Saturday, October 26, 2013

Unconditional Surrender ~ Eric Smith

Those who are unreasonable lose their right to expect others to be reasonable with them. Those who are intolerant lose their right to expect others to be tolerant of them. For years the Republican Party & the Far Right has flat out refused the pleas of President Obama and others on the Left to meet them halfway, to be reasonable and to work things out through genuine compromise where each side gives a little and gains a lot. It has always been their way or the highway; their way or nothing at all.

It is telling how after the debt limit standoff of 2011 Speaker John Boehner said "We got 98% of what we wanted." This is telling for this reason; Republicans/Conservatives define "compromise" as getting 95% to 98% of whatever they ask for. The problem is not so much that this is how these people really think but that we Democrats in general and we on the Left in particular have allowed them to get away with this way of thinking & attendant behavior for far too long; so long in fact that it would be unrealistic on our part to expect them to think any other way now.

We have historically caved, given in, whenever they have accused us of being unreasonable, of refusing to meet them "halfway" whenever we have refused to give them at least 90% of what they've asked for and I'm like what type of damn fools have we on the Left been?! Seriously, if the Republicans/Conservatives want to accuse us on the Left of being unreasonable or unwilling to meet them "halfway" because we and President Obama have finally come to our collective senses and realized that giving them 98% of what they want is not compromise but conquest, so what?

Let them scream, let them holler, let them throw all the tantrums they want but don't give another inch of ground. Compromise, real compromise, is a 50/50 split; it is straight down the middle and if they can't accept that then fine; we will be more than within our rights to demand 100% of what we want and not allow them to have anything because we have allowed them to get too much of what they've wanted for far too long. There comes a time when the only sane thing to do once you have your foot on an opponent's neck is not to lift it up but to keep pressing down on your opponent's neck until you feel that neck break.

That is where we on the Left stand in relation to the Far Right now. We must press our foot down on its neck until it breaks. Forget compromise, forget being reasonable; we must say to them what President Truman said to the Japanese in 1945 and that is that nothing less than "unconditional surrender" is acceptable at this point. We must mean it and we must act accordingly. Unconditional surrender is what we Democrats and those of us on the Left must demand of the Republican Party & the Far Right. Nothing else will do and in light of their history and current conduct, nothing less than unconditional surrender makes a damn bit of sense.

Friday, October 25, 2013

I Have To Laugh ~ Ruth Ann Satchfield

My employee-insurance management company reported year-over-year double-digit percentage growth in operating income which was 30.0 percent, to $7.1 billion in third-quarter 2013. They made $16.6 billion in the first nine months of 2013. I want you to realize the size of the company we are talking about.

I have carried insurance on both my husband and myself for over 25 years. In January, they stopped covering my husband's bills. Why? A software glitch. They had changed companies for management of their insurance program. The new management company lost many dependents in the transfer. If my husband had not been a service-related disabled veteran, we would be up the proverbial creek. The company has been telling us not to worry, that he is covered, and that they will pay us back. This has been happening since January, 2013.

I just received my new packet of information, and it has "dependent" checked just as it should. The packet also includes information about the Affordable Care Act (ACA) for younger employees, about saving money in the Marketplace established by ACA with this statement: "In the Marketplace, you could be eligible for a new kind of tax credit that lowers your monthly premiums." They left the choice up to each employee to decide what is best. This is a massive company that had good rates, but evidently our insurance advisers feel that at least the people on COBRA might do better with the provisions of the ACA. 

When we hear the people in Congress posturing about the failure of the ACA website, I want to laugh. Many of these people never supported the ACA in the first place. When we hear them complaining about the failure of the website, I wonder where they were when the drug program (for seniors) became law. Did they not hear of all the problems that the program had? One more thing: the ACA is a lot more complex - with many more plans and options - than my employee benefits, and I have been waiting for 10 months to be reimbursed. So, when some say that the private sector could do it better, I have to laugh.

Income Inequality ~ Eric Smith

Today my friends I want to discuss income inequality; namely the difference in the amount of money a man earns and a woman who does the same job and works the same hours. Now it is generally understood that on the average for every dollar a man earns a woman only earns seventy seven cents. So forgetting deductions for taxes, Social Security etc; for every $10.00 a man earns a woman earns $7.70. 

Now let's say the man and the woman work an eight hour day. In the course of that day the man will earn $80.00 whereas the woman will earn only $61.60 because remember the woman twenty three cents for every dollar she makes doing the same job and working the same amount of hours as the man and she is losing these twenty three cents not because the man is doing the job better but only because she is a woman. In short she is losing $18.40 a day for no other reason than that she's a woman.

Now let's go to the typical forty hour work week. A man earning $10.00 per hour working eight hours a day and five days a week will earn $400.00 because of course eight times five is forty. Now a woman who only earns only seventy seven cents for every dollar a man makes will earn what? Multiply $7.70 by 40 and you will come to $308.00. In other words a woman who does the same job and works the same hours as a man will earn $92.00 less than a man for no other reason than that she is a woman.

Now let's look at how income inequality stacks up over the course of a month. With a forty hour workweek you are talking about on the average four weeks so multiply forty by four and you come to one hundred and sixty. So a man who earns $10.00 hour will over the course of 160 hours earn $1,600.00. That will be his monthly taken. Now factoring in income inequality where the woman will only earn seventy seven cents for every dollar a man makes, what will be her take for the month? Multiply $7.70 times 160 and you will come up with $1,232.00. In other words with income inequality a woman who does the same job and works the same number of hours as a man will earn $368.00 less per month than the man not because she doesn't do the job as well but only because she is a woman.

Now let's top it off by looking at yearly income. A person works one hundred and sixty hours per month and there are twelve months per year. So to come up with the number of hours worked per year multiply 160 times 12 and you will come up come up with 1920 working hours per year. So a man earning $10.00 per hour will earn how much if he works 1920 hours per year? Multiply 10 times 1920 and you will come up with a yearly income of $19,200.00 for the man. Now a woman earning seventy seven cents for every dollar a man earns will make how much over the course of the year doing the same job and working the same number of hours. Multiply her $7.70 times 1920 and you will come up with a yearly income of $14,784.00. Now with income inequality how much less will the woman make per year solely because she is a woman. Subtract $14,784.00 from $19,200.00 and you will come up with $4,416.00. 

