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Thread: How much has Obamacare saved the American people?

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    A primary argument made for passing the Affordable Care Act (ACA, or so-called “Obamacare”) was that only such an expansion of the federal role in healthcare could successfully slow the growth of national health costs and thereby avert fiscal disaster. During the first few years after the law’s enactment, many of its supporters contended it was already accomplishing this, which other analysts strongly disputed. But more recently a quiet consensus has overtaken the former controversy: thus far the ACA’s cost-containment mechanisms are failing, and the net effect of the law has been to make our national healthcare affordability problem worse than it was.

    The ACA was complex legislation containing on the one hand several elements expected to increase healthcare spending, and on the other hand several it was hoped would reduce costs. On the cost-increasing side, the law significantly expanded federally-subsidized health insurance coverage, lowering millions of Americans’ out-of-pocket contributions to their own healthcare purchases. It is well documented that the greater the share of individuals’ healthcare financed by insurance, the more services they tend to use. The ACA’s coverage expansion, direct benefits, premium assistance and cost-sharing subsidies thus all increased healthcare demand, utilization and costs.[1]

    At the same time, the ACA contained various provisions designed to slow healthcare spending growth. It established a new excise tax on high-premium employer-sponsored plans, the so-called “Cadillac plan tax,” intended to counter the cost-driving effects of the longstanding federal tax preference for employer-sponsored health insurance. The ACA also constrained Medicare provider payment growth, which it was hoped would have “spillover” effects of forcing efficiencies and generally lowering costs. The law also created a new Independent Payment Advisory Board (IPAB) with powerful authority to further constrain Medicare spending growth, while limiting lawmakers’ opportunities to override IPAB’s decisions. Also included in the ACA were various provisions designed to limit hospital readmissions, promote bundled payments, and move to value-based provider reimbursements.

    Importantly, these provisions taken together were not projected to lower spending as much as the ACA’s subsidized coverage expansion would increase it. Specifically, the Centers for Medicare & Medicaid Services actuaries estimated the ACA would increase total health spending while assuming each of its cost-saving provisions would be fully implemented.

    Unfortunately from a fiscal perspective, the ACA’s cost-increasing provisions took effect while many of its cost-saving provisions did not. The Cadillac plan tax was immediately postponed until 2018 in the reconciliation law amending the original ACA, and was more recently postponed to 2022 in the latest omnibus appropriations act. Some previously-planned Medicare Advantage cuts were scaled back, while the vast majority of the ACA’s scheduled Medicare payment reductions are only beginning to be implemented. IPAB was also repealed earlier this year. These events conformed to previous warnings that the proceeds of the ACA’s various savings provisions could not be safely spent until they had actually accrued.

    National healthcare spending growth slowed significantly in the years leading up to and after the ACA was passed, tempting some to assert that the ACA itself was holding down cost growth. This was never a fully credible claim, not least because the spending slowdown was an international phenomenon and preceded the ACA’s 2010 enactment, but also because it long preceded 2014 when the ACA’s main coverage expansion provisions took effect. Subsequent evidence is that the ACA’s net effect has been to push healthcare spending higher.

    Figure 1 shows historical and projected growth in National Health Expenditures (NHE) per capita. The graph suggests a trend. Annual percentage growth in NHE per capita was declining substantially before the ACA was enacted in 2010. In 2014, however, the ACA’s coverage expansion kicked in, and its effect of increasing national health spending was immediate. For the past few years NHE growth per capita has been elevated, a trend projected to continue in the near future.




    Note that these raw per capita growth figures only tell part of the story, because NHE growth tends to rise and fall with broader economic growth. Figure 2 shows how historical and projected per capita GDP growth looks over the same time period. The trend in Figure 2 is partially, but not wholly, parallel with Figure 1; it shows faster growth after the ACA was enacted than before. With respect to GDP growth, this reflects the enactment of the ACA just after the Great Recession.




