Obamacare gets started as government shuts down

By Bruce A. Smith

 Today is the first day to register for Obamacare, known to pundits and bureaucrats as the Affordable Care Act. This historic moment is occurring at the same time as the federal government shuts down over a budgetary dispute triggered by right-wing opposition to the national health care program.

 However, Obamacare, along with Social Security and other “safety net programs” like food stamps, are immune to the shutdown as they have received prior, non-negotiable funding.

 Hence, people are deluging Obamacare hotlines today to get health care coverage, and as of 1:30 pm this afternoon the computers crashed at Washington Healthcare Finders, the primary local clearing house for questions about Obamacare and the place to register for medical insurance.

 As a result of the jam-up, many public officials engaged in the enrollment process were happy to talk about Obamacare with inquisitive journalists.

 Lori Culver, the Executive Director of the Eatonville Family Agency who held a public information forum last week on Obamacare, gave the Mountain News a substantive overview of the program.

 Despite the political uproar, it seems that Obamacare will really impact only a handful of people. Most folks who have medical insurance will continue with their current health providers. Some details may change in terms of premiums, benefits and costs, but not critically.

 The big change is for Washington residents who do not have medical insurance or the money to buy any coverage. These citizens will now be enrolled in a state program called “Medicaid Expansion,” which is an enlarged version of the old Medicaid, which was basically Medicare for kids and the disabled.

 Essentially, Obamacare is Medicaid.

 However, the administration of Medicaid is being totally revamped to deliver a broader level of state assistance. 

 To begin, the Medicaid program is being moved from the Washington State Department of Social and Health Services (DSHS) and placed in another state agency, the Health Care Authority (HCA). This second agency is not wholly new, as it was the organization that managed the health care plans of state workers.

 In addition, the HCA has “re-branded” Medicaid and is calling its new program “Apple Health.”

 All states have this expanded Medicaid feature, and many are giving their programs a regional flavor.

 According to Jim Stevenson, an official at the HCA, Wisconsin is called their program “Badger Care,” and Georgia is naming their Medicaid expansion, “Peach Care.”

 As for Washington’s Apple Care, it will handle the distribution of medical benefits to about 1.5 million Washington residents.

 Stevenson told the Mountain News that about 1.2 million Washingtonians are presently enrolled on the DSHS Medicaid program, and two-thirds of this group are children, about 800,000 kids. Hence, about 400,000 adults are currently on Medicaid and will be automatically transferred to Apple Care, along with the young ‘uns.

 Stevenson said that an additional 328,000 new adults, aged 19-65, will be enrolled on Apple Care, as well. Essentially, this will be the new group of Washington citizens receiving Obamacare. Their medical benefits will parallel those currently available under the DSHS Medicaid program, and will be free to those who earn up to 138% of the federal poverty limit, which is about $15,000 per year in income for an individual or about $25,000 for a three-person family.

 Stevenson characterized Apple Care as medical coverage for the “poorest of the poor.” 

 People making more than these minimums will be eligible for insurance premium subsidies. Stevenson called this secondary group the “working poor” – folks who make too much money for a totally subsidized package of care.

 Stevenson also said that Washington currently has about 800,000-1,000,000 additional uninsured citizens. He said the HCA expects about half of this group to receive medical coverage through some expansion of medical insurance at work or via a tax credit subsidy.

 Actual medical benefits under Obamacare begin January 1, 2014, and Washingtonians can register for Apple Care and the other programs until March 31, 2014.

 For more information on Obamacare, or to register, call or contact:

 www.wahealthplanfinder.org

360.688.7700 or 1. 855. 923. 4633

Addendum, 10. 1. 13

The following information has been provided by Richard Smaby of the Pierce Progressive website.

http://www.thepierceprogressive.org/wastatehealthexchangeopen

109,000 Pierce County residents do not have health insurance. 54% of them are estimated to be eligible for the Medicaid expansion. 80% are eligible for tax credits to reduce their cost for health insurance. Those of the 109,000 not eligible for Medicaid need to buy insurance from private insurers. These are the same insurers as before, except they are more tightly regulated and purchasing through the exchange may provide a subsidy for the individual.

