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

[First]

Something interesting from ccchr's Forbes article:


It appears that the main group signing up through the exchanges are not the uninsured, but those who already had health insurance and are taking the opportunity to get it more cheaply. Outside of employer-furnished health insurance, the number of those who now have health insurance thanks to the ACA (1.1 million) is little more than the number of those who now don't have health insurance thanks to the ACA (< 1 million.) Not too impressive.

I'm not sure I understand the Rand numbers the way you do, so I'd have to look into it more. But I do think it's very clear there are millions who previously didn't have health insurance that are now on Medicaid, so the fact that fewer previously uninsured will choose more expensive private plans on ACA doesn't terribly surprise me. Though I find it more than unlikely that just 1.1M of the 7.1M (now 7.5M) that signed up for private insurance were previously uninsured. I think it'll be significantly higher, though either way the net effect is still the same to me (and these newly insured Americans) whether they have a private plan or a Medicaid plan, other than the financially burdensome aspect, for some, of certain ACA plans in certain states.

If I were a Democrat politician (Heaven forbid!) running in a red state, I'd be slamming the Medicaid expansion message every opportunity. My daughter-in-law is one of those who lost her (crappy) health insurance and is unable to afford an Obamacare policy - she just doesn't make enough money to pay enough tax to get enough subsidy to make an ACA-compliant policy affordable. (And the stupid facilitators sold her a policy she could afford - a life insurance policy!) There have to be a lot of people in that situation.

Yup, it's quite tragic. Medicaid/Medical has been a lifesaver for several friends of mine here in CA, and I honestly can't imagine what they'd do in a non-expanding state like TX or FL. Especially TX, who have so many poor people already living on the brink.

 

[werepossum]

Democrats don't believe that people have the intelligence to make choices themselves, thus why government needs to make the choices for them. No, we don't trust you to manage your retirement funds, therefore we'll oppose to the death any privatization of social security regardless of whether it's appropriate for you or not. We don't trust you to pick a health "insurance" option that meets your needs, thus we'll force you to buy a plan containing what we say you need.

That's why the Democrats are doomed to failure unless they change their approach. In the modern, hyper-personalized and customized world trying to impose massive 19th century top-down political solutions *will* fail. Not that the Republicans are any better, but at least their default mode isn't to resort to Soviet style collectivism for every problem. Of course on social issues the GOP default mode is more like the Salem witch trials and burning heretics in the name of "family values."

I dunno, I think long term Democrats will be the single party for our nation. Not only did Kennedy's '65 Immigration Act stack the deck with immigrants most likely to vote Democrat, but seems to me that increasingly people want not only to have someone else pay for the things they want, but also decide how and what will be provided. Witness all the young people who do not believe that Social Security will be there for them but also do not want the responsibility of managing their own retirement accounts.

If the ACA is so great, lets implement the whole thing. Including the employer mandate. There are millions of working class families who would love for their rich employer to be forced to provide health insurance. Lets start with walmart, mcdonalds,,,, and all of the fortune 1,000 companies.

Over 9 million people obtained insurance, that is great. Except some of them bought insurance under duress. Either buy health care or get fined by the IRS.

Honestly, is that the kind of nation we want to leave our children?

We have decided as a society that it is not acceptable to leave people without health care when they need it. Can't have entitlement without an accompanying responsibility, so everyone who can afford health insurance has to buy it, even if that means they don't have broadband or a smart phone.

 

[Gonad the Barbarian]

The bodies probably aren't piled high enough yet to make a difference, but come 2016 these Republican governors and/or state legislatures should have quite the death toll to add to their list of accomplishments.
http://talkingpointsmemo.com/livewire/harvard-study-medicaid-expansion-deaths

 

[Incorruptible]

You unwittingly confirm what I offered, as you have with every post you ever made to this forum. Your delusions are all encompassing & self reinforcing, the product of enormous propaganda inflicted on a weak & gullible child like mentality.

Let me put it this way- If you're dumb enough to spout the shit that you do, that means you're too dumb to have thought it up yourself. You were taught to believe in things that you don't understand in a truly exploitative manner. You're a victim in ways that you can't possibly comprehend, quite by design.

Intellectually & emotionally, you've been crippled, damaged to serve ends you'll never appreciate.

Again spouting BS. You deserve to be teabagged.

I don't understand you Incorruptible. You of all people should be supporting a reform to our healthcare system. You clearly are mentally ill and need access to affordable healthcare. Odds are you are young enough to still be on your parent's policy which probably wasn't possible before the ACA.

