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Groovanauts.com > Everything Else > Politics / Economics > Carney: Obamacare Worth It, No Matter Political Consequences
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translucent
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Originally posted by bxbomb
i recall only Iran Contra was his only i cant remember buillshit
and that was later in his life and he really did suffer from some sort of dementia for some time

THis prez is a full blown liar and has been proven over and over but doesnt care because he knows he has about half the country of people like yourself that will make excuses for him at every turn and has about 80% of the media not doing thier job


Hey, it's not like Barry lied about selling weapons to murderous regimes, funding death squads or invading a sovereign nation over bullshit WMD claims. He fudged a bit on passing legislation that helps millions of Americans.



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bxbomb
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Originally posted by translucent
Hey, it's not like Barry lied about selling weapons to murderous regimes, funding death squads or invading a sovereign nation over bullshit WMD claims. He fudged a bit on passing legislation that helps millions of Americans.

about half the country of people like yourself that will make excuses for him at every turn



can you throw in a nixon reference as well to to deflect away from the fact barry is a sociopathic liar

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At least Nixon started the EPA. Close to half the country are GOP bozos who don't believe in climate change.



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love how Huffpo/AP labels this buried article

Obamcare Impacts Primary Care Doctor Shortage

implying that he its making an impact in a posiitive way on the shortage he has created


Obamacare Impacts Primary Care Doctor Shortage

Obamacare Increases Primary Care Doctor Shortage

You're welcome AP



MIAMI (AP) — When Olivia Papa signed up for a new health plan last year, her insurance company assigned her to a primary care doctor. The relatively healthy 61-year-old didn't try to see the doctor until last month, when she and her husband both needed authorization to see separate specialists.

She called the doctor's office several times without luck.

"They told me that they were not on the plan, they were never on the plan and they'd been trying to get their name off the plan all year," said Papa, who recently bought a plan from a different insurance company.


It was no better with the next doctor she was assigned. The Naples, Florida, resident said she left a message to make an appointment, "and they never called back."

The Papas were among the 6.7 million people who gained insurance through the Affordable Care Act last year, flooding a primary care system that is struggling to keep up with demand.

A survey this year by The Physicians Foundation found that 81 percent of doctors describe themselves as either over-extended or at full capacity, and 44 percent said they planned to cut back on the number of patients they see, retire, work part-time or close their practice to new patients.

At the same time, insurance companies have routinely limited the number of doctors and providers on their plans as a way to cut costs. The result has further restricted some patients' ability to get appointments quickly.

One purpose of the new health law was connecting patients, many of whom never had insurance before, with primary care doctors to prevent them from landing in the emergency room when they are sicker and their care is more expensive. Yet nearly 1 in 5 Americans lives in a region designated as having a shortage of primary care physicians, and the number of doctors entering the field isn't expected to keep pace with demand.

The Association of American Medical Colleges projects the shortage will grow to about 66,000 in little more than a decade as fewer residency slots are available and as more medical students choose higher-paying specialty areas.

For now, experts say most patients are receiving the care they need, even if they have to drive farther, wait longer or see a nurse practitioner or physician assistant rather than a doctor.

More importantly, many are getting care for the first time. The surge also has forced many doctors to streamline their practice and rely more on mid-tier professionals instead of seeing every patient themselves.

"Family doctors are seeing a pretty significant increase in requests for appointments from new patients," said Dr. Wanda Filer, a primary care doctor in York, Pennsylvania, and president of the American Academy of Family Physicians.

In response, the academy of more than 115,000 doctors say they're adding new physicians to their practices, relying more on nurse practitioners and physician's assistants, adding evening and weekend appointments. Despite the demand, Filer said most patients can get same-day appointments with someone on their team.

Dr. Laura Byerly has seen a surge of more than 2,000 new patients since January at her chain of health clinics in Hillsboro, Oregon, about 30 minutes west of Portland. Many had sporadic or no medical care for many years.

She hired new primary care doctors, receptionists and nurses whose sole role is to see new patients and prepare the chart for the first visit with the doctor. They even opened a new clinic so patients who used to drive 45 minutes for a visit could now see a doctor five minutes from home.