    Figure 2 thus provides context for Figure 1, but neither figure tells the whole story. To reveal the healthcare spending growth trend, the critical factor to isolate is the difference between the two figures – that is, the difference between per capita NHE growth and per capita GDP growth, or in other words, “excess” NHE growth. Figure 3 shows the evolution of excess NHE growth.




    Figure 3 shows that excess NHE growth spiked during the Great Recession: basically, the economy contracted but NHE did not, causing a substantial differential. During 2010-13 excess NHE growth effectively disappeared, as the economy recovered while health spending moderated. But then in 2014 the ACA’s coverage expansion began, which meant that despite our continuing economic recovery, the problem of excess NHE growth re-emerged.

    While health economics is too complex for us to blame the ACA alone for the recent adverse trend, the evidence on balance points to the ACA increasing rather than decreasing health spending.



    https://economics21.org/html/obamacare-failing-contain-healthcare-costs-3108.html

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    Quote Originally Posted by Oneuli View Post
    If your kids already had insurance at a group rate (e.g., through an employer), then you wouldn't have seen a big savings. If, on the other hand, they had been buying on the individual market, the cost of going on your insurance would have been much lower for any given level of coverage.
    In most cases, that wasn't the metric. It was more a question of whether your college grad kids would have ANY insurance, instead of not having any protection. Kids almost never think about health insurance.

    Until they break a leg skiing.
    Once in a while you get shown the light, in the strangest of places if you look at it right.

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    Quote Originally Posted by Oneuli View Post
    That's easy enough to test, isn't it? If the Republican control of Congress were the determining factor, then we'd expect the deficit decline to have started in FY 1996 (they won in calendar year 1994, took their seats at the start of calendar year 1995, and the first budget they worked on was for FY 1996, which starts in October 1995. And, if the Republicans were the key factor, we'd expect that good fiscal run to have been enhanced starting in 2001, when there was still Republican control of the Congress, and they also had an ally in the White House.
    Democrats dominated the Congress for 30 plus years. Republicans took over in 1995. After that, the Government experienced the first ever surplus. Deficits dropped significantly until they began seeing a surplus in 1998 as a result of the Contract with America, until after 9-11 and our subsequent invasions into Iraq and Afghanistan. Stop being a dishonest dumbfuck and pretending that there wasn't a reason the deficits began again. Find a single war that was ever fought with a surplus.

    Quote Originally Posted by Oneuli View Post
    If, on the other hand, Bill Clinton were the key factor, we'd expect the deficit decreases to have started in FY 1993 and ended around FY 2000, like his presidency.
    Deficits went up and down for thirty plus years dishonest dumbass. They didn't become a surplus until Republicans took over the Congress. Congress holds the purse strings.

    Where BillyBob Clinton gets credit is that unlike the Obama moron, he saw the American people's will and signed onto Newt Gingrich's agenda. Pretending it was a result of Clinton makes you look ignorant, dishonest and a partisan hack.

    Quote Originally Posted by Oneuli View Post
    So, which is the case? Well, it turns out, the deficit started falling in 1993, and we headed back in the other direction starting in 2001 (with renewed deficits in FY 2002). So, what does that say about your hypothesis?
    The deficit fell in 73 and 74, then increased again. The deficit fell in 79, then increased again. The deficit fell in 84, then increased again. The deficit fell in 87, then increased again. What does that say about your moronic hypothesis?

    The Republican controlled Congress in the 90's had the first surplus since 1969. What does that do to your hypothesis. STFU, seriously. You look like a moron.

    Quote Originally Posted by Oneuli View Post
    There's always an excuse, of course. If Clinton had served between 2001 and 2008, and the huge boom had been then, you'd be citing the rise of smart phones as the reason his economic performance doesn't count. If his great run had been in the 1980s, you'd be citing the rise of the business computer and the fall of interest rates as the reason his economic performance doesn't count. The point is that no matter what, wingnuts will always have some talking point about why the inevitable success of Democratic leadership doesn't count.
    Yes, partisan hacks like you are quite full of excuses, moronic hypothesis and a lot of "IFs". Dunce.

