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While Oregon is blazing Obamacare trails, its neighbor to the east is having a harder time getting up to speed. The Idaho legislature—massively Republican—spent much of its session in a fight over whether or not to bow to Obamacare or pretend like it didn't exist.

But unlike many of his red state compatriots, Gov. Butch Otter (yes, that's really his name and of course he's a Republican) pushed hard for the state to create its own exchange, arguing that if it did so, it wouldn't be under the heel of the federal government. Eventually, the legislature concurred, and in late March approved it as a private, nonprofit corporation. Now the state is scrambling to get it ready by October.

The newly formed Idaho exchange board and the federal exchange office have been talking about ways the state can remain in control of its exchange while borrowing pieces of the federal exchange’s infrastructure. As interim Chairman Stephen Weeg puts it, Idaho is looking to “beg, borrow and steal” its way to the Oct. 1 start of open enrollment.

“We’re trying to scramble and put everything together in an incredibly short amount of time,” said Weeg, who took the helm of the board when it was established last month. [...]

While even the states most enthusiastically implementing Obamacare are working through complicated policy and technical issues three years into building their own exchanges, the new Idaho exchange board still has to figure out the basics with less than five months until open enrollment starts — things like getting an office, setting ground rules for itself and getting the OK to draw down on federal grants. [...]

Still, there’s real concern within the exchange board about doing anything with the feds.

“The Legislature is not interested,” state Sen. Jim Rice, who sits on the board, said during a Thursday afternoon meeting. “That’s, frankly, why we set this up the way we did.”

Unfortunately, the Idaho legislature is interested in very little that might actually help Idaho residents, like considering taking federal Medicaid money to provide expanded health care to more residents. As far as a good chunk of the legislature—and obviously part of the exchange board—is concerned, sabotaging the state's own homegrown exchange isn't out of the question. Perhaps what the board should be doing is looking west, and consulting Oregon for how to do this.

Originally posted to Joan McCarter on Fri May 10, 2013 at 02:06 PM PDT.

Also republished by PacNW Kossacks and Daily Kos.

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Comment Preferences

  •  I'm surprised more states didn't do this (7+ / 0-)

    Not delay until the last minute, but tackle the exchange so they would have control over it instead of letting the Federal government run it and risk having this be a case of the federal government doing good and making people in that red state believe in government again.

    As it stands now, it looks like there's a lot of hoping by Republicans that the exchanges fall flat and there also seem to be a number of Democrats who are wanting to wait and see what happens rather than getting out there and trying to make things work.  Colorado very early on started working to implement it, but I feel for people in states where they're letting things go till the last minute, with Republicans lined up to slam every little issue that comes up as being Chicken Little moments.

    •  Connecticut was up early (4+ / 0-)

      Our state had some money from the tobacco settlements which I think was used to set up and enhance the program.  

      From my point of view it's going to be a million times better than the crap we have now.  I am looking at going from paying $569 a month for insurance for myself and $80 for my son to $124 a month for the whole family.  That's a savings of over $6,000 a year.  So yeah the states that set up their own plans were smart and I suspect that Oregon will be reaping the benefits of it while Idaho will be floundering.    

      This is your world These are your people You can live for yourself today Or help build tomorrow for everyone -8.75, -8.00

      by DisNoir36 on Fri May 10, 2013 at 02:58:44 PM PDT

      [ Parent ]

      •  DisNoir36--Did the $124 a month insurance premium (3+ / 0-)

        quote come directly from your actual state health insurance exchange, if I may ask?

        We have been very worried about Mr M's company's threat to pull insurance coverage beginning in 2014, because of the expected health insurance premium increase.

        Indeed, one posting here (DKos) from a commenter living in California indicated that his premium (according to the information he's gleamed from the California Exchange) would be more than he could afford.

        Hopefully, most states will be like Connecticut!

