Yogi Berra and ObamaCare

April 2, 2014

Cartoon from Tom Toles at the Washington Post, April 2, 2014:

“ObamaCare: Nobody goes there. It’s too crowded.” Tom Toles in the Washington Post, April 2, 2014.

Why you need to know a little history to get good jokes:

Yogi Berra is famous for his sayings, some of which sound foolish at first, but which generally pack a lot of wisdom or sharp observation.

Berra grew up in St. Louis, which has many famous restaurants.  On some occasion, someone suggested the group should go eat at Ruggeri’s, and Yogi’s reply became famous:

On why he no longer went to Ruggeri’s, a St. Louis restaurant: “Nobody goes there anymore. It’s too crowded.”


How has ObamaCare (the Affordable Care Act) affected your family? Please take this poll

March 31, 2014

Taking America's pulse and heartbeat

Taking America’s pulse and heartbeat

Answers cannot be traced by me, by the way; answer accurately, with abandon.


Still have questions on Obamacare? Here’s the answer site (and a poll)

March 22, 2014

Here.  NPR is our most trusted news organization, and it has answers to specific questions and a collection of great stories on the entire law.

Is that a coincidence, or did they plan it that way?

Your Questions About The Affordable Care Act

By Danny DeBelius, Christopher Groskopf, Jessica Pupovac, Matt Stiles, Christopher Swope and Julie Rovner

NPR’s guide to the dozens of common questions about the new health care law known as Obamacare. Did we miss something? Send us your questions, and read our latest news stories on the issue.

Questions on the Affordable Care Act? Answers all over. Click the picture to go to the New York Daily News FAQ on the law, and how it affects you.

Questions on the Affordable Care Act? Answers all over. Click the picture to go to the New York Daily News FAQ on the law, and how it affects you.

Wait a minute, you say: “I want answers to questions, not just news stories.”

Yeah, they know:

Find Answers To Common Questions

What are the basics of the law?

Am I eligible?

How do I enroll?

How do the exchanges work?

Get the picture?  Click over there and start learning.

Then, when you’ve changed yoru health care plan (if you change it), come back here and answer this poll.  It should go without saying that you can answer the poll now if you’re not going to change.  Please answer only once.

The Millard Fillmore’s Bathtub Poll – Affordable Care Act


Pat Bagley: Corporate slavery, or “Misreporting the ACA”

February 7, 2014

Congressional Budget Office (CBO) figures show as many as 2 million Americans might quit jobs they don’t like, and go chase their dreams, because now they can get health insurance under the Affordable Care Act (ObamaCare).

Conservatives, and more than a few news organizations, misreported the study to say, as they claim, that the ACA will require the firings of 2 million people.

You can read the CBO report here, and draw your own inferences (make them reasonable, please); but Pat Bagley, the master cartoonist at the Salt Lake Tribune, put it in picture form.  Several panels in this cartoon, each telling no fewer than a thousand words.

Pat Bagley's cartoon from the Salt Lake Tribune, on reports that the ACA would enable workers to quit jobs they keep solely to keep health care benefits.

Pat Bagley’s cartoon from the Salt Lake Tribune, on reports that the ACA would enable workers to quit jobs they keep solely to keep health care benefits.

This is why the GOP doesn’t like ACA, you know. It really does give average citizens some choice.  Freedom to choose NOT to feed the profit-gouging machines of the friends of the GOP threatens the GOP much more than did Americans drinking coffee instead of tea, in 1773.

Bagley’s cartoon is more than picture-perfect. It’s truthful.


Texas State Sen. Kirk Watson warns state not to make ObamaCare navigators’ jobs tougher

January 6, 2014

After a convicted felon produced an edited video that appeared to show National Urban League “navigators” agreeing to allow the felon might file inaccurate information to get covered for health insurance under the Affordable Care Act, Republicans in Texas called for greater regulation of the navigators.

Such is the topsy-turvy world of GOP gotcha politics in Texas.

After committees of the U.S. House of Representatives held press conferences* damning the Affordable Care Act, the Texas Department of Insurance (TDI) is holding hearings across Texas to develop regulations to restrict actions of those people who act as navigators to enroll people into federal health insurance programs or private insurance through ACA.

In short, the Texas government is working to screw up federal law and deprive Texans of health care insurance (yes, that’s probably a felony, but who could prosecute it under the current political climate?).

Burnt Orange Report described the situation:

On January 6th the Texas Department of Insurance will hold its last public hearing regarding the state’s regulation of health care navigators. The navigators are responsible for helping individuals get enrolled through the new Healthcare.gov exchange, but in Texas Governor Rick Perry has been working to add unnecessary red tape in order to impede the success of the law. Reputable non-profit organizations in Texas like United Way received $11 million in federal grant money to help enroll individuals in local communities across the state.

In September just days before the health insurance exchange website went live Perry ordered TDI to craft new rules that included additional training and background checks for individuals who serve as navigators. Apparently even Senator Kirk Watson the author of the bill (that authorized navigators in Texas) was unaware that TDI had sent a letter to federal Health and Human Services Secretary Kathleen Sebelius, or the plan to implement rules that, “appear to both conflict with federal law and be inconsistent with SB 1795.”

