One who intends to leave others better off for his having existed.


Dr. Andrew Brod, my deadline for this article is Monday morning at 10am.

I believe you are not telling the truth. If you would like to provide proof that you are not, please do so, otherwise the following should be published in Yes Weekly next Wednesday;

"On March 21, 2014, the Obama administration's stated "the Affordable Care Act reduces the deficit, saving over $200 billion over 10 years".

In online debates at Council Member Tony Wilkins' Facebook page and Ed Cone's blog before and after the council debate, UNCG Senior Research Fellow Dr. Andrew Brod stated "It's silly to say that the ACA is "mathematically unsustainable." The best math we have on this are projections by the CBO [Congressional Budget Office], indicate that the ACA is quite sustainable. The CBO projects that the ACA will (slightly) reduce the federal deficit” and "the ACA will reduce the federal deficit over time, precisely because "how we pay for it" has already been nailed down in the law."

Directly contradicting the Obama administration and Dr. Brod's assertions, Table B-1 of a February, 2014 report by the CBO entitled "Effects on the Deficit of the Insurance Coverage Provisions of the Affordable Care Act" says the Net Cost of Coverage Provisions to the federal government is projected to be $1.487 Trillion between 2015 and 2024."

"To help ensure sufficient access in Medicaid as enrollment increases, the health reform law requires states to raise their Medicaid fees to Medicare levels at least, for family physicians, internists, and pediatricians for many primary care services.

On average, Medicaid physician fees for primary care services will rise by 73% in 2013. In 2013, most states will have to increase their 2012 Medicaid fees to comply with the requirement to pay qualified physicians at least Medicare rates for ACA primary care services."

"The ACA took steps to align payments to Medicare Advantage plans with the cost of traditional Medicare."

"The estimated SGR to go into effect on March 1, 2010 was -8.8%, and the conversion factor for the physician fee schedule was -21.3%.[2]

On March 3, 2010, Congress delayed the enforcement of the conversion factor until April 1, 2010 with the passage of the Temporary Extension Act of 2010.[5][6]

On April 15, 2010, Congress enacted the Continuing Extension Act of 2010 to again delay the implementation and extended the 2009 rate to June 1, 2010.[7]

On June 25, 2010, President Obama signed the Preservation of Access to Care for Medicare Beneficiaries and Pension Relief Act of 2010 that not only delayed implementation of the conversion factor until December 1, 2010 but also increased reimbursements by 2.2%.[8]

The 2.2% increase was retroactive to June 1, 2010, and expired on November 30, 2010.

On December 16, 2010, President Obama signed the Medicare and Medicaid Extenders Act of 2010 into law, delaying the implementation of the SGR until January 1, 2012.[9] This prevented a 25% decrease in Medicare reimbursements from taking effect on January 1, 2011.[9]

When President Obama signed the Middle Class Tax Relief and Job Creation Act of 2012 on February 22, 2012, the implementation of the conversion factor was again delayed until January 1, 2013, when the cut was estimated to be 27.4%.[10][11][12]

Congress passed the American Taxpayer Relief Act of 2012 on January 1, 2013, which states in section 601 that the conversion factor for 2013 "shall be zero percent."[13] This delays the implementation of the conversion factor until January 1, 2014."

Twice a year—generally in January and August—CBO prepares baseline projections of federal revenues, outlays, and the surplus or deficit. Those projections are designed to show what would happen if current budgetary policies were continued as is—that is, they serve as a benchmark for assessing possible changes in policy. They are not forecasts of actual budget outcomes, since the Congress will undoubtedly enact legislation that will change revenues and outlays.

"In an earlier version of the House bill, Democrats included a measure to avoid scheduled cuts in doctors' payments under Medicare. They removed the measure when they couldn't get the numbers to add up, but they have continued to pass temporary delays of the cuts and have vowed to tackle the issue separately from the current health care bill. In the letter, CBO projects that if the so-called "doc fix" were added to the legislation, it would produce deficits of $59 billion from 2010 to 2019.

[This letter] is just simply acknowledging that CBO analysis can vary greatly based on the questions you ask them. And clearly, Democrats kept tweaking the language until they were able to get the CBO score they wanted."

"Because the ‘doc fix’ costs so much, it was removed from the calculation of the cost of the health reform bill to make it more likely that the health reform bill will pass.

...Since Medicare is the largest payer, it is likely that other insurers will follow suit and cut physician fees.

Vineet Arora is an internal medicine physician, MARCH 17, 2010

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