        Mollie

        "Only he who can see the invisible, can do the impossible."-- Frank L. Gaines


        hiddennplainsight

        by musiccitymollie on Fri May 10, 2013 at 03:20:25 PM PDT

        [ Parent ]

        •  There's also whatever subsidies might be (2+ / 0-)
          Recommended by:
          musiccitymollie, Words In Action

          available.  DisNoir36 may be getting subsidies.  I won't, but that's a price I'm willing to pay for health care for most. I like not having someone who's sick handling my food, coughing on me in public places and driving up my costs by being forced to use emergency rooms for issues that could have been handled through preventative care and regular treatment.

          •  Hey, ColoTim, believe me, didn't mean to imply (3+ / 0-)
            Recommended by:
            Words In Action, ColoTim, Youffraita

            any negative connotations when I asked DisNoir36 if this was information directly from her Exchange.

            I certainly harbor no ill will toward 'anyone' getting insurance through an exchange, subsidy or no subsidy.

            If you've seen the ACA chart for allowable income, it is not 'very likely' that anyone who has enough income to shell out (as she has) $649 per month for her health insurance premiums, would come under the low income level to qualify for a subsidy in the Health Exchange.  Unless there are variables that I've never read about.

            The cutoff for a subsidy under the ACA is an annual income [for a family of two] of approximately $46,000, unless it's been revised.

            My only 'beef' will be if we (Mr. M and I) lose our extensive health insurance coverage, and are forced into the federal health exchange (our state refuses to set one up), where our premiums will be age-rated.

            Our obvious concern being that the premiums could shoot up so high that we won't be able to afford carrying health insurance any longer (age-rating allows premiums to be up to 3-times higher for seniors/Boomers--which we are).  

            Obviously, we didn't have that concern under our 'group' health insurance plan.  And, naturally, we don't qualify for a subsidy.

            Guess we'll get the 'final word' by September, since the exchanges open in October.

            Dems better hope that a rash of major companies and corporations don't join the 'dump their employees' health insurance bandwagon.  

            Some folks who are uninsured but won't be insured now since their states didn't opt in to Medicaid will be mad, and that will be bad enough.  

            But imagine how angry folks who've had insurance all their lives will be, if 'they' are now dumped due to the ACA (this is of course, the reason cited to us.  Whether or not it based in fact--that they would lose a great deal of money due to the new regulations--they ARE self-insured--is really beside the point, since the end result would be disastrous for us, period).

            Anyway, good luck with your HE in Colorado.  

            Here's an interesting blurb about Colorado, from Kaiser Health News:

            Myung Oak Kim, director of communications and outreach for the Colorado exchange, said internal research showed just 10 percent of Coloradans were familiar with the marketplace. “We needed to get a wider awareness of our organization in a short amount of time to help prepare people for the changes that will be taking place,” she said.

            The Colorado marketplace hopes to sign up about 136,000 people in the first year of operation.

            The state has about 800,000 uninsured people and a total potential  base of 1 million consumers, including those who have small group or individual coverage today. About 500,000 residents are expected to be eligible for premium subsidies based on their income.

            The exchange plans to spend at least $10.5 million to provide in person consumer assistance to help people sign up for coverage in the first year and may get additional money from private foundations. Funding for consumer assistance will vary widely by state, with states running their own marketplaces spending more money generally than those relying on the federal exchange.

            Mollie

            "Only he who can see the invisible, can do the impossible."-- Frank L. Gaines


            hiddennplainsight

            by musiccitymollie on Fri May 10, 2013 at 05:36:10 PM PDT

            [ Parent ]

            •  Sorry if I was critical (2+ / 0-)
              Recommended by:
              musiccitymollie, Youffraita

              I don't begrudge anyone being helped to get what should be a human right rather than a privilege.

