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Article milestones Date Process Result October 20, 2013 Good article nominee Listed February 5, 2014 Peer review Reviewed April 9, 2018 Good article reassessment Delisted News items involving this article were featured on Wikipedia's Main Page in the "In the news" column on March 22, 2010, and June 28, 2012. Current status: Delisted good article

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Text and/or other creative content from this version of Patient Protection and Affordable Care Act was copied or moved into Provisions of the Patient Protection and Affordable Care Act with this edit. The former page's history now serves to provide attribution for that content in the latter page, and it must not be deleted as long as the latter page exists.

Material from Patient Protection and Affordable Care Act was split to Implementation history of the Patient Protection and Affordable Care Act on 6 April 2018‎ from this version. The former page's history now serves to provide attribution for that content in the latter page, and it must not be deleted so long as the latter page exists. Please leave this template in place to link the article histories and preserve this attribution. The former page's talk page can be accessed at Talk:Patient Protection and Affordable Care Act.

This article has previously been nominated to be moved. Please review the prior discussions if you are considering re-nomination. Discussions: RM, Patient Protection and Affordable Care Act → Obamacare, Not moved, 22 August 2013, Talk:Patient Protection and Affordable Care Act/Archive 7#Requested move (August 2013) RM, Patient Protection and Affordable Care Act → Obamacare, Not moved, 28 September 2013, Talk:Patient Protection and Affordable Care Act/Archive 8#Requested move (September 2013) RM, Patient Protection and Affordable Care Act → Affordable Care Act, Not moved, 30 December 2013, Talk:Patient Protection and Affordable Care Act/Archive 13#Requested move 3

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In the interests of clarity and neutrality I think we should create a new section or subsection specifically on the insurer cost-sharing subsidies. It would cover the problem in the original act, Obama's executive order, the lawsuit, Trump's executive order, the Murray-Alexander bill, and any subsequent developments. This would make things so much easier to understand than our current structure in which we have this content scattered among "Legal challenges," "Actions to hinder implementation," and "Murray—Alexander Individual Market Stabilization Bill." If it gets too long (likely) it could be spun off into a separate article. --Dr. Fleischman (talk) 16:40, 19 October 2017 (UTC)[reply]

Agree, I'll pitch in.Farcaster (talk) 21:47, 19 October 2017 (UTC)[reply]

Ask and ye shall receive. Initial draft done.Farcaster (talk) 23:13, 19 October 2017 (UTC)[reply]

Nice, thanks. Actually though, this isn't quite what I meant. You framed the section solely around the Trump administration's efforts to undermine Obamacare by not paying the subsidies starting in October 2017. But the subsidies story began way before this month, at least as far back as 2014. This 2015 opinion piece provides some good back story, even if it isn't reliable. Some of the story and sources can be found in House v. Price. --Dr. Fleischman (talk) 23:41, 19 October 2017 (UTC)[reply]

Aug 2019: I started looking at this article and adding to it a few weeks ago, and did just realized that a section of Cost-sharing reductions (under provisions) was needed, and then caught this section here indicating it was found needed two years prior. So I stuck it in today. I think I've matched the intent of the original poster.

(Note that I am using the term "Cost-sharing reductions", which mean the same thing, (according to a link in my section). I find "reductions" clearer, as there may be confusion when "subsidies" are used, since direct Federal payments were stopped by the Trump administration.)

Also, when I did the section, I noticed the omission of the silver-plan loading reaction in many or most states, by many insurers (or all insurers in the state, depending on state government orders). Where it was done, the silver loading more-or-less nullified the problem, as long as people not eligible for cost-sharing can figure out to avoid the silver plans. (In the section, I have a reference to Health Affairs describing this silver loading, if you don't know exactly what I'm talking about. It was started, and reported on by Health Affairs and others, at the time of the Trump action.)

NormSpier (talk) 21:35, 25 August 2019 (UTC)[reply]

I am going through the Good article reassessment request backlog. This article has outstanding and valid tags so that needs fixing. It is also incredibly long (94KB readable prose), which is almost certainly split territory. Given the narrow scope of the article I would say it fails criterian 3b. I will give a chance for editors to respond before going through a more formal process. @Sb101, Fat&Happy, DrFleischman, Innab, TVC 15, Farcaster, Myownworst, George Orwell III, Lfstevens, Prototime, Hauskalainen, Cybercobra, and Kurykh: all editors with over 100 edits to the article (ping others if you want). Plenty of interested editors so hopefully someone will be willing to work on it. AIRcorn (talk) 06:40, 23 March 2018 (UTC)[reply]

• Support fork The article is too long. I nominate the "Implementation history" section for a fork to its own article. This section is 37k and is of the least interest to most current readers. Blue Rasberry (talk) 13:06, 23 March 2018 (UTC)[reply]

Looks like your nomination wins by default. Will do the split and see what we are left with. AIRcorn (talk) 00:58, 6 April 2018 (UTC)[reply]

Split and trimmed. It was full of off topic and overly detailed information. It was self referential. Can someone double check it. I feel something similar needs to happen to the other sections. I will probably look to delist this if it is not improved in a week r two. AIRcorn (talk) 01:34, 6 April 2018 (UTC)[reply]

• This article is not even close to GA. I wouldn't spend more time on an assessment. I support the split, because it may give this article a chance to stabilize. Lfstevens (talk) 00:29, 10 April 2018 (UTC)[reply]

This discussion is transcluded from Talk:Patient Protection and Affordable Care Act/GA2. The edit link for this section can be used to add comments to the reassessment.

The main issue here is focus (crieria 3b. The article sits at 81KB readable prose and this was after I personally trimmed and split the section on implementation history. This is also slightly misleading as it does not take into account the bulleted lists and tables which make up a large part of the article. There are a few main articles so no reason not to use WP:Summary Style. It is also overloaded with sub and sub-sub headers (twenty two under Provisions). Some f these consist of a single sentence. There are also issues regarding tags that need sorting. AIRcorn (talk) 23:10, 9 April 2018 (UTC)[reply]

• Delisting per above. AIRcorn (talk) 10:50, 5 May 2018 (UTC)[reply]

I agree. The "Legislative history" section needs to be trimmed. Also, old data needs to be removed from "Implementation" section. 131.252.12.89 (talk) 16:51, 15 May 2018 (UTC)[reply]

(AUG 2018) Portions of this article read as though they were written by the government and therefore should be questioned as political propaganda. Instead of reading in a more neutral manner, many of the points play out in a consecutively gratuitous manner toward the subject of the article. It reads more like a brochure and less like an objective analysis. There is far more positive POV description of the law than neutral or negative, and much time is spent in this article describing the components of the law AND "why that is good" for you, in a symbiotic relationship. Too much of this feels like it was written by someone who heavily supports the law and it feels strongly as though it is purposefully omitting many studies which have shown to portray the effects of the law in a neutral or even negative light, while selecting studies mostly that show the law as achieving the results the creators proclaimed it would. It does not even take the time to mention in the very least, that for SOME people, many of the included studies do not reflect their experiences, especially concerning deductible increases etc. — Preceding unsigned comment added by Lbredefe010 (talk • contribs) 12:48, 20 August 2018 (UTC)[reply]

I User:NormSpier' (Aug 2019) have added a Problems Section (i.e. Problems with the ACA). It has 5 problems listed, including the deductibles. It us under heavy attack over multiple Wikipedia standards issues by User:Newslinger being considered partial, "original research" (applied to my example-case, regerneratable from references, calculations of deductibles and over the cliff premiums as a percent of household's modified adjusted gross income. I think also, on one of the problems, Medicaid estate recovery for a large proportion of ACA recipients, listing of cases of states doing and having rescinded the recovery--the listing of states in each case being considered "original research".

There are other issues being criticized as violating Wikipedia standards.

Over one of the problems, listed in this article, and also Medicaid estate recovery, (the problem is with the interaction of the ACA and Medicaid estate recovery, resulting in many ACA recipients actually having not insurance, but just a loan, needing to be paid back by estates at death, for all medical expenses), User:Newslinger has indicated bias and violation of Wikipedia standards of proportional representation, that is, he wrote: "We try to reflect all major viewpoints covered by reliable sources in proportion to their prominence. If an issue is "underpublicized", it should be featured less prominently in an article." Thus, I have identified this principle as forcing us into the establishment-voice-only representation talked about in Manufacturing consent. As far as I can figure, since the establishment sources pay little attention to the issue now (though they did just a bit in 2013/2014, and they have, just a bit, later, in certain states where bold reporters choose to bring it up, or where there was grassroots activism), and also since there has been no response by any government agency in the press to any issues on the problems side, it seems quite possible that that the one serious problem, the Medicaid estate recovery loan-not-insurance issue will have to be removed from this article, and Medicaid estate recovery as well. (Removed or watered-down so much that its seriousness is not evident.) Anyway, I can't stop Wikipedia policy from having the problem deleted from Wikipedia, but I can suggest that Wikipedia might want to stop bugging everyone every year with requests for a donation on grounds of it preserves neutrality and non-establishment voices, and that it just go ahead an get the money from Pfizer.)

Additionally, I have from User:Newslinger "The Verifiability: Readers should be able to verify every single statement in a Wikipedia article with a reliable source."

