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Female Physician holding bottle of pills up to camera, focus on pills.
Bang-up statistics for rates of insurance under Obamacare are one thing, but for the truly human benefit of the law, you have to look deeper. And here's an excellent example: Actual health care, in the form of prescription drugs, is getting to the people who need it.
People who signed up early for insurance through the new marketplaces were more likely to be prescribed drugs to treat pain, depression and H.I.V. and were less likely to need contraceptives, according to a new study that provides a much-anticipated look at the population that signed up for coverage under the new health care law. […]

The study, to be released Wednesday by the major pharmacy-benefits manager Express Scripts, suggests that early enrollees face more serious health problems and are older than those covered by their employers. The study also showed a higher use of specialty drugs, which are often used to treat diseases like cancer and rheumatoid arthritis; the use of such drugs could hint at more costly medical problems.[…]

In addition to finding increased use of drugs to treat pain, seizures and depression, the study also found that 6 in every 1,000 prescriptions in the marketplace plans were for drugs that treat H.I.V., a number that was nearly four times the figure among those with employer coverage.

That's because, of course, people with HIV, cancer and rheumatoid arthritis could have been barred from getting health insurance before the law. It's not terribly surprising that the first enrollees out of the gates—and the first to be registering prescriptions—would be the people with serious, chronic conditions that kept them out of the market previously. As the study's authors write, "This early analysis suggests this new benefit is providing patients with access to the medication they need."

That's just one more thing Republicans want to shut down with repeal: people getting the treatments they need to survive.

Originally posted to Joan McCarter on Wed Apr 09, 2014 at 11:05 AM PDT.

Also republished by Obamacare Saves Lives and Daily Kos.

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Comment Preferences

  •  Tip Jar (39+ / 0-)

    "The NSA’s capability at any time could be turned around on the American people, and no American would have any privacy left, such is the capability to monitor everything. [...] There would be no place to hide."--Frank Church

    by Joan McCarter on Wed Apr 09, 2014 at 11:05:28 AM PDT

  •  There are some Republicans who wish that (7+ / 0-)

    "people with HIV, with cancer and rheumatoid arthritis" would just die and those who don't have that wish don't care if they live, or die.

    Okay, this is clearly an overstatement, but not as much of an exaggeration as I wish it was.

    Roman Catholic by birth---thoroughly confused by life.

    by alasmoses on Wed Apr 09, 2014 at 11:30:30 AM PDT

    •  You're right; they want people to die quickly (5+ / 0-)

      & decrease the surplus population. They are unrepentant Scrooges.

      That's why they like guns; they want us to exterminate each other.

      nosotros no somos estúpidos

      by a2nite on Wed Apr 09, 2014 at 12:03:36 PM PDT

      [ Parent ]

      •  What THEY consider to be (0+ / 0-)

        "Surplus population" that is. It's because anyone that isn't wealthy is considered to be surplus, unless they can work themselves to death for the wealthy.

        Can't work to make more money for the wealthy? Then in their minds you should be wiling to crawl away and die quietly.



        Women create the entire labor force.
        ---------------------------------------------
        Sympathy is the strongest instinct in human nature. - Charles Darwin

        by splashy on Wed Apr 09, 2014 at 04:00:05 PM PDT

        [ Parent ]

    •  Priceless commentary on the success... (5+ / 0-)

      ...of the Affordable Care Act, this week's New Yorker cover, as Republicans line up to take their medicine.

      “When it comes to this, I shall prefer emigrating to some country where they make no pretense of loving liberty—to Russia, for instance, where despotism can be taken pure and without the base alloy of hypocrisy.” —Abraham Lincoln

      by Pragmatus on Wed Apr 09, 2014 at 02:56:57 PM PDT

      [ Parent ]

    •  And I've met more than one Conservative (1+ / 0-)
      Recommended by:
      alasmoses

      who regards depression and all other mental illnesses as simple moral failings.

      Reading DailyKos is like getting the newspaper two weeks early. But without the lottery results.

      by jazzmaniac on Wed Apr 09, 2014 at 07:37:40 PM PDT

      [ Parent ]

  •  *A+* (4+ / 0-)

    Nice job Obamacare.

