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grantcart

(53,061 posts)
Thu Oct 3, 2013, 03:01 PM Oct 2013

Finally got my Health Insurance. The Affordable Care Act isn't that good.

It is fucking unbelievable.

No wonder they are scared.

1) Application Process
I am 'beached' with nothing to do because of the shutdown so I have a lot of time and once it is settled will have nonstop work until December so I was highly motivated to get it done fast.

I made several calls, used the chat operation and finally found that 3 AM was the time when I could get on.

Once in the system the actual sign up process is amazingly well done. It is easy, approachable and if you have problems you can use the chat or the phone to talk to somebody. The phone wait time dropped from 45 minutes to immediate pick up right now.

The phone counselors don't have a lot of options at their end but I was able to get information to fix some hiccups. It was obvious that the entire site is straining and the people answering questions also are having problems using the site.

I finished all but the last page which sets up payment options and then the site froze again. When I talked with the operator I was shocked when he said that I was the first person he had talked to that was able to get that far in the process. Of course some people managed to get all the way through and wouldn't need to call.

What is interesting is that they have been able to ramp up the call center so that there is no wait at all but that the traffic on the site is staggering.

2) Subsidy

I think that most of us have had the experience of making too much to qualify for government support except in some exceptional times. I am sure that I am not alone in thinking that the subsidies wouldn't be that great.

I was shocked to find that the ACA is paying 40% of my premium.

Last year was something of an unusual year for me. I am self employed and moved states so my gross income was lower and I had a lot of business expenses so my adjusted gross income was in the low 40s to low 50s (not sure which income they used because I recently filed an amended return). I never expected that level of subsidy, hell I didn't expect a dime.

3) Plans

I intended to search and pick out the lowest non profit plan I could find. Because of the subsidy though I decided to go to get a gold plan.

It had low co pays, zero deductible and maximum $ 10,000.

It is 'for profit' but the HMO is ranked #1 in my state and I have 1000 primary doctors in the system.

Total Cost $ 765 per month, my monthly premium is $ 444 for my wife and I.

For a 59 year old diabetic that is a stunning, revolutionary change.

4) Glitches

There were several glitches along the way. Among them:

1) People who you call in to really don't have any 'super power' at this time to over ride the system.
2) Lots of little things aren't working for example I had a lot of problems logging in so I tried 'forgot my password' option and a message came up saying they sent an email to my account but none came.
3) Another glitch at one point I had a verification problem for my wife and had to upload immigration documentation but it wouldn't upload.

But the biggest problem we had was verifying my wife, a permanent resident. As part of the process they are using IRS and Immigration databases to verify and there is a typo in my wife's name on her green card.

They have a "live" human option to assist with verification. If you have a verification problem then you will need your ID# and phone in and tell them that you need to set up a "Verification conference call with Experian" to verify the disputed person.

Now here is the interesting part: We had the problem last night at 3:00 am "Experian" wasn't open so we had to get back in line this morning and try again but when we logged on the verification was settled. That means that either they began waving all of the people with similar problems (one of the phone counselors said they were getting a number of people with verification problems) or that they automatically flagged my application for review and did it individually. Either case that shows a pretty high level of course correction in the middle of a unbelievable traffic.



Some here have health insurance and don't realize what it is like to go a decade without access to good care when you have a serious problem (and this was after I had very high level PPO plans for 20 years but lost it when I got sick).

I know that there will still be some for who this plan isn't going to deliver as much help as they need.

But, at least in my case, it was a much much better plan than I think even the more optimistic of us thought. If the shutdown is concluded and I can get back to work I will be able to finish the year at a level that may make them take back the subsidy and that would make me very happy but I was stunned to see how big the subsidy was based on last year's numbers.

This is going to be a major improvement in a lot of peoples lives and that is why the Republicans are trying so hard to sabotage it.



There is going to be one economic boom related to the ACA early next year. There are going to be millions of people like me who have "pent up demand" for medical services who are going to rush in for medical care in January. In the beginning the insurance companies are going to have to write big checks for a lot of people who have been putting off medical care. I predict that the final irony of the initial stage of the ACA will be that it will be a minor stimulus event on its own during the first quarter of 2014.

This isn't the end but the first step until we get universal single payer. In my opinion its a much bigger first step than we thought it was.

