Now that Obamacare has officially been upheld in the Supreme Court, what are you going to do next?

Do you have health insurance now, @Fly? I’m curious how much you pay for your insurance and if you don’t have insurance, how much will it cost you with the mandate?

@bkcunningham I have insurance, but I’m under my dad’s policy so I don’t pay for insurance and I can’t answer any of your questions. But I am extremely thankful to be able to remain on his insurance until age 26 under this mandate! And I certainly don’t mind paying higher taxes if it means providing insurance for countless people, including my mom, @augustlan.

I’m extremely happy! Prior to ‘Obamacare’, I had been unable to obtain insurance for myself for years (pre-existing conditions meant no one would insure me at any price). I was recently able to become an insured person at a reasonable rate, and am so, so grateful for that. Thanks, Obama!

It would have sucked to have it yanked out from under me.

How much does it cost you in your state, @augustlan?

$287.00 per month, @bkcunningham. In my state, they decided to let the federal government run the plan. Now, $287/month may not seem ‘reasonable’ to some folks, but I was paying over $300/month for just one of my medications (I take 5 Rx medications per day, a total of 8 pills/day). That Rx now costs me only $50/month. As soon as I get it switched to a 90 day Rx, it will cost even less.

More importantly, I can now afford to have my routine follow up visits and lab tests done on a regular basis (every 6 months) rather than stretching it out till I can save up the money to pay for it (roughly every two years). I have kidney disease and a host of other auto-immune issues, so regular testing is vital.

I’m pretty excited. I doubt the bill will have much of an effect on me personally (though I will be eyeballing my rates to see over the next few years)... But I have several un-insured friends, including one with cancer… who were helped greatly by this.

The provision allowing you to stay on your parents insurance til 26 is the only reason my one friend is likely alive today.

That cost is comparable to the cost in Florida for the basic, cheapest option, per month, per person age 45 to 54. From age 55 plus, the cost increases to $376 per person/month. There is a $2000 deductible for in-network doctors. The prescription drug plan in Florida really sucks for the people in the pool. There is a $500 deductible. If you do the mail order plan, you have to pay $100 per refill even if your deductible is met.

@bkcunningham There is a deductible here, too, but preventative care is 100% covered, from day one.

I know many people who can’t afford the costs. Really sad. Count yourself fortunate, @augustlan.

Mitt mutters under his breathe so low that only the closest can hear: “It’s actually Romneycare. I thought of it first…”

Now it’s time to work on the President’s re-election so that the ACA is fully implemented in 2014.

[mod says] This is our Question of the Day!

How much does it cost an individual in your states, @zenvelo and @tedd?

I am really quite excited. I am proud of our president and of the supreme court. I am also really hoping that for the first time in about four years I might actually be able to afford health insurance.

Okay, I’ll ask you too, @SuperMouse. lol How much will it cost you?

I am going to be amused tremendously by things like this

Roberts surprised me. I was sure he was hust a puppet. Good for him for doing the right thing.

I don’t know what it will cost once the reform goes through. I have shopped for policies periodically and minimal health care coverage would have cost me close to $1,000 a month. Ridiculous for a healthy woman with zero pre-existing conditions. Buy health insurance or keep a roof over my kids’ heads. I’ll take shelter thanks.

@ragingloli I could not help myself and changed over to Fox while the news was breaking. I LOL’d. Right now some Romeny minion is speaking on MSNBC and I am thoroughly enjoying listening to the spin.

@bkcunningham I do not know what it will cost; 2014 is eighteen months away. But I am fortunate enough to get insurance through my employer.

I’m hearing conflicting reports on whether the states must set up the exchanges.

@zenvelo, why are you happy about it if you don’t know what people will have to pay. What about people I know who can’t afford the mandate now?

@bkcunningham They’ll have to pay a fine, just like they would if they drove a car without auto insurance.

It was a 5–4 decision, not 6–3.

@bkcunningham, the exchanges stand. The only thing the ruling limits is the way the expansion of Medicaid is implemented; ultimately not a big deal.

Also, you realize that if you can’t afford the mandate, the federal government gives you a subsidy so you can afford it, yes?

Thanks, @Qingu. I was hearing conflicting reports.

@Qingu Sorry, basing it off of the early reports. Thanks for the correction!

To answer the question: I was planning on dying of some debilitating disease, but now I guess I’ll have to stay healthy. Thanks a lot, Obama. ~

Here is a calculator for how much you will get in subsidies to buy insurance:

http://healthreform.kff.org/SubsidyCalculator.aspx

I’m not sure if that’s current; but it’s from 2010, so probs accurate.

And from Wikipedia, here’s the penalty/tax amount for not buying insurance:

“Impose an annual penalty of $95, or up to 1% of income, whichever is greater, on individuals who do not secure insurance; this will rise to $695, or 2.5% of income, by 2016. This is an individual limit; families have a limit of $2,085.”

FYI, the subsidies are substantial. For example, someone making 30k gets a 1,400 subsidy for non-employer insurance. That’s more than the tax/penalty.

@Qingu I’m sorry, but that’s not apocalyptic enough. You’re making it sound like grandmothers won’t be gutted in the streets while their families are forced to watch. Don’t you realize that this is the end of the world? ~

The dissent (written by Kennedy, signed by Scalia, Thomas, and Alito) is creepy as hell.

From the closing paragraph:

“The Constitution, though it dates from the founding of the Republic, has powerful meaning and vital relevance to our own times. The constitutional protections that this case involves are protections of structure. Structural protections—notably, the restraints imposed by federalism and separation of powers—are less romantic and have less obvious a connection to personal freedom than the provisions of the Bill of Rights or the Civil War Amendments. Hence they tend to be undervalued or even forgotten by our citizens. It should be the responsibility of the Court to teach otherwise, to remind our people that the Framers considered structural protections of freedom the most important ones, for which reason they alone were embod- ied in the original Constitution and not left to later amendment. The fragmentation of power produced by the structure of our Government is central to liberty, and when we destroy it, we place liberty at peril. Today’s decision should have vindicated, should have taught, this truth; instead, our judgment today has disregarded it.”

That’s right. According to the conservative justices and “swing-vote” Kennedy, the Constitution’s structural limits on federal power and states rights are more important than the Constitution’s and amendments’ “romantic” notions about personal liberty. That’s fucked up.

I think it is a perfect time to get really, really, sick.

@bkcunningham, who are these people you know who “can’t afford the costs”? How much do they make?

There are real life people I know, @Qingu. A couple from Washington state. He is a retired deputy sheriff and she is retired from several occupations; banking, real estate, daycare. Because of budget cuts, he was forced into early retirement, two years before he qualified for Medicare and five years before she qualified. They paid unbelievable monthly rates for COBRA and finally decided they couldn’t afford it any longer. He just got on his Medicare and she still doesn’t have insurance. Both were denied private insurance for pre-existing conditions. His was his blood pressure. She was denied because she was too fat. LOL

She’s 4’9” and weighs 160. Neither smokes. They are vegetarians. He said if she gets seriously ill, he put her in the car and have an accident so the auto insurance will pay part of the costs of her hospitalization.

I know another couple from Massachusetts in pretty much the same age scenario. She is going to have to wait three years for her Medicare. He’s on Medicare now. He was an over-the-road tractor trailer driver, she worked for an airline. She has a pension coming when she is old enough. He got too ill to work because of heart problems.

None of the people in the two examples can afford the $270 a month. Sad isn’t it? I know many,many other people in similar situations. I haven’t asked them how much they make a month in their retirement. But we’ve all talked about how much fear we have in holding onto our retirement money and still maintaining a decent life with a roof over our heads and food on our tables.

@bkcunningham if they do not work, they have no income and thus qualify for Medicaid.

@bkcunningham I’m wondering what the people in your example do when they do get sick? If they can’t afford the subsidized premiums, then who pays for their medical care?

Probably continue what I have been doing, which is paying my own bills and somebody else’s too.

How much does it cost? How much does it cost? Far too fucking much, I’ll tell you! No, not the penalty. That’s chump change. Do you want to know how much I’ve been paying for insurance? Do you want to know how many years I’ve been paying it? I’ll tell you.

While your friends haven’t been able to afford $1200 a year, or whatever it is, I’ve been paying $18,000 a year for family coverage. Yes. Me, an just about everyone who is employed at a firm that offers decent coverage has been subsidizing everyone else who doesn’t have any insurance at all. And we’ve been doing this for thirty years or more!

I’m sorry, but whining about the mandate is a little insensitive and little bit venal. You want me to keep on paying for your health care? Really? Talk about handouts!