    Republicans - No solutions, just reasons why other peoples solutions will not work.

    by egarratt on Wed Apr 09, 2014 at 02:40:23 PM PDT

  •  And, just as it is logical that those who (4+ / 0-)

    signed up immediately were those who really NEEDED to be insured, it is also logical that many of those who waited until the last minute are amongst the "young invincibles", those without chronic health issues who are getting the insurance BECAUSE of the mandate.

    I’ve said before, I will always work with anyone who is willing to make this law work even better. But the debate over repealing this law is over. The Affordable Care Act is here to stay. -- President Barack Obama

    by Its the Supreme Court Stupid on Wed Apr 09, 2014 at 02:42:46 PM PDT

  •  It's a good thing when citizens have some of (4+ / 0-)
    Recommended by:
    Pragmatus, jfdunphy, kellius, The Nose

    their tax dollars returned to them via Obamacare, SS, Medicare and Medicaid.  On the other hand, the GOP would rather have those same taxes available to award contracts to the MIC, subsidies to oil, gas, big pharma and agribusiness because they will cycle those big bucks back into campaign chests.  Individual pissant citizens just don't have the politician purchase power of those groups and the individual 1%ers.
    Don't we too deserve to get some of our money back for our needs?

    Building a better America with activism, cooperation, ingenuity and snacks.

    by judyms9 on Wed Apr 09, 2014 at 02:54:47 PM PDT

    •  Not according to the Grand Old Party! (0+ / 0-)

      "Don't we too deserve to get some of our money back for our needs?"

      No.  We get our tax dollars back with roads, bridges, ports, and presidential libraries.  

      We aren't supposed to live long enough to enjoy them, of course; we're only supposed to live long enough to BUILD them.

      "Conservatives are not necessarily stupid, but most stupid people are conservatives." - John Stuart Mill, 1806 - 1873

      by Terry S on Thu Apr 10, 2014 at 06:46:19 PM PDT

      [ Parent ]

  •  In the South, HIV is now a disease of the poor (1+ / 0-)
    Recommended by:
    Pragmatus

    Originally, HIV was a disease that mostly hit gay men and IV drug users. But now, in the South, it's a disease that hits poor people.

    People who get treated for HIV are much, much less likely to infect other people. And now, poor people in expansion states can get on Medicaid and get treatment for their HIV, so they don't infect their children, their partners, and their partners' partners.

    In the South, though, more and more poor people are going to be HIV+. Thanks, Republicans, Proud Party of Spreading Infectious Diseases.

  •  Was really glad that our tax preparer (1+ / 0-)
    Recommended by:
    The Nose

    was good about showing each of his clients how much the penalty was if we didn't have insurance. Might have gotten a few off their rears to apply.

    Got my eyes opened a couple years ago. A fall down a slippery slope dislocated my ankle and shattered the bones. The total bill would have been over $35 thousand. Even with insurance we paid (actually are still paying) over $3 thousand.

    It takes two to speak the truth -- one to speak, and another to hear ~ Henry David Thoreau

    by SisTwo on Wed Apr 09, 2014 at 02:58:14 PM PDT

  •  I can't recommend this post (0+ / 0-)

    The headline should read: "More evidence Obamacare is working to provide the health care SOME people need", or even MOST people but I'm not going to do any celebrating until the millions that fall in the gap, AND DYING EVERY DAY BECAUSE OF IT, are covered. Why isn't this little fact almost always ignored in these Obamacare diaries?

    "Given the choice between a Republican and someone who acts like a Republican, people will vote for a real Republican every time." Harry Truman

    by MargaretPOA on Wed Apr 09, 2014 at 03:01:24 PM PDT

    •  O-care isn't the answer (2+ / 0-)
      Recommended by:
      jfdunphy, mzkryz

      Single Payer IS.

      HMSA seeks 12.8% rate increaseApril 9, 2014
      The Associated Press
      Save |
      HONOLULU (AP) - The Hawaii Medical Service Association is asking the state to approve a 12.8 percent rate hike on its health insurance plans for most small-business workers.

      The Honolulu Star-Advertiser reported Tuesday that the insurer says it needs the increase to pay for costs associated with President Barack Obama's federal health care overhaul and increased drug costs.

      The increase would affect plans covering about 77,000 workers in small businesses.

      Commissioner Gordon Ito of the state Insurance Division said that the agency is reviewing the proposed increase and how it will affect consumers and businesses.

