Dear Mr. H,

Thank you for your clarification...I clearly misunderstood your intent.  And, of course, I know I am my own boss (as noted, it didn't stop me from opening my mouth again!).

Relative to SS and Medicare being entitlement programs:

First, I misused the term.  In that context, I should have said they are "FREE MONEY."  In that regard, they are only received by those that earn wages and pay SS taxes commensurate to the wages they collected over their working lifetime upon retirement age.  They are not paid to individuals that never earned wages.  The initial intent of these programs was to serve as an alternative to private retirement accounts, with the FICA withholding to go into a trust fund comparable to a privately funded returement account.  Had the funds been so appropriated, individuals would not be collecting more than alotted them. 

As to whether they are entitlement programs, I did check my facts and stand by the correctness of the statement.  I realize they are called that by many, but by definition and in reality, they are not.  

An entitlement program is a government-sponsored program designed to provide guaranteed benefits to its citizens, through right or legislation.  Clearly they do not fall under that definition, as they can be modified or even eliminated by a majority vote of congress along with the President's signature.  Already, the retirement age has been pushed back several times, and based upon our current economic crisis, there are certain to be more adjustments made (unlike public employee pensions which are a contractual obligation now threatening many state and local governments with bankruptcy). 

--finis-- 

correction: " I should have said they are NOT free money."

I'm confused as my posts go to Obabmcare and now we are focused far away on basic definitions.......where we still disagree.  Opinions are like beliefs in that everybody gets to form their own.  You get to pick your religion and also your view of Obabmacare......what you do not get to pick, however, is your facts.  I respectfully disagree with you in that Social Security, Mecicare, Medicaid and Obamacare are all cetainly government entitlement programs.  Hey, don't believe me, just ask any member of US Congress or any State house.  Some beneficiaries are paying a portion for each and some get much more than others.  Check history when SS was being created in the 30's.  Much rhetoric is same as today.  And ALL of them can be changed by changes in the law.

Happy to continue here if you wish, but we do at least need to begin with same definitions.

Good news, Texas the home of Perry has been forced by other Republicans in the state to participate in the ACA program.  Too many people wanted to apply to the program and were yelling at their legislators.

As a social worker I have had to work with people who have no health care insurance, have lost their homes because of medical bills, cut back on medication because they didn't have the money.  Fortunately in Illinois their is Kidcare which provides health care to children but how odd that it's ok for their parents to not have any health care.  Anyway, I too would have preferred a single payer plan.  I am grateful that at least we have made a start at universal coverage. There are still people who will not be covered but I hope in time that will change as well.

I have to answer Steve's question about our feeling for Medicare.  It amazes me that people thing that this is a low cost program. As far as I am concerned this is not an entitlement program.   Part A is free to all which covers hospitalization but Part B costs I think this year is $104. a month.  Then you need a supplemental health care plan that covers all the deductible costs that Medicare expects plus what they don't cover, and the cost of this depends on what kind of plan you decide to get but the average would be about $150 a month.  So now your health care cost for the month is $254 and then there is Medicare Part D for medications and that could be another $30 a month depending on what medications you take.  I really feel the Medicare Part D program is not consumer friendly.  It is weighted toward the pharmaceutical and insurance companies who can change what they charge you wheneve they wish, but the consumer only can change the company once a year.  How much sense does is make to have 41 companies (this is in the north suburban Chicago area) charge different amounts for the same medications?

I am volunteering at my former agency to help sign people up for the ACA.  It's roll out has been a mess.  I have to say they developed the least comprehensible manual I have ever been trained on.  It doesn't go along with the online training program.  sigh  The site looks better than it has and has become more user friendly.  It is a complicated program because income has to be checked through the IRS and also for lower income people the Department of Human Services has to interface as well before information about what people will end up having to pay for their program.  I still think it's ridiculous that they offer 3 different levels of coverage. I am a democratic socialist at heart.

Hi Trudi,

I heard that you all just had some fun at the mini-reunion on Monday.  Bravo!  A wee bit too far for me to make it......and who in their right mind would travel from this warm weather to Chicago in December!?

