Obamacare

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CHOICE is what matters. Even if you had a government-run system, you want one that preserves individual CHOICE. I deal with most medical matters via holistic and natural remedies BEFORE I'd go to a doctor for a pill or a surgical procedure. The government plan does not intend to protect that. The push has been ongoing to force any VITAMIN over a specified IU dosage to be available only by prescription. As mega doses of vitamins have been proven to treat many conditions, it's denying a CHOICE to the health care consumer.

Government-run health care creates a monopoly. Even with oversight committees, government operates too slow, and often without any business acumen, to properly protect the interests of the consumer.

As someone posted in a video, a big part of the US health care system is that we pay too much for everything. We want competition for health care products, but that there isn't more scrutiny on what a patient will be charged for a product or service is a big reason why were are overcharged so much. I'd not want only one option for a replacement knee. The company that wins the bid for my state might not have an overall superior product, and I'd want to be able to buy from the provider of my choice, even if I have to pay a premium out of pocket for what I judge to be the better product.

A 10,000+ page bill drafted by nobody with any real medical expertise is not going to work...period.

Frankly, you are seeing only the benefits and not the liabilities.

You are asserting something that has not been proven to any extent. All the numbers I've seen says the exact opposite.

The problem is that the ACA was passed solely by one side, and once passed, their attitude to the other side is to go bugger off. Nothing short of the threat of full repeal over a presidential veto brings the passing side to the bargaining table.

Obama said hit himself with his very first visit with Republican leaders, "I won." He made it clear that he WOULD NOT work with the other side even though the custom of every administration post-election is to try and put partisanship behind them and work together. Obama came in with a Democrat majority in both houses of Congress. He felt he didn't need to work with the Republicans, and that's been his position to this day as evidenced by what he actually does...not what he says. Only when he is over a barrel and needs something from the Republican-controlled House does he become cooperative.

If the far right would stop spending the majority of their time, effort, and money into trying to eliminate something that they know damn well is not going to go away (42 purely symbolic votes in the House to repeal so far, plus filibusters, wasted floor time, and a government shutdown) and started proposing viable solutions to the problems inherent in the law as written, maybe they could get something accomplished other than political grandstanding and finger wagging.

You know something, I've not met ONE PERSON who wants the ACA.

The local political rag (er...I mean newspaper), did a whole expose on the implementation of the ACA. Story after story of how people who hoped to benefit were really going to have to opt to pay the tax rather than get a policy because they weren't poor enough to get coverage for free, or even with a subsidy, the out-of-pocket for the policy would (a) cost more than the tax and/or (b) have to come from what they'd still have to pay for needed medical care. THIS IS FROM A PAPER THAT HAS CONSISTENTLY CARRIED WATER FOR THE OBAMA ADMINISTRATION. They couldn't even find ONE person who found the ACA to be an answer to their prayers.

All the ACA does is mandate you buy an insurance policy, and most of the offering SUCK.

Myself, my coverage is becoming MORE expensive (not cheaper, and I'm not anywhere near "rich"). More so, to get something similar to what I have right now, I would pay a good bit more...and still be having a reduction in benefits. To keep the price about the same, I'd take a severe cut in benefits. Hooray for the ACA (that's sarcasm...in case you don't notice it). I'm unemployed right now, and I can't afford my health insurance, but (a) I can't afford to give it up as I have my old policy for another year rather than the ACA policy, and (b) I STILL CAN'T GET ANYWHERE WITH THE EXCHANGE TO SEE WHAT OPTIONS I HAVE. I can go to the insurance provider and do something, but you only get the subsidy if you go through the central program. I WILL NOT spend hours on the phone for someone to attempt to get me through...especially as the outcome could be to push me onto Medicaid (which could involve legal complications I don't need in my life).

PEOPLE WANT OBAMACARE REPEALED.

The people rooting for it have NO CLUE what's actually coming and are incredulous when you try to tell them what is actually in the law.

There is no question that America needs to reform how we approach health care, but the ACA was never about fixing the problem. It was an opportunity to seize power over 1/6 of the nation's economy and to further destroy individual liberty.

The War on Poverty and the War on Drugs both seemed like a good idea...and indeed may have been based on very good intentions, but both have made things worse.

