Lee Goldberg, National Academy of Social Insurance

March 23rd, 2012 will mark the second anniversary of the signing of the Patient Protection and Affordable Care Act (ACA). This legislation represents one of the largest and most comprehensive reforms to the American health care system since the enactment of Medicare and Medicaid in 1965. The ACA seeks to extend coverage to roughly 50 million uninsured Americans, slowing down the growth in the cost of health care, and improving the quality of care health care by changing the delivery system.

The ACA would achieve these goals by eliminating the ability for insurance companies to reject a patient due to pre-existing conditions, allowing children to remain on their parents’ health insurance until age 26 and expanding the eligibility of Medicaid for millions of Americans. Additionally, the ACA calls for the creation of state-based health insurance exchanges that will increase the competitiveness and transparency of the individual and small group market for insurance. These exchanges will also provide subsidies to individuals and families to purchase health insurance. If exchanges are successful, they will be a significant help to individuals and small businesses looking to purchase coverage.

Since early 2011, with funding from the Robert Wood Johnson Foundation, an expert NASI study panel released several reports examining exchange design and implementation issues.

Just two weeks before the second anniversary of the passage of the ACA, HHS released the final rule on guidelines for exchanges. Secretary Kathleen Sebelius emphasized the flexibility states will have in designing exchanges. Tim Jost, law professor at Washington & Lee and a member of the health insurance exchange study panel, summarizes the final rule on the Health Affairsblog, and George Washington University’s Health Reform GPS website provides useful information on key developments in exchange regulations. While many provisions in the ACA have yet to take effect, many states have begun to build the basic framework of the exchanges.

NASI will continue to study the upcoming challenges policymakers will face in implementing exchanges. Of two upcoming reports, one will focus on plan management in exchanges and the other will focus on establishing information technology infrastructure in exchanges.

Posted on: March 19, 2012


  1. dennis volk June 9, 2012 at 1:47 am - Reply

    i feel that health care
    i feel that health care should be a moral right. its not a choice, to get sick and find a way to take the huge profit out of health care. A single payer plan would work. If they would stop playing politics with pepoles lives. do your job in congress. Obama plan is not a 100 precent right but at least its a start. The european county s have a health plan that works with no problems. why cant we adopt the same policy? I believe its because of politics!!! Your are not working for your party you are working for the people. Get out of bed with the big corporations and do whats right!!!

    P.s For the people and do whats right it should not be about money,

  2. Nathan Banta June 28, 2012 at 8:00 am - Reply

    mr. volk makes a terrible
    mr. volk makes a terrible argument especially mentioning european healthcare. you do know that health care in europe is horrible and it is partly to blame for the current economic collapse that the entire european union had just recently. universal health care is not capitalist, it’s socialist. government has no right in the private companies. the fact that they have horrible laws in the first place for trade agreements for medical supplies is why the private health care companies are forced to charge so much. if they want to reform their own medicare/medicaid policies then i say good for them but they need to stay out of a private company’s business. i myself don’t have any insurance nor do i want any. it’s my right as a citizen of this country to not have it and i have personal reasons against western medicine so i exercise that right. it also means that i can form an unbiased opinion about health care legislation since i’m not worried about it effecting my wallet. and my opinion is that universal health care is crap. you can’t be turned down in an emergency room anywhere in the country. there’s laws against it. you can’t be sued for medical debt. there’s laws against it. if anybody reading this has had one of those two things happen to them then they should get an attorney and sue the hospital that broke the law.

  3. Kimberly June 30, 2012 at 3:23 am - Reply

    I like the idea that no one
    I like the idea that no one would be turned down for insurance. A hospital can not sue you but they can ruin your credit if you don’t pay the bill. So you are saying that you would rather run up medical bills and not have them paid. Typical of some business owners. You know it is us middle and lower class people that don’t have all this money to pay cash for things. We rely on our credit to be good so that we can have things in life. With insurance being available to everyone regardless would help the economy. Alot of business owners don’t give a darn about their employee’s. It is all about the upper management. Corporate world sucks now days. We have hard workers out there trying to make a living while you owners think about yourself. You know money is a materialistic thing and you can not take it with you when you die. At least we can do is have insurance for anyone who wants it. With nobody being denied because of a stupid pre-existing condition.

  4. Will Cook July 1, 2012 at 1:07 am - Reply

    ObamaCare will cripple
    ObamaCare will cripple Healthcare as we know it. Goverment Insurance programs don’t work. Socialized medicine is criminal and provides a quick extermination program for those who are critically ill. Insurance companies should be allowed to sell across state lines, thereby providing competetive programs for all individuals. This type of competition among the insurance providers will drive healthcare insurance down, making coverage much more cost effective for all people. I have been a Respiratory Therapist for 23 years and have seen government implemented programs fail and fail miserably, leaving a path of destruction and economic failure.

  5. bettyann July 3, 2012 at 3:05 am - Reply

    The democratic leaders are
    The democratic leaders are giants for doing this. I am so proud of them and our president. There are a lot of people out there who are hurting and have no other way to get health care. Millions of new jobs will be created. Congratulations to all who made this happen.