In other words, TDI’s actions, on orders from Gov. Rick Perry, may violate Texas law as well.

State Sen. Kirk Watson provided this testimony at the TDI hearings today:

Texas State Sen. Kirk Watson, D-Fort Worth, wrote the law that enables Affordable Care Act Navigators to work in Texas, and testified that further state regulation would be expensive, confounding bureaucracy.  Star-Telegram photo by Ron Ennis

Texas State Sen. Kirk Watson, D-Fort Worth, wrote the law that enables Affordable Care Act Navigators to work in Texas, and testified that further state regulation would be expensive, confounding bureaucracy. Star-Telegram photo by Ron Ennis.

Posted on January 6, 2014 at 10:12 am.

State Senator Kirk Watson issued the following statement Monday regarding the Texas Department of Insurance’s hearing on proposed rules for healthcare navigators:

Texans have made themselves heard, and it’s clear what they want: fair rules that truly protect consumers without making it harder for them to find health insurance.

The vast majority of healthcare navigators are honest folks who are working hard, and in good faith, to connect their fellow Texans with health insurance. The Department of Insurance should create regulations that protect the state from bad actors without making it harder for navigators to do their jobs.

Texans support common-sense requirements such as criminal background checks for navigators. The bill I passed in the legislative session allowing for navigator regulations prohibits convicted felons from providing these services. Of course the state should enforce that provision and protect consumers. We shouldn’t have electioneering; my bill prevents that too. And we need to be sure we protect privacy.

But some other proposed rules appear designed only to make it harder for navigators to do their jobs.

The Department of Insurance has proposed requiring 40 hours of navigator training on top of the 20-30 hours that’s already mandated by law. That kind of training requires real time and costs real money. Where did the additional 40 hour requirement come from exactly? Who is it truly meant to help? How will Texans benefit if navigators are spending as much as 200 percent more time in class? So far, TDI has failed to provide any explanation although repeatedly requested to do. If the Commissioner waits until the final rules are out, she robs Texans of a transparent, accountable process and avoids a fair debate on this issue.

It’s also patently unfair to assess fees on navigators who, by law, aren’t allowed to charge Texans for their services. The fiscal note on my original bill said the Department of Insurance could implement these rules using existing resources. Why is it now proposing these costly, burdensome fees?

I thank Commissioner Rathgeber for scheduling this second public hearing in response to my request for it. And I urge her to listen to the Texans she’s heard from in this process.

It’s wrong to impose heavy-handed, politically motivated rules that primarily serve to make life harder for hard-working Texans who are simply trying to help their friends and neighbors find affordable health insurance. Common-sense regulations should strike a balance that actually protect Texans, both by protecting their privacy and by protecting their ability to find good, reliable, affordable health insurance.

Sen. Watson also contributed more detailed suggestions in writing:

Posted on January 6, 2014 at 12:16 pm.

Jan. 6th, 2014

Good morning, Commissioner Rathgeber and Assistant General Counsel, John Carter. Thank you for scheduling this second public hearing in response to my request for it. There remain a number of questions which TDI has yet to answer and the people deserve another opportunity to be heard on this important issue.

First, I want to be very clear about avoiding the political straw men in this this conversation.

Texans support common-sense requirements such as criminal background checks for navigators. The bill I authored in the legislative session allowing for navigator regulations prohibits convicted felons from providing these services. Of course the state should enforce that provision and protect consumers. We shouldn’t have electioneering; my bill prevents that too. And we need to be sure we protect privacy.

We are all in agreement that these requirements are paramount to protecting consumers – that’s why we put them in the bill.

—-

But my bill authorizes TDI to create regulations that protect the state from bad actors without making it harder for navigators to do their jobs.  Remember the purpose clause of SB 1795:  the purpose of this chapter is to provide a state solution to ensure that Texans are able to find and apply for affordable health coverage under any federally run health benefit exchange, while helping consumers in this state.

Your goal is to help ensure that Texans are able to find and apply for affordable coverage under the federally run exchange.  Remember, those in control of the capital have chosen not to have a Texas exchange, creating the need for SB 1795.

—-

The vast majority of healthcare navigators, as you can see and have seen from the testimony you received on September 30, 2013 and most recently on December 20, are honest folks who are working hard, and in good faith, to connect their fellow Texans with health insurance.

TDI has yet to provide justification for why it has gone as far as it has with these rules.

—-

On December 20, I and several other senators submitted a letter to you in which we requested explanations to very specific questions. The people of Texas deserve answers to these questions. They deserve to know why some of these proposed rules are so far-reaching.

What’s very troubling to me is that my office asked when we might expect answers to these questions. We were told that an email you sent on December 23 was a reply.  But that so-called reply reads as an acknowledgement of receiving the letter – not as a response to it. In fact, you seem to suggest you will answer these questions in the final rule order.  With all due respect, Commissioner, that’s inappropriate.  As I stressed in my September 30 testimony to you, because this issue has been so politicized, people have reason—even an obligation to be skeptical.  So process matters here.

