Posts Tagged ‘Patient Protection and Affordable Care Act (PPACA or ACA)’

Cheeps and Chirps for March 2017 (catching up)

June 19, 2017

By Matthew E. Milliken
MEMwrites.wordpress.com
June 19, 2017

More catching up from my Twitter feed!

• ZOMG Donald Trump (and comrades)!

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Cheeps and Chirps for April 10, 2017

April 10, 2017

By Matthew E. Milliken
MEMwrites.wordpress.com
April 10, 2017

Spring is here. What better time than now to revisit my tweets? (Since we haven’t done this since January, and since I can’t bear to squander any precious gems, this installment will run from late January through the end of February; I’ll catch up on the rest later.)

 

• Donald Trump tackles immigration

 

• Donald Trump makes dubious personnel choices 

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The news cycle gazes fondly upon Trump, but only for a brief moment in time

March 3, 2017

By Matthew E. Milliken
MEMwrites.wordpress.com
March 3, 2017

President Donald Trump’s address to a joint session of Congress on Tuesday was, by his low standards, not a bad speech. Trump largely stuck to his script, offering little in the way of needless provocation. While the address contained plenty of misleading information, it featured a notable dearth of novel or headline-making lies. This is, shall we say, a slender basis for praising the leader of the free world. Then again, that’s where we are in 2017.

Unfortunately, much of what the president said was undercut either by the facts or by his earlier statements — in some cases, ones that Trump had made that very morning.

Trump took a few seconds at the beginning of his remarks to condemn the wave of anti-semitic bomb threats and cemetery vandalism as well as “last week’s shooting in Kansas City,” an apparent reference to what appears to have been a racially motivated murder in Olathe, Kansas. Some commentators called this a grace note, but this was literally the least that the president could have done — Trump, who is quick to snipe at people who disagree with him on Twitter, had been silent on the subject for days. Moreover, that morning, he’d suggested to Fox News interviewers that the wave of anti-semitic incidents might be a false-flag operation designed to make him and his deplorable followers look bad.

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Cheeps and Chirps for Aug. 27, 2016

August 27, 2016

By Matthew E. Milliken
MEMwrites.wordpress.com
Aug. 27, 2016

Some Twitter for you!

• Comedy!

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Cheeps and Chirps — belated July 2016 Republican National Convention edition!

August 11, 2016

By Matthew E. Milliken
MEMwrites.wordpress.com
Aug. 11, 2016

Twitter feed, represent!

Sadly, this could be an evergreen tweet

 

• Reminder: The U.S. is still at war

 

• Comedy!

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Recent Readings for Jan. 9, 2016

January 9, 2016

By Matthew E. Milliken
MEMwrites.wordpress.com
Jan. 9, 2016

• “The Fall of King Coal.” In December, a federal jury convicted former Massey Energy Chief Executive Don Blankenship of conspiracy to violate federal mine-safety laws, a misdemeanor punishable by a maximum of a year in prison. In “The Fall of King Coal,” which Mother Jones published in the fall as Massey’s trial was getting under way, reporter Tim Murphy took a close look at Blankenship’s career, which involved breaking union strikes as well as existing contracts and safety and environmental regulations.

“It was very, very obvious from the first part that [Blankenship] cared about one thing and one thing only, and that was the dollar, and it was clear that he worshipped at the altar of greed and dollars, and he wouldn’t let anything get in the way,” one longtime union foe told Murphy.

• “The Corporate Takeover of the Red Cross.” The American Red Cross did not have a good 2015, when several reports came out exposing it as a floundering and at times ineffective organization. Take, for instance, a June report from ProPublica and NPR that bore the headline “How the Red Cross Raised Half a Billion Dollars for Haiti and Built Six Homes.”

Last month, Justin Elliott extended his reporting on the American Red Cross by describing how former AT&T executive Gail McGovern has brought a businesslike mentality to the charity that has coincided with, if not actually caused, budget deficits, layoffs, internal cutbacks, sagging morale and the loss of trust by countless volunteers and partners. One of McGovern’s apparent missteps was hiring Jack McMaster, a former AT&T colleague who ran a Dutch telecom company into the ground before getting a job with the Red Cross.

