So who is looking to sign up for "Obamacare" in about 2 weeks?

[tru_m.a.c]

http://www.thelocal.se/20140117/hospital-queues-tied-to-insurance-trend

So the long wait times are real

They been real. Your insurance affects the quality of care you get too. Total BS by hospitals, clinics, dentists, you name it. at least in my state.
Cheap ass insurance = long wait time, nurses/doctors/receptionist don't care about you or treat you nice.
Bomb ass insurance = You in there immediately, they wait on you hand and foot.

wait times are dependent upon the volume of patients and access to physicians

 

[tru_m.a.c]

In Cook County, nearly a year into CountyCare, Stroger Hospital still serves just as many ER patients as ever — an average of 383 people per day. More than half lack insurance coverage, and many of them stop by in the evening. Similarly, about a third of patients at the University of Illinois at Chicago's emergency room come in after 5 p.m., officials said.

"People have figured it out," said Jeffrey Schaider, chairman of the department of emergency medicine for the Cook County health system. "If you're working 7 a.m. to 8 p.m. every day, when are you going to see your primary care doctor?"

Of course, even insured people need the emergency room in urgent situations. But visiting the ER instead of a primary care doctor makes sense on another level.

"It's not an irrational choice," said Dr. Mark Mackey, vice chairman of clinical affairs in the University of Illinois Hospital and Health Sciences System's department of emergency medicine. "I don't have to wait. I can be seen right away. … We've really evolved into this rapid diagnosis and treatment center."

And yet, emergency departments are not set up to serve as medical homes. "Some patients are very complicated," Mackey said. "They have a long list of medications. Those patients are best cared for by an individual who's quarterbacking their care."

Over the next few years, Illinois officials expect the number of people in the Medicaid system to swell from 2.7 million to more than 3 million. In Cook County, 76,000 residents now have health care coverage as a result of CountyCare, officials said Friday.

But access to doctors remains a significant issue, said Huang, who published research on the issue last year in the journal Health Affairs. "If there's a 20- or 30-day wait to get in to see the doctor, you're going to show up at the emergency room," he said.

Millions of Americans live in areas where demand for primary care exceeds the supply, Huang said.

"For Medicaid patients, the issue is who's going to accept them, and where," he said. "Doctors often practice on the Gold Coast or in well-off suburbs, not in the poorest areas. "That's not very helpful for patients who live in Lawndale or Englewood. Those areas of the city are medical deserts, and the Affordable Care Act doesn't solve the medical desert problem."

Huang estimates that Oak Lawn would need 16 more primary care providers than its current 427 to handle the growth in newly insured patients — the largest number of any suburb or Chicago neighborhood. Blue Island had the highest proportional need: two more providers than its current 19, according to his analysis.

Government officials cannot force doctors to see patients on Medicaid, which pays providers far less than Medicare, the federal program for people 65 and older, and private insurance. Illinois also is often tardy in sending the money, a problem state officials acknowledge.

As part of an ACA incentive to motivate more physicians to accept Medicaid patients, 9,600 Illinois doctors who enrolled in a federally funded enhanced payment program for 2013 and 2014 receive Medicare rates for Medicaid services in those years. No one, including state health officials, seems to be counting on a permanent boost.

The federal government also is paying 100 percent of Medicaid expenses in the first three years of the expansion; CountyCare receives $629 per member each month. After 2017 the federal share will scale back gradually to 90 percent by 2020, and no one knows if Congress will continue federal funding after that.

Despite the new financial resources, some doctors remain unwilling or unable to add Medicaid clients, whose cases are often more complicated and time consuming.

"Insurance doesn't equal access," said the U. of I.'s Mackey. Nationally, about 75 percent of physicians accept patients on public insurance such as Medicaid.

A December report from the National Center for Health Statistics found that 8.3 percent of adults 18 to 64 with only this type of coverage reported being told within the last year that a doctor's office did not accept it — more than three times higher than the percentage for their peers with private insurance.

Still, state and county officials say they aren't overly worried about a physician shortage. Julie Hamos, director of the Illinois Department of Healthcare and Family Services, said nearly 17,000 doctors in the state now accept Medicaid patients, an increase of more than 250 since Dec. 31, 2012.

In Cook County, "there's nothing in our network that at this time is showing a lack of capacity to serve the newly eligible Medicaid recipients," Glass said.

And for the patients, he said, "It's giving them dignity about having insurance and improving their health."

http://www.kaiserhealthnews.org/Sto...1jF-t_tArTRHJ9AURUV2pqaEdEX-Mw&_hsmi=11850659

 

[Everythingg]

So this is mandatory right?

 

[The Bilingual Gringo]

I finished up my certification for selling the Marketplace plans over the weekend for individuals and small businesses.

I will have to say the idea behind the small business plans are nice, their plans are along the lines of the individual ones (albeit not as many plans) but some cool features were added, allowing individuals to pay more out of their pocket and others less as opposed to a uniform amount across the board.