"The new patients required a significant amount of work to understand just what medications they should be on, what are their active diagnoses, what studies are needed now, and just who they are and what their life is like," said Byerly, who is the medical director of the Virginia Garcia Memorial Foundation health clinics.

Dr. Jack Chou takes patients only during open enrollment. Otherwise, it's a six to nine-month wait at his Los Angeles-area practice, where most of the new patients were covered through Medicaid expansion.

"The initial visit takes much longer because we're trying to learn about patients who had fragmented care or no care at all," said Chou. Despite the staffing struggles, "it's actually a godsend for some of my patients."

While most doctors are successfully juggling the influx, there have been cases like that of the Papas, in which consumers call multiple doctors only to find they are not in network or the doctors are not taking new patients.

Insurance agent Anthony Halby heard similar complaints from his clients in Grass Valley, California, a Sierra foothill community about an hour east of Sacramento. He said half a dozen consumers wanted him to switch their health plans as soon as the second round of open enrollment started earlier this month. They told him the plan they chose last year made it extremely difficult to find primary care doctors.

Only two insurance companies in the Gold Rush-era town offer coverage through the state exchange, and just four or five primary care doctors out of about 135 signed up with one insurer.

The other insurer has more doctors, but most are considered out of network. That means patients who use them will pay 60 percent of the bill, he said.

"Coverage does not equal access," said Halby, who instead recommends his clients choose a plan outside the exchange that has a much broader provider network but also will not come with the government premium subsidies given to most of those who buy insurance through the exchange. "I tell people this up front: The premiums are going to be higher because there's no subsidy. However, I'm going to guarantee you can keep your doctor."



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Obamacare has made the practice of primary care an administrative bureaucratic nightmare where primary care doctors spend more time pushing paper and ...doing data entry than caring for patients. More busywork, less patient face time, less pay. Would that sound appealing to you if you were more than $100,000 in debt from med school, college, etc? Of course not. So add it all up. Primary doctors can see fewer patients, fewer med students want to be primary care doctors and the established primary care doctors are looking to retire early or do something else. Thank's Mr. President, you gave us insurance that no doctor wants to accept and that causes fewer doctors to be available. And make no mistake, this was not an unintended consequence. Anyone who read the bill saw this as plain as day...if they read it before voting on it that is.

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There was an increasing Family Care MD shortage for well over a decade. This trend started in the 90's, when the cost of education started its hockey stick curve upward. The single biggest reason is that specialists make a shitload more than PC/FC docs. If you had a choice of earning $150k or $400k/yr, which would you go for, especially if you're mired in debt from medical school?



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the downtrend was minor to what has happened under the passage of obamacare
and his regualtions have forced exisitng DRs to stop taking patients or just quit ...something that wasnt happening in droves since obama took office and people knew where he was going with this craptacualr law

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What the ACA did was make being FC doctor less profitable as it drove medical costs down. So, yes, Obamacare definitely precipitated an increase in the shortage. However, any healthcare reform legislation that tried to contain costs would do the same. Here's a good article that covers the reality of what's going on:

Apprehensive, Many Doctors Shift to Jobs With Salaries
By ELISABETH ROSENTHALFEB. 13, 2014


American physicians, worried about changes in the health care market, are streaming into salaried jobs with hospitals. Though the shift from private practice has been most pronounced in primary care, specialists are following.

Last year, 64 percent of job offers filled through Merritt Hawkins, one of the nation’s leading physician placement firms, involved hospital employment, compared with only 11 percent in 2004. The firm anticipates a rise to 75 percent in the next two years.

Today, about 60 percent of family doctors and pediatricians, 50 percent of surgeons and 25 percent of surgical subspecialists — such as ophthalmologists and ear, nose and throat surgeons — are employees rather than independent, according to the American Medical Association. “We’re seeing it changing fast,” said Mark E. Smith, president of Merritt Hawkins.