Health care is the hidden handout that no one ever talks about. We, the fully insured, have been subsidizing the health care of the uninsured for far too long. And this is not like subsidizing other welfare programs. There are perfectly healthy people working and making money who don’t spend a dime on health insurance, and when they do need care, they go in, and they get care and if they can’t afford it, they still get it. Then maybe they go bankrupt in order to deal with the bills.

This is the stupidest way to pay for health care, ever. Now, with people paying a little (and not even their fair share—just a highly subsidized share), at least things should get better for those of us who have been subsidizing the others.

And you who have been uninsured will experience a lot of benefits. Pay attention to @augustlan‘s story. See how she can get preventive care now? See how she can get her meds? She will be healthier and as a result, she will cost less to care for, and we will all save money. When everyone is healthier, we all save! When all these people who say they can’t afford insurance must get insurance, even they will be healthier, against their own desires, I guess.

Probably the hospitals are secretly against this, because if people get healthier, they might have less business. Except people will live longer and eventually, they’ll need care, so it’ll be a wash, probably.

I am concerned about the ruling against the mandate for Medicaid expansion. The most likely states to refuse to expand Medicaid to 150% of poverty (or whatever it is) are the Southern and poor states, especially those with lots of immigrants. These people will still get sick, and hospitals in those states will still have higher uncompensated care burdens. This will make those hospitals more precarious, financially speaking.

On the other hand, if the economy gets better, it may be easier for these states to expand Medicaid, and once they do, it will be harder to take it back. This legislation may actually help the economy move, as it kicks in, slowly. It should. It gives people more security. People don’t worry about health care, and they can afford to move for a job or take a job with out worrying about pre-existing conditions and so on. This legislation may turn out to be one of the best things Obama has done for the economy. Of course, people won’t see that until much later, but you’ll see.

The couple from Washington, the wife hasn’t been sick, @YARNLADY. The couple from Mass., she has gone to a clinic here that charges $90 per visit. She needed antibiotics.

Take time to absorb the shock. I really felt the law would be repealed. As usual the copycat Thomas voted along the same line with Scalia. I wonder as to whether people recall this law had been watered down so much before it even passed. Overall, I’m pumped. Feel like having great sex! Lol.

@bkcunningham, why don’t the non-working, non-Medicare members of the couples you mentioned qualify for Medicaid?

I would only be able to guess, @Qingu. I imagine their savings is too much. The husband of the couple from Washington works part-time.

EDIT: Also, both husbands are old enough and receive their SS. The wives aren’t old enough yet and don’t have any disabilities.

Well then. sounds like your friends will be helped immensely by Obamacare for the next few years while they wait to get old enough to qualify for Medicare.

They will still have to pay, @Qingu.

If it were going to benefit them, it would benefit them now because Florida has the pool and the cost is too much for them.

@bkcunningham If that low cost is too much, then perhaps they need a case manager or someone to help them sort through the options.

Although, it is possible that the pool isn’t really working. This is why we needed the government option in order to provide some serious competition for the private sector.

@bkcunningham, not if Medicaid expansion or subsidies cover them.

And if neither of those covers them, then I don’t give a crap if they have to pay, because they would clearly be wealthy enough to afford it. And better that than them being freeloaders on the system.

And no, the Florida pool status quo is not going to cover them better than Obamacare. I don’t actually think you understand what Obamacare does; I have doubts that you understand your friend’s financial situation.

This cracks me up. Some are trolling, yet others are serious.

Heave a big sigh of relief.

I will not be as affected as many, since I already have health care. But it will be nice to think that if I actually get sick, I won’t be dropped by my insurance company for, you know, being sick.

@Mama_Cakes I wonder if they realize that they’re threatening to move to a country that also has socialized medicine…?

@Fly That’s what I was thinking.

Canada does not have socialized medicine. It has universal coverage through a single-payer health insurance system.

I can understand the idiots out there in twitterland not having a clue. But it makes me sad when people on fluther have such misunderstandings about the issues.

@wundayatta: even most reasonably literate Americans don’t know the difference. :(

@wundayatta, are you saying it’s not socialized because the hospitals and such are not government-run?

Because I’ve often heard, and have no problem referring to, Canada’s system as “socialized.” I don’t use that word as an epithet, of course.

From Sarah Palin:

Thank you, SCOTUS. This Obamacare ruling fires up the troops as America’s eyes are opened! Thank God.

This proves to be such an unsettling time in America as we undergo the fundamental transformation that Barack Obama promised he would do to us if elected. Obamacare was dealt in deception and confusion by flooding the public with an overwhelming amount of conflicting “rationale” via thousands of pages of unread legislative detail, which is the radical left’s M.O. Obama promised the American people this wasn’t a tax and that he’d never raise taxes on anyone making less than $250,000. We now see that this is the largest tax increase in history. It will slam every business owner and every one of the 50% of Americans who currently pay their taxes. The other 50% are being deceived if they think they’re going to get a free ride – because Medicaid is broke. Recipients of Obama’s “free health care” will have fewer choices and less accessibility. Trust me – this much more expensive health care WILL be rationed; to claim otherwise defies all economic and common sense.

We will not retreat on this. A newly elected legislative branch is key to defending our Republic and fundamentally restoring all that is good in America.

SCOTUS now rules this is a tax? Well, Congress has the ability to create taxes – and also has the ability to rescind them. Upon their return from the July recess, Congress should act immediately to repeal this terrible new tax on the American people, and indeed they must repeal all of Obamacare. This is the most brazen and sweeping new tax and government overreach imposed on us. We the People did not ask for this tax, we do not want this tax, and we can’t afford this tax. This is not an answer to America’s health care challenges.

It’s time, again, for patriotic Americans to rise up to protest this obvious infringement on our economic and personal freedom. November is just around the corner. Today, the Supreme Court issued their ruling on Obamacare. In November, We the People will issue ours.

- Sarah Palin

Why do conservatives always complain about the length of bills? “Thousands of pages of unread legislative detail”?

Is it because they tend to be illiterate?

I mean, it’s possible that Palin, for example, is simply demagoguing about the scary new “tax” that is the mandate penalty and knows it’s not actually a big deal and has little to do with the legislation’s cost. On the other hand, she probably is stupid enough to not have a clue.

@Mama_Cakes: that’s a little embarrassing to even read.

@Qingu: it’s opportunistic. Much legislation is naturally long, and they did the same thing when they were in power.

“This is not an answer to America’s health care challenges.” I love how those who bitch about the Affordable Care Act never have any suggestions about how to fix it.

I’m not sure what the ruling changes for me personally, but I’m glad people are being taken care of.

So it looks like conservatives (based on Fox News’ front page and Sarah Palin’s idiot screed above) are going to push the idea that the entire health care law is a tax.

As opposed to, you know, the fine for a small number of individuals who can afford to, but nevertheless do not, purchase health care, the fine which exists solely to prevent free-riders for community rating and has nothing to do with actually funding the law, is a tax.

Why be honest when “tax” is such a nice, scary word to throw around to your political advantage?

Wait and see how it will affect me but I am delighted that it was upheld. This is a baby step on the way to what we really need – universal, single payer health care.

Well, @Qingu, if it matters so little for the financing of the act, then why not get rid of it?

Are people who refuse to purchase coverage, but who pay the penalty/tax, covered in some way?

As to “socialized,” you know that the health care delivery system in Canad is a privately owned and managed system. To call it socialized, by any stretch of the imagination, is wrong. It would have to be a government managed health delivery system, such as they have in Britain, to be called socialized.

Canada does have socialized health insurance, which, of course, is a damn good thing. A very large portion of Canadians, based on polls, love their system. Although a few do complain about lines and rationing. Big whoop. They are healthier than Americans are, on average. But then so, it seems, are Cubans.

I’m not afraid of the term, “socialized.” When you think that a poor country like Cuba can do as well or better than the US at keeping it’s population healthy, it seems like it would make people want socialized medicine. Of course, idiots like Sarah Palin completely miss the point, as usual.

@wundayatta, the tax penalty does not fund the act. It deters people from “Free-riding”; ie not purchasing insurance until they get sick (since the act outlaws discrimination against people with pre-existing conditions).

If lots of people did that, then insurance would only carry sick people. Meaning it would be crazy expensive, meaning that the system would be completely unworkable. So you need to deter free-riders, which is the purpose of the tx penalty.

If the law works properly and ideally, nobody will even pay the tax penalty, because everyone will choose to purchase insurance.

And no, people who refuse to purchase insurance and who thus pay the tax penalty are not covered.

@Qingu, regarding your response to people I know who can’t afford the price of joining Florida’s insurance pool, your lack of pity for the aging poor really is unsettling. I thought you preached compassion for the poor. That doesn’t include the sick and aging?

