Healthcare Reform Begins To Be Implemented

Access to Insurance for Uninsured Americans with a Pre-Existing Condition. Provides uninsured Americans with pre-existing conditions access to coverage. The temporary high-risk pool will serve as a bridge to when the new health insurance Exchanges are up and running, at which point insurance companies will no longer be able to deny coverage based on pre-existing conditions. Effective 90 days after enactment.

Small Business Health Insurance Credit. Provides a tax credit for qualified small businesses to help them afford insurance coverage for their workers. The credit is up to 35 percent of the employer’s contribution to the employees’ health insurance. There is also up to a 25 percent credit for small nonprofit organizations. Effective taxable year 2010. (In 2014, when health insurance Exchanges are operational, tax credits will be up to 50 percent of premiums, and up to 35 percent for non-profits.)

No Discrimination Against Children With Pre-Existing Conditions. Prohibits new health plans in all markets and grandfathered group health plans from denying access to and coverage of children with pre-existing conditions up to age 19. Effective 6 months after enactment. (Beginning in 2014, this prohibition would apply to these plans for all individuals.)

Relief for Seniors Who Hit the Medicare Part D ‘Donut Hole.’ Provides a $250 rebate check for Part D enrollees who hit the gap in prescription drug coverage known as the ‘donut hole.’ Currently, the coverage gap falls between $2,830 and $6,440 in total drug spending. Effective calendar year 2010. (Beginning in 2011, seniors who reach the donut hole will get a 50 percent discount on brand-name drugs and gradually increasing discounts on generic drugs. The donut hole will be closed completely by 2020.)

Prohibits Dropping Coverage When People Get Sick. Prevents insurance companies from withdrawing coverage when a person gets sick as a way of avoiding covering the costs of enrollees’ health care needs. Effective six months after enactment and applying to all plans.

Eliminating Lifetime Limits on Insurance Coverage. Prohibits insurers from imposing lifetime limits on benefits. Effective six months after enactment and applying to all plans.

Regulating Use of Annual Limits on Insurance Coverage. Tightly regulates plans’ use of annual limits to ensure access to needed care in all group plans and all new individual plans. These tight restrictions will be defined by the Secretary of Health and Human Services. Effective six month after enactment and applying to new plans in the individual market and all employer plans. (In 2014, the use of annual limits will be banned for new plans in the individual market and all employer plans.)

Covering Preventive Health Services. All new plans must cover preventive services at no charge by exempting these benefits from deductibles and other cost-sharing requirements. Effective six months after enactment.

Improving Preventive Health Benefits. Requires State Medicaid programs to cover tobacco cessation services for pregnant women. Effective Fiscal Year 2011.

Extending Coverage for Young Adults. Requires health plans that provide coverage for children to continue to make that coverage available until the child turns 26 years of age. The requirement applies to all plans in the individual market, new employer plans, and existing employer plans – unless the adult child has an offer of coverage through his or her employer. Both married and unmarried children qualify for this extended coverage. Beginning in 2014, individuals up to age 26 can stay on their parents’ employer plan even if they have an offer of coverage through their employer. Effective for plans starting six months after enactment.

Bringing Down the Cost of Health Care Coverage. With the exception of employers that self-insure, all health plans must report on the share of premium dollars spent on medical care versus other expenses, such as salaries and administrative costs – their medical loss ratio (MLR). Beginning not later than January 1, 2011, plans that spend too much on overhead must provide consumer rebates if they fail to meet the MLR standard. Reporting requirement effective for plan years starting 6 months after enactment; consumer rebate requirement begins not later than January 1, 2011.

Reducing the Cost of Covering Early Retirees. Creates a new temporary reinsurance program (until 2014 when the health insurance Exchanges are available) to help offset the costs of expensive premiums for employers and retirees for health benefits for retirees age 55-64. Effective 90 days after enactment.

