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United States Government Medicine

Statisticians Study Who Was Helped Most By Obamacare 739

HughPickens.com writes We know that about 10 million more people have insurance coverage this year as a result of the Affordable Care Act but until now it has been difficult to say much about who was getting that Obamacare coverage — where they live, their age, their income and other such details. Now Kevin Quealy and Margot Sanger-Katz report in the NYT that a new data set is providing a clearer picture of which people gained health insurance under the Affordable Care Act. The data is the output of a statistical model based on a large survey of adults and shows that the law has done something rather unusual in the American economy this century: It has pushed back against inequality, essentially redistributing income — in the form of health insurance or insurance subsidies — to many of the groups that have fared poorly over the last few decades. The biggest winners from the law include people between the ages of 18 and 34; blacks; Hispanics; and people who live in rural areas. The areas with the largest increases in the health insurance rate, for example, include rural Arkansas and Nevada; southern Texas; large swaths of New Mexico, Kentucky and West Virginia; and much of inland California and Oregon.

Despite many Republican voters' disdain for the Affordable Care Act, parts of the country that lean the most heavily Republican (according to 2012 presidential election results) showed significantly more insurance gains than places where voters lean strongly Democratic. That partly reflects underlying rates of insurance. In liberal places, like Massachusetts and Hawaii, previous state policies had made insurance coverage much more widespread, leaving less room for improvement. But the correlation also reflects trends in wealth and poverty. Many of the poorest and most rural states in the country tend to favor Republican politicians.
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Statisticians Study Who Was Helped Most By Obamacare

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  • Lemme guess (Score:5, Insightful)

    by marcello_dl ( 667940 ) on Friday October 31, 2014 @05:32AM (#48276493) Homepage Journal

    A: the insurance companies.

  • Redistribution (Score:3, Insightful)

    by jamesl ( 106902 ) on Friday October 31, 2014 @05:52AM (#48276549)

    It has pushed back against inequality, essentially redistributing income ...

    So it is an income redistribution plan. What we really need is a prosperity plan and other than getting out of the way, that is not something government can do.

    • Re:Redistribution (Score:5, Insightful)

      by pijokela ( 462279 ) on Friday October 31, 2014 @06:02AM (#48276573)

      People with health care should be more able to prosper because they are healthy and can work. People with untreated sickness are not going to prosper regardless if how incentivized they are to work harder.

      • Re:Redistribution (Score:5, Insightful)

        by Morky ( 577776 ) on Friday October 31, 2014 @06:14AM (#48276629)
        Also, a workforce not afraid to lose insurance if they leave their jobs is a more mobile workforce, able to migrate to regions with better job markets.
        • Re:Redistribution (Score:5, Interesting)

          by DamonHD ( 794830 ) <d@hd.org> on Friday October 31, 2014 @06:39AM (#48276703) Homepage

          Bingo! I would not have been able to do multiple start-ups and freelance in banking and writing if tied to a job by health insurance given that I have had imperfect health.

          Score one for the UK NHS, even though also imperfect, for giving me mobility.

          Rgds

          Damon

        • Re: (Score:3, Interesting)

          Not sure how well the mobile part works when you actually have to pay for the insurance. A lot of people I know don't leave a job not because of their health insurance but because of all the other debt payments and obligations. P>

          ACA does not get "free" until you are pretty heavy out of pocket on expenses or have been unemployed for some time. Also thanks to the stipulations in the ACA if you move to another State guess what does NOT follow you there, that's right your insurance, because now you ha

          • Not sure how well the mobile part works when you actually have to pay for the insurance. A lot of people I know don't leave a job not because of their health insurance but because of all the other debt payments and obligations. P>

            ACA does not get "free" until you are pretty heavy out of pocket on expenses or have been unemployed for some time. Also thanks to the stipulations in the ACA if you move to another State guess what does NOT follow you there, that's right your insurance, because now you have to join an insurance provider in that State. Yours in most cases will not be waiting for you there.

            If anything it binds you even tighter to a job and location.