Your process – your refusal to answer critical questions prior to the final rule order – leaves no opportunity to discuss fallacies or poor decisions before the proposed rules are final. More importantly, it robs Texans of a transparent, accountable process and avoids a fair debate on the issue.

—–

So, what are the questions that haven’t been answered?

  1. TDI has yet to explain how it arrived at the arbitrary 40 hour training requirement, in addition to the 20-30 federally required training hours.
  2. Nor has TDI explained how it arrived at the 13-13-14 hours of training in the areas of Texas Medicaid, privacy and ethics, respectively.
  3. TDI has not explained why navigators will have to pay registration fees as well as significant costs associated with additional training in light of a) the fact that navigators cannot charge a fee for their service, and b) the fiscal note for SB 1795, based on information provided by TDI, assumes any cost associated with implementation of the bill would be absorbed with existing staff and resources.
  4. TDI has yet to explain how it arrived at the proposed options for proving financial responsibility, which include surety bonds.
  5. TDI has yet to provide a detailed timeline showing each step that a navigator organization and individual navigators must accomplish to come into compliance with the proposed rule. We also haven’t seen a timeframe for which each step can reasonably be completed — an essential question for honest, hard-working Texans who are working right now to connect folks with health insurance.
  6. TDI has not explained how extending the registration requirements to almost anyone providing enrollment assistance protects Texas consumers, or how restricting the use of the term navigator outside of the federally operated insurance exchange protects Texas consumers.

—-

Under your proposed rules, navigators must comply with many of the rules’ requirements by March 1, 2014. Assuming this rule becomes effective in early February, navigators and navigator organizations will have only about a month to come into compliance.

Given that the open enrollment period for people seeking coverage in 2014 ends on March 31, I fear that many navigator entities will face significant problems in meeting your proposed rules without compromising their ability to help Texans secure health care. I respectfully request that you postpone the compliance deadline until after the open enrollment period ends.

And although the training requirements for TDI-certified courses are not applicable until May 1, 2014, I question how many companies will be able to set up the training and examination requirements precisely as you’ve laid out in the proposed rules. An open and transparent process shouldn’t result in a product that only a certain business or type of business can provide.

People have a right to question whether the timing, combined with the extremely expanded training requirement that doesn’t seem capable of justification other than because the Governor suggested it, might be to benefit a private provider of training.  Perhaps one that already has a contract with the state.  This would put public money that should be going to help people get health coverage in a private enterprise’s hands.  Again, with no justification.

I respectfully request that you delay the implementation of the state training requirements until the universe of potential providers can be better assessed.

We still have time to do this right. You still have the opportunity to strike the appropriate balance between two equally important responsibilities: protecting consumers, and ensuring Texans have access to the health insurance that’s right for them.

I urge you to provide answers to the questions raised by members of the Senate on December 20 and to do so before you finalize this rule.

In Texas, the Republicans will consort with convicted felons to hoax up stories about people trained to help enroll Texans for health insurance, and make completely unsubstantiated claims that the helpful people are felons, and Texans should worry about it.

If the GOP will take the word of felons to impugn the Affordable Care Act, why are they worried about the honesty of others who are not known to be felons, on the other side?

If it doesn’t make your head hurt, you’re not paying attention.

More:


Insta-Millard: GOP lied? Not 5 million losing insurance to cancellations, but 10 thousand.

January 2, 2014

Hey, the numbers are off only by a factor of 500.

Gotta give credit to the GOP propaganda machine to have gotten so many Americans so soundly disinformed and het up about such a small number, smaller than anyone expected.

Should this qualify as a hoax?  If Obama had screwed up a number by 500, what would the headlines be?

Parody of James Montgomery Flagg's World War I recruiting poster, suggesting that Uncle Same wants people to have access to health care, affordably.  New reports suggest it's going to happen, and that reports of massive health insurance cancellations are inaccurate.

Parody of James Montgomery Flagg’s World War I recruiting poster, suggesting that Uncle Same wants people to have access to health care, affordably. New reports suggest it’s going to happen, and that reports of massive health insurance cancellations are inaccurate.

More:


Jonathan Gruber explaining ObamaCare a year ago: The Comic Book

November 1, 2013

THERE MUST BE A BETTER WAY: Some 2,700 people lined up in July for free medical treatment at the Virginia-Kentucky Fairgrouds, in 2009. Inc. Magazine photo

THERE MUST BE A BETTER WAY: Some 2,700 people lined up in July for free medical treatment at the Virginia-Kentucky Fairgrouds, in 2009. Inc. Magazine photo

Description from PBS NewsHour:

Published on Jun 8, 2012

Health correspondent Betty Ann Bowser talks with Jonathan Gruber, the author of “Health Care Reform,” the comic book. The MIT economist and professor of economics hopes the graphic layout of his book will help more Americans understand the complex law and its implications.

Read more about Gruber’s book and the health care reform law on the NewsHour’s Health Page: http://www.pbs.org/newshour/topic/hea….

Be sure to see what’s going on more than a year later, in the immediately previous post, “Winners and losers.”