            •  My husband's employer is looking to do the same. (3+ / 0-)
              Recommended by:
              Just Bob, ColoTim, musiccitymollie

              There are rumors of them dropping coverage, and we hardly pay anything for it now and it is good insurance.  We also won't qualify for a subsidy and we have a son with special needs and due to my husband's age....we figure it will mean a 10,000 to 12,000 per year salary cut for my husband.  We are scared to death about it.

                If it weren't for our son, we would just live with no insurance and pay the fine, as it will be much less than the insurance prices we have seen using the online calculators.  However, we can't be without insurance with our son, and we have such good insurance now, that we are simply praying we can keep it.  

            •  Utilize the power of this community (3+ / 0-)
              Recommended by:
              ColoTim, eps62, musiccitymollie

              We should all be working together and comparing rates, coverage, customer service, everything.  I'd like to know what others are paying and getting out of the exchanges. I have great coverage through my employer but who knows how long that will last. I'm disgusted that we're still toiling in the 20th century with our employment-linked health insurance while the rest of the world provides it to everyone regardless of employment status.

              [Terrorists] are a dime a dozen, they are all over the world and for every one we lock up there will be three to take his place. --Digby

              by rabel on Sat May 11, 2013 at 07:51:58 PM PDT

              [ Parent ]

        •  Info was directly from the exchange (4+ / 0-)

          and my tax preparer based on my taxable income.  

          And Yes ColoTim I will be getting subsidies.  Infact EVERONE who has a family of 4 and makes under $90,000 annually will be getting some subsidies in CT and for families of 4 making under $30,000 they'll be on Medicaid.

          If you don't believe me you can check for yourself

          This is your world These are your people You can live for yourself today Or help build tomorrow for everyone -8.75, -8.00

          by DisNoir36 on Fri May 10, 2013 at 06:47:19 PM PDT

          [ Parent ]

          •  Hey, let's be fair, DN36--I most definitely did (0+ / 0-)

            not imply that you were not telling the truth.

            As a matter of fact, I said to Tim:

            . . . didn't mean to imply any negative connotations when I asked DisNoir36 if this was information directly from her Exchange.
            So now that that's understood, I was going on 'the mention of' you and a son (and looking at the situation from a family of two--not four).  Obviously, that would make a huge difference since a family can make a combined salary in the $90,000 plus range.

            BTW, I've read that the online calculators are not always accurate.  Now, I'm referring to those at various health news websites.  Not the ones at the actual state exchanges.  I've not visited them.

            The following information may explain this, since the calculators that I've used, never spelled out 'what income is.'

            I'm furnishing you this information because you mentioned going by preparer based 'taxable income.'  

            If by that you mean  mean AGI, or Adjusted Gross Income--and that is the income on which federal taxes are based--it is a different figure (potentially) from the figure that will be used to determine eligibility for subsidy.

            Here you go:

            . . . The ACA requires use of MODIFIED ADJUSTED GROSS INCOME (MAGI) instead of ADJUSTED GROSS INCOME for all determinations made by an Exchange including eligibility for Medicaid, except in certain cases.

            So, in this lesson, we’ll refer to annual income as MAGI.

            Modified Adjusted Gross Income (MAGI) is defined as 'Adjusted Gross Income' PLUS

            a) all tax exempt interest accrued or received in the taxable year;

            b) the non-taxable portion of Social Security benefits provided under Title II of the Social Security Act which includes old-age benefits, disability benefits, spousal benefits, child benefits, survivor benefits and parental benefits;

            c) tier 1 Railroad Retirement benefits that are not included in gross income; and

            d) the exclusion from gross income for citizens or residents living abroad.

            The adoption of MAGI, created by the ACA, is defined in a new section of the IRS code.

            Clearly, if none of these payments apply to you or any of your family members, hopefully the calculations that you've done will be accurate.

            I hope that all the exchanges will be as strong as yours sounds, in Connecticut.  Good luck!

            Mollie

            "Only he who can see the invisible, can do the impossible."-- Frank L. Gaines


            hiddennplainsight

            by musiccitymollie on Fri May 10, 2013 at 08:55:37 PM PDT

            [ Parent ]

        •  I'm in California. (3+ / 0-)

          57 years old, not married, no kids.