One of the interesting things that they haven't been clear about is the whole guaranteed issue thing comes with a small caveat. After this year, there will be open enrollment for people from Oct to Dec each year, so nobody will be able to purchase a policy at any time unless they have a specific life changing event that's noted in the law.

I'm still holding my breath as a whole regarding the long term effects pan out and what's going to happen to the rates. Another thing that was eyebrow raising was how the other parts of the government were tied into this, between DHS and IRS, it's somewhat creepy.

 

[DEAD7]

I'm just waiting to see how the conversation changes when the fines start rolling out...

 

[No1]

The White House is relaxing the employer mandate again

• BY SARAH KLIFF
• February 10 at 4:15 pm

• 
  
  Comments
  
  
  
  (Photo by Robyn Beck/AFP/Getty Images)
  
  The Treasury Department rolled out Monday afternoon more tweaks to the health care law's requirement that all large employers--those with 50 or more workers--provide insurance coverage to their workers. This is the part of Obamacare was supposed to take effect at the start of 2014, but was delayed by the White House this past summer as the White House was facing significant push back from employers.
  
  In today's final rule, the Obama administration is essentially relaxing the employer mandate for 2015--in a big way for medium-sized businesses, and a smaller way for the largest employers. Here's a rundown of the key changes.
  
  1. Employers with between 50 to 99 employees get another year of transition. The Obama administration will give medium-sized businesses another year's pass on providing insurance coverage to workers. Treasury estimates that about 2 percent of American businesses fall into this category, but does not have numbers on how many people work for businesses of this size. For these companies, the employer mandate does not take effect until 2016.
  
  Employers who want to take advantage of this particular exemption will need to certify with the federal government that they are not cutting back on positions just to fall below the threshold. "It's simply so they don't game the system," one senior administration official told reporters on a phone call this afternoon. "They have to certify they're not doing that and not dropping their coverage."
  
  2. Employers with 100 or more workers aren't required to cover everyone. Previous regulations had required large employers to offer coverage to 95 percent of full-time employees to be considered in compliance with the employer mandate. Today, Treasury is ratcheting that requirement back: Large companies that offer coverage to 70 percent of their employees will be counted as fulfilling the employer mandate. This is a transitional measure and, by 2016, large employers will need to hit the original, 95 percent target. Treasury estimates another 2 percent of American businesses fall into this category, with more than 100 employees, but again, we don't have numbers on how many workers those companies employ.
  
  3. Volunteers won't be counted as full-time employees. There had been some tussling on Capitol Hill over whether certain volunteers - mostly volunteer firefighters - would count as full-time employees, for purposes of the health care law. Today's rule clarifies that they do not count as employees--which eliminates any incentives to get rid of volunteer positions.
  
  There are other, smaller tweaks in the new Treasury rule that deal mostly with how, exactly, employers are supposed to count how many hours employees work (for seasonal workers, for example, or teachers, this can actually be a pretty difficult task.) It's hard to to know how many people will be impacted by these changes since there isn't great data on how many people work for the different-sized employers.
  
  In general though, the employer mandate is not an especially important policy lever in the Affordable Care Act. The vast majority of large employers - somewhere around 95 percent - already offer health insurance. They did so before the Affordable Care Act ever contemplated requiring them to do so because, for one reason or another, they thought it was a good investment and way to compensate their workers. Massachusetts' universal coverage law has an employer mandate--and, since it passed seven years ago, employer-sponsored coverage has been pretty much stagnant.
  
  Delays to the employer mandate can matter politically. But as for what they mean for who Obamacare covers, this delay will likely amount to a relatively small, if non-existent, change.
  

 

[DEAD7]

I was under the impression that the bill crumbled without the mandate, yet every time I turn around, there are waivers being granted or roll backs on the mandates effective date.

 

[The Bilingual Gringo]

I'm just waiting to see how the conversation changes when the fines start rolling out...

There's a good bit of lack of information about the whole thing in general, and I think this will play a huge part in things, but we won't see the effects until a year.. The majority of people I've spoke with about things are going to take the fine the KIM for this year.

The whole hurry up and wait aspect of it all bugs me more than anything.

 

[BeeCityRoller]

The big businesses get another break but the regular guy still has to suck the big one

Health Insurance in the US

 

[River_trey]

I was under the impression that the bill crumbled without the mandate, yet every time I turn around, there are waivers being granted or roll backs on the mandates effective date.

The whole thing is . I basically stopped keeping up with it because there are completely different spins on it almost weekly. I also understood that the bill would crumble under the mandate, then they said it would be ok if they gave the employers an extension.

Another confusing thing was the fact that they were going to try to get the younger demo (that never bought healthcare) to buy in to make up for the expenses. How could this even be pulled off when they passed a law that lets kids stay on there parents health insurance until 26. Can someone explain how that's supposed to work?

 

[DEAD7]

The whole thing is . I basically stopped keeping up with it because there are completely different spins on it almost weekly. I also understood that the bill would crumble under the mandate, then they said it would be ok if they gave the employers an extension.