I'm finding this stifling, to the point where I can't a useful, well-though-out article, with explanations where the reader will need them, can be constructed. It sounds like every single sentence has to be an idea taken from a reference. No explanation, even of obvious things. I've pointed out that they don't do that in other places, such as Internal Combustion Engine, Calculus, and Banach space, they don't do the reference on every statement. So this also impeding the reporting of the ACA Problems.

People interested in this should see the section of this talk page below called "Noticeboard discussion regarding User:NormSpier's recent edits (started by User:Newslinger), as well as the noticeboard he created, WP:NPOVN § Medicaid estate recovery and User:NormSpier.

NormSpier (talk) 13:32, 3 September 2019 (UTC)[reply]

I have done a more careful look at this full article, and have agreement with whomever added the Aug 2018 comment "It reads more like a brochure and less like an objective analysis." Outside of what I have added, there was some legal challenges stuff, and constitutional kinds of challenges, and perhaps compulsion challenges mentioned. But not a thing (correct me if I am wrong), saying the ACA wasn't working perfectly. It was a law working well. Perfectly, except where the Republicans messed it up, from the article's POV. Just amazing how good a law it was.

The sections I added change that. The problems section was entirely mine (8/2019), where 5 real problems are listed, some rather perverse.

Within my separate "outline of coverage mechanism section", there is also a bit on where problems may arise. The section was not primarily added to describe problems. It was designed to describe the mechanism of giving coverage to individuals without other adequate insurance in a clear fashion, so that a person has a clear understanding of how the ACA is supposed to get everyone covered. It's supposed to be clear enough that a person with appropriate skills can see how it works, and can use the power of reasoning to see as to where it will likely work, and where it may fail. A person may also find some understanding of the financing restraints on the program, in that the program is tightly limited in who can get a subsidized on-exchange plan. For example, from this, one might see that the law keeps people on Medicaid when possible, with no option for a (federally paid for) on exchange plan, because states have to pay a good share of cost, and as well, because Medicaid has very low reimbursement rates. Much lower than private insurers. One can see this might result in hidden tax on people privately insured, driving up their rates.

I also added some other stuff for clarity, including on the stopping of the cost-reduction payments to insurers (which had actually, unbeknownst to me at the time, been requested on this page), and the silver loading response. (There is nothing that addition that reflects negatively on the ACA. I'm not out to kill it. I'm out to make it, its mechanisms, and its problems, clearly understood.)

NormSpier (talk) 01:37, 5 September 2019 (UTC)[reply]

Create Texas et al v. United States of America et al article, due to Fate of Obama's health law set to be decided by supreme court – again (15.Dec.2018) ? See Patient Protection and Affordable Care Act#Texas et al v. United States of America et al here in article. X1\ (talk) 20:04, 15 December 2018 (UTC)[reply]

There should be a 48 hour waiting period... Allow a couple of days for WEIGHT and further details to appear. Cheers Markbassett (talk) 04:53, 16 December 2018 (UTC)[reply]

I know this has been discussed before, but I'd like to give a different perspective on the subject. I know there are probably still some people out there that think this article should be moved to "Affordable Care Act" or "Obamacare" per wp:COMMONNAME. However, I don't think that is the whole story. From my experience, "Obamacare" refers more commonly to the provisions of the act, not the act itself. If this is true, then the common name of the act itself would most certainly be "Affordable Care Act." This exact issue doesn't appear to have come up in past move discussions. Bneu2013 (talk) 03:45, 11 June 2019 (UTC)[reply]

There is a noticeboard discussion regarding the neutrality of NormSpier's edits to this article (Special:Diff/909824345/912954601) and other articles related to Medicaid estate recovery. If you're interested, please participate at WP:NPOVN § Medicaid estate recovery and User:NormSpier. — Newslinger talk 17:15, 30 August 2019 (UTC)[reply]

Please see my comments on the noticeboard.

Essentially, after {u:AnUnnamedUser} made comments a week or two ago, I have attempted to repair, but {u:Newslinger} is finding the same problems.

Thus, on my own, I lack the eye, at this point, to find the problems on my own.

Thus, if you could:

a)point out specific passages that should be removed, reworded, and exactly how, if a rewording. (Or, ask for clarification, where does the reference say that?, etc.)

or b)do the deletion or rewording yourselves, using whatever editor consensus procedures you have to make sure there is sufficient agreement on your end. (Delete whatever you need to, if there is no resource to make to conform.)

Thanks

NormSpier (talk) 14:11, 31 August 2019 (UTC)[reply]

Also, note. Of the various articles in question (in the messageboard), probably the most critical for it not to appear to others of bias in favor of the ACA, covering up defects, is the ACA article itself, where the section Problems (which I added) lists 5 problems,

5 Problems 5.1 Subsidy Cliff at 400% FPL 5.2 Sometimes-Unaffordable Out-of-Pocket Maximums 5.3 Family Glitch 5.4 Estate Recovery under 138% FPL 5.5 Coordination of Medicaids with On-Exchange Plans

Note that most of the problems, including estate recovery when it is done by states non-long-term-care-related, are in multiple sources, and in particular this reliable one: https://tcf.org/content/report/key-proposals-to-strengthen-the-aca/ (co-authored by Tim Jost, an academic lawyer who did most of the the Health Affairs "Covering the ACA" posts until a year or two ago.)

Specifically, 4 of the 5 wikipedia ACA section 5 "problems" are within the text of the single "proposal to strengthen" article:

5.1 is within "Increase Credits for Moderate- and Middle-Income Families" 5.2 is within "Reduce Cost-sharing and Out-of-Pocket Limits and Improve Minimum Employer Coverage Requirements." 5.3 is within "Fix the Family Glitch" (you only have to go so far as the title) 5.4 is within "Eliminate Medicaid Estate Recoveries from the Expansion Population" 5.5 is the only one not in "proposal to strengthen". But I have reliable references (last paragraph in the article), including actual continuity of coverage issues found in the GAO report. NormSpier (talk) 15:46, 31 August 2019 (UTC)[reply]

I have some prior comments on the noticeboard regarding my contributions, which now remain only on this ACA Wikipedia article, and also Medicaid estate recovery.

Here let me add issues relevant to the ACA article, in reaction to comments by Newslinger which are on the noticeboard. (They also may have relevance to the general ACA article, for future editing and such.)

From the bulletin board, Newslinger has written

(1) "It is fine to include some of the criticism listed at Patient Protection and Affordable Care Act § Problems, although the length of the content should be reduced. For instance, the listed examples for silver/bronze plans are considered original research since they're not covered in reliable sources, and they should be removed."

(2) Verifiability: Readers should be able to verify every single statement in a Wikipedia article with a reliable source.

These two principles, let's call them Newsl1 and Newsl2, seem to be causing problems with the ability of the ACA article here to have information to be useful to certain readers needing more than superficial information. In my opinion.

Thus, on removing the bronze and silver plan examples, which is used in two of the "problems" sections: the example provides useful information that a quantitative mind will seek about the issue. For example: over-the-cliff, total expenses, premium plus out of pocket max will be 41% of MAGI, and 27% under the cliff. Values in dollars are also there. The understand is too muddy and incomplete without an example like this.

Thus, the request of Newslinger (Newsl1) to remove the bronze and silver examples would make this Wikipedia article something that I would find, myself, substantially less useful for any kind of numerate understanding of the issue.

(Unfortunately, I see that the two examples, both silver and bronze, are more than we would like. Ideally, only say silver. But the problem comes up from the states' and insurance companies mixed reactions to the Trump order on the stopping of Federal payments of cost-sharing subsidies, which may or may not have silver loading. Doing silver only is flawed. (See my first explanation of the need to avoid silver only, under "subsidy cliff". Silver only would be a flawed analysis, and note the references to Health Affairs, and as well a spreadsheet on silver loading that I think Health Affairs did. I can't do a flawed analysis. I have to respect the quest for truth. I understand the need to simplify. I cannot, however, oversimplify to the point of making the exposition flawed.)

Questions are raised here as to both what level this Wikipedia article is at, and also to how well it is equipped to give adequate information.

The ACA article looks to me roughly at the level of the NY Times. Higher than USA Today, but lower than a graduate math text, or mathematical economics journal, or say the wikipedia article Banach_space.

But, in trying to be at the NY Times level, it still fails. The examples the NY Times might put in, doing its own work. (They have enough policy people and people skilled at calculation to do it.)

However, here at Wikipedia, I was unable to find a reliable source with the information, so I did the numbers myself. I've been asked to remove it. (The calculations are my own, based on the information on the Federal healthcare.gov site, and are thoroughly traceable (for the duration of 2019). However, Wikipedia would hopefully have enough people around, both able to calculate, and with knowledge of the details, to verify. Then, hopefully they would be able to archive the verification somewhere: maybe with a footnote on the table pointing to the verification. Presumably, the NY Times has a procedure like this.

