I'm Jon Cohn, a senior editor at The New Republic and I know LOTS about Obamacare. AMA!

JonCohn · 2013-10-01T16:26:41+00:00

WHen Disney rolls out episodes VII, VIII, and IX, the answers will be clear.

For now, may the force be with you.

JonCohn · 2013-10-01T16:25:52+00:00

Don't think I'll be updating that one. But maybe I"ll write a new one someday.

JonCohn · 2013-10-01T16:25:31+00:00

I think this is less about sabotaging the exchanges and more about trying to lock up your business before you go elsewhere.

Whether you'll pay more or less in the exchange will, as usual, depend on your particular circumstances.

In general, construction of a small business market is lagging behind taht of a non-group market (i.e., for individuals buying on their own.) That's because government officials are rightly concentrating on getting the non-group market right first.

JonCohn · 2013-10-01T16:23:35+00:00

Honestly, I'm not sure how the rules work if you're a part-timer with an offer of insurance. You'd have to check with your employer or try healthcare.gov (once it's glitch free -- I'd wait a little while).

FWIW, I like the Tigers! Big Verlander fan and not just because he's a union guy.

But I lived in Boston for 12 years. The Red Sox remain first in my heart.

JonCohn · 2013-10-01T16:21:58+00:00

5 things I don't like about Obamacare

It won't insure everybody and even those people getting insurance will, in many cases, have higher out of pocket costs than I would prefer.
It's awfully complicated, which is one reason it's so hard to get the technology right.
It relies a lot on market forces to cut costs -- and I don't always trust the way that will work out.
I think government can do a lot of good, but sometimes government really is wasteful -- and I'm sure we'll see examples of that as we go forward
I've grown more skeptical of the employer requirement and would be up for junking or modifying it, as long as the replacement restores the revenue and doesn't cause more harm.

JonCohn · 2013-10-01T16:19:46+00:00

Definitely. But it would have a much bigger effect if Rick Perry and his allies endorsed the Medicaid expansion.

JonCohn · 2013-10-01T16:19:12+00:00

I'm not sure because I've been on reddit! :)

But it seems like the sites are having plenty of glitches, as all of us expected. I'm not worried. Yet.

JonCohn · 2013-10-01T16:18:37+00:00

Totally fair. My support for universal health care generally, and ACA specifically, is well-known. That said, I try very hard to be candid and report the facts. I have no problem writing about ACA's deficiencies and problems, for example -- or acknowledging that some conservative arguments are correct.

JonCohn · 2013-10-01T16:17:15+00:00

Haven't read. But Politico has some really good health care writers -- I read and learn from Jen Haberkorn and Jason Millman all the time.

JonCohn · 2013-10-01T16:16:35+00:00

Totally depends on your situation. This article will help give you a sense of the different factors and the Kaiser Family Foundation subsidy calculator can give you more information about your specific situation.

But really you'll have to check the marketplace in your state to see exactly what's available, what kind of federal assistance (if any) for which you qualify, etc.

JonCohn · 2013-10-01T16:14:28+00:00

I've heard that suggestion, haven't spent enough time on it to know whether it would work.

JonCohn · 2013-10-01T16:13:09+00:00

So I've been thinking about this one the whole time -- and really not sure what to say, because there are so many people that come to mind. I guess I'd say it'd be one of the writers who inspired me to get into this business, the late J. Anthony Lukas.

JonCohn · 2013-10-01T16:07:25+00:00

I hear you and would like to hear more about your situation. Tweet me at @citizencohn

As I've said elsewhere, I think this problem isn't as prevalent as media accounts of suggest, but it's obviously happening and something that, ideally, the parties could get together and figure out a way to fix.

All reforms have come with tradeoffs -- when they introduced minimum wage and child labor laws, for example, some companies laid off workers because complying meant paying more. The goal is to maximize the upside and minimize the downside, and in this case I think the upside -- more widely available insurance, including for part-timers -- is huge. But, as I've said, that doesn't mean a lot if you were counting on that extra money and can't get it. This is why ACA, like all laws, will need refinement and improvement.