Resorting to insults because you got nothing. Run away you coward.

 

[glenn1]

I'm not sure I understand the Rand numbers the way you do, so I'd have to look into it more. But I do think it's very clear there are millions who previously didn't have health insurance that are now on Medicaid, so the fact that fewer previously uninsured will choose more expensive private plans on ACA doesn't terribly surprise me. Though I find it more than unlikely that just 1.1M of the 7.1M (now 7.5M) that signed up for private insurance were previously uninsured. I think it'll be significantly higher, though either way the net effect is still the same to me (and these newly insured Americans) whether they have a private plan or a Medicaid plan, other than the financially burdensome aspect, for some, of certain ACA plans in certain states.



Yup, it's quite tragic. Medicaid/Medical has been a lifesaver for several friends of mine here in CA, and I honestly can't imagine what they'd do in a non-expanding state like TX or FL. Especially TX, who have so many poor people already living on the brink.

Several nonpartisan studies (like the one from Oregon) has shown Medicaid patients have worse outcomes than those outright uninsured. Even the ones with most positive results find Medicaid very minimally better than being uninsured. I'm not sure why the left wants to continue with well-intentioned experiments that have shown poor results when actually implemented and then double down on expanding them further.

 

[fskimospy]

Again spouting BS. You deserve to be teabagged.

Resorting to insults because you got nothing. Run away you coward.

This would be another guy next to texashiker that I wouldn't mind seeing banned.

If people are having trouble determining if you're a bot or not, you are a truly worthless poster.

 

[werepossum]

I'm not sure I understand the Rand numbers the way you do, so I'd have to look into it more. But I do think it's very clear there are millions who previously didn't have health insurance that are now on Medicaid, so the fact that fewer previously uninsured will choose more expensive private plans on ACA doesn't terribly surprise me. Though I find it more than unlikely that just 1.1M of the 7.1M (now 7.5M) that signed up for private insurance were previously uninsured. I think it'll be significantly higher, though either way the net effect is still the same to me (and these newly insured Americans) whether they have a private plan or a Medicaid plan, other than the financially burdensome aspect, for some, of certain ACA plans in certain states.

Yup, it's quite tragic. Medicaid/Medical has been a lifesaver for several friends of mine here in CA, and I honestly can't imagine what they'd do in a non-expanding state like TX or FL. Especially TX, who have so many poor people already living on the brink.

I'm not surprised either. Most people without health insurance either honestly couldn't afford it or were marginal even before the ACA-mandated cost increases. Given that, it makes sense that most of these people will either qualify for Medicaid or will pay the penalty and go uninsured, especially in non-expansion states. I suspect most if not all states will eventually expand Medicaid, which should get some more of them. If it becomes politically acceptable to the Dems to allow the penalties to be implemented and grow as designed, that will get some more who don't want the pain of paying premiums but who will cave rather than paying a substantial amount of the premiums in return for nothing. For instance, I met a guy who showed me pictures of his brand new and dolled up Harley after I showed up for a meeting on my bike. As we were commiserating about crazy automobile drivers, he mentioned that it was particularly risky for him as he could not afford health insurance, which is shocking in someone who just told you about purchasing a motorcycle that had to cost upwards of $25,000. When I told him I paid $5,000 for my brand new Ninja 650 - the closest I could come under the circumstances to telling him he's an idiot making bad life decisions - he just nodded and told me I got a good deal. Such a powerful disconnect that he could not see any connection to his own situation, that perhaps if one wants a motorcycle one need not necessarily buy one's dream bike. That's an example of the intentionally uninsured who choose lifestyle over a safety net.

Then again, maybe he had some very serious pre-existing condition that made his insurance unaffordable. For all I know he might be one of Obamacare's winners enjoying his new insured status today. lol

 

[shortylickens]

"Incorruptible" and "realities" in the same sentence is a non sequiter. He shares common reality only in the sense that he can use the internet.

Or do you have some translator program/ magic decoder ring indicating you should believe otherwise?

Yeah, umm, he was definitely assuming.
I hate the ACA.

The biggest problem is its a band-aid to a wound that no wants to stitch, I guess cuz the profit made from selling varying types of band-aids is so god damn profitable. Making a 2nd bad system to cover up a 1st bad system is NOT progress. It just multiplies the wasted resources. And also gives Big Brother even more control over our lives than before.

 

[ivwshane]

Several nonpartisan studies (like the one from Oregon) has shown Medicaid patients have worse outcomes than those outright uninsured. Even the ones with most positive results find Medicaid very minimally better than being uninsured. I'm not sure why the left wants to continue with well-intentioned experiments that have shown poor results when actually implemented and then double down on expanding them further.

