What Obamacare Does and Doesn’t Do

I am sick and damn tired of all these uninformed, misinformed, sanctimonious President Obama-haters who are using the Patient Protection and Affordable Care Act, also known as Obamacare, as a whipping post to try to get rid of the President and all Democrats now holding elective office.

The elected office holders and candidates, like Romney and McConnell and Boehner and Berg, know better than to spout their venom against the law of the land, but they do it and get away with it because no one in the media challenges them. And it stirs the letter-to-the-editor writers and radio talk show callers who DON’T know any better, and who stretch what those who do know better say even further, to the point of absurdity. At times, you can hear them actually frothing at the mouth as they talk to the Limbaughs of radioland.

Dammit! What’s happening is that we are turning into a mean, angry country. I hate it. We are better than this. We are good people in a great country, and we deserve better from our leaders. I don’t understand the anti-Obama vitriol. I’m almost 65 years old and I have never, ever seen the people of our country sink to the depths of outright hatred that conservative leaders are taking us into now.

Obamacare is their rallying point. Most of these Hate-spouters have no idea of what it really is. So, with the help of some credible sources, I’m going to try to explain it. Not that any of them will read it and believe it. But so you can counter their rhetoric when you get the chance. Here are real facts:

First, the law DOES NOT create a new government-run insurance plan.  Period.  What DOES it do? The existing Medicaid program will be expanded to cover more low income people, government regulation of the health insurance industry will be increased, and tax credits will be provided to make private health insurance more affordable. Here are the specifics:

  • Starting in 2014, most U.S. citizens and legal residents will be required to obtain health insurance, or pay a penalty. Here’s why. Presently, people who have no health insurance and cannot afford to go to a doctor, end up in emergency rooms, where they cannot be turned away, instead of in a doctor’s office. The hospitals have to get these services paid for somehow, so we end up paying through higher insurance rates and co-payments. When everyone has health insurance, medical costs should go down. Should. All we have to do is trust the hospitals to do the right thing. I wish I felt a little better about that part.
  • Individual states and the federal government will set up Insurance Exchanges where people who do not have insurance now can purchase insurance. Low and moderate income people who have to purchase insurance through the new Insurance Exchanges will get tax credits, based on their income, to help them cover the cost of their insurance.
  • Medicaid will be expanded to cover nearly all low income people, regardless of age. Poor people will be able to get health care under Medicaid. Period.
  • Starting in 2014, all health insurers will be required to sell coverage to everyone who applies, regardless of pre-existing conditions.

That’s what it DOES. Here‘s what it DOES NOT do:

  • The new law DOES NOT require employers to provide health benefits. Large employers, those with more than 50 employees who don’t provide coverage will pay a penalty, however. Small businesses with less than 50 employees are not affected. But small businesses who DO provide health insurance for their employees will get tax credits to help them pay for it.
  • The health reform law does not cut Medicare benefits. Period.
  • The myth that there will be “death panels” who will make decisions about end-of-life care is just that—a myth. Congress considered some kind of end-of-life panels and rejected them early in the process.
  • Undocumented immigrants are not eligible for any financial help from the government to buy health insurance. Nor are they eligible for Medicaid if they buy insurance through Exchanges with their own money.

Okay, that’s the truth about the Patient Protection and Affordable Care Act. The facts are provided by the Henry J. Kaiser Family Foundation, which is “a leader in health policy analysis, health journalism and communications, dedicated to filling the need for trusted, independent information on the health issues facing our nation and its people,” according to its website.

The Foundation also says on its website “The health reform law promises to deliver big changes in the U.S. health care system. But, as with other sweeping pieces of legislation, it can be hard to get the real facts about what it does. And it is all too easy for misinformation about the law to spread. Take our short, 10-question quiz to test your knowledge of the law, and then find out how you compare to the rest of the country, as represented by the findings of the Kaiser Family Foundation’s monthly Health Tracking Poll.”