  6. Dina July 4, 2012 at 5:08 am - Reply

    I have to say that a health
    I have to say that a health care insurance mandate is necessary. Many people who have insurance are healthy, adding healthy insureds to the pool will lower insurance costs (more people paying in / lower percentage of people using). For those who are un-ensured and unhealthy, while their addition to the insurance pool may add to the costs to the insurance company, it will save the hospital money in bad debts, and as most of those losses were simply added into the price for everyone else, with these bad debts being greatly reduced with people now being covered, the price of healthcare for everyone will go down. To the person, who in earlier comments stated that you are against insurance and western medicine and do not have insurance for that reason, I would like to point out that, god forbid, you have a heart attack or are in a car accident, you will be serviced by hospitals and ambulances whether you like it or not. You won”t be in a state to say “let me die in the street” or ask for some alternative. Those expenses will be astronomical, and unless you are above middle class and have a significant (hundreds of thousands of dollars) savings for just such an emergency, you will end up with a heavy financial burden and if you are in the lower classes, you will most likely have to default on the bills. The mandate and reforms help prevent this from happening and it doesn’t seem, from what I have read thus far, that insurance companies are being illiminated, just regulated, so there will still be a choice for those who decide the government-provided insurance is not the right fit for them.

    We are an amazing country and I know that we can work to make this system better than socialized medicine, leaving room for capitalism while still ensuring certain social growth and a higher standard of living. We have to move forward or we will be left behind.

  7. David D July 6, 2012 at 6:44 am - Reply

    Both Nathan and Will make
    Both Nathan and Will make good points: healthcare is expensive because of existing regulations that prevent both the providers and insurers from cutting costs and increasing revenues. Over-regulation of trade, even across state lines inhibits growth and increases costs in any business.

    While healthcare can be considered a “moral right”, it is not an inalienable right. The right to life, liberty, and the pursuit of happiness are the only God granted rights guaranteed under the Constitution. Legislation should be passed that lifts the regulations already pointed out while addressing issues such as pre-existing conditions. I agree that insurance companies should not be able to turn down applicants based on pre-existing conditions, and I can see a need for children to remain on their parents insurance for a longer period of time (although 26 seems high).

    The issues is that the government should not be in the healthcare business (or any business), and granting them the power to decide for you is sacrificing your liberty for a system that will drive this economy into a tailspin. Dina pointed out that hospitals will benefit by collecting on bad debt, however it is the American taxpayer that will ultimately absorb that debt in higher taxes. So while you may never need extended or expensive healthcare that would wipe out your savings, you will pay for it in higher taxes regardless.

    As far as the European (and the Canadian) healthcare systems, do some research on how effective and efficient they really are.

    Changes need to be made to the healthcare system, however you don’t throw the baby out with the bathwater.

  8. Brent Rayburn July 7, 2012 at 2:29 am - Reply

    However Mr. Banta, you can be
    However Mr. Banta, you can be turned away by an insurance company….as was I. I am HIV positive and my medicine costs $1,600 per month. How would you like to pay that all because an insurance company isn’t willing to help you? Could you afford that sir? I certainly can’t. Those pills keep me alive and cost almost my entire monthly income. I shouldn’t have to depend on a charity for help when I would gladly pay into an insurance policy…if someone would allow me to.

  9. jennifer July 10, 2012 at 2:01 am - Reply

    I agree with kimberly. I beg
    I agree with kimberly. I beg to differ on the europen healthcare collapsing because of the economy. I have friends in the UK, and they like the universal healthcare system (aka govenment run system if you will). What they didnt like… is that alot of the doctors they were given were crappy. “That was thier words not mine.” I imagine though, once you get to know the good from the bad doctors then you avoid the bad doctors. (just a thought).

    If someone is offended by being giving “Obama Care”: I say if you don’t want health insurance and the government gives it to you then look at it as a gift and just dont ever go to a doctor or maybe try being a naturalist and visit a naturopathic doctor. That maynot be covored by “Obama Care or the Affordable Care Act”.

    Nathan Banta…Sadly, just because theres Laws against or about somethings, it still happens. A relative of mine was refused service by a hospital close by & he needed the ER! He was unresponisve in his front lawn & they wouldnt come pick him up.

    People say Obama Care will damage Healthcare? How? it cant get anyworse…It’s expensive, my place of business switches healthplans every year just to save themselves some money and in the end it making hard for me to keep the same doctors and I have a pre-exsisting condition. I have been struggleing just going to get my degree because I always have to have insurance. OH.. im over 26 (Thank You).And how is the Affordable Care Act hurting us?

  10. Rachel July 14, 2012 at 2:23 am - Reply

    A lot of people think Obama
    A lot of people think Obama care is socialist Medicine. News flash its not people still have to pay insurence premiums its not tax payers. What Obamacare does is regulate the insurance rates so people can actually afford it. Our president is looking out for us and all we want to do is complain that its unconstitunal. Tell me would you want to be 19 years old struggling to make and on top of it all get hit with a 5,000 dollar bill from your primary care doctor? I dont think you would or what about the 4,000 dollar bill from the ER when you had mono but your doctor was booked for the next 4 months? Obama care would A) give you a copay option from and affodable health care plan as well as B) give you a choice in who you see for a doctor. A lot of doctors will only keep you as a patient until you bill reaches so high and you still cannot pay it then they send you out of their practice and its hard to get into another one. So I like the though that our president cares enough to regulate big insurance corperations to make us be a healthier nation.