The one thing they could and should still do is to restrict people applying on a particular day by limiting those to certain letters of the alphabet. For example first day Last Names starting in A-D and so on. That would solve a lot of problems and reduce wait time.
195 replies = new reply since forum marked as read
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Finally got my Health Insurance. The Affordable Care Act isn't that good. (Original Post) grantcart Oct 2013 OP
This message was self-deleted by its author Squinch Oct 2013 #1
Wow. That is great for you. and the rest of us. I know there are still things that need to Hoyt Oct 2013 #2
...oops. Missed that second line. But I read the WHOLE rest of it, I swear! Squinch Oct 2013 #3
Thank you so much grantcart for your very informative post pnwmom Oct 2013 #4
well I was a strong supporter of it after I learned that they would control the Medical Loss Ratio grantcart Oct 2013 #7
I'll be stuck w bronze plan with 40% out of pocket WillYourVoteBCounted Oct 2013 #120
If you go to the relevant page 13 grantcart Oct 2013 #133
When you said "10,000" maximum that isn't a cap is it? Maraya1969 Oct 2013 #145
It means maximum out-of-pocket Autumn Colors Oct 2013 #150
Oh, OK... IthinkThereforeIAM Oct 2013 #160
Kicking so more people see this. nt riqster Oct 2013 #5
k&r HappyMe Oct 2013 #6
Wow, that seems equivalent to the cost of high-quality employer insurance frazzled Oct 2013 #8
well copay for hospital is $ 500 a day but I am fine with that grantcart Oct 2013 #12
That's $10k for the whole year, right? Nye Bevan Oct 2013 #20
I assume so but won't know all the details until I get the fine print grantcart Oct 2013 #23
"The highest plan you can afford with subsidies" might not always be the best choice. missingthebigdog Oct 2013 #42
Okay, but if you're 59 and have diabetes ... frazzled Oct 2013 #45
I absolutely agree that if you are going to utilize it heavily, missingthebigdog Oct 2013 #68
K&R! Whisp Oct 2013 #9
K&R B Calm Oct 2013 #10
Good to hear. SalviaBlue Oct 2013 #11
Well I prefer 'sardonic understatement', lol, but thanks. grantcart Oct 2013 #14
$444 is what you'll pay each month? Puzzledtraveller Oct 2013 #13
for me an Mrs. grantcart grantcart Oct 2013 #16
I wonder what my total plan cost is. Puzzledtraveller Oct 2013 #22
Ah... let me guess, Union job? druidity33 Oct 2013 #103
K&R for Unions. The ACA too. dotymed Oct 2013 #152
This is great news for you and your wife, grant! sheshe2 Oct 2013 #15
Woohoo! Thanks for posting. judesedit Oct 2013 #17
Thanks for the report. Wish I could do this. freshwest Oct 2013 #18
It is a start Nimyth Oct 2013 #19
Welcome to DU. grantcart Oct 2013 #21
Congrats. Daniel537 Oct 2013 #24
Agreed. Repubs are trying to sabotage the ACA via refusing Medicaid expansion. riqster Oct 2013 #35
Kick and Rec Kingofalldems Oct 2013 #25
Can you imagine how this will translate to economic growth? Old and In the Way Oct 2013 #26
Or how the entire medical industry will have 10 million paying customers dumped on grantcart Oct 2013 #38
we are licking our chops here in chicago. mopinko Oct 2013 #127
Congrats. But do you resent burning $5k a yr on ins? leftstreet Oct 2013 #27
I already pay 12K a year. Through my employer plan. riqster Oct 2013 #29
Well that should change by 2018 leftstreet Oct 2013 #33
My employer pays the premiums, but we have a 12K deductible. riqster Oct 2013 #40
For the people who's employer offers coverage Puzzledtraveller Oct 2013 #41
Describes it perfectly. riqster Oct 2013 #67
Of course not. Based on the income it is very fair. grantcart Oct 2013 #31
Well that's cool leftstreet Oct 2013 #37
on 50 grand income questionseverything Oct 2013 #69
a little misunderstanding grantcart Oct 2013 #74
How much would he have to burn in a Universal/Single Payor system?? cbdo2007 Oct 2013 #63
Would you be asking the same question if it was taxes paid for health coverage? Ikonoklast Oct 2013 #83
If we were both to get sick same year, we'd need to come up with a minimum 3Ok to pay blue cross for DeschutesRiver Oct 2013 #90
Spreading outside of DU (with the author's permission) riqster Oct 2013 #28
I don't know why I never realized that YOU were Mr. Blunt & Cranky. You're awesome. kestrel91316 Oct 2013 #59
Thank you! riqster Oct 2013 #65
I never looked at your profile. It's right there, lol. kestrel91316 Oct 2013 #71
3 a.m. EST, CST, MST or PST, because mrmpa Oct 2013 #30
3 am Eastern. grantcart Oct 2013 #34
Same here in South Cackalackey. StandingInLeftField Oct 2013 #171
Congrats! Good post. n/t Benton D Struckcheon Oct 2013 #32
Excellent, very happy for you. I enjoy reading how in specifics ACA is making such a difference Jefferson23 Oct 2013 #36
K&R BumRushDaShow Oct 2013 #39
you rock, grantcart! BlancheSplanchnik Oct 2013 #43
Fabulous! I'm in NC, so I'm nervous... OneGrassRoot Oct 2013 #44
Experian wasn't open? That's a credit reporting agency. denverbill Oct 2013 #46
They weren't open at 3:00 am for a "live" conference call with the ACA counselor grantcart Oct 2013 #51
OK if they are using it to verify the name that makes more sense. denverbill Oct 2013 #54
They are included as trusted data sources. Puzzledtraveller Oct 2013 #56
OK, that makes sense as well now. denverbill Oct 2013 #58
Thank you, grantcart, Sissyk Oct 2013 #47
THIS is driving the freepers INSANE! Rex Oct 2013 #48
They must like spending more to get less, and hate saving money. Ikonoklast Oct 2013 #87
That was a GREAT headline tease. :) tofuandbeer Oct 2013 #49
No insurance for 3 years, HockeyMom Oct 2013 #50
I understand the need to be pro active and I got my Diabetes under control by being pro active and grantcart Oct 2013 #53
If you got hit by a car next month you'd be glad you had Medicare. n/t pnwmom Oct 2013 #72
No HockeyMom Oct 2013 #93
I didn't say you would die. If you were a mass of broken bones pnwmom Oct 2013 #99
It is the not dying that is a bitch. Curmudgeoness Oct 2013 #102
Or badly wounded but not dead IronLionZion Oct 2013 #114
If you break an arm, will you set it yourself? SheilaT Oct 2013 #82
I had food posioning 3 years ago HockeyMom Oct 2013 #94
Lots of people have had food poisoning and didn't go to the hospital. pnwmom Oct 2013 #100
Yes, you have that right. But it sounds almost like a death wish. IrishAyes Oct 2013 #124
I had food poisoning about 7 years ago davidpdx Oct 2013 #146
I was my Mom's Health Proxy HockeyMom Oct 2013 #105
I still wonder what you'll do if you break an arm or a leg. SheilaT Oct 2013 #135
I got some kind of bug bite a week ago HockeyMom Oct 2013 #174
So you really will set a broken arm or leg yourself. SheilaT Oct 2013 #175
