President Obama has done more to help the poor and middle class than any President since LBJ

[ProSense]

160. You appear

In the words of Indigo Montoyo,"I do not think it means what you think it means" when you use the word "fact".

It is not a "fact" that the ACA was "real reform". It is your "opinion". It is my "opinion" that not only is the ACA not "real reform", but the ACA is 180 degrees from "real reform" since it permanently institutionalizes what I believe is the rot at the core of our health care system -- private insurance companies and the profit motive.

The only "fact" consists of the fact that Omaha pursued and ultimately signed the ACA which is not primarily a health care bill but an insurance bill. He did not pursue single payer and ultimately did not even get the health care bill he campaigned on which was NO MANDATE and public option. This might have led to single payer federal insurance.

As a fact, the ACA does not expand life-saving care, it mandates that US citizens buy private insurance. Whether that insurance gives more life saving care than emergency rooms remains to be seen. It does make sure that hospitals get paid.

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...to be confusing your opinion with fact. (emphasis added above) Dismissing facts and asserting that your opinion is fact doesn't make it so.

Fact: DNC Speaker Stacy Lihn: Obamacare ‘Is Saving My Daughter’s Life’
http://www.democraticunderground.com/101754938

Fact: Here’s one way Obamacare changed today
http://www.democraticunderground.com/1251288922

Fact: Rules finalized for the good stuff in Obamacare
http://www.democraticunderground.com/10022415967

Facts:

Who Benefits from the ACA Medicaid Expansion?

A key element of the Affordable Care Act (ACA) is the expansion of Medicaid to nearly all individuals with incomes up to 138 percent of the federal poverty level (FPL) ($15,415 for an individual; $26,344 for a family of three in 2012) in 2014. Medicaid currently provides health coverage for over 60 million individuals, including 1 in 4 children, but low parent eligibility levels and restrictions in eligibility for other adults mean that many low income individuals remain uninsured. The ACA expands coverage by setting a national Medicaid eligibility floor for nearly all groups. By 2016, Medicaid, along with the Children’s Health Insurance Program (CHIP), will cover an additional 17 million individuals, mostly low-income adults, leading to a significant reduction in the number of uninsured people.

Medicaid does not cover many low-income adults today. To qualify for Medicaid prior to health reform, individuals had to meet financial eligibility criteria and belong to one of the following specific groups: children, parents, pregnant women, people with severe disability, and seniors. Non-disabled adults without dependent children were generally excluded from Medicaid unless the state obtained a waiver to cover them. The federal government sets minimum eligibility levels for each category, which are up to 133% FPL for pregnant women and children but are much lower for parents (under 50% FPL in most states). States have the option to expand coverage to higher incomes, but Medicaid eligibility levels for adults remain very limited (Figure 1). Seventeen states limit Medicaid coverage to parents earning less than 50 percent of poverty ($9,545 for a family of 3), and only eight states provide full Medicaid coverage to other low-income adults. State-by state Medicaid eligibility levels for parents and other adults are available here.



The ACA expands Medicaid to a national floor of 138% of poverty ($15,415 for an individual; $26,344 for a family of three). The threshold is 133% FPL, but 5% of an individual’s income is disregarded, effectively raising the limit to 138% FPL. The expansion of coverage will make many low-income adults newly eligible for Medicaid and reduce the current variation in eligibility levels across states. To preserve the current base of coverage, states must also maintain minimum eligibility levels in place as of March 2010, when the law was signed. This requirement remains in effect until 2014 for adults and 2019 for children. Under the ACA, states also have the option to expand coverage early to low-income adults prior to 2014. To date, eight states (CA, CT, CO, DC, MN, MO, NJ and WA) have taken up this option to extend Medicaid to adults. Nearly all of these states previously provided solely state- or county-funded coverage to some low-income adults. By moving these adults to Medicaid and obtaining federal financing, these states were able to maintain and, in some cases, expand coverage. Together these early expansions covered over half a million adults as of April 2012.

Eligibility requirements for the elderly and persons with disabilities do not change under reform although some individuals with disabilities may become newly eligible under the adult expansion. Lawfully residing immigrants will be eligible for the Medicaid expansion, although many will continue to be subject to a five-year waiting period before they may enroll in coverage. States have the option to eliminate this five-year waiting period for children and pregnant women but not for other adults. Undocumented immigrants will remain ineligible for Medicaid.

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http://www.kff.org/medicaid/quicktake_aca_medicaid.cfm

Long before this Supreme Court decision, through the Affordable Care Act, seniors began to see positive changes in their prescription drug costs, access to preventive health care, and more. Thanks to the Supreme Court’s decision the following provisions will continue to be provided to seniors:

Medicare Improvements

The ACA contains several important improvements to the Medicare program, many of which are already helping seniors today.

1) Closing the donut hole

a. Medicare Part D covers the cost of medications up to a certain point. Between that point, and a catastrophic coverage threshold, the older adult must pay out of pocket for medication (this gap in coverage is often called the Part D “donut hole”). One in four beneficiaries fall in this gap, and end up paying an average of $3,610 out of pocket on drug expenses.

b. The ACA requires drug manufacturers to reduce prices for Medicare enrollees in the donut hole. Beginning in 2011, brand‐name drug manufacturers must provide a 50% discount on brand‐name and biologic drugs for Part D enrollees in the donut hole. By 2013, Medicare will begin to provide an additional discount on brand‐name and biologic drugs for enrollees in the donut hole. By 2020, Part D enrollees will be responsible for only 25% of donut hole drug costs.

c. This is a benefit seniors are getting now, and will continue to get as a result of this decision.

