Affordable Care Act aka Obamacare 2012-16

Written by  //  December 15, 2016  //  Health & Health care, U.S.  //  1 Comment

15 December
Opinion: He won’t actually take away my insurance, will he?
(NYT) “I kept hearing informed voters, who had watched the election closely, say they did hear the promise of repeal but simply felt Trump couldn’t repeal a law that had done so much good for them.”
Linger on that last phrase: simply felt Trump couldn’t repeal a law that had done so much good for them.
It comes from Sarah Kliff of Vox, who went to Corbin, Ky., to interview people who had received health insurance from Obamacare — and then voted from Donald Trump.
To some extent, they understood what they were doing, that their insurance was a result of Obamacare, and that Trump vowed to repeal it. They voted for him anyway, because they liked other things about him and because they figured he wouldn’t really get rid of their insurance. If anything, they hoped he would fix the parts they didn’t like, just as he promised.
But there is no magical fix for Obamacare. Our health care system is a messy hybrid of the public and private sectors. Obamacare eschewed radical change — which would have been even less popular, given the disruptions — for progress within the current framework. And the law has done far more good than bad, by expanding insurance coverage and helping slow the growth of medical costs.
The Republican Party has essentially tied itself to a magical solution: getting rid of the law while keeping its benefits. The party does seem committed to repealing major parts of the law early in 2017, as Nicholas Bagley of the University of Michigan laid out in a smart tweetstorm yesterday. Yet Republicans could cause a lot of anger and frustration if they stick to their plan.
How do they solve their dilemma — a dilemma with real-life consequences for many people? It’s one of the biggest mysteries of 2017. I’ll continue to hope that those Kentucky voters have their optimism rewarded, but it’s a deeply wishful form of optimism.
The full Opinion report from The Times follows, including Faysal Itani on what comes after Aleppo falls and Mark Galeotti on how to fight Putin. I also recommend thinking about the question David Pozen poses: If the Electoral College doesn’t have a role to play now, shouldn’t it be abolished?
David Leonhardt, Op-Ed Columnist

29 November
Donald Trump picked an Obamacare critic as his health secretary. Tom Price, a former orthopedic surgeon, has advocated replacing Obamacare with a plan of tax credits, health savings accounts, and lawsuit reforms. Trump is also expected to name consultant Seema Verma to lead the Centers for Medicare and Medicaid Services.
(Reuters) Trump cast Price and Verma as a “dream team” to help him once he takes office on Jan. 20 with his campaign pledge to repeal Obamacare, the health law formally known as the Affordable Care Act. Since its enactment in 2010, it has been a target of Republican attacks.
Price has characterized Obamacare as “doing real harm to American families” and has co-sponsored legislation to replace it.
Verma helped Pence, the Indiana governor, add conservative pieces to Medicaid coverage for the state’s poor by requiring beneficiaries to make contributions to health savings accounts. She also worked on Medicaid reform programs in Iowa, Ohio, Kentucky and Tennessee.
Chuck Schumer, a top Senate Democrat, was among defenders of the law who criticized Price’s selection. “Nominating Congressman Price to be the HHS secretary is akin to asking the fox to guard the hen house,” Schumer said.

25 November
(NYT)  The president-elect and Republicans in Congress are vowing to repeal much or all of the Affordable Care Act
More people in Florida than in any other state got insurance through the new exchanges. Many refuse to believe that a benefit they count on would be taken away. (Many in Florida Count on Obama’s Health Law, Even Amid Talk of Its Demise)
But open enrollment for 2017 is underway, and Americans are steadily signing up or renewing their coverage.

