Heeeeeeere's Obamacare!

Can someone concisely explain the perceived benefit of having this mix of federal mandates and state exchanges?

It would seem obvious that if companies could compete for a national customer base, there would be economies of scale and increased competition, and this state-to-state disparity (which seems unfair) would go away.

What am I missing?

States demanding the right to have substantive legislative and regulatory control over the insurance industry and medical industry within their own states.
 
Can someone concisely explain the perceived benefit of having this mix of federal mandates and state exchanges?

It would seem obvious that if companies could compete for a national customer base, there would be economies of scale and increased competition, and this state-to-state disparity (which seems unfair) would go away.

What am I missing?

This was a key feature of the Heritage plan. Republicans insisted that any insurance exchanges be state run (which is ironic considering that all the red states subsequently refused to set them up, leaving them in the hands of the feds). I agree with you that federally run exchanges with uniform rates across the country would be better. Incidentally, this is a great argument in favor of single payer. It's a fact that larger pools drive down costs, and universal pools that include everyone drives them down further. On top of this, a single payer can negotiate rates with hospitals and doctors as well. Consider the issue of doctors being "in network". If everyone was on one single plan, ALL doctors would be in network. Imagine how much cheaper our health care would be in that case?

I think the next step is to phase out deductibles. The theory was that by making people have "skin in the game" it'd lower health care costs. This hasn't worked. And now, even people with insurance have trouble paying for routine costs and in fact defer care until it's very serious. If we phase out deductibles and adjust premiums accordingly, people will go when they get sick. From there it's a short leap to either increase subsidies for people like you, or exert more price controls on insurers and hospitals, or cut out the middlemen and go single payer.

I've been saying for a few years that the first step was getting people used to universal coverage. Once people all expect to be covered, we'll start arguing over how to best pay for it. The answer? Three words: "Medicare for all".
 
Can someone concisely explain the perceived benefit of having this mix of federal mandates and state exchanges?

It would seem obvious that if companies could compete for a national customer base, there would be economies of scale and increased competition, and this state-to-state disparity (which seems unfair) would go away.

What am I missing?
Political power grabs, insurance boards to pack with high-paying jobs for friends and cronies, regulatory agencies to do the same, and much higher prices for consumers as insurance companies and health care providers have to hire teams of people to navigate the byzantine laws for every state they do business in.
 
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CNN says 1.1 million.

I wonder how many lost coverage? And even if that is a net figure it still leaves over 30 million Americans with no coverage at all, isn't that the problem this was supposed to solve?

That's just the federal exchange. The state exchanges are about a million as well.
 
That's just the federal exchange. The state exchanges are about a million as well.

Not only that, but it takes brass balls to complain the law isn't covering enough people when states like Texas are deliberately leaving one million people without coverage.

On purpose.

Sometimes I think conservatives are the worst people on earth.
 
I don't think he's crying. He's expressing an opinion based on the actions of conservatives.

Do you think Texas conservatives are doing a good thing by not allowing 1 million people to get health care coverage?

On the contrary, apparently they think Texas' coverage is entirely too generous.
 
CNN says 1.1 million.



I wonder how many lost coverage? And even if that is a net figure it still leaves over 30 million Americans with no coverage at all, isn't that the problem this was supposed to solve?


The 1.1 million is through the federal website. Obamacaresignups.net takes into account all the state exchanges as well.
 
CNN says 1.1 million.



I wonder how many lost coverage? And even if that is a net figure it still leaves over 30 million Americans with no coverage at all, isn't that the problem this was supposed to solve?


You do realize that people can continue to sign up for coverage past the first deadline, right? :rolleyes:

Speaking if which, did you ever get signed up?
 
You do realize that people can continue to sign up for coverage past the first deadline, right? :rolleyes:

Speaking if which, did you ever get signed up?
Nope, I chose not to. I'm just below the Medicaid threshold, it was a bad year. I'm worried that if next year is better (and I certainly hope it is) I'll get hit with a huge bill for Medicaid I can't afford to pay. This whole thing is not designed for those of us with wildly inconsistent incomes from year to year.
 
That was the number given yesterday on Meet The Press.

And Nightly News said that was "total enrollment".


They're wrong; my guess is they're confusing total enrollment with enrollment via the federal website. Total private plan enrollment is about 2 million. If you want to see the full state-by-state breakdown, go to Obamacaresignups.net
 

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