  11. jay July 15, 2012 at 7:43 am - Reply

    I think that it should be up
    I think that it should be up to me whether I want coverage or not. I go to the doctor maybe once a year if that. A doctor visit is $70. I am on an antidepressant known as venlafaxine and it costs about $120 a month from wal-mart pharmacy (cheapest pharmacy I’ve found). After years of paying that price I tried to use a discount card from my doctor’s office and the girl said “Oh, we have our own.” She scanned it and the price went down to below $20. That is just ridiculous! I was happy and p’ed off at the same time. How could she (been the same girl forever working there) just look at me and let me hand her $120 every time before that knowing she had access to this wal-mart pharmacy “discount” card. The fact that the price dropped down that much means that they were making AT LEAST a hundred dollar profit off of me. They still have to make some profit so what do they pay for the drug? $10? $5? So don’t blame trade agreements when they are messing up lives at the counter as well. Thats a hundred dollars that could have gone to feeding my sons. They need to regulate the prices pharmacies and hospitals are allowed to charge. The United States is full of greedy doctors and pharmaceutical companies who don’t care about anyone so long as they make a buck off of them. I used to think people who said the government is hiding cures for cancer, obesity, AIDS, and other fatal diseases in order for pharmaceutical companies to make money were crazy. Now not so much. Anything is possible. Theres a reason our hospitals are full of foreign doctors. Other countries have free education and don’t overpay their doctors and hospital staff. Im not saying they don’t deserve to be paid more, but it shouldn’t be about money that motivates one to become a doctor. Think about it. If you think Obamacare is meant to benefit the indigenous think again. This is just another way for a politician to scratch the back of lobbyists and corporations. Anyway, I bet insurance will cost more than what I pay now for healthcare no matter how cheap obamacare makes it. And even if I qualified for medicaid under the new act I wouldn’t want it. I don’t want hand outs. However, I do think programs that we have in place already for children, elderly or otherwise disabled people (medicaid, medicare, etc) are necessary. Leave it up to the working class whether they want insurance or not. Grrr I am so upset with my country over this nonsense. Gonna tell me I HAVE to pay for something I’m doing just fine without. I don’t make much money and struggle as it is and now I will have to pay more. RIDICULOUS

  12. jay July 15, 2012 at 8:06 am - Reply

    I have a great idea.
    I have a great idea. Legalize marijuana and we can reduce state and city spending on arrests and incarceration. Impose a hefty penalty for people who grow or deal without a license. Impose a heavy tax on marijuana, alcohol, and tobacco and with the money brought in from the bad things some good can come of it. If you want to drink and smoke yourself to death, fine, but you can pay for everyone else’s healthcare while you are at it. People are not going to stop smoking or drinking and neither will stoners. Let’s see… Add $2 tax to cigarettes, add $.25 tax per “drink” for alcohol (for liquor if a fifth is 10 shots thats $2.50 more per bottle), and for marijuana $10 tax per 1/8 oz. The profit from that plus the money saved on police and feeding/housing incarcerated marijuana offenders should definitely help out. With that money we can have universal healthcare, paid for by idiots. Perfect.

  13. jay July 15, 2012 at 8:34 am - Reply

    Many people are making a
    Many people are making a serious error in thinking this is going to help them. Maybe the AIDS patient it will help, but the real winners are the insurance companies. Now you HAVE to pay them. World domination.

  14. Ginger July 16, 2012 at 4:21 am - Reply

    You aren’t going to get free
    You aren’t going to get free insurance. You’re going to have to pay for it, and you’re going to be required by law to do so. Win for the insurance companies.

  15. Sam July 20, 2012 at 12:34 am - Reply

    I have a lot of questions
    I have a lot of questions about obamacare. The first question I have is it true that insurence companies now cannot turn you down for insurance? Second question for people that are purchasing their own insurance is their a way anything in place for these companies to keep the companies from making their rates so high that people cannot afford them or their restrictions so strict that the insurance wouldn’t be worth the cost? Is obamacare increasing our government debt or helping it?

    I am seeking the truth not a fight between the parties. Thank you.

