Tag Archives: ACA

15,000 Join Women’s March in Tucson (video)

Women's March, Tucson

Women’s March, Tucson

One day after Donald Trump became president of the United States the world saw the largest mass protest ever.

On January 21, 2017, the Women’s March on Washington drew more participants than Trump’s inauguration the day before, and “sister marches” were held in 600 locations around the world. If you are a long-time follower of my blogging, you know that I have attended and videotaped many protests, marches and rallies. This was by far the largest protest march I have seen in my 35 years in Tucson. It was impressive.

The Tucson marchers were a diverse group. Although the event was dubbed the Women’s March, everyone was invited, and everyone came. From children to seniors, all ages were represented. There was an impressive number of men who marched, and the LGBTQ, Latino,  and African American communities were also well-represented. There were people in strollers and people who use wheelchairs. For more photos, go to my Facebook page.  (Video after the jump.)

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Top 20 Reasons Why Republicans Want to Repeal Obamacare (video)

elysium-NLIn Elysium, Matt Damon’s 2013 post-apocalyptic drama, the 1% are safely ensconced on a idyllic floating space station (Elysium). In contrast, the 99% toil in poverty and grime and suffer from police oppression on Earth, which has been destroyed by pollution and over-crowding.

Early on in Elysium, Damon, a former thug who works in a giant factory with no safety equipment, workplace regulations, or human resources protections, has an industrial accident and is exposed to a lethal dose of radiation. Fellow workers hear his screams from the radiation chamber and try valiantly to get him out, but the supervisor tells them to leave him in there and go back to work “because he’s already dead”. After the exposure, they drag Damon out (literally) and take him to the factory clinic. When the CEO sees him, he tells the supervisor to send Damon home before he soils the sheets. At several junctures in the movie, the dire, dirty conditions on Earth are juxtaposed with the gleaming perfection of Elysium, but the contrast in healthcare is the most stark. On Elysium, people have high-tech, full-body scanners that can cure all diseases. On Earth, people are left to die.

At one point, the CEO says to a worker whose daughter is dying, “This isn’t Elysium. We can’t just heal her.” This movie is the Koch Brothers’ wet dream and our nightmare. If the Republican Party could get away with it, this is where we will be by 2154 (the date of the movie) or sooner. Getting rid of the Affordable Care Act and social safety net programs are the first steps.

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ACA Update: Are Insurance Companies Ill-Equipped for ‘Obamacare’ Roll-Out?

HealthNet stock prices from Bloomberg News. Note the stock price on Nov 8, 2013 was 27.7 (a few days after the ACA began), and the stock price for March 10, 2014 was 35.09.Someone is making money.

HealthNet stock prices from Bloomberg News. Note the stock price on Nov 8, 2013 was 27.7 (a few days after the ACA began), and the stock price for March 10, 2014 was 35.09.Someone is making money.

Since October 2013, Americans have been enrolling for health insurance under the Affordable Care Act (ACA) on Healthcare.gov or through insurance agents and brokers. With only a few weeks to go before the March 31, 2014 ACA enrollment deadline, the US Department of Health and Human Services has reported that more than 5 million Americans have enrolled for health insurance through the state-based exchanges.

Enrollment in the ACA and in expanded Medicaid has been patchy because states were given too much leeway regarding what care would be available, how people should enroll, and how much money and effort would be invested into educating residents about enrollment. Some states (like California) have well-developed online insurance exchanges of their own, while other states (like Arizona) allowed the federal government to create their ACA exchange websites and did little to educate residents about health insurance enrollment.

During the final weeks, non-profit groups and volunteers in Arizona have been scrambling to enroll people, while the Arizona Republican Party is scrambling to spread misinformation to discourage enrollment– with multiple speaking engagements and mass distribution of an editorial entitled Obamacare: To Enroll Or Not To Enroll? That Is The Question by local doctor, Elizabeth Lee Vliet. And on the national level millions is being spent to dissuade Americans from enrolling, while Republicans in the House offer bait-and-switch alternativesto the ACA which would cost more and cover fewer people.

As both sides of the political spectrum work hard to sway the public, my question is: Are the insurance companies really up to the task of providing care for so many new enrollees?  Continue reading

The “Managerial Republican” is mostly a fantasy

I will say that Ronald Brownstein’s recent column in the National Journal is a bit better than what we’ve been getting lately from the hordes of DC pundits attempting to analyze Arizona. In particular, I liked this bit at the end:

After Arizona’s tax revenues plummeted with the housing market collapse, Brewer backed a temporary 1-cent sales-tax increase to limit spending cuts. But even so, since 2008, the GOP majority’s commitment to squeezing government has produced the nation’s third-largest reduction in per-student K-12 spending; the largest percentage reduction in per-student support for public higher education; and the biggest public tuition hikes. No other choices capture as starkly the contrasting priorities of a ruling GOP coalition that still receives almost all of its votes from whites (many older, rural, and exurban) and a minority population that now represents the clear majority of students in Arizona’s public schools.