Health economists are nearly unanimous that the United States should move away from fee-for-service payments to doctors, the traditional system where private physicians are paid for each procedure and test, because it drives up the nation’s $2.7 trillion health care bill by rewarding overuse. But experts caution that the change from private practice to salaried jobs may not yield better or cheaper care for patients.

“In many places, the trend will almost certainly lead to more expensive care in the short run,” said Robert Mechanic, an economist who studies health care at Brandeis University’s Heller School for Social Policy and Management.

When hospitals gather the right mix of salaried front-line doctors and specialists under one roof, it can yield cost-efficient and coordinated patient care. The Kaiser system in California and Intermountain Healthcare in Utah are considered models for how this can work.

But many of the new salaried arrangements have evolved from hospitals looking for new revenues, and could have the opposite effect. For example, when doctors’ practices are bought by a hospital, a colonoscopy or stress test performed in the office can suddenly cost far more because a hospital “facility fee” is tacked on. Likewise, Mr. Smith said, many doctors on salary are offered bonuses tied to how much billing they generate, which could encourage physicians to order more X-rays and tests.

Mr. Mechanic studied 21 health systems considered good models of care — including the Mayo Clinic and the Palo Alto Medical Foundation — and discovered that many still effectively rewarded doctors for each procedure. “It doesn’t make any sense,” he said.

Hospitals have been offering physicians attractive employment deals, with incomes often greater than in private practice, since they need to form networks to take advantage of incentives under the new Affordable Care Act. Hospitals also know that doctors they employ can better direct patients to hospital-owned labs and services.

“From the hospital end there’s a big feeding frenzy, a lot of bidding going on to bring in doctors,” Mr. Mechanic said. “And physicians are going in so they don’t have to worry — there’s a lot of uncertainty about how health reform is going to play out.”

In addition, Medicare had reduced its set doctors’ fees over the last decade, while insurers have become more aggressive in demanding lower rates from individual practices that have little clout to resist. Dr. Robert Morrow, a family doctor in the Bronx, said he now received $82 from Medicare for an office visit but only about $45 from commercial insurers.

Dr. Cathleen London practiced family medicine for 13 years outside Boston, but recently took a salaried job at a Manhattan hospital. She said she accepted a pay cut because she could see that she was losing ground in her practice. “I think the days of what I did in 1999 are over,” she said. “I don’t think that’s possible anymore.”

The base salaries of physicians who become employees are still related to the income they can generate, ranging from under $200,000 for primary care doctors to $575,000 in cardiology to $663,000 in neurosurgery, according to Becker’s Hospital Review, a trade publication.

Because of the relatively low salaries for primary care doctors, Dr. Suzanne Salamon said that for the last two years she has had trouble filling a prestigious Harvard geriatrics fellowship she runs.

Dr. Howard B. Beckman, a geriatrician at the University of Rochester, who studies physician payment incentives, said reimbursements for primary care doctors must be improved to attract more people into the field. “To get the kinds of doctors we want, the system for determining salaries has to flip faster,” he said.

Doctors can become employees by practicing in a hospital building, or by selling their multispecialty practice to a hospital, so their office becomes part of a network. That has attracted specialists, including many cardiologists who took up such offers several years ago after Medicare reduced physician payments for cardiac procedures like the placement of stents to hold open clogged arteries. The fraction of cardiologists employed by hospitals rose to 35 percent in 2012, up from 11 percent just five years earlier, according to the American College of Cardiology.

Dr. Joel Jacowitz, a cardiologist in New Jersey, and his 20 or so partners decided to sell their private practice to a hospital. In addition to receiving salaries, that meant they no longer had to worry about paying malpractice premiums themselves or finding health insurance for their staff members.

Dr. Jacowitz said that the economics drove the choice and that the only other option would have been to bring in more revenue by practicing bad medicine — ordering more heart tests on patients who did not need them or charging exorbitant rates to people with private insurance. He said he knew of one cardiologist in private practice who charges more than $100,000 for a procedure for which Medicare pays about $750.

“Some people are operators and give the rest of us a bad name,” he said, adding that he had changed his opinion about America’s fee-for-service health care system. “I’m fed up — I want a single-payer system.”