So here is the deal with gender inequality. With a woman earning only seventy seven cents for every dollar a man makes who does the same job and works the same number of hours that the man does will earn $18.40 less per day, $92.00 less per week, $368.00 less per month, and $4,416.00 less per year than the man who does the same job and works the same amount of hours and earns $10.00 per hour, $80.00 per day, $400.00 per week, $1600.00 per month, and $19,200.00 per year! 

That my friends is income inequality! Not only is it wrong and immoral; from a purely economic standpoint it is profoundly stupid since that lost income for a woman is taxable income; it is money that if paid could be used to help fund our schools, police & fire departments, among other things. It is taxable income that could be used to put additional funds back into Social Security to be used for higher Social Security payments upon retirement or in the event of disability. It is extra money that could be used to pay for food, clothing, housing; money that could be returned to the economic pot in the form of buying goods & other products; increasing the demand for them and necessitating the number of more people to help meet those demands and lower unemployment and pull more people out of poverty.

In short, income inequality based on gender ultimately shortchanges us all for it collectively lowers the quality of life for the nation, it makes woman economic second class citizens, and it starves our economy of needed funds in the form of additional taxable income. That is why it must be addressed and why it must be eliminated for income inequality has no place in a society that professes to be free for its existence denotes the absence of full freedom and is a sign of economic stupidity of the highest order.

Thursday, October 24, 2013

It Sticks In My Craw ~ Eric Smith

It sticks in my craw that not one member of the Republican Party, not one member of the Tea Party, and not one member of the Libertarian Party called out that racist Texas yahoo who waved the Confederate flag and gave a rebel yell in front of the White House during the government shutdown; not one and I am seething over that. I remember calling my parents in New York to say goodbye to them in January of 1987 because I was half convinced that I was going to get killed when I participated in second Cummings GA march the following day and so did they.

I remember the Confederate flags being waved by racist lunatics who had shotguns clearly visible in the back seat. I remember seeing signs like "N*****s ain't got no God!" and of a little boy getting slapped silly by his parents after smiling and waving at me as I marched past. I remember the sharpshooters on every overpass as our bus made the 35 mile trip from Atlanta to Cummings and I recall being told by the marshal on board not to rest my head against the window for fear that a sniper would shoot it off.

I recall the sign "Welcome to Cummings!" right next to which stood three people holding a large flag of the Ku Klux Klan; the flag that had a cross with a drop of blood in the center. I remember entering the town square just at its edge and being pressed against National Guardsman who stood between us and a murderous mob. I remember my college roommate saying "E, you wanted to see a Ku Klux Klansman well there he is!" and then looking over and seeing one of those clowns in full white sheets & pointed hood waving the Stars & Bars. 

Yet most of all I remember seeing those three helicopters hovering overhead, the lowest of which was no more than twenty five or thirty feet above us and telling folks nearby that if one of those racist yahoos managed to shoot it down or it crashed on its own accord we were all dead. I remember how after the demonstration was over and we began to make our way back to the buses along the route from which we'd come, I broke ranks and rushed to the aid of a woman who had fainted and then hearing loud screaming as I stepped away after realizing that she was okay; only to be cursed out by my roommate who said that in the commotion I had nearly backed into that very Ku Klux Klansman I had seen earlier and who had caused the Guardsman to lower their face masks and charge into the crowd after calling one of them the "n" word and trying to throw something, probably a panic bomb designed to trigger a fatal stampede, and of course I recall that guard ordering me to look away as the National Guardsmen began to make their charge and my responding "Hell no! If I'm to die here I'm determined to see who does what!"

So from where I sit, the fact that those in the GOP, the Tea & Libertarian Parties stood silent in the face of that atrocity in front of the White House tells me that they are complicit in it; even if it is only a complicity of silence. You see people were enslaved because of that flag; people died because of it, and our nation was almost destroyed because of it. I am not interested in hearing sugarcoated platitudes or excuses for that kind of hateful conduct; to me words of dismissive justification are empty because I almost lost my life opposing that flag and for standing up against the hate and evil it represents. 

To me that flag and all those who support it for whatever rhyme or reason are my mortal enemies. There is no middle ground; no room for compromise, accommodation, or debate with anyone or any party that thinks it is in any way acceptable; even if that acceptance is conveyed through one's refusal to speak out against it. The Confederate flag is pure evil, period, and by either embracing or showing tacit acceptance of that flag through a refusal to condemn it, the GOP, and the Tea & Libertarian Parties are equally evil; evil not only in their embrace of a hateful symbol of slavery, segregation, and Judge Lynch but of treason as well for make no mistake, that flag was ultimately created for one reason and one reason alone; to keep human beings enslaved and to forever rip the United States of America apart and if that wasn't the essence of evil then I don't know what is.

The Old John Birch Society Born Again ~ Claire Conner Mork

Conventional D.C. punditry, says Ted Cruz, has destroyed the GOP's standing and made it possible for Democrats to take back the House. This is, in my opinion, pie in the sky. 

Listen to this assessment of Cruz's impact on the GOP on Texas. "Just about every GOP candidate with aspirations to statewide office in 2014 seems to be styling himself or herself after Cruz. In tight formation, they are moving hard to the right and looking for the next big populist rallying cry — secession, rolling back the state’s liberal immigration laws, impeaching President Obama, amending the Constitution to end the direct election of U.S. senators."

Look at the list of ideas these folks are touting:
1. Secession.
2. Rolling back immigration laws.
3. Impeaching the president.
4. Getting rid of the direct election of senators.

These folks are not humbled. These folks are not swayed by polling. These folks are revolutionaries.

By the way, the John Birch Society is pushing the idea of nullification (a popular idea in Dixie before the Civil War). The John Birch Society is anti-immigration reform. The John Birch Society led the push to impeach President Clinton. The John Birch Society opposes the direct election of senators.