It’s refreshing to see a conservative admit outright that Arizona Republicans have slashed public education funding (instead of doing the Goldwater Institute song and dance about how the schools are really funded quite generously if you look at all these charts and squint) and that the cuts are ideological and not fiscal in purpose.

Brownstein’s main thesis is that Arizona’s politics operate along fault lines of age and race, with the older whites voting overwhelmingly GOP and the Democratic base being younger and browner. I take no issue with that assessment. What I do dispute is this: Continue reading

Boo Hoo: Two Sick Babies Hurt AOL’s Bottomline… Not

by Pamela Powers Hannley

AOL Chairman and CEO Tim Armstrong reported that the highly profitable, multi-million-dollar company was forced to cut employee benefits because of  increased insurance costs under the Affordable Care Act (ACA) and the cost of care for two sick dependent children born to AOL employees. 

Armstrong (who made $12 million in 2012) said because AOL paid $1 million for medical care for the two babies, the company must scale back the employee retirement plan. He also claimed that the ACA has increased AOL's insurance cost for 5000 employees by $7 million.

On the same day that Armstrong blamed the babies, AOL announced it's "strongest revenue growth in decades" — with 2013 revenue at $679 million, up 13% over 2012. 

Oh, right, blame the sick babies! It's obviously their fault. It has nothing to do with corporate greed or over-blown CEO salaries. 

Shopping the ACA Marketplace: One Small Business’ Route to ‘Affordable’ Healthcare

ACA-paper12-sig-sm72by Pamela Powers Hannley

With full implementation of the  Affordable Care Act (ACA), January 2014 marks the beginning of a new era in health insurance in the US.

For the chronically uninsured and for those with pre-existing conditions, it's been a long and financially perilous wait for all of the ACA benefits to kick in.

For anti-government, conservative ideologues, the three-year waiting period gave them time to mercilessly attack reform that will provide insurance for millions of Americans, spread layers of misinformation about "Obamacare," hold dozens of meaningless repeal votes in the Republican-controlled House of Representatives, and hold the country hostage for 16 days in a multi-million-dollar government shutdown fiasco.

Today, December 23, 2013 is the cut-off date for enrollment in ACA insurance plans which begin January 1, 2014; the final deadline for ACA enrollment is March 31, 2014. Since the beginning of December, I have been shopping the healthcare marketplace on behalf of the ultra-small business that I work for–The American Journal of Medicine. On Friday, I submitted our final paperwork to our insurance broker.

This is the story of one small business' route to "affordable" care.

Our Journey

Our journey began long before the premier of Healthcare.gov, the much-maligned ACA enrollment website, and even before the ACA was signed into law in 2010. At the Journal, we had been unhappy with our health insurance plan through Aetna for years. Like clockwork, the cost went up 10-25% each year, forcing us to rethink coverage multiple times in order to live within our budget.  We also were dissatisfied with the limited number of even more expensive alternative plans offered to us. The Journal's editorial pages have been pushing for Medicare for all for years and broke the stories about medical bankruptcy in 2009 and continued medical bankruptcy under Romneycare in Massachusetts in 2011. Consequently, we were ready for the public option back in 2009; today, we're just glad that the ACA made it through the Republican gauntlet and the Supreme Court. Unlike recent news stories about people and small businesses wanting to keep their existing healthcare plans, we were waiting with baited breath for three years to dump our plan.

The bottomline is that with Obamacare, the Journal — and the emplopyees– will pay less for healthcare insurance. Read about our ACA Marketplace experiences and lessons learned after the jump.

Pub-opt113-sig-sm-72In early November, when the mainstream media was flooding the airways with stories about the "botched" rollout of the ACA website, I started poking around the plans and prices. Although the sheer amount of information on Healthcare.gov was daunting, the website worked fine–until I couldn't create a log-in and an account. Stalled at this juncture, I gave up for a few weeks until President Obama announced at the end of November that the ACA website had been fixed.

Shopping the SHOP

During the first week of December, I started shopping the Small Business Health Options Program (SHOP) in earnest. After entering the basic information– the state and county location of the business and the ages of our three employees– the site generated a massive spreadsheet (pictured above) of information, prices, options, brochure links, and telephone numbers for the 84 plans available for small businesses in Pima County, Arizona.

To sift through the options and prices and discuss them with employees and my boss, I downloaded the data to Microsoft Excel and printed them out. Even though I hid at least 30% of the 75 columns of data before I printed out the spreadsheet, it was four feet long when the legal-sized sheets were taped together. With colored highlighters and a long ruler in hand, I started to comparison shop. Initially, I looked at the basics– office visit cost, specialist cost, and deductible– and then I compared prices for the business, the employees, and the dependents we wanted to add. When a plan looked interesting and affordable, I went back to the computer and clicked on the plan details– co-pays, co-insurance, emergency room visits, urgent care visits, per person and per family deductibes, total-out-pocket cost, drug benefits, and special options like dental and vision add-ons.