            While insurance plans are still regulated state by state (this is a bigger problem with the industry) at least now they are available via one very similar channel (the insurance exchanges) so you can pick one up wherever you go. You may not see an advantage to this, but anyone with a family (or is interested in starting one) certainly does, and many DO stick to jobs that are inadequate just because the insurance benefits amount to several hundred dollars a month (and possibly several tens of thousands of d

          • Re:Redistribution (Score:5, Informative)

            by laird ( 2705 ) <lairdp@gmail.TWAINcom minus author> on Friday October 31, 2014 @08:13AM (#48277063) Journal

            "Not sure how well the mobile part works when you actually have to pay for the insurance"

            ACA helps because when you switch jobs, you know that you can get reasonably priced insurance afterwards. And because the insurance companies can no longer use the job change to declare any current medical conditions "pre-existing" and deny you insurance.

            Previously there are _many_ people trapped in jobs for the health insurance, because if they went to a startup or became an independent consultant they had to pay absurdly high rates for insurance. Or because they had any medical condition that the new insurance company didn't want to cover they'd be denied insurance completely if they change jobs.

      • Re:Redistribution (Score:5, Insightful)

        by Attila Dimedici ( 1036002 ) on Friday October 31, 2014 @07:58AM (#48276977)
        Yes, but the article is NOT about health care. It is about health insurance. They are not the same thing. Having health insurance is not a benefit if there is no one to provide you with health care, which is what is happening with this law. Most of those who now have health insurance that did not have it before are those who have been added to the Medicaid rolls. Yet the number of health care providers who accept Medicaid patients has fallen.
    • Re:Redistribution (Score:5, Insightful)

      by mwvdlee ( 775178 ) on Friday October 31, 2014 @06:04AM (#48276591) Homepage

      Every single government thing involving any money at all is an income redistribution plan.

      Corporate tax benefits are income redistribution plans.
      Military spending budgets are income redistribution plans.
      Spectrum auctions are income redistribution plans.

      This particular income redistribution plan is only different in that income is redistributed to the poor instead of the rich.

    • Re:Redistribution (Score:4, Insightful)

      by Anonymous Coward on Friday October 31, 2014 @06:46AM (#48276735)

      the people who cry about wealth redistribution never seem to cry about the last 30 years of American productivity re-distribution to the rich.

    • Re:Redistribution (Score:4, Insightful)

      by Mr D from 63 ( 3395377 ) on Friday October 31, 2014 @07:33AM (#48276875)
      It is worth noting this article and effort was pushed forth by O-Care supporters. It fails to answer the most important questions.. has your healthcare improved or lowered in cost? Are you using it? There were a lot of free health services available to people before they were required to sign up for O-Care. The fact that many of the (very optimistically estimated) number of those who were added to O-Care rolls did not want or feel they needed it should be considered as well. In other cases, such as ones I am very familiar with, previously covered spouses were forced to move to their own plan if their work provider had coverage available. This means that although a new health care subscriber can now be counted, that person was already covered and that family is now paying more and having to deal with two health plans, which adds its own set of complications and reduces the value of deductibles on a per person basis.

      It is interesting, but not surprising, that the liberal talking points are heavily embedded, a clear flag that the study has an inherent bias. The "poorest states" being conservative sounds counter to only the picture that liberals try to paint of conservatives, not to reality for anyone who pays any attention. Hard working rural America has always been conservative. More often than not, it is the large urban populations that shift state's support bias to liberal, and it is those same urban areas that hold the most desperate and dependent populations of the truly underprivileged.

      Polls can give you the result you intend. This is simply a poll result, not a sophisticated statistical analysis as the title would have you believe. Its not that hard to play with numbers to make any point you want. Those that want to believe the results will, those that don't won't.
      • Re:Redistribution (Score:5, Informative)

        by dmr001 ( 103373 ) on Friday October 31, 2014 @09:20AM (#48277695)
        As a physician, the new system doesn't feel particularly more intrusive than what we had previously. What we do have is a lot of new patients who were previously uninsured. They don't seem angry about it; they seem happy (to a person, at least amongst the newly insured). And we can get to work preventing their modest problems from turning into gigantic, expensive once that got handled "for free" in the emergency department by spreading the cost of their uncompensated care around to everyone else.

        Some of our previously insured patients seemed miffed because, just like before, medical care is expensive and the system is complicated. Some of them who used to blame the insurance companies now blame Obamacare.