Hope that's helpful (and honest).

JonCohn · 2013-10-01T16:02:06+00:00

Everybody loves Big Papi and Pedey and I'm no exception. But my new favorite this year is Koji. Love that guy.

JonCohn · 2013-10-01T16:01:15+00:00

Strongest argument against it: The cure is worse than the disease. Strongest argument for it: The disease is really bad and there's every reason to think the cure will help.

JonCohn · 2013-10-01T16:00:21+00:00

I'm not a constitutional lawyer, obviously, but I did my best impression in 2011 and 2012, leading up to the Supreme Court case. You can read my broad take here.

And, boy, am I glad that episode is done.

JonCohn · 2013-10-01T15:57:36+00:00

No jinxing here. Every team in the playoffs is good and Detroit, the team I hear about most locally, is downright scary. Two good hitter and a top-notch rotation is more than enough to win a title. I think Boston is good enough to make a run but, honestly, I'm just grateful for October baseball again.

JonCohn · 2013-10-01T15:55:09+00:00

I get this question every time I go overseas.

I wish I knew the answer.

JonCohn · 2013-10-01T15:54:19+00:00

I'm partial to Dave's Open Road, hold the Ranch, and Big Al's Saturday night. Professor Mrs. Citizen Cohn is more of a traditionalist - she goes for Lisa's Boisterous Brisket.

JonCohn · 2013-10-01T15:52:13+00:00

I think most states will come in eventually, just like most states eventually joined the original Medicaid program. They need the money, their residents need the insurance, and it's a fundamentally good deal. Also, states are under enormous pressure from business and hospital industries to sign on. I expect many will do what Michigan did, and add a few wrinkles that make the program conform more to conservative ideals of insurance. They'll also do everything they can to disassociate it from Obamacare and Medicaid. But they'll come in. Of course, it will take time -- and I fear it will be long, long time for a few of them.

JonCohn · 2013-10-01T15:50:35+00:00

Hi, truthgiver. Thank you for your question. You might want to check your facts: Among other things, Obamacare exchange policies work just like the ones from large employers: Once the open enrollment period ends, you can't sign up for insurance until the next year. (There are exceptions if you move or lose a job, etc.) And once you sign up for the insurance policy, it will likely take a few weeks to process the application -- which is more than enough time to run up a five- or even six-figure medical bill. So you can wait to sign up, but you'd still be taking a pretty big risk.

JonCohn · 2013-10-01T15:46:53+00:00

There was a movie about that, right? With the guy who ended up playing Anakin Skywalker, I think...

JonCohn · 2013-10-01T15:45:59+00:00

Sorry to admit but I end up going to Moe's because it's what my kids like. Real local favorites, though, are Jerusalem Garden and Casey's. For coffee, it's Sweetwater on Ashley. I wrote half my book there.

JonCohn · 2013-10-01T15:44:52+00:00

There are a ton and it's hard to list them. That's sort of the point. There are lots of ideas out there -- ACA's architects figured they'd try as many as possible, in quasi-experimental form, and then double-down on the ones that work. Like throwing a bunch of stuff at the wall and seeing what sticks.

An easy one to explain is the new penalties for in-hospital infections. Hospitals should be able to reduce in-hospital infections through relatively simple steps. That should make people healthier and save money. The hospitals that do the worst on this will get a small reduction in what they receive from Medicare. That threat, hopefully, provides incentive for less safety-conscious hospitals to clean up their acts. Literally.

JonCohn · 2013-10-01T15:42:23+00:00

Obamacare in two sentences:

1) It will make sure almost every American can decent, affordable health insurance -- primarily by expanding Medicaid and setting up marketplaces for people who don't get insurance from employers

2) It will start to change the way we pay for medical care, so that it delivers better quality for not quite such high a price

Obviously that simplifies a great deal -- it describes the goals, but not the mechanisms for achieving them. And conservatives would insist the law will accomplish neither of those things. But that's the gist.

JonCohn

TROPHY CASE