I know what a broken bone looks like HockeyMom Oct 2013 #176
That sounds cool. Crunchy Frog Oct 2013 #182
One of the worst scenarios I can imagine is having a disabling stroke, No Vested Interest Oct 2013 #136
My father went through several strokes davidpdx Oct 2013 #149
David, I'm sorry you experienced that at the end No Vested Interest Oct 2013 #164
Well, your health must be excellent, that's good nadinbrzezinski Oct 2013 #165
kick Liberal_in_LA Oct 2013 #52
grantcart, for the self-employed are they using Lex Oct 2013 #55
I don't know. grantcart Oct 2013 #61
Thanks. Lex Oct 2013 #122
I can't imagine they would use gross income Abq_Sarah Oct 2013 #134
sounds good... awoke_in_2003 Oct 2013 #57
Thanks, great info! About that verification problem - MH1 Oct 2013 #60
I use e-verify at work..... llmart Oct 2013 #111
Wow, that's interesting. MH1 Oct 2013 #125
Yeah, I was thinking that the teabaggers...... llmart Oct 2013 #148
That is wonderful! TxDemChem Oct 2013 #62
Damn right! The AFA is far from great. It's just a baby step in the right direction. maddiemom Oct 2013 #64
You obviously didn't read the OP. He says it's a "stunning, revolutionary change" pnwmom Oct 2013 #73
to be clear it is a stunning, revolutionary change for grantcart Oct 2013 #75
My healthy 26 year old will pay half as much pnwmom Oct 2013 #77
Well, that kind of sucks Art_from_Ark Oct 2013 #106
People on Medicare ALREADY have this kind of coverage. pnwmom Oct 2013 #107
Here's the deal with my family member: Art_from_Ark Oct 2013 #110
Do you know why she's having to pay so much for drugs? pnwmom Oct 2013 #115
I don't know why, exactly, that one drug costs so much Art_from_Ark Oct 2013 #117
If she has a paid-for home, there is the option of pnwmom Oct 2013 #119
She did look into a reverse mortgage, Art_from_Ark Oct 2013 #128
She is right not to get into any kind of arrangement like that pnwmom Oct 2013 #129
I just heard from her Art_from_Ark Oct 2013 #186
I'm so glad for you both. pnwmom Oct 2013 #187
K & R SunSeeker Oct 2013 #66
So glad to hear that - TBF Oct 2013 #70
Wonderful to hear this!! K&R! hue Oct 2013 #76
Please stop spreading this propaganda. The freeper heads are exploding and the noise is keeping me Happyhippychick Oct 2013 #78
I got mine yesterday Cryptoad Oct 2013 #79
great grantcart Oct 2013 #80
$444 JustAnotherGen Oct 2013 #81
Individual results may vary. Orsino Oct 2013 #84
As soon as I get back home, I'm dumping my plan. Ikonoklast Oct 2013 #85
Well I wouldn't dump it until you have gone through the process. grantcart Oct 2013 #86
Already looked at what's available, I'll save $95 a month and get much better coverage. Ikonoklast Oct 2013 #88
Remember, it goes into effect in January, No Vested Interest Oct 2013 #140
I'm already paid up into November, the next bill from them will be my last. Ikonoklast Oct 2013 #144
Thank you, grant! Cha Oct 2013 #89
Excellent read!! TY Hulk Oct 2013 #91
nice report, thanks for all the info! n/t coeur_de_lion Oct 2013 #92
Thanks for taking so much time to convey pangaia Oct 2013 #95
WOW... humbled_opinion Oct 2013 #96
A number of things grantcart Oct 2013 #109
Interesting humbled_opinion Oct 2013 #167
Young folks can opt for catastrophic only, for about $ 1.50 a day grantcart Oct 2013 #169
Glad to hear it! Looking forward to signing up, too Maeve Oct 2013 #97
I'm still shopping the ACA, but you're right! ffr Oct 2013 #98
It is unbelievable Mnpaul Oct 2013 #101
That sounds like a glitch. Keep trying and/or phone the call center. hedda_foil Oct 2013 #141
We had a working insurance marketplace Mnpaul Oct 2013 #151
Thanks for posting. hay rick Oct 2013 #104
You had me going there with your subject title Grateful for Hope Oct 2013 #108
Good for you! llmart Oct 2013 #112
Wow. Just wow. Thank you so much for putting this together for all of us here. Hugs & nt. Hekate Oct 2013 #113
Good idea. I've been thinking the same thing chill_wind Oct 2013 #116
Awesome! 47of74 Oct 2013 #118
Drat your hide, man! IrishAyes Oct 2013 #121
Well it wasn't aimed at the home team but all the Freepers, Cave Dwellers and Trolls grantcart Oct 2013 #123
Well, a good jolt to the heart is helpful at my age! Most fun I've had all day. IrishAyes Oct 2013 #126
in that case stop by here and MFM will give you a nice bump every day grantcart Oct 2013 #132
Thanks. I subscribed. IrishAyes Oct 2013 #157
Happy for you! cilla4progress Oct 2013 #130
Thanks grant for using your enforced off time from work so Cha Oct 2013 #131
Great "how-to." Thank you! emsimon33 Oct 2013 #137
It will benefit the working poor more than anything. joshcryer Oct 2013 #138
. mzmolly Oct 2013 #139
Curious how you got a subsidy for a gold plan eridani Oct 2013 #142
Here's some info I found. DebJ Oct 2013 #153
and this also: DebJ Oct 2013 #154
Early on you are asked if you want to go straight to the plans or see if you qualify for a subsidy. grantcart Oct 2013 #155
I've been self employed in the past and insurance was always an issue Matariki Oct 2013 #143
Grant you old devil, your sarcasm is baddddddddd! davidpdx Oct 2013 #147
K & R! lonestarnot Oct 2013 #156
My rate is going down $9 PasadenaTrudy Oct 2013 #158
how much better is the coverage? grantcart Oct 2013 #159
No deductibles PasadenaTrudy Oct 2013 #166
Kick for Visibility. NYC_SKP Oct 2013 #161
I also got something amazing!! Autumn Colors Oct 2013 #162
great grantcart Oct 2013 #177
oh the horror konnie Oct 2013 #163
Suggest you use sarcasm in your OP title.... Populist_Prole Oct 2013 #168
cool. nt Deep13 Oct 2013 #170
Can someone tell me more about the ACA paying premiums? Have a lot of relatives who hate this law. tjdee Oct 2013 #172
I recommend that the best way is to go to Healthcare.gov and try for yourself grantcart Oct 2013 #173
Thank you! will definitely pass that on. nt tjdee Oct 2013 #179
Sounds pretty good to me cristianmarie533 Oct 2013 #178
good luck and welcome to DU grantcart Oct 2013 #195
Great post. SoapBox Oct 2013 #180
That's 10% of your pretax income. grahamhgreen Oct 2013 #181
What about that increased demand? beakt Oct 2013 #183
Welcome to Du, may you read and learn here. A couple points. WTF. And why are you here? uppityperson Oct 2013 #184
...and I would add cyberswede Oct 2013 #190
Hi cswede, there is that too. uppityperson Oct 2013 #192
Perhaps the most ignorant statement ever made on the subject. grantcart Oct 2013 #185
I found that in Indiana with our Tea Bagger Governor that INdemo Oct 2013 #188
Awesome post as always GC. n/t vaberella Oct 2013 #189
thanks grantcart Oct 2013 #191
Thanks for post of excellent topic. lots of good Affordable Care Act advice here. Sunlei Oct 2013 #193
thanks grantcart Oct 2013 #194

