# What is your ongoing opinion of the Affordable Care Act? (Title Edited)

**URL:** <https://boards.straightdope.com/t/what-is-your-ongoing-opinion-of-the-affordable-care-act-title-edited/647561>\
**Category:** Politics & Elections\
**Created:** [January 17, 2013, 11:21pm UTC](https://boards.straightdope.com/t/what-is-your-ongoing-opinion-of-the-affordable-care-act-title-edited/647561 "2013-01-17T23:21:39Z")\
**Posts on this page:** 20\
**Page:** 46

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**Author:** ![iiandyiiii](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/iiandyiiii/32/7924_2.png) [@iiandyiiii](https://boards.straightdope.com/u/iiandyiiii)\
**Post date:** [December 30, 2013, 12:32am UTC](https://boards.straightdope.com/t/what-is-your-ongoing-opinion-of-the-affordable-care-act-title-edited/647561/902 "2013-12-30T00:32:42Z")

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> [@adaher](#):
>
> You guys are trying to have it both ways. Things that don’t work aren’t important, but you’re pissed they don’t work. Are they important, or not?

The rollout was important in the short term, not so much in the long term.

> [@](#):
>
> You’ve already pretty much said that it doesn’t matter if more people are uninsured next year than the year before. That’s a basic goal of the law, to expand coverage. Actually, it’s the entire purpose of the law. Now sure, it should expand coverage in later years. if more people are uninsured in 2016 than in 2013 that would really be something. The law would certainly deserve repeal then, would it not?

What are you trying to say? Are you trying to say it’s a failure now, or it will be a failure in the future? You’re totally incoherent and walk back nearly every claim you make. The coverage numbers now are only important, politically speaking, now. In the long term, let’s see what the coverage numbers are.

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**Author:** ![DMC](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/dmc/32/18049_2.png) [@DMC](https://boards.straightdope.com/u/DMC)\
**Post date:** [December 30, 2013, 1:26am UTC](https://boards.straightdope.com/t/what-is-your-ongoing-opinion-of-the-affordable-care-act-title-edited/647561/903 "2013-12-30T01:26:07Z")

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We should be nice to ol’ **adaher**. His track record for his claims panning out (much less actually backing up with data) is so bad that if he bought 258,890,849 different combinations on MegaMillions tickets, I’d pay a hundred grand for that one $1.00 combination that he didn’t choose.

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**Author:** ![Snowboarder\_Bo](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/snowboarder_bo/32/229_2.png) [@Snowboarder\_Bo](https://boards.straightdope.com/u/Snowboarder_Bo)\
**Post date:** [December 30, 2013, 2:24am UTC](https://boards.straightdope.com/t/what-is-your-ongoing-opinion-of-the-affordable-care-act-title-edited/647561/904 "2013-12-30T02:24:09Z")

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> [@adaher](#):
>
> This is really basic stuff. So let’s fight some ignorance here:
> 
> [http://www.familiesusa.org/issues/private-insurance/legal-rights/hipaa-and-portability-of.html](http://www.familiesusa.org/issues/private-insurance/legal-rights/hipaa-and-portability-of.html)
> 
> For consumers who are HIPAA-eligible and who seek to purchase a policy in the individual market, HIPAA does the following:
> 
> ```
> guarantees the right to purchase individual coverage;
> prohibits preexisting condition exclusions for the specified HIPAA policies;
> requires the issuance of certificates of creditable coverage; and
> guarantees renewal of individual health insurance coverage.
> 
> ```

Ah, so you were only talking about people eligible for coverage under HIPAA, not, as it seemed, everyone. In any case, those assertions are untrue. That cite seems to have some key aspects of HIPAA wrong; for instance, under HIPAA insurers certainly (pre-ACA) could reject people for pre-existing conditions. [Cite

> [@](#):
>
> Title I requires the coverage of and also limits restrictions that a group health plan can place on benefits for preexisting conditions. **Group health plans may refuse to provide benefits relating to preexisting conditions for a period of 12 months after enrollment in the plan or 18 months in the case of late enrollment.** [5] However, individuals may reduce this exclusion period if they had group health plan coverage or health insurance prior to enrolling in the plan. Title I allows individuals to reduce the exclusion period by the amount of time that they had “creditable coverage” prior to enrolling in the plan and after any “significant breaks” in coverage.[6] “Creditable coverage” is defined quite broadly and includes nearly all group and individual health plans, Medicare, and Medicaid.[7] A “significant break” in coverage is defined as any 63 day period without any creditable coverage.