14 November
Better Off Before Obamacare?
People are now spending larger shares of their income on health care than before Obamacare, but that’s not because of the law—it’s because health-care costs are growing faster than incomes.
(The Atlantic) Before the law, which Trump has said he would repeal, health insurance was cheaper for a few, but outright unattainable for many.
Repealing Obamacare is Republican voters’ biggest priority for the Trump administration, according to a recent Politico/Morning Consult poll. People who are unhappy with the Affordable Care Act overwhelmingly voted for Trump, and now 74 percent of Republicans want it gone.
The frustration with the health law is understandable; many people are struggling to afford medical care even if they have insurance. The problem is, it’s not clear Americans would have been better off had Obamacare never been passed.
First, some people might be confused about what, exactly, they’re angry at. When we talk about “Obamacare,” we’re talking primarily about the 12.7 million people who are buying individual insurance coverage through state marketplaces or Roughly 60 million people voted for Trump last week, so they can’t all be on Obamacare exchange plans. More than half of all non-elderly Americans still get insurance through work, and premiums on employer-based plans are actually growing more slowly than average. (About a third of Americans are either on Medicare or Medicaid, and the rest are uninsured. Only about 4 percent are on the exchanges.)
Before Obamacare, insurance premiums on the individual market were rising by about 10 percent a year. But, it’s important to note, the cost of any given person’s health plan purchased this way depended on how sick they were. Insurance companies could charge people more if they had cancer, for example, or deny them coverage entirely. Insurers were partly able to keep costs down just by keeping sick people off their plans. Under Obamacare, insurers can’t do that anymore.
In 2014, right after most of the Affordable Care Act sprang into action, a middle-of-the-road plan—the “second-lowest cost silver-level” plan—was between 10 and 21 percent cheaper than a similar plan was before the ACA in 2013. So concluded an analysis published in Health Affairs in July by the economists Loren Adler and Paul Ginsburg, two health-care experts at the Brookings Institution.

2 November
(The Atlantic) Health and Safety: Back in the U.S., Donald Trump yesterday convened a “meeting talking about health care,” at which medical professionals spoke in support of the nominee’s health plan. But the specifics of that plan aren’t very clear. Despite his promise of a solution for “repealing and replacing Obamacare,” Trump’s plan seems to boil down to people simply paying their own medical bills outright. That’s not to say the current system is perfect—far from it. For example, though one of Obamacare’s biggest achievements has been expanding access to birth control, gaps in insurance coverage and states’ failure to expand Medicaid mean millions of low-income women still aren’t able to get it.
Trump’s Health Plan: Pay Your Own Medical Bills Using Money You Saved  OUCH – pretty harsh review.

28 October
Figuring out how Obamacare is faring has always been hard.
(NYT Opinion)  It’s been hard because many Republicans are rooting for the law to fail and try to make any flaw sound existential. And it’s been hard because we in the media haven’t always done a good job covering the law. We tend to sensationalize its problems, rather than distinguishing between routine ones and truly worrisome ones.
The recent spike in premiums — raising the cost of many insurance plans — is a real problem. But it’s also contained to the smaller part of Obamacare’s coverage expansion, and it’s a problem that could be easily solved by a functioning Congress.
First, some context: The 260 million or so Americans who receive health insurance through their employer, Medicare or Medicaid (including through Obamacare’s Medicaid expansion) are unaffected by the prices increases. The increases instead apply to the 10 million people who buy coverage on one of the private-insurance exchanges established by the law. Even among those 10 million, the vast majority receives government subsidies that will largely or partly cancel out the price increase.
So why do I say the price increases are a real problem? Because those insurance exchanges are vital to the idea of universal coverage in this country. Without them, many people who don’t qualify for government insurance or aren’t covered through their job will be stuck without good medical care.
The spike in premiums is a sign that not enough healthy people are signing up for the exchanges. Without healthy people to balance out the sick, insurance stops being insurance and becomes terribly expensive.
The basic solution is straightforward. It involves increasing the subsidies for lower-income families — while also increasing the penalties for people who refuse to sign up for health insurance. The overall cost of this fix would be modest, and a better functioning Republican Party would have no problem agreeing to a compromise. It would preserve a robust role for the private market, after all.
The more boldly liberal solution is to create a so-called public option on the exchanges — a government insurance plan anyone could buy. In a Times Op-Ed today, Jacob Hacker — one of the architects of the public option — makes the case for it.
I’ll confess to being torn about whether the public option is a more complex solution than the current problem requires. I encourage you to read Hacker’s piece – and also this recent Times piece raising questions about the public option. If you have thoughts after doing so, send me an email, at
David Leonhardt, Op-Ed Columnist

