Yeah. Im not sure how thats going to work out now. Ill be honest, my wife takes are of it all. It was quite a process to get into, i have to say. She was on the phone for many, many hours. Host brian, that cost you told us you paid, that covers you and your wife . Caller yes, yeah. And it has eye glasses and dental. Host thank you sir, thank you for sharing your experience. From the wall street journal this morning, consumers still confused ahead of insurance sign ups. The online insurance exchanges are set to go live again tomorrow when people will be able to buy new coverage taking effect on january 1. Insurance companies are required to send letters explaining changes to their customers plans before open enrollment starts. But some consumers say they havent gotten their letters yet and dont know whether they need to shop around for a new plan. Many consumers are unaware that the exchanges are reopening this weekend. A survey by consultants mckenzie and Company Conducted between november 6 and 10 found that 54 of uninsured respond yents and a quarter of those with existing individual plans didnt yet know about the new open Enrollment Period. Survey found 67 of those who have plans expected to reenroll, but only 23 of the uninsured said they would definitely sign up for coverage. About three quarters of those who are expected to stay uninsured were eligible for federal subsidaries to help with their premiums but 87 of those people didnt realize they qualified. This years Enrollment Period is shorter, feppeding february 15 and consumers must sign up by december 15 if they want a new plan that will start on january 1. Timely from the wall street journal, insurers in states using the federal health care. Gov, including tennessee, werent allowed to send letters to enroll lees that include details about next years plans until they got a final signoff on november 5. A federal spokesperson for the federal centers for medicare and Medicaid Services which overseas health care. Gov said insured letters we are sent after it was final in order to reduce consumer confusion and it is near when consumers are near to take action. They are also getting notices from health care. Gov. Well, our conversation is going to continue on this topic coming up next, Jane Odonnell of u. S. A. Today, if youre already on the line, already on the phone, already dialed in, dont hang up, were going to continue with the same kind of phone culls, but Jane Odonnell is a Health Care Reporter with u. S. A. Today, well talk with her. After that well look at the Economic Impact of the Affordable Care act. House is in at 9 00 a. M. This morning so just a two hour washington journal. Capitol hill is back in action and the new incoming senator jord leader Mitch Mcconnell talked about health care. Senator mcconnell, you did Mention Health care and i wanted to get you and anyone else to weigh in on these videos of this grouper, jonathan grouper. What does it tell you if anything thats new and does it change the way you plan to approach obama care in the new majority . Well, i think what he said, i think you all have heard the definition of a washington gap, when a politician mistakenly tells you what he really thinks. We were subjected during the obama care debate to a whole lot of stuff that we all knew was not true. Not even close to true. And what this insider is saying, confirms, that they were spinning tales from beginning to end because they knew they couldnt tell the truth about obama care and have a chance of passing it, even with its Democratic Senate with 60 votes. So, look, the American People hate to test and despise obama care. Virtually all of us would like to see it pulled out root and branch. We understand that the president is obviously not sympathetic with that point of view but well be voting on those issues, but both the overall obama care issue and the various pieces of t, like the individual mandate and trying to restore the 40 hour work week. Washington journal continues. Host Jane Odonnell is with u. S. A. Today, a Health Care Reporter for that newspaper. Open enrollment begins tomorrow. Is it going to be ready . Are the cites going to be ready . I think its going to be as ready as it possibly can be. All the works been done, were all waiting to see and im sure folks in the government are nervous, but probably not as nervous as they were last year because theres been so much more testing, its incredible. Its weeks and weeks compared to 10 days. March 23, 2010 that the president signed the a. C. A. Whats the consensus on its success . Its still pretty divided. Certainly listening to your callers and talking to people regularly, people are pretty divided. Its very politically polarized as you well know. You tend to hear from people who are unhappy more than you hear from people who are happy. Ive heard from a certain number of people that even if theyre unheam with certain aspects of finding the doctor they want in a plan they can afford, thats a big concern. But some people are getting here that they never could have gotten. So i do hear with a fair number of people with advanced stage cancers who would be bankrupt if it wasnt for the law. I do tend to hear more about people who are paying out of pocket. New republican majority, both house and senate, hows that going to affect the a. C. A. . Guest you didnt hear as much on the campaign trail, it wasnt the big hot button issue that some expected maybe a year ago that it was expected it would be. What im hearing is that there isnt going to be the mood, or even the its not likely to be repeeled. Theyre probably going to