    Quote Originally Posted by Oneuli View Post
    That's the key choice people have on election day. If you want results, vote Democrat. If you want professionally tuned excuses for why the results don't count, vote Republican.
    You have it ass backwards. When Democrats took back control of the Congress for a very short four year term with Nancy Pelosi at the helm of the purse strings, deficits shot up to $1.4 trillion and we ended up with a massive and costly healthcare plan that never worked. Dunce.

    Quote Originally Posted by Oneuli View Post
    You lost track of the thread. Try rereading.
    You never had a track on it snowflake. Try re-thinking and this time use what little brain you have.

    Quote Originally Posted by Oneuli View Post
    What part of what I wrote did you misread as me pretending he didn't lie? Be specific, please, twinkletoes.
    Blah, blah, blah, whine, Blah, blah, blah, whine, Blah, blah, blah, whine. STFU, seriously.
    "When government fears the people, there is liberty. When the people fear the government, there is tyranny."


    A lie doesn't become the truth, wrong doesn't become right, and evil doesn't become good just because it is accepted by a majority.
    Author: Booker T. Washington



    Quote Originally Posted by Nomad View Post
    Unless you just can't stand the idea of "ni**ers" teaching white kids.


    Quote Originally Posted by AProudLefty View Post
    Address the topic, not other posters.

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    Quote Originally Posted by Oneuli View Post
    Is there any other period in modern economic history when spending rose as little over an eight-year period as during the Obama years?

    Look, I get it: one of your idiotic blogs handed you a talking point about spending rising unusually quickly under Obama, and you felt compelled to repeat it as fact, and now that you know you were wildly wrong, you're feeling stupid. But resist the urge to change the subject. That humiliation you're feeling serves a purpose. If you learn from it, you can work to improve, and in the future you won't be such a reliable laughing stock here. Good luck.
    Spending rose so little that we ended up with $10 trillion in additional debt. A record no other President will ever supersede. You really are too stupid for words, seriously.
    "When government fears the people, there is liberty. When the people fear the government, there is tyranny."


    A lie doesn't become the truth, wrong doesn't become right, and evil doesn't become good just because it is accepted by a majority.
    Author: Booker T. Washington



    Quote Originally Posted by Nomad View Post
    Unless you just can't stand the idea of "ni**ers" teaching white kids.


    Quote Originally Posted by AProudLefty View Post
    Address the topic, not other posters.

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    Quote Originally Posted by Oneuli View Post
    I should be taken seriously because my points are well argued and backed up with facts. As you'll remember, I never claimed spending didn't increase. I said it increased at an unusually slow rate. And now you know, contrary to your hilariously bone-headed assertions, that's correct. Learn from your error and improve.
    No; you should be laughed at for being such a clueless hyper partisan moron.
    "When government fears the people, there is liberty. When the people fear the government, there is tyranny."


    A lie doesn't become the truth, wrong doesn't become right, and evil doesn't become good just because it is accepted by a majority.
    Author: Booker T. Washington



    Quote Originally Posted by Nomad View Post
    Unless you just can't stand the idea of "ni**ers" teaching white kids.


    Quote Originally Posted by AProudLefty View Post
    Address the topic, not other posters.

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    Quote Originally Posted by Oneuli View Post
    It slowed the rate of growth and that saved money relative to what would have spent without the change. Obviously.

    Think!
    Once again, the American taxpayer hasn't saved anything no matter how many strawman claims you continue to construct scarecrow. When you add in the massive cost of subsidies the taxpayers have to come up with, they are in far worse shape than had NOTHING been done.

    I would ask you to THINK, but you lack sufficient grey matter to comprehend the OBVIOUS.
    "When government fears the people, there is liberty. When the people fear the government, there is tyranny."


    A lie doesn't become the truth, wrong doesn't become right, and evil doesn't become good just because it is accepted by a majority.
    Author: Booker T. Washington



    Quote Originally Posted by Nomad View Post
    Unless you just can't stand the idea of "ni**ers" teaching white kids.


    Quote Originally Posted by AProudLefty View Post
    Address the topic, not other posters.