      • It is worth noting this article and effort was pushed forth by O-Care supporters. It fails to answer the most important questions.. has your healthcare improved or lowered in cost? Are you using it?

        Let me give the experience of my best friend. He's probably in upper half of what one would call the Middle Class in the USA. I work for The Man so I've always had health insurance via my job. He is a small business owner. His business employees his wife and between 1 and 3 other employees at any given time, depending on a variety of factors. He does not offer health insurance to his employees. As a small business owner, he's had to get insurance on his own for himself, his wife and one child. He is

      • Re:Redistribution (Score:4, Informative)

        by Geoffrey.landis ( 926948 ) on Friday October 31, 2014 @10:01AM (#48278175) Homepage

        ...The fact that many of the (very optimistically estimated) number of those who were added to O-Care rolls did not want or feel they needed it should be considered as well.

        I personally know several people who were able to get insurance under Obamacare but didn't have it before. Not one says that they "did not want or feel they needed" insurance. What they say is, "Thank God, this is saving my life."

        However, even if what you said was true: what you are implying is that there is a body of people who previously were saying "I don't want or need insurance, because if I get sick I'll go to a hospital that is legally is not allowed to turn me away, and the taxpayers will pay for it," -and they are now paying for their own health care. That's a win for the taxpayers.

        In other cases, such as ones I am very familiar with, previously covered spouses were forced to move to their own plan if their work provider had coverage available. This means that although a new health care subscriber can now be counted, that person was already covered

        That's not the way the number of uninsured is counted. That would count as a wash: neither an addition nor a reduction to the number of uninsured.

        ... More often than not, it is the large urban populations that shift state's support bias to liberal, and it is those same urban areas that hold the most desperate and dependent populations of the truly underprivileged.

        Sorry, the belief that poverty is an urban phenomenon is another myth. It's a myth that's pervasive among liberals and conservatives, but simply not true. There are actually more poor and underprivileged people in rural America. You're right about urban areas being liberal and rural conservative, but wrong about being able to attribute that to "dependent populations of truly underprivileged": the greatest use of food stamps, as a percentage of population, in poor rural areas, not urban areas.

        .... Its not that hard to play with numbers to make any point you want.

        But you don't have to do that, because it's even easier to simply say "Those numbers don't support my political bias, so they are wrong."

    • Re:Redistribution (Score:5, Interesting)

      by apcullen ( 2504324 ) on Friday October 31, 2014 @08:02AM (#48276985)
      It is, only in that it redistributes money from the healthy to the insurance companies. Saying that "these people are better off because they now have insurance" is misleading. They now have to pay for that insurance, and the cost of insurance has skyrocketed since the law was passed. Furthermore, they can only be said to have benefited from having insurance if they get sick, or if they were already sick and would have been denied coverage.
    • Re:Redistribution (Score:4, Insightful)

      by NoImNotNineVolt ( 832851 ) on Friday October 31, 2014 @12:01PM (#48279591) Homepage

      So it is an income redistribution plan. What we really need is a prosperity plan

      I'd argue that there's certainly plenty of wealth in this country. Net national wealth [wikipedia.org] is $83.7T, so that's about $280k per person (or $301k per person according to a recent Credit Suisse Global Wealth report [cnn.com]); most people wouldn't be complaining if their net worth was $280k --- most Americans today have a net worth that is less than $45k. While more prosperity is always nice, it's somewhat unreasonable to make baseless claims that redistribution of wealth is less needed than prosperity. While I can sympathize with the fact that redistribution of wealth may not be compatible with your personal ideology, it would probably be better for everyone if we could discuss these issues in terms of numbers and facts, not political preferences.

  • Many of the poorest and most rural states in the country tend to favor Republican politicians.

    I've observed this myself. Quite baffling that those who would profit most from social reforms mostly advocated by the left are very often politically oriented towards the right.

    And then you have the super rich, who are strongly favored by right-leaning policies, asking the government to tax them more...

    Crazy world.

    • Re: (Score:3, Insightful)

      by drinkypoo ( 153816 )

      And then you have a tiny minority of the super rich, who are strongly favored by right-leaning policies, asking the government to tax them more...

      FTFY. For every Warren Buffet there's a hundred fucks who won't cough up a dime unless you punch them in the gut.