Reducing Barriers to Providing Home and Community-Based Services (HCBS) in Medicaid. Gives States more flexibility to provide HCBS and to extend full Medicaid benefits to individuals receiving these services. Effective the first day of the quarter after the date of enactment, or April 1, 2010.

Strengthening Community Health Centers. Provides funds to build new and expand existing community health centers. Effective Fiscal Year 2011.

Strengthening the Primary Care Workforce. Expands funding for scholarships and loan repayments for primary care practitioners working in underserved areas participating in the National Health Service Corps. Effective Fiscal Year 2011.

Ensuring An Effective Appeals Process for a Denial of Coverage. Requires new plans to implement an effective internal and external appeals process for coverage determinations and claims. Effective six months after enactment.

Improving Consumer Information through the Web. Requires the Secretary of Health and Human Services to establish an Internet website through which residents of any State may identify affordable health insurance coverage options in that State. Effective not later than July 1, 2010.

Improving Consumer Assistance. Requires the Secretary of Health and Human Services to award grants to States to establish health insurance consumer assistance or ombudsman programs to receive and respond to inquiries and complaints concerning health insurance coverage. Effective upon enactment.

Cracking Down on Health Care Fraud. Requires enhanced screening procedures for health care providers to reduce fraud and waste in Medicare, Medicaid, and CHIP. Many provisions are effective on the date of enactment.

Improving Public Health Prevention Efforts. Creates an interagency council to promote healthy living and establishes a Prevention and Public Health Fund with $15 billion in funding over ten years to provide an expanded and sustained national investment in prevention and public health programs. Interagency council must submit first Report on its activities and progress by July 1, 2010 and funding appropriations begin in Fiscal Year 2010.

Extending Payment Protections for Rural Providers. Extends Medicare payment protections for small rural hospitals, including hospital outpatient services, lab services, and facilities that have a low-volume of Medicare patients, but play a vital role in their communities. Effective calendar year 2010.

Ensuring Medicaid Flexibility for States. A new option will take effect allowing States to cover individuals up to 133 percent of the Federal Poverty Level (FPL) and receive current law Federal Medical Assistance Percentage (FMAP). Effective April 1, 2010.

Expanding the Adoption Credit and Adoption Assistance Program. Increases the adoption tax credit and adoption assistance exclusion by $1,000, makes the credit refundable, and extends the credit through 2011. Effective for tax years beginning after December 31, 2009.

Encouraging Investment in New Therapies. A two-year temporary credit subject to an overall cap of $1 billion to encourage investments in new therapies to prevent, diagnose, and treat acute and chronic diseases. Available for qualifying investments made in 2009 and 2010.

Providing Tax Relief for Doctors, Nurses, and Other Health Professionals with State Loan Repayment. Excludes from taxable income payments made under any State loan repayment or loan forgiveness program that is intended to increase the availability of health care services in underserved or health professional shortage areas. Effective for amounts received by an individual in taxable years beginning after December 31, 2008.
Establishing a National Health Care Workforce Commission. Establishes an independent National Commission to provide comprehensive, objective information and recommendations to Congress and the Administration for aligning federal health care workforce resources with national needs. Effective not later than September 30, 2010.

Strengthening the Health Care Workforce. Expands and improves low-interest student loan programs, scholarships, and loan repayments for health students and professionals to increase and enhance the capacity of the workforce to meet the range of patients’ health care needs. Effective calendar year 2010.

Special Requirements for Blue Cross Blue Shield (BCBS). Requires that non-profit BCBS organizations devote 85 percent or more of their premium dollars to patient care in order to take advantage of the special tax benefits provided to them under Internal Revenue Code (IRC) Section 833, including the deduction for 25 percent of claims and expenses and the 100 percent deduction for unearned premium reserves. Effective for tax years beginning after December 31, 2009.

Associated Press
June 28, 2012 7:57 AM

WASHINGTON -- The Supreme Court has upheld the individual insurance requirement at the heart of President Barack Obama's health care overhaul.