Links to said studies?

 

[Incorruptible]

This would be another guy next to texashiker that I wouldn't mind seeing banned.

If people are having trouble determining if you're a bot or not, you are a truly worthless poster.

So you don't believe in free speech? You want to shut down those who disagree with you? jhhnn is a nutjob who has to resort to personal attacks yet you won't call him out.

 

[Texashiker]

This would be another guy next to texashiker that I wouldn't mind seeing banned.

Your mom never told you to play nice?

 

[fskimospy]

Several nonpartisan studies (like the one from Oregon) has shown Medicaid patients have worse outcomes than those outright uninsured. Even the ones with most positive results find Medicaid very minimally better than being uninsured. I'm not sure why the left wants to continue with well-intentioned experiments that have shown poor results when actually implemented and then double down on expanding them further.

Yeah, I think you should go back and study those survey results a bit. The one that showed Medicaid patients being worse off than those without insurance didn't make sure that the starting populations had similar health demographics. Not having comparable samples is a big research no-no.

The one you are talking about from Oregon did not in fact show that Medicaid patients were worse off than the uninsured, what it showed was that they didn't have a statistically significant improvement in a few health outcomes. The thing is that such a small percentage of the Medicaid sample had these conditions that a statistically significant outcome was almost impossible.

What I'm not sure about is why people bother reading studies if they are somehow going to end up even less well informed than when they started.

 

[fskimospy]

So you don't believe in free speech? You want to shut down those who disagree with you? jhhnn is a nutjob who has to resort to personal attacks yet you won't call him out.

Free speech is protection from the government stopping your speech, it doesn't mean that the rest of us need to be saddled with worthless people such as yourself.

 

[Incorruptible]

Free speech is protection from the government stopping your speech, it doesn't mean that the rest of us need to be saddled with worthless people such as yourself.

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

 

[glenn1]

Links to said studies?

Here's some of the more recent and famous ones. Note these are the actual studies, I have no doubt both sides will quote opinion articles with arguments trying to spin the results to support their preferred policy position. Too bad both the right and left are too invested in the outcome of the political fight over Obamacare to even give a shit about what actually benefits real people anymore rather than servicing their political boogeymen or moral blind spots. Too bad, because the country could really benefit if the left could ever get past their stubborn pride and fallacies about how to help people.


http://www.nejm.org/doi/full/10.1056/NEJMsa1212321#t=articleTop

http://www.nejm.org/doi/full/10.1056/NEJMsa1013285

 

[Texashiker]

We have decided as a society that it is not acceptable to leave people without health care when they need it.

Can't have entitlement without an accompanying responsibility, so everyone who can afford health insurance has to buy it, even if that means they don't have broadband or a smart phone.

With that same logic, shouldn't all companies who can afford be required to provide health care for the employees?

Who is more likely to be able to afford the policy price, mcdonalds, or someone making minimum wage?

We also need cost control on our health care. What hospitals are allowed to charge is outrageous.

it doesn't mean that the rest of us need to be saddled with worthless people such as yourself.

No wonder you are not married.

With that kind of attitude no sensible woman in her right mind would keep you.

 

[AViking]

You appear to be a mentally ill bot. Maybe a ban would be good for you. Look at how crazy you get on these forums. Surely some fresh air would be great for your well being.

 

[Incorruptible]

You appear to be a mentally ill bot. Maybe a ban would be good for you. Look at how crazy you get on these forums. Surely some fresh air would be great for your well being.

You appear to be a mentally ill bot. Maybe a ban would be good for you. Look at how crazy you get on these forums. Surely some fresh air would be great for your well being.

 

[Pens1566]

So you don't believe in free speech? You want to shut down those who disagree with you? jhhnn is a nutjob who has to resort to personal attacks yet you won't call him out.

You don't understand the concept of free speech, and it's limitations. You have displayed this ignorance over and over and over again.

 

[Texashiker]

You appear to be a mentally ill bot. Maybe a ban would be good for you. Look at how crazy you get on these forums. Surely some fresh air would be great for your well being.

Monday, Tuesday and Wednesday I planted a row of squash, row of zucchini, 2 rows of beans, and raked up around the potatoes.

All of that was done after work.

Friday and Saturday the corn and watermelons are going in the ground.

Each row is about 100 feet long.

I assure you, I get plenty of fresh air.