• “Republican doom doesn’t equal Democrat victory: Our political chaos could destroy them both.” Salon columnist Andrew O’Hehir blasts the left and the right in this essay:

Clinton’s tone and rhetoric have been measured during this campaign, but as Salon’s Bill Curry wrote recently, she remains an unregenerate foreign-policy hawk who shows every sign of yearning to double down on failed military overreach. Whatever you think she may have said, Clinton has absolutely not ruled out sending American troops by the thousands to fight a ground war against the Islamic State. She has called out Republican candidates for their “bluster and bigotry” and rejected talk of a “war on Islam,” which is all to the good. But the policy proposals discernible below her calm and resolute-sounding language over the last month are virtually indistinguishable from those of the non-Trump GOP contenders: More war, more surveillance, less First Amendment. “You are going to hear all the familiar complaints: ‘Freedom of speech,’” she told a Brookings Institution audience on Dec. 6. I know! As if that’s in the Constitution or something!

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Tax deductions and magical thinking: When smart policy makes for unpopular politics

October 10, 2015

By Matthew E. Milliken
MEMwrites.wordpress.com
Oct. 10, 2015

Republican tax plans all seem to have something in common — something besides lowering the top individual and corporate income-tax rates, that is. See if you can spot it.

Real estate mogul and reality TV host Donald Trump’s tax plan aims to lower taxes and to simplify the tax code. Trump’s proposal claims that its “tax cuts are fully paid for by:”

1. Reducing or eliminating most deductions and loopholes available to the very rich.…

3. Reducing or eliminating corporate loopholes that cater to special interests, as well as deductions made unnecessary or redundant by the new lower tax rate on corporations and business income…

Former Florida Gov. Jeb Bush’s tax proposal would:

• Simplify the tax code for all Americans to lessen the power of the IRS and increase both prosperity and fairness.

• Reduce loopholes and special tax provisions created by lobbyists that invariably benefit those at the top.

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June 26, 2015: The Supreme Court extends marriage equality to all, and history is made

June 27, 2015

By Matthew E. Milliken
MEMwrites.wordpress.com
June 27, 2015

I don’t remember much about when or why I first started thinking seriously about gay marriage. I do know this, however: I used to be on the wrong side of history and justice.

I’m the kind of moderate who usually prefers to split the difference rather than award one or the other side an outright victory on any given issue. Gay marriage initially seemed to me to be frivolous — a pointless expansion, and perhaps even an outright redefinition, of marriage. If homosexuals could obtain civil unions that afforded them all the same legal rights as marriage, then why was there any need for gay marriage?

Granted, many states didn’t allow civil unions for homosexuals. This left life partners at the mercy of blood relatives and courts who were often hostile to their interests when one member of a couple was hospitalized or died. Still, civil unions were a reasonable intermediate step. If they could be implemented throughout the nation, I thought, it would moot the struggle over gay marriage.

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My trip to the eye doctor (part 2)

June 26, 2015

By Matthew E. Milliken
MEMwrites.wordpress.com
June 26, 2015

And now, I continue the story of my trip to the eye doctor

When the examination was complete, the doctor walked me over to the spectacle showroom. I heard him asking two assistants (opticians? I dunno) who was up; one replied that neither was. “You’re not the only one in this office with a sense of humor,” I said to the doctor as he left. We both smiled, as did the optician (technician?).

Looking at the frames on display, I was quickly drawn to a pair that closely resembled the ones I’m wearing now. I didn’t like the fact that they had Nike swooshes on the side, but after perusing two or three whole cases, they were the spectacles to which I was most drawn.

Some of the rectangular frames were attractive, as were some that lacked rims on the bottom of the lenses, but I was afraid they’d look goofy on me. And so I went with the first — really, the only — pair that I’d picked.

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A brave exercise in truth-telling: The Heritage Foundation’s Obamacare recap promotes bad news about a bad law

March 27, 2015

By Matthew E. Milliken
MEMwrites.wordpress.com
March 27, 2015

With the fifth anniversary of the Affordable Care Act, a.k.a. Obamacare, taking place on Monday, the media have been packed with assessments of the law. But not all assessments are created equal.