Dr. Kirk Moon, a radiologist in private practice in San Francisco, also sees advantages for the nation when doctors become employees. “I think it’s pretty clear that sooner or later we’re all going to be on salary,” he said. “I think there’ll be a radical decrease in imaging, but that’s O.K. because there’s incredible waste in the current system.”

Various efforts to change incentives for doctors and hospitals are being tested. An increasing number of employers or insurers, for example, pay health systems a yearly all-inclusive payment for each patient, regardless of their medical needs or how many tests are dispensed. If doctors order unnecessary tests, it costs the hospital money, rather than bringing it in.

And instead of offering bonuses for productivity — doctors cite pressures from hospital employers to order physical therapy for every discharged patient or follow-up M.R.I. scans on every patient who got an X-ray — some hospital systems are beginning to change their criteria. They are providing bonuses that reward doctors for delivering high quality and cost effective care, such as high marks from patients or low numbers of patients with asthma who are admitted to the hospital.

“The question now is how to shift the compensation from a focus on volume to a focus on quality,” said Mr. Smith of Merritt Hawkins. He said that 35 percent of the jobs he recruits for currently have such incentives, “but it’s pennies, not enough to really influence behavior.”

http://www.nytimes.com/2014/02/14/us/salaried-doctors-may-not-lead-to-cheaper-health-care.html?_r=0



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Breaking news: Obamacare works. Who will be the first Republican to look at the mounting evidence and admit that he or she was wrong?
NEW YORK DAILY NEWS
Wednesday, March 18, 2015, 4:22 AM

This week brought the good news that 16.4 million Americans have gained coverage under the Affordable Care Act — taking a 35% bite out of the ranks of the uninsured.

Last week, the Congressional Budget Office calculated that the law’s tax subsidies are costing 20% less than projected five years ago, when it was passed.

And in December, the feds reported that the once-ruinous spiral of spending on medical care slowed to just 3.6% for 2013 — “the lowest increase on record in the national health expenditures going back to 1960,” according one of the report’s authors.

It’s increasingly obvious, in other words, that the ACA, aka Obamacare, is beating expectations — not just of its critics, but also its supporters — and moving the country toward the sanity and security of universal health coverage.

So who will be the first major Republican to admit that Obamacare is working?

Who among the GOP’s brain trust is intellectually honest enough, or brave enough, to follow the developing facts instead of talking points and opinion polls?

Don’t look to Congress, where, despite the evidence, the law remains a favorite whipping boy of Republicans.

New Senate Majority Leader Mitch McConnell has vowed to make “every effort” to repeal the law. And wiping out Obamacare featured prominently in the budget proposal rolled out Tuesday by House Speaker John Boehner.

When Boehner called his umpteenth repeal vote last month, freshman Syracuse-area Rep. John Katko was one of only three Republicans who bucked the party line by voting “no.”

Nor are profiles in courage arising among the Republican field for President.

Jeb Bush — who has stood up to his party’s base by advocating comprehensive immigration reform and defending the Common Core standards — still panders to it by labeling Obamacare a “monstrosity.”

He should have known better, having served on the board of Tenet Healthcare, which actively encouraged people to enroll in Obamacare and credited the law for dramatically boosting its revenues.

Also predictably in the anti-Obamacare camp is early front-runner Scott Walker of Wisconsin, one of the many Republican governors who turned down the chance to expand his state’s Medicaid plan for the poor at federal expense.

In fact, Walker rolled back eligibility to push thousands of Wisconsinites off the Medicaid rolls — arguing they could now afford to buy their own coverage through Obamacare. How’s that for having it both ways?

At least this isn’t 2009, when Sarah Palin spouted off about “death panels” — which was her purely demagogic spin on an ACA provision that sensibly encouraged doctors to talk to their patients about end-of-life issues, such as living wills and advance directives.

And at least this isn’t 2010, when McConnell, John McCain and others were ranting about 16,500 agents the IRS would supposedly be hiring to enforce the law — which some in the conservative media ominously portrayed as a paramilitary force.