@bkcunningham, enough. You either didn’t read what I wrote, or you’re being deliberately dishonest.

I have pity for the poor. If your friends are poor, Obamacare will cover them either through subsidies or the Medicaid expansion.

If your friends are not covered by either of those things, they are not poor.

I’m convinced @bkcunningham is just trolling at this point…

@Qingu I understand about free riders. I don’t know if the penalty is big enough to overcome that problem. It seems to me it is probably a wise decision to pay the penalty until you get sick, and then buy health insurance.

Ah well, I’m sure there are many ways this program can be gamed. It’s not single-payer. It must have more loopholes than a life-size crocheted MRI machine.

@wundayatta, you could be right, but there’s also a carrot. The fed. gov. provides subsidies for buying insurance, to the tune of $500 billion’s worth iirc. So if you are not wealthy, the options become
• Pay tax penalty for not buying insurance
• Get free or cheap insurance

And needless to say, “getting sick” isn’t the only thing that might happen to you to require insurance. Another good reason to have insurance is in case of a car accident or something like that. Which is why people who can easily afford to do so almost always have insurance.

As for loopholes, I’m sure you’re correct. The law is a long way from ideal. But it’s much, much better than the status quo.

@wundayatta To clarify, I was referring to their healthcare system, I should have been more clear in my wording. People just commonly say “socialized medicine” in reference to Canada, and for all intents and purposes, the phrase gets the point across.

@Qingu, do you know the qualifications for Medicaid?

@bkcunningham Are you saying people should get free healthcare? Let’s say they don’t pay for healthcare, what should we do if they get hospitalized? Who should pay?

@Fly I have mixed feelings. What bothers me about Obamacare is he worked on getting people coverage, but did not really work on a lot of what I call scamming in the system. We need tranparency in billing, and get rid of all this bullshit we have with ten different prices depending on who someone is insured with. I don’t mind paying for different types of coverage, but literally different prices? Doctor’s cannot answer how much a procedure will be, they sell a service and don’t know what they charge. It’s insanity. Think about it like this, if I have car insuarnce and get in a wreck, hopefully the body shop has a price for what it costs to fix the damage. Then deoending on my insurance coverage I might have to pay part of it because of my deductable. But the price of the service should not vary drastically based on my insurance.

I really want government to come after the integrity in health care, health insurance and billing. As it is now, mostly what Obama accomplished is making the bad system available to everyone more readily.

What am I doing now? I’m celebrating! It’s not everything, and we still have a LONG way to go, but it’s a start.

@bkcunningham, it varies from state to state, does it not? I’m looking it up for Florida now.

http://www.medicaidresource.com/medicare_vs_medicaid.html

BTW, Obamacare expands Medicaid coverage. Though that is a little up in the air because of the SCOTUS ruling.

Are you going to acknowledge anything I’ve said, @bkcunningham? I mean, do you actually realize that your friends will directly benefit from the ACA?

@JLeslie, actually the ACA does work with accountability. That’s where the “death panel” rumors originally started, I think; it sets up a board whose job it is to figure out which procedures are actually cost-effective and distribute those procedures nationwide.

It also forces insurance companies to have English-readable bills.

Holy crap, thanks for the news, I didn’t know that. Now I might not have to move to Europe.

@Qingu Ok, maybe I am not aware of everything the plan covers. Well, I definitely am not. Will there be changes in billing ractices? I am so disgusted. My hospital bill was $30k, knocked down to something like $2500 because my insurance is so wonderful. All total bullshit. No one would be billed $30k for the two days I was in the hospital.

No, @Qingu. I don’t understand how forcing them to pay for something they can’t afford is going to benefit them. That is my point. They cannot afford to pay the premiums. I’m not sure what part of that you don’t understand.

@bkcunningham, the part where you think Obamacare will not cover their expenses, either through Medicaid expansion or subsidies.

What part of that do you not understand? Or do you just not acknowledge that this part of the law exists?

@Qingu, not everyone qualifies for Medicaid my friend.

You know, it’s funny, but I’ve been arguing health care reform with a cousin of mine on Facebook. Actually, it’s not funny.

He keeps say things like “Stop the madness, vote the fucker out” and “So much for freedom” (except that pretty much every word is misspelled). Yet when I ask “Why? What specifically do you disagree with?”, all he can provide are Faux News talking points. When I try to have an informed debate by providing references and sources (on often simply researched factual items), he doesn’t even try to rebut, he just moves on to the next unsupportable, ignorant rant. It’s frustrating, but what’s so sad is how many Americans seem to be functioning at the same level (excepting here on fluther, of course!). And even stranger to me is the fact that he is exactly the sort of person that will benefit most from this program.

I worry for our culture, our ability to work for the common good rather than overt partisanship…hell, there’s so much wrong with our country.

@bkcunningham, no shit. People like your friends fall through the cracks.

That is why Obamacare expands Medicaid. If your friends are not poor enough to qualify for Medicaid now, they might qualify for it under Obamacare.

If they still don’t qualify for expanded Medicaid, Obamacare will provide them with subsidies, which will pay most or all of their insurance costs.

If they are not poor enough to qualify for subsidies, they are not poor.

Covering people like your friends, who are poor but not so poor to be covered by current Medicaid and thus forego insurance, is the entire fucking purpose of the law.

The shocking thing about this discussion is that I don’t think you actually realized that this is what the law does.

@syz, @Qingu, GAs!

Okay, @Qingu, since you are the expert on Obamacare, please explain how Florida’s Medicaid will “expand.” The link you provided wasn’t for Medicaid. It was for nursing home care under Medicaid. I’m still trying to find the financial guidelines online and I can’t. Will the state of Florida set the limits or will the feds set the qualification limits? What will the limits be? Do we know yet? Where will the funding come from?

bkcunningham, when this all plays out we might make a believer out of you :-)

@bkcunningham, about Medicaid expansion, ACA says that the federal government will pick up 90% of the tab if a state expands its Medicaid coverage. That’s a huge carrot. Originally, it included a “stick,” too, where the government could withdraw existing funds if states didn’t comply—but SCOTUS struck down this stick. But the carrot is still there, and most states will bite (since their citizens still have to pay taxes that fund Medicaid anyway). If they don’t, then the subsidies or financial hardship exception will simply cover people who should be covered by the Medicaid expansion.

I posted a link for calculating subsidies earlier in this question. I also found this as a general guideline for coverage under Obamacare, though I think Medicaid is more up in the air (as I explained above):

• Under $30,000, families qualify for Medicaid and pay nothing for insurance.
• Under $37,000 or so, most families can buy a bronze policy for free.
• Between $37,000 and $45,000, the cost of a bronze policy is quite small, and certainly less than paying the fine.
• Above $45,000, the cost of a bronze policy is a bit more than the fine.
• Above $50,000, the cost of a bronze policy is significantly more than the fine, but there aren’t very many uninsured families in this category.

As for the link I posted, look at the bottom. The page explains there are two sets of requirements for Medicaid, Assets and Income.

Now let me repeat: do you realize that expanding Medicaid and providing money for free or very cheap insurance for people like your friends is in fact virtually the entire point of Obamacare?

I realize that is part of the law, @Qingu.

So if you realize your friends will receive money with which to purchase insurance under Obamacare, likely most or all of the cost of insurance, why are you worried about how they will be affected under the law? Why are you not glad for them?

You are making assumptions, @Qingu. Things aren’t always black and white.

Jesus fucking Christ! What assumptions? What is not black and white?

Your friends don’t qualify for Medicaid, they aren’t 65 yet, and they can’t afford insurance. They will be able to afford insurance under Obamacare. That is the purpose of the ACA. Which part of this do you disagree with, and why?

One set of people in the example I gave own a home in Massachusetts which her elderly parents are living in, @Qingu. They are supporting her parents financially. That is where their “extra” money goes, yet their assets are too much to afford them the luxury of Medicaid. My friend is 70 and on Social Security. It is the wife in this situation who is praying to make it three more years without a serious illness and then who’ll be old enough for her Medicare and Social Security.

@bkcunningham Just curious about your opinion on something. Let’s say the Obamacare fees would easily be half, if everyone had to pay in via taxes to a healthcarse system. Meaning people in their twenties who are very healthy have to pay in also. But, then if they his hard times as adults they are still in the system, or if we simply just spread paying into healthcare over an entire adult lifetime it will be less per years than when people finally have some sort of realization maybe they should get health care.

My BIL was having serious symptoms and got his healthcare insurance a week before his rectal cancer diagnosis. How the hell is that fair to any of us who have always been paying into the health insurance? He was extremely lucky he was able to game the system. At least if we pay into one system, which even under Obamacare we don’t, we would be covered by a system we have contributed to.