Response to grantcart (Original post)

 

Hoyt

(54,770 posts)
2. Wow. That is great for you. and the rest of us. I know there are still things that need to
Thu Oct 3, 2013, 03:09 PM
Oct 2013

be improved quickly for people who fall through the cracks, and folks need to vote out the Republicans from the mostly red states that declined to expand Medicaid.

pnwmom

(108,955 posts)
4. Thank you so much grantcart for your very informative post
Thu Oct 3, 2013, 03:11 PM
Oct 2013

and your willingness to change your mind when the facts turned out to be different than you were expecting.

I know why it is hard to be optimistic these days . . . but I believe the ACA will turn out to be a major -- and progressive -- step forward.

grantcart

(53,061 posts)
7. well I was a strong supporter of it after I learned that they would control the Medical Loss Ratio
Thu Oct 3, 2013, 03:13 PM
Oct 2013

which was in 09, I just didn't think that the subsidy would be that easy to get, hit those income points and that the plans would be that good.

WillYourVoteBCounted

(14,622 posts)
120. I'll be stuck w bronze plan with 40% out of pocket
Thu Oct 3, 2013, 10:03 PM
Oct 2013

so its basically catastrophic insurance, nothing at all like Health Care.

There are 4 plans, premiums priced by % of out of pocket.
For folks who don't qualify for medicaid they will likely choose the "Bronze" plan that requires 40% out of pocket.

Here are the percentages of health care costs you pay for each type of plan.
Bronze plan: 40%
Silver plan: 30%
Gold plan: 20%
Platinum plan: 10% of your health care costs.

(The higher the out of pocket the lower the premium)

http://www.webmd.com/health-insurance/insurance-marketplace/marketplace-insurance-choices

The CBO estimates that in 2022--8 years after the Affordable Care Act has been fully implemented--30 million people will remain uninsured.

“CBO and JCT [Joint Committee on Taxation] now estimate that the ACA, in comparison with prior law before the enactment of the ACA, will reduce the number of nonelderly people without health insurance coverage by 14 million in 2014 and by 29 million or 30 million in the latter part of the coming decade, leaving 30 million nonelderly residents uninsured by the end of the period,” the report said.

http://cbo.gov/sites/default/files/cbofiles/attachments/43472-07-24-2012-CoverageEstimates.pdf

grantcart

(53,061 posts)
133. If you go to the relevant page 13
Fri Oct 4, 2013, 12:31 AM
Oct 2013

It shows that they have radically changed their projections but even with those changes they are projecting that non elderly people with insurance will reach 92% by 2022.

I believe that this projections dramatically underestimate the response.

CBO does a good job with well established historical patterns but this is such a one off new situation I wouldn't take the numbers too seriously.

In 6 months we will have real numbers and see what the CBO projects with the new numbers.

Maraya1969

(22,462 posts)
145. When you said "10,000" maximum that isn't a cap is it?
Fri Oct 4, 2013, 05:37 AM
Oct 2013

I can't figure out what the $10k means. Or maybe is it the most a person can pay for their insurance?

I'm trying to get my republican mother to check it out. She still thinks her insurance of going to go up because of it.

 

Autumn Colors

(2,379 posts)
150. It means maximum out-of-pocket
Fri Oct 4, 2013, 07:22 AM
Oct 2013

That's the maximum amount grantcart will have to spend out-of-pocket in one year.

