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Topic: Obamacare, Charging Insured Patients Extra Fees< Next Oldest | Next Newest >
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PostIcon Posted on: Apr. 11 2014, 6:24 am  Skip to the next post in this topic. Ignore posts   QUOTE

The extra fees are tacked on to the bill that your employer provided insurance pays too - or more accurately, refuses to pay - thus leaving YOU to pay.  So while Obamacare is blamed, EVERY insured patient has to pay.

Of course if you refuse to pay, the bill is turned over to a collection agency and your credit rating suffers - and you could end up in court for refusing to pay the extra, illegal, fees! The burden is on you to prove that the charges are illegal. Those costs, lawyers, etc, can easily exceed the illegal charges.

This makes it very difficult to avoid the illegal charges unless you live in a state with a strong consumer AG like California and New York. Even then, the process of avoiding payment is time consuming and frustrating. So look for these charges to increase in the future. There is no limit on how high these fees can become.

The surest way to avoid such scams is to vote on the US medical care system with your feet - medical tourism . If you live in southern California it is a drive across the border to Mexico, where great quality medical care costs a fraction of the cost in the US. Usually, medical care overseas costs LESS than the insurance company deductible that you have to pay in the US.

From More Calif. Doctors Illegally Charging Insured Patients Extra Fees :

A growing number of California doctors are charging their insured patients extra fees to cover everyday office expenses — a practice that’s illegal under most health care policies, according to KNX1070&#8242;s investigative reporter Charles Feldman.

Doctors in other parts of the country are starting to also add on these extra fees, says David Doyle, CEO of a major physician billing consulting firm in Michigan.

it’s almost impossible for a patient to find out whether their insurance company permits the fees; the contracts are between the insurer and the doctor, leaving the patient only to rely on the doctor’s word that the fees are allowed.
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PostIcon Posted on: Apr. 11 2014, 7:20 am Skip to the previous post in this topic. Skip to the next post in this topic. Ignore posts   QUOTE

Last year everything I saw a Doc for was covered, less a $25 copay.

This year under the new system, I had a minor outpatient surgery in my Doc's office totaling a little over $400. Insurance paid all of $15, leaving me to pay the other $390.

Yep. The new system is working as expected.


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PostIcon Posted on: Apr. 11 2014, 7:58 am Skip to the previous post in this topic. Skip to the next post in this topic. Ignore posts   QUOTE

I for one am glad the government didn't pay for lonewolf's laser hair removal.
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PostIcon Posted on: Apr. 11 2014, 8:28 am Skip to the previous post in this topic. Skip to the next post in this topic. Ignore posts   QUOTE


(Montanalonewolf @ Apr. 11 2014, 7:20 am)
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Last year everything I saw a Doc for was covered, less a $25 copay.

This year under the new system, I had a minor outpatient surgery in my Doc's office totaling a little over $400. Insurance paid all of $15, leaving me to pay the other $390.

Yep. The new system is working as expected.

It sounds like the outpatient surgery was applied to your deductible, and you met it with $15 to spare......No?

Sounds like a pretty reasonable policy.
Also, how does this apply to the affordable care act?
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PostIcon Posted on: Apr. 11 2014, 5:31 pm Skip to the previous post in this topic. Skip to the next post in this topic. Ignore posts   QUOTE

Need to adjust the health insurance policies so they work like Medicare.  Bill is submitted for approval by CMS, the part that is not approved is not payable by Medicare, Supplemental , co-pay or deductible.

The Doctor just wasted time and effort trying to overcharge.

The smart Docs charge exactly what they know that Medicare will approve, and they get every penny of the billed amount.

I hate the wait, but never pay a medical bill until I see the Medicare approval and the Supplemental portion, then pay the balance.  The aggressive ones try to push for earlier payment, but I just ignore them.


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PostIcon Posted on: Apr. 11 2014, 9:09 pm Skip to the previous post in this topic. Skip to the next post in this topic. Ignore posts   QUOTE

QUOTE
Also, how does this apply to the affordable care act?