 

[AViking]

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

 

[ivwshane]

Monday, Tuesday and Wednesday I planted a row of squash, row of zucchini, 2 rows of beans, and raked up around the potatoes.

All of that was done after work.

Friday and Saturday the corn and watermelons are going in the ground.

Each row is about 100 feet long.

I assure you, I get plenty of fresh air.

Perhaps too much fertilizer then?

 

[thraashman]

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

Nobody wants you banned because they disagree with you. They want you banned because you're a detriment to these forums. You never provide anything meaningful to any discussions. You include an insult in almost every post you make but then whine and cry when someone insults you. And when you're called out on your insulting ways you always have an excuse that amounts to "well I'm allowed to insult them because!"

Your presence takes away from every thread you decide to become part of because you make no coherent points or well thought out opinions. You post vitriol and rubbish and insults and nothing else.

You appear to be a mentally ill bot. Maybe a ban would be good for you. Look at how crazy you get on these forums. Surely some fresh air would be great for your well being.

Also this little tactic you use on occasion of repeating exactly what someone else says is literally the most 3rd grade thing one could do. Perhaps when you grow up a bit and learn to discuss things like an adult the rest of us will forgive your current behavior. But as things stand right now, you are harmful to the P&N society. Probably society in general too, but that's just speculation.

 

[glenn1]

Yeah, I think you should go back and study those survey results a bit. The one that showed Medicaid patients being worse off than those without insurance didn't make sure that the starting populations had similar health demographics. Not having comparable samples is a big research no-no.

The one you are talking about from Oregon did not in fact show that Medicaid patients were worse off than the uninsured, what it showed was that they didn't have a statistically significant improvement in a few health outcomes. The thing is that such a small percentage of the Medicaid sample had these conditions that a statistically significant outcome was almost impossible.

What I'm not sure about is why people bother reading studies if they are somehow going to end up even less well informed than when they started.

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.

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?

 

[fskimospy]

Here's some of the more recent and famous ones. Note these are the actual studies, I have no doubt both sides will quote opinion articles with arguments trying to spin the results to support their preferred policy position. Too bad both the right and left are too invested in the outcome of the political fight over Obamacare to even give a shit about what actually benefits real people anymore rather than servicing their political boogeymen or moral blind spots. Too bad, because the country could really benefit if the left could ever get past their stubborn pride and fallacies about how to help people.


http://www.nejm.org/doi/full/10.1056/NEJMsa1212321#t=articleTop

http://www.nejm.org/doi/full/10.1056/NEJMsa1013285

As I mentioned before, I strongly suggest that you actually go and read the studies. You will read paragraphs like this:

Hypertension, high cholesterol levels, diabetes, and depression are only a subgroup of the set of health outcomes potentially affected by Medicaid coverage. We chose these conditions because they are important contributors to morbidity and mortality, feasible to measure, prevalent in the low-income population in our study, and plausibly modifiable by effective treatment within a 2-year time frame.13-16 Nonetheless, our power to detect changes in health was limited by the relatively small numbers of patients with these conditions; indeed, the only condition in which we detected improvements was depression, which was by far the most prevalent of the four conditions examined. The 95% confidence intervals for many of the estimates of effects on individual physical health measures were wide enough to include changes that would be considered clinically significant — such as a 7.16-percentage-point reduction in the prevalence of hypertension. Moreover, although we did not find a significant change in glycated hemoglobin levels, the point estimate of the decrease we observed is consistent with that which would be expected on the basis of our estimated increase in the use of medication for diabetes. The clinical-trial literature indicates that the use of oral medication for diabetes reduces the glycated hemoglobin level by an average of 1 percentage point within as short a time as 6 months.15 This estimate from the clinical literature suggests that the 5.4-percentage-point increase in the use of medication for diabetes in our cohort would decrease the average glycated hemoglobin level in the study population by 0.05 percentage points, which is well within our 95% confidence interval. Beyond issues of power, the effects of Medicaid coverage may be limited by the multiple sources of slippage in the connection between insurance coverage and observable improvements in our health metrics; these potential sources of slippage include access to care, diagnosis of underlying conditions, prescription of appropriate medications, compliance with recommendations, and effectiveness of treatment in improving health.17

What that is basically saying is that due to small sample sizes they weren't able to get statistically significant results. What they WERE able to get were clinically significant results. That indicates a probability that going forward with a larger sample you would see improvements to health from Medicaid that are statistically significant.

I strongly agree that people should not be so desperate to spin a study's outcome to something they are ideologically in agreement with. I think you should take your own advice.