 
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30 Responses to Obamacare gets started as government shuts down

  1. Paula Morris says:

    Thanks for the info. Bruce.

  2. Thanks Bruce, I certainly don’t see anything here that would be dangerous enough to cause a government shutdown. It just looks like we’re finally taking a tiny step toward providing for people who can not afford medical care or who don’t qualify for insurance due to pre-existing conditions. This is long overdue! Once the dust settles on these changes I hope that improvements can be made.

    • brucesmith49 says:

      Yes – what’s the big uproar about? 300,000 folks getting Medicaid is not small potatoes, but shutting down the government?

      It is just another response from the right-wing which makes me believe that they are more interested in an ethnic cleansing of anyone who is poor and sick, especially those aged 19-64. To me, today feels like that day in April, 1861, when the Confederates opend fire on Fort Sumter. I truly believe that many right-wingers want guys like me dead, and instead of using bullets and cannon they are using a more disguised form of violence. The results are the same – death of those they don’t like.

      I think it is time for the Democrats to realize that the so-called Cultural War is about to have very real casualties – how many will die an untimely death or unnecessary pain if Obamacare is derailed, as the Republicans desire?

  3. And, which right wing person claimed that they wanted an ethic cleansing of anyone who is poor and sick???? And, which of you has actually read any of the several thousand page Obamacare bill???? And, why are all members of Congress, the president and Federal workers exempt?? And, why are large corporations (the large donors to the Pres. ) exempt?? And, why is the mandate postponed for a year for businesses???? And, why can’t it be postponed for the taxpaying public who are already seeing their insurance rates and co pays increase?? All the House proposed was that it be delayed one year so that it could be overhauled and understood, and refined so that the costs of implementing it could be contained. And, are you happy that the IRS is going to be the dispensers of this Obamacare? But, again, those who have kept up with what went on in Congress will wonder why the “right wing” offered 4 compromises to come to an agreement but Harry Reid and the president both staunchly proclaimed, over and over, that they would not negotiate.

    • brucesmith49 says:

      I see it in the eyes of the right wingers that I talk with, Claudia. It is a vacant stare that tells me they don’t care if I live or die, only that they want me gone from their lives. All of your argumentation is misleading and offensive. People will die if you get your way. What do you say to that, Claudia?

      • Josh Magill says:

        I disagree with this statement, Bruce. I don’t see how Claudia’s “argumentation is misleading and offensive.” I could say the same about your statement that right-wingers are “more interested in the ethnic cleansing of anyone who is poor and sick.”

  4. Shutter says:

    I think everyone can agree the Healthcare system needs repair. the Government sticking there noses in it will not help. nobody is denied. clinics all over the place. County Hospitals do not refuse anyone. I don’t like either side. so, I’m not a “right winger” I guess we should make everyone pay for car insurance even if they don’t own a car? I don’t agree with being penalized if you don’t want to pay for Heathcare. many companies do not have to provide Heathcare if they are a small company. if you make a certain amount you are forced to get it. lots of companies are cutting back hours due to this wonderful bill. more debt to follow with this for sure. there has to be a better way.

    Ronald Regan warned of this in the 60’s. IF this is true.what he says.we are in big trouble.

    • brucesmith49 says:

      I find your questioning hollow, Shutter. What’s your plan for helping sick, poor people? What advantage is gained by pondering if everyone should be taxed for car insurance? Is that really a useful thought to focus on? It seems worse than a waste of time, but is actually a cerebral ploy to distract folks from taking action to help people in need.

      • Shutter says:

        I didn’t realize it was my problem? I don’t mind helping folks. you are forcing me too! help people in need you say? look around. the supermarket asks for money when you check out. walk outside the mall someone is asking for money. people at every intersection asking for money etc. I help people when I can. if I make 60 grand a year and still float just above water, I can’t afford another bill,but, you will penalize me in my taxes for it? do I move from where I live so the poor & sick guy can survive? it’s already hitting the workforce. they are cutting back hours to avoid this bill. who is helping them?

        So, basically you are stating that people who meet the requirements for insurance even though they can’t really afford it should be penalized in order to help the poor & the sick?
        where do you draw the line. why doesn’t this also involve the very same people who thought up this wonderful idea? they seem to have a choice, no? the main problem I am seeing is the fact of people not understanding what is in the bill, the Senate & large corporations exempted from it seem to know exactly how it works! seems to me they are already stating it’s not going to work for them, but you think it will work for the rest of us?