Making a killing under Obamacare: The ACA gets blamed for rising premiums, while insurance companies are reaping massive profits
Health insurance costs are rising, but why? Let’s take a close look at health insurance companies’ soaring profits
(Salon) Just days before the next open enrollment period was to begin under the Affordable Care Act, President Barack Obama’s signature health care law, Americans received some sobering news about how much more they’ll pay yet again for health insurance, an annual cost that’s already straining many household budgets.People seeking midlevel plans through the public exchange will see premiums jump 25 percent on average in 2017, the Department of Health and Human Services said on Monday. The 154 million Americans who receive their coverage through their employers won’t be hit as hard, but they, too, can expect an average premium increase of 4 percent to 5 percent, while handing over about 9 percent more in deductibles, according to a Commonwealth Fund report released on Wednesday.
While Americans continue to be hammered by rising health care costs, and while congressional lawmakers (with their taxpayer-subsidized health care) do nothing to lower cost of pharmaceuticals and medical care, one group is reaping a windfall in profit: health insurance companies and their investors.


26 June

Barack Obama is officially one of the most consequential presidents in American history

(Vox) After Thursday’s Supreme Court ruling, there’s no longer any doubt: Barack Obama is one of the most consequential presidents in American history — and he will be a particularly towering figure in the history of American progressivism.
National health insurance has been the single defining goal of American progressivism for more than a century. There have been other struggles, of course: for equality for women, African-Americans, and LGBT people; for environmental protection; against militarism in Southeast Asia and the Middle East. But ever since its inclusion in Teddy Roosevelt’s 1912 Bull Moose platform, a federally guaranteed right to health coverage has been the one economic and social policy demand that loomed over all others. It was the big gap between our welfare state and those of our peers in Europe, Canada, Australia, New Zealand, and Japan.
And for more than a century, efforts to achieve national health insurance failed. Roosevelt’s third-party run came up short. His Progressive allies, despite support from the American Medical Association, failed to pass a bill in the 1910s. FDR declined to include health insurance in the Social Security Act, fearing it would sink the whole program, and the Wagner Act, his second attempt, ended in failure too. Harry Truman included a single-payer plan open to all Americans in his Fair Deal set of proposals, but it went nowhere. LBJ got Medicare and Medicaid done after JFK utterly failed, but both programs targeted limited groups.
Richard Nixon proposed a universal health-care plan remarkably similar to Obamacare that was killed when then–Sen. Ted Kennedy (D-MA) walked away from a deal to pass it, in what Kennedy would later call his greatest regret as a senator. Jimmy Carter endorsed single-payer on the campaign trail, but despite having a Democratic supermajority in Congress did nothing to pass it. And the failure of Bill Clinton’s health-care plan is the stuff of legend.
Then, on March 23, 2010, President Obama signed the Affordable Care Act into law. It wasn’t perfect by any means. It wasn’t single-payer; it lacked a public option, or all-payer rate-setting. And it still left many uninsured. But it established, for the first time in history, that it was the responsibility of the United States government to provide health insurance to nearly all Americans, and it expanded Medicaid and offered hundreds of billions of dollars in insurance subsidies to fulfill that responsibility.
To pay for it all, the Affordable Care Act cut back on Medicare spending and hiked up taxes on rich people’s investment income and health plans. It effected a massive downward redistribution of income. It’s one of the most startlingly progressive laws this country has ever enacted.

8 March
Once Again, Obamacare Is Turning Out To Be Cheaper Than Expected
Here’s some good news: the latest report from the CBO has reduced its estimate of the cost of Obamacare. This is due partly to a slight decrease in the number of people CBO expects to be covered, but mostly due a lower estimate of the cost of insurance premiums. Thanks to this, federal subsidies are estimated at $209 billion less over a ten-year period, and the cost of CHIP and Medicaid is estimated at $73 billion less. However, there are also reductions in expected revenues from Obamacare’s excise tax, so the net reduction amounts to $142 billion over ten years. The table below tells the story.