      He said that the division, which is under the Department of Commerce and Consumer Affairs, will try to find a balance between the best interests of consumers and keeping the insurance company financially solvent.

    •  There are a number of people that can't afford (1+ / 0-)
      Recommended by:
      jfdunphy

      a plan from the exchange.  My 30 year old daughter is one.  She's trying to clean up her credit from defaulting on one of her student loans--finally getting it out of default.  She makes a little over $30K and she doesn't qualify for a subsidy.  She checked out the exchange and the lowest cost plan still had $6K deductible/out of pocket.  She lives paycheck to paycheck.  To someone with no cash, a policy with a $6K deductible is like not having insurance at all. So she's going without and hoping for the best--hoping her employer will eventually offer insurance.

      “It is the job of the artist to think outside the boundaries of permissible thought and dare say things that no one else will say."—Howard Zinn

      by musiclady on Wed Apr 09, 2014 at 03:11:27 PM PDT

      [ Parent ]

      •  She doesn't qualify for a subsidy (0+ / 0-)

        because her Silver insurance cost would be less than $2850/year?  What would her Bronze insurance cost be? Seems like having some insurance would be better than having no insurance.  

        •  She said that it would cost about $150 a month (0+ / 0-)

          for the cheapest plan. She also said that one must meet the deductible before one pays just a copay to see a doctor.  I'm not sure if that's the case but that's how she interpreted the info on healthcare.gov.

          “It is the job of the artist to think outside the boundaries of permissible thought and dare say things that no one else will say."—Howard Zinn

          by musiclady on Wed Apr 09, 2014 at 04:37:52 PM PDT

          [ Parent ]

          •  People Just Don't Understand Insurance (1+ / 0-)
            Recommended by:
            The Nose

            Most insurance pays for doctor visits with just a copay.  Some drug plans require a small deductible before they cover with copay.  The deductibles normally just apply to hospital outpatient and inpatient charges.  So, your daughter could have acquired a policy and unless she needs expensive tests or outpatient/inpatient services, she would be covered.

            And as to the deductible, it sure as heck doesn't take long to exceed $6000 for anything remotely serious.  In one year I had two outpatient surgeries and the total came to over $30,000.  Compared to getting saddled with that total, $6000 would seem like a blessing.

            When the power of love overcomes the love of power, the world will know peace. Jimi Hendrix

            by Dave B on Wed Apr 09, 2014 at 05:31:31 PM PDT

            [ Parent ]

            •  Agree about people not understanding insurance. (0+ / 0-)

              I think she thought that the deductible applied to everything not just hospitalization.  Is that how the exchange plans work?  I don't know because I didn't go on the website.  Unfortunately you had to create a login and profile to look at the plans.  Not needing insurance myself, I couldn't look at the plans.

              “It is the job of the artist to think outside the boundaries of permissible thought and dare say things that no one else will say."—Howard Zinn

              by musiclady on Wed Apr 09, 2014 at 05:34:11 PM PDT

              [ Parent ]

              •  Marketplace Plans (0+ / 0-)

                I did not buy on the marketplace, I have my own company and provide the same insurance to myself and my employees that we have had for years.  However, I did go there and shop just to see what the plans and prices looked like.  Next year after things have settled out, I may look to buy there for our company.

                In the summary of plans page, they only showed deductible and max out of pocket.  If you clicked on the plan, you had the option to view PDF's of provider networks, plan summary of benefits, and brochures.  That is where your daughter would learn the details of how office visits work, office visit copays, out of network charges, drug deductibles & copays, etc.

                From talking to friends who were upset about losing coverage the "loved" and having to pay more, etc. I have concluded that one of the big problems with getting ACA off the ground is peoples general ignorance about how insurance works, especially those who this law aims to help, the uninsured.

                I wish your daughter luck and hope she puts the effort in or gets the help she needs to navigate the process next time enrollments open up.  In fact, she should seek out a face-to-face with an actual navigator!  Good Luck!

                When the power of love overcomes the love of power, the world will know peace. Jimi Hendrix

                by Dave B on Wed Apr 09, 2014 at 09:11:59 PM PDT

                [ Parent ]

              •  Our experience bears this out… (0+ / 0-)

                What your daughter is finding is true for some plans under Obamacare.  There are definitely “high-deductible” plans that require you to meet the entire deductible before they start paying benefits (I was told by one provider, even before being allowed to do co-pays, in some plans), both for medical and prescriptions (excluding the mandated once-a-year doctor visits, and contraceptives.