Take the article (excuse me — I meant to say, the “brave exercise in truth-telling”) written by Melissa Quinn of the Daily Signal, an outlet of the conservative Heritage Foundation. She got things off to a terrible start:

Five years ago on March 23, 2010, President Obama signed the Affordable Care Act into law.

Many of the health care law’s provision took effect in 2013, and Americans have since been experiencing the effects of the law—both good and bad. Millions learned they were not able to keep their original insurance plans and more than 7.7 million received subsidies from the federal exchange.

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Bias, bias everywhere, and not a drop of good old-fashioned patriotic American red-blooded conservative coverage of Obamacare

March 26, 2015

By Matthew E. Milliken
MEMwrites.wordpress.com
March 26, 2015

With the fifth anniversary of the Affordable Care Act, a.k.a. Obamacare, taking place on Monday, the media have been packed with assessments of the law. Two of them caught my eye, for no other reason than that they flitted across my Twitter feed.

Tony Pugh of McClatchy’s Washington, D.C., bureau wrote more than 1,400 words on the Affordable Care Act’s rocky five-year history. PolitiFact’s Steve Contorno and Angie Drobnic Holan assembled an assessment that spanned more than 2,000 words. (That count doesn’t include the article’s bibliography, which lists 31 different interviews, articles and studies that formed the basis for the story.)

Now, conservatives love to bellyache about how the mainstream — oh, excuse me; lamestream — media is biased toward liberals. Sadly, anywhere one turns, one finds evidence that these complaints are accurate. Check out these fawning paragraphs that Pugh wrote to conclude his story:

As the health care law hits age five, it’s way too early to pass judgment on its effectiveness, said health care blogger Robert Laszewski. The law’s main provisions have been in place for only about 18 months, Laszewski said. Marketplace insurers are still being subsidized by the federal government, and only about half of the estimated 22 million marketplace plan members the CBO envisions in coming years have purchased coverage.

“I would rate Obamacare, 18 months after implementation, as incomplete,” Laszewski said. “Anybody who wants to look at Obamacare and talk about whether it’s a success or a failure, call me in 2017.”

Obviously this reporter is totally in the tank for Obama, right?

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The mystery of the misunderstood Obamacare provision: Another take on the Halbig imbroglio

August 7, 2014

By Matthew E. Milliken
MEMwrites.wordpress.com
Aug. 7, 2014

Feature or bug? That’s a crucial debate being contested as a result of the Halbig lawsuit, which is part of the right wing’s War on Obamacare.

Liberal commentators such as Brian Beutler argue that the Patient Protection and Affordable Care Act provision that’s at the heart of the Halbig tussle represents a drafting error, not the intent of the law’s architects. To say otherwise is to dismiss as irrelevant the vast majority of the reportage and analysis that took place as the massive health-care reform bill was being crafted and implemented.

In fact, to adopt the now-popular conservative argument that Obamacare must be have been precisely designed to function exactly and only as it is written is to call into question the integrity of virtually everyone who discussed and wrote about the law as it was crafted, passed and initially launched.

After all, over that period, few if any people mentioned the supposed fact that Obamacare’s drafters intended to bar people who purchased health insurance through online marketplaces or exchanges that were run by the federal government. And the current conservative line is that the provision is a major feature, not a bug, in the health-care reform initiative.

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Did political convenience convince a conservative journalist to re-categorize a bug as a feature? An examination of the Welch–Beutler–Suderman spat

August 6, 2014

By Matthew E. Milliken
MEMwrites.wordpress.com
Aug. 6, 2014

A Twitter feud between left-wing and right-wing pundits caught my eye last week.

The spat was launched by this tweet:

The difference between intellectual honesty () and a hackish attempt at oppo marginalization: ()

— Matt Welch @mleewelch 10:51 AM – 29 Jul 2014

Welch is the editor in chief of Reason, the libertarian magazine produced by the Los Angeles–based Reason Foundation. His tweet praised an article written by Reason senior editor Peter Suderman and published in Reason while panning one written by Brian Beutler, a senior editor at The New Republic, and published in that left-leaning magazine.