]([Health Insurance Portability and Accountability Act - Wikipedia](http://en.wikipedia.org/wiki/Health_Insurance_Portability_and_Accountability_Act#Title_I:_Health_Care_Access.2C_Portability.2C_and_Renewability))

Again, your assertions are just assertions, without much, if any, basis in fact, as the cite you offered shows.

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**Author:** ![Terr](https://avatars.discourse-cdn.com/v4/letter/t/839c29/32.png) [@Terr](https://boards.straightdope.com/u/Terr)\
**Post date:** [December 30, 2013, 2:37am UTC](https://boards.straightdope.com/t/what-is-your-ongoing-opinion-of-the-affordable-care-act-title-edited/647561/905 "2013-12-30T02:37:20Z")

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> [@Snowboarder\_Bo](#):
>
> That cite seems to have some key aspects of HIPAA wrong; for instance, under HIPAA insurers certainly (pre-ACA) could reject people for pre-existing conditions.

No, they could not. They could exclude those conditions from coverage for 12 months, but they had to accept them for all other conditions and cover them for pre-existing ones after the exclusion period. Did you read your own cite?

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**Author:** ![Iggy](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/iggy/32/3364_2.png) [@Iggy](https://boards.straightdope.com/u/Iggy)\
**Post date:** [December 30, 2013, 4:19am UTC](https://boards.straightdope.com/t/what-is-your-ongoing-opinion-of-the-affordable-care-act-title-edited/647561/906 "2013-12-30T04:19:20Z")

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There is a huge difference in insurance-speak between refusing coverage and a pre-existing condition being subject to an exclusion period.

Even the almighty PPACA allows for [loopholes](http://www.growingfamilybenefits.com/affordable-care-maternity/pre-existing-condition/) that effectively provide for an exclusion period for a pre-existing pregnancy or [refusal to cover](http://quinnscommentary.com/2010/07/05/no-maternity-coverage-for-adult-children-under-ppaca-why-do-we-need-insurance-anyway/) a pregnancy altogether for certain women insured as dependents.

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**Author:** ![JohnT](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/johnt/32/15048_2.png) [@JohnT](https://boards.straightdope.com/u/JohnT)\
**Post date:** [December 30, 2013, 1:08pm UTC](https://boards.straightdope.com/t/what-is-your-ongoing-opinion-of-the-affordable-care-act-title-edited/647561/907 "2013-12-30T13:08:28Z")

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> [@adaher](#):
>
> the exchanges are just a small part of ACA? Okay.
> 
> This is what I’m talking about with the goalpost moving. Everything that’s been postponed or failed is called “not that important to the law”. Suddenly the employer mandate doesn’t matter, the exchanges don’t matter, and heck, it doesn’t even matter anymore if young people even sign up.
> 
> What supporters are basically saying is that none of it matters. It’s the ideological win that’s important. There is a universal health care system in this country. Whether it works is of secondary importance.

Haven’t read the responses after this, but what the h:

1. The website is working. A startup glitch does not invalidate the whole system. Have you tried pricing out a policy?
2. There’s more than the website and the mandates. The increased coverages. The women’s care and OB/GYN mandates\*. Making denial of coverage for pre-existing conditions… that in itself is, imho, as big a win as the rest of it combined.
3. The problems will be (and in many cases, have been) fixed. That is what people do. We build and fix things. Like backyard sheds and broken health care systems.
4. Your talk of elections is irrelevant. There are _always_ elections coming up. To paraphrase Ayn Rand, you make it sound like it’s preferable that nothing gets done so that nobody gets blamed for the act of moving. Obama’s already passed Obamacare and (in the Republican’s eyes at least) we just had an election that was a mandate on Obamacare in 2012.
5. Your side shut down the government for nothing more than an ideological loss. In the manner of a 5 year-old who destroys his sisters doll out of jealousy, your side decided it was better to throw a temper tantrum, damaging 10’s of millions of Americans financially and losing us part of the “decent respect of the opinions of mankind” that we’ve taken 200+ years to build up. So don’t come accusing me about wanting nothing more than “ideological” wins. At least _my_ win benefits millions of my poorer fellow man.
6. Since the rollout of the latest (online-access required) SimCity was so horrible, should the existence of the game be legislatively banned?