(Besides my own thought that a reliable, verifiable (with a little math and policy knowledge) table from a contributor should be acceptable, I caught that a table from 2014 apparently missed quality control. This was the original one under "Premium subsidies". The last column was labelled "cost-sharing subsidies", but had numbers like $1000 for income at 350% of the Federal Poverty Level. This was just wrong. Cost sharing subsidies stop at 250% FPL. I also manually checked some of the other numbers, and they were off. (Small amounts only, fortunately, like a few hundred dollars.) (I replaced the table with my own, for 2019. Although it is completely verifiable with minor math, and the references I provided, you probably need to delete it under your policies.)

Otherwise, I'm seeking clarification Newsl2 ("Verifiability: Readers should be able to verify every single statement in a Wikipedia article with a reliable source."), because I'm finding articles where that's not the case. Thus Internal combustion engine, and Calculus, and to a lesser extent, Banach_spaces.

Apparently, in the case of those articles, people writing and editing both have an understanding of the technical details, and are not requiring every sentence to have a reference. However, on the ACA-related articles, I've been told everything needs a reference. (So, for example, the obvious assertion that a Medicaid that has all medical expenses being recovered is a "loan" needs references. So I put them in, but now I'm getting that some of the sources may not be reliable.) (I suspect the different treatment of hard-science articles vs. the ACA may have something to do with that in the hard sciences, only people who know what's going on get involved, but in anything with any political component, everyone gets involved, and so controls, and everything verified in little baby steps becomes needed as a control against chaos. But, as I see it, the current Wikipedia procedures are hindering and perhaps blocking a lot of information needed to keep from a muddy, emptyish presentation.)

As for this, I'm not intending on removing important information myself. I am more than happy to help in finding better ways to organize the material, but I can't myself do a gross removal of most of the important information. I understand that general written and unwritten Wikipedia policies and viewpoints will likely result in a gross removal of much or most useful information I have added by others, and that's O.K. with me. NormSpier (talk) 15:59, 1 September 2019 (UTC) NormSpier (talk) 15:59, 1 September 2019 (UTC)[reply]

I need to add another comment on this article in response to a third request of Newslinger. Somewhere (I'll save myself the time of finding), he said "too many references" or maybe it was "far too many references". There may official or unofficial policy on this, and I'm not seeking an exception, but I do see that the general policy, like other policies, is removing lots of useful information for certain people. Thus, I have many references at the point where I introduce the controversy around the ACA and Medicaid estate recovery ("The issue of the negative interaction of the ACA with Medicaid estate recovery was noticed in many places starting from the time of ACA passage.[355][356][357][358][359][360][361][362][363][364][365][366][367][345]") Some people may wish to find the original articles, which are from different sources, to get a complete and richer understanding. In separate places, the estate recovery practices of specific states are documented in references, and people might find them useful, or being necessary backup to my claim that a lot of states stopped non-long-term-care-Medicaid estate recovery timed in reaction to ACA, while at least 10 or so have not. I see there is an issue of visual impediment to reading of so many references, but somewhere I think Newslinger has a workaround to that--a "reference group" or something.

Let me repeat also my issue (originally posted on the bulletin board page https://en.wikipedia.org/wiki/Wikipedia:Neutral_point_of_view/Noticeboard)

Newslinger wrote "Reliability: On Wikipedia, sources are considered reliable if they have a reputation for fact-checking and accuracy, and if they are endorsed by other reliable sources."

This sounded to me (perhaps adding other of his comments) like he was saying referencing opinion is no good, you can reference only facts from reliable sources.

So I checked the reference, and found that opinion references are fine, as long as opinion and fact are clearly separated in the article.

My response was:

"I have looked at https://en.wikipedia.org/wiki/Wikipedia:Reliable_sources#Usage_by_other_sources , as one of the issues. (This is the 5th of your issues: Reliability) it says, under: Statements of opinion "Some sources may be considered reliable for statements as to their author's opinion, but not for statements asserted as fact. For example, an inline qualifier might say "[Author XYZ] says....". A prime example of this is opinion pieces in sources recognized as reliable."

This is coming up here in the ACA article, where I have references (repeating my example) on: ("The issue of the negative interaction of the ACA with Medicaid estate recovery was noticed in many places starting from the time of ACA passage.[355][356][357][358][359][360][361][362][363][364][365][366][367][345]"). My labeling does not say everything is absolute, uncontrovertible fact. There are accepted mainstream references, like Seattle Times and Washington Post and Health Affairs (academic journal) post. There are, as well, opinion pieces, notably one from a Paul Craig Roberts, who, though not a mainstream source, does have a Ph.D. in economics, and as well, served as an Undersecretary of the Treasury. Further, though many of his points are expressed heatedly, and he is to the right of me by a good bit, I see that many of the facts he brings up are important, sharp, and not made elsewhere.

Thus, my opinion is that it may be policy or practice to not have many footnotes, and I can understand that you have a policy or practice, and there may be good reasons for that policy or practice. Just please note that the policy or practice removes information that a person might find very useful to really understand both the economic mechanisms involved, and even the emotional flavor and feelings of the real people involved. For example, the reaction of some people from being compelled to sign up for the ACA under threat of penalty, and then as thanks for that, being forced to be exposed to Medicaid estate recovery both of capitations for services not actually used, as well as large recoveries for all medical expenses paid out (no insurance at all).NormSpier (talk) 17:28, 1 September 2019 (UTC)[reply]

(Note the ACA Problems section was the main section at issue in the "noticeboard on" section (the prior section) started by Newslinger. So there is some discussion there. Under attack was both the use of simple calculations and lookups from healthcare.gov in my silver and bronze plans examples, which Newslinger categorized as "original research", as well as the mention of the Medicaid estate recovery issue (on grounds of "original research" and proportional-to-mainstream coverage).

I'm not revisiting that here, but rather focusing on whether each of the 5 problems in the section have sufficient information so that the rough magnitude of the financial strain (or medical strain) on people relying on the ACA from each problem is clear. (Any numerate critical thinker will probably want to know the rough magnitude of the financial strain. Other people should see it, even if they don't immediately realize themselves they need to see it, to get an understanding of the issues.)

For "subsidy cliff" and "sometimes unaffordable out of pocket max", I believe my bronze and silver plan examples do exactly that. (Thus, premium plus oop max, some people are at 41% of Modified Adjusted Gross Income. The dollar amounts are also there, so a person, in their head, might also be able to factor in what a household might also have in savings to make up for what is tight by income alone.) (It would certainly be better, to have taken numbers similar to the example numbers I have calculated from a fact-reliable source: the the NY Times, or Health Affairs, the the Kaiser Family Foundation. Unfortunately, I could not find them on search. Wikipedia is unreliable (Wikipedia itself correctly categorizes itself as an "unreliable" source). A sensible reader will not trust numbers in Wikipedia, and would like to, for numbers he/she finds important, to be able to click on a reference and check that the numbers and labeling are correct in Wikipedia. In lieu of an ability to take numbers from a reliable source, a reviewer with some numbers facility should check every calculation in Wikipedia. I've never seen it done before, but numbers or a table could have an "independently checked", when independent checking was done, to give a reader whatever confidence it would add. (I myself noted numbers in a column being non-trivially in error. It was a table in the "premium subsidy" section. It seems to have been sitting there for 5 years uncorrected. It has been replaced by me by a similar, updated from 2014 to 2019 table, though missing two less important columns.)

For "family glitch", what is the magnitude of the unaffordability? One sees that an individual in the household can get an employer plan for 9.86% MAGI or less for themselves. So if its a couple and kids to be insured, one might guess 2.5x to 3x 9.86% MAGI--up to about 30% MAGI for the only plan they can get (besides unsubsidized on-exchange ACA). The quick reasoning and mental multiplication should be doable by people at the level of those who have interest in a real understanding of the problems. So the needed quantitive impact info is there. (There is some possibility, depending on Federal/State laws, that employers can charge actuarially more for spouses and children than employees. So my 2.5x to 3x may be flawed. Someone could conceivably see if that's an issue. If it is an issue, then posting the level of detail may drive the editors, and possibly some readers, crazy. But I'd certainly like to know, and see it in a Wikipedia-article-for-me.)

For Estate Recovery under 138% FPL, that the recovery from the estate is "of all other Medicaid services for people 55 and older". So a person should be able to figure out, that if they have $900,000 in hospital expenses on expanded Medicaid, while 55 or older, their estates may have to pay that entire $900,000, in the states that do non-long-term-care-related Medicaid estate recovery. So the needed quantitive impact info is there. (In more detail, covered in the Medicaid estate recovery article, the recovery may be a mix of capitations (paid to providers at a blanket rate whether or not the person uses the services) and direct payment of hospitals and providers of all medical expenses, so the person can switch over to that article (at least as it is now) for that more detailed picture. But the bottom line is still that what's at risk for the estate can be all-direct medical expenses, like a million dollars, as if the person had no insurance at all.)

