Coincidentally, the same state governments that are opposed to people voting are also opposed to people having health coverage, so this shouldn't change much.
Some say, for instance, that offering registration through exchanges would be a boon for Democrats in reaching minorities or poor and working-class voters. Others have said letting the exchanges register voters is a backdoor attempt to "resurrect" ACORN, the much-maligned and now-defunct community group that represented low- and moderate-income families.... "It's about building a permanent, undefeatable, always-funded Democrat majority," [pill-popping draft dodger Rush Limbaugh] said.
Man, between this and the fried chicken woman in Colorado, I'm getting really worried about the post-Romney Republican outreach effort to non-whites.
1: No, remember, the exchanges are the part you can't opt out of: if you do, the federal government takes over. (Although it's going to be pretty horrible working at one in the red states, having to tell people "Sorry, you make too little money for us to help you.")
Of course this is a great idea but my prediction is that it won't go anywhere in states that resist it. The statutory question is whether the exchanges are offices that "provide public assistance", which doesn't appear to be further defined in the statute. I wouldn't expect the courts that matter to conclude that the provision encompasses the exchanges (except maybe to the extent that they overlap with e.g. Medicaid offices).
Also, it makes a lot of sense considering the exchanges are already required to check someone's immigration/citizenship status.
4: That section is about whether a state is required to provide the services in its own offices, but the federal government is doing the work in 27 states including FL, OH, PA, VA, and NC, and they're going to be offering registration. State election officials' cooperation is still an issue, granted.
Someone should break into the computers of major news orgs and plant a script that makes a computer overheat and melt whenever they type the phrase, "Some say..."
6: Sure, but the Motor Voter Act as a whole is only about state obligations.
Further to 8, of course federally-run offices can register voters if they want, and to the extent that ACA puts new federal offices in states (esp. states that suck w/r/t voter registration, since there's a correlation with ACA intransigence), that'll be a very good thing. But that has nothing to do with the Motor Voter Act, and as to whether the MVA will apply here and require state-run offices to register voters, I think the answer of the five people who will ultimately decide the question will likely be no.
What does the Motor Vehicles Act require? I don't remember being asked if I wanted to register to vote when getting a driver's license in a new state. In NJ I told the person getting me the license I wanted to register to vote and she told me it was too late because she had already started typing in my info and the voting registration had to be done before the other steps, or something like that. In short, it was not my impression that many people were going to be registered to vote in the process of getting a driver's license.
Ah, I see. (I'm curious, though, if there's some other law imposing the same requirement on federal benefit providers like the SSA - if this is discretionary or mandatory on the administration's part.)
They should have people standing in the DMV holding the forms to register people. You could give them special, distinctive straw hats, so anybody unregistered could just look for a motor voter toter boater.
10: It requires that your driver's license application also serve as a voter registration application w/r/t federal elections. I'm sure there are various ways for states to comply but it sounds like your NJ experience didn't (unless that was about registering for purposes of state elections, which isn't covered by this law). The last two states I got licenses in, it was (IIRC) just a little extra section on the application.
(The law also has provisions unrelated to driver's licenses, including a requirement that states designate offices providing public assistance as voter registration agencies, which is where the ACA exchanges potentially come in.)
12: or even look for a motor voter boater toter.
I can't really remember what happened in MA. I think I did check a box about voter registration at the DMV but then a couple months later when I went to get an absentee ballot it turned out I wasn't registered.
If you crossed the straw hat with a helicopter beanie, you'd have a motor voter rotor boater toter.
And if they didn't flush you might find a motor voter rotor boater toter floater.
I have to admit, watching the ACA from afar, it never occurred to me that the exchanges would be actual physical locations open to the public. I'd assumed it would all be online or postal, with info provided by the states at post offices/town halls etc.
Our motor vehicle people are notorious for the length of time it takes for a registration to get to the right office. Fortunately we have same day reg, so the people who did it at motor vehicles and aren't on the rolls can go downtown and still vote. Unfortunately, the Rep majority in the leg, in order to disenfranchise students and other people who move, want to get rid of same day reg -- ostensibly because the lines get long for the people registering at the courthouse on election day (yes, that's Rep logic). Fortunately, our Dem gov vetoed the bill. Unfortunately, the leg was able to get repeal of same day reg on the ballot next year.
Will students vote in an off year election? How many can be convinced that since any one vote doesn't actually matter, they should just stay home?
(No point in counting the students who can be convinced that there's no difference between the party that wants them to vote and the party that wants to prevent them from voting.)