Last year that minor surgery would have been 85% covered by insurance even before my deductible.
This year it was about 4% covered with the remaining going towards my deductible, which is also higher than it was last year. And my rates went up.

My insurance changed that much with ACA passage.


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PostIcon Posted on: Apr. 12 2014, 1:21 am Skip to the previous post in this topic. Skip to the next post in this topic. Ignore posts   QUOTE


(Montanalonewolf @ Apr. 11 2014, 6:20 am)
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Last year everything I saw a Doc for was covered, less a $25 copay.

This year under the new system, I had a minor outpatient surgery in my Doc's office totaling a little over $400. Insurance paid all of $15, leaving me to pay the other $390.

Yep. The new system is working as expected.
So, MLW: Montana has a state health exchange? As best I can tell, Montana neither set up a state exchange nor expanded Medicaid. (Much like Texas, it would seem, but the actions by the state of Texas didn't really affect my insurance, for the good reason that I didn't enroll for any coverage under the ACA, and simply retained my old coverage under private auspices - although I note that that did change, as it always does, every year.)

I know that I'm setting myself up for one of your patented "you don't know anything about me" tirades, but I assumed you had insurance at your workplace (I assumed you worked), but now we have to assume that you signed up for insurance at healthcare.gov, I suppose, given that this admittedly year-old assessment here (http://kff.org/health-....montana) says that, after failing to set up a state exchange, the governor of Montana vetoed at least some legislation handed to him attempting to limit or curtail establishment of any exchange whatsoever, and that a committee of sorts (Center for Consumer Information and Insurance Oversight (CCIIO)) was set up to "maintain control over plan management functions despite not having entered into a state-federal partnership exchange".

What I'm saying here, in typical long-winded fashion, is that, without much more information about your particular case, it's hard to say why your insurance changed the way it did, or what the actual impact of the ACA is in your case. From what you've said (you're under a "new system" - though clearly you didn't have insurance under the ACA last year!), not much can be said about the question of why your insurance changed so dramatically.
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PostIcon Posted on: Apr. 12 2014, 6:58 am Skip to the previous post in this topic. Skip to the next post in this topic. Ignore posts   QUOTE

You mean other than the company HR department told employees the changes and increases were a direct result of ACA?

I work for a very large company based out of MN that has numerous federal government contracts. Any changes pretty much anywhere within the federal system impacts us.


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PostIcon Posted on: Apr. 12 2014, 11:03 am Skip to the previous post in this topic. Skip to the next post in this topic. Ignore posts   QUOTE

Apparently, at least in MLW's company, Obama's Fault has been extended from the San Andreas to Montana.

For a skinny black kid Obama certainly has amazing power and reach, neh?


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PostIcon Posted on: Apr. 12 2014, 11:27 am Skip to the previous post in this topic. Skip to the next post in this topic. Ignore posts   QUOTE


(Montanalonewolf @ Apr. 12 2014, 6:58 am)
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I work for a very large company based out of MN that has numerous federal government contracts.

LOL - Mr "Get the gummit outta my life" makes his living off of federal tax dollars. Can't say I'm the least bit surprised at the hypocrisy.
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PostIcon Posted on: Apr. 12 2014, 1:12 pm Skip to the previous post in this topic. Skip to the next post in this topic. Ignore posts   QUOTE


(Montanalonewolf @ Apr. 12 2014, 3:58 am)
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You mean other than the company HR department told employees the changes and increases were a direct result of ACA?

And of course you believe what you're told.......


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PostIcon Posted on: Apr. 12 2014, 3:06 pm Skip to the previous post in this topic. Skip to the next post in this topic. Ignore posts   QUOTE

Because of Obamacare, the ACA, I can no longer purchase an "affordable" health insurance policy that excludes coverage for cancer, cardiovascular disease, MRI's, preventable medical measures, physician visits, maternity care, ER visits, etc - with an annual maximum of $5000. Instead of $65 per month for health insurance that covers pretty much nothing, I have to pay $235 a month for a policy that actually pays off when health care is needed - and there is no annual or lifetime maximum.