Okay, so you’ve read the primer. Heard the lecture. Now go here to take the quiz. And then next time your neighborhood right wing Democrat-hating loudmouth nutcase starts ranting about a government takeover of health care, challenge him with the facts. Because if you don’t, he surely won’t get them anywhere else, and he’ll just keep it up, right through Election Day. That’s a long time to listen to this crap.

34 thoughts on “What Obamacare Does and Doesn’t Do

  1. Excellent work, Jim. Thank you.

    One step might be thought of as missing. It’s the one between emergency room provision of costly services to the uninsured and the increase in our insurance rates. That step is, the hospital can’t refuse to provide care to the insured poor, so they must have somewhere to go to re-coop their costs of serving that population. That “somewhere” is their insured patients and they spread the cost of serving the poor across those insured patients by billing them more for the services they receive than the services actually cost. The insurers incur more costs in fulfillment of the insurance policy promises
    so the cost of those promises goes up — i.e. those who have insurance pay more for it. Under our current system, those who have insurance incur the risk that those who don’t have insurance will need medical services. Hint: the risk is high.


  2. Thanks Alice. Two more things it DOES do:
    –It requires insurance companies to let young family members up to age 26 remain on their family’s health insurance plan, instead of kicking them off as soon as they graduate from college. That can save a college graduate struggling to pay off college loans anywhere from $300 to $700 a month.
    –A Dorgan-Conrad-Pomeroy-sponsored provision known as the Frontier Amendment keeps Medicare reimbursements to medical providers artificially high in low population states like North Dakota. That means as much as $50 million a year to doctors and hospitals in North Dakota. Shit, even Rick Berg supported that initially, when he first got to Congress, but now that it’s campaign season he wants to repeal the entire act, including this provision and the one allowing college graduates to remain on their parents’ health insurance plan.
    From the July 3 Bismarck Tribune: “’The first step is to repeal,’ Berg said. Berg said if next week’s vote fails, the Republicans need to win control of the Senate and White House in November and repeal the law. He said he would work to repeal the law if elected to the Senate.”


  3. You conveniently forgot at least one important FACT:

    Obama has granted numerous waivers to his cronies.

    Perhaps the most egregious example is the waivers he has given to the SEIU, an organization whose PAC spent tens of millions on Obama’s election campaign.


  4. I approved the earlier comment from someone named Anarcho-Capitalist (What kind of a name is that? What kind of parent would name their child Anarcho-Capitalist? Surely that’s his or her real name–people who comment on blogs aren’t afraid to use their real names, are they?) so you can see the kinds of drivel the antis spread about this issue. The truth about this specific accusation can be found at this website: https://action.seiu.org/page/share/affordablecarewaivers. The fact is, the law Congress wrote allows the Department of Health and Human Service to grant temporary waivers from the program to businesses (and yes, unions) who have their own health insurance programs for their employees or members.

    Earlier, here’s what the National Journal had to say about the waivers program: “Typically, the waivers go to firms that offer ‘mini-med’ plans with a lower annual coverage limit and cannot meet the new annual floor of $750,000 for 2011. They are meant as a stopgap measure until new state-run insurance exchanges are opened in 2014. The use of waivers has become a political fighting point for Republicans, who say they are proof that the law is flawed and should be repealed. They have also accused the administration of using the waivers as gifts to union allies, a charge HHS has rebutted.”

    If you want to see how this kind of information is spread, just Google the phrase “Obama has granted numerous waivers to his cronies” from Anarcho-Capitalist’s comment above. You’ll find a rant from every conservative rag in the country. It’s a hoot.


  5. Jim, you would go crazy if you lived in the area where I live now!!! Conservatives all over the place–including Tea Party people. At least one of my neighbors is a Democrat–they are such nice people too (not because they are democrats, but that helps!) Keep up your good work. I enjoy reading things from ND. I also read the Dickinson Press and the Bismarck Tribune on-line. Take care and greetings to your fishing partner, Jeff W.


    1. As opposed to your “thoughtful” response? Ha!

      If you are going to make the claim that this entry is “emotional”, then you will have to provide an explanation. Otherwise, people will surely think you are responding in a purely emotional fashion yourself.


