Understanding the Affordable Care Act - A Beginning

Obamacare, or the Affordable Care Act is causing one of the greatest United States legislative controversies since the advent of Medicare and Medicaid. What IS it? Read the following article, from the Washington Post, and post a comment, at the end. Please note that this article is not current, but it is a good overview of a very complicated issue. You may also draw on knowledge from other adults/resources, but your blog MUST show knowledge of this article. (Be sure to click on and read the blog directions, first!)

Facts about the Affordable Care Act

By Ezra Klein, Published: June 24, 2012 at 6:25 pmE-mail the writer

62

Comments

More

In the past week, both Alec MacGillis and Sabrina Tavernise have written articles touching on how little the uninsured actually know about the Affordable Care Act. Given that polling shows the law remains unpopular even as its component parts -- with the notable exception of the individual mandate -- are very popular, it seems they're not alone. So here's a refresher on some of the law's most significant policies and consequences:

1. By 2022, the Congressional Budget Office estimates (pdf) the Affordable Care Act will have extended coverage to 33 million Americans who would otherwise be uninsured. Here's the graph:

2. Families making less than 133 percent of the poverty line -- that's about $29,000 for a family of four -- will be covered through Medicaid. Between 133 percent and 400 percent of the poverty line --  $88,000 for a family of four -- families will get tax credits on a sliding scale to help pay for private insurance.

3. For families making less than 400 percent of the poverty line, premiums are capped. So, between 150% and 200% of the poverty line, for instance, families won't have to pay more than 6.3 percent of their income in premiums. Between 300 percent and 400 percent, they won't have to pay more than 9.5 percent. This calculator from the Kaiser Family Foundation will let you see the subsidies and the caps for different families at different income levels.

4. When the individual mandate is fully phased-in, those who can afford coverage -- which is defined as insurance costing less than 8 percent of their annual income -- but choose to forgo it will have to pay either $695 or 2.5 percent of the annual income, whichever is greater.

5. Small businesses that have fewer than 10 employees, average wages beneath $25,000, and that provide insurance for their workers will get a 50 percent tax credit on their contribution. The tax credit reaches up to small businesses with up to 50 employees and average wages of $50,000, though it gets smaller as the business get bigger and richer. The credit lasts for two years, though many think Congress will be pressured to extend it, which would raise the long-term cost of the legislation.

6. Insurance companies are not allowed to discriminated based on preexisting conditions. They are allowed to discriminate based "on age (limited to 3 to 1 ratio), premium rating area, family composition, and tobacco use (limited to 1.5. to 1 ratio)."

7. Starting in 2018, the law imposes a 35 percent tax on employer-provided health plans that exceed $10,200 for individual coverage and $27,500 for family coverage. The idea is a kind of roundabout second-best to capping the tax code's (currently unlimited) deduction for employer-provided heath insurance. The policy idea is to give employers that much more reason to avoid expensive insurance policies and thus give insurers that much more reason to hold costs down.

8. The law requires insurers to spend between 80 and 85 percent of every premium dollar on medical care (as opposed to administration, advertising, etc). If insurers exceed this threshold, they have to rebate the excess to their customers. This policy is already in effect, and insurers are expected to rebate $1.1 billion this year.

9. The law is expected to spend a bit over $1 trillion in the next 10 years. The law's spending cuts -- many of which fall on Medicare -- and tax increases are expected to either save or raise a bit more than that, which is why the Congressional Budget Officeestimates that it will slightly reduce the deficit. (There's been some confusion on this point lately, but no, the CBO has not changed its mind about this.) As time goes on, the savings are projected to grow more quickly than the spending, and CBO expects that the law will cut the deficit by around a trillion dollars in its second decade. Here's its graph, which covers the period between 2012 and 2021:

The ACA's taxes and spending cuts make it a slight deficit reduce in its first decade. (CBO)

10. In recent years, health-care costs have slowed dramatically. Much of this is likely due to the recession. Some of it may just be chance. But there's also evidence that the law has accelerated changes in the way the medical system delivers care, as providers prepare for the law's efforts to move from fee-for-service to quality-based payments.