Ted Cruz and his Texas fans are the old John Birch Society born again in red cowboy boots, waving their Lone Star flag and demanding the destruction of the federal government. 

Wednesday, October 23, 2013

Kings Who Take Money From Those Who Are Not Christian Enough ~ Claire Conner Mork

I had to post a huge segment from this piece or you would scoff at my note. Yes, Ted Cruz's father is a big evangelical preacher and he sees his son as one of the "anointed ones." This ought to give every one of us the creeps. But, there's more. The old Cruz calls for America to have a king who will take money from those who are not Christian enough and give that wealth to preachers (and their anointed sons.

Here's the article, "The father of right wing Texas Senator Ted Cruz, the most visible leader of the now-ended government shutdown, is seen in recently uncovered videos calling for America to be ruled by “kings” who will take money from anyone who is not an evangelical Christian and deliver it into the hands of fundamentalist preachers and their acolytes."

"Megachurch preacher Larry Huch suggested that Rafael Cruz’s own son, Ted, is one of those “kings.” And in fact, at a ceremony this past July Ted Cruz was “anointed” by a group of fundamentalist preachers in a special blessing ceremony."

During the 2008 presidential campaign, then-Senator Barack Obama was accused by conservatives of advocating “redistribution of wealth” from the wealthy to the needy. But in his speech given last year, Rafael Cruz calls for “a great transfer of wealth.”

The difference is, in Cruz’s scheme, the transfer will occur through a war against “the wicked” led by Christian preachers who will take the wealth from nonbelievers.

“The wealth of the wicked is stored for the righteous,” said the elder Cruz at an Irving, Texas megachurch in August of 2012. “And it is through the kings, anointed to take dominion, that that transfer of wealth is going to occur."

“I know that's why God got Rafael's son elected - Ted Cruz, the next Senator,” said Huch, pastor of the New Beginnings megachurch, introducing Rafael Cruz’s speech.

"Kings who are anointed for a totally different reason than priests,” Rafael Cruz went on to say. "Kings who are anointed to take dominion. Kings who are anointed to go to war, win the war, and bring the spoils of war to the priests.”

Sounds like King David and company from the Old Testament. 

The self-inflicted SABOTAGE of Obamacare ~ William Boyle

Whether it was deliberately included in order to sabotage the Affordable Care Act, or whether it was inadvertently left in because of carelessness, there is one BIG item that is presently implied by the law that may sabotage the ENTIRE Affordable Care Act.

This toxic item is the mandatory reduction in adjunct (part-time) college professors' working hours due to the ACA.

So, why is this item toxic?

It is because the majority of college professors are, in fact, part-time faculty. Colleges do this to reduce the costs of faculty (Some estimates indicate that nationally, some 70% of all college professors are adjuncts!)

And, it should be noted that most adjunct professors are barely getting by.

Reducing their working hours -- and their salary! -- is not likely to make these adjunct professors very happy.

If the majority of college professors are not happy with Obamacare -- What are these professors going to tell their students about Obamacare?

And, because to make the economics of the law work, it is necessary that a majority of young, healthy citizens sign up for insurance through the exchanges -- The young, healthy citizens that are most likely sign up for insurance through the ACA exchanges are college students.

So, just what do you think is going to happen to the implementation of the ACA, if young, healthy college students DON'T sign up for health insurance, because of the negative impression of Obamacare that they are getting from all of their college professors that are being HURT by this apparently obligatory aspect of Obamacare?

If this was intended as a deliberate sabotage of Obamacare, it is very cunning and crafty...

Are the people in charge of the rollout Obamacare aware of this toxic aspect of the law?

Yes, the intent of the law was to provide this segment of the population with health insurance.

However, in my particular case, I have been told that I will NOT be employed starting this coming January, because of Obamacare.

And it is particularly ironic, that President Obama spoke to promote the ACA at my college (Prince George's Community College) less than a month ago, on September 26...

However, my question is not, "How do I pay for health insurance come next year?"

My question is, "How do I pay for rent then? -- or even for food?"

(Also, as an "education worker" I am not eligible for unemployment compensation!)

...And, how many other adjunct professors are there in my same situation?

And -- what will happen if this problem is not solved right away?

See for example:
Honey, They Shrunk My Job

ObamaCare List Hits 313 As 54 Colleges Cut Adjunct Hours

Under the provisions of the Affordable Care Act, the average income of an adjunct has fallen to $2,700 per course, less than $25,000 per year, and this is to prevent colleges and universities from having to provide benefits.

Obamacare trainwreck: bankrupting, hurting and killing America

Saturday, October 19, 2013

What is the Medical Device Tax? ~ Barbara Cobuzzi & Lynne Smith

What is the Medical Device Tax?  Why there is such a battle to remove it as a revenue source of The Affordable Care Act (ACA) and/or Obamacare?  The Medical Device Tax has become one of the primary centerpieces of “what is wrong about ACA” for the Republicans.  Republicans advocated for removing this tax because it would be a burden on the American people and on the Medical Device manufacturers.  Looking at the history of revenues for new programs, the financial picture of Medical Device Manufacturers, and the process of determining how to pay for ACA/Obamacare will be reviewed to help the reader determine whether the tax is reasonable or a burden for the taxpayer and medical device manufacturers.
As lawmakers in Congress and the White House were developing the ACA/Obamacare, major healthcare industry players, including but not limited to the pharmaceutical industry, hospital industry, and healthcare insurance industry, were invited to participate in the process and offer suggestions about how the law could best be paid for.  Most of the industries contributed some revenue ideas to help fund the law, negotiated others and finally compromise on a plan and agreements were made on how the ACA/Obamacare would be funded.  However, one health care industry, The Medical Device Industry, appears to have refused to make suggestions, offer possible revenues, or suggested how they could contribute to the process of funding this law. (  Instead they suggested other industry players be the sources of revenue.  The medical device industry never offered any contribution in order to provide health insurance coverage to the 40-50 million uninsured Americans.
What is important to understand is that the Medical device industry is an exceptionally profitable industry.  It includes not only the manufacture of artificial knees and hips, but also CT and MRI equipment made by companies like GE and Seimans.   Recently on the news, it was reported that an artificial hip, just the hardware for it is manufactured for about $350.00 and sold for over $10,000.00. ( The patient may pay in excess of $20,000.00 for the surgery.  This represents an approximate 900% mark-up on the device alone.
After discussions and negotiations with industry leaders a “forced tax”, of 4.6% was levied, since the Medical Device industry was the only industry player to not offer a contribution to funding the Affordable Care Act. (Resource)  The planned contribution was an estimated $40 billion over 10 years.  This tax was cut in half from 4.6% to 2.3%, and the expected contribution was dropped to $20 billion.  But the industry’s profits have spiked recently, so the revised estimated ACA contribution from this tax is now $30 billion over 10 years due to the industry’s increased profitability. ( )
On the one hand the medical device industry was complaining about the $30 billion price tag, the industry invested $30 million a year to lobby congress in order to get this tax removed.   They spent in one year of lobbying, the cost to them for the ACA over 10 years.  Think about it, if 2.3% of profits over the next 10 years is $30 billion, that means that the medical device industry’s profits over the next 10 years is $1.3 trillion dollars, or on average, $130 billion a year. (