ObamaCare working in Utah?

October 11, 2013

GOP panic spreads.  But will they run the correct way in their panic, say to vote for a clean, 12-month continuing resolution and and a raise to $18 trillion in the debt ceiling?

ObamaCare working in Utah.  Who would have imagined that?  The Sherburnes seem happy with what they bought.

Chris Detrick | The Salt Lake Tribune Phil Sherburne and his wife Leia Bell pose for a portrait with their kids Cortez, 11, Oslo, 6, and Ivan, 9, at their home in Salt Lake City Wednesday October 9, 2013. Sherburne and Bell, owners of the frame and art store called Signed & Numbered, succeeded last weekend in signing up for health coverage on healthcare.gov.

Chris Detrick | The Salt Lake Tribune Phil Sherburne and his wife Leia Bell pose for a portrait with their kids Cortez, 11, Oslo, 6, and Ivan, 9, at their home in Salt Lake City Wednesday October 9, 2013. Sherburne and Bell, owners of the frame and art store called Signed & Numbered, succeeded last weekend in signing up for health coverage on healthcare.gov.

More:

M. Turner snapped this self-portrait that went viral in the debate over President Obama's Affordable Health Care Act.  M. Turner photo, via CNN

M. Turner snapped this self-portrait that went viral in the debate over President Obama’s Affordable Health Care Act. M. Turner photo, via CNN


Annals of ObamaCare: Restaurant hiring increased since the bill passed

July 30, 2013

Watch the charts, get the facts.  Obamacare is working well.

First, let’s look at the food service industry.  Hoaxsters claim that restaurants are cutting hours of employees and refusing to hire, to avoid the law. Not so.

Growth in restaurant employment and sales since Affordable Care Act was signed into law

Growth in restaurant employment and sales since Affordable Care Act was signed into law

So food service establishments — restaurants — have experienced sales and employment growth as has the rest of the economy during the Obama administration.  What about employees?  Are restaurants cutting back their hours to avoid providing benefits to employees?  Evidence suggests the opposite:  Hours worked per employee are increasing.  Go to the chart:

Average weekly hours worked in restaurants, per employee, since the Affordable Care Act became law

Average weekly hours worked in restaurants, per employee, since the Affordable Care Act became law

These are the official figures from the White House.  More [links added here]:

During the four years since the recession ended in June 2009, 87% of the increase in employment has been due to a rise in the number of workers in full-time jobs. And looking at the period since ACA was signed in March 2010, more than 90% of the rise in employment has been due to workers in full-time jobs. Moreover, the length of the average workweek for private sector production and nonsupervisory employees has returned to its level at the start of the Great Recession.

And while the number of involuntary part-time workers has declined roughly in line with previous recoveries, it spiked up 322,000 in June. However, nearly 30 percent of the June increase was due to federal employees. This suggests that furloughs contributed to the pickup in part-time employment.

These observations strongly suggest that the Affordable Care Act has not constrained growth in hiring or work hours. So what is the ACA doing? It’s slowing the growth rate of health care costs for consumers, creating new incentives for providers to raise the quality of care, and adding new transparency and accountability in the insurance marketplace—all steps that help the economy.

ObamaCare is working — the Affordable Care Act has provided cheaper health care, much broader insurance coverage, better health — and seems to be stimulating industry, too.

More:

 


Got questions about ObamaCare? Check out this site

June 24, 2013

I get e-mail; this one may prove useful to more than a few people, especially anyone who owns a small business and has questions about how ObamaCare — the Affordable Care Act — will affect your taxes, your hiring, your expenses, etc.:

The White House, Washington

Hi, all –

In fewer than 100 days, the new health care reform law takes an important step forward. On October 1, 2013, Health Insurance Marketplaces will open in every state, and millions of Americans will be eligible to apply for coverage. Between now and then, we’re sure that lots of people will be looking for information about the upcoming changes.

That’s why we revamped HealthCare.gov.

On the updated site, you’ll be able to get a personalized list of coverage options, tailored to your situation, and a checklist to help prepare for October 1. You’ll find a rich set of answers to frequently asked questions, powerful search features to help you find the specific information you need, and two great ways to talk to customer service representatives, 24/7: a new 1-800 number (1-800-318-2596) and online chat.

When open enrollment starts on October 1, 2013, you’ll be able to use the site to compare various health care plans side by side to find a plan that fits your life and your budget. You’ll even be able to use HealthCare.gov to apply for coverage or be directed to your own state’s application portal.

We hope you’ll use the site to get answers to your questions about the health care law — and forward this email to your friends so they can do the same.

Thanks!

Tara

Tara McGuinness
Senior Communications Advisor
The White House

P.S. — Have questions about what else you can expect from health care reform? Click here for a timeline of the key features of the Affordable Care Act.

Visit WhiteHouse.gov

[My e-mail address cut out ]

The White House • 1600 Pennsylvania Ave NW • Washington, DC 20500 • 202-456-1111

Several people I’ve run into have questions about the program — some of the questions are serious, and difficult for me to answer, and some are silly (“Why do I have to give up my insurance now?” Answer:  You don’t.)  There’s a great need for answers.  Distortions of the plan from the nasty political fights involved, have taken hold in the mind of many as representations of what the plan weill do.