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    Quote Originally Posted by Oneuli View Post
    It rose briefly and then fell dramatically.
    It rose to $1.4 trillion, then $1.294 trillion, then $1.299 trillion, $1.087 trillion. There is nothing dramatic about it except for the massiveness of the numbers you willful idiot. Obama has the distinction of having amassed more deficit than the previous three Presidents combined.

    Quote Originally Posted by Oneuli View Post
    By comparison, it's now rising rapidly with no sign there will be any reversal.
    Defenders of Obama's massive trillion dollar deficits have no room to whine about any Presidents spending......EVER. Unless, of course, you want to look like a brain dead, dishonest, clueless partisan hack moron on steroids. Right now you have that distinction.
    "When government fears the people, there is liberty. When the people fear the government, there is tyranny."


    A lie doesn't become the truth, wrong doesn't become right, and evil doesn't become good just because it is accepted by a majority.
    Author: Booker T. Washington



    Quote Originally Posted by Nomad View Post
    Unless you just can't stand the idea of "ni**ers" teaching white kids.


    Quote Originally Posted by AProudLefty View Post
    Address the topic, not other posters.

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    Passing the Affordable Care Act was always much more about extending coverage than cutting costs. Still, as the landmark law faces one challenge after another, new data are giving a better picture of how the law has played out. That includes a new study that looks at how Obamacare affected household medical spending.

    The short answer: On average, Obamacare did not affect household medical spending very much.

    The study was looking for how Obamacare was affecting medical spending. As with everything with Obamacare, it's complicated. But here we go: In a nationally representative sample of over 80,000 adults, overall, in the first couple of years after Obamacare really kicked in — 2014 and '15 — out-of-pocket payments dropped by an average of $74.

    Meanwhile, the insurance premiums that households paid rose by an average of $232. So it's a funny little coincidental parallel — out-of-pocket payments dropped by 12 percent, but premium payments rose by 12 percent.

    The good news is that out-of-pocket, high-burden spending fell by 20 percent overall — and it especially dropped for poor people. The not-so-good news is that among middle-income households, there was a 28 percent increase in high-burden spending on premiums.

    In the study's conclusions the authors write that without the individual mandate, the numbers of people without insurance will go back up again, as will out-of-pocket costs, and premiums will likely rise, too, because healthier people won't be buying insurance.

    https://www.wbur.org/commonhealth/2018/01/23/obamacare-household-spending

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    Quote Originally Posted by Truth Detector View Post
    It rose to $1.4 trillion, then $1.294 trillion, then $1.299 trillion, $1.087 trillion. There is nothing dramatic about it except for the massiveness of the numbers you willful idiot. Obama has the distinction of having amassed more deficit than the previous three Presidents combined. Defenders of Obama's massive trillion dollar deficits have no room to whine about any Presidents spending......EVER. Unless, of course, you want to look like a brain dead, dishonest, clueless partisan hack moron on steroids. Right now you have that distinction.
    Quote Originally Posted by Oneuli View Post
    I decide which possibilities seem the most likely based on the available evidence, and I form my opinions around those.
    She decides which possibilities seem the most likely based on the available evidence, and she forms her opinions around those.

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    Quote Originally Posted by Legion View Post
    She decides which possibilities seem the most likely based on the available evidence, and she forms her opinions around those.
    She's an idiot; could we expect anything but?
    "When government fears the people, there is liberty. When the people fear the government, there is tyranny."


    A lie doesn't become the truth, wrong doesn't become right, and evil doesn't become good just because it is accepted by a majority.
    Author: Booker T. Washington



    Quote Originally Posted by Nomad View Post
    Unless you just can't stand the idea of "ni**ers" teaching white kids.


    Quote Originally Posted by AProudLefty View Post
    Address the topic, not other posters.

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    Quote Originally Posted by Althea View Post
    As one who has been in the individual market for almost 40 years, I've seen the various changes to health insurance laws. Before ACA, you had to be covered for pre existing conditions, PROVIDED that you didn't have a lapse in coverage of more than 30 days.