For "Coordination of Medicaids with On-Exchange Plans", one issue (and which was explicitly found in a referenced federal report), is coverage gaps. So it's clear that the person has no insurance for a period of time, and that could be the same $1,000,000 magnitude thing. There is also just repeated switching back and forth between expanded Medicaid and on-exchange plans a few times a year. The reader should be able to figure out that it can be a lot of work switching providers all the time, and bad for health and could kill a sick person (new doc unfamiliar with your body; delays till new provider can see you; can't get needed procedure approved until new insurance is in effect). So the needed quantitive impact info is there. — Preceding unsigned comment added by NormSpier (talk • contribs) 14:34, 4 September 2019 (UTC)[reply]

NormSpier, what Wikipedia editors do is to summarize published reliable sources, and personal interpretations and assessments by individual editors are simply not allowed. No original research is a core content policy, and following it is mandatory. Cullen³²⁸ Let's discuss it 22:08, 5 September 2019 (UTC)[reply]

Some of the discussion with one of the editors (above and in various places linked to above) had me assuming that editor has some level of official authority in the Wikipedia hierarchy of editors. So I put a question on the teahouse about editor authority, and have gotten back a response:

"@NormSpier: Welcome to Wikipedia. We do not operate with ranks or levels of authority. Wikipedia is built by consensus between editors. If someone makes a change you don't agree with, discuss it on the article's talk page. See WP:BRD and WP:DR for details. RudolfRed (talk) 20:53, 5 September 2019 (UTC)"

Whoops: the answer to my question is growing. Here's the full thing at the TeaHouse: https://en.wikipedia.org/wiki/Wikipedia:Teahouse#Determining_official_Wikipedia_editor_role_and_authority_of_editors_coming_in_commenting_on_a_persons_additions

I haven't seen anyone besides the editor in question coming in with an opinion or suggestions so far in 6 days. Hopefully, other editors, skilled in working with the Wikipedia rules, and who also understand the technical issue under discussion in the ACA and also Medicaid, will be able to come in and produce some sort of procedurally correct final article. NormSpier (talk) 21:51, 5 September 2019 (UTC)[reply]

Editors are volunteers who work on what they want to work on. Patience is advised. If an editor makes changes to an article that result in other editors adding tags at the top, it is advised that the editor not remove those tags. David notMD (talk) 11:14, 6 September 2019 (UTC)[reply]

Please consider joining the feedback request service. An editor has requested comments from other editors for this discussion. This page has been added to the following lists: Politics, government, and law Economy, trade, and companies Maths, science, and technology When discussion has ended, remove this tag and it will be removed from the lists. If this page is on additional lists, they will be noted below.

Over the past month, 54kb of content was added to this article. Should we restore the article to the August 7 version (before the additions) or should we retain the current September 7 version (after the additions)? — Newslinger talk 05:53, 8 September 2019 (UTC)[reply]

I included the word, "vote" in parentheses (below) because "survey" does not clearly communicate the purpose of the section. The purpose of the Survey ("Vote") section is for editors to register their opinion, a process that usually facilitates consensus-building. While the Survey ("Vote") section might look like a traditional tally, where the majority would win, that is not actually the case. On the contrary, most decisions on Wikipedia are not made by popular vote, but rather through discussions to achieve consensus.   - Mark D Worthen PsyD (talk) (I am a man. The traditional male pronouns are fine.) 05:08, 12 September 2019 (UTC)[reply]

Explanations are not mandatory. If you choose to include an explanation, please make it concise, e.g., one or two sentences.

Indicate your recommendation (opinion) using one of the following three options:

  - Mark D Worthen PsyD (talk) (I am a man. The traditional male pronouns are fine.) 05:08, 12 September 2019 (UTC)[reply]

• Restore - My eyes glazed over trying to read the current prolix version.   - Mark D Worthen PsyD (talk) (I am a man. The traditional male pronouns are fine.) 04:36, 12 September 2019 (UTC)[reply]

-- End of survey (!vote) section. Record your opinion above this line. --

• The added content contains significant violations of Wikipedia's core content policies, and is not fit for article space in its current state. Refer to my analysis (and the version without threaded discussion) for details.

  I would retain the most current version of the article if all three of the following happens:

  1. No original research: All of the content I have identified in my analysis as original research is removed, or cited to reliable sources that directly and fully support the content.
  2. Verifiability: All of the citations I have identified in my analysis as unreliable are removed. If this would leave content unsupported by reliable sources, then that content is treated as original research above (deleted or properly cited).
  3. Neutral point of view: In the "Outline of Coverage Mechanism" section, everything after the "Impediments and Imperfections to Design" label is removed. It can optionally be incorporated into the appropriate sections (such as "Problems" and "Criticism and opposition"), and is also subject to the other two policies listed above.

Reader, note, user:Newslinger's (just above) "all I have identified" refers to stuff below.NormSpier (talk) 22:02, 9 September 2019 (UTC)[reply]

(3) could be done (on part of "Outline of Coverage Mechanism" after "Impediments and Imperfections to Design"). There is some loss of valuable information in a place where the reader might want it: in a little spot right where the mechanism is densely expressed with details on the interaction Perhaps I could reference it from Problems if needed. I'd have to think about whether there's any value in moving and keeping the "Impediments and Imperfections to Design", and putting it below. (It's not needed there.) Also, you can see the issue of requesting the removal is indicative of tight worrying about the exact emotional first impressions people get of the law--we're in image-manipulation-accusation territory. NormSpier (talk) 21:28, 9 September 2019 (UTC)[reply]

(2)Looks OK. I don't need the references, though I think Huffington post should be allowed. It is for opinion, not fact.

(1) is still problematic on what you consider "original research" on a few grounds.

(a)My bronze and silver plan examples on two of the problems you are considering "original research" for just a few calculations, and I can't see that. It may be that the pair of examples, Bronze and Silver, is confusing, and there is an exposition problem therefore. Why not one example? The natural silver? Because of the potential silver loading, and that could be an unnaturally expensive plan, because it has to support cost-sharing-reductions. Thus, I would be tricking the reader by only silver. I could do just bronze, but the numbers calculation goes through silver. By dropping all examples, the numerate reader is left in the dark on magnitude of the problem. I can't see leaving the reader in quantitative la la land. (A numerate reader could regenerate the numbers in 8 minutes, but only after looking up details of subsidy structure, etc. and we should save the numerate reader the time.)

(b)There is some economic mechanism understanding and law details needed to verify some of the things you pointed out in all 3 sections.

(i)On outline of coverage mechanism, the whole thing has to be removed. That wouldn't be the end of the world for me, but I'd feel some enlightenment lost for the capable reader, forcing the reader into a weaker understanding, like they get from USA Today.

(ii)Affect of loss of Penalty for Not Carrying Coverage on Affordability over the subsidy cliff: Could be removed, It's a shame. It's economically obvious. It's a bit of darkness we're leaving the reader in.NormSpier (talk) 21:58, 9 September 2019 (UTC)[reply]

(iii)The "original research" you've listed in "cost-sharing reductions" is economically obvious. I had added the information to the incomplete information that was in the article when I got to it, which mentioned the Trump stopping of the payment to insurers of cost sharing reductions, but had a horrible omission of that the action was countered in many or most cases by states authorizing or ordering silver loading. But then, why did the states do that? Your "original research" is the explanation. The particular aspect may or may not be documentable in the Health Affairs blog. I'll take a look. If I can't find it, I can just knock the article down to its state of ignorance on silver loading, that it was in before I got to it. But I would find it a shame.NormSpier (talk) 21:58, 9 September 2019 (UTC)[reply]

(I guess these removals would not be fatal. It's kind of a shame that Wikipedia can't support more complete analysis.)

In summary, with your requests, I would not abandon the article, and have it rolled back. I would do the changes, under a bit of protest, with a mind towards stopping or reducing contributions in the future for non-hard-science / math stuff. But I still seek the RFC vote, because I'm not comfortable with all the stuff you are calling "original research": calculations and economically obvious things. I look at it as a real limit on the capabilities of Wikipedia, and I can't imagine how you would apply the sentence reference sentence reference verifiability model to, say, math.NormSpier (talk) 20:53, 9 September 2019 (UTC)[reply]

• Good lord. Revert the changes and gain consensus for individual changes. I read enough to realize that there are pretty serious problems in unencyclopedic tone throughout. If nothing else, much or all of it needs to be rewritten. But ain't nobody going to sort through the 8,300 words in this section already, in addition 54kb of changes to the article, and 96 additional sources used. RfCs are not tools for deciding sweeping rewrites of an article. You need to discuss each individual change individually and if you cannot reach a consensus on some change in particular, then start an RfC. Everyone step away from the espresso and try to have a concise and targeted discussion. GMG^talk 18:06, 11 September 2019 (UTC)[reply]

Objection by User:NormSpier to Framing by User:Newslinger as a binary "kill all" or "keep all"

• I disagree with the presentation of the question for RFC by User:Newslinger as binary, "keep all" or all "remove all". My choice would be to keep the article, and hopefully this broad-coverage RFC will attract enough eyes that any adjustments, additions, or deletions needed.

• I find the "in or out" method too blunt, and not useful in the construction of sharp, comprehensive wikipedia articles.

• Further, since Democratic debates about "repair or replace" are ongoing, the Problems of the ACA should be available to citizens right now.

• User:Newslinger has not explicitly stated his position directly above, but let me clarify that it is to kill all, in case it is unclear.

