Will say is they better straighten the law out before they ever introduced into the country, we would not have all of this trauma or the political moves to do waivers. On and on a ghost. It is politically motivated and it is ridiculous. There is no health care and available, it is just Health Insurance. Guest the law had an infamously strange route to passage where only democrats supported in congress and they had to do a little maneuver at the end to dodge the republican senator scott brown, who joined the senate in january before the law ever became final. The criticism is fair that it was a work in progress when it became law and they have had to do a lot of creative regulation, lets say, to get the law off the ground. Host lets go to west virginia. Democrats. Caller good morning. I would like to go off the subject a little bit. This has to do with, are you aware the Medicare SupplementInsurance Program has preexisting conditions in it, and it has been there for years . It has been underwriting since the Affordable Care act did away with preexisting conditions, and it is still in medicare and nobody is bringing that up or doing anything to fix that problem . Are you aware of that . Guest the caller is talking about medigap plans, which cover benefits under the traditional Medicare Program, which doesnt pay for i am not super familiar with the program, but i do not think it is medically underwritten. I have gotten this call on cspan before from folks concerned about that. It is worth noting the president is looking to make real changes to require people to pay more for it if they get coverage, or medigap covers all of your costs outside the traditional program. For some want to ask you more about the announcement from last week. What does it mean for states, are we likely to see them opening more exchanges or dropping them . Guest another change they made in the lawn last week was they will have till the end of june to decide whether they want to create their insurance change. Hours better. Previously, the deadline was the end of january. June 30th of this year, they want to take over the Health Insurance exchange in november. They would have to be doing work now to make that happen. I do not know of any states planning to join the Exchange System or takeover the exchange themselves at this point. Host on our republicans line, dixon, illinois. Caller i had a question. It seems to me if you cannot afford affordable Health Insurance, then most likely you will go back to medicare because of the subsidies and it might end up being more expensive than if you took to the Affordable Act. There are a lot of people who cannot afford the Affordable Act insurance policy. In general, it will just go back to medicare anyway. I have a question about that. Thank you for taking my call. Guest you might be talking about medicaid. That is being expanded in about 26 states now to cover folks earning higher incomes just above the poverty line. It is a there is a clear demarcation in the law between ellsbury for medicaid and for the Affordable Care act insurance exchanges. If you are not eligible for medicaid, you are eligible for insurance exchanges. If you are eligible for the insurance exchanges, youre not eligible for medicaid. It is not easy to fall back on medicaid if you do not fall back on if or book cap. Host next up in houston, texas, on the democrats line. Caller i was going to ask our guest, do you think the word will be reintroduced again . The only thing that has come true about the whole debate is that word has been eliminated. I am sure to the delight of big business republicans. I do not know why democrats have allowed this to happen. Guest the caller is talking about reimportation for Prescription Drugs from countries like canada. It was never put on paper, but there has always been speculation that as part of the Affordable Care act, the Obama Administration may have promised the drug industry that reimportation would have not be brought up in a serious way by the administration and we have not seen it in his budget for the last four years as far as i know. It does not appear reimportation is anything anyone in congress is seriously considering right now. Host there is a march 31 signup deadline. How are things faring now . Guest they said in february they have for me 4 Million People signed up by late february. We will find out this week how many people have actually signed up by the end of february. They are still hoping to get 6 million by the end of march. It will probably get a couple more million through the course of the year as people change coverage, they lose their jobs and get divorced and have events in their life that require them to change coverage. They are hoping to have 6 million enrolled just in private plans by the end of march. Host how does the president s budget deal with the Affordable Care act . Guest there was not much in there posing to change the form will care act. Much of his budget probably sees word were toward policies. He wants to cut spending in those programs to scale back growing costs. Host diana is in kentucky and on the line for republicans. Caller thank you. I just wanted to share my experience here. My husbands employer sent a letter in october that explained to us because were turning 65 this year, our Prescription Drug plan with the Insurance Company is not creditable coverage. I had no idea what that meant. As a retired librarian, i have been do my homework. I checked social securitys website, the