  6. Good job Jim!! It is a shame that so few people can think for themselves but rather react angrily when their misinformed childhood teachings are challenged. They take it out on the most convenient scapegoat (usually a minority). Conservative Republicans are the worst because they are wired up so rigidly in their thought. They rigidly think they are right. There is no flexibilty in those brains.


  7. I’d just like to ask any Republican OR person what are you against in the health Care Bill?
    Leaving Your Kids on the policy until they turn 26.
    Eliminating life long cap on benefits.
    Rules so Medical Insurance companies can not cancel your policy when you get sick.
    Lowering the cost of care and prescriptions for Medicare. (Elderly and poor)
    Covering preventative care at no additional cost
    Strengthening Fraud protection by increasing penalties
    Stopping Insurance Companies from Denying Children because of preexisting
    Stopping Insurance Companies from arbitrarily jacking up prices.
    Giving a rebate to Customers of Companies who spend too much on ADs and CEO bonuses.
    Tax Credits to Small businesses to be able to afford Quality Health insurance for their workers.
    Building and Improving quality health Care Centers in Communities.
    Giving workers a TAX Credit so they can afford quality health insurance. (2014)
    End discrimination, allowing Adults with Pre existing conditions to purchase insurance. (2014)
    Prevents Insurance companies from Charging more for Female buyers based ONLY on gender(2014)
    Creating health Care Exchanges where Buyers can shop and compare and get the most Value for their Dollar. (2014)

    SO.. whats wrong with this agenda? Another Question I’d like to know.. When the bill was passed the Medical providers, insurance Companies were all for it, now they are not. Why this change? I think that they would like to pick the things that are an advantage to them, and change the laws where it is not an advantage to them. So then they can have their cake and eat it too!


  8. Jim: I hope you’re right! However, because of Obamacare women can only have a pap smear every (5) years!!!!! A man cannot have a PSA test at all!! My husband is in remission from prostate cancer, which was found from a PSA test. How long will it be before women cannot have a mammogram every year?!?
    I think people are being “snowed”. All it takes is reading between the lines. Judy


    1. Judy, you are 100 per cent wrong. In fact, something like 20 million women will now have pap smears covered by their insurance that did not have that coverage before.You must be getting your information from Fox News or else reading it on the Internet. I’m not going to waste my time finding the cites to show you that you are wrong. But you are.


      1. Also, Jim, after a woman reaches a certain age, she should have a pap smear EVERY year! Yes, under Obamacare 20 million women will now be able to have pap smears, but it will be every 5 years. They could be dead by then. And, what about the PSA testing?


      2. Judy, while I sympathize with you and your husband, your doctor is badly misinformed. The recommendations for Pap smears and PSA tests do not come from “Obamacare.”
        Recent Pap smear guidelines have come from the U.S. Preventative Services Task Force and the Amercian Cancer Society, which state the Pap smears are suggested once every three years. Those are only suggestions – if your doctor tries to tell you that you can’t have a Pap smear whenever you want one, I would suggest switching doctors. There is no plausible reason to deny that procedure to a patient who understands what they are asking for.
        Likewise, PSA testing is absolutely not “forbidden” under “Obamacare.” This is an outright manipulation of the “death panel” rumors that surfaced at the beginning of the debate over this law. There is an ongoing debate outside of the “Obamacare” law about the validity of a PSA test, but there are many, many people who have detected prostate cancer using a PSA test, and there is simply nothing in “Obamacare” that outlaws a PSA test.
        It is ludicrous that your doctor even suggested that PSA tests will not be allowed, and if your doctor is trying to suggest that he/she can’t give a PSA test, then I would be gravely concerned about said doctor. You always have the right to preventative health care measures.