NormSpier (talk) 09:21, 9 September 2019 (UTC)[reply]

• Another reason I oppose a kill decision (which User:Newslinger I think intends may lead to eventual return of some or all of the content eventually in some form when editors with the right technical skills and areas of expertise set get to look at it), is that there don't seem to be any editors around with the needed skills and areas of expertise, so far, willing to invest the time. ( User:Newslinger has, prior to this RFC, sent around requests for help to a bunch of working groups, about a week ago. The list included the one I picked as especially likely to be able to help, on economics topics.) So I see kill as "kill permanently", due to a lack of willing and able editors for the topic.NormSpier (talk) 18:05, 10 September 2019 (UTC)[reply]

Scope of disagreement

• The content was added by me, and the contention is between User:Newslinger and me only at the point of construction of the RFC.

NormSpier (talk) 09:08, 9 September 2019 (UTC)[reply]

Scope clarification (number of articles)

• There were initially 6 wikipedia articles involved, which is to inform the readers as to why a link from prior discussion that User:Newslinger provided (WP:NPOVN § Medicaid estate recovery and User:NormSpier) mentions 6 articles. (I decided 4 of the articles were not that important, and further, that the content I added could be considered to violate "no original research", though I myself thought I was just guiding the reader to a better understanding by making an obvious-to-statisticians-like-me point, and not doing "original research".) Those 4 articles are not part of the issue before us now.).

• There are two articles remaining of contention between User:Newslinger and me. I think User:Newslinger intends this RFC to be on Patient_Protection_and_Affordable_Care_Act only. There is a second article, Medicaid estate recovery, which I think he may be conceding should not be rolled back. If he could clarify on that, or perhaps there will be a separate RFC, that would be great.

• Note that one of the Problems discussed in Patient_Protection_and_Affordable_Care_Act#Problems is the subject of a large part of Medicaid estate recovery. The latter article has a bit more detail. And, as well, I'm confident it is not perfect, so people may want to comment on that article for improvement.

NormSpier (talk) 09:08, 9 September 2019 (UTC)[reply]

Arguments Against The Position of User:Newslinger by User:NormSpier

• I note that the main contention points of User:Newslingers about violation of Wikipedia standards is Patient_Protection_and_Affordable_Care_Act#Problems, and at might appear to some that the action to remove the section may be a partisan attempt to cover up problems with the ACA. (User:Newslinger creates the appearance of attempting to cover up the defects of the ACA, you will see in details that follow. However, I don't believe he is doing such a nefarious thing, but rather that he is far too busy doing other Wikipedia tasks to focus adequately on this particular article or pair of articles. He has indicated he is very, very busy.) NormSpier (talk) 00:23, 9 September 2019 (UTC)[reply]

• User:Newslinger, nor anyone else, has asserted any information in my content is incorrect. (Some eyes have passed over my content, I know from typo and spelling corrections made, and such. But I have no idea if anyone in those passes was looking for incorrect information.)NormSpier (talk) 00:23, 9 September 2019 (UTC)[reply]

• The section Patient_Protection_and_Affordable_Care_Act#Problems is the one that User:Newslinger has pointed out 3 objections to, in the thing (maybe you call them "tags"?--note I'm new) he put at the start of the section.

• User:Newslinger objection 1. "Some of this article's listed sources may not be reliable." I respond that the facts on the existence and details of each problem, and all supporting minor calculations, are in reliable sources (newspapers like the Washington Post, reliable health insurance information sources like Kaiser Family Foundation and Health Affairs, and federal and state government sites, and a few others that I believe are reliable). However, for opinion, I have included some less reliable sources, like a physician writing in Huffington Post. I've done this particularly in the problem "Medicaid estate recovery", where opinion often has sharply hurled terms like "it's a big con". I think they help give the flavor of the controversial aspect, but the facts on the problems are documented in detail from sound references. (I note that Wikipedia reliability standards treat fact sources and opinion sources differently. Absolute reliability is needed only for fact, and I believe I am compliant with the intent of those standards.)

• User:Newslinger objection 2. "The neutrality of this article is disputed". I respond the section is called "problems". It points out problems. The article in question, on the ACA, in general, is quite positive about the ACA, overwhelmingly positive, and avoids any mention of defects in the functioning of the law. And, in fact, a year ago, in "talk", Talk:Patient_Protection_and_Affordable_Care_Act#POV_issues, I quote: "Too much of this feels like it was written by someone who heavily supports the law and it feels strongly as though it is purposefully omitting many studies which have shown to portray the effects of the law in a neutral or even negative light, while selecting studies mostly that show the law as achieving the results the creators proclaimed it would." ( I, in constructing the section, have tried to be careful to not claim the law is working for no one. I've used section titles like "Sometimes Unaffordable Out of Pocket Maximum", not "Always Unaffordable". On an example calculation, I've gone out of the way to say "The age was chosen to illustrate the case where the unsubsidized-premium cost issue is more severe—older people." Etc. If anyone finds other cases where better wording indicating that it's not a problem for everyone, please indicate that to me, or make changes yourself.

• User:Newslinger objection 3. "This article may lend undue weight to certain ideas, incidents, or controversies." I respond, again, it's a "problems" section. (And otherwise, as to "objection 2".) (Note: I actually supports the ACA, but want the problems fixed, and not ignored or covered up.)

• Note the above 3 objections by User:Newslinger seem to be confined to my section Patient_Protection_and_Affordable_Care_Act#Problems. The below one may apply in multiple places, because I took it from the top of the article, rather than the top of the section.

• User:Newslinger objection 4. "This article possibly contains original research. (I recollect from prior discussion with User:Newslinger that this refers to Bronze and Gold Plan calculations in two of the problems within Patient_Protection_and_Affordable_Care_Act#Problems, and as well, possibly a replacement set of calculations to those in the table in Patient_Protection_and_Affordable_Care_Act#Premium_Subsidies, which I replaced because the last column was entirely in error, another column was off by smaller amounts of a few hundred dollars, and because the table was for 2014. (Mine is 2019.) Additionally, User:Newslinger may also be referencing the looking up of some number of states which do and not do Medicaid estate recovery for non-long-term-care-related expenses, in Patient_Protection_and_Affordable_Care_Act#Estate_Recovery_under_138%_FPL.

• On objection 4, I, rather than "original research", view the modest calculations not to be "original research" but rather as the author (and also a subsequent checking reviewer) not being lazy, and trying to provide information useful to a numerate, critical thinking reader. The numbers are verifiable from sources I have referenced with simple calculation, though at end of Oct. or around there, the healthcare.gov numbers will be updated for 2020. (Someone should indeed check the calculations and not rely on just me. It shouldn't be hard, at least for many people, who, say, fill out their own tax forms. I can help guide them, if they are unfamiliar with the details of ACA subsidy determination, etc.) In the term "lazy", I realize that there's a real available resource issue for suitably qualified editors at Wikipedia, so I'm using the term light-heartedly, but intentionally, to mean that we have to put in the work to do a good job. I think at Encyclopedia Brittanica, they would put in simple calculations of their own, where helpful to the reader. Also, I consider the listing of some states doing and not doing the non-long-term-care-related estate recovery to not be "original research", but rather, doing necessary minor work, in an effort to give necessary information to the critically-thinking reader. The critically-thinking reader will want to know if the issue applies in a significant number of states, and the reader can see that it does, because the author did the work. The reader also will want to know about the timing of the decision of some states switching to not do non-long-term-care-related estate recovery, and see that it is timed to the start of the ACA main provisions, or soon after, and often timed in response to public concern over the issue documented in newspapers. (All kinds of Wikipedia articles have tables. Like lists of variants of linux. It doesn't count as original research there, apparently.) Also, note, there are reliable references for each looked up state in my enumerations. (NormSpier (talk) 22:59, 8 September 2019 (UTC) timing of signature: last 2 bullet items.)[reply]

• I want to point out that by deletion of all my content (3 sections) that User:Newslinger is requesting, two of them in fact answer requests on the talk page for the article in question. Already discussed, the hotly contested by User:Newslinger Patient_Protection_and_Affordable_Care_Act#Problems answers the point of the Talk:Patient_Protection_and_Affordable_Care_Act#POV_issues allegation of gross pro-ACA bias. Additionally, Patient_Protection_and_Affordable_Care_Act#Cost-sharing_Reductions fulfills the request in "talk" Talk:Patient_Protection_and_Affordable_Care_Act#Cost-sharing_subsidies. (Both sections were put in by me based on instinct of where the article needed fixing, without having spotted them on the "talk" page first. I noticed the requests at some subsequent point.)