The articles promote dueling interpretations of the issue that many people refer to as Halbig. The tag comes from the plaintiff in one of a handful of pending lawsuits that seek to cripple the right’s favorite whipping boy, the Affordable Care Act.

The key to Halbig — beyond, of course, understanding that conservatives are obsessed with (a) opposing anything associated with Obama, especially (b) the health care reform law that is familiar known as Obamacare — is the question of whether one provision in that law means what it appears to say in the narrowest and most literal possible meaning.

This is the position on the right wing. As a result, they assert, buyers in states that did not establish their own online health-insurance marketplaces are ineligible for the tax credits that they were promised. In many cases, these subsidies make the coverage affordable.

Should this argument prevail, it could affect more than 7 million residents in the 36 states that rely on HealthCare.gov. (That’s the federally run website for comparing and purchasing health insurance plans offered by private companies; the site was created for residents of states that declined to create their own online exchanges.)

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Cross-border care: When health insurers send Americans to other countries

July 8, 2014

By Matthew E. Milliken
MEMwrites.wordpress.com
July 8, 2014

Adam Teicholz and Glenn Cohen took an interesting look in The New Republic the other day at cross-border care, a relatively new phenomenon in which U.S. health insurance companies send patients out of the country — mainly to Mexico — for certain tests and other medical procedures.

Cross-border care is distinct from medical tourism. In the latter, which is better known, people travel to other nations for medicine or procedures that are easier to obtain away from home.

“Easier to obtain” often refers to a difference in costs, which the website MedicalTourism.com says can be up to 90 percent cheaper than in the United States. For example, the site lists the cost for a heart bypass as being $144,000 domestically. Overseas, the same procedure can cost as little as $5,200 in India. (That accounts for airfare for two, but not food, lodging or other expenses.) In all of 10 other countries that the site lists, a heart bypass is estimated to cost less than $30,000. Even accounting for travel costs, a patient can come out ahead.

For this very reason — that charges for health care can be significantly lower outside of the U.S. — a handful of American insurers are requiring their clients to leave the country for some care. And therein lies the key difference: Medical tourism is generally undertaken on an individual’s initiative, while cross-border care is spurred by institutional imperatives.

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With Hobby Lobby, the Supreme Court majority paves the way for minimal changes initially, great changes eventually

July 1, 2014

By Matthew E. Milliken
MEMwrites.wordpress.com
July 1, 2014

Author’s note: This post was updated on July 4 to correct the name of the author of a commentary on Supreme Court racial discrimination rulings that Reuters published in May.

With a 5-4 decision, the Supreme Court ruled on Monday morning that the government could not compel closely held for-profit corporations to provide contraception to its employees. The majority opinion, written by Associate Justice Samuel Alito, essentially prioritizes the 1993 Religious Freedom Restoration Act over a contraception coverage mandate contained in 2010’s Patient Protection and Affordable Care Act.

One of Alito’s key arguments in Burwell v. Hobby Lobby, beyond his assertion that for-profit businesses are entitled to religious beliefs, is that there is no legal basis in the 1993 law for distinguishing among nonprofit and for-profit corporations. While the justice concedes that providing widespread contraception coverage is in fact a compelling government interest, Alito asserts that the Obamacare law’s mandate is not the least restrictive means of furthering that interest, and thus should be stricken.

Defenders of the ruling note that it is narrow; indeed, the court’s summary includes a disclaimer that “[t]his decision concerns only the contraceptive mandate and should not be understood to hold that all insurance-coverage mandates, e.g., for vaccinations or blood transfusions, must necessarily fall if they conflict with an employer’s religious beliefs.”

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North Carolina Republican tries to tarnish Obamacare for the crime of … mandating maternity coverage!

June 21, 2014

By Matthew E. Milliken
MEMwrites.wordpress.com
June 21, 2014

A short item that Tara Culp-Ressler posted at Think Progress caught my eye on Thursday.

Mandy Cohen of the Center for Medicare and Medicaid Services, who is due to give birth in about three weeks, recently appeared at a House Oversight and Government Reform Committee hearing entitled “Poised To Profit: How Obamacare helps insurance companies even if it fails patients.”