So it is Obama's fault that I have to pay $235 a month instead of $65 per month.
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PostIcon Posted on: Apr. 12 2014, 3:27 pm Skip to the previous post in this topic. Skip to the next post in this topic. Ignore posts   QUOTE

Disclaimer: However much my first post above might have seemed like "snark", I didn't intend that. I simply observed that, based on what you said, there was absolutely no way to determine what effect the ACA had on your specific insurance situation.

====================================================

The fact that you responded that your assessment of the impact was, in effect, hearsay, even if you obtained the assessment from your company's HR rep, is somewhat telling, at least to me. For instance: if someone in the HR dept. where I work had said that to me, and given that I'm on an entirely different side of this argument (for another thing), I would have challenged that statement instead of simply accepting it, which I'm assuming you did. IOW, I'd have required proof before accepting such a bald statement as actual fact.

The fact is, insurance changes every year with a new contract between your employer and the insurance company. This has been true for as long as I can remember, for as long as I have worked. I don't know what company or what insurance contractor handles your insurance (and it's really none of my business), but if it's like mine at all, the primary factor in determining your specific contractual arrangement is the negotiating clout of your company against what is, most times, a rather large insurance corporation. The quality of employer-based insurance has been on a steep decline for some time now, and I can attest to the fact that the "gold-plated" coverage I once took for granted is now a thing of the past. This had very little to do with the ACA, given that it's been going on for (at least) decades now, though that strong negative cost/coverage trend in insurance was at least some of the reason for the law itself.

Finally, it's entirely possible, as Bass suggested (I think) in a previous post, that there was at least some impact based on provisions in the ACA for actual real coverage for real health problems that people incur. Without more information - which I certainly would not expect to be provided - it's impossible to tell.

=================

ETA: On what amounts to almost another subject entirely, though I think it's relevant here, I once got into a conversation with a friendly & talkative guy with a lot of time on his hands (both of us sitting in my cardiologist's waiting room, which was filled to capacity at the time), and the topic turned to insurance.

As luck would have it, we were both there for the same procedure - an annual test that involved tracing heart flow under a "stress test". After some discussion, it turned out that, while I typically paid about $700 for the test through my company's insurance coverage (a large national company), he was paying nearly $2000 for the exact same test, primarily because that's what his insurance company paid. Apparently, we both paid attention to the bills which were sent to us, even though we didn't actually pay the dollar amounts stated - the insurance paid for it.

So, there are simply no guarantees out there, given the inherent "capitalist nature" of our insurance and healthcare systems, which traits remain, of course, even after ACA and despite what you may have heard to the contrary - there are no guarantees that your experience will be like mine or mine like yours. I strongly suggest that the changes in your insurance are more of this type of thing than anything having to do with "government taking over the insurance industry", though I could, of course, be completely wrong.
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PostIcon Posted on: Apr. 12 2014, 3:31 pm Skip to the previous post in this topic. Skip to the next post in this topic. Ignore posts   QUOTE


(Bass @ Apr. 12 2014, 12:06 pm)
QUOTE
Because of Obamacare, the ACA, I can no longer purchase an "affordable" health insurance policy that excludes coverage for cancer, cardiovascular disease, MRI's, preventable medical measures, physician visits, maternity care, ER visits, etc - with an annual maximum of $5000. Instead of $65 per month for health insurance that covers pretty much nothing, I have to pay $235 a month for a policy that actually pays off when health care is needed - and there is no annual or lifetime maximum.

So it is Obama's fault that I have to pay $235 a month instead of $65 per month.

See, because of ACA you have no choice to keep that great, cheap insurance that covers splinters and sniffles  ???

When I was insured through my last employer my insurance was about $225.00 a month.


