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Heeeeeeere's Obamacare!

KoihimeNakamura said:
Pretty sure HHS has the ability to delay or alter ACA regulations.
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The HHS does not have the statutory authority to delay the employer mandate. Nor does the IRS have the authority to demand corporations certify that they are not laying off any employees because of Obamacare.
 
plague311 said:
I didn't know there was a bidding process when it came to heart surgery, then again I've never needed it. My whole point being is the story that was cited contradicted itself and is basically just another example of how the big bad Obamacare is messing up our entire country, we're all going to die, CHICKEN LITTLE!!!!

The hospital is playing favorite, and it has every right to do so. However, the fact that the hospital are being ******** doesn't reflect on the law, it reflects on the hospital.
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The article was not another "basically just another example of how the big bad Obamacare is messing up our entire country, we're all going to die, CHICKEN LITTLE!!!!". It was simply an information piece to let people know Stony Brook University Hospital was not going to accept insurance from the ACA. It also let people know which other hospitals accepted which ACA insurances. Newsday is not a bash Obama or ACA type of paper.

The hospital also was not just playing favorites. Most sources agree hospitals lose or make little money on medicaid and have too watch what their mix patients are. The rates the ACA say they will pay are skewing that mix.
This is a complicated question especially for a non profit hospital owned buy a State University.

Top 5 Reasons Hospitals Are Losing Money
Hospitals should examine the mix of patients who utilize their facility. If the majority of a hospitals patients are Medicare/Medicaid patients then it is more likely for them to be suffering financially.
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Drop in Private Insurance Hurting Hospitals
Even a 1 percent shift in revenue from more-profitable private-pay sources to Medicaid can have significant consequences for a hospital or health system.
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Most hospitals lose money on every Medicaid patient they treat. On average, Ohio hospitals are reimbursed only 82 percent of what they spend on Medicaid patients (down from 95 percent in 2004).
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If the mix of patients shifts even slightly to fewer private insurance billings, revenue for a hospital system can take a beating.
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eeyore1954 said:
The article was not another "basically just another example of how the big bad Obamacare is messing up our entire country, we're all going to die, CHICKEN LITTLE!!!!". It was simply an information piece to let people know Stony Brook University Hospital was not going to accept insurance from the ACA. It also let people know which other hospitals accepted which ACA insurances. Newsday is not a bash Obama or ACA type of paper.
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The problem is that the hospital contradicts itself and is blatantly bias against Obamacare. I don't care what newsday is or it's reputation as I am not refuting the article or it's accuracy. I apologize if for some reason I was unclear. Also, there is no "accepting insurance from the ACA." The "ACA" isn't providing health insurance, the companies that are on the exchange are providing the insurance. See what I'm saying? We can split hairs if need be, but those are the facts. The hospital says they receive compensation that is "below Medicare and approaching Medicaid." However, they still take BOTH of those, yet they are making the decision to deny the insurance that the patients get off of the ACA. I am not sure which part of this is confusing, but it speaks for itself. The hospital is the party saying this and I took it from your own article.

eeyore1954 said:
The hospital also was not just playing favorites. Most sources agree hospitals lose or make little money on medicaid and have too watch what their mix patients are. The rates the ACA say they will pay are skewing that mix.
This is a complicated question especially for a non profit hospital owned buy a State University.
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A hospital that despite being not-for-profit still brought in multiple millions of dollars in revenue and profit. If they are losing money on Medicaid, why are they still taking it? They have the opportunity to stop taking medicaid, but they don't, why? So I am fine with saying that you aren't wrong, but something isn't adding up here.
 
plague311 said:
The problem is that the hospital contradicts itself and is blatantly bias against Obamacare.
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No it's not. The State runs the hospital. The State pays for about half of Medicaid. By charging Medicaid patients less than what they actually cost, and requiring other patients to pay more than cost, the State saves money.
 
Newtons Bit said:
No it's not. The State runs the hospital. The State pays for about half of Medicaid. By charging Medicaid patients less than what they actually cost, and requiring other patients to pay more than cost, the State saves money.
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So the state over charges people who are on insurance, and charges people on medicaid less? I don't see how that could drive up insurance prices at all. Nothing to see here. That's a great justification.
 
plague311 said:
The problem is that the hospital contradicts itself and is blatantly bias against Obamacare. I don't care what newsday is or it's reputation as I am not refuting the article or it's accuracy. I apologize if for some reason I was unclear. Also, there is no "accepting insurance from the ACA." The "ACA" isn't providing health insurance, the companies that are on the exchange are providing the insurance. See what I'm saying? We can split hairs if need be, but those are the facts. The hospital says they receive compensation that is "below Medicare and approaching Medicaid." However, they still take BOTH of those, yet they are making the decision to deny the insurance that the patients get off of the ACA. I am not sure which part of this is confusing, but it speaks for itself. The hospital is the party saying this and I took it from your own article.