@augustlan Does your insurance and deductables actually wind up cheaper than if you paid out of pocket for the same amunt of visits and tests to the doctor? Assuming no major emergencies, just the regular care you feel is appropriate for your health issues.

@JLeslie I can answer that question, and yes, it is much less. Even if she only bought prescriptions, she would meet the deductible in a matter of months. That’s not including the expensive blood tests that she needs that she normally has to put off because of money.

@JLeslie, are you saying a system where whoever works pays into healthcare account, like Social Security, except everyone has the same type of insurance?

@bkcunningham Yes. Do you think that is a better option than what Obama has done still having people pay into private insurers?

@Qingu Under obamacare have waiting times been banned? For instance when I started working at Bloomingdale’s years ago, I had to work 6 months before I could join their health care insurance.

@Fly Do you see any problem with that? I mean do you question at all how expensive health care is in general? I just wonder if you question the profitting in the system, which Obama has left somewhat intact.

I am so very pleased that this happened today. To me, the affordable care act is Obama’s most important accomplishment.

Of course, this act has a large impact on me personally. I will be able to stay on my parents’ health insurance until I am 26, which is fantastic because my health problems have slowed my progress through college and I won’t be in the workforce earning my own insurance until I’m 23, 24. Before the ACA, I believe children were kicked off their parents’ insurance at age 19, unless they were full time students, in which case they could be kept on for longer. I turned 19 in the midst of my Year of Many Surgeries, during which time I had temporarily dropped out of school. What a time that would have been to lose my insurance! I was in no state to work, so I might have lost my insurance, which would immediately put me hundreds of thousands of dollars in debt. And then of course I would never be able to get insurance again because of my “preexisting condition.”

I really don’t think this is how a civilized nation should treat its ill, which is why I’m terrified by the prospect of Romney getting elected and immediately striking down the ACA.

In this scenario, @JLeslie, does everyone pay exactly the same amount for the exact same kind of care? I mean, everything is available for everyone? If someone doesn’t work, they are given the same care as everyone else at no cost? If that is the case, it would take more than just a revamp of how we pay for insurance, wouldn’t it?

@bkcunningham A percentage of their income, yes. Total revamp, yes. If they don’t work, they get the same health care, yes.

I don’t want to completely take the Q off track, I just want to put out there my hesitancy regarding being thrilled abut Obamacare. It is not because I want to go back to the days before obamacare, it is because I think the most fair system would be to get rid of insirance companies and move to a fully socialized system where everyone pays in throughout their lifetime, and everyone is covered. That to me seems to be the least expensive way to provide healthcare to the nation.

@JLeslie I do, but this is just one step. I think you are being quite unrealistic. Obama can hardly get a bill passed in the first place, nonetheless one that fully socializes medicine in the United States. Think about how hard this bill was to pass; now, imagine how difficult it would be to pass such a bill as you propose- it would be impossible. This is just one part of fixing the whole, and Obamacare is certainly a step in the right direction, so I really don’t understand your hesitancy. Yeah, it sucks that we can’t just jump right to the ideal outcome, but that’s just the way it is. To make any progress at all, we have to take steps.

So regardless of where you go to college and med school and regardless of where they practice medicine you get paid a flat salary? I can go to a doctor at Vanderbilt instead of a doctor in a little town in Michigan? I can go to a specialist Johns Hopkins or does someone dictate what doctor I can see?

@Fly That is my hope, a first step in the right direction. I agree with you, this is probably the best he culd do with such opposition.

@bkcunningham What are you talking about? Seeing a specialist at John Hopkins is not the same care a doctor here in Memphis. Seeing a specialist is not the same as a GP.

That is what I’m asking. I have to see the doctors in my area or could I go to a doctor that provides what I consider a better a level of care?

@bkcunningham If Johns Hopkins will take your case, sure you can go there.

The same government that oversees our Social Security Insurance fund oversees this fund? Hmmm I have to think about this one. lol

@bkcunningham, I notice that nothing you’ve said since my last post, has anything to do in any way with the questions I directly asked you.

I mean you continue to talk about how your friends don’t qualify for current Medicaid. You have not acknowledged ACA’s medicaid expansion. You have not acknowledged ACA’s subsidies for which they would presumably qualify.

It’s almost as if you’re not actually interested in discussing the ACA’s effects on your friends at all.

@Qingu, I am assuming that owning two homes would put you out of the qualifying for subsidies. Both of the women will qualify for SS within three years.

I am beginning to think that these people are not poor old ladies at all.

@Qingu, it depends on your definition of poor. Are they the poorest people I’ve ever met. Absolutely not. Can they afford the extra $376 a month for the Preexisting Condition Insurance Plan pool that Florida is offering under Obamacare? Nope. It isn’t black and white.

Simple, sell your house and get a apartment.

Seems pretty black and white to me. If a person is wealthy enough to own two homes, I won’t be shedding any tears if that person is fined for not paying for health insurance.

Of course if they have no income then they will qualify for subsidies, is my understanding at least.

In any case, I really don’t understand why you expect anyone to give a shit about these two-home-owning people having to pay $95 for three years if it means that millions of people will have insurance and health care who did not.

@bkcunningham are you so desperate to bad mouth president Obama’s healthcare plan that you expect us to feel sorry for a couple that owns two houses and has to pay under $100 for three years for healthcare coverage? The reasoning behind your stance here does not compute.

@wundayatta does an excellent job of describing the fiscal reality of the current healthcare system. It seems to me that even we were to take the whole “everyone deserves access to life saving healthcare” thing out of the argument, affordable healthcare for everyone is sound fiscal policy.

I’m very happy for those who are helped by the ACA. :-) However, I prefer a single-payer system to the mandate. I’m sure the ACA would be even more A, if the insurance companies were removed from the system.

I don’t think my wife and I have to do anything, because we’re already covered by Medicare. If I’m wrong about that, please let me know.

@Brian1946, you’re good for now. Obama’s death panels will be contacting you once the law goes into full effect in 2014.

@Sarah Palin

Obama’s death panels will be contacting you once the law goes into full effect in 2014.

I’m not worried about that, because we’re going to move to Canada or the UK before then, to avoid Obama’s socialist medicine! ;-)

This thread…..

@SuperMouse, I didn’t insult the POTUS. I was discussing the issues. For the record, I don’t expect you to feel sorry for anyone. My FRIENDS own two homes and are taking care of a set of aging and ill parents. They both worked hard their entire life for what they have and they are taking care of their family by allowing them to live out the rest of their lives in their home in Mass. They are doing the right thing. They can’t afford to pay an additional $376 a month for insurance. It really pisses my off the arrogant way their situation is discussed by you guys. Such compassion. ~ It is a reality that none of you have apparently had to face. I hope you never do.

I’m pretty sure that dependents are included in figuring out people’s eligibility for subsidies. If not now, then that would be fixed soon, but it’s a pretty standard thing. And yes, parents can be dependents.

@bkcunningham let’s see I am a mom of three kids and full-time student trying to finish a degree.I do not own real estate and my assets include pretty much my clothes, things for my kids and a mini-van with over 100,000 miles on it. I am the main (unpaid) care-giver for my husband who is quadriplegic. I have not had health insurance for four years now. The father of my kids lost his job and as a consequence I lost child support payments. I work as many hours a week as possible but with trying to finish school and run a household and pay that hovers right around minimum wage, it doesn’t go very far. I am fairly familiar with doing the right thing. After paying into the system for 20 some odd years I do not qualify for a single penny of assistance from the state.

Arrogant about their situation? I think not. Distressed that you are so insistent that president Obama’s health insurance plan (which you seem uninterested in learning more about) will do nothing for them? Absolutely.

I’m sorry, @SuperMouse. I don’t want to play a game of trying to one up you with whose situation is worse. I wish you the best.

@bkcunningham it is a game you began with your remark about my lack of compassion and patronizing statement about never having faced challenges. It is fascinating to me that rather than getting the real scoop on what will happen to your friends (and the myriad others who are low income and currently uninsured), you took that tactic.

If you want to know the truth, @SuperMouse, you make me so mad with your remarks my hands are shaking and I’d rather not get into it with you. I really wish you would go back and read my remarks. Neither of us know the other. You don’t know me or my friends or their situation. Let’s leave it at that before something is said that can’t be taken back and we might regret.

@bkcunningham I sincerely apologize for causing you so much upset, that was certainly not my intention. I have been pulling for this program from the jump and I find it incredibly frustrating when people insist that the plan in unworkable. They way the situation was presented by you, it seems that president Obama’s healthcare plan can and will help your friends.