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PostIcon Posted on: Apr. 14 2014, 11:23 am Skip to the previous post in this topic. Skip to the next post in this topic. Ignore posts   QUOTE


(Montanalonewolf @ Apr. 11 2014, 9:09 pm)
QUOTE
QUOTE
Also, how does this apply to the affordable care act?


Last year that minor surgery would have been 85% covered by insurance even before my deductible.
This year it was about 4% covered with the remaining going towards my deductible, which is also higher than it was last year. And my rates went up.

My insurance changed that much with ACA passage.

MLW, while I think you might be mistaken, because what you previously had appears to have been co-insurance, but i'll give you the benefit of the doubt.

But more importantly, what you're trying to tell us, is that before the doom & gloom of "Obamacare", you were getting awesome insurance at low rates that never went up?

I've been the insurance administrator at my current company since 2002.  Insurance has gone up ever year, with the coverages getting worse & worse every year, no matter who has been in office.  We work with a BCBS independent representative.  They blame politics for the increase every single year.  Last summer they were screaming about the sky falling.... "Obamacare is going to make your premiums go up 200%, deductibles will be $20k", etc etc.  Interestingly enough, when we got our renewal prices in December, the plan had stayed the same, and premiums went up around 8%, which is very close to being the smallest increase since I've been here.

Its really easy to blame Obama for everything these days, because most people are too lazy.  I bet a lot of companies insurance rates did go up, because they bought into the anti-obamacare hype and were too lazy to price out their policy renewal.  They just took it up the you know what because they believed they were just screwed...because of Obama.
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PostIcon Posted on: Apr. 15 2014, 12:01 am Skip to the previous post in this topic. Skip to the next post in this topic. Ignore posts   QUOTE


(UlightBandit @ Apr. 14 2014, 11:23 am)
QUOTE

(Montanalonewolf @ Apr. 11 2014, 9:09 pm)
QUOTE
QUOTE
Also, how does this apply to the affordable care act?


Last year that minor surgery would have been 85% covered by insurance even before my deductible.
This year it was about 4% covered with the remaining going towards my deductible, which is also higher than it was last year. And my rates went up.

My insurance changed that much with ACA passage.

MLW, while I think you might be mistaken, because what you previously had appears to have been co-insurance, but i'll give you the benefit of the doubt.

But more importantly, what you're trying to tell us, is that before the doom & gloom of "Obamacare", you were getting awesome insurance at low rates that never went up?

I've been the insurance administrator at my current company since 2002.  Insurance has gone up ever year, with the coverages getting worse & worse every year, no matter who has been in office.  We work with a BCBS independent representative.  They blame politics for the increase every single year.  Last summer they were screaming about the sky falling.... "Obamacare is going to make your premiums go up 200%, deductibles will be $20k", etc etc.  Interestingly enough, when we got our renewal prices in December, the plan had stayed the same, and premiums went up around 8%, which is very close to being the smallest increase since I've been here.

Its really easy to blame Obama for everything these days, because most people are too lazy.  I bet a lot of companies insurance rates did go up, because they bought into the anti-obamacare hype and were too lazy to price out their policy renewal.  They just took it up the you know what because they believed they were just screwed...because of Obama.

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PostIcon Posted on: Apr. 15 2014, 6:34 am Skip to the previous post in this topic. Skip to the next post in this topic. Ignore posts   QUOTE

QUOTE
But more importantly, what you're trying to tell us, is that before the doom & gloom of "Obamacare", you were getting awesome insurance at low rates that never went up?

The rates did go up before but not to the degree they did this year and my % share of payment was significantly lower.


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PostIcon Posted on: Apr. 15 2014, 8:33 am Skip to the previous post in this topic. Skip to the next post in this topic. Ignore posts   QUOTE


(Montanalonewolf @ Apr. 15 2014, 6:34 am)
QUOTE
QUOTE
But more importantly, what you're trying to tell us, is that before the doom & gloom of "Obamacare", you were getting awesome insurance at low rates that never went up?

The rates did go up before but not to the degree they did this year and my % share of payment was significantly lower.

Like I said....