  16. Jewels July 25, 2012 at 1:15 am - Reply

    In the grand scheme of things
    In the grand scheme of things what is all this for. New presidents will rise into power and their will probably be people who hate him more than they did the last one, their will also be people who support him and think he’s good. But can anyone tell me what the purpose of all this is? Coming into the world knowing nothing and dying with the same amount of knowledge and going to some eternal black pit of all the nothingness that I spent my entire life working for just does not sound good enough to me. So what is good enough? When I look back at my life I don’t want to say ” …. average” but how can I not say that when I am just human, there is nothing good in me, I hate to admit it but I mess up, I’m super prideful and I like to think that I am right about everything, but I’m not. You know what the only thing that you will ever find that is extraordinary in this life is Jesus Christ. Doesn’t it make you stop and wonder why everyone is Ok with sharing all religions except the one that preaches against religion the one that talks about a God who loves you desperately and wants a relationship with you. So this is the only one everybody is not Ok with…. isn’t that just a little intriguing. This God that these Christians preach humbled himself and became man and died for me…. I don’t get that, but I accept it. NO other religion has a god that loves me, all the other “gods” would hurt me they say if I fall out of line, that or they just simply wouldn’t care. Thats comforting, so if I mess up I either get beaten up or nobody cares, yep that sounds fun…? The choice is yours really its up to you, Jesus Christ doesn’t force a relationship on anyone. Thats why bad stuff happens, ultimately it was our choice to allow sin to come into the world, and not gonna lie sin is fun but its not profitable. Maybe its fun now and a year or so from now, but the pain and the consequence catch up with us. But through all this Christ wants us to make a choice for Him despite things going wrong. He never said it would be easy, and it wont be. But through it all Christ owns this fragile heart, cause it couldn’t be in better hands. And for all the people who say they don’t believe in any ” god” lets face you all serve a god, whether its your phone, tv, or yourself your serving something, but their is only 1 God ( capital G) that is worthy of your praise, and that God gave His life….. for you

  17. BILL BRITT July 30, 2012 at 7:52 am - Reply


  18. Canadian Chris August 11, 2012 at 1:43 am - Reply

    If you were on the ball, you
    If you were on the ball, you would stop with insurance companies all together. They are in the business of making a profit and people’s health should not be controlled by whether or not you are getting rich or not. Somebody has sold Americans a bill of goods by using the word “socialist” because they know that it takes you back to the cold war. The word “Obamacare” politicizes the entire debate and turns it into a republican vs democrat war. It’s funny that no one called it “Romneycare” when Mitt did exactly the same thing in Massachusetts.

    To the people who only visit a doctor once a year, congratulations for now…but I can tell you that things can change very, very quickly. In one year, a small problem of mine turned into heart failure which shut my kidneys down. I see a number of specialists on a regular basis and I NEVER worry about the money. I was hospitalized for a week and when the doctor told me I was ready to go home, I simply got dressed and left. No bill.

    Canadian health care isn’t perfect…we have to wait for elective surgery, and we have to wait our turn in the emergency room…first come is not first served…a heart attack takes precedence over a cold. BUT, we don’t wait if it’s serious. When my GP diagnosed me with heart failure, I was in a hospital bed 30 minutes later.

    Our doctors don’t make millions. Our socialized system basically allows a GP to make $300,000 a year. They get paid by the procedure and there is a limit. Basically the government says that if you are doing more procedures than a particular number, you can’t be giving good care. Specialists make a lot more but not even close to a million…but…they don’t wait for payment because the government pays them from taxes so doctors don’t need to spend all that money on collections, etc.

    You need to think carefully where your money goes. I can see any doctor I want and get a second opinion, a third and a fourth if I wish…and while I complain, I wouldn’t trade my system for yours any day. My daughter goes to school in the U.S. and her health insurance costs are crazy high. I’m so thankful when she comes home for holidays because she gets everything done, including elective surgery.

    Something to think about…the Canadian population is healthier than the American…for example, fewer babies die at birth and people live longer…yet we pay far less per capita than they do in the U.S. European health care didn’t kill their economies…it had more to do with banking, borrowing and unsustainable spending. The problem with the U.S. economy is that your banks are out of control and regulation seems to be a bad word. Canada’s economy survived because our banks are heavily regulated by the government and they weren’t allowed to play games as the U.S. ones were.

    Think hard about being sold a bill of goods by people who have no concept of what it means to worry about whether you can take your child to the doctor…research, ask questions, learn the facts…

  19. Bonnie Williams August 19, 2012 at 8:54 am - Reply

    There is too much about Obama
    There is too much about Obama Care that remains unknown. What I have heard is that it will provide insurance to all non-US residents even if they are here illegally. The Government can also have access to lyour bank account and will have authority to make electronic fund transfers from those accounts. Cancer hospital will ration care according to the patient’s age. Anytime the government gets into issues that they should not — becomes a disaster for the American people.

  20. Lacie September 3, 2012 at 3:57 am - Reply

    My birth control pills have
    My birth control pills have gone up to $106.10, doesn’t that seem a little ridiculous? that much money just for a pack of birth control pills? When I had insurance they were only $45. I guess that was about 3 years ago. Then my dad switched jobs, and his new job didn’t offer a health insurance plan. At first without insurance they were $70, but I’ve watched the price just keep going up and up to what it is now, and I’m sure it will continue to go up, before ya know it I’ll be paying $200 for birth control pills.
    I figured that the reason they kept raising the price was because the price of the ingredients to make the pills went up, thus raising the price the supplier offers to the pharmacy. But after reading Jay’s comment, maybe they are just greedy bastards taking advantage. I mean how much could those little pills cost them? probably like $10. But what do I know.
    Any way, I rarely get sick and I only visit the doctor once a year. My dad makes pretty good money. As it is right now, it’s cheaper for him to just pay the $106 a month, rather than buying a health insurance plan and paying $500 a month. That’s why he’s so pissed off about this ACA. But i’m thinking more about when I have to pay for these pills and doctor’s visits myself, would the ACA help me? I’m not really sure, there’s so many different opinions, if it would lower the price of health insurance plans, then yes, but some people are saying that it could have negative effects. I guess I will just keep researching it.