Concessions Requested by Republicans for ACA: Do They Pass The Truth Test? ~ Barbara Cobuzzi & Lynne Smith

While Republicans are playing a game of chicken with the Democrats,  that may mean America will not be able to pay their bills, they have once again tried to pull the “wool over the eyes” of the American people with two new myths about the Affordable Care Act. These myths are at the center of the debate of keeping the government shut down as well as whether to default on our debt.  The House Republicans refuse to sign a clean Continuing Resolution which would insure our government is reopened and more important we do not default on our debts. As many of you know, most of the time when we write a blog, we go through a long process of verifying the information we put in this blog stating the source so anyone can re-check the facts.  However, in order to get you information in real time, today we are simply going to  tell you the issues the Republicans have indicated are “bad for the public”, worthy of keeping the government closed and possibly defaulting on the country’s debt to “save the American people” from  ACA law and then counter these issues with the truth.  There will be no rhetoric.  The information contained in this blog is just the facts. As author’s of this blog, we recognize changes need to be made to ACA, however these are minor changes and easily fixed by the Congress or administrative modifications, if they just do their job, instead of playing politics with the well-being of the American public.  The Republicans, especially those in the Tea Party, are reporting to the American people that  they are trying to “save them” from the Affordable Care Act.  That is simply untrue, rather they are trying to “save face” and be able to say they won out against big government and out of control spending.  Being correct on the ACA is very important to them, even though, polls indicate the Congressional Republicans approval rating is less than 5%.  The Republican stubborness reminds me of the last election when these same Republicans, supported by FOX news denied that President Obama was elected.  They were sure, that their polls were correct, stating Nate Silver’s 535 predictions were wrong and numbers coming from the voting precincts along with the pundits who declared President Obama the “winner” were just plain wrong.  Of course, in the end the polls cited by the Republicans were wrong and President Obama was re-elected. However, this proved just how out of touch these Republicans are with the reality of how Americans feel in this country.  Now, they are exhibiting the same denial of truth, as moderate Republicans and Speaker Boehner are over-ruled by about 40 members, primarily of the Tea Party  who seem to care very little about the impact shutting our government down and/or defaulting on our debt could have on the American people and the world economy. The two newly reported major myths being spread by the Republicans, in a desperate attempt to have some concessions, surround verifying a person’s income  to “make sure” they are eligible for subsidies and/or cost sharing, as well as forcing ONLY members of Congress to buy insurance from the exchange, effectively exempting their staff from participating. While they are manipulating the data with regard to many issues, what they are saying about the ACA, in this case, is simply categorically untrue.  Let’s begin with the issue of verifying income.  As one of the writer’s of this blog, I can assure you from personal experience that income is verified when applying for coverage through the website. I have recently finished signing up for a policy through the health care exchange and my income was verified immediately within the process.  In fact, during the sign-up process, I was asked to project what income I thought I would have in 2014,  Now, based on recent information, I have determined my income in 2014 will be greater than it was in 2012.  So, I declared what my best guess is of what my income will be and clicked on enter.  After a small waiting period, I received a message indicating that my stated anticipated income did not match income previously declared on my tax returns.  I was asked to review my information and then asked again if this was my anticipated income for 2014.  I clicked yes, and received a message, that I needed to submit documents to verify my income.  Now, in my case, I could submit a written document by me describing why my income would be increasing.  I was offered many choices on how to verify income, including pay stubs, prior tax returns, etc.  While I was able to continue in the enrollment process and see what subsidies and cost-sharing if any, I was entitled to, based on the income I submitted, I had to electronically agree that the information I was giving was true and correct to the best of my belief and indicate I understood I had to submit documented evidence prior to a certain date to actually get the insurance.  The exchanges do verify income.  This has been a part of the Affordable Care Act from the beginning.  Any information to suggest otherwise is simply false.   Why are the Republicans making this demand about insuring people are truthful about their anticipated income suddenly?  It is part of the same tired strategy and stereotype they have used to demean and embarrass anyone who participate in what they perceive is an entitlement program.  They are trying to make people believe that by nature, Americans will lie about their income and be “given” a handout by the federal government in the form of undeserved subsidies and/or cost sharing. Americans, who would accept a tax incentive or subsidy must be a “shady” kind of person.  Remember. these are also the folks who say millions of people apply for food stamps when they aren’t “truly” needy.  The studies show however that less than three percent of food stamp recipients lie in order to get food stamps. They also ignore the fact, that not only do people have to verify their income at the time of application, but also have to electronically sign a document indicating they know that if their income is proven to be greater in 2014 than stated on their application, they will be liable to return the money on their tax return when they file in April of 2015. Income is verified then at two points, both prior to obtaining insurance and on their 2014 (filed 4/2015) tax return to validate they told the truth on their application. This is simply another untruth promoted by the Republicans to make ACA is a “hot button” issue. The second issue that the Republicans are “taking a stand” on involves whether they and their staff should enroll in the federal exchange.  Initially, they tried saying Congress was exempt from the Affordable Care Act and that wasn’t fair to the average American.  They tried to make it seem as if they had been exempted from a “terrible program”. First of all, Congress and their Staff receive their insurance via the federal employee health insurance group.  Anyone reviving their health insurance from a large employer are not allowed to shop for insurance in the exchanges.  