4 March
In Anti-Obamacare Case, Ruth Bader Ginsburg Questions the Foundation of the Lawsuit
The Supreme Court justice zeroes in on whether the plaintiffs even have a basis to sue.
(Mother Jones) During the Supreme Court oral arguments Wednesday morning in King v. Burwell, the case that threatens to destroy Obamacare, Justice Ruth Bader Ginsberg wasted no time in grilling the attorney seeking to eviscerate the Affordable Care Act about a significant technical matter that could blow up his case. As soon as Michael Carvin, the Jones Day partner representing the four plaintiffs named in the anti-Obamacare suit, started his opening statement, Ginsburg interrupted him with a slew of questions about whether his plaintiffs had a recognizable injury that would allow the case to proceed. A plaintiff, she declared, “has to have a concrete stake in the question…you would have to prove the standing if this gets beyond the opening door.”


7 November
9 Reasons Why The Challenge To Obamacare Could Fail
(HuffPost) The ruling in King v. Burwell will hinge on whether the plaintiffs can prove that President Barack Obama’s signature health care law does not provide tax credits to Americans in more than 30 states who purchased health insurance through the federal exchange, built by the Department of Health and Human Services. The law clearly provides those same credits to people who bought insurance through the state exchanges.
“At the time of the ACA’s enactment, it was well understood that without the subsidies, the individual mandate was not viable as a mechanism for creating a stable insurance market.”
“The ACA would be self-defeating if taxpayers who purchase insurance from an HHS-created Exchange are deemed ineligible to receive subsidies.”
“The majority opinion ignores the obvious ambiguity in the statute and claims to rest on plain meaning where there is none to be found.”
“Simply put [the law] interpreted as Appellants urge would function as a poison pill to the insurance markets in the States that did not elect to create their own exchanges. That is surely not what Congress intended.”
“It makes little sense to think that Congress would have imposed so substantial a condition in such an oblique and circuitous manner.”
“The simple truth is that Appellants’ incentive story [see below] is a fiction, a post hoc narrative concocted to provide a colorable explanation for the otherwise risible notion that Congress would have wanted insurance markets to collapse in States that elected not to create their own Exchanges.”
“If an HHS-created Exchange does not count as established by the State it is in, there would be no individuals ‘qualified’ to purchase coverage in the 34 States with HHS-created Exchanges. This would make little sense.”
“The record indicates that, when the ACA was enacted, no State even considered the possibility that its taxpayers would be denied subsidies if the State opted to allow HHS to establish an Exchange on its behalf. Not one.”
“The IRS’s and HHS’s constructions of the statute are perfectly consistent with the statute’s text, structure, and purpose.”

The Supreme Court Is Now a Death Panel
(The New Republic) The contested text could be fixed with a comically simple technical corrections bill, which Democrats would happily support. If Republicans were to sit on their hands, or use the ensuing chaos as leverage to extract unrelated concessions, it will cost people their lives. That is a cardinal reality facing justices, and the people soliciting their conservative activism.

6 November
McConnell and Boehner Announce Plan to Take Health Insurance Away From 1 Million Americans
Mitch McConnell and John Boehner have announced that one of the first things that the new Republican controlled Congress will do is take away health insurance from 1 million Americans.
In their Wall Street Journal op-ed McConnell and Boehner wrote:

We’ll also consider legislation to help protect and expand America’s emerging energy boom and to support innovative charter schools around the country.These bills include measures authorizing the construction of the Keystone XL pipeline, which will mean lower energy costs for families and more jobs for American workers; the Hire More Heroes Act, legislation encouraging employers to hire more of our nation’s veterans; and a proposal to restore the traditional 40-hour definition of full-time employment, removing an arbitrary and destructive government barrier to more hours and better pay created by the Affordable Care Act of 2010.

A return to tradition sounds nice, until one understands what that means. Republicans are trying to take private employer based health insurance away from one million Americans. House Republicans tried this same move in February 2014, and the impact on healthcare was spelled out by the CBO.