Relevant

Behl. Pretty much anybody needs to do better than just come up with an anecdote about themselves or their friends to show a policy is a bad idea. How about some statistics? Does it hurt more people than it helps? Does it hurt a protected minority unreasonably? Does it actually solve a pressing problem?

If you have 100 people affected by a policy, you can bet someone will be affected negatively. With hundreds of millions affected, you can probably find a lot of negatively affected people. You at least have to weigh all the pros and cons.

@bkcunningham, there’s actually a very simple way to resolve this. Why don’t you see if your friends qualify for subsidies under Obamacare. I posted the link to do so.

@JLeslie sorry I missed your question. I don’t think ACA outright bans waiting times, but it does fine businesses that don’t offer insurance to their employees. (And offers subsidies to businesses who can’t afford to insure their employees). So I’m assuming that will help eliminate waiting times.

The law also makes it much easier to get insurance outside of your employer.

You also asked about insurers profiting—the law has a provision called the 80/20 rule where at least 80% (85 in large groups) of premium costs must be spent on actual health care (as opposed to overhead). If less is spent, the consumer gets a rebate.

Read about all the people who are so pissed about this socialist ruling, they’ve decided to move to Canada. Canada: Where Universal Healthcare Just Won’t Stand.

@Qingu Thanks.

One other thing I am confused about was I thought there was not going to be a government option we can buy, but it seems like maybe there is? Or, is the option just that medicaid has expanded, but middle class and higher must still get it through their employer? I personally hate health care insurance is offered through employers, but that is the system we have for now. You said easier for us to get it outside our employers, but I am assuming you still mean from private insurers.

You know what I love about the ACA? That it outlaws gender rating, the practice wherein insurers can (and did) charge women a substantial amount more than men, even if the plan doesn’t include maternity care and covered the exact same things it did for the men on it. Before, 90% of the top plans charged women more, even though only 3% included maternity care, and a third of plans without maternity care charged women 30% more than men for the exact same coverage. Now? Illegal. Everywhere.

@JLeslie, there is no government option (it was called the “public option” but never made it into the law).

The law sets up exchanges on which individuals can buy private insurance. The exchanges are highly regulated. Today, buying insurance as an individual is way more expensive than getting it through your employer because the employer can buy in bulk (and also because of community ratings—the fact that healthy as well as sick people are on the plan, which drives down costs), and the individual can’t. The new exchanges, on the other hand, will benefit from economies of scale and community ratings and should be much cheaper. Poor people will also receive subsidies to use the exchanges.

Some people have theorized that the exchanges will slowly peel people away from employer-based coverage, though that depends on a lot of things happening. At minimum, it means if you lose your job it will be much easier and cheaper to find insurance in the meantime.

@Qingu So I should expect to get solicited in the mail by health insurance companies now? Wanting my business?

@bkcunningham May I suggest something? The couple who is living in one of their daughter’s homes, if they pay rent, then it seems they very well could qualify for medicaid? I understand your point I think that the homes are owned by the children, not the people who you are concerned about cannot afford the medical coverage. This sort of fits into one of the things I tell conservatives who are against social services, I am not saying you are against them, is medicaid and medicare and social security not only help the person themselves who needs it, but the family also. Without those systems the family would have to chalk up the money to keep their relative from winding up in the street. That is unless they are fine with them being in the street. I get that you are saying the children of your friends are doing what they can to provide for their parents. If we had socialized medicine, or basically medicare for everyone in the country, all ages, your friends would not be in the difficulty they are with health insurance.

Also, were these people who you areconcerned about poor all their lives? It doesn’t seem to me they were. Sounds like they had jobs with decent wages.

Thank you, @JLeslie, the couple who is living in their daughter’s home is in their 80s. I am friends with the daughter who is in her early-60s who owns the house. My friend, the daughter is helping her ailing and very aged parents. I appreciate that you are trying to help. I really do. I wish I hadn’t brought my friends’ situation or their business to Fluther. It feels like nobody really reads what you are saying they are just promoting an agenda. I don’t want to discuss their situation with Fluther any more. Thank you though. : )

@bkcunningham I see, so I had that a little confused. So the children need the health care coverage? And, the 80 year old parents cannot support themselves? Do they get medicaid?

I don’t know about mail solicitations. Most of this stuff doesn’t even take effect until 2014 anyway.

I am very happy for the 30 million Americans.

I am very happy for the hundreds of thousands of unborn babies of previously uninsured pregnant mothers, who now get the same prenatal care without having to rely on charity. I foresee infant mortality rates in the US catch up with West European standards.

@mattbrowne, what do you mean? Can you explain that a little more? In the US, we already have programs for women and infants. Pregnant women and children do get medical care on a sliding scale – regardless or income levels. All women, regardless of income, get OB/GYN care on a sliding scale – regardless of income. Most localities provide dental care for children in the same manner through the state health departments.

You really have no clue what the state of our health care system is now, do you, @bkcunningham?

I asked @mattbrowne a question, @Qingu. Can you read his mind and answer for him?

@bkcunningham The US has the highest infant mortality rate in the industrialized world.

Would you like to answer the question I asked @mattbrowne, @Aethelflaed?

@bkcunningham No need for the tone.

No tone intended to you, @Aethelflaed. You probably felt the ripples of my disdain for @Qingu. If that is the case, I apologize to you. :-)

@bkcunningham – I think there are two problems for unborn babies

1) Uninsured mothers with low income slightly above the income threshold to be eligible
2) Uninsured unhealthy mothers who become eligible when they get pregnant

From what I heard #1 differs from state to state, but overall there are still hundreds of thousands of mothers who are not eligible but can still not afford health insurance. Pregnancy is often treated as a preexisting condition making the monthly premiums far more expensive.

Many women are in bad shape for years before they become pregnant without being able to afford a visit to a doctor. Very often they suspect being pregnant quite late and then it takes them a while figure out how to apply for free prenatal care. I tried to find some numbers:

- 13% of pregnant women have no insurance of any kind.
– Of these uninsured pregnant women, 57% receive no medical care for themselves or their babies until the fourth month of pregnancy, or later.
– Of every 100 births, 12 take place before the end of the ninth month.
– 1 out of every 10 newborns is low birth-weight, and thus at an increased risk of disease or deformity for the rest of its life

http://www.asuses.net/Basics/maternity-insurance.html

If women already have health problems that weren’t treated properly in the past, doctors can’t fix everything in the remaining period of the pregnancy. Damage is being done to the baby. And it’s one explanation of the high infant mortality rate in the US despite the programs you mentioned. The solution is health insurance for everyone, something Germany has had for the past 60 years. It did not destroy our country. We still built the forth biggest economy in the world. The US is number one. It is an incredibly rich country and ultra-conservative zealots organize demonstrations against insuring 30 million Americans, a measure that would also protect countless unborn babies. Europeans simply don’t understand this. There’s no logic behind it. And no humanity.

Thank you, @mattbrowne, for your reply. I appreciate your thoughts on this subject and respect your insight. Would you explain to me how the American healthcare law that the SCOTUS just upheld as the law of the land helps these unfortunate women and children. I mean, how does it work? They are going to receive medical care from the exact same physicians and healthcare facilities as they are now that are providing you with these dismal statistics. Unfortunately, I am a woman who has buried children. Two to accidents and three from the womb. One was born at six months into my pregnancy. The other two were under 4 months. But anyway, I look forward to your reply and thank you in advance, @mattbrowne.

Now that Obamacare has officially been upheld in the Supreme Court, what are you going to do next?

Be thankful.

I am almost certain that doctors have held off with officially diagnosing me with an auto-immune disorder since I would then have a pre-existing condition.

@bkcunningham, the answer to your question to matt has already been explained to you, repeatedly, by me.

Allow me to repeat.

The people matt mentioned fall through the cracks; they are not so poor to qualify for Medicaid, but they still cannot afford insurance. ACA expands Medicaid. And if they are still not poor enough to qualify, ACA offers them subsidies to buy insurance on a regulated market.

Prior to Obamacare, every child in America had access to healthcare, and still does. Every woman, regardless of income, every woman had/has access to reproductive health medicine. Every pregnant woman has access to medical care. The doctors these pregnant women see, where they live, are the same OB/GYN doctors that they would see if they had the best medical insurance money could buy. I can’t really see how anything changes for them. You can keep repeating the same thing over and over, @Qingu. It doesn’t address what @mattbrowne said. “I am very happy for the hundreds of thousands of unborn babies of previously uninsured pregnant mothers, who now get the same prenatal care without having to rely on charity. I foresee infant mortality rates in the US catch up with West European standards.”