At least this isn’t 2012, when GOP presidential candidate Mitt Romney campaigned against the health law — even though Obama had modeled it on one Romney proudly pioneered as governor of Massachusetts.

Yes, Obama spread misinformation about the law, too — by repeatedly vowing that, “If you like your health plan, you can keep it.” That wasn’t true for some percentage of Americans, and he knew it.

But his far more important promise — to make affordable health coverage available to those who need it without breaking the bank — is being kept.

To be fair to doubters of good faith, the odds were long.

It’s succeeding in spite of the ugly sausage-making of its trip through Congress.

It’s succeeding in spite of the hash job that the Obama administration made with its original website.

It’s succeeding in spite of Republican rhetoric that stoked fear and misunderstanding in the public.

It’s succeeding in spite of Congress’ perverse refusal to fix technical glitches large or small — including the ambiguous wording behind an opportunistic legal challenge currently before the Supreme Court.

Barring a bad ruling from the court — which could deal a huge setback — the ACA’s much-mocked hundreds of pages of legislation and thousands of pages of regulations are working better than Obama himself had any right to expect.

Republicans used to support the goal of universal coverage. Some of them used to support the ACA’s core concept of requiring Americans to be insured — the so-called individual mandate — as a market-based way to move toward universal coverage .

Now they only seem know what they’re against.

whammond@nydailynews.com

https://www.nydailynews.com/opinion/bill-hammond-breaking-news-obamacare-works-article-1.2152882



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bxbomb
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yes when you take away from others who worked for their insurance its easy to get the other numbers up

EMployer mandate hitting htis year that should be fun telling me how much of a success its been

why are you even trying to go down this road

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Before Obamacare, every time someone without insurance showed up at the ER, that was money taken away from others who worked for their insurance. Those ER visits didn't pay for themselves.



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it certainly wasnt as bad as it is now or is going to be for the half that works for their shit

that showing up to ER didnt have any negative outcome to my health insurance

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Originally posted by bxbomb
it certainly wasnt as bad as it is now or is going to be for the half that works for their shit

that showing up to ER didnt have any negative outcome to my health insurance


It didn't have any impact on your insurance as far as you knew. In actuality, it very much did. Your insurance rate factors in the cost of healthcare provided. The cost of healthcare is raised by hospitals and doctors having to eat the cost of ER visits from uninsured people. Since Obamacare there's a sharp decrease in the rate at which healthcare costs were climbing. Eventually, we might even see costs go down or at least flatten out.



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bxbomb
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no... not really
NEVER have I or millions of others noticed this much negative change in premiums, coverage, dedcutibles, doctor choice etc

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So far, formerly 11M uninsured people have insurance. I'm not even gonna bring up the number of people who would've been either dropped or paying through the nose for preexisting conditions. I'd say that alone is worth it for the relatively small percentage of the population who were impacted negatively by the ACA. Also, let's not gloss over the fact that for the majority of people for whom premiums went up, it's because before, their plans barley covered anything. The ACA did away with that and forced a minimum standard of coverage and services. Of course insurance companies had to raise rates on those plans to cover the fact that they'd actually have to pay for treatment in case someone on the plan got sick.



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So our health sector has been thrown into turmoil, millions of people have lost their private health plans, $1 trillion in new and higher taxes have been imposed on individuals and businesses – and the uninsured rate has dropped a net of 1.5%.
Many workers have lost jobs and hours because businesses couldn’t afford to provide ObamaCare’s expensive benefits or pay thousands of dollars in penalties.

But the requirements on companies nonetheless persist: They are required to track the number of hours worked by each of their employees to determine whether they hit the magic 30-hour-a-week threshold that the law defines as a full-time job. Companies can be penalized if they don’t offer affordable insurance to full-time employees.

Businesses also are required to track and report the months an employee is covered by insurance and the cost of premiums so the government can decide if the coverage is affordable under the law. Not one minute of these compliance costs adds to the value of the company or helps it grow or improve its products or services.
As much damage as the law is doing, it could be worse. The law that passed five years ago is not the one that is being implemented today.