      • Josh Magill says:

        Again, I disagree. Shutter’s points are not hollow. They have merit. It has been shown that the ACA will only work if the “young and healthy” are part of the insurance system because the insurance companies need that money to pay for the many healthcare issues of the “sick and aging.” So the money paid in by the “young and healthy” will be what pays for the medical of the “sick and aging.”

      • brucesmith49 says:

        Hi Josh,

        Regarding Claudia and Shutter’s comments, let me say this in general.

        One, I don’t feel any compassion in any of their commentaries. Rather, what I feel is a dismissible of my needs and those of other poor, sick Americans. As a result, the comments feel hollow and offensive.

        As for misleading, where in Claudia’s argumentation does she provide a ray of hope for anyone in medical difficulty? I see none whatsoever. If anything there is a chastisement to suck it up, quit whining and stop being a “taker.” Or not, and the inference is, but not said, please die and stop costing me money.

        Both Claudia and Shutter wrote me long, impassioned private emails to further their rants, and Claudia has provided me with many lengthy missives over the years to know her arguments well. Nevertheless, one thing she fails to point out is that she once told me that her personal income is eight million a year.

        Nevertheless, I respect their anger and I do not tolerate fraud or abuse, nor condone irresponsible behavior on the part of people receiving governmental services. Further, everyone receiving assistance should take steps to prove their active commitment to health by praying, meditating, eating nutritious foods, and developing healthy attitudes and dealing with toxic ones.

        So, the Bottom Line as I see it is: why are so many people so angry about Obamacare? It’s gotta be more than just money.

        What do you think?

      • Josh Magill says:

        Bruce, you read too much into things by saying there is an inference of “please die and stop costing me money.” The “please die” part is BS and just your way if sensationalizing it. I do agree that they want other people to stop costing them money. Why should I pay for anyone’s healthcare but mine and my family members? I shouldn’t be forced to pay more because we are all being forced to have coverage and some can’t pay for … Hence I pay mor in premiums and taxes to cover it. The ones that can’t afford it get a break. (I know! … You won’t call it a break, but it looks that way when I have to pay for someone else. You are right, it isn’t only about money. That is just part of it. It is about fairness. You say it is only fair that the young and healthy help pay for the elderly and sick. Not everyone sees that as fair because so far the elderly haven’t left me with much other than a crappy congress on both sides, a lot of national debt, some dumb people in their teens and 20’s because education went downhill, and not much respect for the baby-boomer generation.

        Regarding Claudia’s income … Who cares??? What does that have to do with this? You feel because she may (or may not) make that she has to give it up to help others? That would be her decision, not yours or anybody in government.

        That is the other issue with this besides money. It is about having something forced on you and taking the decision making away from everyone. Last time I looked it was my decision what to do with my money.

        Your argument that people want you, or others that may be sick or old to die so that the young and healthy can move on doesn’t fly. It has one BIG hole in it … There will ALWAYS be sick and elderly. That is a fact. Soon I will be the old and possibly sick one … It will then be my responsibility to figure out how to live with it and make my life better, but it won’t be on the backs of others younger and healthier than me.

      • brucesmith49 says:

        Greetings Josh,

        Your commentary is the essential argument – what responsibility do you have to take care of me, and by extension, what responsibility do I have to help take care of you and your family?

        Your commentary suggests very little responsibility, if any. What I hear you say is: take care of yourself and I’ll take care of myself.

        It’s a reasonable notion. However, the rub comes in when one of us can’t take care of ourselves; then what?

        The Republicans have been floating the concept of taking care of the “most vulnerable” as they advocate cutting benefits. When I asked local Republican candidates and office-holders who the most vulnerable are, they squirmed. The blind? How blind? Zero vision, 20-100, 20-500? Only those with wet macular degeneration but not dry macular degeneration? Who makes the determination? What do you say to an 89 year-old woman with dry MD who still can’t read her mail such as my mother, and needs a neighbor to come over and read the bills, etc. Yet she lives alone and can take care of herself otherwise. Is she a “most vulnerable?”