Unfortunately, the leg was able to get repeal of same day reg on the ballot next year.
This was done, by the way, by violating Senate rules and refusing to recognize Dem members asserting the absence of a quorum.*
* Not actually a quorum, but absence of a member, which, when brought to the attention of the chair, prevents further action on the bill. So the chair intentionally ignored the inconvenient evidence (being shouted to him) that proceeding on the bill was a violation of the rules. Still no difference between the parties that a student who wants to exercise her constitutional right to vote ought to recognize . . .
12 -- Our local young progressive group outfits its voter registration volunteers with large pink bunny ears. One sees them frequently at public festivals etc.
20: I didn't think they would be actual physical locations, at least ones which a citizen could visit in person. Presumably they'll need to have physical offices from which those administering the online insurance marketplace work.
However, quite a few people don't have computers or online access, so a physical office open to the public makes sense. And then you're looking at staff charged with aiding the public with navigation of the system and so on, which begins to look a lot more like the DMV (MVA).
Does anyone have clarification on this? Or have I just been confused about this?
I think it varies, but California will have a website, community partnerships, and "trained state staff available in person or by phone or certified assisters who will be able to meet with you in person in every part of the state". Not sure how that will work out in practice.
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Speaking of health care this story is remarkable:
I explained that just because he had health insurance didn't mean he had to use it in every situation. After all, when people have a minor fender-bender, they often settle it privately rather than file an insurance claim. Because of the nature of this man's policy, he could do the same thing for his medical procedure. However, had I been bound by a preferred-provider contract or by Medicare, I wouldn't have been able to enlighten him.
...
Most people are unaware that if they don't use insurance, they can negotiate upfront cash prices with hospitals and providers substantially below the "list" price. Doctors are happy to do this. We get paid promptly, without paying office staff to wade through the insurance-payment morass.
So we canceled the surgery and started the scheduling process all over again, this time classifying my patient as a "self-pay" (or uninsured) patient. I quoted him a reasonable upfront cash price, as did the anesthesiologist. We contacted a different hospital and they quoted him a reasonable upfront cash price for the outpatient surgical/nursing services. He underwent his operation the very next day, with a total bill of just a little over $3,000, including doctor and hospital fees. He ended up saving $17,000 by not using insurance
On the other hand, this makes me very suspicious about the accuracy of that story:
Dr. Singer practices general surgery in Phoenix, Ariz., and is an adjunct scholar at the Cato Institute.
But still interesting.
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Most people are unaware that if they don't use insurance, they can negotiate upfront cash prices with hospitals and providers substantially below the "list" price.
Doubtless there's no ulterior motive in the dude from Cato failing to mention that your insurance company pays substantially below the list price as well because they've already pre-negotiated what they'll shell out for procedures.
29: "trained state staff", okay. Well, that's wonderful! Go CA!
I should see how my state is addressing this.
Sarah Kliff reports that Oregon's system will not allow citizens to access their exchange personally, at least initially:
Oregon announced last week that it would delay a pretty significant element of its marketplace: When it launches in October, only certified insurance brokers and "community partners" will be able to use the site. Individuals will not have access on their own; they will have to seek out a broker or partner who can sign them up.
This strikes me as uncool, though understandable from an administrative standpoint.
Oops, I'm supposed to be just figleaf.
Some rocks fell off the back of a dump truck onto our car while driving in Ontario, I dutifully called insurance the same day in case they could get a lead on who the driver was (we had pictures) but then it turned out the repair was less than the deductible, so I told them I didn't want to report any damages. Does this still count as a claim in their system- i.e. are they going to fuck me and raise my rates/reset my "no claim for X years" discount even though I didn't even get money from them?
By "interesting" do you mean "total bullshit that has apparently taken you for a ride"?
Doubtless there's no ulterior motive in the dude from Cato failing . . .
Oh, I'm sure there's an ulterior motive, but in this case it's possible (though not explicitly stated) that the major savings are from using different hospitals for surgery and recovery:
"The insurance policy, the clerk said, would pay up . . . to $2,500 for the hospital's charges for the operating room, nursing, recovery room, etc. The estimated hospital charge was $23,000. "
...
" We contacted a different hospital and they quoted him a reasonable upfront cash price for the outpatient surgical/nursing services."
And then there's this bit, which does seem like it has the potential to make lots of people unhappy.
"[The clerk] asked him to pay his estimated portion in advance. (More hospitals are doing that now because too often patients don't pay their portions of the bills after insurance has paid.) "
So the guy's insurance plan pays up to $5k, but instead he didn't use it and paid the $3k bill out of pocket? That's awesome, where do I sign up for such a plan?