ObamaCare has been changed at least 49 times since it was enacted March 23, 2010. The Obama administration has made 30 major changes, many without statutory authority. In addition, Congress has passed and the president has signed an additional 17 changes, and the Supreme Court made two major modifications to the law, according to our count at the Galen Institute.

Had so many provisions of the law not been repealed, delayed, or defunded, it surely would be even more unpopular than it already is. Since the law passed, the employer and individual mandates have been delayed, countless waivers and exemptions have been granted to favored groups, the 1099 reporting requirement on small businesses was repealed, the long-term care CLASS act was axed, funding was shut off for the troubled non-profit co-ops, and the Supreme Court changed the Medicaid expansion mandate into an option and transformed the individual mandate into an optional tax.

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Fist off, all those people losing coverage are also getting new, often better coverage. It's not like they're all becoming uninsured since the ACA. If that was the case, the rate of uninsured people wouldn't be dropping. Second, it's a given that the ACA is poorly written and needs revisions. Unfortunately, the GOP is not interested in fixing it. All they want is its complete repeal without offering any viable alternative. they're just concerned in the optics of handing Obama and the Dems a defeat on their signature act.



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Ted Cruz, who wants to eliminate Obamacare, plans to register for Obamacare
BY Glenn Blain , Adam Edelman

NEW YORK DAILY NEWS

Published: Tuesday, March 24, 2015, 4:49 PM
Updated: Tuesday, March 24, 2015, 9:10 PM

If you can't beat it, join it.

Presidential candidate Sen. Ted Cruz, who has been an outspoken critic of Obamacare, is planning to use the program he wants to abolish to obtain health insurance coverage.

“We will presumably go on the exchange and sign up for health care and we’re in the process of transitioning over to do that,” Cruz, a conservative Republican from Texas, told The Des Moines Register.

Cruz, who has repeatedly called for Congress to repeal Obama’s Affordable Care Act, finds himself in need of insurance because his wife is taking an unpaid leave of absence from her job at Goldman Sachs and will lose her health care. Cruz had been receiving coverage under his wife’s employee coverage.

Under the law, members of Congress are required to purchase their health care through Obamacare exchanges.

“Well, it is written in the law that members will be on the exchanges without subsidies just like millions of Americans so that’s — I think the same rules should apply to all of us,” Cruz told the newspaper. “Members of Congress should not be exempt.”

Asked by CNN whether he would accept the government subsidies available to lawmakers for their health care coverage under Obamacare, Cruz said he will “follow the text of the law.”

“I strongly oppose the exemption that President Obama illegally put in place for members of Congress because (Senate Minority Leader) Harry Reid and the Senate Democrats didn’t want to be under the same rules as the American people,” Cruz said. “I believe we should follow the text of the law.”

After the interview, a Cruz rep told CNN that he wouldn’t take the contribution.

Aides said there was nothing unusual about Cruz signing up for insurance coverage through his employer because Obamacare has wiped out the individual market, leaving Cruz with few options, according to CNN.

Later Tuesday, Cruz spokesman Rick Tyler told the Washington Post that a final decision had not been made. “Sen. Cruz said he would ‘presumably’ use his employer health insurance, for which the only option is Obamacare,” he said. “But there are other options that the senator is considering before making a final decision about how to make sure his family is insured.”

Cruz still believes Obamacare should be repealed.

“What is problematic about Obamacare is that it is killing millions of jobs in this country and has killed millions of jobs,” Cruz said. “It has forced millions of people into part-time work. It has caused millions of people to lose their insurance, to lose their doctors and to face skyrocketing insurance premiums. That is unacceptable.”

gblain@nydailynews.com

https://www.nydailynews.com/news/politics/ted-cruz-sign-obamacare-abolish-article-1.2160977



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and???

Under the law, members of Congress are required to purchase their health care through Obamacare exchanges.

would you propose a future candidate for president to violate a law

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More Previously Uninsured Californians Got Coverage Under Obamacare
July 31, 2015 9:56 AM ET


Just over two-thirds of Californians who did not have health insurance before the Affordable Care Act went into full effect in 2014 are now covered, according to a survey from the Kaiser Family Foundation.