        Most notably, where does a 64 year-old journalist with a cardiac history and no money or medical insurance, but nevertheless grappling with a major depression, vertigo and a funky auto-immune disorder that periodically wrecks havoc with my gastro-intestinal system – fit on the scale of public assistance. Tough luck, Chuck? If so, then what happened to all the FICA and Medicare taxes that I paid for 40 years? Don’t I get any help?

        As a journalist I was only afraid for my life three times. Once with a bunch of thugs involved with a dog-fighting ring in Graham. The other two were women in the same place at the same time – a hotel in downtown Tacoma where local Republicans had gathered to hear the vice-presidential debate in 2008 when Sarah Palin faced off against Joe Biden. When I entered the hotel one of the woman who was helping organize folks coming into the building saw my press pass and went ballistic. She appeared so out of control that I thought she was just going to flail into me until she dis-membered me. So I know when people hate me and want me dead.

        Remember, I grew up in a right-wing household in a very right-wing town. I have heard right-wing commentaries all my life. Believe me, I truly know when people want me dead, and there are plenty of people that do. Don’t believe me? Well, what can I say?

        But some know what I’m talking about. Matt Hamilton, the chair of the 2nd LD Repubs and now a candidate for the House of Representatives in WA, once remarked when I walked into a Repub meeting, “So, Bruce, you’re still alive, eh?” He appeared genuinely surprised and pleased.

        I think that denying health care to someone is, in effect, a death sentence. How do you get around it? Calling it “sensationalism,” misses the mark. Dead is dead. I’m just asking right-wingers to be honest about the impact of their actions. I want them to accept responsibility for their actions.

        For those who want me dead, I understand and will make all the adjustments I can. I just want you not to lie about it, and until right-wingers do admit the truth of their actions I will be holding their feet to the fire. Sensational? Yeah, so is killing people in a veiled, sanctioned manner.

        Bruce

      • theauthors says:

        As part of the silent majority I have been reading this commentary and telling myself that I really don’t have time to jump in and get involved. I’m finally getting to the point where my conscience won’t allow me to stay silent. I can totally understand why Bruce feels the way he does and it just makes me feel sick.
        First let me say that I am one of the lucky ones. My husband and I have managed to achieve the American dream in our lifetime. If things continue to go the way they are now, my generation is probably the last to be able to achieve this. Conditions in this country are making it impossible for young people to do what we have done.
        We are definitely not rich by any measurement, but my husband and I have managed to work our way from a near poverty level to a middle class status and now have a comfortable retirement. We have very good medical coverage. We are on Medicare and have Tricare as a secondary due to Ron’s retirement from the Air Force Reserves. Both of our insurances are government run and our only complaint is that not all doctors want to deal with it so our selection of doctors is somewhat limited. I have high hopes that once the Affordable Care Act is in place and the kinks are worked out, this issue will also go away.
        Last year I had to visit a local emergency room due to a heart condition. I felt very fortunate to not have to worry about how I was going to pay for the excellent care I received. It is true that hospitals do not turn away the very ill poor, but I can’t help but wonder if they would get the same level of care that I did. I also know that treating people who can’t afford to pay for their healthcare is one of the reasons for the high cost of medical care in this country. The Affordable Care Act will also do away with that issue also.
        It is true that the Affordable Care Act is too complicated and has lots of issues. That is due, at least in part, to concessions made along the way to get the bill passed. It is the product of lots of extensive compromise and debate. Getting it passed was a major hurdle, and getting it approved by the supreme court as a law should have been the last hurdle. Yet congress has spent so much time trying to fight it they haven’t done much else.
        This stunt of tying the defunding of Obamacare to passing the budget and shutting down the government is unconscionable. I see in the news that this stunt is risking the lives of some of the very ill that are having to put off unapproved treatments because of the shutdown. I am always researching new treatments for Chronic Lymphocytic Leukemia due to the fact that my husband has it. I am seeing lots of progress lately, with people’s lives being saved by these trial treatments. I have taken great comfort in the fact that we could take advantage of these trials should he take a turn for the worse before they get approved.
        You can try to answer that the republicans are now trying to pass some piecemeal measures to restore some of these vital services to try to make it not so visible that they really don’t care about human life, but the President and Congressmen who are trying to do the right thing have been put in an impossible situation. Tying the passage of a budget to the defunding of a law that has been passed, challenged, compromised, and re-approved so many times and stomping on the hopes of so many does amount to extortion. If we give in to extortion and kill this law, we are setting such a dangerous precedent that it could kill our democratic process for the silent majority. I would like to appeal to the silent majority to come out of their silence and let their feelings be known. That is probably the only way to stop this travesty.
        I have always had a high regard for the American people and our way of life and I still feel that the majority of the people who are trying so hard to stop this law are just not looking at the whole picture. I am still feeling that the majority are not so hard hearted that they would purposely kill even one person to get their way on this.
        Congress needs to pass a clean bill and get things moving again. The states have been given a lot of latitude to clean up the bill, and I trust the state of Washington to do this. It will take some time, but it is doable. And as it stands, it is a major improvement to the status quo. Congress needs to get back to running our government as they were elected to do.
        We have made lots of progress in coming out of our recession it the past few years. Let’s not allow this progress to be lost. The silent majority needs to ban together and get vocal this time. I, for one, will be trying to do my part.