NormSpier (talk) 09:08, 9 September 2019 (UTC)[reply]

• In the apparent attempt to immediately remove all of my additions until it can be made more or less perfect by every Wikipedia standard, User:Newslinger appears to be working under the theory that Wikipedia information is perfect, or else that he will make it so. In fact, Wikipedia has errors and omissions and miserable presentation all over the place, and there is nothing he will be able to do about it. I have noticed the errors in applied math. I have noticed them in the article in question, on the ACA. A fully erroneous last column in a table. (I fixed it.) An incoherent failure to cover "cost-sharing subsidies" in the section on ACA features. (I added it.) A failure to add to the Trump blocking of cost-sharing subsidy reimbursements to insurers with the response silver-plan-loading. I'm pretty sure people who know the ACA and have a head for its mechanisms, will conclude its not a real good article. (Not much said on rules affecting employer insurance. Pretty muddy and mish-mashy in many places. I see from the blue "Categories" box at the bottom of this RFC that the article is generally rated C class, and that's about where I'd put it.) (Wikipedia is extremely useful with its problems, but the reader has to take into account the massive quality problems that may be present.) NormSpier (talk) 09:59, 9 September 2019 (UTC)[reply]

• Wikipedia invites its users to contribute. The ACA article invited me to contribute. It said "be bold". (The particular article said "be bold, but don't be reckless" because it is in a touchy area. I have not been reckless. I have been going "straight for the truth".) The Medicaid estate recovery article was a stub when I got to it, and it said "please help expand this article ...". By insisting on completely removing imperfect content after the user has been invited to put it in, when, as before, Wikipedia content is generally all so imperfect and often quite defective, is an inconsistency. Be consistent, people.NormSpier (talk) 10:44, 9 September 2019 (UTC)[reply]

• This RfC is a continuation of the noticeboard discussion at WP:NPOVN § Medicaid estate recovery and User:NormSpier, and asks for a version of the article that should be used as a starting point for discussion. If you have identified specific portions of the added content that you believe should be included or excluded, please say so. If this RfC concludes that some of the content should be removed, it can optionally be added to the article sandbox for future improvement.

  Three sections were added during the past month: the "Outline of Coverage Mechanism", "Cost-sharing Reductions", and "Problems" sections. Please refer to Special:Diff/909824345/914372500 for a full comparison of the August 7 and September 7 article versions. — Newslinger talk 05:53, 8 September 2019 (UTC)[reply]

  Both NormSpier and I have written plenty on this subject. At this point, I would really appreciate some more opinions from other uninvolved editors. — Newslinger talk 04:29, 10 September 2019 (UTC)[reply]

• At least , some of the additions seem to be non-encyclopedic.

So we have total medical expenses potentially at 42% of MAGI in that case...

... it should be noted that we have presented premiums and out-of-pocket maximums.

Who's we?

Also, the RfC should probably be edited to make it easier to !vote. For example, word it so that Support or Keep clearly means the current version, and oppose or revert means the August 7 version, without a need for more words. Usedtobecool ^TALK ✨ 15:19, 8 September 2019 (UTC)[reply]

agree w/ Usedtobecool--Ozzie10aaaa (talk) 21:53, 9 September 2019 (UTC)[reply]

Emphasis on "retain" and "restore" is probably enough. Usedtobecool ^TALK ✨ 15:22, 8 September 2019 (UTC)[reply]

Hi, User:Usedtobecool. Note I am new at the process, and may have place my response in the wrong place. So please let me know, if I did that, and where I should put it.

The calculations "42% of MAGi", etc., were done by me, User:Usedtobecool. They are verifiable from sources I have referenced with simple calculation, though at end of Oct. or around there, the healthcare.gov numbers will be updated for 2020.

("we", in both case, is me, User:NormSpier.) I thought that was how it's done. (I used to be a statistician, and I think that was the way we often wrote. It was a while back. Anyone: Feel free to supply a better way to write it than "we".)

"Encyclopedic" stuff, I don't know about. I'm new to the standards. My thought was that to be a decent presentation, informing the reader, that the numbers should be available. (In the "talk" section, I actually ask, on all 5 problems, is the magnitude of the financial or health problem illustrated to keep the reader out of quantitative darkness?, and I answer yes, with the Silver Bronze examples needed on the two problems where I have them.) I think Encyclopedia Brittanica can come up with helpful, accurate tables where they are needed. Wikipedia may or may not be different.

Also note, I have expressed disagreement with the whole binary "in or out" voting that you talk about. More nuance is needed then a yes or no vote. I can't imagine good work on complicated issues or topics is possible with such a coarse approach.NormSpier (talk) 19:57, 8 September 2019 (UTC)[reply]

From MOS:TONE: "Articles should not be written from a first- or second-person perspective." — Newslinger talk 07:31, 11 September 2019 (UTC)[reply]

The added content (Special:Diff/909824345/914372500) contains significant violations of Wikipedia's core content policies (mostly the no original research and verifiability, and neutral point of view). This analysis focuses on the three new sections, "Outline of Coverage Mechanism", "Cost-sharing Reductions", and "Problems". Content was also added outside of these sections.

• No original research: Substantial portions of the section do not cite any sources, or make extrapolations that are not directly and entirely supported by the cited sources:

Much of this I look at as that to explain the law and how it is functioning, you need people who understand the mechanisms. My analogy is to some science / engineering things, where there is a lot of acquired understanding. I think you user:Newslinger may have a model: sentence 1, reference 1, sentence 2, reference 2, sentence 3, reference 3,..., where an editor reviewing can easily go "looked up sentence 1 ref, see it there, look up sentence 2 ref,... . I'm not sure complicated things can be well described if article construction requires verifiability by that standard. I had prior brought up with you these examples: Internal combustion engine, Calculus, and Banach space, and I said "they don't do it there" and you responded that it was because they were older articles before the new Wikipedia rigourous standards. As I see it, you're not going to find quite the description I put down anywhere. I think Paul Krugman once put some explanation of the mechanism, close to this, but less detailed. Jonathan Gruber has a graphic novel where he tried to explain. However, yes, based on understanding, and careful looking up of precise details, I have designed the exposition to be clear (to a suitably analytical reader), in order to make it possible for people to be able to see where the thing will work, and not work, by putting in exactly the right details. The several "moving parts" needed to understand how the law works: employer coverage, traditional Medicaid & CHIP, expanded Medicaid, ACA insurance plans, and ACA subsidies, are listed, and the critical factor, who is eligible for subsidies on the ACA plans, is presented. The user is supposed to see all the working parts in one place, all together.

Verification would need people who understand the law and how it works, like economists and possibly health economists, or other people fluent in (very simple) economic mechanisms. (A large number of people already know how the law works, and to them the correctness or any incorrectness would be obvious after looking up one or two details.) I'm thinking like Internal combustion engine, where there are few references, and the writer understood how an engine works, and probably the reviewer, as well, or at least the necessary physics. But I see your critique. It does pull down the level of understanding available from what people can write at Wikipedia too much, in my opinion. NormSpier (talk) 18:14, 9 September 2019 (UTC)[reply]

You might consider it like a calculus teacher, who knows calculus. There's a text, maybe, but the presentation of the teacher is designed to be as helpful as possible. That's not research. But I see Wikipedia capacity is taxed in able to handle that, and that's a real world problem for Wikipedia that it may not be able to fix. NormSpier (talk) 18:26, 9 September 2019 (UTC)[reply]

Here's another example, from elementary economics: Supply and demand. This is an elementary topic, ideas from Econ 101 or an elementary Price Theory course. It's impossible to do sentence 1 reference 1 sentence 2 reference 2 sentence 3 reference 3. Similarly, from a economics GA-rated article, Risk_parity#Equally-weighted_risk_contributions_portfolios, its a presentation of basic well-known theory by a mind that understands the theory. In certain economics articles, the topic is substantially history, so what happened needs references about what happened and when, and they have them here Panic of 1907, and where the article focus is who came who came up with the idea, or where the analysis is sufficiently non-elementary that it has to come from research papers, the research papers of course have to be referenced.NormSpier (talk) 01:25, 11 September 2019 (UTC)[reply]

The verifiability policy only requires inline sources when the content is "challenged or likely to be challenged". The content above is currently being challenged. Regarding the other articles: if content is uncontroversial, then it does not need to be sourced with inline citations, but it must still be verifiable to some reliable source(s) cited on the page (and the editor who added the content should be able to point out which ones when challenged). Lead sections are exempted, but only if the uncited claim summarizes properly cited content in the rest of the article. You are welcome to improve the sourcing of any article on Wikipedia, including the ones you pointed out. — Newslinger talk 01:47, 11 September 2019 (UTC)[reply]

• Verifiability: Substantial portions of the section reference unreliable sources, including:
  1. Paying for Senior Care, a blog

That link is just used for Federal Poverty Levels. The reason I chose it over a more reliable site like Kaiser Family Foundation or U.S. government, is that it has specific percent of FPL values calculated, like 150% of FPL, 200% FPL, etc., and might be more helpful to readers. It could, of course, be replaced with Federal or Kaiser, or something.NormSpier (talk) 18:22, 9 September 2019 (UTC)[reply]

• 1. healthinsurance.org, a shopping tool for insurance

The information looks roughly accurate to me, who knows the law, so I'm confident the information is at least not bogus. I see your point--it's not enough. It could be replaced, though I chose it because it has a nice direct definition of "Medicaid expansion" that pops up for the reader, rather than having to go through more complicated reading. (The reference could even be knocked off entirely, under the assumption of a reviewing editor who understood the law. But you won't do that here.) (No point in me making the joke "but it says "A TRUSTED INDEPENDENT HEALTH INSURANCE GUIDE SINCE 1994" on the top of the page.) — Preceding unsigned comment added by NormSpier (talk • contribs) 18:36, 9 September 2019 (UTC)[reply]

• 1. ElderLawAnswers, a shopping tool for legal aid

This could easily be removed. I find the site myself quite reliable, and it comes up first on the google search for "Medicaid estate recovery". It's not essential. Everywhere I use it, the same in information is referenced on the Federal Medicaid site. I had placed it here to help the reader, who might find it clearer and more direct to the point than the Federal. — Preceding unsigned comment added by NormSpier (talk • contribs)

• 1. a former version of the Wikipedia article for Medicaid estate recovery (see "Wikipedia is not a reliable source")

This is me not knowing that a reference is used at Wikipedia only as something that makes something airtight. Apparently, I used it as a see also. My view, before being informed, had been that you could use it to help a reader get more of a sense of the issue, if not with perfect reliability. (Being only, roughly as reliable as the place it is linked from, another Wikipedia article.) It could, of course, be removed. Somewhere, there should be a "see also", though, because why not help the reader get additional information?NormSpier (talk) 18:58, 9 September 2019 (UTC)[reply]

• 1. a former version of the Wikipedia article for National Federation of Independent Business v. Sebelius

This could be replaced. I'm sure it's somewhere considered reliable. — Preceding unsigned comment added by NormSpier (talk • contribs)

• Neutral point of view: All of the content after the "Impediments and Imperfections to Design" label is inappropriate for a section named "Outline of Coverage Mechanism". This content should be merged into appropriate sections (such as "Problems" and "Criticism and opposition").