The newly insured are much less likely to say that paying for health care is a problem, compared to when they were uninsured.

"This is really great news for California," said Sarah de Guia, executive director of the California Pan-Ethnic Health Network, an advocacy group. She spoke of people being lifted from the fear of paying for care. "There's this sense of relief, that they're not one accident or incident away from bankruptcy. ... They can keep their costs contained."

The rate of newly insured — 68 percent — is an increase over the first Obamacare open enrollment last year. Then, 58 percent of the previously uninsured had gained covered.

At the same time, nearly a third of those surveyed this year — 32 percent — are still uninsured. Many of them fall into two categories. One group, about four in 10, are undocumented immigrants and ineligible for coverage.

"Another chunk of those people who are remaining uninsured have been uninsured for a long period of time and therefore may be harder to reach, a harder group to bring into the fold," said Bianca DiJulio, associate director with the foundation's Public Opinion and Survey Research Program.

The largest share of the newly insured — 34 percent — are covered in the Medi-Cal, the state's version of Medicaid. Fourteen percent say they are insured through their employer and 12 percent purchased insurance through Covered California, the marketplace established under the ACA.
Peter Lee, executive director of Covered California, (left) poses with his uncle, Philip Lee, and father Peter Lee (seated) at the younger Peter Lee's home in Pasadena, Calif., in 2013.
Shots - Health News
Meet The California Family That Has Made Health Policy Its Business

The newly insured largely say their health care needs are being met with 86 percent saying their needs are being "very well" or "somewhat" well met, up from 51 percent in 2013.

Before the health law, nearly 6 million adults in Californians were uninsured, the most of any state, and Latinos made up more than half of them. While initial campaigns to reach Latinos were widely criticized, newer efforts seem to be more successful. The survey found that whites and Latinos signed up in nearly equal proportions, 79 percent for whites and 74 percent for Latinos (after excluding those Latinos who would be ineligible for ACA benefits due to their immigration status).

Yet last year's survey of the previously uninsured after the first open enrollment concluded showed that whites and Latinos signed up at the same rate, 61 percent.

Advocate de Guia said the small gap found this year — five percentage points — was worrisome, because grants to community groups to help people sign up have declined by millions of dollars. "Enrollment dollars are going down or being cut," she said. "We don't want to see that gap widen over time."

Gerald Kominski, director of the UCLA Center for Health Policy Research said the survey findings were "obviously very good news," but cautioned that the findings have a limitation. The group of people that is being followed all had previously lacked insurance.

"There's another cohort of Californians who are not in this survey — people who had insurance and lost it," he said in an interview. "Some portion of those individuals remain uninsured."

Overall, those saying it's hard to afford health care dropped from 86 percent in 2013 to 49 percent today.

In the survey, 85 percent of the uninsured say paying for health care is their top financial concern — ahead of paying their mortgage or rent. Of those who have gained coverage, paying for health care now ranks fourth among financial concerns — behind rent/mortgage, utilities and even gasoline.

"It's below the price of gas," said UCLA's Kominski. "I found that truly remarkable ... the fact that health care for people newly insured (is) no longer a primary concern, I think is significant."

While 76 percent of the newly insured say their experience with their plan has been positive, some are reporting issues in accessing care, including 28 percent who say they had to wait longer than they thought they should have to for an appointment or finding that a doctor said they would not accept their insurance (17 percent of Medi-Cal recipients; 23 percent of people with a Covered California plan).

This survey is the third in a series of people who were uninsured in 2013, before the Affordable Care Act went into full effect. From February 18 to May 13, 2015, 1,105 adults who had participated in the first survey were contacted. The margin of sampling error is plus or minus 4 percentage points for results based on the full sample, 5 percentage points for recently insured Californians, and 8 percentage points for those Californians who remain uninsured.

http://www.npr.org/sections/health-shots/2015/07/31/428014751/more-previously-uninsured-californians-got-coverage-under-obamacare



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