Makes me feel right Christian-ly, it does!

\*As a Catholic of the Roman variety, I don’t give the slightest shit what the church has to say about procreation and sex. Giving volunteer celibates decision-making authority about family planning makes as much sense as giving a random 18yo power of attorney over my whole estate. So, go Obamacare! (I wore pro-Obama pins to church last year - some people were _not_ happy, but Fr. Carlos never said anything to me.)

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**Author:** ![JohnT](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/johnt/32/15048_2.png) [@JohnT](https://boards.straightdope.com/u/JohnT)\
**Post date:** [December 30, 2013, 1:16pm UTC](https://boards.straightdope.com/t/what-is-your-ongoing-opinion-of-the-affordable-care-act-title-edited/647561/908 "2013-12-30T13:16:40Z")

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" Making denial of coverage for pre-existing conditions…"

Should read

“Making denial of coverage for pre-existing conditions much more difficult, if not illegal…”

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<div class="post-metadata">

**Author:** ![iiandyiiii](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/iiandyiiii/32/7924_2.png) [@iiandyiiii](https://boards.straightdope.com/u/iiandyiiii)\
**Post date:** [December 31, 2013, 1:57pm UTC](https://boards.straightdope.com/t/what-is-your-ongoing-opinion-of-the-affordable-care-act-title-edited/647561/909 "2013-12-31T13:57:20Z")

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[Here’s](http://talkingpointsmemo.com/edblog/where-does-obamacare-stand) a nice discussion of how the ACA has affected health care coverage in the USA. In short, taking into account the Federal and state exchanges, the Medicare expansion, and various other provisions of the bill, about 9 or 10 million additional people have health care because of the ACA.

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**Author:** ![lance\_strongarm](https://avatars.discourse-cdn.com/v4/letter/l/87869e/32.png) [@lance\_strongarm](https://boards.straightdope.com/u/lance_strongarm)\
**Post date:** [January 2, 2014, 1:57pm UTC](https://boards.straightdope.com/t/what-is-your-ongoing-opinion-of-the-affordable-care-act-title-edited/647561/910 "2014-01-02T13:57:55Z")

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> [@Snowboarder\_Bo](#):
>
> Ah, so you were only talking about people eligible for coverage under HIPAA, not, as it seemed, everyone. In any case, those assertions are untrue. That cite seems to have some key aspects of HIPAA wrong; for instance, under HIPAA insurers certainly (pre-ACA) could reject people for pre-existing conditions.

Here’s my personal experience with that. I have a child with what the insurance companies consider a pre-existing condition (Down syndrome, even though it’s not really a medical condition, but rather a risk factor for several conditions). I tried to get private coverage for her and was rejected. But under HIPAA, as I recall, every state had to have one designated private policy that would cover people with pre-existing conditions, so I got that.

However, that policy was ENORMOUSLY expensive - something like $1,100 a MONTH.

I couldn’t have kept paying it for long before getting group coverage again. (I might have been able to get her on Medicaid at the time, I’m not sure.) And I could only get the HIPAA policy after doing COBRA, which was also really expensive.

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**Author:** ![lance\_strongarm](https://avatars.discourse-cdn.com/v4/letter/l/87869e/32.png) [@lance\_strongarm](https://boards.straightdope.com/u/lance_strongarm)\
**Post date:** [January 2, 2014, 2:01pm UTC](https://boards.straightdope.com/t/what-is-your-ongoing-opinion-of-the-affordable-care-act-title-edited/647561/911 "2014-01-02T14:01:00Z")

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> [@Terr](#):
>
> No, they could not. They could exclude those conditions from coverage for 12 months, but they had to accept them for all other conditions and cover them for pre-existing ones after the exclusion period. Did you read your own cite?