11. The law's long-term success at controlling costs will likely hinge on its efforts to change the way health care is delivered, most of which have gotten very little attention. They include everything from encouraging Accountable Care Organizations to spreading medical homes to penalizing hospitals with high rates of preventable infections to creating an independent board able to quickly implement new reforms through the Medicare system. A partial list of these efforts can be found here.

Acknowledgments: Much of the information in this post comes from the Kaiser Family Foundation's excellent summary of the Affordable Care Act's provisions.

http://www.washingtonpost.com/blogs/wonkblog/wp/2012/06/24/11-facts-about-the-affordable-care-act/

Ezra Klein is the editor of Wonkblog and a columnist at the Washington Post, as well as a contributor to MSNBC and Bloomberg. His work focuses on domestic and economic policymaking, as well as the political system that’s constantly screwing it up. He really likes graphs, and is on Twitter, Google+ and Facebook. E-mail him here.

WHAT ABOUT THAT FISCAL CLIFF?

We all have heard about the Fiscal Cliff for months, but there is no easy explanation of what it is! Most accounts agree that taxes on couples will not rise unless they are earning over $450,000 (median US income is about $50,000 now.) There will be some small increases in "payroll taxes," but those are estimated to be about 2% for most, or $2000 per $100,000.

Your assignment for this blog is two read two news articles (below):

http://www.cnn.com/2013/01/02/politics/fiscal-cliff-5-things/index.html:

http://usnews.nbcnews.com/_news/2013/01/04/16334798-fiscal-cliff-deal-includes-at-least-679-billion-for-special-interests?lite

These are a brief CNN account (and you may look at the 45 second video clip), and an NBC view of what "special interests" received $ from the recent compromise deal between Republicans and Democrats in the Senate and the House.

I urge you to discuss/ask about this topic with a parent. This stuff is not easy!! (but it is important)

Write your comment addressing one or more of the following.

1. Would you have voted for the bill or not (no fair picking pieces)? Why or why not?

2. Any special interests make you angry? Any that you support?

3. What else do you know about the "fiscal cliff" (any opinions?)

4. Does this change or add to your knowlege of this whole discussion? How?

Remember to post by 9pm Sunday, and 150-200 words is plenty. Proofread before you publish!!

Wind Farm off the Cape?

WALL STREET JOURNAL, Aug 12, 2012

Cape Cod Wind Farm Tiptoes Ahead     
 http://online.wsj.com/article/SB10000872396390444900304577581460741815638.html

By JENNIFER LEVITZ

BARNSTABLE, Mass.—Philip Scudder said his ferry company here was once a vocal opponent of the alternative-energy proposal that blew into Cape Cod nearly a decade ago. The U.S.'s first offshore wind farm? In the middle of pristine Nantucket Sound? He wondered how his boats carrying vacationers bound for Martha's Vineyard would navigate around the turbines.

Enlarge Image

Matthew Healey for The Wall Street Journal

Randolph Bolton is shown Thursday with a tube of sediment from the sea floor collected as part of survey work for the Cape Wind project.

But now, Mr. Scudder, a 13th generation Cape Codder and part of the family that owns Hy-Line Cruises, supports Cape Wind, the proposal to place 130 wind turbines, with the highest blade tip reaching 440 feet above water, some five miles offshore. He says it would bring not only clean energy but economic opportunity: Hy-Line is now shopping for vessels to eventually give "eco-tours," educational boat rides out to see the turbines up close.

Mr. Scudder illustrates the conflicting views on the long-debated project in an area known as the jewel of Massachusetts and a vacation land for the affluent. After a decade, Cape Wind developer Energy Management Inc. is beginning geological survey work in the sound, a precursor to its goal of starting construction next year.

But whether the wind farm is built remains to be seen. Cape Wind has yet to receive all the approvals it needs to start construction. Opposition is firm and has included wealthy Cape Cod homeowners from the late Sen. Edward Kennedy to Republican donor and energy businessman William Koch.

The Obama administration is pushing for more renewable-energy projects, both on and offshore. This week, the Interior Department said it was assessing a proposal by the North American arm of StatoilSTO -0.35% ASA, a Norwegian energy company, for a wind farm off the coast of Maine.