People paying attention who appreciated history saw the push for the ACA for what it was. These were the same type of people crying out against the passage of the PATRIOT Act and its later ilk. None of these things were for the good of the populace...they were for the good of the state.

The REALITY you MUST accept is that the "rich" will always have it better. Every nation with socialized medicine still has a wealthy group that can go wherever to get the medical care they desire with no restrictions.

CHOICE is what matters.

I deal with most medical matters via holistic and natural remedies BEFORE I'd go to a doctor for a pill or a surgical procedure. The government plan does not intend to protect that. The push has been ongoing to force any VITAMIN over a specified IU dosage to be available only by prescription. As mega doses of vitamins have been proven to treat many conditions, it's denying a CHOICE to the health care consumer.

Lasik, for a long time, was NOT covered by insurance. It was expensive and experimental. Now, it's common, better and quite affordable. WHY? Because doctors had to be COMPETITIVE for the patients. Making it better and cheaper was the ticket to growing their business.

Government-run health care creates a monopoly. Even with oversight committees, government operates too slow, and often without any business acumen, to properly protect the interests of the consumer.

You stick with what works and eliminate what does not work. A 10,000+ page bill drafted by nobody with any real medical expertise is not going to work...period.

Every program you {songofghandi} mention, for all the good they might have done, are outweighed by the EVILS they unleash as a result of government bureaucracy.

Workers more interested in propagating their continued employment than serving the people results in a lot of bad laws/regulations, a lot of "violations" against individual liberty not needed to meet their agency's stated goal(s), and an expansion in both size and expense of what is supposed to be a limited government.

All the numbers I've seen says the exact opposite.

Obama said hit himself with his very first visit with Republican leaders, "I won." He made it clear that he WOULD NOT work with the other side even though the custom of every administration post-election is to try and put partisanship behind them and work together.

Obama came in with a Democrat majority in both houses of Congress. He felt he didn't need to work with the Republicans, and that's been his position to this day as evidenced by what he actually does...not what he says. Only when he is over a barrel and needs something from the Republican-controlled House does he become cooperative.

Before it came into effect, anyone who had to deal with the DMV (although in my region they are pretty decent and efficient if you catch them at the right time of day) or the post office DREADED what would happen to health care. The evidence of what happens when the government takes over was plain to see.

The ACA was NEVER about improving healthcare. It has always been about access to healthcare.

The majority of the policies going into effect this year cover MORE things, have LOWER copays, and have LOWER deductibles. If you aren't willing to do the research about the different policies available and what they cover, don't try to tell me what is in them.

If you are unemployed, your premiums will be subsidized IN THEIR ENTIRETY. If you don't want to spend a few hours to get yourself insured, that is your own choice and your own problem. Also if you are unemployed, how long do think you would be able to afford your current coverage? You should be glad that there is now the possibility for you to get at least some coverage in the future instead of just being SOL.

And again I must mention that the ACA isn't about fixing healthcare. It is about making sure that people are able to get healthcare. The ACA was written specifically to minimize the government's involvement in the actual healthcare itself. It is about protection, not power, no matter what Rush Limbaugh and Sean Hannity tell you.

Government has no magic. All it does is shuffle stuff around, and it does it less efficiently, some will be winners, overall more will be losers.

Many here seem to forget that I spent time administering a welfare program. It proved to me that you can't trust government to "fix" social ills through the laws and policies they enact.

I seriously don't think anyone could foresee the future of Medicare. But at least he wants to fix it, rather than just getting rid of it, like the right wants to do.

Insurers will be prohibited from imposing annual or lifetime coverage caps on these essential benefits. These cover: "ambulatory patient services; emergency services; hospitalization; maternity and newborn care; mental health and substance use disorder services, including behavioral health treatment; prescription drugs; rehabilitative and habilitative services and devices; laboratory services; preventive and wellness services and chronic disease management; and pediatric services, including oral and vision care." In determining what would qualify as an essential benefit, the law required that the scope of standard benefits should equal that of a "typical employer plan". States have some discretion in determining what should be considered the benchmark plan within the requirements of the law, and may include services beyond those set out by the Secretary.

Among the essential health benefits, preventive care, childhood immunizations and adult vaccinations, and medical screenings will be covered by an insurance plan's premiums, and have co-payments, co-insurance, and deductibles eliminated. Specific examples of such services covered include: mammograms and colonoscopies, wellness visits, gestational diabetes screening, HPV testing, STI counseling, HIV screening and counseling, FDA-approved contraceptive methods, breastfeeding support and supplies, and domestic violence screening and counseling.