QUOTE
Its really easy to blame Obama for everything these days, because most people are too lazy.  I bet a lot of companies insurance rates did go up, because they bought into the anti-obamacare hype and were too lazy to price out their policy renewal.  They just took it up the you know what because they believed they were just screwed...because of Obama.
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(wwwest @ Apr. 11 2014, 5:31 pm)
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Need to adjust the health insurance policies so they work like Medicare.  Bill is submitted for approval by CMS, the part that is not approved is not payable by Medicare, Supplemental , co-pay or deductible.

The Doctor just wasted time and effort trying to overcharge.

The smart Docs charge exactly what they know that Medicare will approve, and they get every penny of the billed amount.

I hate the wait, but never pay a medical bill until I see the Medicare approval and the Supplemental portion, then pay the balance.  The aggressive ones try to push for earlier payment, but I just ignore them.

Yeah...because medicare works so well  :laugh:

The "smart docs" are increasingly NOT taking medicare patients


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PostIcon Posted on: Apr. 15 2014, 9:27 am Skip to the previous post in this topic. Skip to the next post in this topic. Ignore posts   QUOTE


(Montanalonewolf @ Apr. 15 2014, 6:34 am)
QUOTE
QUOTE
But more importantly, what you're trying to tell us, is that before the doom & gloom of "Obamacare", you were getting awesome insurance at low rates that never went up?

The rates did go up before but not to the degree they did this year and my % share of payment was significantly lower.

Higher rates and much higher deductibles

Because we want everyone to suffer

Should call it the LACA

less affordable care act


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PostIcon Posted on: Apr. 15 2014, 10:53 am Skip to the previous post in this topic. Skip to the next post in this topic. Ignore posts   QUOTE

My company had an increase of less than 4% in our health care rates, AND they increased coverage.

Guess Obama must have forgotten to screw us over.....

Another factor in your renewal pricing is how much the insurance company paid out in claims for the prior year.  Have a few people with expensive long term issues like cancer and the company will see a MUCH bigger increase in premiums.

I believe in our company of 600 people about 5% of the people had something crazy like 80% of the costs.  A few high dollar claims can really screw  you over!!!!

MLW.....If your HR person had told you that they had gotten a great deal thanks to Obama with the smallest increase in a decade I am guessing you would not believe them.  Yet for my company that is EXACTLY what happened.

Obama and the ACA had NOTHING to do with it at all.  Yours, mine, ANYONE with company provided healthcare.
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Fred Cruz recently asked on his Facebook page whether the health law has improved people’s lives. By the thousands, people told him it had, which wasn't the response he was expecting.

Like a true republican he deleted the poll and blamed the numbers on left wing sites that posted links to the poll.

If you don't like the truth, delete it.


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PostIcon Posted on: Apr. 15 2014, 5:48 pm Skip to the previous post in this topic. Skip to the next post in this topic. Ignore posts   QUOTE

Best pick-up line for the most gullible person in a bar:

"Guess what bad thing happened to me because of ObamaCare...".


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PostIcon Posted on: Apr. 15 2014, 6:01 pm Skip to the previous post in this topic. Skip to the next post in this topic. Ignore posts   QUOTE

Here is the alternate story to use if you are are trying to pick up a Republican in that bar, works like a charm on Tea Hatters:

Ms Dill, a 32-year-old Florida mother of three with a history of heart problems, collapsed and died in a stranger's house while working as a vacuum cleaner salesman - one of her three part-time jobs.

Ms Dill had stopped taking prescription medication for her condition after she no longer qualified for Medicaid - the government health-care programme for the poor - because her yearly income of $9,000 was above the maximum amount to qualify for coverage.

On March 21, Ms Dill - who was born in Pennsylvania and moved to Florida when she was 18, estranged from her husband and on her own raising children ages 3, 7 and 9 - passed away. And now the painful question: Was her death preventable? Those who have spread word of her story argue that it was.

You see, Ms Dill would have been covered by Medicaid if Florida had taking advantage of federal funding to expand the programme under the Affordable Care Act.