22 July
Two Republican Judges Gut Obamacare, Threatening Health Care For Millions
Two Republican judges on the D.C. Circuit Court have ruled that the equivalent of a typo is enough to strip health care subsidies from up to 5 million people, dealing what would be a death blow to the Affordable Care Act if the decision is allowed to stand. The one Democrat on the panel dissented.
The three-judge panel ruled in Halbig v. Burwell that people in the 36 states that use the federal health insurance exchange are ineligible for subsidized insurance. The decision would also affect those who purchased insurance through the exchange but don’t receive subsidies, as reneging on the payments would lead to a rapid increase in insurance rates for everyone.
The White House said Tuesday the decision will be appealed to the entire D.C. circuit court — what’s known as an en banc review — where Democrats hold a majority that is nearly certain to overturn the GOP judges’ aggressive move. The next step could be the Supreme Court, which already upheld the Affordable Care Act in a separate case two years ago. Separate U.S. Appeals Court Upholds Subsidies Under Obama Health Law

5 June
Latest Gallup Numbers Confirm 10-12 Million Newly Insured Under Obamacare
(Mother Jones) Gallup’s latest poll number for the uninsured is out, and it’s stabilized now that the open enrollment period for Obamacare has ended. It was 13.4 percent in April and it’s 13.4 percent in May
This is a drop of about 4 percentage points from the 2011-12 baseline, and represents about 10 million newly insured—a figure that’s been confirmed elsewhere and now seems like a pretty good estimate. Add to this the number of children and sub-26ers who are newly insured, and you’re probably up to 12-13 million who are newly insured under Obamacare. Some of this comes from people buying insurance through the exchanges; some comes from Medicaid signups; and some comes from people signing up for insurance at work thanks to the individual mandate. (HuffPost) Obamacare Has Drastically Cut The Uninsured Rate For Blacks, Hispanics

10 April
Kathleen Sebelius to step down as HHS secretary; OMB director will take her place
(WaPost) Health and Human Services Secretary Kathleen Sebelius is resigning, ending a tumultuous tenure as the public face of the Affordable Care Act. President Obama will nominate his budget director on Friday as her successor, according to White House officials.
Sebelius entered the Cabinet in 2009, three months into Obama’s presidency, as a well-regarded former governor of conservative Kansas. She is leaving after months of intense criticism over the botched rollout in the fall of the insurance marketplace.
During the firestorm, Obama made clear to his aides that he would not seek the resignation of his health secretary, and her departure is timed to brighter news for the White House as enrollment soared late last month.
According to White House officials, Obama will nominate Office of Management and Budget Director Sylvia Mathews Burwell to take Sebelius’s place. Although Burwell does not have an extensive background in health-care policy, she is known for her strong management skills and has experience in issues of poverty and global health issues from her time at the Bill and Melinda Gates Foundation.


The Khan Academy presents a brilliant, simple explanation, “not taking political sides, but shedding light on what people are debating”

White House website on Health Reform
Washington Post — Obamacare: Understanding the Affordable Care Act
To help readers understand and maneuver through Obamacare — the Affordable Care Act — the Washington Post has published a variety of consumer stories, FAQs, online chats and video segments, linked below. Check back for regular updates.

Affordable Care Act
Attention, consumers! If you are a consumer and have specific questions about the Affordable Care Act, please visit, the official Affordable Care Act website, for more information. In March 2010, President Obama signed comprehensive health reform, the Patient Protection and Affordable Care Act (ACA), into law. The law makes preventive care—including family planning and related services—more accessible and affordable for many Americans.  While some provisions of the law have already taken effect, many more provisions will be implemented in the coming years. Get Ready for ACA Enrollment which Begins October 1, 2013 for coverage beginning January 1, 2014
Up-to-date information about enrollment and implementation can be found at
View video about the new Health Care Marketplaces which will be going live October 1, 2013
Look up your state’s plan on state-by-state fact sheets
Top ten things to know about the health care law for special populations such as women, clinicians, small businesses, others
Sign up for text and email updates about your state’s ACA implementation

Obamacare Facts: Affordable Care Act, Health Insurance Marketplace
Unbiased Facts on Obamacare (the Affordable Care Act), Health Care Reform, and the Health Insurance Marketplace.

