But if it means more states like yours will share the responsibility of administering insurance exchanges, perhaps this is a concession Washington would be willing to consider, especially given likely implementation challenges associated with setting up a larger-than-expected national exchange within very tight timelines.
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Earlier efforts to come to an accommodation with religious groups had run into problems because many large employers, including big Catholic institutions, self-insure, meaning they act as insurance companies by assuming the full responsibility for the health costs of their workers and use traditional insurance companies only for administrative services.
Under the Affordable Care Act, the Federal government, State governments, insurers, employers, and individuals share the responsibility to reform and improve the availability, quality, and affordability of health insurance coverage in the United States.
And the implication is that Mitt Romney bears responsibility for the death of this man's wife because he lost his insurance when the plant closed in 2001 and then, in 2006, his wife who was uninsured at the time, died of cancer.
Obviously the individual responsibility portions of the Affordable Care Act are the basis and the foundation for examining and doing away with insurance company discrimination on behalf of preexisting conditions.
The social norm of individual responsibility must be equated with purchasing health insurance.
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For example, Liberty Mutual, charged with selling insurance, among the most commoditized of categories, determined that pitching "responsibility" would help its brand stand out in a sea of price quotes and same-as-same-old promises.
The insurance company knows this, so they created a way to ensure a consistent level of responsibility and participation.
The individual responsibility provision in this is necessary in order to allow those with preexisting conditions to stay and keep insurance.
It gives the supermarket chain's employees financial incentives for taking responsibility for their own health, decreasing Safeway's insurance costs significantly while improving participants' well-being.
For the 83% of Americans who have coverage and who are already taking responsibility for their health care, their insurance premiums will decrease over time.
The irony Republican governors face is this: if you do not act to set up an insurance exchange in your state, you will be effectively expanding the new national insurance exchange, an outcome which you and your political supporters may dislike more than accepting responsibility for an insurance exchange tailored to your state that you can directly administer.
The Affordable Care Act, through the individual responsibility requirement, will require everyone, if they can afford it, to carry some form of health insurance since everyone at some point in time participates in the health care system, and incur costs that must be paid for.
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