The court on Thursday handed Obama a campaign-season victory in rejecting arguments that Congress went too far in requiring most Americans to have health insurance or pay a penalty.

WASHINGTON (AP) -- The Supreme Court on Thursday upheld the individual insurance requirement at the heart of President Barack Obama's health care overhaul.

The decision means the historic overhaul will continue to go into effect over the next several years, affecting the way that countless Americans receive and pay for their personal medical care. The ruling also handed Obama a campaign-season victory in rejecting arguments that Congress went too far in requiring most Americans to have health insurance or pay a penalty.

Chief Justice John Roberts announced the court's judgment that allows the law to go forward with its aim of covering more than 30 million uninsured Americans.

The court found problems with the law's expansion of Medicaid, but even there said the expansion could proceed as long as the federal government does not threaten to withhold states' entire Medicaid allotment if they don't take part in the law's extension.

The court's four liberal justices, Stephen Breyer, Ruth Bader Ginsburg, Elena Kagan and Sonia Sotomayor, joined Roberts in the outcome.

Justices Samuel Alito, Anthony Kennedy, Antonin Scalia and Clarence Thomas dissented.

Prescription Drug Discounts. Seniors who fall in the coverage gap will receive a 50 percent discount when buying Medicare Part D covered brand-name prescription drugs. Over the next ten years, seniors will receive additional savings on brand-name and generic drugs until the coverage gap is completely closed in 2020. Effective January 1, 2011. Click here to learn more.

Free Preventive Care for Seniors. The law provides certain free preventive services, such as annual wellness visits and personalized prevention plans for seniors on Medicare. Effective January 1, 2011.

Improving Health Care Quality and Efficiency. The law establishes a new Center for Medicare & Medicaid Innovation that will begin testing new ways of delivering care to patients that improve the quality of care, and reduce the rate of growth in health care costs for Medicare, Medicaid, and the Children's Health Insurance Program (CHIP). Additionally, by January 1, 2011, HHS will submit a national strategy to improve the quality of care provided by these programs. Effective January 1, 2011.

Improving Care for Seniors After They Leave the Hospital. The Community Care Transitions Program will help high risk Medicare beneficiaries who are hospitalized avoid unnecessary readmissions to the hospital by coordinating care and connecting patients to services in their communities. Effective January 1, 2011.

New Innovations to Bring Down Costs. The Independent Payment Advisory Board will begin operations to develop and submit proposals to Congress and the President aimed at protecting and improving benefits for seniors and extending the life of the Medicare Trust Fund. It will target waste in the system, reduce costs, improve health outcomes for patients, and expand access to high-quality care. Administrative funding becomes available October 1, 2011.


Increasing Access to Services at Home and in the Community. The new Community First Choice Option allows States to offer home and community based services to disabled individuals through Medicaid rather than institutional care in nursing homes. Effective October 1, 2011.

Strengthening Community Health Centers. The law includes new funding to support the construction of and expand services at community health centers, allowing these centers to serve some 20 million new patients across the country. Effective 2011.



Bringing Down Health Care Premiums. To ensure premium dollars are spent on health care, the new law requires that at least 85% of all premium dollars collected by insurance companies for large employer plans are spent on health care services and health care quality improvement. For plans sold to individuals and small employers, at least 80% of the premium must be spent on benefits and quality improvement. While insurance companies must use some money to administer their plans -- and do things like prevent fraud and improve information technology -- the Affordable Care Act ensures that insurance companies spend more on patients and less on paperwork and overhead. Plans that spend too much on overhead must provide rebates to consumers. Rebates begin no later than January 1, 2011.