  21. Pamela September 19, 2012 at 10:34 am - Reply

    We are a family owned private
    We are a family owned private company that has been in business 20 years. We had no insurance for our family during our three C-sections and paid off every hospital bill and doctor bill, may have only been $10.00 a month but as long as you were making a payment of any kind they couldn’t ruin your credit or anything else. We did that before we started our own business 20 years ago. Since all the companies we worked for never offered health insurance we wanted to offer that to our employees. So until 3 years ago we paid 100% of the major medical for our employees. Then as cost began to rise higher than we could afford we had to require the employees pay 10% and now 25% of the cost. Last year to due Obama care our insurance company completely got out of the health insurance altogether and our rates went up 68%.
    To Jennifer: Companies don’t switch insurance every year to save money, they do it to keep insurance for their employees and stay competetive in their market. Our product along with everyone else’s cannot afford to keep tacking on higher cost. You the consumer will just go by a foreign made product. And then gripe about our cost! The change in insurance companies affects everyone in the company including the owner and guess what we don’t want to change either but we have to.

    To Brent: If you have HIV because of a blood transfusion (out of your control) that is one thing. But if you have it because of personal choice why should I have to pay for your choices?

    To Rachel: If you went to the ER for mono you waited to late, I would have gotten another doctor and in our area there are plenty of am/pm clinics that don’t cost as much.

    The so called rebate from insurance companies that Obama Care made them pay back to people due to not paying out 80% in premiums. We got the rebate for our employees and it was a whole $6.99, We gave that back to each employee but it cost us an additional $7.68 per employee to do that. Our government doesn’t ask what it takes to run a business and how best can we help, that is why we need a businessman in the white house and no more politicians anywhere in our government. We need business people.

    Due you know that Nancy Pelosi stated “You have to pass it to see what’s in it”? With that said her and Harry Reid have given more waivers to their district and state for companies to be exempt from Obama Care. Harry Reid got the whole state of Nevada exempt per one listing. And they themselves are exempt because they are a elected official. Get Real! What’s good for the gander ought to be good for the goose, don’t you think?

    Due to out of control workers comp in our state, the increased unemployment due to extensions, the health care rates going out of control, the EPA and Osha and other federal mandates that have been imposed on small businesess for the last 3 1/2 yearss we are struggling with a decision to make. That is whether to try to stay in business as is and raise cost to the consumer even more or send all our hourly employees through a temp service.

    This is a very hard decision but something has to give, the consumers don’t want to pay more and we don’t blame them because even though we are a business owners we are all consumers as well. I just paid $2.69 for a head of lettuce last night that used to cost 69cents. Come on people please stop thinking that the government can solve all your problems. We need to get back to the fundamentals our country was started on. Think of when the colonies started and when they realized some people were just lazy and wanted everything given to them, the fixed it and they either worked or didn’t eat. It was their choice. We have to get our country on the right road and letting government run everything is not the way to do it!

    If you enjoy the privledge of owning a gun in order to defend your family, your property or just feed your family you will not vote for Obama! Everyone knows there are nuts out there with guns! And taking away all guns will not change that. Because they don’t get them legally anyway. You just take away the right to defend yourself. Our founding fathers knew what we might do to ourselves and that is why they wrote the Constitution and we need to have it upheld by our elected officials. If we don’t start now it is going to be to late.
    Just for the record I don’t vote any party lines, I vote for who I believe is the right candidate to get the job done!

  22. Brian October 18, 2012 at 6:56 am - Reply

    First of all, European
    First of all, European economies and the US economy are in the same boat, They have a universal plan, we don’t. Economy has almost nothing to do with healthcare and everything to do with the banking systems we have in place. Look at Canada for a prime example; they regulate their baking to avoid corruption while also providing a single-payer plan and they’re doing just fine.

    Everything we know and have ever been told in the US about a universal plan has been one lie backed up by another lie and supported by another lie. The quality of care is the same, if not better. The wait times are the same, if not less. The tax rates for their healthcare is the same for our military (about 30%) – the tax rates for their military is the same as our healthcare (about 5%). The doctors do make high salaries and still require medical degrees – if anything you can argue that the lack of plastic surgeons and lucrative specialties weeds out the doctors who love their work from the ones who simply want the money.

    The money’s already in the system, we just need to reallocate it to places that matter and NOT our military.

    The only people who suffer from a universal plan are the rich; the ones who can already afford highly specialized team of doctors to work day and night on their failing health. The rest of us have nothing to lose and everything to gain.

    Even business owners complaining about this need to wake up and smell the coffee! A universal plan means they no longer have to find a provider and cover their staff. Providing a benefits package isn’t a huge ordeal at that rate and qualified candidates can base their decision making on the merits of working for the company vs the benefits package offered – small businesses will be able to compete with the corporate giants at that level. This will also reduce the burden and workload on the HR departments, no longer needing a specialized person just to cover the health plans.