          I went to the premium estimator page at:

          http://coveredca.com/...

          For a "Silver" plan, the calculator says the cost for me will be

          $702 PER MONTH!

          Right now, I pay $56 every 2 weeks for Kaiser Permanente insurance. If my employer drops it, I don't have an extra $600 a month to buy this coverage. And I make too much to get any help.

          For me, it's a ripoff. This money won't go to cover my care, it will go in the pocket of a CEO pimp letting him buy another mansion.

      •  Connecticut was way too early (2+ / 0-)
        Recommended by:
        ColoTim, musiccitymollie

        Way too early...

        T]he decision [for the shorter forms] could pose problems for states that are already far along in developing their exchange IT systems, according to the executive director of one state-run exchange.

        Kevin Counihan, CEO of the Connecticut Health Insurance Exchange, said the change announced Tuesday came after his exchange has already completed coding required for system integration based on the original, 21-page application. The state exchange's IT system may not recognize data from the new form.

        Wowsers. Who could have predicted that a late-stage change on all the inputs to the fucking system would cause ripple effects on dependent subsystems? But read on for CMS's response:

        Counihan voiced his concerns today to Chiquita Brooks-LaSure, deputy director on policy of CMS' Center for Consumer Information and Insurance Oversight at the National Health Insurance Exchange Summit in Arlington, Va. “Is there anything HHS can do to stop making changes right now,” Counihan asked her.

        Brooks-LaSure responded that states have the option of using the new, streamlined application that's three pages long or can still use the original, longer document.

        Well, great. If you accept that the original, 26-page sucked, here are the options that CMS just gave the good folks in CT:

        1. Start recoding, and try to get the Feds to cover the budget over-run, or

        2. Use the 26-page form, and watch your enrollment decrease because of the rotten user experience. Which is exactly what Obama says will happen: "People aren’t going to have the patience to sit there for hours on end."

        So Obama throws the CT exchange under the bus because PR, and (as usual) those who trusted the guy got betrayed. Obama's making the Rick Perrys of this world -- the states that don't want to build their own exchanges -- look awfully good, and making his own supporters in CT look awfully stupid.*

        This does not bode well.
        •  Except it's not 26 pages online is it? (2+ / 0-)
          Recommended by:
          ColoTim, eps62

          Even with the 21 page form(I think it was 21, not 26), I think people pointed out that it included space to fill info for a family of 6(that was 12 page itself). A single person would simply need to fill out 4 pages.

          And online, there were would prompts so you could fill out only what you need to fill out.

          •  Credit Agencies are now in the mix. (1+ / 0-)
            Recommended by:
            musiccitymollie

            The input is now switched to the back end.  You just fill the form, sign the perjury declaration, and IRS, Homeland Security, and other public and private agencies will weigh in to determine which bucket you fit in.  What could possibly go wrong?  Search for "Obamacare Clusterfuck" to learn more...

            •  Check Correntewire! (0+ / 0-)

              That has the most complete elucidation of the current exchange clusterfuck.  You will be amazed!

            •  Why Form is shorter! (1+ / 0-)
              Recommended by:
              ColoTim

              Credit Agencies will help.

              UPDATE Why this policy determination now? (Interestingly, a search on “consumer reporting agencies” at Kaiser, the goto source for health care reform, shows two hits. From 2009.) It would be irresponsible not to speculate, and my speculation is this: A second difference between the draft (HHS, 26 page) and the finalized (Obama, 3 page) form is what system architects call “placement of function.” In the draft form, the function of gathering income data was placed at the front end (that is, on the web site or the paper form), where the user answers questions, rather like on a 1040. In the finalized form, these questions have been removed, and this function has been placed at the back end, meaning that the system itself will merge (“match”) information from various data sources to determine income (hence eligibility) by itself, without asking the user.