This is false. I know because I was rejected - not subject to a waiting period, but rejected outright - by private insurers when I applied for my daughter.

Only one very expensive policy from one insurer was available to us without a waiting period or outright exclusion of my daughter. All the others simply said no.

Perhaps the law was amended after that though, but my experience wasn’t very long ago.

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**Author:** ![lance\_strongarm](https://avatars.discourse-cdn.com/v4/letter/l/87869e/32.png) [@lance\_strongarm](https://boards.straightdope.com/u/lance_strongarm)\
**Post date:** [January 2, 2014, 2:03pm UTC](https://boards.straightdope.com/t/what-is-your-ongoing-opinion-of-the-affordable-care-act-title-edited/647561/912 "2014-01-02T14:03:21Z")

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> [@Iggy](#):
>
> There is a huge difference in insurance-speak between refusing coverage and a pre-existing condition being subject to an exclusion period.
> 
> Even the almighty PPACA allows for [loopholes](http://www.growingfamilybenefits.com/affordable-care-maternity/pre-existing-condition/) that effectively provide for an exclusion period for a pre-existing pregnancy or [refusal to cover](http://quinnscommentary.com/2010/07/05/no-maternity-coverage-for-adult-children-under-ppaca-why-do-we-need-insurance-anyway/) a pregnancy altogether for certain women insured as dependents.

Also, there was a difference between group and private coverage. Group coverage (what people get from their employer) couldn’t exclude people for pre-existing conditions, but private policies (what you go out and buy on your own if you don’t have it at work or are unemployed) could.

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**Author:** ![Terr](https://avatars.discourse-cdn.com/v4/letter/t/839c29/32.png) [@Terr](https://boards.straightdope.com/u/Terr)\
**Post date:** [January 2, 2014, 3:20pm UTC](https://boards.straightdope.com/t/what-is-your-ongoing-opinion-of-the-affordable-care-act-title-edited/647561/913 "2014-01-02T15:20:30Z")

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> [@lance\_strongarm](#):
>
> This is false. I know because I was rejected - not subject to a waiting period, but rejected outright - by private insurers when I applied for my daughter.

Because she was not HIPAA eligible. Did you read the cite?

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**Author:** ![lance\_strongarm](https://avatars.discourse-cdn.com/v4/letter/l/87869e/32.png) [@lance\_strongarm](https://boards.straightdope.com/u/lance_strongarm)\
**Post date:** [January 2, 2014, 3:33pm UTC](https://boards.straightdope.com/t/what-is-your-ongoing-opinion-of-the-affordable-care-act-title-edited/647561/914 "2014-01-02T15:33:43Z")

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> [@Terr](#):
>
> Because she was not HIPAA eligible.

You seem to be contradicting your previous post. You seemed to be claiming that nobody could be rejected outright for a pre-existing condition.

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**Author:** ![2ManyTacos](https://avatars.discourse-cdn.com/v4/letter/2/3da27b/32.png) [@2ManyTacos](https://boards.straightdope.com/u/2ManyTacos)\
**Post date:** [January 2, 2014, 4:30pm UTC](https://boards.straightdope.com/t/what-is-your-ongoing-opinion-of-the-affordable-care-act-title-edited/647561/915 "2014-01-02T16:30:10Z")

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I just think that it’s worth pointing out that most of the ACA coverage expansions and reforms officially went into effect yesterday and - gasp! - the sky didn’t fall and the world hasn’t collapsed.

That is all.

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**Author:** ![Terr](https://avatars.discourse-cdn.com/v4/letter/t/839c29/32.png) [@Terr](https://boards.straightdope.com/u/Terr)\
**Post date:** [January 2, 2014, 4:31pm UTC](https://boards.straightdope.com/t/what-is-your-ongoing-opinion-of-the-affordable-care-act-title-edited/647561/916 "2014-01-02T16:31:12Z")

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> [@lance\_strongarm](#):
>
> You seem to be contradicting your previous post. You seemed to be claiming that nobody could be rejected outright for a pre-existing condition.

“under HIPAA”. Did you see that in the post to which I was responding?