      3. I didn’t say, or mean, women couldn’t have a pap smear every year. What I meant, is that the government health care will only pay for one every 5 years. Yes, I can have as many as I want if I want to pay for them out of my own pocket. As for PSA testing – there are an awfully lot of doctors who believe the government insurance will not pay for any PSA testing.
        Every woman knows that to prevent cervical cancer, it’s wise to do a pap smear every year.
        With government insurance this will not be the case for a lot of women (as well as men for PSA testing). You should be concerned since your obviously a male.


      4. For cripes sake, Judy, it’s obvious you have drank the kool-aid. No one will ever convince you that the president is not an evil man. The government does not regulate what medical procedures you can have. You can have a pap smear every 20 minutes if you want to. Your husband can take a PSA test every Saturday morning if that’s how he wants to start his weekends. What’s negotiable is how often your insurance company will pay for them. I assume you have your own medical insurance and will not be taking advantage of the tax credits and improved access the Affordable Care Act provides. A simple phone call to your insurance company will tell you how often they will pay for these tests (probably not every 20 minutes). You probably misunderstood your doctor–I’d check back with him or her too, or check on getting a new doctor.


      5. This conversation is going no where! You obviously have on “rose-colored glasses” when it comes to Obamacare! Good luck with your new government insurance – you’re probably going to need it. I will admit there are a lot of good things about it, but someone will suffer because of it. Do you remember the fairy tale about “The Pied Piper”? Think it might fit in this case?


      6. You see, ladies and gentlemen, this is what I was writing about in my post. Judy doesn’t understand that the “government health care” she is talking about is Medicare and Medicaid, which already exists and whose benefits are now going to be extended to some people who are not eligible now. Otherwise, the Affordable Care Act simply provides access to private insurance for people who are now uninsured, whose employers cannot afford to or choose not to insure them. There is no new “government health care” program. Unless she is a poor person and becomes eligible for Medicaid, or elderly and is eligible for Medicare, the has no dog in this fight. So now I am just going to ignore any further posts from her. She just doesn’t get it, and doesn’t want to.


  9. The Ranters have gained ground. They don’t have the good of the country in mind. There are two sides to everything at this point. The Ranters, who are not hampered by conscience, are not interested in resolving anything. I have dilegently checked some of their statements like the trip to India, which everyone of the Rantors plus Backman stated that it cost the US upwards of $350,000,000. Backman came in the highest at somewhere over 400 mil. The cost including pentagon expense was about 2 mil. They just throw it out and move on.
    I just ask where they got the information and refuse to rant..however the truth needs to be told. Dont know how to go about that…I have the same concern of what it is doing to our country. What is the goal here? Global Warming? Who benefits from this obviously stupid arguement? The real concern is: if you lie often enough, people will start to believe it. Hitler made that point..
    I guess we will survive, historically there have always been distructive radicals. However, there has never been this much media involved in the same spin. It scares me.
    I believe we are charged with getting out the truth. Not more rant. We have to seek the truth on issues. And get the truth out…That cannot be overcome.

    Healthcare is a tough one because it is too much info, here and there. Thanks for delving into that Jim.


  10. The sad part of the quiz is that a score of 100 percent is better than 99.6 percent of the population. This topic is too important to our future to be misinformed about it.


  11. Hmm.

    Judy Harrison says: “Oh, and Brian, where do you think these “recent” guidelines for pap smears came from??? Could it be from our new government insurance???

    She sounds like the Church Lady on SNL: “Could it be…SATAN?

    I don’t have to THINK imaginitively to come up with where the guidelines in qustion came from, since the truth about where they came from is readily available to anyone who cares about the truth and not distorting it to score political points. (You, for instance.)

    As you also point out, there is no such thing as “our new governement insurance.”

    I am a physician working in public health and a proud son of Williams County, ND. The lives of millions of Americans are at stake in this conversation, and the willful liars and distorters “contributing” to it make my blood boil. Whatever happened to eighth commandment? God bless you, Jim, for your work to spread the truth on this subject.


  12. “Nor are they (undocumented persons) eligible for Medicaid if they buy insurance through Exchanges with their own money.”

    That is not correct. It should be: “Nor are they eligible for Medicaid and they cannot buy insurance through Exchanges even with their own money.”