In addition, the law establishes four tiers of coverage: bronze, silver, gold, and platinum. All categories offer the same set of essential health benefits. What the categories specify is the division of premiums and out-of-pocket costs: bronze plans will have the lowest monthly premiums and higher out-of-pocket costs, and vice versa for platinum plans. The percentages of care that plans are expected to cover through premiums (as opposed to out-of-pocket costs) are, on average: 60% (bronze), 70% (silver), 80% (gold), and 90% (platinum).

Insurers are required to implement an appeals process for coverage determination and claims on all new plans. They are also required to spend at least 80–85% of premium dollars on health costs and claims instead of administrative costs and profits; rebates must be issued to policyholders if this is violated.

Effects on insurance premiums

Several studies on insurance premiums expect that with the subsidies offered under the ACA, more people will pay less (than they did prior to the reforms) than those who will pay more, and that those premiums will be more stable (even in changing health circumstances) and transparent, due to the regulations on insurance. The Kaiser Family Foundation has calculated that about half the people who currently buy insurance on their own today will be eligible for subsidies. Among those receiving subsidies (which excludes those with incomes above four times the poverty line — about $46,000 for individuals or $94,000 for a family of four), the subsidies are projected to be worth an average of $5,548 per household, which would effectively discount the projected price of insurance by two-thirds, on average. For individuals, NPR and the Kaiser Family Foundation collaborated to produce a quick online calculator for people to estimate their premiums and subsidy amount, based on where they live, income, and family size.

For the effect on health insurance premiums, the CBO forecast that by 2016 the individual market would comprise 17% of the market, and that premiums per person would increase by 10% to 13% but that over half of these individuals would receive subsidies that would decrease the premium paid to "well below" premiums charged under current law. It also forecast that for the small group market, 13% of the market, premiums would be impacted 1% to −3%, and −8% to −11% for those receiving subsidies; for the large group market comprising 70% of the market, premiums would be impacted 0% to −3%, with those under high premium plans subject to excise taxes being charged −9% to −12% less. Factors taken into account by this analysis included: increased benefits particularly for the individual market, more healthy policyholders due to the mandate, administrative efficiencies related to the health exchanges, and high-premium insurance plans reducing some benefits in response to the tax. As of September 2013, the final projections of the average monthly premium scheduled to be offered in the exchanges came in below CBO expectations, reducing expected costs not only for consumers but also for the government by reducing the overall cost of the subsidies.

Larry Levitt, a health policy analyst from the Kaiser Family Foundation, noted that the individual market compromises a relatively small share of those under 65, and said, in contrast, "I don't think anyone expects significant [cost] increases in the employer market," where the majority of Americans get their health insurance. Secretary of Health and Human Services Kathleen Sebelius also indicated that some cost increase in the individual market was expected because the standard of insurance allowed in the insurance exchanges would be higher quality than that generally available currently (and thus more expensive), and that the government subsidies provided to make insurance affordable are intended to more than offset this effect.

In June 2013, a study by the Kaiser Family Foundation focused on actual experience under the Act as it affected individual market consumers (those buying insurance on their own). The study found that the Medical Loss Ratio provision of the Act had saved this group of consumers $1.2 billion in 2011 and $2.1 billion in 2012, reducing their 2012 costs by 7.5%. The bulk of the savings were in reduced premiums for individual insurance, but some came from premium rebates paid to consumers by insurance companies that had failed to meet the requirements of the Act. The Associated Press reported that, as a result of ACA's provisions closing the Medicare Part D coverage gap (between the "initial coverage limit" and the "catastrophic coverage threshold" in the prescription drug program), individuals formerly falling in this "donut hole" would save about 40 percent. Almost all of the savings came reportedly because, with regard to brand-name drugs, ACA secured a discount from pharmaceutical companies. The change benefited more than two million people, most of them in the middle class.

Healthcare Cost
...
The Business Roundtable, an association of CEOs, commissioned a report from the consulting company Hewitt Associates which found that the legislation "could potentially reduce that trend line by more than $3,000 per employee, to $25,435", with respect to insurance premiums. It also stated that the legislation "could potentially reduce the rate of future health care cost increases by 15% to 20% when fully phased in by 2019". The group cautioned that all of this would be dependent upon the success of the cost-saving government pilot programs which must then be wholly copied in the private market.