During her testimony, Rep. Mark Meadows pressed Cohen about a provision in the Affordable Care Act that requires insurance companies to include maternity coverage in all new plans that they sell. The Republican representative, whose district covers the mountainous western corner of North Carolina, asked if there other coverages that insurers must sell (and which ipso facto consumers must buy) because of Obamacare.

Cohen: It depends on your personal family situation and your medical situation. I’ll say as an internist, and a primary care doc, that sometimes you don’t know what that medical situation will be going forward, and that’s the nature —

Meadows: But maternity is one that you can probably analyze pretty well for someone who’s in their 50s.

Cohen: Right, but it’s a minimal essential benefit we wanted to make sure every American has.

If this is going to be one of the GOP’s main points of contention about the Affordable Care Act, then the law could well have a very rosy future. Is it unfair for people (read: men) to pay for coverage that they aren’t going to use? Perhaps so, but that’s also a fundamental component of insurance.

And let’s remember what the health-insurance market was like before Obamacare mandated maternity coverage. The National Women’s Law Center released a study in early 2012 that captured many unsavory aspects of those not-so-good days.

Back then, gender rating — that is, charging women more than men for comparable coverage — existed without restriction in 36 states. Businesses with mainly female work forces were “routinely” charged more than others, the center reported. This disparity affected many hospitals, medical offices, pharmacies, community-service organizations, and home-health-care and child-care businesses, all of which skew female.

But gender rating may have had the biggest impact on the individual market. “Even with maternity coverage excluded, nearly a third of plans examined charged 25 and 40-year-old women at least 30% more than men for the same coverage,” the report stated (emphasis added).

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To pay or not to pay? Conservatives grapple with Medicaid estate recovery issues

December 23, 2013

By Matthew E. Milliken
MEMwrites.wordpress.com
Dec. 23, 2013

Last week, I looked at how the expansion of Medicaid under Obamacare might be changing the scope and reach of Medicaid’s estate recovery provisions. As the Democrats’ Patient Protection and Affordable Care Act continues taking effect, I suspect we’ll hear a lot more people raising questions about how these two programs interact with one another. 

Of course, some conservative writers have already expressed their thoughts on the matter, and they’re rather dire. At Breitbart, Debra Heine wrote ominously that “enables the Federal government to go after your estate after you die in order to pay for the healthcare expenses you have incurred while on Medicaid.”

Dr. Jane Orient, a conservative physician, offered this: “Expanding Medicaid to persons with modest assets will enable estate recovery to become a cash cow for states to milk the poor and the middle class.”

Blogger Alex Gimarc rendered this verdict: “I cannot think of a better way to impoverish the young and keep them impoverished for all time.” Gimarc then went on to quote George Orwell’s 1984: “If you want a vision of the future, imagine a boot stamping on a human face — forever.”

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Life, death and health care costs: Long-standing estate recovery provisions and Medicaid expansion under Obamacare raise concerns

December 18, 2013

By Matthew E. Milliken
MEMwrites.wordpress.com
Dec. 18, 2013

On Sunday, The Seattle Times printed an interesting feature by Carol Ostrom about a presumably unintended effect of Medicaid expansion under Obamacare. Here’s the heart of the story:

If you’re 55 or over, Medicaid can come back after you’re dead and bill your estate for ordinary health-care expenses.

The way [Port Townsend, Wash., resident Sofia] Prins saw it, that meant health insurance via Medicaid is hardly “free” for Washington residents 55 or older. It’s a loan, one whose payback requirements aren’t well advertised. And it penalizes people who, despite having a low income, have managed to keep a home or some savings they hope to pass to heirs, Prins said.

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Re-debunking one easily debunked conservative lie about Obamacare and HealthCare.gov

November 13, 2013

By Matthew E. Milliken
MEMwrites.wordpress.com
Nov. 13, 2013

On Oct. 25, Republican Rep. Marsha Blackburn of Tennessee appeared with CNN anchor Carol Costello to discuss GOP charges that HealthCare.gov might be compromising the privacy — specifically, the medical information — of its users.

Now, I certainly can’t vouch for the security of HealthCare.gov. What I would argue, however, is that if the data it collects from other website visitors goes no deeper than what I provided — and that’s my understanding based on reporting on the matter — then everyone’s medical history is completely safe.