  • by Squidlips ( 1206004 ) on Friday October 31, 2014 @06:03AM (#48276583)
    It must be nice to have the State-run Media on you side
  • Comment removed (Score:5, Interesting)

    by account_deleted ( 4530225 ) on Friday October 31, 2014 @06:20AM (#48276649)
    Comment removed based on user account deletion
    • by Lumpy ( 12016 )

      Doctors price gouge.

      20 minute visit with 120 seconds of the doctors time, 18 minutes of sitting in a room with only yourself. $325.00 if you dont have insurance and pay cash. Sorry, that is a complete ripoff, Doctors should be ashamed of themselves for charging that.

      The ripoff that is the american health system starts with the Greedy asshole doctors.

      • THAT PROBLEM IS CREATED BY THE INSURANCE INDUSTRY

        They don't have as much overhead and staff without it.

        • by tazan ( 652775 ) on Friday October 31, 2014 @11:13AM (#48279047)
          Yeah, a few years ago when I was young and didn't have insurance there was a cash doctor in town. Her office didn't take insurance at all, you paid in cash. And her cash price was the same as I would later pay for a copay when I did get insurance. That does make me think most of the cost of a doctors visit is overhead for insurance record keeping and wonder if there is any benefit to it.
      • by mark_reh ( 2015546 ) on Friday October 31, 2014 @07:36AM (#48276893) Journal

        You don't understand. Your visit to the doctor costs what it does because of the complexities of the insurance system, including both health insurance and malpractice insurance. Doctors have a lot of overhead to pay, and in hospitals, they are just employees with no control over their schedules. If the administrators put 40 people per day into their schedule, they see 40 people per day. People without insurance use the emergency room to fix problems after they occur, a very expensive way to deal with health problems - something which Obamacare was feebly attempting to address. Everyone else who uses the place has to pay more to cover those costs. Every time a doctor makes an error the patient calls a lawyer. Doctors order test after test to cover their asses against malpractice suits- they are told to do so in "risk management" seminars put on by insurance companies that they must attend every year to maintain their malpractice insurance. The system is full of waste at every level. Doctors are not the cause of the problem. They have been made to look that way by insurers and hospital administrators who want to deflect attention away from themselves.

        When you look at Las Vegas, what do you see? You see huge luxury hotels, bright lights, excitement, partying, etc. Where does that money come from? From losers. Yet it's the winners who get the attention. Yeah, great, Vegas baby! Now look at insurance companies. Huge luxury office buildings, executives who make millions- it's a lot like Vegas. Where does the money come from? Losers like you and me who have to pay ridiculous premiums for minimal coverage. Yeah, Insurance baby!

        My son has expressed an interest in studying medicine when he graduates from high school. My wife is a physician and I am a dentist. We have suggested that he get a degree in business and become a hospital administrator. Those people make $ millions with no special skill set and without the arduous training imposed on healthcare providers.

        • look at insurance companies. Huge luxury office buildings, executives who make millions- it's a lot like Vegas. Where does the money come from? Losers like you and me who have to pay ridiculous premiums for minimal coverage. Yeah, Insurance baby!

          That's how it has worked in the past, yes, but the affordable care act actually did something about that [whitehouse.gov]. Insurance companies' profits and overhead margins are now capped at either 20% or 15%, depending on the size of the company. If they don't pay out the rest in claims, they have to refund it.

          It's not perfect and insurance companies will still make a lot of money, but it is a start.

          • by mark_reh ( 2015546 ) on Friday October 31, 2014 @10:08AM (#48278263) Journal

            That's like saying that rich people have to pay taxes shown in the tables that the IRS provides to everyone with their tax forms. There are so many accounting tricks and loop-holes in the laws that that 15-20% limit is NEVER going to be achieved. The real solution to the problem is universal healthcare funded directly by tax payers. The republican complaint against it is that you'll have to hire an army of people to administer it- BIG GOVERNMENT! What we have now is insurance companies with armies of administrators and lawyers working to prevent spending on health care because it is more profiable to collect premiums and not pay money out. With a single-payer system you have an army of people working to ensure spending is going to health care and not fraud. I know which I would rather fund.