    Our current system provides none of this. It’s nothing more than financial Darwinism, ensuring only the wealthy survive.

  23. david guy October 20, 2012 at 5:11 am - Reply

    I was recently sued for over
    I was recently sued for over 2000 dollars and have lost over 3000 dollars due to our insurance not paying our bills. I do not know what to do and we have had no major illnesses or hospital stays. The state of Nebraska allows attorneys to take your money out of your account and payroll. I hate our healthcare system amd dont really see anything changing with Obamacare. My wife needs some major surguries but is trying to hold out until she is able to get medicare. But i am wondering if that will even be there for us. I have been working and paying for SS and medicare ever since i was 16
    and now i am sick that the government thinks they have the right to take iy away. I am sick of both parties. You have to be either rich or poor to make it in this country. The good news is I guess i am going to make it!

  24. Kathy October 25, 2012 at 12:56 am - Reply

    I have read all of the above
    I have read all of the above comments and all I hear is Obama did this and Obama did good for the country!!
    Obama is a Joke!!…Stop lying to yourselves people, You want a change for America or a change of color in the white house??
    I ain’t white!! and I may be darker than OBAMA but whats right is right and his MUSLIM (ain’t black ass) is the ANTI-CHRIST!!!…. At this point, the guy next door has my vote!! ANYBODY BUT OBAMA!!

  25. Celora October 25, 2012 at 8:10 am - Reply

    1) Lacey it is called planned
    1) Lacey it is called planned parenthood, $11 a month for birth control, This is the organization Romney is trying to shut down.
    2) Canadian Chris I was raised in New Zealand so I know the benefits of free health care.
    And yes people, tax money will pay for it. Taxes should go back to the people thats what it is for.
    Obamacare is not exactly free medicine and there is a lot of improvements that need to be made. honestly I have not read it word for word.
    It is sad that so many countries are killing their own with sadistic rulers but what America is blind to is the fact that America is killing its own everyday by suppressing cures and having big pharmaceutical and insurance companies rule who lives and who dies.
    Disability is a joke, I know a couple who get $5000 a month on disability, one is on it because she had a heart attack while doing illegal drugs so she never has to work again and he works full time cash money while getting disability. I say mandatory drug testing and more rules be set.
    Single parents use the system for food and medical for their children mainly in part because the estranged parent skips out on paying child support. For a single parent to get these benefits they have to have a fulltime job.
    Romney scares the crap out of me as he has ruined so many lives to line his pockets.

  26. Celora October 25, 2012 at 8:29 am - Reply

    Ps, stop bring religion into
    Ps, stop bring religion into politics. The most evil people of this world hide behind their religion, religion is not God, Religion is based on what humans dictate and perceive, not what God is or is not.

  27. Patrick October 30, 2012 at 4:22 am - Reply

    I work in the healthcare
    I work in the healthcare industry, and have already seen some negitave effects of ObamaCare set in. Healthcare employers have stopped hiring so many new employees, doctors are bracing themselves, hoping they don’t end up in the food pantry because of ObamaCare’s “cost cutting” provisions.

    Do I think the Health Insurance system needs overhauled? heck yes
    Do I think Socialized Medicine is the answer? Heck NO!

    The Socialized Medicine in England, that ObamaCare was modeled after, is not working AT ALL! It takes 3 months to see a doctor for anything. You’re screwed if you have a serious condition because you’re most likely going to die waiting to be seen.

    And, I just had to add my two cents to Kimberly’s Comment… Where do you get off saying business owners don’t care about their employees? You, my friend, have obviously never worked in upper management. When I started my own company 4 years ago (which I might add, failed because of the Obama Administration), I cared deeply about all of my employees. I knew all of them by name, and had an open door policy. I’m not the only one doing this, either. Of course, theres the 5% rule in every crowd, but for the most part, upper management truely does care.

    So anyway, I’ve said my piece. Down with ObamaCare!

  28. Charles Kranichfelt November 2, 2012 at 5:10 am - Reply

    Do you want to know about
    Do you want to know about ObamaCare? Or, are you confused about ObamaCare?

    Watch the Bipartisan Meeting on Health Reform to see who is looking out for your interest.

    Bipartisan Meeting on Health Reform: Part 5 Uploaded by whitehouse on Feb 25, 2010

    You may have to copy the link and paste it into your web browser.

    For more information that may help you decide who to vote for in this election, then visit

  29. danielle November 8, 2012 at 1:02 am - Reply

    Have some of you even read
    Have some of you even read about this?

    Obama Care guarantees that Health Care is available to any legal U.S. resident who cannot otherwise obtain “good” healthcare through their employer. Your access to health care is no longer in the hands of health care and insurance companies.

    ObamaCare requires that all Americans have health insurance either through a private provider or by the Health Care for America Plan.

    • Obama Health Care isn’t a mandate it’s a tax (you can opt out and pay a tax if you don’t want health insurance). What ObamaCare does do however is give all Americans the option to be covered regardless of income or preexisting conditions and can’t be dropped from their insurance when sick.

    You can opt out but why would you? You either pay for it through work or a health care plan. I do not see how any of this is bad!