IthinkThereforeIAM

(3,075 posts)
160. Oh, OK...
Fri Oct 4, 2013, 11:43 AM
Oct 2013

... I was wondering about the, "$10,000", mentioned in your post, too. I had gall bladder removal surgery this past January and the total costs, including 2 emergency room visits, ultra sound and CAT(on successive visits) along with the hospitalization, OR and surgeon's fees(he waived all after what Medicare B paid, bless his heart) it came to $18,000, of which I had about $1,500 to pay out of pocket. I know, I should have been under a supplementary plan, but procrastination seems to be my favorite hobby.

Needless to say, the surgeon chewed out the OR director as I sat in the exam room following my second ER visit. They should have never let me go home after the first one, and I ended up having to have emergency surgery as I had 8 gall stones and my gall bladder was the size of a flip phone, ready to burst.

on edit: typo

frazzled

(18,402 posts)
8. Wow, that seems equivalent to the cost of high-quality employer insurance
Thu Oct 3, 2013, 03:16 PM
Oct 2013

I think that's about what mr. frazzled's part of the contribution is each month for his institutional plan (although it's probably gone up the last few years, and it's kind of hard to see what you are actually paying). We too picked an "HMO" insurance plan, after finding deductibles going up on our PPO plan. We love it. Same doctors we had before, including specialists, zero deductibles -- and we've had to use it for a couple of fairly intense hospital stays, which were 100% covered.

It sounds like you're getting a great deal, and I encourage people to look at the highest plan they can afford with subsidies.

Congratulations, and keep that diabetes in check!

grantcart

(53,061 posts)
12. well copay for hospital is $ 500 a day but I am fine with that
Thu Oct 3, 2013, 03:19 PM
Oct 2013

because the total limit is $ 10,000.


I had more or less reached the point that if anything really major came along it wasn't going to be worth it to survive that and live in permanent debt the rest of my life.

Now anything major will be limited to $ 10k.

Nye Bevan

(25,406 posts)
20. That's $10k for the whole year, right?
Thu Oct 3, 2013, 03:22 PM
Oct 2013

And I would think that a single hospital stay is capped at considerably less?

missingthebigdog

(1,233 posts)
42. "The highest plan you can afford with subsidies" might not always be the best choice.
Thu Oct 3, 2013, 03:40 PM
Oct 2013

The maximum individual out of pocket for these plans is $6350.00

Some people pay significant premiums for a "cadillac" plan that they never access. It may make more sense to go with a less expensive plan, and put the difference in a savings account toward that maximum. If you have no major illnesses for a period of time, you will not need to continue to contribute to the savings account. More money in your pocket, less to the insurance company!

YMMV. Run the numbers to see if this works for your situation.

frazzled

(18,402 posts)
45. Okay, but if you're 59 and have diabetes ...
Thu Oct 3, 2013, 03:47 PM
Oct 2013

or really, if you're 59 at all, you're going to be using that insurance.

I used practically no medical services my entire adult life (except 2 pregnancies and the yearly OB-GYN exam). Then in my late 50s, early 60s ... well, stuff just starts to happen. Nothing major for me, but a lot of little stuff that adds up medically and has the potential to get very expensive.

missingthebigdog

(1,233 posts)
68. I absolutely agree that if you are going to utilize it heavily,
Thu Oct 3, 2013, 04:48 PM
Oct 2013

you should get the most insurance you can afford.

But for lots of people that are not in your situation, opting for lower premiums might make sense.

One of the frustrations I had with health insurance when I was younger was looking at how much money I had given the insurance company at the end of the year, and realizing that I could have done better paying out of pocket for my care.

One size definitely does not fit all. I'm glad the exchanges will give us so many options!

Now if I could just get through the log in process. . . . .

SalviaBlue

(2,914 posts)
11. Good to hear.
Thu Oct 3, 2013, 03:17 PM
Oct 2013

I almost didn't click on your thread because of the negative title. I didn't realize that it was sarcastic until I read the post.

Puzzledtraveller

(5,937 posts)
13. $444 is what you'll pay each month?
Thu Oct 3, 2013, 03:19 PM
Oct 2013

I suppose that's why people with employee coverage are not eligible for subsidies.

Puzzledtraveller

(5,937 posts)
22. I wonder what my total plan cost is.
Thu Oct 3, 2013, 03:22 PM
Oct 2013

Since the Commonwealth of Kentucky pays the bulk, my employee contribution for just me is $26 a month and I have the 2nd best plan offered.

Nimyth

(34 posts)
19. It is a start
Thu Oct 3, 2013, 03:21 PM
Oct 2013

I think they had to make a lot of compromises and concessions to Ins. Lobbyist Pharma Lobbyist, TBagger Lobbyist etc... Hopefully after it is running for a while they will be able to make improvements.

 

Daniel537

(1,560 posts)
24. Congrats.
Thu Oct 3, 2013, 03:24 PM
Oct 2013

Unfortunately no Medicaid expansion here in Florida means I, and millions of others, are going to have to wait a while to join the ranks of the insured.

riqster

(13,986 posts)
35. Agreed. Repubs are trying to sabotage the ACA via refusing Medicaid expansion.
Thu Oct 3, 2013, 03:33 PM
Oct 2013

They're doing it in Ohio, too. Fuck them, and the Supreme Court for legislating form the bench and allowing this to happen.