                That said, I would still advocate your daughter getting the insurance (if she still can), as I agree with others here that even the $6,000 max OOP is much better than 10’s of thousands of dollars of medical bills additionally hanging over her head, if something unforeseen happens.  And she does get the free preventative care, which will help her keep an eye on her current health.  

                My “consumer’s viewpoint” is based on doing (lots!) of research among the plans available to us, and several calls and online chats with both the Marketplace and various providers, about specifics.  Read more for our journey with this, in my reply to my own post, below…

                •  ...our family's saga continued... (0+ / 0-)

                  Here in our part of Arizona (probably partly/mostly because it’s Arizona… snark added), there were very wide differences in plans, both in coverage and cost (can somebody explain why there are some plans with less coverage but substantially higher premiums?).  

                  My wife was losing her employer insurance coverage (not related to O-care, but poorly managed company finances), and she was the only one covered in our family.  Our family budget is tight, so we were trying to get coverage for all of us, but stay within the amount they were “crediting” her for not continuing coverage (the subsidy seemed like it might make it possible).  I was trying to balance monthly premium cost against likely medical costs (I have a prescription medicine I take, and we each have a couple of doctor visits a year for followups on non-serious but chronic conditions). Between the premium credit from the company, and money we would have because we lost our HSA access, we had about $400/mo to work with.

                  Our choices came down to this… a Bronze plan for about $330/mo, with a $5,500/$11,000 deductible and generally 50% co-insurance for both medical and prescriptions (**after deductible for both medical and prescriptions), or a Silver plan for about $480/mo, with a $2,500/$5,000 deductible and then 20% co-insurance for doctor visits, and fairly high co-pays for prescriptions, especially the Tier 3 migraine medicine.  Both plans had about the same max OOP of about $12,500.

                  I did an extensive spreadsheet to test different medical scenarios, plugging in my $100/mo medicine and our general assortment of doctor visits and requisite lab tests, and then various possible minor “disasters”.  Perhaps not surprisingly, it was about a wash, annually (damn those accurate actuaries!).  And, yes, I did deduct our once-a-year free “physicals”…

                  What I found was that paying essentially cash, under the Bronze plan, for the few remaining the doctor visits, the migraine medicine, and an urgent-care visit or two (we have a 10-yr-old), was just about the same as the extra $150/month premium, for the Silver plan, plus what we would have still paid for co-insurance and drug co-pays — especially since the deductible would have to be met in many cases before the co-insurance would kick-in.

                  All of us are relatively healthy at the moment, and my wife and I are managing our conditions well with exercise and lifestyle.  So, ultimately, we decided to go with the cheaper Bronze plan (for this remaining 9 months of 2014) and see if we come out ahead by not needing the doctor visits as much.  But, we know we are covered if something catastrophic happened (an accident or newly discovered major illness…).  

                  It’s better than we were doing before, with my wife’s crummy employer “catastrophic” insurance (even when she had it…) and no coverage for anyone else.  At least the whole family is covered and the worst that could happen financially is a $12,500 hit in costs, which we felt we could cover between savings and available revolving credit.

                  Next year (2015), we’re hoping to be making a bit more as a family, and would like to move up to a lower deductible, more-copay based Silver (or, hey, maybe even Gold…) plan.  We can dream, right?

                  Sheesh… Can’t wait for the day of “single-payer”!

          •  She would get a FREE checkup every year, (0+ / 0-)

            FREE flu shots, FREE contraception. The deductible doesn't apply to those FREE things.

            She can still sign up. She can sign up right now.

          •  She needs (0+ / 0-)

            to call or meet with one of the trained advisors.  Might be too late for this year's enrollment, but she will need to know FOR SURE what her options are next year.  I feel awful for people who didn't get the help they needed to enroll AND for the people who fell through the crack (which I hope will be fixed ASAP so that nobody is excluded).  I'm definitely for single payer, but we have to make this first step as comprehensive and comprehensible as possible until then.

      •  Honestly if you're sick enough for the deductable (1+ / 0-)
        Recommended by:
        Dave B

        to kick in you are sick.  The copays for doctor visits and meds generally make up quite a bit of the premiums.  I think $6K for a heart transplant is reasonable.

