't exist before.

Sorry, certain things should either be cost shared or made free to incentivize their use. Free birth control barely costs anything when averaged over every insurance plan in the country and yet it could do a lot to reduce the birthrate with low income people, which then means that unborn child doesn't have to get that free dental plan. One annual checkup and preventive care should be free to even the bronze plans because at least even the barebone plans should try to get people to see a doctor before they get very sick. The goal is to ultimately reduce some of the expensive parts of health care if they can. The free annual checkup may not save any money in the end, but free birth control could really save state/federal government a lot of money.

You're using the mantra of the "ends justify the means" re: BC. Doesn't it bother you that the gov't has seized so much control of your health insurance policy that they're now requiring you to buy one that includes a Rx for free that only a few Americans use? I know you agree with the concept but it opens the door for administrations that you don't agree with to put more and more burdens on your plan. I would argue that BC was not included for the reasons you list but for political reasons. It was a political ploy in the Dems War against Women campaign. When politics affects your private Health Insurance plan, we're in big trouble

 

[Sea Ray]

There's plenty of evidence that costs will skyrocket. Here's one:

http://www.forbes.com/sites/scottgo...8-insurance-brokers-analysts-blame-obamacare/

I hope such predictions are wrong. Believe me, if Obama was right and my premiums went down $2500/yr I'd be singing his praises and thanking him profusely. Unfortunately that's just one more case of him predicting a rosey future that was not reality. After awhile, I get frustrated with such people

 

[fskimospy]

There's plenty of evidence that costs will skyrocket. Here's one:

http://www.forbes.com/sites/scottgo...8-insurance-brokers-analysts-blame-obamacare/

I hope such predictions are wrong. Believe me, if Obama was right and my premiums went down $2500/yr I'd be singing his praises and thanking him profusely. Unfortunately that's just one more case of him predicting a rosey future that was not reality. After awhile, I get frustrated with such people

What a terribly misleading article without context. Your article says that individual insurance premiums are going up on average 11% year over year, with all the extra sick people, etc, added to the individual insurance market. Guess how much they were going up year on year in the individual market before the ACA? About 10% a year.

Not only that, but the focus on premiums is a terrible idea anyway. The actual focus should be total health costs. Your wallet doesn't care if you pay a dollar in premiums or a dollar for medical care. It's all money out the door. Medical cost inflation so far has been very low since the ACA has been passed. While it is unclear how much credit the ACA gets for this, clearly costs have not "skyrocketed" so far.

 

[Matt1970]

What a terribly misleading article without context. Your article says that individual insurance premiums are going up on average 11% year over year, with all the extra sick people, etc, added to the individual insurance market. Guess how much they were going up year on year in the individual market before the ACA? About 10% a year.

Not only that, but the focus on premiums is a terrible idea anyway. The actual focus should be total health costs. Your wallet doesn't care if you pay a dollar in premiums or a dollar for medical care. It's all money out the door. Medical cost inflation so far has been very low since the ACA has been passed. While it is unclear how much credit the ACA gets for this, clearly costs have not "skyrocketed" so far.

Good lord son, you couldn't move the goalposts any further if you put them in another county.

 

[fskimospy]

Good lord son, you couldn't move the goalposts any further if you put them in another county.

lol, please tell me what goal posts I moved.

 

[Sea Ray]

What a terribly misleading article without context. Your article says that individual insurance premiums are going up on average 11% year over year, with all the extra sick people, etc, added to the individual insurance market. Guess how much they were going up year on year in the individual market before the ACA? About 10% a year.

Not only that, but the focus on premiums is a terrible idea anyway. The actual focus should be total health costs. Your wallet doesn't care if you pay a dollar in premiums or a dollar for medical care. It's all money out the door. Medical cost inflation so far has been very low since the ACA has been passed. While it is unclear how much credit the ACA gets for this, clearly costs have not "skyrocketed" so far.

You don't understand the article. It's not 11% year to year. It's 11% quarter to quarter...big difference. Did you miss the part that this represents the biggest increase ever?

If you want to support Obamacare, fine but let's at least get our facts straight

 

[Sea Ray]

The April survey shows the largest acceleration in small and individual group rates (for renewing health plans) in any of the 12 prior quarterly periods when the regular analysis has been conducted. The average increases for the present quarter are in excess of 11% in the small group market and 12% in the individual market, where consumers purchase coverage directly from health plans. Some states show increases 10 to 50 times that amount. The analysts conclude that the &#8220;increases are largely due to changes under the ACA.&#8221;

http://www.forbes.com/sites/scottgo...r-years-of-obamacares-rollout-heres-the-data/

 

[fskimospy]

You don't understand the article. It's not 11% year to year. It's 11% quarter to quarter...big difference. Did you miss the part that this represents the biggest increase ever?

If you want to support Obamacare, fine but let's at least get our facts straight

Ahh you're right, my bad. I did look into that survey more and it is still a horrifyingly misleading article. For example the idea that insurance premiums increased 90% in New Hampshire? That's based on a sample size of... one. Factcheck.org has already addressed this survey:

http://www.factcheck.org/2014/04/how-not-to-use-a-survey/

So yes I agree, we should keep our facts straight.

 

[fskimospy]

http://www.forbes.com/sites/scottgo...r-years-of-obamacares-rollout-heres-the-data/

This is also a terribly misleading article, which I guess is not surprising since it comes from a guy who works for a right wing think tank.