Addressing Overpayments to Big Insurance Companies and Strengthening Medicare Advantage. Today, Medicare pays Medicare Advantage insurance companies over $1,000 more per person on average than Original Medicare. These additional payments are paid for in part by increased premiums paid by all Medicare beneficiaries, including 77 percent of seniors not enrolled in a Medicare Advantage plan. The new law levels the playing field by gradually eliminating Medicare Advantage overpayments to insurance companies. Seniors in a Medicare Advantage plan will still receive guaranteed Medicare benefits and the law provides bonus payments to Medicare Advantage plans that provide high quality care. Effective January 1, 2011. Click here to learn more.

You Republicans, Conservatives, Tea Partiers (whatever you call yourselves these days) need to get a grip.

The sky is not falling, the “end days” are not here, and freedom has not been abolished.

President Obama is not a Nazi, Muslim terrorist, communist, socialist, or illegal alien.

You have to face the fact that Obamacare is modeled after Romneycare and that Mitt Romney is your nominee for president.

The “individual mandate” that upsets so many of you is a Republican idea that was first introduced by Newt Gingrich and his Republican colleagues in the ’90s.

It seems to me, your getting just what you wanted.

Breathe, people, breathe…

It is absolutely amazing to me how ignorant (and lazy for not educating themselves) the people of this country are with regard to the ACA, and the Obama administration needs to take some responsibility for that.

The main points of the ACA are basic and uncomplicated, and yet its critics make statements that are unfounded and based in ideology.

I’ve been reading hundreds of blogs from around the country. It is obvious from the comments who watches Fox News and listens to Rush Limbaugh and his type. There isn’t an original thought among them. The bloggers simply repeat Limbaugh and Fox News’ talking points which are not based in fact, but in ideology.

It’s really sickening, and frankly scary, that so many people can be so easily misled.

Linking Payment to Quality Outcomes. The law establishes a hospital Value-Based Purchasing program (VBP) in traditional Medicare. This program offers financial incentives to hospitals to improve the quality of care. Hospital performance is required to be publicly reported, beginning with measures on treating heart attacks, heart failure, pneumonia, surgical care, health-care associated infections, and patients' perception of care. Effective October 1, 2012.

Encouraging Integrated Health Systems. The new law provides incentives for physicians to join together to form "Accountable Care Organizations," through which doctors can better coordinate patient care and improve the quality, help prevent disease and illness and reduce unnecessary hospital admissions. If Accountable Care Organizations provide high quality care and reduce costs to the health care system, they can keep some of the money that they have helped to save. Effective January 1, 2012.

Reducing Paperwork and Administrative Costs. Health care remains one of the few industries that relies on paper records. The new law will institute a series of changes to standardize billing and requires health plans to begin adopting and implementing rules for the secure, confidential, electronic exchange of health information. Using electronic health records will reduce paperwork and administrative burdens, cut costs, reduce medical errors and most importantly, improve the quality of care. First regulation effective October 1, 2012.

Understanding and Fighting Health Disparities. To help understand and combat persistent health disparities, the law requires any ongoing or new Federal health program to collect and report racial, ethnic and language data. The Secretary of Health and Human Services will use this data to help identify and fight disparities. Effective March, 2012.


Providing New, Voluntary Options for Long-Term Care Insurance. The law creates a voluntary long-term care insurance program -- called CLASS -- to provide cash benefits to adults who become disabled. Effective October 1, 2012.

Someone asked me yesterday, why would Newt Gingrich, or any Republican for that matter, support the “individual mandate” clause of the ACA as it seems to be diametrically opposed to everything conservatives believe in.

Well, not quite.

It’s simple really. Newt was tired of the “freeloaders” and “welfare queens” receiving free healthcare at his and the taxpayers’ expense.

If you think about it, Newt’s support of the “individual mandate” is consistent with traditional, conservative thinking. Reducing and/or eliminating welfare and the individual’s dependence on the state for financial support is a very conservative position.

BTW…Mitt Romney supported, advocated for, and implemented the “individual mandate” in Massachusetts.

Sarah Palin rears her ugly head...again.

Why does anyone listen to this idiot?

Death Panels

BTW...Obamacare is not a public, government insurance company. The government is not "running" healthcare.