U.S. health secretary calls for probe of Obamacare website launch
(Reuters) The website’s disastrous debut created a political crisis for Obama and fellow Democrats.
Sebelius, who is scheduled to testify before a congressional panel later Wednesday, also said she had asked Marilyn Tavenner, the chief of the Centers for Medicare and Medicaid Services, to create a new chief risk officer position at CMS.
The new official’s first assignment would be to review information technology contracting and identify the “risk factors that impeded the successful launch of the website,” Sebelius said.
Late last month, the Obama administration announced that QSSI, a unit of health insurer UnitedHealth Group, would serve as a general contractor to oversee repairs to
Obamacare Enrollments Surpass 1 Million
More than two months after Obamacare’s ugly debut, the number of Americans using the system is starting to grow: Nearly 1.2 million people are on track to have health coverage in place next year from the law’s health insurance exchanges, the Department of Health and Human Services announced Wednesday.
The new data don’t include an apparent flurry of enrollments in the early days of December., the federal portal to health coverage in more than 30 states, still has problems, but appears to doing what it’s supposed to do: enabling consumers to do shop and sign up for health benefits for next year.

3 December
Surprise-Obamacare Now Projected To Cost Hundreds Of Billions Less Than Expected
(Forbes) Amidst the dark skies of the launch, some daylight may finally be emerging with respect to one of the critical goals of the Affordable Care Act—bending the cost curve of America’s expensive healthcare system.
According to a New York Times report out Tuesday, the Congressional Budget Office has quietly removed hundreds of billions of dollars from the projected costs of Obamacare, primarily the result of an anticipated decrease in the federal government’s contribution to the Medicaid expansion program along with the projected cost of the subsidy payments to those buying private insurance policies on the healthcare exchanges.

29 November
David Jones: American system prior to Obama’s nuclear intervention was fine
David Kilgour: Canada’s system can no longer be considered a point of pride

15 November
President Calls GOP And Insurance Companies’ Bluff
President Obama tells insurance companies they have the freedom to extend the policies but cannot force them. That removes the narrative of Obama/government takeover of your healthcare. He forces insurance transparency by requiring insurance companies to come clean on their substandard policies relative to the Affordable Care Act. In doing this the American citizens purchasing these policies know upfront that they are purchasing junk.
The fact that many will now have the comparison and the knowledge that there may be subsidies on the exchange will limit the size of that insurance market. This means it is unlikely many insurance companies will bite. There are some people who will not get subsidies, will not have policies extended by insurance companies, and will be upset that they will pay higher rates. The president put the onus of fixing that on working with Congress. Congress can choose to engage or not. Not engaging becomes a new campaign direction for Democrats.

14 November
Obama announces change to address health insurance cancellations
(WaPost) President Obama relented to pressure from the public and his own party Thursday and changed one of the bedrock requirements of the new health-care law to fulfill his promise to allow people to keep their insurance plans if they want.
While the move was aimed at solving a problem that was threatening the president’s credibility and public faith in the law, it raised a slew of new questions, including whether insurers would adjust, whether millions of customers would pay higher premiums and whether states would make the fix available. …
The president was contrite, and his admissions were many — he conceded that he was left in the dark about aspects of the crowning achievement of his presidency, he acknowledged that he and his advisers underestimated how hard it would be to sell insurance over a Web site, he could not guarantee that the site would work well for everyone by the end of the month, he allowed that federal government rules were an impediment, and he lamented the political problems he caused for members of his party.

26 October
After tough week, White House buys time for Obamacare website fix

(Reuters) – President Barack Obama promised on Saturday that his troubled healthcare website was just weeks away from a cure as he struggled to convince Americans he is on top of what has become a self-inflicted wound to his signature first-term achievement.
His administration unveiled a plan on Friday to make Obamacare insurance marketplaces on – a website riddled with error messages, long delays and bugs – work better by the end of November.