So, by design, Congress and their Staff should not be eligible to get their insurance in the ACA exchanges. While the ACA was in bill form, Senator Grassley (R) submitted an amendment that would require Congress and their staff to be receive their health insurance from the ACA federal exchange like all individuals, families, and smaller businesses in this country.  According to some Republicans he added this amendment as a “poison pill”, thinking that it would cause the bill to not be passed even by its supporters in Congress.  To Senator Grassley’s surprise, the ACA bill passed and became a law, with the Grassley amendment, meaning that all of Congress and their staff would receive their insurance via the ACA exchanges.  So, because of the Grassley Amendment, Congressional Republicans found themselves in the position of having to use the federal health exchange.  However, the executive branch and their staff will continue getting their employer sponsored insurance and rightly so because ACA was passed to insure people with out insurance, those who could not afford insurance, those who had pre-existing illnesses and young adults under the age of 26 would have a cost effective means of  obtaining insurance. Since the inception of the Affordable Care Act, Congress and their staff have known they would  be required to be a part of the exchange beginning in 2014.  In fact, over the past two years, the Government Insurance Health Administration (GIHA) has coordinated the Pre-Existing Condition Insurance Plan (PCIP), that provided insurance to thousands of people, like me, with pre-existing conditions beginning in 2011.  However, the Affordable Care Act is not perfect and there are things that should have been “tweaked” in terms of the law.  One of the tweaks needed involved how members of Congress and their staff, would be able to use their “employer contribution” when purchasing plans.  In the last two years, Republicans in the Congress have flat out refused to fix any issues associated with ACA, instead they appealed the law to the Supreme Court and made over 44 attempts to repeal or defund the law in Congress.  In response to Republicans continuous refusal to “tweak” the bill, President Obama signed an executive order indicating that all federal employees who were staff members or Congressman could use their “employer” contribution to pay for all or part of their insurance through the federal health exchange and still be eligible for subsidies and cost-sharing. In a move that is so hypocritical, it is hard to believe, the Tea Party specifically, and Congressional Republicans have added the Vitter amendment to the Continuing Resolution which will take away the employer contribution to the healthcare plan for all of congress and their staffs.   This represents a income reduction for everyone in Congress as well as their staff.  This does not effect the actual members of Congress to a great degree because due to their salary, they will not be eligible for tax incentives or cost-sharing.  But their staff, is a different story.  Staff members may earn  $40,000 to as high as $175,000 per year.  Taking away the employee benefit which pays for part of their healthcare insurance premium from these employees is simply unfair.  They should not be used as a political pawn just to prove a point by Congressional Republicans.  They are punishing the very people who help them do their job.  Why would they take away the possibility of their own staff members or others who work in the Capital from getting subsidies or cost sharing?  It makes absolutely no sense.  They are not doing the right thing and protecting their employees.  In essence, they are denying them tax cuts or tax incentives that everyone else in the country in the exchanges receive.  The Republicans proclaims that they want more money going to the average American and yet, they want to deny their staffs  the ability to get health insurance for less money so they can say they got a “concession” and declare victory to their constituents.  This is just plain cruel and clearly supports that these Republicans care very little about the people around them or their constituents. A third issue that is being considered in closing a deal to re-open the government and increase the debt limit is to remove the medical device tax.  Again this is being considered as a concession to the Republicans and the Tea Party.  The Medical Device Tax is one source of funding the ACA and removing this tax will require congress to find alternative funding.  The reason there is so much pressure to remove this tax is because the medical device manufactures (ie: GE, Seimons, J&J, etc) have been spending millions of dollars lobbying congress to remove this tax.  So you understand, this is a tax on the artificial hip that costs $350 to manufacture and ultimately costs over $30,000.  The margins in these products are huge and they can well afford this tax. Many of these companies do not pay any income taxes currently (ie: GE) because of tax loopholes.  Removal of this medical device tax will cause us to have to pay for it somewhere else. Watch our blog and we will let you know they want to replace these funds. Once again we have proven that the “concessions”  or major issues associated with ACA are manipulations and/or just plain lies being spread by the Republicans in Congress.  If Republicans and/or Tea Party Republicans were educated about ACA, and they should be because that is their responsibility and their job, they would know one of their “demands” may actually financially harm members of their own staff and the other demand to verify income is already a part of the law.   That is why we have decided to award Republican members of Congress and specifically the Tea Party our first “stupid and you know it” award. Call your Representative and Senators today and tell them to stop these ridiculous demands.  Let them know you are educated about the issues and you want truth as opposed to dishonest rhetoric.They need to re-open the government and not allow the United States to default on it’s debt  for their own political gain. About the Authors: By: Barbara J. Cobuzzi, MBA, CPC, CPC-H, CPC-P, CPC-I, CENTC, CPCO and Lynne Smith, MSSW. Barbara is an industrial engineer with an MBA. She worked in the pharmaceutical industry for many years before moving into the healthcare industry where she had a company where she provided top quality coding, compliance and revenue cycle management services for physicians. She has since moved into full time consulting for physicians. Barbara is a nationally known expert known for her education, consulting and expert witness services. Lynne has dedicated her career to helping others. She has experience as a social worker in a rural county, an administrator in a large hospital network and as a College Professor. She uses the skills she developed over the years as an advocate in a variety of areas including her most recent venture serving as a Healthcare Advocate. Together, Lynne and Barbara own the ACA Healthcare Advocates consulting firm and are available to individuals, families and businesses to help them meet the requirements of the Affordable Care Act in order to meet the specific needs of the client while optimizing the fiscal considerations.  Please direct your questions and/or inquiries to  