In June 2013, a majority of the public (52–34%) indicated a desire for "Congress to implement or tinker with the law rather than repeal it". Following the Supreme Court upholding the constitutionality of the individual mandate in National Federation of Independent Business v. Sebelius, a poll released in July 2012 showed that "most Americans (56%) want to see critics of President Obama's health care law drop efforts to block it and move on to other national issues."

Non-cooperation

Officials in several states have decided to oppose those elements of the ACA over which they have discretion. For example, Missouri declined to expand Medicaid or establish a health insurance marketplace but is also engaged in an active program of non-cooperation, having enacted a statute forbidding any state or local official to render any aid not specifically required by federal law to the functioning of the Affordable Care Act. Other Republican politicians have tried to discourage efforts to advertise the benefits of the law, and some conservative political groups have launched ad campaigns to discourage enrollment.

2013 federal government shutdown

Strong partisan disagreement in Congress has prevented adjustments to the Act's provisions. However, at least one change, a proposed repeal of a tax on medical devices, has received bipartisan support. Some Congressional Republicans argue against improvements to the law on the grounds they would weaken the arguments for repeal.

Republicans attempted to defund its implementation, and in October 2013, House Republicans, supported by Senators Rand Paul, Ted Cruz, Mike Lee, and Marco Rubio, refused to fund the federal government unless accompanied with a delay in implementation of the ACA, after the President unilaterally pushed back the employer mandate by one year, which critics claim he had no legal right to do. The Republican-held House of Representatives passed three versions of a bill funding all elements of the government while submitting various versions which would repeal or delay the ACA, with the last version delaying enforcement of the “individual mandate”. These bills were unable to muster enough votes in the Democrat-held Senate, with Democratic leadership stating the Senate would only pass a "clean" funding bill without any restrictions on the ACA. After Congress failed to pass a continuing funding resolution by midnight on October 1, a government shutdown ensued. Conservative groups such as Heritage Action provided lobbying support for the linkage between the ACA and the government shutdown. Senate Republicans threatened to block appointments to relevant agencies, such as the Independent Payment Advisory Board and Centers for Medicare and Medicaid Services.

Job consequences of ACA

The House Republican leadership put forth the argument in favor of repeal that "this is a job-killing law, period." They contended that the ACA would lead to a loss of 650,000 jobs, attributing the figure to a report by the Congressional Budget Office. However, FactCheck noted that the 650,000 figure was not included in the CBO report referred to, saying that the Republican statement "badly misrepresents what the Congressional Budget Office has said about the law. In fact, CBO is among those saying the effect [on employment] 'will probably be small.'" PolitiFact also rated the Republican statement as "False".

Jonathan Cohn, citing the projections of the CBO, summarized that the primary employment effect of the ACA is to alleviate job lock: "People who are only working because they desperately need employer-sponsored health insurance will no longer do so." He concluded that the "reform's only significant employment impact was a reduction in the labor force, primarily because people holding onto jobs just to keep insurance could finally retire" because they have health insurance outside of their jobs.

Impact of repeal on federal budget projections

In May 2011, the nonpartisan Congressional Budget Office (CBO) analyzed proposals to repeal the law. Mirroring its analysis of the law itself, the CBO estimated that repealing the entire law (both its taxing and spending provisions) would increase the net 2011–2021 federal deficit by $210 billion. Revised CBO accounting, following the July 11, 2012, House repeal vote (H.R. 6079), and taking into account the impact of Supreme Court ruling, was consistent with its previous estimate: that repeal would cause a net increase in federal budget deficits of $109 billion over the 2013–2022 period.

Illustrative Examples of the Magnitude of the Exchange Subsidies Relative to the Tax Exclusion In addition to considering the share of its workers and their families who will be eligible for Medicaid, CHIP, or exchange subsidies under the ACA, a firm will also weigh the cost to its workers of obtaining insurance through exchanges (after accounting for any subsidies) against the cost of obtaining insurance through the firm (after accounting for the tax exclusion). From the workers’ perspective, the latter cost includes the entire amount of the premiums (because the cost to firms of providing health insurance is ultimately reflected in lower wages and salaries paid to their employees), less the savings workers realize in taxes because the
compensation they receive in the form of health benefits is generally not taxed.