They don’t rely on charity. They rely on state sponsored health departments. These health departments act as a liaisons for women and children for everything from contraceptives, setting them up with appointments to see the OBs in their areas to food stamps.

Medicaid has nothing to do with the reproductive healthcare available to women in the US an fit has nothing to do with medical, and in most cases the dental care of children in this country. They already have access to these doctors through our state run, county health departments.

@SpatzieLover, I am hopeful for some people. I’m addressing the statement that @mattbrowne made that it will help combat the infant mortality rate in the US. I’d like to understand how. The women and infants will still be visiting the exact same doctors they see now. It isn’t that complicated.

@bkcunningham it would helpful if you were to explain exactly what you have been trying to accomplish with your participation in this thread. Are you trying to prove that president Obama’s healthcare plan will not be good for the country? Do you think providing everyone with access to quality healthcare is bad thing? Are you unconvinced that the ACA will do what it says? I am not very clear on what points you are trying to make.

@SuperMouse, @mattbrowne made a statement and I am asking him about his statement. Are you afraid of discussion? I don’t understand why that upsets you so much.

What about my question to @mattbrowne don’t you understand. I’ll try to explain it to you.

And to be more to the point, I’m trying to find out how it is going to help infant mortality rates. I think that is a very valid discussion.

@bkcunningham this thread really seems to be causing you stress. While you made clear that my responses upthread frustrated you, I see no need for the tone you are taking now. I am in no way afraid of discussion and nothing close to upset. I am just having a hard time understanding what point you are trying to make with regard to president Obama’s healthcare plan.

As to the issue with @mattbrowne, he seems to have answered you very clearly, and you seem willfully ignorant of it.

So what is your point in getting back in the discussion, @SuperMouse? My question was directed at @mattbrowne. I think he is capable of reading my response and understanding what I’m saying. He seems pretty intelligent to me.

@bkcunningham first, might I suggest you lighten up a bit? Second, my point was/is to try to understand your perspective on this healthcare plan and to get an idea of why you seem so insistent that it will do no good.

Where did I ever say it would be no good, @SuperMouse. You seem adamant to put words in my mouth and try to make be out to be your adversary. I’m asking a question in hopes of learning something from @mattbrowne. I trust his perspective.

Debate is the fuel of progress, so let’s enjoy the debate knowing that there always will be different opinions and different interpretations. I’m sharing my opinion here. I said that I am very happy for the hundreds of thousands of unborn babies of previously uninsured pregnant mothers, who now get the same prenatal care without having to rely on charity. Because insured pregnant mothers will enjoy good health care even before they become pregnant. This is good for the unborn baby as soon as the pregnancy begins. An example would be diabetes or hypertension of the mother having be properly treated before the pregnancy. With proper insurance I also expect good medical care for the mothers and their unborn babies before the fourth month of pregnancy. The fourth months is very late.

@mattbrowne, did you know that women can get prenatal care in America now through state sponsored county health departments?

Any woman. Even if she has insurance. Even if she doesn’t. The fees are on a sliding scale and are topped at a very, very low level. No pregnant woman is ever denied care.

@bkcunningham then share what you do think of it! That is my whole point, I am trying to understand what you think about president Obama’s healthcare plan. Rather than sharing how you feel, you continue to ask questions that seem driven by the fact that you think it will do no good. If that is not the way you feel, and you clarify it, then no one will have to resort to using your posts here to “put words in your mouth.”

Again, might I suggest that you lighten up just a little?

That’s very good if the system really works, @bkcunningham, but what about the time before she gets pregnant? Why not make sure that every American has health insurance? And how do you explain the higher infant mortality rate? Even Cuba is doing better and they are a relatively poor country compared to the US.

@mattbrowne, I don’t know how to explain the infant mortality numbers either. It doesn’t make sense. Women in this country have access to the same healthcare through the same medical facilities and the same healthcare providers they will have with Obamacare.

You would think the infant mortality rate would be very low in this country. I don’t want the issue to be swept under a rug and everyone say, “We have healthcare. Babies are going to be healthier.” That doesn’t make sense to me. They are going to have the exact same care. That is what I’m asking.

Perhaps it is the lack of care she receives before she gets pregnant. Her eating habits? Her work environment? I don’t know. I’m just saying it is a problem we need to focus on. If nobody wants to address it and everyone just says it will get better now because the SCOTUS upheld the healthcare law, it won’t get the attention I think it deserves.

@bkcunningham do you have any data to support your assertion that uninsured pregnant women are currently receiving appropriate prenatal care? You make it sound like 100% or pregnant women get appropriate care. Is there any data to show this is true?

I don’t believe I indicated they received “appropriate” care, @wundayatta. I said they receive care. In most cases, it is the same care they would receive, the same OB/GYN doctors and facilities they’d use with private insurance. That is my point. Think about it. You are almost getting my point, @wundayatta.

Why would their care all of a sudden become better with Obamacare? That is my entire point. There is something else wrong that is causing the outrageous infant mortality rate we have in this country.

@bkcunningham Well, without data, we’re all just blowing smoke. However, theoretically, the care is different if you are insured compared to uninsured. The uninsured do delay care as long as possible, and when they get care, they get less than they could benefit from. This is true even when there is charity care available.

The problem with charity care, is that people don’t know about it. When they find out, they are usually much farther past when they need it. They are treated differently by caregivers, even though they are not supposed to be. Because they don’t have insurance, they have less access to information about appropriate health care. Many young pregnant women don’t even know they are supposed to get care. If they were insured, they would be getting annual checkups, and would have a relationship with a caregiver, and would be more likely to get information urging them to get prenatal care.

Having insurance makes a difference, I believe. There are still going to be problems getting appropriate care to folks who are not educated about health care. But it will be easier to get them up to speed if they are insured.

There are many, many reasons why poor people have poorer health, even though they have access to Medicaid. That will be an area of study and it is a problem we need to address. It will be harder to help people who are uninsured.

So I suspect you are wrong. It is not the same care. The care provided to folks receiving charity care, or folks without insurance is different than that provided to those with insurance.

I see this in my own care. As soon as I tell people what kind of insurance I have, their attitude changes. They know I can get any care they prescribe. They don’t have to skimp and scrape because my insurance won’t cover what I need. So they give me the best treatment.

Everyone should have that. But we have a system that relies on insurance and not all insurance is the same. Medicaid is not as good as private health insurance. It doesn’t pay as much. Doctors treat people differently.

To some degree, having insurance will make a difference in the care people get. I don’t know how much of a difference it will make and I can’t tell you how signficant the difference is, but I bet it is fairly significant.

@wundayatta you are so right about charity care. A couple of months ago I was dealing with a very painful infection and without insurance I couldn’t afford to pay the cost to see a doctor. I contacted the local Planned Parenthood clinic and they couldn’t even get me in for almost month. I am fortunate because I can receive free medical care at the health clinic at the university I attend. Even then the tests and the prescription were darn pricey, I couldn’t afford the best medicine to treat what I had so I had to settle for a generic that took twice as long to take effect. Our state does have a program where women of a certain age can get annual check-ups. However, in order for that to even kick in a woman has to be early 40’s even then the care is limited to a pap and pelvic every two years and a mammogram every year. This is a great program, bur rather limited in scope and of no use whatsoever to women in their prime child bearing years.

@wundayatta, what data do you want me to provide? Data showing the US operates a the US Department of Health and Human Services and administers aid to each state to operate public health departments in their counties that provides gynecological care for women, prenatal care for pregnant women, medical care for infants and dental care for children (in some places)?

Title V Maternal and Child Health Services Block Grant Program

Enacted in 1935 as a part of the Social Security Act, the Title V Maternal and Child Health Program is the Nation’s oldest Federal-State partnership. For over 75 years, the Federal Title V Maternal and Child Health program has provided a foundation for ensuring the health of the Nation’s mothers, women, children and youth, including children and youth with special health care needs, and their families. Title V converted to a Block Grant Program in 1981.

Specifically, the Title V Maternal and Child Health program seeks to:

1. Assure access to quality care, especially for those with low-incomes or limited availability of care;
2. Reduce infant mortality;
3. Provide and ensure access to comprehensive prenatal and postnatal care to women (especially low-income and at risk pregnant women);
4. Increase the number of children receiving health assessments and follow-up diagnostic and treatment services;
5. Provide and ensure access to preventive and child care services as well as rehabilitative services for certain children;
6. Implement family-centered, community-based, systems of coordinated care for children with special healthcare needs; and
7. Provide toll-free hotlines and assistance in applying for services to pregnant women with infants and children who are eligible for Title XIX (Medicaid).

