People of low income africanamericans, hispanics are signing up with higher rates. Women are getting higher insurance rates than men. People in rural areas are enrolling with higher rates. Who are the people who did not have insurance before, who are the ones who were shut out before. Is also shows in large part the power of the medicaid elf pangs. Some states did not expand. Were saying theres a huge disparity between the states expanded and those that did not. If you are low income person in a state like minnesota, and you are likely to get insurance. If you are a low income person in a state like florida, your options are much more limited. Host in the piece you did, you break it down by race as well. 26 drops down to 16 . You can see, more whites or asians with Health Insurance. That is going down as well. Almost every group saw reductions in the rate of insurance. If you didnt have insurance there were other options available. Certainly, the groups that were most disadvantaged fall the most substantial gains and are starting to catch up. Host will go to cornelia. Caller hi, everybody. Basically, i believe that our entire medical system in america is broken. Obamacare is not helping. If it is making it worse. We need Health Savings plans ffrom the bottom up. Our pharmaceutical companies are in cahoots with fda. Talk about the militaryIndustrial Complex. We have a pharmaceutical Industrial Complex that is running our medical system in america. Guest the Pharmaceutical Company if you look at we have the biggest profit margin. To go to the broader issue there are a lot of people who are still unhappy with the functioning of the healthcare system. The Affordable Care act was never intended to fix everything with the healthcare system. It was intended to make a start. Mostly focused on coverage. Secondary focus on cost. Starting to give a push to a system that was changing he was anyway. There are still people who want to go far off in one direction, far off in another direction. If you look at the difficulty the congress has just passing the Affordable Care act it is difficult to imagine anything that would more drastically change the system. The system is on a path to reshaping itself. Its hard to know whether that is going to be better or worse or how much people will like it. Host this is a story that was tweeted out theres an obamacare rule saying that the government could reenroll you and obamacare, choosing your plan, dr. And coverage. Guest this shows the challenges that people have in implementing this law. Say you sign up for a plan in 2014. You take no action. You dont shop around or update your information. The government will reenroll you automatically in that plan. Obviously, you can go in and cancel. The goal is to keep people continuously insured. What we found the fear is that the plans that were really popular the first year are experiencing the highest increases in premiums. What the government has proposed is giving people a choice when he signed the first time you can say in advance, if i do nothing, i stay in the same plan, no matter how expensive it gets. Or, consumers can say, if i do nothing, i would rather stay in the cheapest plan. For people who pick that choice, they may end up with a different insurance play. It may not could have the doctors or drugs they had before. It would be an all matic process. I think is important to note that even if the government goes through with this people have a choice as to what default option exists. If youre the kind of person that wants to stay in the same plan, you wouldnt choose that. Also, everyone every year has option to go in during the open Enrollment Period and shop around. This would only apply to people who take no action. All evidence to suggest that people are better off going back and doing the hard work to shop for the better plan. The premiums are changing and other parts of their plans are changing too. People need to see what is best for them. Guest people can still change up until february 15. They will get a letter saying they are reenrolled in a plan. Or the plan does not exist anymore, you have been reenrolled in a similar plan to what you have. No matter why, you should go back and make sure. Maybe the premium is the same, but how much you pay for your drugs, or your doctor, that may have changed. You can always go back and look. You may want to go in and change. No matter what, it is good to go in and look at your plan. If youre in it now and youve been reenrolled, you have until february 15. Guest its important to say the proposal to change the switching mechanism, it is not final. It is just a suggestion that the government has put out. It may or may not become final. Host bob from virginia. Caller i hope santa claus was very good to you ladies. Basically i want your opinion on my opinion. I called in several months ago and made the same point. It seems that in this country we forgotten to be what its like to be a society the gentleman who called an earlier was talking about paying for Reconstructive Surgery individually, i cant build a road or a watcher sewage system and that sort of thing individually but as a society we can. I do not have any children, by do not mind paying my taxes towards the education of other peoples children. It just seems like we have forgotten what its like to be a society. I would like your opinion on that. Guest this is the whole concept of insurance. You think about Fire Insurance or car insurance, bad things only happen to a few people. If everybody pays in a little bit, you can afford to pay for the big amount for the bad things that happens. For health care, one of the problems is Everybody Needs some. That is why it is so expensive. There are very few people who never go to the doctor. Eventually everybody will need health care and health care is expensive. That has become the problem with Health Insurance. That was certainly the idea one of the big problems