Congress had intended for the expansion to be mandatory, but in 2012 the Supreme Court ruled that states could choose to opt out - and 21 states, thanks largely to Republican efforts, have done so. In those states, there is a gap in coverage for those who make too much to qualify for Medicaid but too little to receive insurance subsidies provided by the Affordable Care Act - a gap into which an estimated 5 million Americans fall.


http://www.bbc.com/news/blogs-echochambers-27027361


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(geophagous @ Apr. 15 2014, 10:53 am)
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MLW.....If your HR person had told you that they had gotten a great deal thanks to Obama with the smallest increase in a decade I am guessing you would not believe them.  Yet for my company that is EXACTLY what happened.

Obama and the ACA had NOTHING to do with it at all.  Yours, mine, ANYONE with company provided healthcare.

This.

If your company provided healthcare cost skyrocketed or coverage got much worse, an inquest needs to be done at your human resources dept....because they have failed at their jobs.  Insurance providers are like cable companies.  If you don't keep them honest by bidding out their services at least every other year, they are going to raise your prices until you say something.

Blaming Obama, even applauding him & the ACA, for something that happened with your companies insurance plan is just plain lazy.
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PostIcon Posted on: Apr. 16 2014, 10:09 am Skip to the previous post in this topic. Skip to the next post in this topic. Ignore posts   QUOTE

Has anyone else noted how much trouble BB has distinguishing "smart" from "greedy?"

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PostIcon Posted on: Apr. 22 2014, 10:47 am Skip to the previous post in this topic. Skip to the next post in this topic. Ignore posts   QUOTE


(Montanalonewolf @ Apr. 11 2014, 7:20 am)
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Last year everything I saw a Doc for was covered, less a $25 copay.

This year under the new system, I had a minor outpatient surgery in my Doc's office totaling a little over $400. Insurance paid all of $15, leaving me to pay the other $390.

Yep. The new system is working as expected.

Contrary to the actual data, proponents continue to champion the winners, and dismiss any of the negative impacts on the losers created by the ACA (particularly with respect to employer sponsored coverage). The fiscal reality is that the cost of coverage expansions required by the ACA must be, will be, and is being pushed to the consumer. Increasing premium cost, and increasing deductibles are the most common approach. You are paying a higher deductible to enable your co-worker to keep his 25 year-old “child” on the company plan.
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PostIcon Posted on: Apr. 22 2014, 1:05 pm Skip to the previous post in this topic. Skip to the next post in this topic. Ignore posts   QUOTE

Coldest winter in North Texas in years.

Before ObamaCare, was much milder.

Just sayin'.


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PostIcon Posted on: Apr. 22 2014, 1:23 pm Skip to the previous post in this topic. Skip to the next post in this topic. Ignore posts   QUOTE


The Congressional Budget Office and the Joint Committee on Taxation have released their latest
projections  regarding the cost and effectiveness of the Affordable Care Act, known as ObamaCare.
Their findings:

   "Relative to their previous projections, CBO and JCT now estimate that the ACA’s coverage
provisions will result in lower net costs to the federal government: The agencies now project a
net cost of $36 billion for  2014, $5 billion less than the previous projection for the year; and
$1,383 billion for the 2015–2024  $104 billion less than the previous projection ....

   "CBO and JCT project that 12 million more nonelderly people will have health insurance in 2014
than would have had it in the absence of the ACA. They also project that 19 million more people will
be insured in 2015, 25 million more will be insured in 2016, and 26 million more will be insured
each year from 2017 through 2024 than would have been the case without the ACA."

As the report also notes, taken as a whole, ObamaCare is still projected to reduce the federal
deficit over  the 10-year window of 2015-2024.


http://www.ajc.com/weblogs....e-insur


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PostIcon Posted on: Apr. 23 2014, 10:49 am Skip to the previous post in this topic.  Ignore posts   QUOTE

On both sides, people see what they want to see. Politics is all about confirmation bias.

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