Go try the site.  Does it answer your questions?  What questions do you have that are not answered by this site?

More:

Screenshot of HealthCare.gov. Click to visit the site.

Screenshot of HealthCare.gov. Click to visit the site.


V for Vaccine: A slightly rude film with a powerful point

January 10, 2013

A couple of kids in the Dallas area have died already from influenza — neither had been vaccinated against it.  Deaths have occurred across the nation, frequently in young, otherwise healthy people.

Nasty flu bugs going around this year, and the every-year epidemic has hit about two months early.  One part of the good news is that the vaccines this year are especially well-suited to target the viruses that cause the trouble.  The vaccines work well every year, but especially well in 2012 and 2013.

The bad news is that millions of people haven’t bothered to get vaccinated. That’s not good.

  1. Under Obamacare, there’s no copay for insurance for a flu shot.  It’s “free” if you have any kind of insurance. In addition, county health offices offer the vaccines for free to any comers.  A couple of weeks ago at the pharmacy I stood behind a woman who confessed she’d not gotten a flu shot (pharmacies are pushing vaccinations these days, to promote their mini-clinics).  “I’ve got that crappy teachers’ insurance,” she told the technician.  “It never pays for anything like that.”  The tech looked it up, and told her that her copay was zero, and her insurance paid for it — essentially a free shot, to her.  On the way into the clinic she said, “I’ve never gotten a flu shot before.”  Oy.
  2. Think Herd Immunity:  Are you usually healthy?  Great.  But if you’re pregnant, or you work around people who are or may be pregnant, or if you’re over 60, or if you have any chronic condition like diabetes, high blood pressure, chronic sinusitis, or a raft of other things, you’re at risk, and you put others in those risk categories at risk.  My grandfather worked at a hospital while my mother and my oldest brother were living with him; after a week of my grandfather’s working in the polio ward, my brother came down with the disease.  Of course we don’t know for sure, but my grandfather kicked himself for 40 years, until his death, because he thought he’d brought home the disease my brother caught.  With vaccines, those incidents become much more rare.

Risking this blog’s G rating, I’m going to post this film, “V for Vaccine.”  Found it at New Anthropocene.  Turn up your offense filter, or ignore the language — but pay attention to what this guy says, PowerM1985:

Is it worth getting your children vaccinated if it risked them becoming autistic? In this video I give a short demonstration of why I personally believe that even if there was a risk of my child becoming autistic (AND THERE IS NOT!) I would still get them vaccinated.

You should probably know that the work of the Centers for Disease Control to correctly predict which strains of the viruses will be most prevalent, and get vaccines that will fight those viruses, has been very, very good this year.

  • Influenza A (H3N2), 2009 influenza A (H1N1), and influenza B viruses have all been identified in the U.S. this season. During the week of December 23-29, 2,346 of the 2,961 influenza positive tests reported to CDC were influenza A and 615 were influenza B viruses. Of the 1,234 influenza A viruses that were subtyped, 98% were H3 viruses and 2% were 2009 H1N1 viruses.
  • Since October 1, 2012, CDC has antigenically characterized 413 influenza viruses, including 17 2009 influenza A (H1N1) viruses, 281 influenza A (H3N2) viruses and 115 influenza B viruses.
    • All 17 of the 2009 influenza A (H1N1) viruses were characterized as A/California/7/2009-like. This is the influenza A (H1N1) component of the Northern Hemisphere vaccine for the 2012-2013 season.
    • Of the 281 influenza A (H3N2) viruses, 279 (99%) were characterized as A/Victoria/361/2011-like. This is the influenza A (H3N2) component of the Northern Hemisphere influenza vaccine for the 2012-2013 season.
    • Approximately 69% of the 115 influenza B viruses belonged to the B/Yamagata lineage of viruses, and were characterized as B/Wisconsin/1/2010-like, the influenza B component for the 2012-2013 Northern Hemisphere influenza vaccine. The remaining 31% of the tested influenza B viruses belonged to the B/Victoria lineage of viruses.

What are you waiting for?  Go get a flu shot!

More:

English: This is CDC Clinic Chief Nurse Lee An...

This is CDC Clinic Chief Nurse Lee Ann Jean-Louis extracting Influenza Virus Vaccine, Fluzone® from a 5 ml. vial. (Photo credit: Wikipedia)

Graphic on influenza, 2013 - Flu.gov

Information from Flu.gov; click image to get to active Flu Vaccine Finder


Fact vs. Fiction on the Affordable Care Act (Sen. Leahy)

July 2, 2012

From the good offices of Vermont’s Sen. Pat Leahy (a few links added):

Fact vs. Fiction

It is disappointing that inaccurate and purposely misleading information regarding health care reform continues to be widely circulated. Throughout the past two years during the lengthy debate on Health Care Reform, Senator Leahy has continued to post updated information regarding the various health care legislative proposals being debated, including the full text of proposals, questions asked by directly by Vermonters, and daily updates on floor proceedings in the Senate in an effort to provide Vermonters with accurate and timely information on the health care reform debate.