No more "free-riders" a la Newt Gingrich..."I like mandates"

More "free-rider" elimination via an "individual mandate". A conservative idea...

"Individual Responsibility Program" is PC speech for individual mandate. Mitt Romney: "I'm very pleased" with the individual mandate "essential for bringing healthcare costs down".

FACT CHECK: On keeping your current health plan

CALVIN WOODWARD and RICARDO ALONSO-ZALDIVAR
Associated Press


WASHINGTON (AP) -- In promoting the health care law, President Barack Obama is repeating his persistent and unsubstantiated assurance that Americans who like their health insurance can simply keep it. Republican rival Mitt Romney says quite the opposite, but his doomsday scenario is a stretch.

After the Supreme Court upheld the law last week, Obama stepped forward to tell Americans what good will come from it. Romney was quick to lay out the harm. But some of the evidence they gave to the court of public opinion was suspect.

A look at their claims and how they compare with the facts:

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OBAMA: "If you're one of the more than 250 million Americans who already have health insurance, you will keep your health insurance. This law will only make it more secure and more affordable."

ROMNEY: "Obamacare also means that for up to 20 million Americans, they will lose the insurance they currently have, the insurance that they like and they want to keep."

THE FACTS: Nothing in the law ensures that people happy with their policies now can keep them. Employers will continue to have the right to modify coverage or even drop it, and some are expected to do so as more insurance alternatives become available to the population under the law. Nor is there any guarantee that coverage will become cheaper, despite the subsidies that many people will get.

Americans may well end up feeling more secure about their ability to obtain and keep coverage once insurance companies can no longer deny, terminate or charge more for coverage for those in poor health. But particular health insurance plans will have no guarantee of ironclad security. Much can change, including the cost.

The non-partisan Congressional Budget Office has estimated that the number of workers getting employer-based coverage could drop by several million, as some workers choose new plans in the marketplace or as employers drop coverage altogether. Companies with more than 50 workers would have to pay a fine for terminating insurance, but in some cases that would be cost-effective for them.

Obama's soothing words for those who are content with their current coverage have been heard before, rendered with different degrees of accuracy. He's said nothing in the law requires people to change their plans, true enough. But the law does not guarantee the status quo for anyone, either.

So where does Romney come up with 20 million at risk of losing their current plans?

He does so by going with the worst-case scenario in the budget office's analysis. Researchers thought it most likely that employer coverage would decline by 3 to 5 million, but the range of possibilities was broad: It could go up by as much as 3 million or down by as much as 20 million.

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ROMNEY: After saying the new law cuts Medicare by $500 billion and raises taxes by a like amount, adds: "And even with those cuts and tax increases, Obamacare adds trillions to our deficits and to our national debt, and pushes those obligations onto coming generations."

THE FACTS: In its most recent complete estimate, in March 2011, the Congressional Budget Office said the new health care law would actually reduce the federal budget deficit by $210 billion over the next 10 years. In the following decade, the law would continue to reduce deficits by about one-half of one percent of the nation's gross domestic product, the office said.

The congressional budget scorekeepers acknowledged their projections are "quite uncertain" because of the complexity of the issue and the assumptions involved, which include the assumption that all aspects of the law are implemented as written. But the CBO assessment offers no backup for Romney's claim that the law "adds trillions to our deficits."

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OBAMA: "And by this August, nearly 13 million of you will receive a rebate from your insurance company because it spent too much on things like administrative costs and CEO bonuses and not enough on your health care."

THE FACTS: Rebates are coming, but not nearly that many Americans are likely to get those checks and for many of those who do, the amount will be decidedly modest.

The government acknowledges it does not know how many households will see rebates in August from a provision of the law that makes insurance companies give back excess money spent on overhead instead of health care delivery. Altogether, the rebates that go out will benefit nearly 13 million people. But most of the benefit will be indirect, going to employers because they cover most of the cost of insurance provided in the workplace.