The Maternal and Child Health Services Block Grant includes State Formula Block Grants, Special Projects of Regional and National Significance (SPRANS), and Community Integrated Service Systems (CISS) projects. Section 502 of the Social Security Act states that of the amounts appropriated, up to $600,000,000, 85% is for allocation to the States, and 15 % is for SPRANS activities. Any amount appropriated in excess of $600,000,000 is distributed as follows: 12.75% is for CISS activities; of the remaining amount, 85% is for allocation to the States, and 15% is to support SPRANS activities. Individual State allocations are determined by a formula which takes into consideration the proportion of the number of low-income children in a State compared to the total number of low-income children in the United States.

State Maternal and Child Health agencies (which are usually located within a State health department) apply for and receive a formula grant each year. In addition to the submission of a yearly application and annual report, State Title V programs are also required to conduct a State-wide, comprehensive Needs Assessment every five years. States and jurisdictions use their Title V funds to design and implement a wide range of Maternal and Child Health and Children with Special Health Care Need activities that address National and State needs.
Unique in its design and scope, the Maternal and Child Health Block Grant to States program:

1. Focuses exclusively on the entire maternal and child health population;
2. Encompasses infrastructure, population-based, enabling, and direct services for the maternal and child health population;
3. Requires a unique partnership arrangement between Federal, State and local entities;
4. Requires each State to work collaboratively with other organizations to conduct a State-wide, comprehensive Needs Assessment every 5 years;
5. Based on the findings of the Needs Assessment, requires each State to identify State priorities to comprehensively address the needs of the MCH population and guide the use of the Maternal and Child Health Block Grant funds; and
6. May serve as the payer of last resort for direct services for the maternal and child health population that are not covered by any other program.

SPRANS projects support research and training, genetics services and newborn screening, and treatments for sickle cell disease and hemophilia. CISS projects seek to increase local service delivery capacity and foster comprehensive, integrated, community service systems for mothers and children.

Title V Maternal and Child Health Block Grants to States

States and jurisdictions must match every $4 of Federal Title V money that they receive by at least $3 of State and/or local money. This “match” results in more than $6 billion being available annually for maternal and child health programs at the State and local levels. At least 30 percent of Federal Title V funds are earmarked for preventive and primary care services for children and at least 30 percent are earmarked for services for children with special health care needs. States and jurisdictions may spend no more than 10 percent of Federal Title V funds on their administrative costs. The level of expenditure for each State’s and jurisdiction’s maternal and child health programs must also equal the amount provided in 1989.

A total of 59 States and jurisdictions receive Title V Maternal and Child Health Block Grant funding. In fiscal year 2009, State Title V programs served over 39 million individuals. Among the individuals served were 2.5 million pregnant women, 4.1 million infants,
27.6 million children, and 1.9 million children with special health care needs.

There is more about the program here:

http://mchb.hrsa.gov/programs/titlevgrants/index.html

Data about how many people actually benefit from these programs, compared to the number that are eligible. Data about whether people have access to care who need it. That sort of thing. Eligibility and utilization data.

All of that data is on the linked website, @wundayatta.

“I am almost certain that doctors have held off with officially diagnosing me with an auto-immune disorder since I would then have a pre-existing condition.”

I can totally confirm this. My doctor did the same. She said she would alter her diagnosis since I would never be able to buy insurance if she wrote down what was actually wrong.

Luckily Obama helped.

Bless her for helping you, @johnpowell. Since you say you didn’t have insurance, I’m just curious what type of circumstances you were seeing this doctor through. Medicaid or something else.

LOL umm hmmm.

I’m not at all happy that it was upheld. Go ahead and jump on me. Give @bkcunningham a breather.

And for the record, I think those of you who pissed all over anyone here who had a different opinion are so far beyond wrong, it’s not even funny. Maybe it’s time for you to go color and take a nap.

You’re acting like you want more attention, @WillWorkForChocolate. You’re cute—the way you jump up and down and all—but it’s kind of hard to take the things you say seriously. But good luck getting more attention and all. I’m sure you deserve it.

^^ That attitude is exactly what I’m talking about. I don’t want your damned attention. I want the douchebaggery to stop.

@WillWorkForChocolate why are you unhappy that it was upheld? What are your issues with president Obama’s healthcare plan?

And for the record no one was “pissed on” in this thread, just asked to share their opinion clearly.

Hmmm… so in the course of “just being asked to share a clear opinion”, a jelly was called ignorant and a liar. And that’s not pissing on her. Right.

I have too many issues with Obamacare to even get into. Especially because I refuse to get into another pissing match with @wundayatta right now. Think hard about the attitudes on this thread, the attitudes on the recent Republican bashing thread, and the attitudes on the recent Meta question about how people ask questions. Then look at how many jellies, old and new, we’ve lost because of it. This kind of bullshit is going to destroy Fluther.

Edit: don’t bother. I’m unfollowing. Have fun.

@WillWorkForChocolate one thing I know for sure about this thread is that the people who oppose president Obama’s healthcare plan have steadfastly refused to explain why they oppose it. If you are so concerned with the attitudes on Fluther, why jump into this thread now with a gigantic chip on your shoulder?

@SuperMouse What if she has a gigantic chocolate chip on her shoulder? ;-p

[Mod says] Flame off folks. Please remember to disagree without being disrespectful toward one another and making it personal

@SuperMouse Indeed. People are only trying to understand why someone would oppose healthcare. You can only explain things so much until you have no choice but to suspect ignorance or malice. Then, refusing to explain yourself only makes it worse. That is really the strangest part, and it only helps others see into the psyche of some people.

@Blackberry I think those who oppose it are afraid it will cost them more money, and most do not believe the government has the right to mandate coverage. In my opinion, we are already paying for people who do not have coverage, and this will lower our burden in favor of those who are now going to be required to pay into the system.

As far as government mandates, they are generally best for the greatest number of people.

@SuperMouse, let’s settle this between you and me once and for all. Would you please copy and paste and show me where I directly or indirectly said that I opposed The Patient Protection and Affordable Care Act, ACA or the fact that the US Supreme Court upheld the law.

Are you all upset that I am asking questions about the law? Are you mad because I have friends who will not benefit from this legislation? I am too. I’m upset that people are painting it like it is the best thing since sliced bread. I’m upset that someone, with a gentle heart and all the best intentions from another country indicates fewer babies are going to die in America because of Obamacare – without anything to really back it up.

I thought you were the scientific minded people who criticize and sometimes refuse to discuss subjects unless you have empirical evidence. I have asked people how much they will have to pay for their insurance under this plan and they don’t flipping know BUT still they won’t discuss people who may fall through the cracks ONCE AGAIN and the fact that not all women and children aren’t going to instantly be healthier and living longer because of this healthcare reform. Forgive me, but it is almost comical to me. It reminds me of a twisted version of The Emperor’s New Clothes, except I liked that story. I don’t like this story much anymore. It is a sad day when you can’t have a discussion without feeling like you have to defend yourself from insults and people twisting what you are saying and asking into something it isn’t.

And thank you @WillWorkForChocolate. I appreciate your kindness. I hope you aren’t punished for coming to my defense. lol

@bkcunningham Science doesn’t mean you can’t discuss things without empirical evidence. The only way to get the evidence is to try stuff out, and the only way you try stuff out is by discussing what you’d like to try and then implementing it. We don’t have empirical evidence that this legislation will be better, or the best, because it hasn’t been fully implemented, and it does have to be implemented for several years for us to be able to gather that data. We do know that other countries have similar, though not identical, healthcare, and that they have benefited from it greatly.

If you aren’t opposed to the ACA, I wish you’d just come out and said that much earlier.

I’m not sure it’s really far to ask people to post how much they’ll be paying for their new insurance; money tends to be a fairly private thing, and most people shy away from exact numbers, especially on a public thread.

No, all women and children won’t instantly be better and healthier and live longer. The law isn’t perfect. But I think many women and children will get better treatment. Before, pregnancy and c-sections could be classified as pre-existing conditions, which meant that if you didn’t have insurance before you got pregnant, you would have a hell of a time getting it now that you were pregnant. There are sometimes programs, but they are often time-limited, have many qualifications, and enough red tape as to be pointless for many women, since you have to get the coverage before you pop out the kid. Many preventative care measures are now covered with no extra premium charge and no co-pay, like screening and treatment for gonorrhea and chlamydia (both of which can affect a woman’s fertility), regular pap smears (also affects fertility), domestic violence screenings (stress and dv can be rather brutal on a pregnancy), birth control (those women who have endometriosis and would like to have babies later, but not now, are thrilled), and smoking cessation treatment. Additionally, insurance companies can no longer charge women more than men, especially in cases where the coverage doesn’t include maternity, which means that young women are more able to afford going to the doctor regularly, which will help keep them healthy for any later pregnancies they might chose to have.