be changes made. Probably changes that everyone would agree should be made, certain loopholes closed. But youll be hearing a sell about it but i dont think its the priority that it once was. Supreme court, whats going to happen up there . Goodness, i certainly dont know that. But i would tell con seemers, even though the Supreme Court will look at whether the subsidaries are in fact legal if youre a state that didnt set up your own exchange, everythings going to go as it is now. No matter what the Supreme Court does, consumers shouldnt do anything different. They should still, what is it about 80 of people are eligible for subsidaries that buy on the government exchanges. So people should still pursue those subsidaries. Host is that the only case on health care that the Supreme Court is going to hear in the next session . Guest im not a Supreme Court reporter thats the only one im aware of. Thats the big one. Host before we go back to calls, want to point this out, the u. S. A. Today has devoted a page and a half to your story this morning. And its on rural hospitals. Rural hospitals in critical condition, this is the front page of u. S. A. Today this morning. Is this because of the a. C. A. . Guest well, some of them say its a little bit of the last straw. It certainly isnt because of the a. C. A. Rural hospitals have been in decline for a number of years, but its been a accumulation of things, the death spiral theyve been in. One of the hospitals, i went to richland, georgia, right up the street from plains, georgia. Their little hospital there, the Electronic Health records were kind of the last straw, which are required under the Affordable Care act. But largely, the populations that theyre serving, theyre serving very poor populations that are on medicare or medicaid, and of course georgias one of the states that didnt expand medicaid, expansion of medicaid would make a big difference, but wouldnt save a lot of these hospitals. Host and you have a chart in here over some of the hospitals that are closing. Lets show this. Is it centered down in the south . Guest it certainly does seem to be. There is a lot in the south. The south is where theres been the least Medicaid Expansion. There are a lot of these hospitals, its really, ive covered health care over a year, ive been a reporter for a long time. But there are so many issues that go into this. You feel it can be rather depressing and ive covered a lot of depressing things in my career. Theres so much that needs to be done in this air. Theyre not getting the care they need so they certainly need to be getting some Preventive Care and Healthy Lifestyle changes, frankly. Host Jane Odonnell is our guest, u. S. A. Today. Fred is calling from suh city, owa. Caller obama is from an old third world car who operates on socialism. I like capitalism. Hes breaking our country. Host fred, how do you get your insurance . Caller im on medicare and i buy a Supplemental Health care. And im retired. Host can i play devils advocate. You talked about the fact caller you sure cut me off fast, i thought it was my phone call but it seems like you want to control the call, if you cant do that, i guess i have to play by the rules. Host i just want to ask you a question. You talk about the president being a socialist and youre on medicare which is government funded. Do you see any connection or any conflict in that statement . Caller yes, thats true. But you can take that. Im not advocating anything about it at all. Rather to continue on this path, go ahead and take my medicare because our countrys doing down the tube. Its just a matter of time before the whole Financial System collapses, and you want us to pay for this Affordable Care act by sacrificing our military and cutting it back to dards in the ii stan most dangerous time that anybody could live at. Host ok, thank you fred. Any reaction to his call . Guest i will say as an observer of this issue, i find that it is interesting because you brought up the point that comes up for me a lot is a lot of the people that are the biggest opponents of the federal government involved in health care often do get so many entight ltments and so much of their livelihood is dependent on the government. An interesting case, im in Northern Virginia but you go out to rural virginia, its largely republican signs but a lot of federal entitlements. Host have the cost of the a. C. A. Been in line with whats predicted . Have they been higher, lower . Guest i think theyve pretty much been in line. It will take a lot to see what the Health Care Savings are. Youre not going to see the savings of these people that werent getting care, are not getting care. I think its on track so far. Host 36 billion according to a congressional budget office, net cost in 2014, the expected cost 1. 