      • brucesmith49 says:

        Thanks for your substantive reply, Pat.

        B

      • Josh Magill says:

        Bruce, I call “bull” again. I don’t have a problem with the government saying that insurance companies can’t deny you or anyone insurance. (Which is your argument.) But I don’t believe anyone should be forced to have insurance and penalized if they don’t get it. Forcing me to do something that doesn’t negatively impact anyone else isn’t right. (Which is my argument.)

        Dead is dead. That is fact, but saying you know people want you dead because you are old or sick when they didn’t say that to you is sensationalism. You used an example of knowing someone wanted you dead after seeing your press pass … That could be because you are the media she didn’t like, or because you are a man, or for many reasons , but seeing your press pass and going ballistic doesn’t equate to wanting you dead for being old or sick. Use an example that fits the topic. Also, maybe the politician made his remark because you have on occasion ticked people off through your reporting. (Remember You have told me some of that before.) So he may have been referring to that, not because you were wanted dead because of sick or old. Again, stick to the point here.

        I’ll will always support your right to be allowed health care and hope you would support my right not to be forced to pay for insurance if I don’t want to.

      • brucesmith49 says:

        Okay.

        If Obamacare is derailed, how many people will die in 2014 that otherwise would probably be alive to celebrate the arrival of 2015?

        Dead is dead, whether by cannon fire or budget cuts.

        That’s my point. If you don’t believe me when I tell you I know what’s in the heart of my adversaries, okay, don’t believe me. But I assure you I know exactly who right-wingers and tea partiers are talking about when they talk about “losers” and “takers” and the 47% of folks who don’t pay income taxes. It’s me, dude.

        Bottom Line: tell me the projected body count on January 1, 2015, and tell me who is responsible.

        As for not wanting to pay for medical insurance, okay, don’t pay it. Don’t want to pay the penalty? Okay, don’t pay it. But then you have to accept your share of the responsibility for other people’s premiums going up or benefits going down. I disagree with your argument that your non-payment will not negatively impact anyone else. I think that is simply incorrect. Our actions always have an impact on other people, especially in Obamacare. The Big Question is whether you will take responsibility for those impacts.

        Further, it is my observation that most right-wingers don’t acknowledge their contribution to the death and suffering of others. They obfuscate their objection to Obamacare with intellectual argumentation. That tells me that they fundamentally agree with the impacts and accept the deaths of others.

        Bruce

      • Josh Magill says:

        Bruce, premiums are going up because of ObamaCare. I have insurance and people that have insurance like me are getting letters telling us our insurance is going up because of Obamacare. You can try to guilt me with the sensationalism of a “death toll” or “body count” in 2014 or 2015, but it won’t work. I’m not a right-winger, a republican or a democrat. I’m not completely for or against this law. It works and sucks at the same time.

      • brucesmith49 says:

        Please tell us more about the reality of Obamacare.