23 october
Ezekiel J. Emanuel: How to Fix the Glitches
(NYT op-ed) … there are five things we can do now to right the ship of Obamacare.
— The president should create a new position: an independent chief executive of the federal exchange.
— the system needs to borrow from other exchanges. While the federal exchange has been a fiasco, many state exchanges have been working well since they launched earlier this month.
— the administration needs to be candid with the public. Given the disappointing rollout of the Web site, Americans are justifiably suspicious. Starting now, the administration needs to initiate a concerted effort to win back the public’s trust. There should be twice-weekly briefings that feature honest and complete descriptions of both the problems and solutions that the tech team is working on — in all the gory detail.
— delay what can be delayed to focus on the absolute top priority: the customer shopping experience, especially the ability to compare coverage, deductibles, co-pays, subsidized premiums and other information side by side. But there are certain parts of the exchange that can be postponed.
— once the Web site is working reasonably well, there needs to be an enormous P.R. campaign to engage those young invincibles. When President Obama spoke about the Web site issues on Monday, he argued that health care is so important, people will put up with the glitches to get it. That may be true, but the Americans who are likely to endure the frustrations are those who most need coverage — older people with expensive health problems. If the site is too much of a hassle, the healthy 20- and 30-year-olds the system desperately needs to enroll won’t go through the trouble. Everything should done to make their purchasing experience smooth.
Ted Cruz Gets His Health Insurance Through Goldman Sachs, His Wife Confirms
The most vocal opponent of Obamacare enjoys a high-priced health plan through investment bank Goldman Sachs.

21 October
Obama Vows Fixes To Health Insurance Website
(HuffPost) President Barack Obama said Monday that there’s “no excuse” for the technical problems that have plagued the rollout of the Obamacare health insurance website, and promised all Americans would have access to health coverage under his law.
“There’s no sugar-coating it. The website has been too slow, people have been getting stuck during the application process,” Obama said from the White House’s Rose Garden. The president said he is “confident” that the myriad problems with the website,, will soon be fixed. The site is the access point to the health insurance exchanges the federal government is operating in more than 30 states.
Nearly three weeks into the rollout of Obama’s signature domestic policy achievement, evidence is mounting that the technological difficulties stymieing enrollment into health insurance are deeper than the White House anticipated and could take weeks or longer to address.

19 October
5 things that have happened since Obamacare launched
(CNN) — Obamacare has survived a Supreme Court appeal, a government shutdown and ongoing challenges by opposing politicians. With few exceptions, every American must have health insurance by March 31 or pay a penalty fee.
That’s right: The marketplaces that are central to the Affordable Care Act — also known as Obamacare — launched on October 1, despite the shutdown showdown and the much-anticipated premiere of “The Walking Dead.” The government has since reopened, and Obamacare is still the law.
1. Sign up on hasn’t been easy
2. State sites seemed to fare better
3. Overall enrollment numbers are unclear
4. The cost of care has become more clear
5. The shutdown came and went — without changing much
The government shutdown had no effect on users trying to sign up for Obamacare because money designated for the launch was approved in a previous session of Congress and didn’t have to be approved again.
For most people, Obamacare won’t make a direct impact. People who have health insurance through their employer, or through Medicare or Medicaid, can continue to get it that way.

Billionaire Koch Brothers Spending Millions To Deny Health Coverage To Low-Income Americans
Conservative advocates funded by the billionaire industrialist brothers Charles and David Koch have launched a massive campaign pressuring states to deny health care coverage to lower income Americans through the Medicaid expansion contained in the Affordable Care Act.
The effort, orchestrated by the group Americans for Prosperity, is targeting lawmakers in Virginia tasked with deciding whether the state should accept federal dollars to provide insurance to individuals and families below 133 percent of the federal poverty line ($31,321 in income for a family of four).

18 October
Ted Cruz’s claims on Obamacare focus on losers, not winners
Washington Post Fact Checker — The Congressional Budget Office has calculated that by 2018, after the law is fully implemented, 7 million people will be dropped from their employer health plans and 5 million people will shift out of private plans. Put in terms of percentages, that means it would affect about 4 percent of people on employer health plans and 19 percent on people on private plans.
Meanwhile, the number of people without insurance will decrease by 25 million people, a cut of more than 45 percent. In other words, significantly more people will be helped by the law than those who face changes in health coverage. Moreover, the vast majority of people who now get their insurance from their employers likely will see little change.
Those are crucial details that Cruz somehow ignores when he speaks of the millions of victims. Indeed, Oregon announced this week that the state’s uninsured rate has already been cut by 10 percent since Oct. 1, when people were able to begin signing up for Obamacare.