    • by DamonHD ( 794830 )

      For most things maybe you just shouldn't be paying, at all denying treatment to those who happen not to have spare cash, eg students and young adults in general getting going in their jobs. I couldn't have paid anything much as a teenager for my epilepsy diagnosis and treatment; should I have just rotted before I even got to uni? I had left home, BTW.

      (In the UK I do pay for a few things at point of use under the NHS, but often even then fairly small fixed/tiered charges.)

      Rgds

      Damon

    • by Extensa30 ( 1150211 ) on Friday October 31, 2014 @06:45AM (#48276731)
      That you have to pay "cash" to get medical attention strucks me as hard as if you'd had to pay to have the police assiting you, or that if you had to pay to get your children into the school. All of those are basic rights that any development country considers "essential". Of course you pay for them, but you do so in your taxes... and if you want a premium service, then yes: you can use your cash as much as you want, and have hot blonde nurses for all I care. American republicans are fucked up around private healthcare. Why don't they ask for only-private police? that only serves and protects those that can afford it? or only-private education?
    • I've heard several economists say that what really skews our health system is the lack of direct payment. Since we don't pay for anything we don't know what it costs and it makes it easier to over consume health care because we're one or more steps removed from what things cost.

      I totally agree with your criticisms of what really seems like fraudulent billing with in/out of network doctors and drive-by doctoring (I read those NY Times articles, too). It really seems like a deliberately dishonest way to scr

  • by Dorianny ( 1847922 ) on Friday October 31, 2014 @06:45AM (#48276729) Journal
    People hate Obama-care and like the Affordable Care Act.
  • by smooth wombat ( 796938 ) on Friday October 31, 2014 @06:47AM (#48276737) Journal

    are the insurance companies who are raking in tens of millions of free dollars from all the people who are forced to hand over their money to a private company or have the government reach into their bank account and forcibly extract the money.

    This had nothing to do with getting insurance for people because it started with a Republican governor who saw a way to pay back his political supporters and what better way then to have the public hand over their money whether they want to or not.

  • by Charcharodon ( 611187 ) on Friday October 31, 2014 @07:19AM (#48276831)
    You are telling me that the insured rates for "poorer" areas has gone up because we now have a law that say that you have to buy insurance? How is that an improvement?

    Show me a study that shows how much the health of people and the quality of health care has improved and what the price changes of said health care and I might find that interesting.

    Just because they now have "health care" doesn't mean life got any better for them or those that have to pay for their health care.

  • by jsepeta ( 412566 ) on Friday October 31, 2014 @07:43AM (#48276917) Homepage

    the republican party is incredibly successful at turning the victims of their legislation into their voter base. democrats SUCK at messaging.

  • by Karmashock ( 2415832 ) on Friday October 31, 2014 @07:45AM (#48276925)

    ... I mean personally.

    What could you buy before and what can you buy now?

    Because I am not rich... before or after... and it is more expensive now then it was before. I mean... significantly.

    Now do I think we should help people that have a hard time getting medical care afford said care? Yes. Is the best method to provide that care to just throw money into the air until it covers the earth like leaves after autumn? Obviously not.

    Here someone is going to say "but single payer would be better!"... Maybe... but then like... anything would be better then this stupid law. the law is dumb. What we had before for all its flaws was better. My care was cheaper. I am not in some amazing stratospheric yacht class of people that sips expensive brandies while I talk about the little people. This law made my care more expensive. Full stop.

    Now here is where someone says "Okay, what is your solution because we need a better policy!". Okay, look at the price of college education over time. Graph it against the inflation rate. Notice something? Now do the same thing with the cost of housing prior to the crash. Notice something? What is happening is cost inflation due to government subsidization.

    Basically what you are looking at in many markets is the effect that unlimited subsidization has on free market systems when they are purely demand side. That is, if you just give everyone money that can only be spent on a given product or service... people buy that product or service in greater volumes. That then not only consumes the supply of those products or services but also increases what people ultimately can pay for them because not only do they have their own personal resources to draw upon but also this big government check. And so naturally, even if the supply is increased, because people have more money to spend... the costs go up. And the more subsidization you throw into the market the more the prices go up. And the faster you do it, the faster the prices go up. If your level of subsidization is percentage based and not even a flat amount then your subsidization rate can feed back into the supply/demand price loop in real time. Which can mean rapid uncontrolled price inflation.