By "interesting" do you mean "total bullshit that has apparently taken you for a ride"?
I'm rapidly coming to that conclusion, yes.
I was more credulous than I would normally be of a story in the WSJ because it was linked from wonkblog, who I think of as a trusted source for health-care stories. But I don't think the credulity was warranted.
IOW, Mr. Cato screwed him by telling him to go to another hospital where the "list" was only $3k and NOT USE HIS INSURANCE ON THIS LESSER AMOUNT which is stupid, there's nothing to indicate the two are related because he says the patient's insurance "has no provider-network requirements or preferred-hospital requirements."
And the moral of the story in Cato land is Obama is actually screwing those 30 million people by giving them insurance, they shouldn't want it!
OK, so the story is that when a person is well-educated and well-connected person and yet has a crappy insurance policy for some idiosyncratic reason, and that person needs a routine but expensive kind of surgery, comparison shopping for their care may actually make sense? Sounds reasonable when you put it like that.
And Cato and the WSJ thinks public policy should be shaped to meet the needs of people like that? Again, this is unsurprising.
38: I was more credulous than I would normally be of a story in the WSJ because it was linked from wonkblog
Linked by whom from Wonkblog? It makes a difference. You know that Dylan guy is only like 12 years old. (Okay, actually 22 or so, and yes I'm teasing. Sort of.)
Dr. Singer practices general surgery in Phoenix, Ariz., and is an adjunct scholar at the Cato Institute.
A Cato-written piece in the opinion section of the Wall Street Journal. I wonder if it might be utter bullshit. Let's have a look:
Hospitals and other providers make their "list" prices as high as possible when negotiating contracts with health plans and Medicare regulators. No one is ever expected to pay the list price.
Bullshit. Everybody who doesn't have the negotiating leverage of an insurer is expected to pay list prices, as he goes on to admit:
The only people routinely faced with list prices are those few people who have insurance like my patient's--that doesn't include a pre-negotiated fee schedule with contracted providers--or those who have no insurance.
And this, of course, is the exact opposite of the argument that he's proposing here. How is it possible that the uninsured get higher rates if they are better able to negotiate rates? I'm guessing it's because the uninsured are genetically inferior and lack the intelligence to bargain. Higher quality people - the people who deserve better deals - get those deals. Or did in this one case.
Anybody who has seen an "Explanation of Benefits" statement from a health plan will note a very high charge from the provider, and an "adjusted charge" based upon the contracted fee schedule, which usually leaves the patient with little or nothing in out-of-pocket expenses.
This is a basic enough market mechanism that you'd even expect a Cato guy to understand it. People with the leverage to bargain get better rates. Insurers have more leverage than individuals, and Medicare has more leverage than insurers. The results are predictable.
Most people are unaware that if they don't use insurance, they can negotiate upfront cash prices with hospitals and providers substantially below the "list" price. Doctors are happy to do this. We get paid promptly, without paying office staff to wade through the insurance-payment morass.
Jesus, this is tiring. Whose idea is the "list price"? The insurance company's? Horseshit.
Doctors are compelled to accept higher rates by insurance companies? Who the fuck does he think he's kidding?
Insurance companies don't pay promptly compared to the uninsured? What the fuck?
That's all I've got time for right now, but holy Jesus this is transparent nonsense.
I can see I was a little late to the party here.
Linked by whom from Wonkblog?
It was included in the round-up as a "top opinion" piece bulleted, "SINGER: The man who was treated for $17k less."
45: Oh. I suspect that "top opinion" means most talked about opinion pieces. But I don't have a stake in defending the Wonkblog.
And just a reminder to everyone that in 2014, even the "bronze" plans will have an out-of-pocket maximum (including premiums, I believe) of $6,350 per year.
Well I bet you could get past that maximum if you paid for services and never reported it to you insurance company, like this wise gentleman!
I'm reminded of my grandfather-in-law who wanted to find the highest rate he could for his mortgage, because bigger is better when dealing with money.
48: Not including premiums, but including deductible. Both deductible and OOP max varying somewhat by income as well.
Funny, I looked it up on a site the purported to have all the data. Oh, well, they still haven't ever beaten the Dodgers in LA.
Wrong thread, but not worth repeating.
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This sure hits home. Loneliness sucks.
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51: I was thinking the white men on the Supreme Court should get 3/5ths of a vote, but that still leads to a 17/5ths to 16/5ths advantage for the asshole brigade.