medicare website, medicaid and medicare website, i have called the Insurance Company, and the Human Resources person, and his employer, and i think i am getting there with answers, but i tell you i spent hours on this question and i what i think what i know right now is that you just cannot buy d on medicare. You just have to take the whole package. Now that we know his Prescription Drug coverage is noncreditable, we have to dump our beautiful plan with the employer and go on to medicare. We could stay on until he retired at 66, but we are not going to be able to do it. So, anyway, that one little thing will affect a lot of baby boomers who are employed, paying for their own Health Insurance, and this small requirement will have all of these baby boomers dumped into medicare whether they want to or not, and that is what i wanted to share with you. Thank you. Guest my parents were facing a similar situation a couple of years ago. I should point out that does not have anything to do with the Affordable Care act. Seniors have faced this issue for a long time. When i turn 65, whether to join medicare immediately or try to stay on their employer plan. It has never been smooth. The Affordable Care act does not make the Healthcare System any easier to understand, unfortunately. Host Kathleen Sibelius talked recently about how it would be fun the next year. Take a look at what she had to say and then lets get your take. If Congress Funds the president s budget, written to the targets agreed upon by senator murray and representative ryan, this would fully fund the ongoing implementation of the Affordable Care act. We start with that proposal and hope they will indeed fund it. A lot of the 1. 8 billion we have suggested is the appropriate target for implementation, is covered by user fees. 1. 2 of the 1. 8 billion is our projected user fee income for 2015. If Congress Fails to pass a budget, fails to implement the president s budget, then we will look at varying other sources of funding for the full implementation. Guest so the administration has never had much luck getting mom money from republicans ever since they took over the house to met the Affordable Care act. They have been asking for 1 billion or more every year since 2010 to help implement the law and congress has always refused to give it to them. The administration has blamed that by the way for some of the problems they had with the rollout in the fall. In this case, the ministration is asking for 1. 8 million next year starting in october, to enact year two of the insurance exchanges. They will not get that that they will have 1. 2 billion they will collect directly from insurers for fees for using insurance exchanges. Host alan s call froms from comes from cleveland, mississippi, on our independent line. Are you there . You on with alex wayne. Caller [indiscernible] cut out medicaid or medical health, come down here in the south mississippi. You know, the economy down your job wise, it is screwed up. Some folks need this kind of help down here in the south. So many folks come down here and see how the economy down here, they do not understand folks down here need that kind of help. I do not think it is too much of a problem. Guest mississippi is one of 24 states where the state or the governor has said they will not expand medicaid to cover more americans. You can blame that pretty squarely on your local state official there, although they say the Medicaid Expansion would simply cost the taxpayers too much money. That is where the blame for that lies. Without that expansion, the caller is right, it is very difficult to qualify for medicaid, especially if you are a childless adult, and in most states, they are ineligible without the expansion. Even with children, 12 to 14 of the poverty line. Host lets go to chicago, marianne on the democrats line. Caller i wanted him to explain to a lot of people lie insurance that canceled people were canceled. It is easy to say because of the Affordable Care act. Is it because they were going to cancel them anyway . I mean, you know, that guy calling and talking about 500, he probably dont even know 500 people. I go to the doctor and i asked my doctor, a real doctor want people to get help. They want them not to be sick. They love the people come in that are not sick. What about the people who do not have insurance and do not have health care . Who wants a sick country . What is wrong with these people . Thank you. Guest before the Affordable Care act began on january 1, the caller is right the individual Insurance Market, which is what were talking about these canceled plans, a pretty tricky market. In order to get coverage in the first place if you are buying insurance on your own, you generally had to be pretty healthy. If you had any sort of Health Condition like high blood pressure, an Insurance Company could either deny you coverage or charging more than your neighbor who is healthy. It was a pretty messy market to begin with and there was always a lot of turnover insurance. Some of the policies canceled wouldve been canceled anyway, just as part of the routine workings of the individual Insurance Market before the Affordable Care act. Some of them were canceled because they did not comply with some of the new expanded benefits required under the Affordable Care act or some of the requirements under the Affordable Care act that limit costsharing in the Insurance Plans. Host the next caller is in kentucky. John is on the line for democrats. Caller i