Thursday, October 17, 2013

The Must Know Facts for ACA Enrollment ~ Barbara Cobuzzi & Lynne Smith

When shopping and/or purchasing  an Individual  or family health insurance policy through the  federal and/or state exchange marketplace there are several terms you must know to best understand your options and insure you get the best policy for the best cost to cover you and/or your family.  The State and Federal Exchange Marketplaces have been up and available to consumers since October 1, 2013., the primary starting point for Americans seeking affordable health care, opened with a bang, receiving many more hits than expected. saw 8 million unique visitors during the first four days it was open (October 1-4, Tuesday-Friday).( ) This does not include those who went directly to the state run exchanges, for example, California and New York.  Most of those visitors did not purchase insurance when they first visited the website.  There are a variety of reasons for this including but not limited to being a new program, failing to anticipate the number of people who would explore the site immediately after launching it.  Most of the people went on the exchanges to explore, to actually search for the insurance options and some logged on were curious about the exchanges.
Initially upon opening, the website was slow and experienced some glitches, as is often the case on new popular websites upon launch.  I do not think that the designers anticipated the large volume of people that would visit the exchanges all at one time.  As a result, the pent up demand by the long time uninsured, searching for insurance, finally, brought the web site to its knees.  This caused frustration by those excited to price out and find out more about their insurance options which will be effective for them as of January 1, 2014. While many people were frustrated with their inability to access the site, enrollees have until December 15th to sign up for insurance for 2014 beginning on 1/1/2014.  The open enrollment period for 2014 is actually extended for three additional months, from January, 2014 until 3/15/2014.  This will give potential enrollees a little extra time to decide about purchasing health insurance from the exchange.  Enrollment in subsequent years will  last just under three months, from October 1st of the year before the effective date of the insurance year until December 15th before the effective of the insurance year.  So, for the insurance year beginning on of January 1, 2015, we will have an enrollment period of just less than 3 months from 10/1/2014 through 12/15/2014. ‘If someone decides to not enroll in the exchange for 2014, elects to pay the tax penalty, and they get sick or have an accident in the year, they cannot get insurance back dated to the date of the event. This is a common myth that people, who are trying to turn the public against ACA tell people that they don’t need to sign up for insurance, because if something catastrophic happens they can sign up then.  In 2014, if a person happens to have a catastrophic event between January 1st and March 15th, the person will have the opportunity to enroll in ACA with the effective date being about two weeks from the date of their application since the open enrollment period is extended.  However, after March 15, 2013 and in subsequent years, if a person declines to enroll and then gets sick or has an accident, they will not be able to acquire insurance until the next enrollment period, from October-December and their coverage will not start until the following January 1st This could put a large financial burden on the uninsured person and could lead to potential personal bankruptcies.  It is important to remember that more than 60% of households who declare bankruptcy say medical bills were one of the leading causes of their bankruptcy. ( ) 20% of the US population between the ages 19 and 64 are expected to suffer some kind of financial hardship due to healthcare costs.( is something to keep in mind when trying to decide whether to purchase your individual insurance or not. The old adage “better safe than sorry” is a good lesson for all to remember in terms of buying health insurance.
Another reason people did not enroll is because they were just browsing, considering buying health insurance through the exchange while others just wanted to check out the pricing so they can budget for next year or just see what all the controversy is about.  Millions of people in the United States have been unable to purchase insurance because of high prices or because they have had pre-existing conditions which excluded them from underwriting. HHS issued a report on 1/8/2011 that stated “129 million Americans with pre-existing conditions could be denied without new health reform law. Without Affordable Care Act protections, in 2014, 1 in 2 non-elderly Americans could be denied coverage or charged more due to a pre-existing condition”(  These people, who number more than 10 million uninsured, when you consider the people using the  federal exchange and the state exchanges, were excited and relieved at the prospect of being able to purchase affordable insurance for both themselves and/or their families.  Many of these people immediately went on the exchanges to get the information they have been waiting for in the past two years.  They had been anticipating the ability to obtain insurance since the ACA bill was signed into law in 2010.  People with pre-existing conditions wanted to see if they qualified for coverage and those who prior to this time could not afford insurance wanted to see if the Affordable Care Act made insurance truly “affordable.”
According to Mother Jones, “Experience shows that getting lots of uninsured people into private health plans and new Medicaid plans is maddeningly difficult and time-consuming.”( ) This is based on the history from implementation of “RomneyCare” in Massachusetts.  The implementation in MA basically followed the same pattern as what we are seeing with the implementation of ACA nationally.  The Massachusetts exchanges opened in October of 2006 and by the time everyone had to be enrolled into an insurance plan, July 1, 2007, the kinks eventually were worked out and everyone got enrolled by the end of the enrollment period ended on 7/1/07.  It is our expectation that the same thing will happen with ACA.  We have a shorter window and many more states to get fully operational since Massachusetts only had to concentrate on their own needs.  Now, needs to address the specifics of 49 additional states, some on their own state exchanges and some on the federal exchange.  As a matter of fact, HHS (Health and Human Services) took the website down on the weekend of October 11 and 12th for upgrading and maintenance so it would be able to handle the additional traffic. ( Although we are experiencing better access after the upgrades this past weekend, the website still needs some work.  HHS is busily working on addressing all the volume demands.
There has been an incredible amount of false information fed to the American people about ACA and many folks seem to have forgotten the primary goal of the Affordable Care Act was to insure that all Americans had access to affordable health care and that pre-existing illnesses would not longer be a reason people were denied insurance. The Democrats initially wanted a system that would serve all people, however this was an issue that upon negotiation and compromise resulted in the Affordable Care Act. This compromise meant that people who have insurance through their employer or Medicare, are not eligible to purchase insurance through the exchange marketplaces.  This also means, these folks are not eligible for subsidies or cost sharing, which has been frustrating for people who work in low paying jobs, with barely adequate insurance. Only those who do not have any insurance and small businesses can purchase their insurance in the exchanges.  The small business exchange will not be ready for exploring and sign-up until November.