              So why, very late in the day for building a big system under severe deadline pressure, did Obama bet on shifting the income data gathering function from the front end to the back end? I would bet that’s because the credit reporting agencies told him that was a good idea, and that their data would help him make it work. If I had to speculate on Obama’s source, it would be Penny Pritzker, who used to own Transunion, and for all we know still does, through a straw.

              This has got to be "change we can believe in!"

              Privilege of the Pritzkers!

              A few years ago, Penny sold TransUnion, the largest credit reporting agency in America, but there’s a question about whether she sold it to herself by selling it to various hedge funds which her family has a large interest in.  Until she sold it, you could say that Penny Pritzker had more files on every citizen in America than the CIA and FBI combined, because everybody has a credit score and credit report.  Penny Pritzker had the credit scores and report on every single citizen in America.
              Interesting!
  •  Az opted to let the Feds set theirs up ... (5+ / 0-)

    Will be interesting to see what happens in Oct. As someone that pays a lot for individual coverage I'm hopeful ...

    A mind like a book, has to be open to function properly.

    by falconer520 on Fri May 10, 2013 at 02:38:57 PM PDT

  •  The fact is that they don't want it to work. (4+ / 0-)

    Republicans are hell bent on stopping Obamacare no matter what and NOTHING will stop them in sabotaging it!

  •  Sensible people, who cannot afford (1+ / 0-)
    Recommended by:
    Words In Action

    health protection in Idano, should move.  Get the hell out that backwoods place and let the supremacy movement keep the place and its taters.  

    •  Whatever happened to Idahoans such as (1+ / 0-)
      Recommended by:
      Notreadytobenice

      Frank Church and Cecil Andrews?  The fact that a state such as Idaho could elect such people just a few decades ago shows the poison of hate radio and Fox Noise.

      "We have always known that heedless self-interest was bad morals, now we know that it is bad economics." Franklin Delano Roosevelt, Jan. 20, 1937

      by Navy Vet Terp on Sat May 11, 2013 at 06:54:06 PM PDT

      [ Parent ]

      •  Time to reform (1+ / 0-)
        Recommended by:
        Notreadytobenice

        Give 'em hell Democrats.  Go in Idaho and campaign there long term to give people good medicine.

        •  There is Plenty of Hell! (0+ / 0-)

          "Consumer Reporting Agencies, IRS" will determine your eligibility for the 46 different buckets of insurance or not!  
          Much much more Here.
          Why not just use birth certificates aka Single Payer rather than all this intrusion?  This will not go down well.

        •  We're not actually a "hateful" state, (1+ / 0-)
          Recommended by:
          Navy Vet Terp

          but face it, Nazis make for jaw-dropping press. Most of the folks here are ignorant and poorly educated. The right wing here is the Libertarian "keep th' Feddle Gummint outta mah Medicare!" types rather then the religious whackaloons. We do have some religious ones here, but the predominant stream is the Libertarians. The religious ones are Mormons, who tend to be religiously Libertarian.

          But we have a lot of things going for us, too. Idaho had a long history of labor involvement and the first practicing Jewish governor, and still has the oldest synagogue in continuous operation west of the Mississippi. An openly lesbian state representative served for years before recently losing an election, We have large placement communities for refugees from African nations, and lots of Asians coming in for tech work at Micron, so the city is finally starting to get some color. People from bigger cities will still think Boise is the mayo-on-white capitol of the world, but compared to the past this place is getting scarily cosmopolitan.

          But yeah, there are Hammerskins out here too, and the GOP is the dominant party, and of course we have Raul Labrado (sigh), with a tiny handful of Democrats chipping away where they can.

          I'd love to see more progressives move here but I understand why they wouldn't want to. Besides the reputation as the Fourth Reich there's also a lot of very heavy lifting to do, and effort can be spent in swing states where a little effort can make bigger payoffs, faster.