Below are some of the most common myths regarding the Affordable Care Act with accurate information dispelling those myths and providing information about where to learn more.

To review some of the most commonly questions by Vermonters please also visit the Frequently Asked Questions page on this website.

To test your knowledge about what is actually included in the health care reform law visit the Kaiser Family Foundation website and take their Affordable Care Act quiz.

Fact vs. Fiction

  • Fiction

    If you don’t buy health insurance, you will be sent to jail.

  • Fact

    Taxpayers who are required to purchase health insurance and do not will receive a notice from the Internal Revenue Service (IRS) with the amount of the penalty they owe. Individuals who fail to pay the penalty are not subject to criminal prosecutions and the government cannot file notice of lien or levy any property for a taxpayer who doesn’t pay the penalty.

    The obligation for individuals to purchase health insurance beginning in 2014 was included as part of the Affordable Care Act.  The provision requires individuals to maintain minimum essential coverage for themselves and their dependents or pay a penalty of $95 in 2014. Families would pay half the amount for children, and the requirement includes a cap on the total allowable fine per family. If affordable health insurance coverage is not available to an individual, then the penalty would be waived.  Along with the individual responsibility requirement, the Affordable Care Act also provides subsidies to some individuals beginning in 2014 to help pay for their health insurance premiums and other costs associated with their health insurance.

    Taxpayers who are required to pay a fine but fail to do so will receive a notice from Internal Revenue Service (IRS). If an individual still neglects to pay the fine, the IRS can attempt to collect the funds by reducing the amount of their tax refund in the future.  Individuals who fail to pay the penalty, however, will not be subject to criminal prosecution. The government cannot file notice of lien or levy on any property for a taxpayer who does not pay the penalty.

    The aim of this provision is to encourage all Americans to obtain health insurance, which will result in lower health care costs for everyone. The Affordable Care Act relies on the shared responsibility of individuals, employers, states and the federal government.

    For additional information regarding the individual responsibility requirement please visit the Kaiser Family Foundation website.


  • Fiction

    Members of Congress are exempt from the health care reform law.

  • Fact

    No one has received a special exemption from the Affordable Care Act. In fact, the health care reform law explicitly includes language regarding the health insurance plans for Members of Congress and their staff.

    As a United States Senator, Senator Leahy’s health plan options are the same options offered to all federal employees.  Included in the Affordable Care Act, was a provision that requires that “the only health plans that the Federal Government may make available to Members of Congress and Congressional staff shall be health plans that are created under this Act or offered through an Exchange established under this Act.”  Members of Congress and their staffs can only purchase health insurance coverage from the health insurance exchanges that are made available for uninsured Americans. The full text of this provision is available on pages 80-81 in section 1312 of the Affordable Care Act which you can read here.


  • Fiction

    Health care reform will jeopardize Medicare and will mean cuts in services and benefits for seniors.

  • Fact

    Health care reform will help strengthen Medicare so that seniors can continue to receive quality health coverage for years to come.

    The Affordable Care Act explicitly states that no benefits guaranteed under Medicare will be cut as a result of health care reform legislation.  Today’s forecasts estimate that Medicare will be insolvent by 2017 because of ever-rising health care costs.  The Affordable Care Act takes aim at that unfolding threat by addressing cost inefficiencies now, instead of waiting until later.  The Affordable Care Act strengthens the financial stability of Medicare by targeting fraud and ending wasteful overpayments to insurance companies, while maintaining the benefits and services to seniors who use Medicare.  The Act also helps Medicare users by offering prescription drug discounts to seniors who are trapped in the “donut hole,” by creating a better pathway for generic drugs to enter the marketplace, by eliminating the cost-share for preventative services, and by promoting coordinated care to prevent avoidable hospital readmissions.

    For more information about what the health care reform law means for Medicare beneficiaries read Medicare and the New Health Law -What it Means for You prepared by the Center for Medicare and Medicaid Services.

    • Beginning January 1, 2011, Medicare beneficiaries entering the Medicare donut hole will get a 50% discount on brand name prescription drugs. Click here to learn more about this provision.

  • Fiction

    The health care reform law includes a tax on all real estate sales.

  • Fact

    Under the Affordable Care Act, only certain real estate transactions for certain individuals above a particular income level would be subject to a Medicare Tax.

    Unfortunately, much of the information widely circulated about a tax on home sales and other real estate transactions inaccurately describes the purpose and the effect of this provision. The 3.8 percent Medicare tax is often misunderstood, and has frequently been described as a 3.8 percent “sales tax” on all real estate transactions, which is inaccurate.

    The provision that establishes this tax can be found on page 946, Section 1402 of the Affordable Care Act.  This tax is often referred to as the “Medicare tax,” because it was designed to raise funds for Medicare. The Medicare tax goes into effect after December 30, 2012.