    BUT...employers were firing employees who suddenly became gravely ill, and started skewing their group plan rates.

    So yes...the pre existing condition clause saved many lives.
    When you add up Obamcare, Medicare, and Medicaid, it would probably be astonishing to estimate the number of lives saved by these great liberal programs.

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    Quote Originally Posted by Oneuli View Post
    The deficit fell by about half on Obama's watch.
    the national debt doubled under Obama's failure to watch......that's the result of eight accumulated deficits averaging $1.25T a year......you can't be stupid enough to pretend that is good.....

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    Quote Originally Posted by Oneuli View Post
    Yes. This is not a question of opinion. It's right there, in the Congressional record. Now, that doesn't mean it was 100% phased in the moment it became law. Few laws work that way. But it became law as soon as Obama affixed his signature to it. Some of the provisions kicked in immediately, some a few weeks or months later, and some a few years later. But it was law from day one.
    to be fair.....your level of sanity is a question of opinion........the provisions which impacted costs went into effect for self-employed people such as myself in 2014.....they went into effect for people who's employers paid their insurance in 2015........your posing is not successful........

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    Quote Originally Posted by Oneuli View Post
    I agree that we should continue to judge presidents the farther we get from their time, as we gain more perspective. I think Clinton's time looks better and better from that perspective. As of 2000, one might have wrongly concluded that the great run we'd enjoyed on his watch was the "new normal" -- that whatever caused the long dark age of high violent crime, low income growth, rising poverty, and permanent deficits, from the early 1970s through the early 1990s, had worked its way out of the system and it would be smooth sailing now, for reasons unrelated to Clinton's leadership.

    And I think a lot of people believed that. Look how Bush ran in 2000 -- like we could keep the great surpluses going even as we reversed the Clinton tax hikes that made them possible. Like we could keep enjoying the Great Prosperity, but with the improvement of having an amiable dunce as the figurehead, rather than a philandering technocrat. I think it's only with the benefit of decades of history since then that it's become clear just how wrong that was. We haven't seen another surplus since Clinton left, and we're heading fast in the wrong direction. We got essentially a lost decade, after Clinton, when pretty much every measure of social and economic performance got worse. At best, we now seem to be able to choose between fiscally sound economic doldrums, or debt-finance economic orgies that will give us a deadly hangover. The farther we get from the Clinton years, the clearer it becomes just what an unusually good time they were for America.

    As for your assertion that the dotcom bubble bursting in March 2000 caused the recession that started a full year later, that's a hypothesis, not a fact. And it's not at all clear we should believe it. We've had other stock bubbles of roughly the same size deflate without causing a recession. So, why was that one unavoidable? Keep in mind, as of inauguration day, stocks were only down around 13% compared to their high point in late March 2000. A 13% decline isn't exactly earth shattering. By comparison, the stock market is down 13% just since late September. Does that mean we're doomed to imminent recession?

    Or, to take an historic example, between 4/29/2011 and 10/3/2011, the S&P 500 dropped from 1363.61 to 1099.23. Did that mean we were bound to go into recession in early 2012? That's a 19.4% drop.... much larger than the market drop over the same time period after March 2000. Yet, as you know, we didn't go into recession in 2012, or 2013, or any time since. So, why treat a smaller stock decline as if it made recession inevitable?
    So you choose to ignore the explosive economic growth we had in the '80's because you don't like the letter of the party next to the President's name.

    And you continue to spin the dot com bubble as if it is a figment of people's imagination and the Nasdaq crashing was as well.

    And surpluses were projections. You understand what projections are right? The were projections if the bubble kept going, which it never was. I'll continue to repeat myself. You are creating a false economic narrative to match the political narrative you want to tell.

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    Quote Originally Posted by Oneuli View Post
    If your kids already had insurance at a group rate (e.g., through an employer) .
    they did not.......if you had bothered to read my post you would have already known that I was paying for it......and as I have already told you the price was exactly the same you're obviously an idiot for pretending it would have gone down.......as for my insurance.....when Obamacare went into effect for self-employed people in 2014, my premiums doubled......

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