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**Author:** ![lance\_strongarm](https://avatars.discourse-cdn.com/v4/letter/l/87869e/32.png) [@lance\_strongarm](https://boards.straightdope.com/u/lance_strongarm)\
**Post date:** [January 2, 2014, 5:45pm UTC](https://boards.straightdope.com/t/what-is-your-ongoing-opinion-of-the-affordable-care-act-title-edited/647561/917 "2014-01-02T17:45:22Z")

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> [@Terr](#):
>
> “under HIPAA”. Did you see that in the post to which I was responding?

Sigh.

So what you’re saying is that HIPAA totally disallowed exclusion for pre-existing conditions – but that protection under HIPAA didn’t appply to everyone, therefore some people could be excluded for pre-existing conditions despite HIPAA being on the books, like we said in the first place. Is that it?

Perhaps the confusion stems from the term “under HIPAA.” That means “according to HIPAA,” not “according to HIPAA and applying only to those protected by it.”)

The bottom line is that HIPAA did NOT prevent all exclusions for pre-existing conditions.

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<div class="post-metadata">

**Author:** ![Terr](https://avatars.discourse-cdn.com/v4/letter/t/839c29/32.png) [@Terr](https://boards.straightdope.com/u/Terr)\
**Post date:** [January 2, 2014, 5:49pm UTC](https://boards.straightdope.com/t/what-is-your-ongoing-opinion-of-the-affordable-care-act-title-edited/647561/918 "2014-01-02T17:49:00Z")

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> [@lance\_strongarm](#):
>
> Sigh.
> 
> So what you’re saying is that HIPAA totally disallowed exclusion for pre-existing conditions – but that protection under HIPAA didn’t appply to everyone, therefore some people could be excluded for pre-existing conditions despite HIPAA being on the books, like we said in the first place. Is that it?

No. In the first place **Snowboarder Bo** (to whom I was responding and who has since disappeared) claimed explicitly that HIPAA allowed for people to be rejected that were HIPAA eligible.

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**Author:** ![Terr](https://avatars.discourse-cdn.com/v4/letter/t/839c29/32.png) [@Terr](https://boards.straightdope.com/u/Terr)\
**Post date:** [January 2, 2014, 5:50pm UTC](https://boards.straightdope.com/t/what-is-your-ongoing-opinion-of-the-affordable-care-act-title-edited/647561/919 "2014-01-02T17:50:47Z")

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> [@2ManyTacos](#):
>
> I just think that it’s worth pointing out that most of the ACA coverage expansions and reforms officially went into effect yesterday and - gasp! - the sky didn’t fall and the world hasn’t collapsed.
> 
> That is all.

It’s kinda sad when proponents of the law are reduced to boasting about the world not collapsing when the law goes into effect.

It’s a “my candidate didn’t expose himself to anyone today!” kind of boast.

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**Author:** ![JohnT](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/johnt/32/15048_2.png) [@JohnT](https://boards.straightdope.com/u/JohnT)\
**Post date:** [January 2, 2014, 5:56pm UTC](https://boards.straightdope.com/t/what-is-your-ongoing-opinion-of-the-affordable-care-act-title-edited/647561/920 "2014-01-02T17:56:26Z")

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Not “reduced” at all. Just mocking a position that lead to your side inflicting pain on millions by shutting down the government… for nothing other than a temper tantrum that gained, literally, nothing.

Hundreds of millions of people have better health care coverage today than they did Tuesday… and yet the Republic still stands. Amazing.

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<div class="post-metadata">

**Author:** ![lance\_strongarm](https://avatars.discourse-cdn.com/v4/letter/l/87869e/32.png) [@lance\_strongarm](https://boards.straightdope.com/u/lance_strongarm)\
**Post date:** [January 2, 2014, 5:58pm UTC](https://boards.straightdope.com/t/what-is-your-ongoing-opinion-of-the-affordable-care-act-title-edited/647561/921 "2014-01-02T17:58:06Z")

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> [@Terr](#):
>
> It’s kinda sad when proponents of the law are reduced to boasting about the world not collapsing when the law goes into effect.

You got it completely wrong. It’s the kind of “boast” one makes when a literal prediction of the end of the world doesn’t come true.

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