    The Medicare tax is not a tax on all new home sales; it only applies to the profit that certain high income Americans make from the sale of their home.  The groups that may be affected by this provision are individuals with annual incomes over $200,000 and married couples with a joint income of over $250,000. The only home sellers who will be affected by this provision are those who fit the above description, and who sell their home for a profit of more than $250,000. The tax will not apply to the first $250,000 in profits for the individual selling his or her home or to the first $500,000 in profits for a married couple.

    While undoubtedly some home sales will see a tax increase under this provision, the tax will affect only a small percentage of home sales.  A report released by the Tax Foundation on April 15, 2010 predicts that the new tax on investment income (including real estate) will affect only the top-earning 2 percent of American families.

    The full text of the Affordable Care Act is available on the health care reform page of this website.


  • Fiction

    Health care reform will hurt small businesses.

  • Fact

    The Affordable Care Act will help small businesses, many of which are struggling now to even afford health plans for their employees.

    Small businesses are a vital engine of Vermont’s economy. Unfortunately, rising health care costs are hitting small businesses especially hard, putting them at an even greater disadvantage against larger corporations. The Affordable Care Act will help level the playing field and give affordable options to small businesses that wish to offer insurance to their workers.

    For example, the Affordable Care Act:

    • Provides tax credits to small businesses to help them offer health insurance to their employees;
    • Requires insurance companies to provide free preventative care so businesses do not suffer productivity costs because of sick employees;
    • End the “hidden insurance tax” that has prevented small businesses from being able to afford to offer insurance to their employees.  This hidden tax is built in to the premiums for insurance to compensate for the unpaid care given to the uninsured.  Health reform will help get Americans health insurance and will end the inflated premium costs.  And investments to lower health care costs overall will help spur the economy, enabling more businesses to thrive;

    For more information regarding how health care reform efforts will help small businesses please visit the Implementation Center on this website as well as the Small Business Administration website and the Small Business Majority website for additional resources.


  • Fiction

    The Affordable Care Act provides subsidies for illegal immigrants to receive health insurance.

  • Fact

    The Affordable Care Act explicitly defines who is eligible for federal payments, credits or subsidies for health insurance coverage and makes clear that undocumented immigrants are ineligible.

    Some have expressed concerned that undocumented immigrants will have the ability to receive subsidies for health insurance under the reform proposals in Congress.  Senator Leahy does not support using government funding to subsidize insurance for those who have entered the United States illegally or who are residing in the United States in an undocumented status. The full text of the law clearly defines who is eligible for federal payments, credits or subsidies.

    The relevant statutory language is below:

    Patient Protection and Affordable Care Act
    Subtitle D—Available Coverage Choices for All Americans
    PART II–Consumer Choices and Insurance Competition Through Health Benefit Exchanges

    • Section 1312 (f)(3) makes clear that undocumented immigrants are ineligible to participate in the health insurance exchanges: “ACCESS LIMITED TO LAWFUL RESIDENTS- If an individual is not, or is not reasonably expected to be for the entire period for which enrollment is sought, a citizen or national of the United States or an alien lawfully present in the United States, the individual shall not be treated as a qualified individual and may not be covered under a qualified health plan in the individual market that is offered through an Exchange.”

    Subtitle E—Affordable Coverage Choices for All Americans
    PART I—PREMIUM TAX CREDITS AND COST SHARING REDUCTIONS
    Subpart B—Eligibility Determinations

    • Section 1412(d) unambiguously states “NO FEDERAL PAYMENTS FOR INDIVIDUALS NOT LAWFULLY PRESENT.—Nothing in this subtitle or the amendments made by this subtitle allows Federal payments, credits, or cost-sharing reductions for individuals who are not lawfully present in the United States.”

    The Act also establishes a fair process to accurately verify eligibility for participation in the benefits of health insurance reform that does not place unnecessary bureaucratic hurdles for U.S. Citizens nor undue administrative costs on the government.

    Patient Protection and Affordable Care Act

    Subtitle E—Affordable Coverage Choices for All Americans
    PART I—PREMIUM TAX CREDITS AND COST SHARING REDUCTIONS
    Subpart B—Eligibility Determinations

    • Section 1411(a) required that the Secretary of Health and Human Services “shall establish a program . . . for determining . . . whether an individual who is to be covered in the individual market by a qualified health plan offered through an Exchange, or who is claiming a premium tax credit or reduced cost-sharing [is] a citizen or national of the United States or an alien lawfully present in the United States.”
    • Section 1411(b) requires applicants for enrollment in a qualified health plan offered through an Exchange in the individual market to provide “name, address, and date of birth.”  For those individuals claiming eligibility based on an attestation of citizenship, they must provide their social security number.  For those individuals whose eligibility is based on an attestation of their immigration status, they must provide “the enrollee’s social security number (if applicable) and such identifying information with respect to the enrollee’s immigration status as the Secretary, after consultation with the Secretary of Homeland Security, determines appropriate.”

    Senator Leahy has also heard from Vermonters with small businesses who employ seasonal workers and their concern about the requirement that employers purchase health insurance for their employees.

    The Act exempts small businesses from the employer mandate to provide health insurance for employees, and employers are not subject to penalties if they employ 50 or fewer employees.  Seasonal workers do not count towards the 50 employee threshold.  And for those employers subject to the penalty, they are only responsible for providing health insurance for full-time employees.