    We've seen this before. It has happened many times because this is a lesson government and certain ideologues have a very hard time dealing with because it contradicts some political positions that are simply verifiability wrong.

    Where am I going with this? Well, medical costs have been going through the same cost inflation for YEARS. In fact, the very justification for obamacare was that cost inflation. And the cost inflation was caused in large part by government subsidization of healthcare. Look at the price of healthcare prior to the subsidization for something like mending a broken arm. Something that hasn't changed remarkably in a generation. And you'll see the costs were a great deal lower after factoring for inflation.

    So what are my solutions to this problem? Well, rather then give people money so they can pay for increasingly expensive medical care, why not try to make medical care cheaper for EVERYONE. Not by giving people money but effecting the market so that prices go down.

    There are a lot of ways to do this sort of thing. There is a hospital in Texas for example that has a completely different administrative structure. They basically did away with the three upper floors of most hospitals that are full of people that just do paper work. And instead they give shift nurses administrative control over their domain. That in and of itself lowers the cost hugely.

    The price of that is that the hospital outright refuses to deal with complicated paperwork from the insurance companies. They offer various ways of managing that. You can for example deal with the paper work yourself and it is your responsibility to see that the hospital gets paid or that you get reimbursed after paying the hospital out of pocket. They also have sort of a medical plan that covers JUST that hospital.

  • by lophophore ( 4087 ) on Friday October 31, 2014 @08:09AM (#48277027) Homepage

    1.36 trillion dollars over 10 years (http://obamacarefacts.com/costof-obamacare/). That is 136 billion dollars a year. For 10 million people to have insurance.

    By my calculations, that is $13,600 per covered person, per year.

    Hardly "affordable".

  • by schematix ( 533634 ) on Friday October 31, 2014 @09:29AM (#48277811) Homepage
    My family insurance rates went from ~$400/mo for a PPO plan in 2012, to ~$750/mo in 2013, and now just under $1000/mo in 2014, all with declining levels of coverage. Thank you 'Affordable' Care Act. Even a modest 6-figure household income can't realistically afford $1000/mo for health insurance so we dropped it. It doesn't end there either. After $12k in premiums, i have exposure for another $6000 per year. So now we have a bare bones plan and contribute less to the system overall. Worst law in the history of the United States.
  • by hendrips ( 2722525 ) on Friday October 31, 2014 @09:40AM (#48277927)

    I find the meme about poor states = conservative to be a bit annoying and misleading. While it is true that conservative states, especially Southern states, tend to have lower median incomes, they also have significantly lower costs of living. "Studies" like this one never adjust for purchasing power parity, and that oversight always makes me question anything else they have to say.

    For example, according to Wikipedia's article on household income in the United States (alas, the numbers are a couple of years old), strongly Democrat Hawaii, which is the 5th wealthiest state by income, is actually dead last adjusted for cost of living. New York ranks 44th once incomes are adjusted for purchasing power parity. Virginia and Utah are the two wealthiest states in the U.S. by PPP income. Of course, Mississippi and West Virginia are still poor no matter how you slice it, but the correlation between political orientation and real income among states is weak at best.

    This should not be surprising - local government politics in the U.S. look decidedly different from national politics. This is especially true for conservatives - many Republicans are comfortable with giving powers to local or state governments that they would abhor giving to the federal government, and moreover local elections frequently come down to personal, rather than party, politics. So judging the results of a state's internal, local elections and policymaking by how its citizens voted in a national election doesn't make that much sense, because those two things are imperfectly correlated.

    Sorry - that turned out to be a bit long and off topic, but I have a problem trusting articles like this that purport to investigate a fairly complicated and nuanced issue while also making such offhand implicit assumptions.

  • not "helped" (Score:5, Insightful)

    by superwiz ( 655733 ) on Friday October 31, 2014 @10:34AM (#48278573) Journal
    Being forced to buy insurance is not "help." It's being forced to buy insurance. It may be a good idea for some, but calling it "help" is misleading. Most people with this insurance will see more of their money spent on premiums than they would receive in payments even when they do get sick and need medical care. The medical care savings accounts would have been much more helpful for most people in reducing their medical costs and in forcing them into long-term responsible behavior. But we couldn't do that. That would be too Republican an idea.

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