would like you to comment, if you can, about the negative campaigning Health Insurance companies have had against the act. From my perspective, i am a firefighter and emergency medical technician in a large city. The way i see it, there is no more sick people them there were before. No more injured people. The difference is now, more of them have insurance or more of them are at least covered through medicaid now, whereas, in the past, they just called 911 every day and it was a greater expense for taxpayers and hospitals to pass on in terms of higher insurance premiums. Guest yes. If you are seeing more insurance people on your job, that is exactly the outcome the president hoped for when he passed the Affordable Care act. Right now, up from our seat in washington, we cannot really tell if the insurance expansions that are happening are all that broad. Hopefully, that is what is happening. I do not know about Insurance Companies advertising against the law. A lot of Insurance Companies have grudgingly embraced the law. Blue shield will cross especially our invested and doing a lot of advertising in favor of the law to try to get people to sign up. Host talking about the changes announced last week, how are they reacting to those . Guest theyre not real happy with them. Theyre told stu think they were not expected to do. The plans present something of a policy problem. Before exchanges opened, the insurance had proposed rates for their plans and they are not allowed to change those rates. Their rates had assumed all of these presumably young and generally Healthy People who are on these legacy Insurance Plans would have been forced to sign up for a new Affordable Care act plan instead. The plans would have liked to price their rates a little higher if they know the old plans would be extended. Host the next caller is in michigan. Michaels on our republicans line. Caller since you are an expert on the obamacare, number one, obama is taking money out of Medicare Advantage and number two, maybe you could tell our viewers how a law that has become law of the land, how obama can just change everything he wants without taking it to congress. Thank you. Guest the caller raises two good points. The law does depend on the financing for pretty big cuts to the Medicare Advantage program, a program in which private insurers provide benefits to elderly folks and medicare instead of those people staying on traditional Medicare Program. Before the law was passed there are Government Agencies here in washington who said the Medicare Advantage plans were overpaid compared to what the traditional Medicare Program costs. They were created by republicans in 2003 and democrats and the administration have for a long time said they wanted to scale back what the plans were paid to help address the budget deficit. So, you are right. The law did take money out of those plans. It is a difficult question to answer if what the president is doing is legal. There are lawyers that are not republicans or partisan who question whether the changes the president has made are within the bounds of what the president can do. It would be settled if someone were to sue the administration over what they have done and it would be difficult to get into court. Host deborah in ohio on our line for independents. Caller i have a comment. I have two adult grandchildren who are in their mid 20s. One is in college. The other one is still in college and the other is in the real world and both of them refuse to buy anything that has anything to do with the aca. I understand that is a big problem with the Affordable Care act. Young people being unwilling to buy insurance through the exchanges. And another the question i wanted to ask is, since this first kicked in in november or over the last several months, president obama has just changed whatever he wanted to change whenever he wants to change it, which the previous caller made a comment on that. I would like to know, and i am an independent does the president think that since the midterms are coming up that the American People are just blinded and dont realize that all of these recent changes are to strengthen the democrats who are running for reelection . Does president obama not understand we see through the smoke screen . I just wanted to hear your comment on that. Guest i cannot tell you what the president thinks. After getting bolder about how the politics is portrayed, the press release that announced these changes last week mentioned by name 12 or 13 democratic lawmakers and said these people have help the administration in devising these policies. This was a message aimed toward the 2014 elections. I think they are aware that people believe there is a political motive behind some of these changes. I think that motive is becoming more transparent. Host what are you hearing from some lawmakers as these changes come out . Guest landrieu was named. They are supportive. They want any sort of change they can get. That will buffer any criticism they get in the fall for voting for the Affordable Care act and being held responsible for the changes because of it. Host deborah is on the line for independents. Caller hello. I was calling to see his opinion on this going through. It is dependent on Healthy People and all. Do you think if they do not get the amount of people they need that this will be directed toward the singlepayer system . Guest hmm. That is an interesting question. The state of vermont is the only place that is contemplating a