          The internet is ruled by cat people. Dog people are busy playing outside.

          by Canis Aureus on Sun May 12, 2013 at 10:47:41 AM PDT

          [ Parent ]

          •  You have to start somewhere (0+ / 0-)

            My uncle lives in Boise and I've been to Idaho a number of times.  If anything, I would say getting information to people could be what's important.

            I'm aware of the Mormon community.  My mother and uncle come from a Mormon family so they know very well the community's presence in Idaho.

      •  It was Cecil Andrus, and the One-Party state (1+ / 0-)
        Recommended by:
        Navy Vet Terp

        pays them lip service and holds them up as examples of a "robust political discourse" in the state to deflect the criticisms about how the GOP runs everything.

        Really, Boise and Lewiston, IIRC, are the only tiny islands of blue in this sea of reactionary red. We have a Democratic Mayor in Boise who is really popular, but I always say that most of Idaho is a place to go for Mormons who feel that Utah has become "too wild and decadent". I'm not exaggerating, either.

        Not too long ago they gerrymandered our Senate voting districts (imagine that) to keep the old districts from going Democratic. Boise and Lewiston both used to be in the "western half" of the state and the population centers there would have made it Blue. So they split us off and now Boise's votes are counter-balanced by south-east Idaho, or "New Zion".

        It's depressing and annoying both.

        The internet is ruled by cat people. Dog people are busy playing outside.

        by Canis Aureus on Sun May 12, 2013 at 10:36:40 AM PDT

        [ Parent ]

        •  It's really, really (0+ / 0-)

          depressing.  I am surrounded by red.  I have to go to the Unitarian Church just to rub shoulders with blue.  What I wouldn't give to move out of the burbs and into the north end.

          •  The Bench neighborhood by Vista (0+ / 0-)

            is really nice. It's also very international-- that's where a lot of the ex-Yugoslavian refugees settled, and where a lot of the African immigrants have come. A recent attempt to get the area named an "international zone" was shot down by the GOP since, you know, furriners.

            But it's a good neighborhood, and the houses aren't as close together as a lot of the North End seems to be.

            The internet is ruled by cat people. Dog people are busy playing outside.

            by Canis Aureus on Mon May 13, 2013 at 04:44:32 PM PDT

            [ Parent ]

  •  In MA, Rumneycare (0+ / 0-)

    has >99% of our kids insured and 98% of adults. About one percent get an exemption like religion et al and the other one percent have to pay a penalty for being aholes.

    •  High Medical Bankruptcy persists in Mass. (2+ / 0-)
      Recommended by:
      rabel, Notreadytobenice

      "Higher than Expected!"

      Health Affairs abstract:

      We surveyed families participating in unsubsidized plans offered in the Massachusetts Commonwealth Health Insurance Connector Authority, an exchange created prior to the 2010 national health reform law, and found high levels of financial burden and higher-than-expected costs among some enrollees. The financial burden and unexpected costs were even more pronounced for families with greater numbers of children and for families with incomes below 400 percent of the federal poverty level. We conclude that those with lower incomes, increased health care needs, and more children will be at particular risk after they obtain coverage through exchanges in 2014. Policy makers should develop strategies to further mitigate the financial burden for enrollees who are most susceptible to encountering higher-than-expected out-of-pocket costs, such as providing cost calculators or price transparency tools.

      Wow, shocker. Remember that MA Connector was the first implementation of the Heritage Plan that was designed to head off single payer and later became ObamaCare, and that whenever ObamaCare supporters wanted a success story, they would point to it.

      Let's assume for a moment that price transparency is the answer, instead of -- just to pick an idea at random -- health care as right, Medicare for All, and the purchasing power of the Federal government brought to bear. ObamaCare won't be able to provide price transparency, as this post shows, and one reason is the lack of "calculators" and "tools" for out-of-pocket costs.