I agree with your comments and sentiments about Obamacare (more recognized than the ACA label), with one exception (Texas)..that I will get to.  The situation in USA for uninsured folks (or those with crappy insurance) was really untenable.  GOP lost all credibility in my view with no alternative.....except to let uninsured die or go bankrupt.  Obamacare can be improved (like by single payer) but it is at least a start at addressing huge problem.  I do not believe that GOP can practically repeal it all now and they will soon stop that talk.

Medicare for me is useless, as it does not provide benefits if you live outside USA.  I got my Part A card automatically in the mail, but otherwise am not part of it.  Healthcare here is much cheaper than US (and village shamen do not take insurance!).

Obamacare rollout was indeed a mess.....just like every other much program start, but it is getting much better.  Soon public will begin to recognize more the benefits and these problems will be past and forgotten.

Let's chat about Texas.  They still have not accepted Obamacare.  Texas and about 20 or so other GOP controlled States are continuing to screw some of the poor folks and all of the hospitals in their States...and all because they simply dislike Obama.  The part of the ACA that you are helping people with (enrolling and buying insurance) is MANDATORY in all States (Texas and others had no choice).  So benefits like purchasing non-cancellable insurance with no maximum coverage...or staying on parents policy until you are 26....or not being denied insurance because of pre-existing condition are ALL the law of the land now and States cannot reject these concepts.  States do, however (and unfortunately), have an option regarding Medicaid.  Obamacare expands the definition of poor people entitled to Medicaid coverage, but the US Supreme Court made this requirement optional for States.  So States like Texas can opt out of providing Medicaid health insurance for those who are poor, but not poor enough to get Medicaid before Obamacare.  I think this is an outrageous screwing of these citizens by the States doing it because 100% of first 3 years cost to States of this increased coverage is paid by US government (then 90% after first 3 years).  In other words, this is free money to the States for 3 years.  So in States like Texas which have chosen through their GOP leaders to NOT accept this free money, the upper level of poor folks get nothing.....and the hospitals really get cheated as they must continue to provide free care to these people and get modest reimbursement from States (in other words, taxpayers pay anyway).  There is no logical or rational reason whatsoever for these States to not participate and this nonparticipation really hurts some of their citizens and all of their hospitals.  When I search for their reasons, I can only come up with one: intense GOP hatred for Obama.  Anybody out there have another reason, then please share it with us.

steve

Hi Steve:

Nice to hear from you from sunny Thailand.  You are right about Texas, I thought I had read where they had changed their minds regarding the Medicaid Expansion program.  Here is the site I had read thinkprogress.org/health/2013/08/21/2501321/rick-perry-obamacare-hypocrisy/     sigh  I feel so sorry for my brother who retired from Texas Christian University and is staying in Texas.  He is getting burned out trying to be active in the Democratic party in Ft. Worth.

I guess I don't need to say "Stay warm" on this 11 degree, snowy, blowy day in Evanston. 

We did have a lot of fun at the get together last night.  Hope you make it in June.

Hi again Trudi,

That article could easily mislead the reader, as Perry from Texas is indeed asking for Medicaid money under ACA (as discussed in that article).....but NOT Medicaid money for expanding Medicaid program under ACA.  So he is still screwing many of the poor in Texas and all the hospitals...while at the same time, asking for this money under ACA to assist some elderly in Texas, AND at the same time, talking about how horrible the ACA is.  There is a photo of Gov. Perry as an example just next to the word "hypocrite" in the dictionary.

steve

Hi Trudi,

The article below is on the point we have been discussing.  It appears in Wednesday's Huffington Post and can be found at http://www.huffingtonpost.com/2013/12/10/iowa-medicaid-expansion_n_4420424.html?utm_hp_ref=politics .  The article explains what a few ACA co-operating GOP governors are doing.....and therefore also highlights what Texas and most other GOP controlled States are not doing.  This explains it all better than I could.