Pre and post ACA plans are not directly comparable with one another, and the author only mentions premium increases without mentioning the actual price that people will pay. This is an attempt to include all the costs of the law without including the benefits. This is yet another reason, btw, that we should be looking at total health costs instead of premiums. Looking at costs that way does not allow dishonest individuals like this author to try and pull the wool over people's eyes as easily.

 

[Sea Ray]

Ahh you're right, my bad. I did look into that survey more and it is still a horrifyingly misleading article. For example the idea that insurance premiums increased 90% in New Hampshire? That's based on a sample size of... one. Factcheck.org has already addressed this survey:

http://www.factcheck.org/2014/04/how-not-to-use-a-survey/

So yes I agree, we should keep our facts straight.

The survey identifies a huge problem in New Hampshire...and that is that there's only one plan on their exchange site. One.

My point here isn't that we yet have conclusive evidence but we do have "evidence".

Personally my rates went up and I'm someone who this system should have helped. I was stuck with no choices since my wife has had breast cancer. I had to stay with my existing carrier and they jacked up my rates 20-30% every year and I had no other option. Now I have other options but in order to get similar coverage, my rates went up even more when I started a new plan March 1st. (My old plan was canceled for not being ACA compliant)

I think it'll be rare for anyone's rates to go down under Obamacare unless you qualify for a subsidy

 

[Sea Ray]

This is also a terribly misleading article, which I guess is not surprising since it comes from a guy who works for a right wing think tank.

Pre and post ACA plans are not directly comparable with one another, and the author only mentions premium increases without mentioning the actual price that people will pay. This is an attempt to include all the costs of the law without including the benefits. This is yet another reason, btw, that we should be looking at total health costs instead of premiums. Looking at costs that way does not allow dishonest individuals like this author to try and pull the wool over people's eyes as easily.

What's the difference between premium increases and what people pay? Subsidies? I'm not sure what you're trying to say here.

 

[fskimospy]

The survey identifies a huge problem in New Hampshire...and that is that there's only one plan on their exchange site. One.

That would be a very different problem. Additionally, the conclusions of that sample size of one run contrary to some real actuarial analysis of cost changes over time.

My point here isn't that we yet have conclusive evidence but we do have "evidence".

Personally my rates went up and I'm someone who this system should have helped. I was stuck with no choices since my wife has had breast cancer. I had to stay with my existing carrier and they jacked up my rates 20-30% every year and I had no other option. Now I have other options but in order to get similar coverage, my rates went up even more when I started a new plan March 1st. (My old plan was canceled for not being ACA compliant)

I think it'll be rare for anyone's rates to go down under Obamacare unless you qualify for a subsidy

There are actually several states listed in the very survey you cite where rates have gone down quite a bit.

Regardless, yes I'm referring to subsidies and the fact that we should be focusing on total health care costs. Before the ACA in many cases this care was still taking place, just happening through ruinous debt, being picked up by third parties like government, uncompensated care to hospitals, etc. All of those costs were real and remain. This law is (among many other things) an attempt to shift away from that model.

That's why I think focusing on a change in premiums between two time periods where those premiums covered very different things without accounting for all the other changes that happened is a bad idea. I understand why people want to do that for political reasons, but that doesn't make it better.

Just so you know, I'm in the same boat as you. I have a personal history of cancer and I thank my lucky stars every day for this law.

 

[Sea Ray]

I'm not impressed if premiums go down for those "winners" picked by this administration (those that qualify for subsidies). Via handouts, gov't can drive premiums to anywhere but that's nothing more than income redistribution. There's no magic in that.

The bottomline is this: If we're going to offer health insurance to many more sick people AND increase the benefits (free preventative, etc) then it stands to reason that premiums will soar. If Obama had sold it as such, I wouldn't be so mad. He likes to suggest the "rich" pay a little more" in taxes so the rest of the country gets help but here he didn't say that the consumer will pay "a little more" because they'll be getting better policies. Instead he promised decreased premiums.

Finally, premiums are likely to skyrocket next year because they cannot raise the deductibles any further. The reason the premiums aren't higher on the exchange is because they have maxed out deductibles. That's masked many increases. That's what my family deiced to do in order to avoid a 35% increae in premiums. We went with an outrageous deductible

 

[fskimospy]

I'm not impressed if premiums go down for those "winners" picked by this administration (those that qualify for subsidies). Via handouts, gov't can drive premiums to anywhere but that's nothing more than income redistribution. There's no magic in that.

The bottomline is this: If we're going to offer health insurance to many more sick people AND increase the benefits (free preventative, etc) then it stands to reason that premiums will soar. If Obama had sold it as such, I wouldn't be so mad. He likes to suggest the "rich" pay a little more" in taxes so the rest of the country gets help but here he didn't say that the consumer will pay "a little more" because they'll be getting better policies. Instead he promised decreased premiums.

Finally, premiums are likely to skyrocket next year because they cannot raise the deductibles any further. The reason the premiums aren't higher on the exchange is because they have maxed out deductibles. That's masked many increases. That's what my family deiced to do in order to avoid a 35% increae in premiums. We went with an outrageous deductible

Well now you've gone from saying that rates aren't going down for anyone to saying that rates aren't going down for the right people. That's not a very compelling argument.

And yes, you are basically talking about the whole point of the law: it is a three legged stool. One leg is guaranteed issue so you can't turn away sick people. The second is an individual mandate so people don't only contribute when sick, and the third is subsidies to make those premiums affordable. And after accounting for subsidies, most people will be paying less. And why would you not count them?