Can you please show me or direct me to where in the legislation it states that insurance companies, states or the federal government must cover for smoking cessation treatments, @Aethelflaed?

@bkcunningham You can find a list of all the preventative services now covered here. “Tobacco Use screening for all adults and cessation interventions for tobacco users”. It is only for insurances; I don’t know about Medicaid.

And, @Aethelflaed, you are right. It is rude to ask people how much they are going to be paying for certain things. But you see, they could have said that to me. They didn’t say that. They said they don’t know. They could have given me an average. I think price is a very important aspect of this legislation. And for the record, I’m not opposed to this law. I think there are many things that need to worked out and made better.

Ok @bkcunningham let’s do that. Are you for or against president Obama’s healthcare plan?

Most every single post of yours in this thread implies that you are not happy with this healthcare plan and are certain it really won’t improve access to healthcare. Come right out and share your opinion then no one will have any reason to think that you are opposed when you are really in favor of the plan. I am wondering, if you aren’t against it why are you so adamant about pointing out all the the negatives?

The point about your friends is honestly that you refuse to admit that there is some possibility that they will benefit from this law. Why do you insist that you know for an absolute certainty that they won’t, even in light of the information provided by @Qingu? When you weren’t comfortable arguing about that anymore you asserted over and over that pregnant women and children wouldn’t benefit.

For the record, after consulting the link provided by @Qingu, I have found that in my current financial situation I would receive healthcare coverage without cost. I think this is awesome because I live well below the poverty level and in case of a medical emergency and sickness I would be unable to afford healthcare. The thing is that hospitals are compelled to treat me anyway and guess who absorbs the cost of me getting treatment that there is no way I can afford? That’s right the taxpayers. How does that make sense? Before you go saying that taxpayers are paying for this program stop and think which is more expensive providing preventative care before an illness becomes acute, or treating a major illness?

Stop beating around the bush, share your opinion of the law, then this whole misunderstanding can be cleared up.

Post where I said it @SuperMouse or anything like that and keep my friends out of this discussion. You can’t post it because I never said it.

The pregnancy part of the discussion was between Matt Brown and myself. He made a comment and I asked him about the comment. Do you have a problem with that?

@Aethelflaed, I wonder when the states will have to uphold that portion of the bills with their insurance pool coverage? I saw the date on your link to be 2010. Is there a time when that portion will have to be implemented?

@bkcunningham the whole point is that you haven’t clearly stated your opinion. Please, please, please stop saying that you haven’t said you are against the healthcare plan and share your opinion. That is really the only way to clear this up. Why are you so reluctant to come right and out and say how you feel about this bill? When you refuse to come out and say how you feel about it, everyone is left to try to figure it out based on what you have posted. Based on that it seems apparent that you are against the healthcare bill.

Are you insinuating that no one else may comment on your dialog with @mattbrowne?

You really don’t read what I type do you @SuperMouse? That really explains a lot to me.

@bkcunningham You mean when insurance companies must cover preventative care services with no co-pay regardless of if the deductible has been met? It’s started already; I had my annual just a couple weeks ago with no co-pay.

No, not insurance companies, @Aethelflaed. Like in Florida, where I live, the state pool. The PCIP, Pre-Existing Condition Insurance Pool, insurance coverage. It is really Medicaid.

I wonder since Florida was part of the appeal to the US Supreme Court, if there are certain things they haven’t implemented. But we do have the pool. I wonder if it is something to do with who regulates the Medicaid portion of the pool.

@bkcunningham there is truly no discussion with someone who is being willfully ignorant. I am done engaging you on this subject.

@Aethelflaed, I found where Florida’s PCIP does cover smoking cessation medication. They cover it under the higher deductible medical side of the plans and not as a prescription drug. I think it should be covered as a prescription or given away for free.

Thank you for your help.

Don’t mess with me, people- I have chips on both shoulders!

I’m not at all happy that it was upheld.

Would you care to explaining your reasoning? I’m still waiting for a list of the bad stuff it does.

I will even give you lurve if you can propose a better plan. Don’t worry, I am not holding my breathe.

@johnpowell She’s not following anymore.

I didn’t say that @johnpowell. Even if I did, do I have to agree with everything you agree with before we can have a discussion? I’m beginning to think that is true of many people on Fluther. That is sad.

I’m curious why you want a list of “the bad stuff it does,” @johnpowell.

Man, this thread is just an epic communications fail.

Amen.

Except, in fairness, @Aethelflaed, I did learn a few things. One of the things was thanks to you. I couldn’t understand why PCIP in Florida didn’t cover smoking cessation drugs in their prescription plan. You said it was mandated to cover smoking cessation and showed me proof. It triggered something in my mind and I looked in a different place and see where it is covered under medical, which means a higher deductible. So, thank you again.

@bkcunningham Hey, but you did not answer which way you lean on the obamacare issue, a question directly asked to you. Do you tend to like the idea of it or not? Or, are you completely neutral with no opinion, just gathering infromation? If you had to vote today, for it or against it, gun to your head, which way do you vote?

I don’t know what difference it makes how someone leans in order to have a civil discussion. But I did answer, @JLeslie. Not only did I say I wasn’t opposed to the plan numerous times, I answered in something like 20 posts up from this one when I was answering @Aethelflaed.

Now, can you explain to me what difference it makes in regards to having a discussion, if someone agrees with you?

@bkcunningham, it’s always nice to start a discussion with common ground. I thInk you are throwing some people for a loop because we are so used to you leaning far right. When we hear that you might think that it is ok for government to ensure that no one falls through the cracks in regard to healthcare we are confused because it seems opposed to some of the other ideas you have expressed here. It is nice to find common ground.
I had a discussion about food stamps with a right leaning friend and the only common ground I could find with her was when I said, “can we agree that it’s bad for poor children to go hungry?”

@bkcunningham I must have missed it, up to you if you want to copy paste what you had said to @Aethelflaed. I just tried to skim again and couldn’t find it. What @Judi said is correct. You even in one post accuse some of us of being “science-minded” that is right wing speak, so we were wondering which perspective you were coming from regarding obamacare. Typical right wing perspective, or truly open. Sometimes people ask leading questions, I’ve done it, not just open question with an open mind, we had no idea which you were doing. You really did seem like you were avoiding directly answering @SuperMouse‘s direct question on purpose, and then trying to turn the tables on her to make it like she was the obtuse one (which did not work) to drive her and others crazy.

This is a repost of what was previously said. I’m reposting this for you, @JLeslie and explaining the reason for the repost in an attempt to not confuse the discussion.

“And, @Aethelflaed, you are right. It is rude to ask people how much they are going to be paying for certain things. But you see, they could have said that to me. They didn’t say that. They said they don’t know. They could have given me an average. I think price is a very important aspect of this legislation. And for the record, I’m not opposed to this law. I think there are many things that need to worked out and made better.”

I should apologize to @augustlan because she did tell me the cost of the insurance. My statement that nobody would tell me what the cost of their insurance would be wasn’t correct. One person did.

@bkcunningham I did miss that. Why did you not just respond to @SuperMouse when she asked? Why drag it out? You tell @Aethelflaed in a separate paragraph not even addressed to @supermouse. It feels rather passive agressive, purposefully ignoring her direct question.

Two (opinionated) resources:

Relative size of tax increase

ACA explained by Reddit

I am very happy that Mitt Romney, a Republican governor from Massachusetts, came up with this plan. It has worked well and offers some proof of its efficacy. I’m also very happy that President Obama, a Democrat, saw fit to put it into practice for all Americans. Now will someone explain to me why it is being fought so hard? Is it all politics? If so, I am anxious about there being any chance of things changing. Perhaps our form of democracy is doomed to fail after all.

@Sunny2 Yes, it’s all politics. The Affordable Care Act was the Republican version of health care reform back when Democrats supported single-payer health care. As the single-payer system would never get passed by the current Congress, however, Obama took a different path and resurrected an old idea—the individual mandate plan that was supported by Richard Nixon and George H.W. Bush.

Note that this is exactly what the pragmatic side of Obama’s campaign personality promised to do: he said that he would take ideas from any source if he thought they would bring about positive change. So when faced with the task of passing universal healthcare, he discarded a traditionally Democratic idea that wouldn’t pass and adopted a traditionally Republican one that would.

The outrage was predictable, and it shows that what people really dislike about Obamacare is the “Obama” part.

@Sunny2 Because I think the biggest division in the country is north and south. It kind of plays out at republicans vs. democrats; but, up north less so.