Steve

***************************************************************

The U.S. Department of Health and Human Services gave Iowa Gov. Terry Branstad (R) the go-ahead Tuesday to expand Medicaid in his state under President Barack Obama's health care reform law.

Iowa is among the 25 states and the District of Columbia that, beginning in 2014, will open the low-income health care program to any resident who earns up to 133 percent of the federal poverty level, which is currently about $15,300 for a single person. Branstad is one of just 10 Republican governors who have supported the Medicaid expansion. The Washington Post first reported on the approval of Iowa's plan Tuesday.

Iowa had proposed to provide private health insurance coverage to newly eligible Medicaid beneficiaries, including enrolling some into plans available on the health insurance exchange created by the Affordable Care Act, and to charge them monthly premiums for their benefits. Federal authorities agreed only partly to this plan and will permit Iowa to demand premiums only from people with earnings over the poverty level. More than 100,000 additional uninsured, low-income Iowans will be eligible for Medicaid benefits, according to the Center on Budget and Policy Priorities.

“Iowa has pioneered innovative, state-based solutions for Medicaid expansion, and we are pleased to grant this waiver,” Marilyn Tavenner, administrator of the federal Centers for Medicare and Medicaid Services, said in a press release. "CMS stands ready to work with other states to explore options that aim to improve care and lower costs in the Medicaid program.”

The Iowa Department of Human Services referred The Huffington Post to Branstad's office, which wasn't immediately available to comment.

Most GOP governors and state legislators refused to expand Medicaid after the Supreme Court ruled last year that it was optional for states. More than 3 million poor people will remain uninsured in those states as a result, according to the consulting firm Avalere Health. The Urban Institute estimates those states also will forgo billions of dollars in federal funding. The Affordable Care Act provides tax credits to cut the cost of private health insurance for those who earn above the poverty level, but because of the high court's ruling, individuals with incomes below poverty won't qualify for any financial assistance in states that don't expand Medicaid.

Iowa will become the third state to adopt a partially privatized version of the Medicaid expansion, following a model used by Arkansas Gov. Mike Beebe (D) and GOP lawmakers in his state and Michigan Gov. Rick Snyder (R) and his majority-Republican state legislature. Pennsylvania Gov. Tom Corbett (R) and Tennessee Gov. Bill Haslam (R) are still negotiating with the Obama administration over their Medicaid reform and expansion plans.

The urgency of securing federal approval for Iowa's Medicaid plan was intensified by the need to preserve health coverage for tens of thousands of residents currently enrolled in a more limited program called IowaCare, which expires Dec. 31, the Des Moines Register reported. Those beneficiaries are supposed to transition to Medicaid next year.

The Affordable Care Act allows states to extend Medicaid with full federal funding for newly eligible individuals from 2014 to 2016, after which the share gradually diminishes to 90 percent in 2022 and beyond. For current Medicaid beneficiaries, the federal government pays an average 57 percent of the cost, with states paying the remainder.

Nearly 1.5 million people have been newly determined eligible for Medicaid or the Children's Health Insurance Program, a related benefit, since the beginning of the Obamacare enrollment period on Oct. 1, the Department of Health and Human Services reported last week.

Micheal Moore'sNYT  Op- Ed Piece speaks the forbidden truth:

The Obamacare We Deserve

By MICHAEL MOORE

O p- Ed Contributor

By MICHAEL MOO RE

Published: December 31, 2013

TODAY marks the beginning of health care coverage under the Affordable Care Act’s new insurance exchanges, for which two million Americans have signed up. Now that the individual mandate is officially here, let me begin with an admission: Obamacare is awful.

That is the dirty little secret many liberals have avoided saying out loud for fear of aiding the president’s enemies, at a time when the ideal of universal health care needed all the support it could get. Unfortunately, this meant that instead of blaming companies like Novartis, which charges leukemia patients $90,000 annually for the drug Gleevec, or health insurance chief executives like Stephen Hemsley of UnitedHealth Group, who made nearly $102 million in 2009, for the sky- high price of American health care, the president’s Democratic supporters bought into the myth that it was all those people going to get free colonoscopies and chemotherapy for the fun of it.