A hospital that despite being not-for-profit still brought in multiple millions of dollars in revenue and profit. If they are losing money on Medicaid, why are they still taking it? They have the opportunity to stop taking medicaid, but they don't, why? So I am fine with saying that you aren't wrong, but something isn't adding up here.
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They can take a percentage of insurance from medicaid and even if they lose money they are still "profitable" because they get better reimbursement from other sources. They claim if they accept the ACA reimbursements the mix will become to heavy with low reimbursement plans.
 
eeyore1954 said:
They can take a percentage of insurance from medicaid and even if they lose money they are still "profitable" because they get better reimbursement from other sources. They claim if they accept the ACA reimbursements the mix will become to heavy with low reimbursement plans.
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They sure do claim that, don't they?
 
plague311 said:
So the state over charges people who are on insurance, and charges people on medicaid less? I don't see how that could drive up insurance prices at all. Nothing to see here. That's a great justification.
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Obamacare itself does this as well. Obama gave the pharmaceutical companies a deal where he would continue the ban on importing medications from other countries in exchange for federal programs getting better-than-market prices for medications.

There are all kinds of hidden mechanisms whereby the common person on insurance gets screwed. But hey, the administration can claim that the program is "revenue neutral" so that's a win for them.
 
KoihimeNakamura said:
No, actually. I think I'm going to call you out on this. Explain how they didn't do what they did in every other program and give HHS and IRS the authority. (Especially since any source I've seen that is not the RWEC says they did.)
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The law doesn't give specific statutory authority to change the dates of when corporations (or individuals) are required to carry coverage. However the only institution that can reasonably challenge the administration on this is Congress. They're not going to.
 
Emily Cat said:
There are no state or federal rules or regulations governing what private hospitals charge to commercial insurers or to private payers. I assume that you are referencing medicare and medicaid pricing? If so, then yes, those have pricing rules (more like pricing hammers), but that is not the context of the pricing discussion at the moment :)
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No, but there are state and federal rules and regulations that govern what standards and practices hospitals must use with regards to standards of care, pharmaceuticals, supplies and equipment, as well as how these are allowed to be purchased, safely and properly stored, cleaned, sanitized and dispensed. These factors add to the costs both that hospitals must pay for the materials and to the costs that the hospitals must charge in addition to what the hospital paid.

Again I'm not saying that there isn't any fat to trim, merely that most of what looks like "fat" to individual's without experience in the costing of medical care, is not what it appears to be.
 
Newtons Bit said:
Obamacare itself does this as well. Obama gave the pharmaceutical companies a deal where he would continue the ban on importing medications from other countries in exchange for federal programs getting better-than-market prices for medications.

There are all kinds of hidden mechanisms whereby the common person on insurance gets screwed. But hey, the administration can claim that the program is "revenue neutral" so that's a win for them.
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My entire comment had nothing to do with what Obamacare is and isn't doing in regards to the revenue. It pointed out that this specific hospital called out Obamacare as something they weren't going to take. Whether you like it or not, they are playing favorites. They are picking and choosing what they are doing, and they could have just as easily picked to drop either other form, medicaid or medicare, but they didn't. They chose this, it wasn't forced on them. I don't care how you two, or anyone else, justifies it. Those are facts, something I can't understand how it is being missed.
 
plague311 said:
My entire comment had nothing to do with what Obamacare is and isn't doing in regards to the revenue. It pointed out that this specific hospital called out Obamacare as something they weren't going to take. Whether you like it or not, they are playing favorites. They are picking and choosing what they are doing, and they could have just as easily picked to drop either other form, medicaid or medicare, but they didn't. They chose this, it wasn't forced on them. I don't care how you two, or anyone else, justifies it. Those are facts, something I can't understand how it is being missed.
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Actually, you said that the hospital was biased against Obamacare. It's not. It's just doing what is in the financial best interest of the State. This is New York State, remember; not a hot-bed of conservative partisanship against all things Obama.
 
KoihimeNakamura said:
Maybe because the court will probably find the delay is for a valid reason. In any case, I'm going to go head off away from this thread like I should have.
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No, the courts will not, because there is no valid legal justification. You can see a more in-depth argument here:
http://www.washingtonpost.com/news/.../another-day-another-illegal-obamacare-delay/
Obama is likely to get away with this illegal move for a much less comforting reason: it's hard to find anyone with legal standing who would sue. Members of congress who voted for the law would probably have standing to sue (their will has been thwarted), but no Democrat is going to sue Obama over this. And without someone with standing in the eyes of the court, the government is free to break the law with impunity. But make no mistake: that's exactly what they're doing here. They're breaking the law.
 
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