The difference in the net cost of health insurance to workers from those two
sources will depend on differences in the price of health insurance obtained through the exchanges or through the firm and on the relative amount of support provided by exchange subsidies and the tax exclusion, which depends in turn on
workers’ income.

CBO and JCT project that a typical family health insurance policy purchased
through an employer will cost about $20,000 in 2016 and that the typical premiums for the second-lowest-cost silver plan available through the exchanges for that family will be about $15,400. The difference in projected cost for the two
policies reflects various factors: First, employment-based plans are expected to have an actuarial value of 85 percent (roughly comparable with the average for employment-based plans today), and silver plans will have an actuarial value of 70 percent.25 Second, administrative costs are expected to be much higher for exchange plans than for plans offered by large employers, principally because of the higher cost of handling enrollment and collecting premiums. Third, the premiums for the second-lowest-cost silver plan are expected to be below the average premiums for silver plans. Exchange subsidies will be most beneficial for families with the lowest income. Consider a family of four whose income in 2016 is about 200 percent of the federal poverty level, which CBO and JCT estimate will imply modified adjusted gross income of about $50,000.
■ If the family obtained insurance coverage through an employer, then the combination of federal and state income and payroll taxes means that the average family with that income would receive a tax subsidy of 29 percent of the $20,000 premium, or about $5,900.27 The after-tax cost of the premium ($20,000 - $5,900 = $14,100) plus out-of-pocket costs for medical services (which would be about $3,200 for such a policy) would total about $17,300.
■ If, instead, the family obtained insurance coverage through an exchange and
purchased the second-lowest-cost silver plan, it would pay no more than
6.5 percent of its income, or about $3,200, so it would receive a subsidy of its premiums of about $12,200.28 The family would also be eligible for cost-sharing subsidies of up to about $3,600 to reduce out-of-pocket costs for medical services. The after-subsidy cost of the premium ($15,400 - $12,200 = $3,200) plus the remaining out-of-pocket costs (which would be about $2,800
for such a policy) would total about $6,000.29
■ Therefore, for this family, receiving coverage through an exchange would save $11,300 ($17,300 - $6,000) per year relative to receiving coverage through an employer. For families with higher income, however, the advantage of obtaining insurance through an exchange is smaller because such families would receive smaller exchange subsidies (owing to the sliding scale under the ACA) and would lose larger tax subsidies for insurance obtained through their employers (owing to their higher income tax brackets). Consider, then, a family of four whose income in 2016 equals 300 percent of the federal poverty level, which CBO and JCT estimate will imply modified adjusted gross income of about $74,000. If the family obtained insurance coverage through an employer, it would receive, on average, a tax subsidy of 33 percent of the $20,000 premium, or about $6,600. If, instead, the family purchased the second-lowest-cost silver plan through an exchange, it would spend about 9.8 percent of its income, or about $7,200, so it would receive a subsidy of its premium of about $8,200. The family would typically face much higher out-of-pocket costs under the silver plan than under its employment-based plan. On balance, however, receiving coverage through an exchange would save this family about $3,000 per year relative to receiving coverage through an employer. Now consider a family of four whose income in 2016 is just under 400 percent of the federal poverty level, which CBO and JCT estimate will imply modified adjusted gross income of about $99,000. If the family obtained insurance coverage through an employer, it would receive, on average, a tax subsidy of 39 percent of the premium, or about $7,800. If, instead, the family purchased the second-lowest-cost silver plan through an exchange, it would pay about 9.8 percent of its income, or about $9,700, so it would receive a subsidy of its premium of about $5,700. Again, the family would typically face much higher out-of-pocket costs under the silver plan than under its employment-based plan. For this family, receiving coverage through an exchange would cost $700 per year more than receiving coverage through an employer.