I believe Obamacare’s rocky start — clueless planning, a lousy website, insurance companies raising rates, and the president’s telling people they could keep their coverage when, in fact, not all could — is a result of one fatal flaw: The Affordable Care Act is a pro- insurance- industry plan implemented by a president who knew in his heart that a single- payer, Medicare- for- all model was the true way to go. When right- wing critics “expose” the fact that President Obama endorsed a single- payer system before 2004, they’re actually telling the truth.

What we now call Obamacare was conceived at the Heritage Foundation, a conservative think tank, and birthed in Massachusetts by Mitt Romney, then the governor. The president took Romneycare, a program designed to keep the private insurance industry intact, and just improved some of its provisions. In effect, the president was simply trying to put lipstick on the dog in the carrier on top of Mitt Romney’s car. And we knew it.by 2017, we will be funneling over $100 billion annually to private insurance companies. You can be sure they’ll use some of that to try to privatize Medicare.

For many people, the “affordable” part of the Affordable Care Act risks being a cruel joke. The cheapest plan available to a 60- year- old couple making $65,000 a year in Hartford, Conn., will cost $11,800 in annual premiums. And their deductible will be $12,600. If both become seriously ill, they might have to pay almost $25,000 in a single year. (Pre- Obamacare, they could have bought insurance that was cheaper but much worse, potentially with unlimited out- of- pocket costs.)

And yet — I would be remiss if I didn’t say this — Obamacare is a godsend. My friend Donna Smith, who was forced to move into her daughter’s spare room at age 52 because health problems bankrupted her and her husband, Larry, now has cancer again. As she undergoes treatment, at least she won’t be in terror of losing coverage and becoming uninsurable. Under Obamacare, her premium has been cut in half, to $456 per month.

Let’s not take a victory lap yet, but build on what there is to get what we deserve: universal quality health care.

Those who live in red states need the benefit of Medicaid expansion. It may have seemed like smart politics in the short term for Republican governors to grab the opportunity offered by the Supreme Court rulings that made Medicaid expansion optional for states, but it was long- term stupid: If those 20 states hold out, they will eventually lose an estimated total of $20 billion in federal funds per year — money that would be going to hospitals and treatment.

In blue states, let’s lobby for a public option on the insurance exchange — a health plan run by the state government, rather than a private insurer. In Massachusetts, State Senator James B. Eldridge is trying to pass a law that would set one up. Some counties in California are also trying it. Montana came up with another creative solution. Gov. Brian Schweitz er, a Democrat who just completed two terms, set up several health clinics to treat state workers, with no co- pays and no deductibles. The doctors there are salaried employees of the state of Montana; their only goal is their patients’ health. (If this sounds too much like big government to you, you might like to know that Google, Cisco and Pepsi do exactly the same.)

All eyes are on Vermont’s plan for a single- payer system, starting in 2017. If it flies, it will change everything, with many states sure to follow suit by setting up their own versions. That’s why corporate money will soon flood into Vermont to crush it. The legislators who’ll go to the mat for this will need all the support they can get: If you live east of the Mississippi, look up the bus schedule to Montpelier.

So let’s get started. Obamacare can’t be fixed by its namesake. It’s up to us to make it happen.

As a recent arrival to this discussion let me add my humble perspective:

My 30-something daughter was living and working two jobs in New York City, but neither provided insurance coverage and her meager budget just could not afford health insurance.  Until now.  Thanks to her accessing the Patient Protection and Affordable Care Act website (I proudly refer to it as "Obamacare") she has allowed me to sleep better at night.  The only freedom she gave up in the process was from the fear of catistrophic disease or accident, and anybody who has tried to control Anne's behavior knows that the Federal Guv'mint exerts absolutely none over her life (or mine) due to this action.

I know this is only anecdotal evidence but I'm pretty sure there are now over six million souls who are now also sleeping better.

Ron Zager