2) Improving senior’s access to preventive medical services

a. Prior to the ACA, Medicare beneficiaries were required to pay a deductible and 20% copay for many preventive health services.

b. The ACA eliminated cost‐sharing for many preventive services and introduced an annual wellness visit for beneficiaries.

c. The ACA also eliminated cost‐sharing for screening services, like mammograms, Pap smears, bone mass measurements, depression screening, diabetes screening, HIV screening and obesity screenings.

d. This is a benefit seniors are getting now, and will continue to get as a result of this decision.

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http://www.ncpssm.org/Portals/0/pdf/aca-analysis.pdf

MEDICARE’S FINANCIAL CONDITION

Medicare’s financial condition is measured in several ways, including the solvency of the Part A Trust Fund, the annual growth in spending, and growth in spending on a per capita basis. Average annual growth in total Medicare spending is projected to be 6.6% between 2010 and 2019, but 3.5% on a per capita basis (assuming no reduction in physician fees).

The Part A Trust Fund is projected to be depleted in 2024— eight years longer than in the absence of the health reform law—at which point Medicare would not have sufficient funds to pay full benefits, even though revenue flows into the Trust Fund each year. Part A Trust Fund solvency is affected by growth in the economy, which directly affects revenue from payroll tax contributions, and by demographic trends: an increasing number of beneficiaries, especially between 2010 and 2030 when the baby boom generation reaches Medicare eligibility age, and a declining ratio of workers per beneficiary making payroll contributions (Figure 4).

http://www.kff.org/medicare/upload/7305-06.pdf

You: "Last, I hope you are joking if you think a future single payer system would be Obama's legacy. Obama's legacy is the ACA. If sometime in the future, politicians and the Country decide to replace the ACA with a single payer system it will be those future people's legacies. Pointing out that one state has rejected the ACA approach and will implement a single payer system is not Obama's doing. His system and legacy is a system of mandated private insurance."

You found the fact that Vermont's single payer system will be federally funded through the ACA to be a joke?

Vermont also intends to be the first state in the U.S. with a single-payer health-care system, in which the government pays all of its residents’ medical bills and insurance companies are unnecessary. The state legislature passed a law in 2011 to steer the state toward adopting such a system in 2017, the soonest possible under the federal health-care law.

http://www.bloomberg.com/news/2013-04-01/vermont-s-first-look-at-insurance-exchange-rates-shows-savings.html

In her study, Grubb points out that Vermont created the Green Mountain Care Board to slow the rising cost of health care. She says administrators have worked to reduce redundancy and improve transparency, while developing a state-exchange that will be 100 percent federally funded.

http://www.vpr.net/news_detail/98021/study-states-learn-from-vermonts-health-care-refor/

Still, you're right that ACA will be President Obama's legacy.

Why Republicans are So Intent on Killing Health Care Reform

by Richard Kirsch

It’s not just about expanded care. It’s about proving our government can be a force for the common good.

Why are John Boehner, Eric Cantor and Mitch McConnell so intent on stopping health care reform from ever taking hold? For the same reason that Republicans and the corporate Right spent more than $200 million in the last year to demonize health care in swing Congressional districts. It wasn’t just about trying to stop the bill from becoming law or taking over Congress. It is because health reform, if it takes hold, will create a bond between the American people and government, just as Social Security and Medicare have done. Democrats, and all those who believe that government has a positive place in our lives, should remember how much is at stake as Republicans and corporate elites try to use their electoral victory to dismantle the new health care law.

My enjoyment of the MLB playoffs last month was interrupted by ads run by Karl Rove’s Crossroads front group against upstate New York Rep. Scott Murphy, who was defeated last Tuesday. Rove’s ads rained accusations on Murphy, including the charge of a “government takeover of health care.” Some might have thought that once the public option was removed from the health care legislation, Republicans couldn’t make that charge. But it was never tied to the public option or any other specific reform. Republicans and their allies, following the advice of message guru Frank Luntz, were going to call whatever Democrats proposed a government takeover.

There’s nothing new here. Throughout American history, health care reform has been attacked as socialist. An editorial published in the Journal of the American Medical Association in December 1932, just after FDR’s election, claimed that proposals for compulsory insurance “were socialism and communism — inciting to revolution.” The PR firm that the American Medical Association hired to fight Truman’s push for national health insurance succeeded in popularizing a completely concocted quote that it attributed to Vladimir Lenin: “Socialized medicine is the keystone to the arch of the Socialist State.”

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President Obama and Democrats in Congress understood the historical importance and profound moral underpinnings of the new health care law when they enacted it earlier this year. And they knew that the right-wing attack had soured the public in swing Congressional districts and states on reform. They stood up then. They will have to stand up again, understanding that if they give way to Republicans, they lose more than the expansion of health coverage. They lose the best opportunity in half a century to prove to Americans that government can be a force for the common good.

http://www.nextnewdeal.net/why-republicans-are-so-intent-killing-health-care-reform