11 October
Obamacare Has Gotten More Popular Since The GOP Shut Down The Government To Defund It
(Think Progress) According to a new poll, Obamacare is actually gaining in popularity at the same time as the Republican Party has taken extreme measures to take a stand against it.
A new NBC-Wall Street Journal poll finds that 38 percent of Americans say Obamacare is a good idea, which represents a 7-point jump from last month. It’s the third-highest popularity rating for Obamacare — which typically doesn’t poll well as a whole, even though Americans tend to support its individual provisions — since the health law was first enacted.
The poll also finds that 50 percent of voters don’t want to eliminate funding for the health reform law, and the vast majority are opposed to tying Obamacare to the ongoing negotiations over the government shutdown. Just 23 percent of Americans say they want to continue the current shutdown to sabotage the health law.

10 October
Oh Dear!
Obamacare website glitches linked to Canadian IT firm
CGI says it’s committed to working with client to make needed tweaks and improvements
(CBC) Blame Canada? A Canadian IT firm, CGI Group Inc., is behind the website that is causing frustration, anger and plenty of headaches for Americans trying to sign up online for a new health insurance plan. is the website launched Oct. 1 that represents the heart and soul of President Barack Obama’s Affordable Care Act, dubbed Obamacare. It’s an online marketplace that allows uninsured Americans to shop for and compare plans, buy one, and check if they’re eligible for any government subsidies.
So far, it’s not working very well. From day one, the website has struggled to handle the millions of clicks it’s getting. Users have received error messages, been booted out of the system, or got stuck somewhere along the process trying to create an account and buy a plan.

1 October
‘Obamacare’ launches amid government shutdown
(BBC) A central provision of President Barack Obama’s healthcare reform law has taken effect, having survived Republicans’ years-long effort to undermine it.
Markets run by federal and state governments opened for the millions of Americans seeking insurance plans.
As many as seven million Americans who do not already have health insurance are eligible to purchase coverage in the coming months.
Obamacare isn’t popular, but government shutdown is even less so, poll shows
Six in 10 people surveyed say avoiding a government shutdown is more important than making changes to Obamacare, a CNN poll shows. A shutdown is ‘just messing with people,’ says one frustrated American.



obamacare comes full circle

28 June 2012
US Supreme Court upholds healthcare reform law
(BBC) The US Supreme Court has said President Barack Obama’s landmark healthcare reform act is constitutional.
The court upheld a core requirement known as the “individual mandate” that Americans buy insurance or pay a fine.
Of the nine justices on the bench, Chief Justice John Roberts’ vote was decisive in the Supreme Court’s 5-4 ruling in favour of the law.
The ruling comes months before the US election, with Republicans vowing to push for a repeal of the bill.
Healthcare is a deeply polarising issue in the US and Republicans strongly opposed Mr Obama’s legislation.

One Comment on "Affordable Care Act aka Obamacare 2012-16"

  1. Diana Thebaud Nicholson November 11, 2016 at 12:43 pm ·

    Combining government-funded health insurance with private plans is like squaring the circle. The single payer government-funded system you have is the only reliable way to furnish health insurance for all. Private companies just can’t make a decent (still less indecent) profit from insurance plans that are both affordable and effective in covering all the services needed—especially treatment for conditions that antedate the start of insurance coverage. What’s starting to happen now is that private companies, which initially welcomed a whole new slew of subscribers (20 million in all), have either stopped offering insurance in certain markets (because they were losing money) or have raised premiums and/or deductibles so much that many people can scarcely afford them, and those are just the people targeted by Republicans determined to “repeal and replace” Obamacare, though the Reps have nothing to replace it with but the rapacity of private insurance companies, which of course is what we had before. It remains to be seen whether or not Dems can stop the Republicans from dismantling all of Obamacare and thus throwing 20 million people into health care limbo. James Heffernan

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