      • Josh Magill says:

        Read the actual law, then I challenge you to do an unbiased article on how it is already affecting those with insurance. Look at the other side. Some families premiums are being doubled and are not eligible for discounts from the government. Some families are now being asked to pay more in insurance premiums per month than they pay for their rent or mortgage. Ask those questions of politicians and insurance companies.

      • brucesmith49 says:

        Okay, give me some names. I’m happy to dig more deeply into the story.

        B

      • Josh Magill says:

        You don’t need names from me. Call any insurance company, any politician, anybody with private insurance.

      • theauthors says:

        Yes, please tell us more Josh. I have been paying insurance premiums for my son’s health insurance because he has a very physical job and doesn’t make a lot of money. We have not received notice that the rates are changing. I checked on the government site a couple of weeks ago and we can get him equivalent care for $160.00 a month less than we are paying for him now. If there is a group that is in an income bracket that will be penalized, there needs to be some changes made quickly. But we still need to pass the budget and get the country going again so we can start addressing the issues. At least the state has leeway to make changes. I wouldn’t trust the federal government to do anything. We need to separate the issues with Obama Care from the budget or we aren’t going to solve either issue.

      • theauthors says:

        Josh,
        I have a problem with people who say they are being penalized by being required to pay what they can afford for health insurance. The majority of the people in this country have been paying their share for years. The only problem is that, people who have not been paying their share have been the ones penalized. The fact that people without insurance or without the means to pay for health care will be treated for life threatening injuries after an accident whether they can pay for it or not. We have never said these people should be allowed to die because they can’t pay and I would never agree to that decision. However, this practice is one of the reasons why the cost of health insurance in this country is so exorbitant. As long as people are only being required to pay what they can afford, I don’t see it as a penalty. I see it as a reduction in the penalty being paid by myself and others who have been trying to do their fair share all along.

      • Josh Magill says:

        I never said “being penalized by being required to pay.” I wasn’t being metaphoric. If you actually know about the new law then you know there is actually a a real penalty fee for not having insurance. There is no choice to have insurance … If you don’t get insurance then the government charges you a penalty fee at the end of the year.

  5. Bobbi Allison says:

    Well done!

  6. smokin says:

    Not getting into the politics – I see both sides because I’ve been on both sides.
    I could tell you stories about government encroachment into healthcare that would tick you off. On the other hand, I could tell you stories about why healthcare costs so much –and it’s not just about insurance. And it’s not just about the big bad medical complex or mean politicians that want little children to die. Believe it or not, in GA, yeah there is an income criteria to qualify for Medicaid, but a lot of people that could get it don’t apply. Now maybe that’s because they don’t know, but people in my region of GA that are admitted to a hospital without insurance or means to pay are automatically forwarded to discharge planners or agencies that check for and help them apply for Medicaid if eligible.
    And yes, on the third hand, (we aliens have 3 hands) I can tell you stories about pre-existing conditions, COBRA, and the devil that is insurance.

    Just saying – in this whole healthcare debate – maybe there are some gremlins and bad players, but overall there are just a whole lot of layers, a whole lot of things – complex and not – soem things that no one wants to talk about that makes healthcare so high and there are no easy answers. Anyone that thinks that the affordable healthcare act is going to “fix” healthcare and provide endless, high tech, unsurpassed, yet cheaper medical care for all is spending way too much time with the bong. But all that’s jmo and for another day.

    For now – just need to make two corrections – Peach Care has been the name of Ga’s Medicaid for kids for years – it is not part of the Medicaid expansion because I’m pretty sure Georgia is one of the states that opted out of the Medicaid expansion.

    As for the insurance exchanges – if they ever get up and running and you go that route – I would just encourage everyone to read the fine print. Lower premiums generally mean high deductibles….this means that upwards of 3000 – 5000 and more coming out of your pocket before insurance kicks in. Just spend some time and look at the whole package – deductibles, what it covers, etc. and know what you’re getting so no nasty surprises down the road. 🙂

    • brucesmith49 says:

      Thanks for the clarification on a few points. Yes, I was surprised when the fella from the HCA told me that Georgia had a Medicaid Expansion program when I thought y’all had opted out. Not sure what it means to “opt out,” for where do those people go?

      Tell us more Smoke- the good, the bad, and the ugly about healthcare. You’ve seen both sides – so tell us all!

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