After about three full days of intense studying Healthcare.gov, investaging insurance carrier websites, I narrowed it down to three to four HealthNet silver plans. I was about to contact our insurance broker, when she called me with the "good news". Our new Aetna contract was ready to sign for 2014, and of course, there was another price increase. I told her that we had no intention to renew our Aetna contract, that I had been shopping ACA plans, and that I wanted their help to finalize the details and get the employees signed up. Initially, she said that neither Aetna nor her firm were participating in the ACA marketplace. "We would actually have to sit down with each client and go through the website and the options with them." Healthcare.gov suggests that businesses work with insurance brokers or agents, but it is not required. After our conversation, I assumed I was on my own to figure out which plan on my short list was best for us.

What Will It Cost?

In the end, our insurance broker had a change of heart about helping clients with ACA enrollment, and in fact, they were instrumental in assisting in final decision-making and enrollment with HealthNet. In 2013, the Journal paid $1260 per month to cover three employees under our Aetna plan, and an additional $240 per month was paid by one employee to cover his two minor children. Other employees tried to add dependents to the Journal's plan in 2013, but it was cost prohibitive. In fact, to add one 60-year-old spouse the quoted price was $820 per month. (The Journal pays employee costs, but employees must pay the full cost for dependent coverage– a common practice.)

The Journal chose a $30/$50/$2000 Open Access silver plan offered by HealthNet because we wanted to keep the monthly cost down but still provide adequate health insurance. (Silver plans are designed to cover 70% of cost of care.) Bronze plans have the lowest monthly cost but the highest cost to plan members; as the the metals go up in value (bronze to platinum), the cost per month and the overall coverage increases. The HealthNet silver plan has a higher deductible than our old Aetna plan ($750 vs $2000) but other costs vary only slightly (ie, office visit $20 vs $30). Being a basically healthy group– after all we work for a medical journal!– we went for a lower monthly cost of the silver plan. Insurance is basically a bet. Are you betting you'll be healthy or sick in the future? Since we have no smokers, no diabetics, and no morbidly obese employees, we bet on health.

Contrary to news stories that report the dire financial consequences of Obamacare to small businesses, the Journal will save $200 per month under the ACA. There were cheaper silver plans through HealthNet, but those offered a limited number of doctor and hospital choices. For example, for $100 less per month, the Journal could have opted for the cheaper, less comprehensive HealthNet Community Care $30/$50/$2000 silver plan, but all employees would have had to give up their current doctors, would not be able to go to the University of Arizona Medical Center (AKA, UMC) for in-network hospital care, and would not have in-network access to University of Arizona (UA) College of Medicine doctors. For the additional monthly cost, our chosen plan allows employees to keep their doctors and have more choices including access to UMC and UA doctors. (As I said, although we bet on health, but we decided if anyone got really sick in our group, we wanted access to healthcare offered by one of the country's best hospitals— the University of Arizona Medical Center.)

As for dependent coverage, the employee with two little kids will get increased coverage– medical, dental, and vision coverage for the three of them– for the about the same monthly cost. Those of us who couldn't afford to add spouses under Aetna can afford the out-of pocket costs to add them to the 2014 HealthNet plan. Remember the $820 per month Aetna quote to add one spouse in 2013? That person costs $500 per month under the HealthNet silver plan– a $320/month savings. In fact, for approximately $1000 per month, two spouses and one college student were added to the Journal's plan.

Lessons Learned

1) The sheer amount of information and plans available to businesses in Pima County, Arizona was daunting. In the end, using an insurance broker helped sort out plan details, compare prices, and cut through some of the red tape with the final sign-up of employees. (According to the ACA website, the insurance companies pay the brokers– not the small businesses.)

2) The ACA website worked perfectly after the November fixes. In fact, the ACA website has tons of valuable, easy-to-read information about the Affordable Care Act and options. Compared to insurance company website, the ACA website was better organized and easier to understand.

3) It was easier to reach the ACA help desk on the phone than it was to reach a real person at any of the insurance companies I called. In fact, I never reached a real person at an insurance company, but on a Sunday, I chatted online with an ACA rep.

4) The Journal and the employees saved money by shopping the ACA Marketplace. Yes, we have a different type of insurance plan, but we believe that it will suit our needs. Small businesses that are concerned about costs can choose even cheaper plans than the one we chose and offer a valuable benefit to their employees.

In the end, the Journal had a plethora of plan choices and price ranges to choose from at HealthCare.gov and ended up saving money on its monthly cost. The employees saved money on medical coverage, added dental and vision coverage, kept our own doctors, added affordable coverage for previously uninsured or underinsured dependents, and have in-network access to one of the best hospitals in the country. What could be better? Medicare for all.