  30. Pamela November 14, 2012 at 2:41 am - Reply

    MY opinion is to GET RID of
    MY opinion is to GET RID of ALL insurance companies……they ARE the biggest scam in AMERICAN history…….. think about it, if you got rid of them the medical field would be free enterprise and competitive…….doctors would have to compete for YOUR business, hospitals would have to perform good service to be recommended by your doctor and ALL the money you would save on insurance premiums could be set aside……medical COSTS would be competitive……….i know this won’t ever happen because there is WAY too much money to be lost for the insurance companies and politicians……..but medical costs didn’t start going out of control until they brought in all these HMOS etc……… I HATE ALL INSURANCE COMPANIES…i have spent so much money on all types of insurance and have had ZERO claims but yet my rates go up……

  31. Linda Tesley Lehman December 2, 2012 at 5:21 am - Reply

    Natural disasters left us
    Natural disasters left us needing entitlement programs and broke. Thanks to Obamacare we are still on our farm and in our home. Without it we would be bankrupt. If you want a really long story how you have helped just ask. We love the fact we have not been forgotton. I am disabled and the drought nearly took everything we had. Also think about the farm bill for rich investors that take advantage of woodland tax credits. It is really unfair and I can explain why. I voluntered for the Wisconsin Dept of Agriculture for many years and do not participate in some programs since they are abused by no resident farmers.

    Linda Tesley Lehman

  32. John Richards December 29, 2012 at 6:21 am - Reply

    I want to buy Obamacare
    I want to buy Obamacare health insurance for someone I know who is poor and needs health insurance. How do I do that? If you know please send me a message to jfr1271@yahoo.com

  33. cytrillia January 26, 2013 at 2:02 am - Reply

    I am disabled, recently
    I am disabled, recently started receiving disability. My issue is this we have a system put in place for people who are perminatly disabled however there is medicine and serguries that can assist them with there disabilities. i have worked since I was 17 years old i have paid for the right to get health care and anything else I should need. Now i’m at a point in my life I have no choice but to receive this help and even noe I am denied health care because i make a few dollars on disability than what they require. I still cant afford to pay for my own health care and you have to wait two years before medicare even kicks in. You know I’d rather have the health care the the money, I’m tired of hurting, tied of know one caring, tired of no one helping.
    I’d rather get the help i need so that i can at least work part time, then to know i have to spend 90% of my time in bed. because i don’t have the medicine and surgery that can allow me to have a life again.

  34. Julie Gutierrez April 11, 2013 at 7:29 am - Reply

    We would like very much to
    We would like very much to know about health care, for my husband and I. My husband will be retiring now on July1,2013, and we will no longer have insurance, as we have it through his job. We have looked but the rates are terrible,as I have had many medical problems, and my husband know has diabetes.If you could show us what direction to go, it would be fantastic. THANK YOU, JULIE GUTIERREZ 750 Toy Lane Bosque Farms N.M. 87068

  35. Sabrina Bailey June 26, 2013 at 12:25 am - Reply

    Well im 36 &we have three
    Well im 36 &we have three young kids so for my company not to have to offer insurance now we are only working part time how does this help us???I have been working there almost ten years as a full time employ but.now I feel I might have to go on welfare working part time so really how does this law health insurance help I bave never been on welfare worked for every thing my family has but my job cut my hours so now what ?????

  36. kayshaewolf September 28, 2013 at 1:50 am - Reply

    The European socialists
    The European socialists health hmmmm don’t those countries have financial problems? Do we really want to go that route? I don’t. If the big deal is health care for everyone we already have that. There is Medicare for those who are not covered by insurance and low to no income. Let those who like their insurance cover and doctors keep what they have like Obama said when he was campaigning. We know everything he “PROMISED” was a bunch of bull crap, which that’s all that comes out of his mouth. Everyone needs to see the movie”Obama 2016! Shows who he is by who his mentors were, they all were/are communists socialists. Obama wants to be a dictator.

  37. Alex October 3, 2013 at 12:46 am - Reply

    I really wish that our
    I really wish that our President’s administration would better clarify to the public what the ACA has accomplished. I’m confident that this is how we got here and how all of this works, but I’m reaching out for a better understanding. Please provide feedback (politics aside):

    Doctors- obligated to provide medical services per their trade/oath, but frustrated with not receiving payments for services rendered

    Insurance Companies- Take premium fees to cover patients for any services rendered with Doctors. They guarantee payments (or portions of) to medical professionals for services provided in exchange for Doctors accepting them as acceptable providers for their services. Through statistics, insurance providers determine what premium/deductible/copay rates are acceptable to be profitable while at the same time consistently paying their medical service providers (Doctors) for services rendered.

    ACA- Accepting all patients, regardless of existing conditions/etc. or being able to pay, to guarantee payment to medical health providers (Doctors). How many people really do not pay for services rendered?

    How does this not raise the risk/rates that private companies will now charge in premiums? Does the ACA subsidize these insurance companies to account for that? How are we sure that these subsidies go where they should? Why would Doctors/Hospitals be upset with this knowing that they are guaranteed payment (similar to the FDIC)? Is this ultimately an argument about the risk/profitability of private insurance companies? Are they sticking with their margins and simply passing these additional costs to the federal government/patient (taxes)?