Why is that? Because HealthCare.gov doesn’t really collect any medical information.

It asked for my name, physical and e-mail addresses, phone number and race. It also asked whether I was a member of a federal recognized Native American tribe, whether I had Hispanic or Latino origins, and whether anyone for whom I was applying for coverage was incarcerated. There were a few multiple choice questions intended to verify my identity: the year was I born, cities in which I had previously lived, the name of the pet for which I had recently purchased veterinary insurance (a red herring; I’ve never owned a pet as an adult).

Excepting, I suppose, the identity verification queries, which the website said were based on the database of the Experian credit bureau, these are all more or less standard questions that any health insurance company would want answered before selling me a policy. In fact, prior to Oct. 1, I’d bet insurance companies would require answers to most or all of those questions before they’d tell me whether they would even sell me a policy.

But HealthCare.gov didn’t ask me any questions about my medical history, except for this: whether I’d regularly used tobacco products over the last six months. (I’ve never smoked — anything at all.)

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My Obamacare + HealthCare.gov adventure: Part 1 of ???

November 12, 2013

By Matthew E. Milliken
MEMwrites.wordpress.com
Nov. 12, 2013

I’ve written a number of times on this blog about the Patient Protection and Affordable Care Act, informally known as Obamacare. On Oct. 31, I criticized President Obama and his administration for repeatedly and explicitly claiming that Americans with health insurance would be able to keep their policies, even though they knew or should have known that this wasn’t the case.

In general, however, I’ve been cautiously optimistic that the law might — emphasis on might — work more or less as intended, which was how I concluded my Sept. 10 post on the topic.

One thing that I haven’t revealed, until now, is that my perspective on the Affordable Care Act is that of a consumer of health care who enjoys having the buffer from bankruptcy and sudden large expenses that solid health insurance can provide. I thought in particular that the law’s guaranteed issue provision, which requires health insurers to sell policies to all who apply, regardless of pre-existing conditions, was something that might benefit me.

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Right-wing blogger finds criminals, criminals everywhere — but not a criminal charge can be found involving an Obamacare-affiliated group

November 2, 2013

By Matthew E. Milliken
MEMwrites.wordpress.com
Nov. 2, 2013

If you happened to visit the conservative website RedState.com this weekend and scrolled down to the very bottom, you might have noticed an article with this headline: “Arrests, Citations Lurk at Union Group Approved by Obama Admin to Promote ObamaCare in Wisconsin.”

The story, by Brian Sikma, was published on Oct. 31 at 4:30 p.m. Here are its first two paragraphs:

Among the 165 groups approved by the Obama Administration to promote or set-up [sic] ObamaCare in Wisconsin is Wisconsin Jobs Now, a liberal get-out-the-vote group affiliated with the SEIU. According to the federal Department of Health and Human Services, the organization is working as a certified application counselor, or CAC. Numerous individuals who have been employed by Wisconsin Jobs Now or who work there now have been investigated, arrested or cited by law enforcement agencies for legal violations.

Wisconsin Jobs Now is not a health insurance group or healthcare provider. It is strictly a community organizing outfit. During elections it runs one of the largest voter turnout efforts in support of Democratic candidates in Wisconsin.

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Emblem or footnote? The spate of health insurance policy cancellations is contrary to President Obama’s explicit promises. But it remains to be seen whether it will matter.

October 31, 2013

By Matthew E. Milliken
MEMwrites.wordpress.com
Oct. 31, 2013

It turns out that, for hundreds of thousands of Americans, despite what the president pledged, they can’t keep their health plans.

That’s the stark truth about Obamacare — a.k.a. the Affordable Care Act — that has come into sharp focus over the past few days.

President Barack Obama has a verbal habit of insisting on clarity in many of his speeches and off-the-cuff remarks. He could hardly have been clearer when he said, multiple times, that Americans who liked their health insurance would be able to keep it under his health-care reform plan.

Only that isn’t true. CBS reports that 2 million Americans have had their policies canceled by insurance companies because they aren’t compatible with various provisions of Obamacare. Understandably, lots of people are unhappy about this, and Republican and conservative critics have jumped all over this broken promise.

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