Old and In the Way

(37,540 posts)
26. Can you imagine how this will translate to economic growth?
Thu Oct 3, 2013, 03:25 PM
Oct 2013

If suddenly, everyone has a few hundred - a thousand dollars/mo extra disposable cash? I'm paying $1400 for a crappy policy and I can't wait to get on th exchange.

grantcart

(53,061 posts)
38. Or how the entire medical industry will have 10 million paying customers dumped on
Thu Oct 3, 2013, 03:34 PM
Oct 2013

its front door in January, especially people with thousands of dollars of pent up demand in needed medical care.

mopinko

(69,990 posts)
127. we are licking our chops here in chicago.
Thu Oct 3, 2013, 11:00 PM
Oct 2013

hospitals and medical research are a huge part of the reason we are not detroit. they are building as fast as they can.
i love it. good jobs for chicago.
and thrown away old hippies like me can say fuck the corporate world. imagine what we will do.
(i already got started.)

riqster

(13,986 posts)
29. I already pay 12K a year. Through my employer plan.
Thu Oct 3, 2013, 03:30 PM
Oct 2013

I'd KILL to signup via the ACA. I'd save a ton on health insurance, but that's not allowed.

leftstreet

(36,098 posts)
33. Well that should change by 2018
Thu Oct 3, 2013, 03:32 PM
Oct 2013
How Obamacare Is Encouraging Employers To Cut Wasteful Spending And Promote Workers’ Health

By Sy Mukherjee on May 28, 2013 at 4:05 pm

In an effort to cut wasteful U.S. medical spending, certain employers will be scaling back expensive health plans available to their employees and encouraging workers to pursue more preventative and ongoing primary care. The move is being prompted by Obamacare provisions that encourage a more cost-sensitive and efficient approach to Americans’ health care than the status quo.

Recently-released government data shows that Americans’ medical bills are completely random, with some hospitals charging as much as $100,000 more for the same services performed at other facilities. In turn, that drives up the costs of many private health plans, and increases companies’ spending on employer-sponsored insurance.

Obamacare attempts to change this dynamic. Under the law, health plans that cost over $10,200 for an individual or $27,500 for a family will have to pay an excise tax of 40 percent on every dollar that they exceed that cutoff beginning in 2018. As Jonathan Gruber, an MIT economics professor who helped design the law, explained to the New York Times, the tax is meant to reorient the way that employers approach their workers’ health problems and their associated costs. “It’s focusing employers on cost control, not slashing,” said Gruber.

Companies aren’t waiting until 2018 to shift their health care models. Some are increasing their use of high-deductible health plans (HDHPs) — which charge workers low monthly premiums but high annual deductibles — in an effort to raise employees’ awareness of how much their health care consumption costs.

http://thinkprogress.org/health/2013/05/28/2064441/employers-obamacare-cut-wasteful-spending/

riqster

(13,986 posts)
40. My employer pays the premiums, but we have a 12K deductible.
Thu Oct 3, 2013, 03:37 PM
Oct 2013

So I am not sure if that will help us. Good info, though.

Puzzledtraveller

(5,937 posts)
41. For the people who's employer offers coverage
Thu Oct 3, 2013, 03:38 PM
Oct 2013

a lot will depend on just how much the employer covers as far as the cost. I'm lucky as I work for state government so they cover a lot of it and premiums are pretty low. There are those employers who are'nt as generous and the individual and family is stuck paying huge premiums but because it's provided by the employer they can't get any relief. They are not eligible for subsidies. Would that describe your situation?

riqster

(13,986 posts)
67. Describes it perfectly.
Thu Oct 3, 2013, 04:46 PM
Oct 2013

I'm not paying "premiums" per se, so my coverage is deemed "affordable". My $12,000.00 dollar per year deductible doesn't enter into their calculaitons, I guess.

grantcart

(53,061 posts)
31. Of course not. Based on the income it is very fair.
Thu Oct 3, 2013, 03:31 PM
Oct 2013

Even in single payer systems you have to "burn" the premium in terms of taxes.

In this case I will get about 40% of my taxes back to be applied to my own health care.

So in effect I just got a $ 3600 reduction in my taxes.

But that is not the big issue for us, we now have limits to our liability.

If we have cancer, a heart attack, or any other catastrophic event it doesn't become a terminal event with crippling debt. I also can get more effective care for the next 5 years until Medicare kicks in.

I know a lot of guys in my same situation that just avoided any medical treatment until they get Medicare. In that sense this will be very helpful in making Medicare more viable.

questionseverything

(9,645 posts)
69. on 50 grand income
Thu Oct 3, 2013, 04:52 PM
Oct 2013

5328 yearly premium plus 10,ooo out of pocket is 30 %,..that is if they used the 50,000 number

we struggle just paying out quarters...you sure have a good attitude for someone looking at 42.5 % of income gone before ya pay ur income tax or a roof overhead

i am assuming diabetic care would hit that out of pocket every year (hope i am wrong because my spouse is on expensive meds too)

i am just trying to learn here and if you are happy,i am happy for u

grantcart

(53,061 posts)
74. a little misunderstanding
Thu Oct 3, 2013, 05:02 PM
Oct 2013

Zero deductibles. Very low copays

The $ 10,000 is the MAXIMUM in the event of a catastrophic event. If I have a massive heart attack and need a heart transplant, my cost will be 10K.

Hope that helps.

As for what I pay, my total taxes was about $ 7,000 but with the ACA I am getting about $ 3,600 back in premium assistance. How is that not a good deal?

Ikonoklast

(23,973 posts)
83. Would you be asking the same question if it was taxes paid for health coverage?
Thu Oct 3, 2013, 06:16 PM
Oct 2013

The ACA is going to be a huge success, and it pisses some people off.

DeschutesRiver

(2,354 posts)
90. If we were both to get sick same year, we'd need to come up with a minimum 3Ok to pay blue cross for
Thu Oct 3, 2013, 06:48 PM
Oct 2013

our premium, copays, deductible and coinsurance for our policy, which we have had with them for 30 years approx. It would not be possible to pay that much in one year, more less if our illnesses required us to pay that every year if they were of a continuing nature. We've only kept this policy as a life or death kind of deal, break glass only in case of dire emergency sort of thing. At our ages, insurance for self employed peeps is really expense, and medicare is still years away.