38 5 to 2024, trillion. Sweetie is in covington, georgia. Hi sweetie. Caller hi, good morning, im glad you took my call. Im going to try to be as nice as i can to our government. The Affordable Care act, i dont need to use it, ive been in business many years, but as a grandmother i have children that do not have jobs and theyre not able to get insurance and theyre refusing to even use the social Service System because theyre saying there are people that are worse off than them. With the Affordable Care act in my opinion, its already successful, because the calls that i heard, i do have a heart for people that never had insurance and now you have insurance, thats an excellent thing. But the whole thing with the Affordable Care act in america, if we continue to break down the person at the top, whos staff to be using his to get america balanced, youre always making references to who the forefathers were. Tell the congress they are the forefathers. The forefathers before did what they had to do. Since they had such an excellent vision, thats why were still tapping into those sources today. Host all right, Jane Odonnell. Anything you want to add to what sweetie had to say . Guest im a little confused, i wasnt exactly sure who she was mad at, but it was interesting to me that she was from georgia because i did spend so much time in georgia. I do wonder if her grandchildren arent able to get jobs, how she would feel about Medicaid Expansions that a lot of people feel it would make such a difference in that state, especially if theyre not willing to use social services. Talk about rural hospitals closing, but the cost to any hospitals that have to continue under law to take these people who arent getting health care, otherwise when they finally do have that hernia or the heart attack or diagnose of cancer they go to the Emergency Rooms and these hospitals are getting less money from the government to care for them. Host what is the resistance to Medicaid Expansion by some of the governors in the country . Host they just say its going to cost them. Sure now the federal government will help them out but in two or three years, theyre going to have to pay, what is it like 10 , and that could be backbreaking and their states are already struggling so much to stay afloat. That is the case. There is so much unemployment and so many businesses closes in a lot of these states that you can understand that point. But it does seem to spend much of next year working on a series of Medicaid Expansion. It will be interesting to see, even where we are right in the middle of maryland and virginia, one that did and one that didnt. It will be interesting to see what the affects are because these people are not getting, the states that didnt get expand arent getting any better and theyre going to need health care at some point. Host when is that series coming out . Guest in a fellowship so ill be working on that, investigating it and learning more about it. Host laila tweets in, how many doctors, clinics hospitals arent accepting obama care . Guest i dont have numbers, there are no good numbers on that, but i did talk to a few people that had a devil of a time finding a doctor who would take their plan. The provider lists are often inaccurate. Theres one man suing Anthem Blue Cross because he must have called 40 doctors and it was either an error or the numbers didnt work or they simply wouldnt take it. So there are some complaints theyre not getting the reimbursements under the Affordable Care act plan as they do under private insurance. Host speaking of numbers, this is from h. H. S. , they say that 10. 3 Million People gained Health Insurance under the Affordable Care act. 32 million still lack coverage. Political reports via h. H. S. That 9. 9 million expected to enroll by the end of 2015. You said its really hard to get good numbers, ive got a headline over here from september that says 7. 3 million have enrolled. Why is it so hard to get good numbers . Guest i did see a report that the 9. 9 million is supposedly the net and your 7. 3 is the net, so either eight or 8. 1 signed up, but then a lot of these people wound up not paying the premiums, which is another problem the doctors have. They dont know whether the persons paying their premiums so they actually treat their parkes and then there becomes a fight with the Insurance Company, they have to least cover part, i think its a month of a cost and on Insurance Companies. For three months you have this 90 day grace period where you an get free insurance. Host when h. H. S. Reports 10. 3 million signed up, does that include the 19 to 26yearolds who stay on their parents plan, Medicaid Expansion . Guest it has to because it is only 7. 3. I think its the people that got in there under their parents. But the 9. 9 is including, thats the net. So that is one of the reasons it seems like such a conservative estimate is because they were saying ok, a certain percentage, maybe another million or two, probably wont pay their premiums. O theyre estimating that now. Host is it tough to get numbers out of h. H. S. . Guest its tough to get everything out of h. H. S. Again ive only covered them for a year, but ive covered federal agencies and this is a tough administration. Host hi alex. Caller good morning. First ive been around the a. C. A. For a year and i get a great subsidary in new york and im happy with it. Just had a couple of comments. Peter, you read from the wall street journal about how many people lack a basic understanding of how they can reenroll. Then you roll that clip of Mitch Mcconnell saying people hate it. How can people hate it if for example they dont even know they can change their policy, like that. That level of ignorance, half of them really say they hate it. My second point it seems like a psychology. I was a School Teacher and i resented to have to get insurance, i always had to be a School Teacher and do something i didnt really like. Now i can do what i want to do and not be tied to my employer for my Health Insurance. Host how much do you pay a much . Caller yeah, i pay around 100 a month for my premium and receive a subsidary of little over 200 a month. And i have a bronze plan. Host are you employed . Do you have a full time job . Caller im self employed. Host ok. Caller and yeah. Host anything else you would like to add . Caller well, i wanted to ask your guest, the psychology of it, it seems im mo