        •  Not sure I understand. (0+ / 0-)

          She said that she would have to pay out of pocket until she meets the deductible before the copays kick in.  If one is just going to a doc once a year for a sinus infection or something like that, having a high deductible doesn't really do anything for you.  It makes me crazy but she can barely pay her living expenses as it is.

          “It is the job of the artist to think outside the boundaries of permissible thought and dare say things that no one else will say."—Howard Zinn

          by musiclady on Wed Apr 09, 2014 at 04:39:59 PM PDT

          [ Parent ]

  •  Just out of sheer curiosity, would you be kind (1+ / 0-)
    Recommended by:
    mzkryz

    enough to give us some indication of where one finds the evidence to support the rather wild assertions you are making?  Or is this just another of the False Noise attempts to stir up . . . whatever False Noise wants stirred by its schlock-meisters?

    Just who ARE these "millions that fall in the gap, AND DYING EVERY DAY BECAUSE OF IT"?  And, just exactly HOW and WHY are they "in the gap"?  Even better, and perhaps more to the point, WHERE IS THIS GAP?

    Now, if you be referring to the people in States that have refused to extend Medicaid, to take advantage of ACA premium discounts for people - among other things - just WHAT do YOU propose be done about that?  And whose "fault" is that?  Certainly, the ACA is there, IF the STATE GOVERNMENT or LEGISLATURE acts to  accept it.

    indeed, I think your "facts" - or assertions, or whatever - are, in truth, NEVER IGNORED, in the Obamacare diaries, or anywhere else where the ACA is covered as carefully and thoroughly thoughtfully as it is here on The Daily Kos.

    •  Other (0+ / 0-)

      than the killer states that still refuse to extend Medicaid, I can't find any other gap.  Don't you think those hold-out states will be shamed into joining the saner states pretty soon? I'm watching for it.  Surely enlightened self interest will kick in---unless they're too dumb to understand that basic survival concept. If they don't join, then hopefully the mid-terms or 2016 will weed them out of office.

  •  Is it just me (0+ / 0-)

    or does that photo look like a drug dealer pushing pills?

    warning: snark probably above

    by NE2 on Wed Apr 09, 2014 at 07:42:48 PM PDT

  •  LEST WE FORGET (1+ / 0-)
    Recommended by:
    Skyprogress

    Lest we forget, OBAMACARE IS NOT WORKING, not as long as it includes a healthcare-for-profit component.

    In a sane society, the relief of pain and suffering, the treatment of disease and trauma, are viewed as obligations of the whole society for everyone of its members. There would be no room for monetizing caring for others, no place for signups and exchanges, no "plans" to choose from other than the one that diagnoses illness and provides  as much treatment to cure it as is humanly possible.

    We could have done better, and didn't.  omoiyari -- Red

  •  ACA (0+ / 0-)

    Yes, Obamacare is working.   The Stooooopid party will never admit it.  

  •  ACA sign-up (1+ / 0-)
    Recommended by:
    catilinus

    Today a young plumber (late 20's?) injured himself while working at our house.  He was bleeding but refused my husband's offer to drive him to the emergency room because he didn't have insurance.  He drove himself away and another plumber arrived to finish the job.

    Why didn't he have insurance since this is California and the exchange here has been working from the start?  My husband hadn't wanted to ask him while he was in pain.  Is he a young invincible or an Obamacare hater or was a plan too expensive?

    It's amazing that I am now shocked to hear that someone doesn't have coverage, when a year ago it wouldn't have seemed unusual.

  •  Quote from the piece- (0+ / 0-)

    "That's just one more thing Republicans want to shut down with repeal: people getting the treatments they need to survive."

    Maybe so, but the end result is more likely: "people getting the treatments they need to survive rather than going broke, having to go on welfare and get treatment at 100% taxpayer expense."

    Why don't they just line up the people they don't think are adequately contributing to society according to their standards and simply shoot them?  It worked for the Nazis.

  •  I'd change one word in the last sentence, Joan. (0+ / 0-)

    "That's just one more thing Republicans want to shut down with repeal: LIKELY DEMOCRATIC VOTERS getting the treatments they need to survive."

    OF COURSE the New Right is wrong - but that doesn't make WRONG the new RIGHT!

    by mstaggerlee on Fri Apr 11, 2014 at 10:48:45 AM PDT

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