of for the Affordable Care act, was only people outside the system, there were not enough people inside the system to spread the cost. And, the people inside the system were paying for the people outside a system. Why not bring more people inside the system and have them pay something. Spread the insurance pool. That is basically the aca in a nutshell. Host what has happened to the cost of healthcare in this country since the aca. Guest this is actually a really interesting story. One of the goals of the Affordable Care act was to lower the cost of health care or slow down the increases. Anyone who pays the Health Insurance premium sees that it goes up every year. Its been a problem for the economy. The federal government pays for medicare and that gets more and more expensive. It is a real head when the premium or deductible goes up every year. A big goal of the law is to slow down that growth in health care costs. Wonderfully, costs have been going down since 2002. We now have a lot of years of data that show we are in an unprecedented slowdown in health care expenses. It is hard to give the Affordable Care act too much credit for that. It is possible that is making some contribution around the edges, i think it is more coincidence. There are a lot of other factors that explain what were seeing right now. I think there is a hope among people who wrote the law and those support it that there are things in the law that can help sustain that trend. It is a really important trend. The country really needs to get a handle on healthcare costs. Host lets talk about politics a bit. Here is a tweet from a republican in tennessee saying we will use every tool in the toolbox to end this destructive program. She has a link to the hills website. Thats the budget reconciliation. Whats in store when they return in january . Guest budget reconciliation is not obscure. Really they do it most years. Arcane maybe obscure, no. It is a piece of the budget process, the way budget process works, each house of Congress Passes a budget resolution. They get together. They come up with one resolution between the two houses and one of the things that budget resolution has many years, but not all years are whats call reconciliation instructions that require the tax writing committees, any committees that control mandatory spending to reconcile that spending to the budget. It has been used in previous years to do a lot of things that have to do with healthcare. Obviously with the tax code, those are big programs. One of the nice things in the senate is that it cannot be filibustered, and you only need 51 votes to get it. Host is it a mandate . Does did go anywhere if you put it in the reconciliation . Guest reconciliation is not a must pass bill in the way the spending bills dont get passed, the government gets shut down. If the resolution bill does not get passed, the government does not shut down. They passed two reconciliation bills in 1987, three months apart. So sometimes it can take them a long time to kind of get their act together. Its just a way to change the rules for mandatory spending program. But it does the big important thing is that you dont need a majority in the senate and it cant be filibustered. They are saying that since the Affordable Care act was passed with the reconciliation process, they can on passive with the same process. There are two problems with that. The a. C. A. Wasnt passed in the reconciliation process. The senate lost its 60th vote. When they passed the built Christmas Eve 1kwr69, they had 60 votes and senator scott brown was elected in massachusetts, they had 59. They basically used the reconciliation bill as a way to do a congress report. There are many things in the reconciliation bill that were not in the main law. The reconciliation bill must be budget related. I dont think if they wanted to. They could cause a lot of problems for the law but they couldnt repeal the law. The other thing is, if they can get to the house and the senate,the president would veto anything that would really undo the health law. The republicans may have some items they want to tinker around with, but a full scale assault seems unlikely. Host republican of georgia was our guest on newsmaker recently, we asked him about this process. You can watch the full thing on our website cspan. Org. He really wants the conference to decide. He said that the lawmakers will be getting together in their annual retreat and he will be listening to his colleagues before deciding. Host i think with the republicans want to do with the Affordable Care act is they have this big dilemma, if they take apart the most controversial and more unpopular things, that could make the law more popular. They do not want to do that. The things they could do is eliminating the medical device tax. There is democrat support for it. They do not want to maybe end up having a law that is more palatable or fixed. While president obama is in office, they cant repeal the whole thing. They are caught in a rock between a rock and a hard place. Host miles go ahead. Caller i am a republican, but since i have been watching obama in office our economy was on the brink of going off a cliff and now all of a sudden our economy is doing better and there are more people that are getting health coverage. Were a party of families, more or less, and values. What has happened to our society when we do not even want to take care of the poor, the kids, the families. Theres something wrong here. Host margot sangerkatz, part of the spending we have seen recently is triggered by people spending on healthcare. Guest healthcare is a really big part of our economy. Its pat of the reason why this law is so controversial. It is so huge. It is not a small thing on the margin. It is a lot of dollars that people spend, the government spends. It really matters for the Overall Health of the economy. Host congressman tweeting this out a new poll shows that the