Our deductibles are 5k for each of us separately, so every year, the first 5k is on us to pay, so we pretty much try not to see doctors. Coinsurance is 50% for some things, with no cap in some situations. Prescription drugs are mostly our responsibility as well. Our premiums are sky high, and we just got a letter from Blue Cross saying that after Jan 1, we will pay several hundred dollars more per month, plus our benefits, if you can call them that, will be drastically reduced. All this money is basically getting us nothing more than catastrophic health care in many ways. The only good news is that we are older but still somewhat healthy, ie the things we don't see a doc for haven't killed us.

I can not fucking believe what I have heard from Cover Oregon, either. We have called several times, because I needed to hear it from several people to be certain there is no mistake....because...

Once I get our new coverage in place, we can finally go see doctors and get whatever care we need, without immediately running the risk of bankruptcy and being old people in the poor house. True, it will not be free care. But at some level, care will finally be possible and that makes all the difference to me.

So while 5k may not seem like a bargain, it depends upon what coverage you have had in the past. Our current policy is affordable SO LONG AS we never get sick and have to use it. It has been very scary. Until now. i still don't believe what I am hearing, but if it is true, I join the OP in saying the repubs are doing this because they are scared shitless.

riqster

(13,986 posts)
28. Spreading outside of DU (with the author's permission)
Thu Oct 3, 2013, 03:28 PM
Oct 2013
http://bluntandcranky.wordpress.com/2013/10/03/a-real-person-signs-up-for-obamacare-reposted-from-another-writer/

Nobody here needs to bother clicking the link. But if you know a non-DUer who should read it, send them the link. That way more people can read Grantcart's awesome post.

Note to the OP: dude, you really ought to blog. The wider world would be richer for it. Just sayin'.

mrmpa

(4,033 posts)
30. 3 a.m. EST, CST, MST or PST, because
Thu Oct 3, 2013, 03:30 PM
Oct 2013

here on the East Coast, I have tried from 9 p.m. until 4:00 a.m. & I can't get anywhere. I was able to log in at one point & got to the pages of personal information (thank God, those pages are saved), but I tried to advance to the next page and just got errors that the page was unavailable.

Have tried several times today, I am able to log in, but the next page is full of errors. I have used both IE and Chrome browsers.

171. Same here in South Cackalackey.
Fri Oct 4, 2013, 02:46 PM
Oct 2013

Reached the so-called "Success URL" page, but it's blank...

Oh well, at least I'm in the system...I hope.

Jefferson23

(30,099 posts)
36. Excellent, very happy for you. I enjoy reading how in specifics ACA is making such a difference
Thu Oct 3, 2013, 03:33 PM
Oct 2013

for people.

Republicans absolutely hate this for those reasons. Affordable health care will begin to diminish political ideologies
within the voters..having peace of mind for yourself and your loved ones will do that.

OneGrassRoot

(22,920 posts)
44. Fabulous! I'm in NC, so I'm nervous...
Thu Oct 3, 2013, 03:43 PM
Oct 2013

I'll dive into it over the weekend, but we're one of the suckier states, so we'll see....

I haven't had insurance, and thus essentially no involvement with the healthcare system for at least 12 years now.

So glad there's good news on your end!



denverbill

(11,489 posts)
46. Experian wasn't open? That's a credit reporting agency.
Thu Oct 3, 2013, 03:50 PM
Oct 2013

That almost makes it sound like some companies want to order credit reports on you to set your rates.

Experian may provide other types of reporting but I know for a fact they do credit. Just seems odd they would need that to sell you insurance.

grantcart

(53,061 posts)
51. They weren't open at 3:00 am for a "live" conference call with the ACA counselor
Thu Oct 3, 2013, 03:53 PM
Oct 2013

The impression I got was that they would get the Experian staff on the line with a conference call with the expectation that in most cases that they would be able to settle it on the spot.

Not to sell insurance but to finish the verification on my wife's name. Her Green Card has a typo on it and is different from our application. The credit company would be able to give a third source to settle the question, I guess.

In any case this morning it was a moot issue.

denverbill

(11,489 posts)
54. OK if they are using it to verify the name that makes more sense.
Thu Oct 3, 2013, 04:04 PM
Oct 2013

Glad the end result worked for you. I know the process will probably take some time to get the kinks out. Couple of weeks will probably make a big difference in that.

Puzzledtraveller

(5,937 posts)
56. They are included as trusted data sources.
Thu Oct 3, 2013, 04:09 PM
Oct 2013

In my training( I do medicaid), it was explained the system verifies information through numerous trusted data sources. These can be credit agencies like Experian. Income is also verified based on your statement compared to IRS data, if your entries are within an acceptable range compared to what the trusted data sources report, your information is automatically verified. If you are outside those parameters are the information you provided does not match then you may be prompted to provide more factual information to a provider or other agent that is designated to take applications for example.

Sissyk

(12,665 posts)
47. Thank you, grantcart,
Thu Oct 3, 2013, 03:52 PM
Oct 2013

for this wonderful analysis of your experience.

And, congrats on having coverage as of Jan 1st.

 

Rex

(65,616 posts)
48. THIS is driving the freepers INSANE!
Thu Oct 3, 2013, 03:52 PM
Oct 2013

I've never seen the morans so transparent as they are now!

GLAD you got some healthcare!

THANK YOU OBAMA!

Ikonoklast

(23,973 posts)
87. They must like spending more to get less, and hate saving money.
Thu Oct 3, 2013, 06:30 PM
Oct 2013

The facts are that they want the ACA to be more expensive so it fits in with their idiotic narrative.