The whole thing could be dumped, I guess, even. The whole thing is teaching kind of exposition, not original research, but you might consider it that by Wikipedia standards. It needs people who understand the law, and can reason about the law in an economically sound, but not especially demanding, way, to determine if it is correct. The whole adding of "Outline of Coverage Mechanism" was to provide, close together, in one place, an exposition on that mechanism, including where it might go wrong. (Actually, a sharp reader will see implications on the financing of ACA: access to subsidies is tight for apparently Federal financial resource reasons.) Rather that the reader having to think more independently themselves, and have to go through all the parts, and really need a lot of skill to see what might work, and what might go wrong. (This kind of thing may be impossible at Wikipedia. There may also be an article-readership-level decision, reasonable, to keep it at New York Times level. I am writing at a higher level, demanding more skill. Maybe of an undergraduate of graduate health economics course.)NormSpier (talk) 18:58, 9 September 2019 (UTC)[reply]

• No original research: Portions of the section do not cite any sources:

For these babies, you really need a reviewer able to work competently with basic economic mechanisms, and able to put the mechanisms together with the structure of the law. If you can do that, it's obvious. Really, it is. This is like Internal combustion engine or Banach space. Whether [[user::Newslinger]]'s model of sentence then reference, then sentence then reference will work for more complicated things is in question, in my mind. It may limit the capacity of Wikipedia, due perhaps, ultimately, to a set of certified-know-what-they're-talking about reviewing editors in fields.NormSpier (talk) 19:11, 9 September 2019 (UTC)[reply]

• Verifiability: Portions of the section reference unreliable sources, including:
  1. Google Docs, a self-published document

This baby seems a little reliable to me because its linked to by Health Affairs. It's not essential. I put it in to let a sufficiently curious and able reader see that the matter of the silver loading is complex, state by state, it changes from year to year, it has some variations. NormSpier (talk) 19:11, 9 September 2019 (UTC)[reply]

• 1. healthinsurance.org, a shopping tool for insurance

This one I chose because it has a nice, complete explanation for the reader. The essential content can be found elsewhere, on a reliable source.NormSpier (talk) 19:11, 9 September 2019 (UTC)[reply]

• No original research: Substantial portions of the section do not cite any sources, or make extrapolations that cannot be directly and entirely supported by the cited sources:

No. If you have available reviewing editors who know or can learn the law, and reason a a light but competent way economically, it's either economically obvious, or else its light calculations that are easy to do for a person who understands the law, with sound sources like healthcare.gov. I believe user:Newslinger has the view that the calculations are "original research". Again, the question of the model: line, reference, line, reference, for complicated stuff.NormSpier (talk) 19:33, 9 September 2019 (UTC)[reply]

"Original research" is clearly defined in the no original research policy. Our core content policies, including no original research, are mandatory, not optional. Saying "No" to a policy because you don't like it is simply not acceptable on Wikipedia. You are welcome to publish original research on your personal webpage, or in some of these alternative outlets, but it doesn't belong on Wikipedia. — Newslinger talk 01:52, 11 September 2019 (UTC)[reply]

• Verifiability: This section contains many instances of citation overkill, but also cites unreliable sources, including:

on the citation overkill, sometimes I really need them, to back up state by state non-LTCR Medicaid estate recovery status. (On my Medicaid estate recovery, on that problem also in problems section, a fellow put in the talk section that I should put each state on a separate line or section or something. But I think that can't be done here. In the yes/no on estate recovery listings, I could put footnotes on each state, rather than at the end. (That would cover two of the three very long footnote listing cases I see. The other one is this: "The issue of the negative interaction of the ACA with Medicaid estate recovery was noticed in many places starting from the time of ACA passage.[356][357][358][359][360][361][362][363][364][365][366][367][368][339]". So it's about the reporting at various times, mostly 2014, and as well as outrage. On Medicaid estate recovery, the person may have suggested say noticed in "The Washington Post", "The Seattle Times", "Health Affairs", and put a footnote on each one. (I have a request for clarification from that gent to see exactly what he meant.) These references may not be essential to document the existence of the problem, but if I don't put them, you're gonna tell me "original research". But, more importantly, the curious reader will want to see that it was reported, and in certain cases, can trace that being reported yielded a quick change of policy, and as well, the reported of the reasoned outrage (mostly in newspapers, 1 or 2 non-airtight sources for opinion) has value. — Preceding unsigned comment added by NormSpier (talk • contribs) 20:02, 9 September 2019 (UTC)[reply]

• 1. eHealth Insurance, a shopping tool for insurance

The definition of "subsidy cliff" is in all likelihood elsewhere you would consider reliable. It's used for the name. That the subsidy cliff exists is economically obvious to people who know the structure of the lwas, and can reason a bit economically. I saw the potential for this type of problem immediately, on ACA passage. — Preceding unsigned comment added by NormSpier (talk • contribs)

• 1. Google Docs, a self-published document — Preceding unsigned comment added by NormSpier (talk • contribs)

I think was referenced prior. Linked to by Health Affairs. It's not essential to any support, but gives the curious and able reader the ability to see that it's being done in varying ways in varying states.

• 1. ElderLawAnswers, a shopping tool for legal aid — Preceding unsigned comment added by NormSpier (talk • contribs)

Was put in because it was nice clear explanation. Redundant with Federal sources. Could be removed.

• 1. a former version of the Wikipedia article for Medicaid estate recovery (see "Wikipedia is not a reliable source")

Same business as before. I didn't realize the purpose in Wikipedia is reliability for footnotes only, at least where they are used for fact, not optiono. — Preceding unsigned comment added by NormSpier (talk • contribs)

• 1. Marshall, Parker & Weber LLC, a self-published blog post from a private law firm

Could be removed. Redundancy of explanation, that a user might feel was clearer than what's on Federal government sites. — Preceding unsigned comment added by NormSpier (talk • contribs)

• 1. Daily Kos community post, user-generated ("This content is not subject to review by Daily Kos staff prior to publication")

I caught that it was removed by me after user:Newslinger and I had initial discussion. It was there for opinion only, and that it's still there was just my error. — Preceding unsigned comment added by NormSpier (talk • contribs)

• 1. HuffPost contributor (RSP entry)

This one I think is perfectly fine. It's there for opinion only. It was written by an MD (unless that's phony, but Huffington post should catch. It's there to give the flavor of the one issue "Medicaid estate recovery", where people were saying there was a "Big Con" going on. If you understand the problem (existence backed multiply), you will see that it was reasonable to say that. — Preceding unsigned comment added by NormSpier (talk • contribs)

• 1. Open Minds, a consulting firm

This is not essential. It looked like a sound source, judging by the info on it. They have a lot of money, do and do research for people and organizations in the medical area. I liked it because it was a source that had attempted to get more information about which states do "Medicaid estate recovery", of those that did the Medicaid expansion. (I think its like 10, and at the time, they noted some changes were in process. I have myself done the work to look up for a bunch states, with references from government or sometimes reliable newspaper sources. It could be removed.) — Preceding unsigned comment added by NormSpier (talk • contribs)

• 1. Iowa Legal Aid, a legal aid directory

The information used is present elsewhere, on an Iowa state site, lined to right next to it. It could be dropped. I put it in because I thought it had a clearer explanation, and maybe other info that Iowa residents would find helpful. (It was on .org, not a .com, whatever that was good for. Legal aid sounded pretty legitimate. It likes like a genuine "doing good" organization from https://www.iowalegalaid.org/resource/applying-for-help-from-iowa-legal-aid , but again, it can be dropped with no loss of backup of assertions. — Preceding unsigned comment added by NormSpier (talk • contribs)

• 1. Idaho Care Line, a blog unaffiliated with the state of Idaho

This one, I couldn't find a government site, which sometimes doesn't exist. So this looked pretty good. What happens is some states don't have anything written anywhere. VT is such a case. I have orally that they don't do non-long-term-care-related estate recovery, but they said it's not on paper or the web. (A person I know also called separately and got the same information.) But I digress. This can be removed, with removal on the not-really-necessary information on the small state of Idaho. (Sorry, Idahoans, its not that we don't care about you...) — Preceding unsigned comment added by NormSpier (talk • contribs)

• 1. Policygenius, an insurance broker

This could be removed. I used it redundantly to an also-reference MACPAC report. — Preceding unsigned comment added by NormSpier (talk • contribs)

• 1. healthinsurance.org, a shopping tool for insurance — Preceding unsigned comment added by NormSpier (talk • contribs)

I've used this either for terminology, or to provide a clear explanation for the reader of some things. Its not essential. Note that ref [534], not by me, uses that source.NormSpier (talk) 19:50, 9 September 2019 (UTC)[reply]

Content that complies with Wikipedia's core content policies isn't necessarily "perfect". Wikipedia also has a list of other policies and guidelines (and I haven't even mentioned the Manual of Style yet). Rather, the three policies I referenced throughout these discussions (no original research, verifiability, and neutral point of view) are minimum standards for acceptable content in Wikipedia. Not all articles meet these standards, and any editor is welcome to address violations when they see areas for improvement.