      70/30 insurance is lose your house territory if anything serious happens.  Medical bankruptcy has not gone down in Mass, even with the great reforms Mitt/Obama have built...
      •  Why Exchanges will not drive costs down (0+ / 0-)

        Exchanges not magic potion:

        However, the levels of coverage in the ACA are not defined using specific deductibles, copays, and coinsurance. Rather, they are specified using the concept of an "actuarial value" (AV). For example, a plan with an actuarial value of 70% (referred to as a "silver" plan in the ACA) means that for a standard population, the plan will pay 70% of their health care expenses, while the enrollees themselves will pay 30% through some combination of deductibles, copays, and coinsurance. The higher the actuarial value, the less patient cost-sharing the plan will have on average. The percentage a plan pays for any given enrollee will generally be different from the actuarial value, depending upon the health care services used and the total cost of those services. And, the details of the patient cost-sharing will likely vary from plan to plan.

        Stop right there. Remember the five criteria for a successful health exchange? ObamaCare fails four of five (and the one they pass is -- and I know this will surprise you -- a "level playing field" for the insurance companies). But the criterion that matters here is this one: "[A]pplying for subsidies must be simple."

        There is much more Here.
      •  MA got 99%+ of our kids insured... (1+ / 0-)
        Recommended by:
        splashoil

        compared to less than 90% for USA.
        98% of adults insured compared to less than 80% for USA.

        You can mess with Texas with 17% kids and 33% adults without h.i. but hard to knock gains made here in Baystate.

        •  Still Medical Bankruptcy (1+ / 0-)
          Recommended by:
          Notreadytobenice

          70/30 insurance is lose your house territory.  That is the best you can get with a subsidy on the Obamacare exchanges!  There is no excuse to throw so many under the bus.  Single Payer and no insurance rentiers is what we need like the rest of civilization!

          •  Single payer will happen. The health rentiers here (0+ / 0-)

            in MA are having a tough time staying under the radar.

            Don't know about the 70/30 insurance. The experience of family members and friends is nothing of the sort.

            And the dividends are really starting to kick-in for citoyens of the Commonwealth.
            Our kids are the healthiest and smartest in the U.S.A. and the adults are more good-looking than 10 years ago.

            Patience grasshopper.

            •  Check PNHP Website (0+ / 0-)

              The numbers there on medical bankruptcy do not support your impressions.

              •  The credibility of your sources are under attack.. (0+ / 0-)

                Check out The Atlantic's critique of PNHP's work:
                http://www.theatlantic.com/...

                More importantly, the data quality is extremely low. The paper doesn't account for obvious confounding factors.  It uses a very small sample for comparison, one that wasn't really selected to assess state-level effects. And by using an overly broad definition of medical bankruptcies, it practically guarantees that reform will show little effect.  Health care reform won't keep a plumber who's been hit by a car at work instead of in the hospital.  It isn't going to mean that nobody ever has an unpaid medical bill at the time of declaring bankruptcy.  It doesn't pay the mortgage if Mom has to quit work to take care of a kid with autism.  Canada still has medical bankruptcies, despite single payer, because medical problems cause income loss as well as higher medical bills.
                Emphasis added
  •  Butch is not the sharpest tack in the box (0+ / 0-)

    by a long, long way, but at some point someone with sense must have convinced him that it is the best thing to do for one of the poorest states in the nation; and probably used the exact same idea on him as he turned around and used to his esteemed colleagues in the Lege.

    Idaho has abysmal pay scales, high unemployment and underemployment, and lots and lots of uninsured working poor.  It's nice to know that some of them will be able to go to a doctor.

    Esto perpetua, Idaho!  (from a home-sick ex-Idahoan)

    •  Butch didn't do it (0+ / 0-)

      for the uninsured.  He did it for powerful insurance business interests.  They convinced Butch using dollar signs and he and the lobbyists strong-armed the lege.  And I remain unconvinced that the exchange will do much to make premiums affordable.  

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