number of americans who say healthcare is personally unaffordable is skyrocketing under obamacare. Guest that is not true. There was a recent gallup poll and they asked people these questions is the amount of money you are spending affordable for healthcare. They basically, theres no change over the past few years. There are people who find it is unaffordable, but is not changing. Host jerry from chicago. Caller listen, i want to comment on one of the previous callers. I have medicare but not a supplement. I got an advantage plus plans through humana. I guess it depends on the state you are in. 8 for not enough, a minimum drug coverage to medicate. I just want to know, do not go for medicare b. You never need that. Secondly i am also a tax visor with a reputable tax firm. Last year we informed all the clients about the mandate. Next week, i will be in office calling all my clients to remind them to bring their 1095 form. They can determine whether you got to get the insurance. Im glad you ladies are out there to exthis to the callers in the country. It is very important. Thirdly, for a country like ours, it is hard it is not a free enterprise. I think there is something we can do. I wish people wouldnt be so hard on the president. Everybody is not a deadbeat in this country. I think there is something we can do. Host we will go to joe joan in maryland. Caller my husband and i went to our annual exam in december. I was expecting to get blood work the kind of exam that president bush had, they do blood work, they found he had a narrow artery, they put a stint in and now he is fine. We were given the sheet of paper to our medicare patients. The annual wellness visit is not the same as what many referred to as a yearly physical exam. Medicare does not cover the yearly physical exam. Medicare is specific as to whether it includes by the way, this is john hopkins physicians. What is included . Talking about your medical missile and risk factors with your dar. How do i know if youre not testing . Measuring your weight, height, and make a plan to keep you healthy based on what . So this was like to me a joke. Medicare will go bust according to the statistics ive read in 2026. Will we be put into the exchanges . What is the plan . Theres also a bipartisan agreement that the independent payment Advisory Board which is a ragsing plan. Nonphysicians will be making plans as to what you can have and what you cant have. Guest start with the last one. It does not exist yet, it is very controversial. Mostly does not exist because it was created to recommend ways to reduce medicare spending if it exceeds a certain threshold. We were talking how health care is growing at a historically low rate. Medicare spending is leading that historically low growth. Nothing is on the horizon that would trigger anything from that. One of the things it specifically says is that it may not recommend any rationing of care. They have to come up with other methods to finding ways to reduce medicare spending. There is a standoff over that. At the moment, does not matter because it is not being triggered. If i could go back a couple calls and talk of Medicare Advantage again. Something the caller was saying is something people should note. If you want to go into a Medicare Advantage plan bbasically a private plan that takes over for medicare. You do have to continue to pay your Medicare Part b premium because thats what basically pays for that private plan. I misspoke there is a guaranteed open enrollment, but only for certain plans. There may be some plans, if you drop your supplement, go into Medicare Advantage go back to Medicare Advantage, want a supplement, you may not be able to get back the one that you had. Host david from glench cove, new york. Caller i was just listening to the last caller. Are you saying that if you have a preexisting condition, you cannot get a plan . Host i do not think we said that. Guest the law says that if you go to the marketplace and you want to get Health Insurance your price will only be based on your age, where you live and what the income is. In the old days, Health Insurance could say, sorry, you have diabetes, no Health Insurance for you. Or, you could have it, but it would be paying two or three times as much as a healthy person, those days are over. Guest i think were talking specifically about the medigap plan. Host well go to kerry in south carolina, a democratic caller. Caller my husband had Health Insurance, he lost it. The employer couldnt afford it anymore. We said, okay. My husband is diabetic. We cannot afford that Affordable Care act because we worked a lot. I work over 60 hours per week. My husband works 50. We have four children. Three in college and one in high school. Because of that, on paper our Health Insurance would be almost 1500, only including two children. That is double my mortgage. We will take the penalty. We have to take the penalty. It is ridiculous. The fact that now my husband has no Health Insurance, we had blue cross blue shield. He is off his diabetes medicines because we cannot afford them. Believe it or not, he is doing better than when he was on medication. Guest im sorry for your situation. I assume that you have gone and tried to get someone to walk through it with you. Host where would she go to do that . Do you call . Guest on the website there is a place that says if you want to find local health, there are people who can walk through the options with you. Sometimes these people are trained, and they are better at parsing out where you might do the best. You have one Family Member who has a preexisting condition something expensive and you want to make sure you get a doctor or a particular drug and sort of work all that out. Host we have a couple more minutes here with our guests. Guest i think that highlights a group of people who are not very benefited by this law peoples incomes are high enough that they are not eligible for any ki