Although small businesses under 50 employees will not be penalized if they do not provide insurance for full time employees (30 or more hours a week), these small businesses, with under 50 employees, can offer insurance to their employees through the SHOP Marketplace designed specifically for small businesses with less than 50 employees (  There are small business tax credits worth up to 50% of the premiums paid available to these small businesses when they do offer insurance to their employees.  Some employers have stated that the tax incentives have made it possible for them to hire more employees.
When you go to to shop for and purchase your individual/family insurance, you will see a lot of different terms that sometimes get confusing.  Below, are the definitions of many terms that will make understanding the policies that you are considering purchasing easier and guarantee you ultimately get the coverage and the premium you feel most comfortable paying.
  • Tax Credit: Tax Credits are a subsidy provided by the government for lower income individuals and families that offset the cost of the monthly premium.  Even though this is a “credit” on your income taxes, it can be taken up front and directly applied to your monthly premiums.  You select that you want to apply the Tax Credit to your premiums and the government will pay that portion to your insurance company towards your premium and you will owe the balance.  This subsidy can be applied to any level policy (Bronze-Platinum) It is important to remember that if you under estimate your 2014 income, you will be liable for any over payment on your 2015 tax return.
  • Cost Sharing: Cost sharing is also a subsidy, but this subsidy is only available on SILVER POLICIES.  Lower income people applying for Silver Plans will see their Deductibles and Co-Pays reduced by a Cost Sharing subsidy.  So, although the policies have a standard deductible and co-pay, this subsidy reduces the out of pocket costs for the individuals.  For example, instead of the standard $2000 deductible and $45 co-pay found in a Silver policy, based on the purchaser’s income and where they live, their deductible might be lowered to $500 and the co-pay to $25.  It is important to remember that if you under estimate your 2014 income, you will be liable for any over payment on your 2015 tax return.
  • Co-Pay:     There are multiple Co-Pays in the policies, depending on the type of service.  Each one is a different flat, pre-defined amount that the patient pays for that service. The services and Co-Pays without cost sharing subsidies in the Silver policy are exhibited below:
    • Preventative Service                                       $ 0
    • Primary Care Doctor’s Office Visit                     $45
    • Specialist Doctor’s Office Visit                          $65
    • Generic Prescription                                        $19
    • Brand Prescription                                          $50 after $500 Rx deductible
    • Lab Testing                                                    $45
    • X-Ray                                                            $65
    • Maternity                                                       $30% after deductible
    • Out-patient surgery                                         $30% after deductible
    • Hospital Stay                                                  $30% after deductible (up to 5 days)
    • ER Visit                                                          $250 after deductible
    • Urgent Care                                                    $90
It should be noted that prior to completing the application for health insurance through the exchange, you can review the available plans.  These plans will not show any cost sharing subsidies for which you may be eligible.  Do not panic or assume you will not be eligible for cost sharing.  You must go through the entire process of signing up and verifying your income and identity to be shown what cost sharing subsidies for which you may be eligible.  You will also have to sign an attestation statement indicating you have stated your potential income correctly and understand that you will have to pay back any subsidy over-payment.
  • Deductible:   Some services, such as Maternity, out-patient surgery, in-patient hospital stay and ER visits require a Deductible be met by the patient before the insurance starts paying anything.  Note above, that this is not the case for Doctor’s visits, prescriptions, lab tests or radiology services.  All of the co-pays for those services are applied to the deductible.  The Silver plan has a $2000 deductible with no cost sharing applied. Note that Brand name prescriptions have their own separate deductible in the plan.
  • Coinsurance:  Unlike the flat Co-pay which is a single flat amount per service, a Coinsurance is a percentage of the approved fee, usually assessed after the deductible has been met.  As you can see above, the Deductible and the Coinsurance are tied together.  So, Maternity, Out-patient surgery, and inpatient hospital stays are all paid at 70% of the negotiated fee schedule once the patient meets the deductible on the silver plan.  This means that the patient pays the amount of the deductible (in the case of a Silver policy, before any Cost sharing, this is $2000).  Then the patient pays a 30% coinsurance of the fee schedule for these services.
  • Out of Pocket Max: Out of pocket maximums are often confused by those purchasing insurance as a deductible and assume this is an added burden or cost.  But this is actually an added benefit of the plan.  Once the patient has spent the out of pocket max in Co-Pays, Coinsurance and Deductibles, the insurance starts covering everything at 100%.  So, for example, the Silver plan has an Out of Pocket Max of $6,350 for an individual and $12,700 for a family without the application of cost sharing.  This means that once the patient has expended $6,300 out of their own pocket in Co-Pays, Coinsurance and Deductibles, the insurance will start to pay for every service in full (at 100%).  Once a family has paid $12,800 over all the members in the family out of their pocket in Co-Pays, Coinsurance and Deductibles, the insurance will start paying in full, at 100% for all the members in the family.
Hopefully, this has given you a better understanding of the unfamiliar terms in your health insurance policy.  It is important to understand each of these terms and how they affect you.  Remember, all of the figures included in this blog are before any subsidies are determined, because the subsidies are personally customized just for you.
Make sure you follow our blog as the next one published will be a description of the four plans, plus an overview of the step by step process on the exchange to shop for, select and purchase your health insurance policy at
About the Authors: By: Barbara J. Cobuzzi, MBA, CPC, CPC-H, CPC-P, CPC-I, CENTC, CPCO and Lynne Smith, MSSW. Barbara is an industrial engineer with an MBA. She worked in the pharmaceutical industry for many years before moving into the healthcare industry where she had a company where she provided top quality coding, compliance and revenue cycle management services for physicians. She has since moved into full time consulting for physicians. Barbara is a nationally known expert known for her education, consulting and expert witness services. Lynne has dedicated her career to helping others. She has experience as a social worker in a rural county, an administrator in a large hospital network and as a College Professor. She uses the skills she developed over the years as an advocate in a variety of areas including her most recent venture serving as a Healthcare Advocate. Together, Lynne and Barbara own the ACA Healthcare Advocates consulting firm and are available to individuals, families and businesses to help them meet the requirements of the Affordable Care Act in order to meet the specific needs of the client while optimizing the fiscal considerations.  Please direct your questions and/or inquiries to

Wednesday, October 16, 2013

Being United ~ Eric Smith

There are two words that will forever haunt me from this latest political crisis in Washington and those two words are what if? What if we Democrats had been this united when we went up against Richard Nixon in 1968 and 1972? What if we Democrats had been this united when we went up against Ronald Reagan and George Herbert Walker Bush in 1980, 1984, and 1988? 