The Interior Department approved Cape Wind in 2010. The project calls for the off-white wind turbines in a 25-square-mile area in a shallow part of the sound, a triangular body of water surrounded by Cape Cod, Nantucket and Martha's Vineyard. The closest vantage point would be nearly five miles away in Mashpee, next to Barnstable.

The turbines are "majestic and beautiful," and on a clear day would appear "like a half-inch sailing mast on the horizon," said Jim Gordon, the president of Energy Management, Cape Wind's developer.

Opponents are skeptical.

"I'm just not buying it," says Barnstable Town Manager Thomas Lynch, who worries about public-safety costs to the town if there were a problem at the wind farm.

The project is estimated to cost $2 billion. Energy Management said it has spent $50 million developing it and is working with Barclays PLC to secure private funding. The wind farm is expected to produce as much as 468 megawatts of renewable energy, which is about 3.5% of the 13,300-megawatts total generating capacity in Massachusetts.

Cape Wind has signed long-term contracts to sell 78% of its power to the state's largest utilities.

The wind power's cost is as much as twice that of conventional power, but because it would be a small portion of the overall energy pool, consumers would see at most a 2.2% increase to their monthly bills, according to estimates in a 2010 report by Massachusetts regulators.

Cape Wind has yet to clear one major regulatory hurdle: the Federal Aviation Administration is reviewing the project after opponents appealed its initial approval in 2010. The FAA must determine whether the wind farm would pose a risk to aircraft radar.

The project also faces headwinds from a decline in the price of natural gas, which undermining the case for renewable energy—though it isn't clear how long the dip will last.

Enlarge Image

Matthew Healey for The Wall Street Journal.

Captain Brad Primer on the Megan T. Miller as it heads out to collect seabed samples for the offshore wind turbine project.

In addition, the federal government's tax-credit program for wind projects is set to expire at year-end, and Congress has shown little gusto for alternative-energy subsidies in the wake of the fallout over government loans to failed solar-panel company Solyndra LLC.

"It's more difficult, but our plan is to do everything we can to move forward in any way," said Mark Rodgers, a spokesman for Energy Management.

Mr. Rodgers believes some opponents, like Mr. Koch, who has a waterfront home on Cape Cod and who is in the coal business, are worried about competition from wind energy. Mr. Koch is a funder of the Alliance to Protect Nantucket Sound, said his spokesman Brad Goldstein. The Alliance is the project's main opponent.

Mr. Goldstein said Mr. Koch's business interests have nothing to do with his opposition to the project. Mr. Koch believes the proposal isn't feasible without government support and that it "spoils a beautiful sanctuary," Mr. Goldstein said.

Thursday, at the harbor in Hyannis Port, a village that is part of Barnstable, Hy-Line's Mr. Scudder watched eagerly from his dock as research crews unloaded ocean samples from a vessel that had returned from the sound as part of Cape Wind's survey work. A decade of review on the project has eased any questions he had, he said.

Motioning out to Nantucket Sound, he said, "Some people are worried because there's never been something out there, so it's unknown. But the chance to have the first offshore wind farm in the U.S. on Cape Cod—I see it as an opportunity."

1. What about birds ..... tourism....... are there any facts/figures you can find?

2. What are the pros and cons? What do YOU vote - yes or no?

Write to Jennifer Levitz at jennifer.levitz@wsj.com

What do you know about the SYRIAN REVOLUTION?

Go to the following link and view the short video about Syrian history and the present conflict. Then read the New York  Times article below, which supports one viewpoint. Then talk with a parent and see what they think. Now respond to at least the first question below.

1. Should the United States intervene in the Syrian Revolution or not? What is your reasoning?
2. What are reasons that we shouldn't intervene?
3. Why is this issue important to the United States? (Think about Afghanistan and Iraq.)
4. What else do you think about this issue?

WATCH THIS:   http://www.youtube.com/watch?v=L69yqivnKSQ
Then READ THIS:

5 Reasons to Intervene in Syria Now

By MICHAEL DORAN and MAX BOOT

Published: New York Times, September 26, 2012

WHETHER you agree or disagree with President Obama, there is no doubt that he has formulated a coherent approach to the use of American power. The Obama Doctrine involves getting into a conflict zone and getting out fast without ground wars or extended military occupations. This approach proved its effectiveness in Libya last year.

follow@andyrNYT.