Is there anything internet friends could be doing to improve things for th chronically lonely here? I am often in that group although I probably shouldn't count since I have actual humans in the home and so on and occasionally get to have meaningful conversations and not just respond to complaints about how the yogurt is too gooey, and I don't know what I'd say I want that doesn't involve magic, but if there were anything I could do to help someone else I would be glad to try.
Magic is a pretty social card game in some ways, I guess, but I'm not sure it's a very good way to alleviate loneliness.
60: I'm not sure whether there is some context I missing here, but video phone calls (E.g. Skype, FaceTime) are pretty good at approximating live human interaction, and produce a similar sense of satisfaction to actually getting out of the house and talking to another human being.
Yet when I use a Turing test on my sister, I'm the asshole.
Nothing can be done.
I...am alone.
I...am...utterly alone.
I've built walls. A fortress deep and mighty.
It's laughter and it's loving I disdain.
But it's ok, cause I will die soon.
Alone.
And be buried in an unmarked grave in unconsecrated ground
With companions the worms below
And the crows above.
And nobody will remember.
And I will leave no trace.
Is that the rest of the lyrics to "I am a rock, I am an island."?
Will the Supreme Court eventually become all democratic women and catholic republican men?
I'd be happy if they'd just have fewer Harvard/Yale grads.
I mean, how else can you assure your base that they're on the right side of the abortion debate without the candidate being able to say anything about it?
This sure hits home. Loneliness sucks.
Yes. It's been a while since I've had the feeling of being really lonely, but reading the article, the feeling she describes felt very familiar.
Is there anything internet friends could be doing to improve things for th chronically lonely here?
That's a good question. I can't speak for teo, but thinking about myself -- I do value unfogged as a group of (pretend internet) friends, but it's more valuable when I don't feel lonely personally. When I do I had more of a tendency to fall into the worries about, "everybody else seems familiar with each other, and I don't really know these people that much."
I noticed today that Unfogged has made me very critical of the quality of overheard arguments.
Keep Branson smugly ignorant of how horrible it is.
My subjective sense of well-being and my actual physical health (measured by things like getting a cold/flu, not actual doctor visits) went way up after I left grad school the first time. Even the other grad school, which I really didn't enjoy in many, many ways, was ok, probably because I made friends and a higher percentage of the work involved actually visibly doing things.
Keep Milwaukee experiencing whatever emotion causes it to serve drinks with sausages in them.
I prefer Indiana's strategy of serving drinks with other drinks in them.
Keep Indiana a marginally functional alcoholic?
That's a very generous motto. Keep Indiana's populace too drunk to escape, maybe.
60, 62 -- I've been meaning to say, since the wingding, that the experience of the chat/hangout in connection with that thing was novel and interesting. Not so much the connection to the actual wingding -- people there were (when I was on) understandably and properly primarily focused of other folks there -- but with other folks on the connection.
I wonder if it might be worth attempting a thread via hangout some time. A virtual meet-up, but in the context of a thread, so we start off with some conversational momentum.
Unfogged meetup + google hangout + camera-equipped wifi-controlled quadcopter => a different sort of knife fight.
I've been wanting to do an unfogged babysplosion google hangout (but not actually telling anybody I wanted to do this), but a quadcopter hangout could work too.
Also this might be violating SOOBC etc. but Charley's hangout strategy I would describe as "I'm in Montana and you're not!" Very effective, in point of fact.
Somebody in the Maryland suburbs could do that strategy best.
"Missoula's okay, I guess, but it's no Bethesda."
I was going for, "I'm in Chevy Chase and you're not."
Ooh, can you control a quadcopter through the Internet? You know, for meetups.
The wifi drones it should presumably be possible. Not sure what the lag would be like.
90: You'd just copy the code the CIA uses to keep its drones operating when the link is down. Comment out the parts of the routine that shoot missiles at the guy with the biggest beard.
Hey, speaking of meetups, I'm gonna be in London the middle of October. Anyone up for a drink?
(I'm also now a paid member of the Mineshaft's official favorite football club! The whole ticket-buying experience is, for an American, deeply strange and perplexing.)
I've been wanting to do an unfogged babysplosion google hangout
The wingding-related hangout was indeed novel and interesting, so I like this idea with the proviso that participation be extended to U-tarians with older children. I'm sure my ten-year-olds would relish the opportunity either to coo over your babies or to mock them for their poor verbal and ambulatory skills.
Oh I didn't figure it would or could be limited to purely babies -- for one thing, they are miserable at working the webcam. More that it would be fun to arrange it so some arbitrarily large number of the babysplosion babies could get on there.