    Patient Protection and Affordable Care Act
    Subtitle F—Shared Responsibility for Health Care
    PART II—EMPLOYER RESPONSIBILITIES
    Section 1513—Shared Responsibility For Employers

    • Section 1513(a) states:

    (B) EXEMPTION FOR CERTAIN EMPLOYERS-

    (i) IN GENERAL- An employer shall not be considered to employ more than 50 full-time employees if—

    (I) the employer’s workforce exceeds 50 full-time employees for 120 days or fewer during the calendar year, and

    (II) the employees in excess of 50 employed during such 120-day period were seasonal workers.

    (ii) DEFINITION OF SEASONAL WORKERS—The term `seasonal worker’ means a worker who performs labor or services on a seasonal basis as defined by the Secretary of Labor, including workers covered by section 500.20(s)(1) of title 29, Code of Federal Regulations and retail workers employed exclusively during holiday seasons.”


  • Fiction

    Health care reform will lead to rationing of health care

  • Fact

    Health care reform is aimed at increasing the options for Americans, not limiting them.

    Unfortunately, prior to the passage of the Affordable Care Act rationing of health care happened all too often. Insurance companies decided whether or not beneficiaries could have a certain test or procedures, based not on medical necessity, but on the insurance plan and whether the test is affordable. This rationing left millions of Americans without adequate care or coverage and is taking away the decision making from patients and their doctors, putting those decisions instead in the hands of insurance company bureaucrats.

    The Affordable Care Act is intended to improve the ability of patients to receive the care they need by setting ground rules for insurance companies to follow.  No longer will insurance companies be allowed to deny coverage for preexisting medical conditions or to discriminate against consumers because of their gender. No longer will insurance companies be allowed to revoke insurance coverage from a patient who has been ill and deemed too sick for coverage. The government will have no role in telling patients what tests they can and cannot have. In fact, for the first time, the Affordable Care Act prohibits insurance companies from limiting choice of doctors.  The Affordable Care Act guarantees your right to choose a primary care doctor from any available participating provider, designate any available participating pediatrician as your child’s primary care provider, and prohibits insurers or employer-sponsored plans from requiring a referral for obstetrical or gynecological (OB-GYN) care. Additionally, the Affordable Care Act prohibits health insurers and plans from restricting access to and charging patients more for out-of-network emergency care.

    Health care reform is about improving choice for all Americans.


  • Fiction

    The health care reform law will force individuals to pay taxes on their health benefits.

  • Fact

    Health benefits will not be taxed under the Affordable Care Act, even though the value of your health insurance will be included on your W-2 form.

    Title IX of the Affordable Care Act, Section 9002 on page 800 states that beginning in the tax year 2011, employers are required to report the value of the health insurance coverage they provide employees on each employee’s annual W-2 Form so that employees can be informed consumers and know the full cost of their plan. The amount reported does not affect tax liability and the value of the employer contribution to health coverage will continue to be excludible from an employee’s income and is not taxable.

    Updates and guidance will be posted regularly on the IRS website regarding all tax provisions included in the Affordable Care Act.


  • Fiction

    The government will encourage or force seniors to choose euthanasia as an end-of-life option.

  • Fact

    This has been shown over and over again to be another false rumor.  Nothing in the Affordable Care Act requires that seniors participate in consultations about their end-of-life wishes.

    Unfortunately, this rumor has been spreading fast and is worrying many Vermonters and Americans across the country. Nothing in the Affordable Care Act will force seniors to have consultations regarding their end-of-life choices, or have a consultation to discuss suicide.

    Currently, voluntary end-of-life planning is covered as a part of the “Welcome to Medicare” doctor visits available to seniors with in the first year of joining the program.   The Affordable Care Act authorized Medicare coverage of yearly physician exams, or wellness visits for beneficiaries. Specifically, section 4103 of the Affordable Care Act provides coverage under Medicare, with no copayments or deductible, for an annual wellness visit and personalized prevention plan services.  Often times patients are not given the time to ask important questions about options available to them such as hospice, or home care, or additional services available to seniors.  This provision would simply give seniors the choice to have a discussion during their wellness visit, about the topics of their choosing, with their doctor. It empowers seniors to have conversations about living wills and other questions they might have but do not have the opportunity to ask.  In no way does the law mandate these conversations or tell doctors what options to discuss.  If seniors do not wish to have these discussions with their doctors and families, nothing will force them to.


Bagley’s cartoon on criticizing Obamacare

April 6, 2012

Generally the Pulitzer Prize committees look at specific works submitted by candidates.  Bagley‘s day-in, day-out brilliance must make it difficult for editors to choose what to nominate, no?

This cartoon is just perfect, in so many ways:

Pat Bagley cartoon, Obamacare critics, March 28, 2012, Salt Lake Tribune

I hope these cartoons get picked up by newspapers far outside of Utah. They deserve to be seen more broadly. Click cartoon to go to Salt Lake Tribune's archives of Bagley's work.


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