What if we Democrats had been this united in the Congressional midterms in 1994 and 2010? What if we Democrats had been this united when we went up against George W. Bush in 2000 and 2004, and what if we Democrats had been this united in the January 2010 Massachusetts senatorial race? What if? What if? What if?

If the lessons of these past two weeks have taught us nothing else, it is that we Democrats have not lost as we have for the past forty five years due to a dearth of good ideas. We have lost due to our lack of a backbone. We have lost because we lacked the courage to stand up and fight for our convictions. We have lost because we have allowed ourselves to be bullied, and we have lost because we showed the fear of cowardice in the face of zealotry. 

In short we have lost because we have not been united, because we have not recognized our strength, and the power we have to make this a more just nation and mold a better world. We have lost because we have not been true to ourselves. 

So let that be our lesson; that united we stand, divided we fall, and that whenever we fall, whenever we falter, so too does America.

Monday, October 14, 2013

Hate Is Hate ~ Eric Smith

Every person of color who is anti gay needs to understand that their homophobic intolerance is the moral equivalent of the Confederate flag as it relates to people of color for at the heart of both is a blanket condemnation of people not because of what they've done but because of who they are and over that which they have no control. The same Bible used by those who are anti gay to say that homosexuality is immoral and runs counter to the Will & the Word of the Almighty is the same Bible that was used to justify the enslavement of people of color and to say that we are less than human and considered immoral & dirty in the eyes of the Almighty.

There is no separating of the two. Hate is hate. Intolerance is intolerance and as such racism, sexism, and homophobia are all cut from the same cloth of bigotry, intolerance, and hatred. One cannot say that they are not one and be any of the other two for if you are one of them you are all of them. If you are a racist you are no different than a person who is sexist and homophobic. If you are a sexist you are no different than someone who is racist & is homophobic, and if you are homophobic then you are no different than someone who is racist or sexist.

You are either none of these things or you are all of them for each is built upon the same foundation of intolerance & built of the exact same stuff; only the outward appearance of each edifice is different. In every other respect they are identical.

So if you are a person of color who is anti gay or sexist, keep your objections to the Confederate flag & to racism to yourself for you have forfeited your right to proclaim them to be objectionable. If you are a woman who is racist & homophobic, then don't complain about your potential loss of your reproductive rights and your inability to earn equal pay for equal work for if as a woman you are racist & homophobic you have forfeited your right to complain about the ill treatment you receive because you are a woman, and if you as a gay person are racist & sexist, then do not complain about those who would deny you the right to marry the person of your choice because you are gay because by being a racist or a sexist you regard those of a different race & gender as not being fully human, and as such you lose your right to complain about those who treat you as being less than a full human being because you are gay.

What it all comes down to is this; our right to expect to be treated justly is predicated on our willingness to do justice by others. It is grounded on the simple rule that if we are to expect just treatment from others that we must first be willing to treat others as we ourselves wish to be treated; to either practice what we preach or stop preaching what we don't practice. It is all as simple as that.

Monday, October 7, 2013

The Type Of Nation We May Yet Become ~ Eric Smith

Let's cut to the chase and that is what Speaker John Boehner and his Tea Party Hatriots are doing in regards to shutting down the Federal Government and threatening the full faith and credit of this country has little, if any, to do with differences in policy and everything to do with a hatred of the color of the skin of the President of the United States. In Speaker John Boehner's eyes and the eyes of his fellow haters of the GOP and the Far Right, the sight of a person of color occupying the presidency is an abomination of the highest order. Just as the exploits of Jesse Owens at the 1936 Berlin Olympics and the magnificent play of Jackie Robinson on a Major League Baseball diamond in 1947 did, the presidency of Barack Hussein Obama turns turns all notions of white supremacy and a master race on its ear.

Every action that Speaker John Boehner is taking right now and every utterance he makes at this point is saying in effect that "the American people do not want a black man calling the shots." That's it in a nutshell for what else about President Obama besides the color of his skin can any reasonable or sane person find objectionable? This man, the product of a mixed race marriage and growing up without his father managed to put himself through Columbia University and secured a law degree from Harvard University while becoming the first African American president of the Harvard Law Review. Rather than seek to enrich himself after acquiring his education he chose instead to help the least fortunate among us by serving as a community organizer.

He later taught law itself and married a magnificent woman who was an outstanding lawyer in her own right and he went on to be a faithful husband to his wife and a wonderful father to his two little girls. No shadow of personal scandal has come close to touching this man and since assuming the presidency he has conducted himself in a cool, calm, and compassionate manner that has brought credit to the presidency and the United States itself. 

President Obama is the American Dream made real and so it is not surprising that his rise has earned the enmity of those to whom America's promise of full equality and equal opportunity for all are nothing more than sweet sounding soundbites to be uttered whenever convenient. For people like Speaker John Boehner may speak of their belief in freedom for all but as proven by their thoughts, words, and deeds what they really believe in is freedom for the few. What they really believe in is an America where the poor and the middle class cater to the needs and whims of the privileged and the rich; an America where white is always right, and white males should always reign supreme.

President Obama strips these Right Winger's feelings of entitlement arising out of their white skin and male gender like an emperor is stripped of his clothes, revealing their naked bigotry and their intellectually puniness to the world. That, along with the color of his skin, is why they so hate him because by merely existing and holding his high office, President Obama exposes the lie that is their lives and casts a harsh light on the vanity of their false pride and phony distinctions. 

This is why those of us who really believe in the American Dream, and so celebrate this country's greatness and promise, honors this president and holds him in that high esteem that through his life and living example he's come to so richly deserve. For in the end when we honor the best among us we celebrate the best within ourselves forever glorifying the kind of people we are and the type of nation we may yet become.