Employers can plow all the rebate money, including the workers' share, back into the company's health plan, or pass along part of it.

The government says some 4 million people who are due rebates live in households that purchased coverage directly from an insurance company, not through an employer, and experts say those households are the most likely to get a rebate check directly.

The government says the rebates have an average value of $151 per household. But employers, who typically pay 70 to 80 percent of premiums, are likely to get most of that.

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ROMNEY: "Obamacare raises taxes on the American people by approximately $500 billion."

THE FACTS: The tax increases fall heavily on upper-income people, health insurance companies, drug makers and medical device manufacturers.

People who fail to obtain health insurance as required by the law will face a tax penalty, although that's expected to hit relatively few because the vast majority of Americans have insurance and many who don't will end up getting it. Also, a 10 percent tax has been imposed on tanning bed use as part of the health care law. There are no other across-the-board tax increases in the law, although some tax benefits such as flexible savings accounts are scaled back. Of course, higher taxes on businesses can be passed on to the consumer in the form of higher prices.

Individuals making over $200,000 and couples making over $250,000 will pay 0.9 percent more in Medicare payroll tax and a 3.8 percent tax on investments. As well, a tax starts in 2018 on high-value insurance plans.

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OBAMA: "Because of the Affordable Care Act, young adults under the age of 26 are able to stay on their parents' health care plans, a provision that's already helped 6 million young Americans."

THE FACTS: Obama is overstating this benefit of his health law, and his own administration knows better. The Department of Health and Human Services, in a June 19 news release, said 3.1 million young adults would be uninsured were it not for the new law. Obama's number comes from a June 8 survey by the Commonwealth Fund, a health policy foundation. It said 6.6 million young adults joined or stayed on their parents' health plans who wouldn't have been able to absent the law. But that number includes some who switched to their parents' plans from other coverage, Commonwealth Fund officials told the Los Angeles Times.

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ROMNEY: "Obamacare is a job-killer."

THE FACTS: The CBO estimated in 2010 that the law would reduce the amount of labor used in the economy by roughly half a percent.

But that's mostly because the law will give many people the opportunity to retire, stay at home with family or switch to part-time work, since they will be able to get health insurance more easily outside of their jobs. That voluntary retreat from the workforce, made possible by the law's benefits, is not the same as employers slashing jobs because of the law's costs, as Romney implies.

The law's penalties on employers who don't provide health insurance might cause some companies to hire fewer low-wage workers or to hire more part-timers instead of full-time employees, the budget office said. But the main consequence would still be from more people choosing not to work.

Apart from the budget office and other disinterested parties that study the law, each side in the debate uses research sponsored by interest groups, often slanted, to buttress its case. Romney cites a Chamber of Commerce online survey in which nearly three-quarters of respondents said the law would dampen their hiring.

The chamber is a strong opponent of the law, having run ads against it. Its poll was conducted unscientifically and is therefore not a valid measure of business opinion.

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Associated Press writers Andrew Taylor and Jim Drinkard contributed to this report.

© 2012 The Associated Press. All rights reserved. This material may not be published, broadcast, rewritten or redistributed. Learn more about our Privacy Policy and Terms of Use.

Link

T wrote:It is absolutely amazing to me how ignorant (and lazy for not educating themselves) the people of this country are with regard to the ACA

I was giving LePage the benefit of the doubt, but I now must include him with this group. His ignorance of (or inability to comprehend) the ACA will cost the state and hand over more control to the Federal government.

I thought giving the Federal government more control was contrary to everything conservatives believe?

or...he, and the other Republican governors, is playing politics at our expense and waiting (hoping) for the ACA to be repealed after Romney is elected president.

Well, that's not going to happen even if Romney is elected and the Republicans manage to gain control of both the House and Senate. We all know too well the ability of the minority party to obstruct. The Republicans have done that very successfully for the past two years. All it takes is 41 senators to keep a bill from being voted on. The likelihood that there will be fewer that 41 Democrat senators elected to the Senate in 2013 is zero.