Here you go; code to pilot a drone via Google Glass.
I could wear my lucha libre mask.
86 and sb but
I'd trade the smoke today, though. Here's how the fire stands today. I probably wouldn't have done much today anyway -- the wife is off kayak camping with a couple of friends, and I have an outdoor concert to go to in an hour -- but smoke really drains away the motivation.
Coming in late, but on the OP:
48, 50: even the "bronze" plans will have an out-of-pocket maximum (including premiums, I believe) of $6,350 per year.
Not including premiums, but including deductible. Both deductible and OOP max varying somewhat by income as well.
I understood that Obama, or Kathleen Sebelius or whoever, had just decided to delay implementation of the out-of-pocket maximum rule for a year.
The cap, which includes deductibles and co-payments, was supposed to limit consumer costs to $6,350 for an individual and $12,700 for a family. But administration officials have quietly delayed the requirement for some insurers, allowing them to set their own limits starting in 2014.
Just some insurers? But, ah:
"The February guidance builds on these landmark consumer protections by requiring that health plans limit out-of-pocket spending for major medical coverage for the first time, in 2014, on time," the official added. "This single limit will apply to additional benefits in 2015."
So the limit on out-of-pocket maximums applies for next year just to bronze level plans. Got it!
I thought it was the out of pocket max still applies per plan, but some people have coverage through multiple plans for different aspect (prescription, major medical, addiction+mental, etc.) and it's just so darn hard to coordinate among different companies what with their fancy computers and all. But if your plan is all through one insurer then the out of pocket max will apply, if not it will apply per piece.
By the by, on the topic of the PPACA, I hope everyone saw this story, linked hither and yon today:
A middle-aged man in a red golf shirt shuffles up to a small folding table with gold trim, in a booth adorned with a flotilla of helium balloons, where government workers at the Kentucky State Fair are hawking the virtues of Kynect, the state's health benefit exchange established by Obamacare.
The man is impressed. "This beats Obamacare I hope," he mutters to one of the workers.
"Do I burst his bubble?" wonders Reina Diaz-Dempsey, overseeing the operation. She doesn't. If he signs up, it's a win-win, whether he knows he's been ensnared by Obamacare or not.
I boggled at this almost as much as I did over the news that an equal number of Republicans in Louisiana blame Obama for the poor response to Hurricane Katrina as blame Bush. But not quite as much boggling: the latter failure can't be attributed to a failure to stay informed, which might be (sort of) forgivable, or understandable.
Still, though: I am looking forward to Obamacare's roll-out with such gusto (!) that learning of this degree of misapprehension on the part of Joe Public is, shall we say, discouraging.
101: Oh. I haven't read a more detailed explanation of just what the deal is; had seen explanations about coverage through multiple plans being a problem, but I hadn't gotten the message that only those multiple coverage arrangements were exempt.
Reading above, is there any job more bullshit than adjunct scholar [sic] for a libertarian think tank?
The delay doesn't apply to individual plans either, just group plans. And it's only for plans that already had separate benefit administrators.
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Pat Lang ...read comments
"IMO a casus belli is being fabricated as the basis for what the civilians think will be an easy win against Assad. pl "
"As I said the civilians foolishly think a decapitation will be easy and will collpase the government. They stupidly believe that the Syrian government side is a one man show just as they did in Iraq. as someone wrote here the US Navy needs justification for their budget. they probably are not pulling their weight in stopping this craziness. CJCS continues to insist to the president/CinC that a cruise missile strike is an act of war and something that will inevitably lead to escalation. pl"
More Evidence Points to Syrian Rebels ...FDL
Juan Cole says he isn't sure
Doesn't matter anyway
"The United States has little doubt the Syrian government used chemical weapons against civilians last week, and any decision to open the site to U.N. inspectors was "too late to be credible," a senior official in the U.S. administration said on Sunday."
...Reuters
Cheers, as Lang says
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105: Man. Okay. Maybe I just haven't been reading in the right places, but it seems to me that the mainstream media have done a poor job in reporting on this.
107: Yep. They said things like "for some plans" - true but unhelpful. Also apparently this delay was announced in February but they didn't start talking about it until recently, after the employer mandate delay made it more printable.
Update on my remark in 32 that Oregon's exchange would be open only to brokers and community partners, initially: from a more recent Sarah Kliff piece, it's clarified that that "initially" means basically for a beta-testing period for Oregon's exchange site, prior to opening it up to the general public, which is projected to be well prior to January 1.