Another confusing thing was the fact that they were going to try to get the younger demo (that never bought healthcare) to buy in to make up for the expenses. How could this even be pulled off when they passed a law that lets kids stay on there parents health insurance until 26. Can someone explain how that's supposed to work?

 

[tru_m.a.c]

The whole thing is . I basically stopped keeping up with it because there are completely different spins on it almost weekly.

There are no spins on it. You're just reading from untrustworthy media sources.

I also understood that the bill would crumble under the mandate, then they said it would be ok if they gave the employers an extension.

There is the individual mandate and the employer mandate. This is the second extension on the employer mandate if I'm not mistaken. This new extension allows small business and large business to enter the fining phase at the same time.

Businesses with 50 to 99 full-time workers—people working at least 30 hours per week—don't have to comply with the mandate until 2016, under final regulations the Treasury Department released Monday.

Larger employers aren't getting an outright delay but will have more time to fully comply with the mandate. Employers with more than 100 full-time workers must offer coverage to 70 percent of their full-time employees this year, and 95 percent after that, to avoid paying a penalty.

The administration noted that only about 4 percent of employers are eligible for one of the breaks announced Monday, although those businesses employ about 72 percent of all private-sector workers.

The vast majority of large employers already provide health benefits to their full-time workers. Monday's changes are unlikely to make a significant difference in how many people the Affordable Care Act ultimately covers.

Monday's regulations also clarify that volunteers—for example, volunteer firefighters—aren't counted as full-time employees, and they give employers more flexibility when counting workers' hours. Those steps were designed to "kind of mitigate the way the 30-hour definition works," a Treasury official said.

Officials said businesses will have to attest that they're not cutting employees just to qualify for the additional delay but noted that businesses are still free to cut their workforces for economic reasons.

Asked where Treasury found the legal authority to phase in the employer mandate, officials said the department has "broad authority" to implement tax laws in a way that will ease the administration of those laws.

And read this as well:

http://www.kaiserhealthnews.org/Sto...QHSdn8sXMgJ9l_epg8K-VtxI0jrhOw&_hsmi=11911487

 

[Yapdatfool]

http://www.kaiserhealthnews.org/Stories/2014/February/11/Questions-And-Answers-On-The-Latest-ACA-Delay.aspx?utm_campaign=KHN: Afternoon Edition&utm_source=hs_email&utm_medium=email&utm_content=11911487&_hsenc=p2ANqtz--DFRpiKdalewsx4-ComwFsQRKQ1somHfWl1GWM-pq5pvhZgbzzGlyoK50mzZYTQHSdn8sXMgJ9l_epg8K-VtxI0jrhOw&_hsmi=11911487

Why do employers get a reprieve from ACA requirements but not individuals?

It’s a question many are asking. Some believe the administration will yield to pressure to delay the mandate for individuals, especially since so many of the online marketplaces proved difficult to navigate.

“How are you going to penalize people who didn’t make it through the system?” wonders Joseph Antos, a health care economist at the American Enterprise Institute.

Insurance companies, which need as much participation as possible to make individual coverage financially sustainable, would sharply oppose such a move. Unfortunately for Democrats, that nuance might be lost on voters.

“It’s hard to explain to the electorate that [postponing the individual mandate] would subvert the risk pool,” said Dan Mendelson, head of consultant Avalere Health.

Of course they would...

 

[DEAD7]

More than four months after its scheduled launch and despite receiving $305 million in federal grants and spending at least $160 million on the website, Cover Oregon has not enrolled anyone.
U.S. Rep. Greg Walden (R-OR) and other leaders of the House Energy and Commerce Committee wrote a letter to the General Accountability Office, stating, "The catastrophic breakdown of Cover Oregon is unacceptable, and taxpayers deserve accountability."

The letter notes that the Obamacare federal exchange, HealthCare.gov, and the various state exchanges "have encountered numerous problems." Yet, according to Walden, Cover Oregon, the healthcare exchange for the state of Oregon, may have won the booby prize.

"Although the rollout of the Patient Protection and Affordable Care Act has been problematic nationwide, no state has had more complications than Oregon," Walden and the other congressmen wrote. "Oregon's state exchange website, Cover Oregon, has been such a technological failure that even now, months after the start of the open enrollment period, the site is unable to enroll anyone."

It is likely the GAO probe will be granted, considering that GAO staff workers helpedCongressman Walden craft the wording of the letter. According to a GAO spokesman, this is believed to be the first time legislators have asked for a federal investigation of an Obamacare exchange run by an individual state.

When CNBC asked Ariane Holm, a Cover Oregon spokeswoman, for an explanation of the website failure, she responded, "We are aware of this and have no further comment."

On the other hand, Walden had plenty to say. "This is an embarrassment for the state to have a website like this that doesn't function, he told The Bulletin, an Oregon newspaper. "It's extraordinary mismanagement."







The roll out 'hiccups' have made the ACA such an easy target.

 

[DEAD7]

http://www.bloomberg.com/news/2014-...obamacare-to-pass-hospital-costs-to-u-s-.html