Governor, the ACA is now the law of the land (with a few minor adjustments). Get over it and get on with running the state.


Link

Here's a classic example of the ignorance that pervades the Internet. This is a post I found on WMTW-TV's website in response to LePage's Gestapo comment and his rant against the ACA.

Mike Janet Dawes · School of Hard Knocks (graduated pie baiter cap)
You'll think it's the Gestapo when you or someone close to you falls on one of the Death Panels. When Obamacare gives up on you it won't be like augueing with an HMO it will be over. Like over 80 no Chemo and so forth. No mammograms until 50, even with family history. You don't see your elected officials accepting this care why should you........

For those of you who care, here are a few facts:

1. If the healthcare plan you have now provides for routine mammograms before age 50 (The American Cancer Institute recommends routine mammograms for women over 40, every 1-2 years), that will not change.

2. The ACA provides for annual mammograms for women over 40. Other services to prevent breast cancer will also be covered, including a referral to genetic counseling and a discussion of chemoprevention for certain women at increased risk.

3. Under the ACA, women’s preventive health care – such as mammograms, screenings for cervical cancer, pre-natal care, and other services – is covered with no cost sharing. For the first time ever, the Department of Health and Human Services has also begun the process for developing women’s prevention guidelines, which didn't exist before the ACA. As it has done with all other scientific prevention guidelines, HHS is relying on independent doctors, scientists, and experts to make these determinations based on scientific evidence, not Sarah Palin's opinion.

4. Death panels don't exist. They are a figment of Sarah Palin's overactive, politicized, self-promoting imagination.

5. Section 1312 of the Affordable Care Act reads as follows:

(D) MEMBERS OF CONGRESS IN THE EXCHANGE.-

(i) REQUIREMENT.-Notwithstanding any other provision of law, after the effective date of this subtitle, the only health plans that the Federal Government may make available to Members of Congress and congressional staff with respect to their service as a Member of Congress or congressional staff shall be health plans that are-

(I) created under this Act (or an amendment made by this Act); or

(II) offered through an Exchange established under this Act (or an amendment made by this Act).

(ii) DEFINITIONS.-In this section:

(I) MEMBER OF CONGRESS.-The term ”Member of Congress” means any member of the House of Representatives or the Senate.

(II) CONGRESSIONAL STAFF.-The term ”congressional staff” means all full-time and part-time employees employed by the official office of a Member of Congress, whether in Washington, DC or outside of Washington, DC.

Link

Despite what Sarah Palin, Sean Hannity, Rush Limbaugh and the like would have you believe (and it's obvious from reading this and other posts from the Dawes, that the Dawes' get their "facts" from them), Members of Congress and their staffs will be shopping in the same state based health care exchanges that many average Americans will be.

I learned something interesting today.

Medicare Part D, a Republican program implemented during the Bush administration, was far more expensive than the Affordable Care Act (Obamacare) and unlike the ACA, was never budgeted for.

...and yet, the Republicans continue to trash Obama and the ACA.

Republican hypocrites

I explored healthcare.gov over the weekend.  The site is fast, accurate, and very easy to use.  Considering the complexity of the ACA, I'd say the website is way ahead of where it would be had a for profit company launched it.  I do most of my "business" online, and half of the websites I use still have problems after having been in business for years.

Medicare.gov is another site that's fast, accurate, and very easy to use and has been around for a very long time.

BTW...healthcare.gov wouldn't even be necessary had all fifty states implemented their own exchanges.  We can thank Republican governors for that.

And one more thing...those headlines claiming that health insurance premiums are skyrocketing due to Obamacare?  They are not.  Costs for individuals, who are now required to purchase minimum levels of coverage, are going up because they will now have adequate coverage for the first time.  The actual premiums are going down.

Another fast, accurate, easy to use big, bad government website.

Social Security