Families with income above 400 percent of the federal poverty level will not be eligible for any subsidies in the exchanges and will receive a significant tax benefit from obtaining insurance through an employment-based plan. For example, a family of four whose income in 2016 equals 500 percent of the federal poverty level, which CBO and JCT estimate will imply modified adjusted gross income of about $124,000, would pay about $6,300 more to receive coverage
through an exchange than through an employer. For every firm, the advantages and disadvantages of offering health insurance coverage will depend on the effects of that decision on its workers as a group—which will critically depend, as demonstrated by the preceding examples, on the composition of that firm’s workforce. For example, if 25 percent of a firm’s workers have income equal to 200 percent of the federal poverty level, another 25 percent have income equal to 300 of the poverty level, and the remaining 50 percent have income equal to 500 percent of the poverty level, calculations like those shown for the illustrative families indicate that the firm’s workers as a group would have a higher cost for coverage through exchanges than through the employer. In addition, firms that chose not to offer coverage would generally pay penalties for doing so, or if they were sufficiently small, they might forgo tax credits for offering coverage. Moreover, because of the penalty that most people would face under the ACA if they do not have insurance coverage, few individuals will want to go without coverage altogether.

Long post, so be patient.
I can tell you flat out that the majority of veterans in the federal workforce far exceed others in terms of motivation, efficiency, accuracy, and efficiency.

To save time and address much of the fabrication and half-truths in this thread, I will simply use Wikipedia (where the PPACA entry is fairly comprehensive, so I'd suggest you read it before tossing out any more BS):

Insurers will be prohibited from imposing annual or lifetime coverage caps on these essential benefits. These cover: "ambulatory patient services; emergency services; hospitalization; maternity and newborn care; mental health and substance use disorder services, including behavioral health treatment; prescription drugs; rehabilitative and habilitative services and devices; laboratory services; preventive and wellness services and chronic disease management; and pediatric services, including oral and vision care." In determining what would qualify as an essential benefit, the law required that the scope of standard benefits should equal that of a "typical employer plan". States have some discretion in determining what should be considered the benchmark plan within the requirements of the law, and may include services beyond those set out by the Secretary.

In addition, the law establishes four tiers of coverage: bronze, silver, gold, and platinum. All categories offer the same set of essential health benefits. What the categories specify is the division of premiums and out-of-pocket costs: bronze plans will have the lowest monthly premiums and higher out-of-pocket costs, and vice versa for platinum plans. The percentages of care that plans are expected to cover through premiums (as opposed to out-of-pocket costs) are, on average: 60% (bronze), 70% (silver), 80% (gold), and 90% (platinum).

Insurers are required to implement an appeals process for coverage determination and claims on all new plans. They are also required to spend at least 80–85% of premium dollars on health costs and claims instead of administrative costs and profits; rebates must be issued to policyholders if this is violated.

For the effect on health insurance premiums, the CBO forecast that by 2016 the individual market would comprise 17% of the market, and that premiums per person would increase by 10% to 13% but that over half of these individuals would receive subsidies that would decrease the premium paid to "well below" premiums charged under current law.

Healthcare Cost
The Business Roundtable, an association of CEOs, commissioned a report from the consulting company Hewitt Associates which found that the legislation "could potentially reduce that trend line by more than $3,000 per employee, to $25,435", with respect to insurance premiums. It also stated that the legislation "could potentially reduce the rate of future health care cost increases by 15% to 20% when fully phased in by 2019". The group cautioned that all of this would be dependent upon the success of the cost-saving government pilot programs which must then be wholly copied in the private market.

And after all that, I will once again say for emphasis:
Many, many problems. But even as it stands now it will benefit far more people than it hurts. It already has.

Things would be much better if both sides started working together to fix the problems instead just digging trenches and shouting at each other about how the other side sucks monkey balls. Both sides have views that need to be addressed instead of attacked.
If the far right would stop spending the majority of their time, effort, and money into trying to eliminate something that they know damn well is not going to go away (42 purely symbolic votes in the House to repeal so far, plus filibusters, wasted floor time, and a government shutdown) and started proposing viable solutions to the problems inherent in the law as written, maybe they could get something accomplished other than political grandstanding and finger wagging.

Something else I will repeat: if the plans in your state suck, blame your state legislative bodies, not the federal government.

And what is your opinion on the "young invincible" Americans age 18-26 signing up to pay for this, or else the premiums have to rise to cover it (as noted per the hyperlinks earlier)?

Will they sign up ?

A single payer system would have a much better approach to take. As it stands right now Obamacare has made any government involvement in healthcare look bad in the eyes of the many and so the healthcare system will continue to be sick.