    What if our President presented a plan that simply looked like this:

    Medical Coverage= ? in monthly tax payments
    Dental Coverage- ? in monthly tax payments
    Visions Coverage= ? in monthly tax payments

    Is this just added into FICA for the average employee? Ultimately, do costs associated with staying in a hospital cost $10k/day, or is this an artificial cost to account for insurance companies maintaining their margins while standing by their commitments to pay the doctors/hospitals for actual costs rendered?

  38. Alex October 3, 2013 at 1:01 am - Reply

    Linda, I respect your genuine
    Linda, I respect your genuine post and how you appreciate our country’s support. We are a united group of people and states, and I can’t imagine that any reasonable person would think otherwise. My family supports farmers, and the silent majority from Texas supports you. God Bless.

  39. Steven W. October 11, 2013 at 2:21 am - Reply

    The amount of things being
    The amount of things being stated here that are simply not true is mind-boggling. There are many things that are both good and bad about the ACA, but many people need to stop believing everything they hear about it and get involved by actually learning for themselves what it says…it’s available online for downloading and reading. People are saying they ‘love’ it or they ‘hate’ it based on political affiliation alone, in the nearly complete absence of knowledge about the program.

    This plan affects us all. Don’t be lazy; study it so you actually KNOW what you are talking about!

  40. Joe October 19, 2013 at 2:25 am - Reply

    I am reading a ton of ill
    I am reading a ton of ill informed, prejudicial and religious comments. First, you need to read the policy and not rely on political party lies, try switching channels to get a broader sense of what this is all about. Second, stop with the fox news tea party nonsense about Obama. He is not a muslem or anything else other then an american and the president of these united states. His accomplishments are far greater then yours by any means. For the religious people, if you are hit by a car, do you want people to get on their knees and pray or do you want an ambulance. Your make believe God will not heal you, so stop the religious nut stuff. Your god has never helped anyone. Everyday people starve and the Vatican sits on many millions of tax free money and does nothing, nor does your make believe friend do anything. Since you people believe that god has a plan for everyone, then it was gods plan that Obama one the election two times, so you should support your gods plan. ACA asks that we all take responsibility for our self. No more free rides to the emergency room that we the people get stuck paying for. No one plans for a Cancer or an accident, but when it happens we all want to be cared for, thats what being responsible is all about. Its funny to hear that you say you don’t need it, that is until something happens. Well you can’t go for a free ride, then get sick or hurt and then say I will pay for insurance now and rack up very high expenses and expect to get fixed. That is just plain greed at the expense of the rest of americans to pay for you. You republicans are always saying that you are against helping others, like people that need food and stuff but you have no problem giving tax breaks to the rich, those people who do not care about you. Large corporations paying zero taxes, corporate welfare, yet if a family is starving and can’t find employment because your corporations moved the jobs overseas so they can pay less and pollute all they want you are ok with that. You all say the talking points of the day and have no thoughts of your own.
    ACA is the best thing to happen to the American people in a long time. People can now get healthcare where in the past they could not. This is not a socialist plan, it is run y the insurance company’s just like it was before and all the Sarah Palin lies (you know, death panels) and other scare tactics will not change what it is. Its funny, you call yourself the land of the free and brave but are afraid of a word, socialist, wow how scary. You believe all the lies told to you by your Glenn Becks, Rush Limbaugh, fox news channels. Use your brains and actually read the ACA, its free to download and then you can respond to it.

    So, stop with the Obama bashing, remember he got that bad guy while your president attack the wrong country and in doing so killed Americans, Obama reversed the hole Bush out us in, he put some controls on the banks and credit cards, he saved the auto industry, he gave you a tax cut from the beginning of his administration. He got us out of Iraq and is now doing the same with Afghanistan. What exactly did Bush accomplish, oh wait, he let America get attacked and then said that its not worth the effort to get the guy who attacked us. He told you lies so he could go into Iraq (weapons of mass destruction) then say sorry, bad intel. Well before you kill Americans you should be sure you have the right intel.
    Obama will go down in history as one of the greatest presidents, not only because he is the first black president, but of his many accomplishments. Oh, lets not forget another republican president, Regan, lets see, he raised taxes on Americans seven times, gave amnesty to millions of illegals while saying he would close the border (NOT) and started the downfall of the middle class with tax cuts for the rich who said give us more and we will make jobs. Well, they got the money and still have not made the jobs, well, not in this country. I say, thank you American people for voting in Obama again and not the Romney/Ryan, we have a plan but we cannot tell you what it is till we get elected LOL!!!!!
    The good news is that the repubs are so dysfunctional now, we the people will have Democratic presidents for the foreseeable future and with luck, dissolve the GOP and its Atkin, Palin and its latest crowd of nuts for good.

  41. Amykjasb10 November 21, 2014 at 6:23 am - Reply

    It was such a warming news to
    It was such a warming news to receive that the Affordable Care Act (ACA) is turning two. The American health care system was taken to a number of steps ahead after the implementation of this act. ACA helped poor people to have better healthcare claims at a lower cost and I hope that it continues. ICD 10 Training

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