Vox explains how does the individual mandate works and why the Obama administration is so confident in it.
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“Obamacare” has expanded health insurance for millions — but as an excerpt from FRONTLINE’s “Divided States of America” shows, its passage also contributed to years of political polarization.
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From veteran filmmaker Michael Kirk and his team, “Divided States” will offer an in-depth view of the partisanship that has gridlocked Washington and charged the 2016 presidential campaign, the rise of populist anger on both sides of the aisle, and the racial tensions that have erupted throughout the country.
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U.S. Senator John McCain was one of three lawmakers who voted down the latest attempt by the Republican-controlled Senate to repeal Obamacare. Susan Collins and Lisa Murkowski also voted against what had come to be called the ‘skinny’ repeal. Replaces an earlier version that contained a spelling mistake.
President Obama explains what the Affordable Care Act — aka, Obamacare — is.
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“I think that any time you’re implementing something big, there’s going to be people who are nervous and anxious about is it going to get done, until it’s actually done.
But let’s just step back for a second and make sure the American people understand what it is that we’re doing. The Affordable Care Act — Obamacare — has now been with us for three years. It’s gone through Supreme Court tests. It’s gone through efforts to repeal. A huge chunk of it has already been implemented. And for the 85 to 90 percent of Americans who already have health insurance, they’re already experiencing most of the benefits of the Affordable Care Act even if they don’t know it. Their insurance is more secure. Insurance companies can’t drop them for bad reasons. Their kids are able to stay on their health insurance until they’re 26 years old. They’re getting free preventive care.
So there are a whole host of benefits that, for the average American out there, for the 85 to 90 percent of Americans who already have health insurance, this thing has already happened. And their only impact is that their insurance is stronger, better, more secure than it was before. Full stop. That’s it. They don’t have to worry about anything else.
The implementation issues come in for those who don’t have health insurance — maybe because they have a preexisting condition and the only way they can get health insurance is to go out on the individual market, and they’re paying 50 percent or 100 percent more than those of us who are lucky enough to have group plans; people who are too poor to get health insurance and the employers don’t offer them. Maybe they work for a small business and this small business can’t afford right now to provide health insurance.
So all the implementation issues that are coming up are implementation issues related to that small group of people, 10 to 15 percent of Americans — now, it’s still 30 million Americans, but a relatively narrow group — who don’t have health insurance right now, or are on the individual market and are paying exorbitant amounts for coverage that isn’t that great.
And what we’re doing is we’re setting up a pool so that they can all pool together and get a better deal from insurance companies. And those who can’t afford it, we’re going to provide them with some subsidies. That’s it. I mean, that’s what’s left to implement, because the other stuff has been implemented and it’s working fine.
The challenge is that setting up a market-based system, basically an online marketplace where you can go on and sign up and figure out what kind of insurance you can afford and figuring out how to get the subsidies — that’s still a big, complicated piece of business. And when you’re doing it nationwide, relatively fast, and you’ve got half of Congress who is determined to try to block implementation and not adequately funding implementation, and then you’ve got a number of members of — or governors — Republican governors — who know that it’s bad politics for them to try to implement this effectively, and some even who have decided to implement it and then their Republican-controlled state legislatures say, don’t implement, and won’t pass enabling legislation — when you have that kind of situation, that makes it harder.
But having said all that, we’ve got a great team in place. We are pushing very hard to make sure that we’re hitting all the deadlines and the benchmarks.”
What Republicans and what Americans hate about Obamacare are different.
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In which John Green pauses, five years after the Affordable Care Act was signed into law, to consider what we know so far about the law’s effectiveness and repercussions. I also look at health care in the United States more generally, and the limited scope of the Affordable Care Act relative to the size of the overall health care system in the U.S.
I got a ton of help from Aaron Carroll, who hosts the great Health Care Triage https://www.youtube.com/user/thehealthcaretriage, but any errors are my fault and mine alone.
More than 17% of US GDP goes to health care expenses: http://en.wikipedia.org/wiki/Health_care_in_the_United_States
The U.S. spends way more on health care than any other country: http://www-tc.pbs.org/prod-media/newshour/photos/2012/10/02/US_spends_much_more_on_health_than_what_might_be_expected_1_slideshow.jpg
And yet our healthcare outcomes are not generally better (and are in many cases worse): http://www.commonwealthfund.org/publications/fund-reports/2014/jun/mirror-mirror
44 (or maybe 46) million Americans were uninsured in 2009: http://www.pbs.org/healthcarecrisis/uninsured.html
This NYT article assessing the ACA is excellent: http://www.nytimes.com/interactive/2014/10/27/us/is-the-affordable-care-act-working.html#/
Understanding pre-existing condition exclusions: http://kff.org/health-reform/fact-sheet/health-insurance-market-reforms-pre-existing-condition/
Medical debt is the biggest cause of U.S. bankruptcy: http://www.cnbc.com/id/100840148
Employer-based insurance distorts the labor market in the United States: https://www.bostonfed.org/economic/conf/conf50/conf50e.pdf
Both the access and the cost savings parts of the Affordable Care Act are discussed really well at this wikipedia page: http://en.wikipedia.org/wiki/Patient_Protection_and_Affordable_Care_Act
We are nowhere close to a path to health care spending stability: https://www.cbo.gov/publication/45471
But the uninsurance rate has dropped dramatically: http://www.gallup.com/poll/180425/uninsured-rate-sinks.aspx
And more than 12 million people have gotten insurance through the health care exchanges set up by Obamacare: http://acasignups.net/
The rollout of healthcare.gov was a disaster: http://en.wikipedia.org/wiki/HealthCare.gov
Insurance premiums rising more slowly than before exchanges: http://kff.org/health-reform/issue-brief/analysis-of-2015-premium-changes-in-the-affordable-care-acts-health-insurance-marketplaces/
More insurance companies are participating in the exchanges this year than last year: http://www.wsj.com/articles/u-s-states-to-get-more-insurers-under-affordable-care-act-1411495473
The law is costing less than expected: http://www.nytimes.com/2015/03/10/us/politics/budget-office-again-reduces-its-estimate-on-cost-of-the-affordable-care-act.html
Is the law actually improving health? It seems so at least for young adults and also for colonscopy screening rates, but much is still unknown: http://www.nytimes.com/interactive/2014/10/27/us/is-the-affordable-care-act-working.html#/
Many are still uninsured and underinsurance is a huge problem: http://www.nytimes.com/2014/12/02/upshot/underinsurance-remains-big-problem-under-obama-health-law.html
(Don’t get mad at me for linking a lot to the New York Times; they do way more data analysis and reporting on this stuff than anyone else I’ve come across)
Britons live longer and healthier lives than Americans despite being pretty similar lifestyle-wise: http://www.ncbi.nlm.nih.gov/books/NBK62373/
Our health care spending will sink us in the long-run, but if anything the situation was worse before the ACA: https://www.cbo.gov/publication/45471
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