"Be bold" is a guideline, but disputed edits are usually subject to immediate reversions until they can be thoroughly examined and discussed. I did not revert all of the added content because it was made over the span of a month, and because I thought it would be good to receive input from more editors. This RfC is one of the ways I am soliciting additional input.

With User:Newslinger's prior line, I raise a serious procedural issue. There is an issue of editor authority and how disputes are resolved. I had raised the topic after interacting with User:Newslinger at Wikipedia:Teahouse#Determining_official_Wikipedia_editor_role_and_authority_of_editors_coming_in_commenting_on_a_persons_additions , where before my request, I had gotten the impression that User:Newslinger was some sort of authorized official policeman from Wikipedia. But, I got the response, that all editors are equal in authority. Content disputes are resolved by some sort of democratic procedure. (This was clearly stated at the Teahouse by user:RudolfRed and user:Beeblebrox, extending even to administrators, of which User:Newslinger is not anyway actually one). So I'm kind of shocked here, on the above section where User:Newslinger wrote "I did not revert all of the added content because it was made over the span of a month, and because I thought it would be good to receive input from more editors." I'm shocked because, the issue at that point, with my content, was, (and still so far is) between me, and User:Newslinger. So, where is the authority to roll back the edits that he indicates he had the right to do?? I am new to Wikipedia writing. You must have some wiki-way to wiki-explain what he wiki-thought he could do, in some wiki document, or by explaining it as informal unwritten wiki-culture or wiki-norms. Please, someone, explain to me on what authority.NormSpier (talk) 17:04, 10 September 2019 (UTC)[reply]

As I and other editors at the Teahouse discussion have explained to you, there is no editor "authority" or hierarchy for content disputes on Wikipedia. It is common practice for any editor to revert disputed edits, and the fact I opted to start an RfC instead of reverting your edits immediately is a courtesy to you. Wikipedia operates on consensus, and the result of this discussion (if more editors participate and express their opinions) will determine any changes that should be made to this article. — Newslinger talk 01:37, 11 September 2019 (UTC)[reply]

Thanks, User:Newslinger, for WP:BRD, which is very useful. I also caught just now that you had the link prior, and I failed to click on it. Hopefully, some people skilled in both the relevant field, and applying wikipedia rules, will show up at our party here, and take us out of deadlock.NormSpier (talk) 19:24, 11 September 2019 (UTC)[reply]

Regarding neutrality, I don't see a pro-ACA bias in the August 7 version of the article. The "Public opinion" section of the article was moderately negative, and the "Criticism and opposition" section was a very substantial portion of the article. However, I don't think the September 7 version has a substantial anti-ACA bias, either, with the exception of the issue in the "Cost-sharing Reductions" section. I posted the noticeboard discussion on the neutral point of view noticeboard because the content additions spanned 6 articles. NormSpier proactively removed the content from 4 of the articles, addressing the bulk of the neutrality issue, and I thank them for doing so.

I know about the public opinion part, so I guess that is a negative about the law in the article before I got to it. But public opinion is different than whether the law is really failing some people. I just read through the section, and its all what people think in a possibly emotional way. Nothing like public reactions to the 5 problems: sometimes excessively high deductibles, unaffordable premiums over the fiscal cliff, etc. So, yes, I guess there is a little something negative, but nothing with the real problems affording the insurance. (The closest in the public opinion section, which is not very close, is that people don't like the mandate.)NormSpier (talk) 20:20, 9 September 2019 (UTC)[reply]

In the "Criticism and Opposition" section, its mostly public opinion, not how the law is functioning. The exception is that unions indicate that their own union (non-ACA) plans are having their coverage disrupted, by things like driving up the cost of union plans. So, yes, this is a case where there is a negative effect on some health insurance, but not saying anything about a problem with ACA health coverage itself.

So I find my addition, of 5 problems with the ACA health insurance to be important fundamental information about the ACA prior conspicuously omitted prior to my arrival on the scene. (More fixes needed available to the reader in one of my references in that section--the article co-authored by Tim Jost of Health Affairs). As well as the "problems" answering the aforementioned pro-ACA-bias cited in Talk:Patient_Protection_and_Affordable_Care_Act#POV_issues, where, I note, one of the specific POV problems there was "It does not even take the time to mention in the very least, that for SOME people, many of the included studies do not reflect their experiences, especially concerning deductible increases etc." The POV concern was "deductible increases etc.". One of my 5 issues added is "Sometimes Unaffordable Out-of-Pocket Maximums", which is the same kind of thing as high-deductibles. It addresses out-of-pocket costs, which is the ultimate real concern with "deductible increases etc.". (This requires a little basic economic reasoning to see that. Insurance is supposed to mitigate the worst that can happen to you. Out of-pocket-expenses include both deductibles and copays, and the out-of-pocket maximum limits the worst than can happen to you--that is, the worst you can be financially hit from deductibles and copays. So what I've done to do the explanation here is "think a little and know just a little", or, "original research", depending on whether you ask User:Newslinger or me.)NormSpier (talk) 16:24, 10 September 2019 (UTC)[reply]

Overall, I appreciate all of the work NormSpier has put into expanding this article and the Medicaid estate recovery article, and I hope NormSpier continues to contribute to Wikipedia with these core content policies in mind. — Newslinger talk 12:59, 9 September 2019 (UTC)[reply]

I appreciate that thought, user:Newslinger. As raised above, the model "sentence, reference, sentence, reference" which may be ingrained in the new standards will likely keep me away from this kind or article in the future. (Some reviewers would need to be able to understand the policy in some detail, as well as light economics to keep me going.) Also, note, if you wind up keeping my contributions, G-d knows who will show up next week, and the week after, and the week after, and we have to start a whole new RFC each time. And who knows if it will say anything about the person's role, or self-appointed role, on their user page, when I click on it.)

Otherwise, its possible that I'm making too many demands on the reader with the quantitative stuff, with the purposeful parsimonious representation of the coverage mechanism, etc. It could be a reasonable editorial decision that demands at that level should be left to hard science and math articles in Wikipedia.

I'm interested in this content in the 2 articles, because there is public discussion by Democrats now of repair or replace. So I think problems should be easy for people to find. Also, people who resent the ACA should at least not have the feeling that real problems are ignored, and thus choose to vote for G-d knows who in response. Many have people have real problems with the premiums, deductibles and copays, and coverage gaps (i.e., a period of no insurance), and such. So I feel I owe the country, and truth, due perseverance on this content.

I may have to stop after this, and just contribute, when I feel in the mood, to math or engineering Wikipedia content.NormSpier (talk) 20:20, 9 September 2019 (UTC)[reply]

Also, I guess I'd like to request again (repeated from somewhere above) that User:Newslinger state what he wants to do with the related content of mine Medicaid estate recovery, whose content is equally in dispute between just the two of us, for similar reasons to ACA. Is he going to do a separate RFC? Etc. (I think this RFC is only on the ACA content, but I'm not even absolutely clear on that.)NormSpier (talk) 17:15, 10 September 2019 (UTC)[reply]

​The Medicaid estate recovery article is not part of this RfC. I'll address any issues on Talk:Medicaid estate recovery when I have time. However, as I have previously requested on your talk page, please reduce the volume of your comments (not just on this RfC, but everywhere). The length of your comments is disproportionate to the lengths of everyone else's comments, and it is deterring other editors from participating in these discussions. — Newslinger talk 01:12, 11 September 2019 (UTC)[reply]

​Another option for people would be to chime in on Medicaid estate recovery here, for the purpose of saving everyone time (overall), as I expect that will yield an RFC as well, and as it's the same just you against just me status. And the contested part of the content of Medicaid estate recovery is virtually the same material as one of the 5 "Problems" in ACA. Rather than making the community intellectually invest to understand that content twice. (To clarify that for people, Medicaid_estate_recovery#Non-LTCR_estate_recovery_and_the_ACA is an expansion on Patient_Protection_and_Affordable_Care_Act#Estate_Recovery_under_138%_FPL, and I suspect much of user:Newslinger's objections to the former are already stated above for the latter.) NormSpier (talk) 03:34, 11 September 2019 (UTC)[reply]