    The bar on purchasing with their own money is a fundamental injustice.


  13. Jim,
    Great job taking on the distortions and continuous lies about what the ACA really is. I would like to add one more positive feature about the insurance exchanges. For the first time in history, consumers will know the company from whom they purchasing their health insurance pays out at least 80% of the premiums they collect in health care benefits. The medical loss ratio is a big consumer benefit in that way. If the company is only paying out 60%, like some are, they either pay a heavy penalty until they reach 80%, or they can’t be in the exchange.

    During last November’s special session, Republicans motivated by partisan politics voted to reject the bipartisan bill for a state-run insurance exchange in favor of letting the federal government run it. This was considered an act of repudiation of “Obama Care”. It’s more like cutting off their nose to spite their face. Works every time.


  14. Bear with me as I may have missed this, but what exactly will be the procedure for poor, uninsured to get Medicaid and what is the earliest date I can sign up for it? I have several life-threatening illnesses and have not been able to see a Dr. in years. Also, will governors (like Jan Brewer here in AZ.) be able to block this expansion of Medicaid as they have in the past? She has illegally gone against the voters wishes and refuses to allow childless adults on Access (our state Medicaid) and vows to make deeper cuts in the future. Can she blatantly go against Federal Law like that and continue to refuse health care for the poor?


  15. Judy Harrison..a perfect example of the mindset that creates and maintains government gridlock. I know I am waaaaay late to this conversation…but…this type of ignorance, when there are so many reliable ways to get the facts…argh! Pap smears every 5 yrs.? WHAT? All she had to do was look it up, or ask a ‘real’ doc (instead of the one she created in her mind to make her comment).As for her ‘government health plan’, as Jim says, the only govt health plan is Medicare/Medicaid. They pay for a pap every year, in almost every case. In some cases it is every 2 years, but if your doc tells them it is needed, you will still be able to get a yearly exam, fully paid. Now, Judy…if you would like to object to the cost being put on the taxpayers…or whatever dead horse you are beating today, please remember that preventing disease is MUCH less expensive than treating. I rarely post on forums/discussions…but since Judy created such a perfect void in reality, I figured that I could help fill that gaping hole with something factual. No doubt she will make up some ‘facts’ to create a larger void. Sad, really, that there are so very many uninformed people who believe that they are in-the-know because Fox ‘news’ told them how to think. Ugh. Disgusting that so large a proportion of our population does not care enough to look past what popular media tells them to think is true, to get the ACTUAL truth.


  16. I’ve never paid much attention to all the talk. Yet, even though my mother contacted uterine and ovarian cancer at 55 and was lucky enough to go to the doctor for a pap smear at just the right time, yesterday when I went for a pap smear I was told, by my doctor, that those over a certain age no longer automatically get pap smears unless they already have signs of cancer. They do a quick check, ask a few questions and that’s it. It was short and sweet, but it left me feeling that those over 65 are suddenly no longer important enough for this needed preventative. It’s new world, but it doesn’t feel right.


  17. Sooo. Three years later, how are those deductibles working out for you?? No gripes or complaints that they soared?? My out of pocket Mac went from 1k to 6k…that’s CHEAP (group policy) compared to the “affordable” marketplace. “Cheap” premium but how about those coverages?!?! CHA CHING. What you libtarded people can’t get through your heads is that NOTHING is free. You impose rules on for profit insurance companies and WE ALL PAY for it through premiums and deductibles SOARING. It’s not brain surgery to figure that out. Free preventive care… LOL. RIGHTTTT. After that 6x raised deductible and tripled copays!!! Dumb ass libtards. And how about those Medicaid sponges???? They are STILL filling the ERs MORE SO now. Why??? Not enough doctors taking medicaid! That was a BRILLIANT idea to expand it. They flock to the ERs for a sore throat not !!!

    I pay out the NOSE a month in premiums and STILL and socked with astronomical out of pockets. I can’t utilize it because I can’t afford it now! You libs must be SO proud.


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