But the president is not applying his own doctrine where it would benefit the United States the most — in Syria. One can certainly sympathize with his predicament. Syria is a mess, and it is tempting to stay out, especially in an election year. Yet inaction carries its own risks. There are five reasons to bring down President Bashar al-Assad sooner rather than later.

First, American intervention would diminish Iran’s influence in the Arab world. Iran has showered aid on Syria and even sent advisers from its Islamic Revolutionary Guards Corps to assist Mr. Assad. Iran knows that if his regime fell, it would lose its most important base in the Arab world and a supply line to pro-Iranian Hezbollah militants in Lebanon.

Second, a more muscular American policy could keep the conflict from spreading. Syria’s civil war has already exacerbated sectarian strife in Lebanon and Iraq — and the Turkish government has accused Mr. Assad of supporting Kurdish militants in order to inflame tensions between the Kurds and Turkey.

Third, by training and equipping reliable partners within Syria’s internal opposition, America could create a bulwark against extremist groups like Al Qaeda, which are present and are seeking safe havens in ungoverned corners of Syria.

Fourth, American leadership on Syria could improve relations with key allies like Turkey and Qatar. Both the Turkish prime minister, Recep Tayyip Erdogan, and his Qatari counterpart have criticized the United States for offering only nonlethal support to the rebellion. Both favor establishing a no-fly zone and “safe zones” for civilians in Syrian territory.

Finally, American action could end a terrible human-rights disaster within Syria and stop the exodus of refugees, which is creating a burden on neighboring states. Mr. Obama pledged earlier this year to strengthen the government’s ability “to foresee, prevent and respond to genocide and mass atrocities.” Now he has an opportunity to do so. And by putting allies in the lead, Mr. Obama could act without sliding down the slippery slope toward a ground war.

Our closest friends in the region — including Saudi Arabia, Turkey, Jordan, Qatar and Israel — would like to see Mr. Assad toppled as soon as possible. France and Britain could also be counted on to help, as they did in Libya. Yet none of them will move until America does.

We cannot wait for the United Nations to act; that is highly unlikely. Nor can we expect the Free Syrian Army to oust Mr. Assad on its own; it is not a cohesive organization. Instead, America must identify those elements on the ground that are the most effective, easily supplied and amenable to help.

The focus should be on Aleppo, Syria’s second largest city and commercial hub. The F.S.A. already controls much of the territory between the city and the Turkish border, only 40 miles away. With American support, Turkish troops could easily establish a corridor for humanitarian aid and military supplies. Defeating the government’s forces in Aleppo would deal a serious blow to Mr. Assad and send a powerful signal to fence-sitters that the regime was dying.  

Damascus, the capital, should be the second target. But unlike Aleppo, it can’t be easily reached from a Turkish base. It could, however, be supplied from Dara’a, which is 70 miles from Damascus and less than five from the Jordanian border. It has been at the forefront of opposition to Mr. Assad. Working with Jordan, the United States could create a second corridor to Dara’a, which could serve as the southern base for the insurgency. On Wednesday, by bombing a military complex, the rebels demonstrated their ability to strike in the heart of Damascus — though they have not yet been able to do so on a sustained basis.

To prevent Mr. Assad from staging a devastating response, the American-backed alliance would have to create a countrywide no-fly zone, which would first require taking apart Syrian air defenses. Mr. Assad has been using jets and helicopters to fight the rebels; a no-fly zone would quickly ground his entire air force. The zone could then be extended to provide the kind of close air support that NATO warplanes provided to rebel fighters in Kosovo and Libya.

While our allies could take the lead in maintaining the no-fly zone, it is necessary in Syria, as in Libya, for America to take the lead in establishing it; only our Air Force and Navy have the weaponry needed to dismantle Syria’s Russian-designed air defenses with little risk.

A “lead from behind” approach can work in Syria. President Obama need only apply it.

Michael Doran is a senior fellow at the Brookings Institution. Max Boot is a senior fellow at the Council on Foreign Relations and an adviser to Mitt Romney’s presidential campaign.