I wonder how many will refuse to use the exchanges and pay higher premiums just to prove a point.

 

HockeyMom

(14,337 posts)
50. No insurance for 3 years,
Thu Oct 3, 2013, 03:53 PM
Oct 2013

old enough for Medicare next month (which I have no intention of using), but if I was not 65 years old, I probably would have paid the fine instead because I don't want medical insurance, or go to a doctor. Never used my health insurance of $160/month with $3,500 deductible employee insurance. Was thinking of dropping it before I quit working.

I am a Dem and understand that other people do not share my views. If they WANT and USE health insurance, then the ACA is good for them, but not me, and I don't object to it. You can lead a horse to water, etc., sums up me going to a doctor.

grantcart

(53,061 posts)
53. I understand the need to be pro active and I got my Diabetes under control by being pro active and
Thu Oct 3, 2013, 03:58 PM
Oct 2013

about $ 400.

But 10 years ago my wife had terrible ovarian cysts that were life threatening. At that time we had insurance and paid a few hundred. Without it we would have paid tens of thousands.


What happens if you get a treatable but catastrophic illness like cancer? I hope you reconsider about Medicare, you already paid for it with payroll taxes, why not sign up and then not use it unless you need it?

pnwmom

(108,955 posts)
99. I didn't say you would die. If you were a mass of broken bones
Thu Oct 3, 2013, 07:45 PM
Oct 2013

would you just go home and tough it out?

Curmudgeoness

(18,219 posts)
102. It is the not dying that is a bitch.
Thu Oct 3, 2013, 07:52 PM
Oct 2013

If something dire happens, but it isn't enough to kill you, just to make you wish it killed you, and you could completely get rid of problem with health care, would you just suffer for years? I am also not afraid of dying, but I am afraid of living in some cases.

IronLionZion

(45,380 posts)
114. Or badly wounded but not dead
Thu Oct 3, 2013, 09:03 PM
Oct 2013

it could happen to anyone at any stage in life whether you're prepared or not.




 

SheilaT

(23,156 posts)
82. If you break an arm, will you set it yourself?
Thu Oct 3, 2013, 05:52 PM
Oct 2013

If you have a heart attack, get some sort of cancer, whatever, you'll just sit home and die? Really?

 

HockeyMom

(14,337 posts)
94. I had food posioning 3 years ago
Thu Oct 3, 2013, 07:28 PM
Oct 2013

It was very, very peaceful and it would have been a good way to die. I had insurance and didn't go on my own. My husband carried me to emergency care. Am I happy he did that? Not especially. I have no desire to live as long as I possbily can.

As I said, I fully recognize that other people have different views. I only ask that I be allowed to have mine. THAT, I believe, is the DEMOCRATIC way. I fully support people who want heath care, but I just don't want it for ME. Not my right????

pnwmom

(108,955 posts)
100. Lots of people have had food poisoning and didn't go to the hospital.
Thu Oct 3, 2013, 07:48 PM
Oct 2013

And there are a lot of things that could bring you great and/or permanent pain but not death. Or conditions that would leave you blind. I bet your husband wouldn't appreciate having to care for a disabled wife because you refused to get your cataracts removed or to get treatment for glaucoma. Or not being able to communicate with you after you refused to see a doctor about losing your hearing.

You've been very lucky with your health so far, but I think you're unrealistic about not needing health care in the future.

davidpdx

(22,000 posts)
146. I had food poisoning about 7 years ago
Fri Oct 4, 2013, 06:10 AM
Oct 2013

It wasn't a severe case, but it sure was uncomfortable. Try teaching while hoping you don't shit your pants. "Um, excuse me kids I have to step out for a minute". *ques whaling sound of horror from the bathroom*

 

HockeyMom

(14,337 posts)
105. I was my Mom's Health Proxy
Thu Oct 3, 2013, 08:27 PM
Oct 2013

She also had a DNR and was 9 years older than I am now. Yes, she had cancer. Before she went into the hospital, she made her own funeral arrangements. She said, "I have lived my life and do not want to become a science experiment to see how long the medical field can keep me alive." "If you do not go along with my wishes and try to keep me alive, I will haunt you for as long as you live." She went into cardiac arrest in the hospital and nothing was done with her DNR. Clear enough? SAVE HER?. No, I didn't. My Uncle was 68 and refused an operation to save his life. His children tried to fight his decision and have him declared mentally incompetent. SELFISH. It was his life, and my Mom's, and it was their death and family should RESPECT their wishes to REFUSE TREATMENT. Why should STRANGERS also have any say with how people choose to die?

Given my Uncle's experience, and the push for medical care, I don't need that. I need a Living Will and a DNR much more. In just my very brief reading of Medicare, I do think it does address this. Oh, the HORROR of that! Death Panels like the Repukes talk about?

 

SheilaT

(23,156 posts)
135. I still wonder what you'll do if you break an arm or a leg.
Fri Oct 4, 2013, 12:52 AM
Oct 2013

Or get a treatable infection of some kind.

As has been pointed out, there are a lot of things that could happen that would leave you in some way needing lots of care but nowhere near death. Especially if you don't bother to seek treatment.

I understand and am with you on the DNR stuff, and the choosing not to have an operation and so on. But there's all sorts of things that could happen that seeking medical care could be a very good idea.

Also, although I know I don't know the specifics of your mother's situation, at end of life palliative care and hospice are excellent alternatives. That's something else to be aware of and look into if the situation warrants it.

 

HockeyMom

(14,337 posts)
174. I got some kind of bug bite a week ago
Fri Oct 4, 2013, 04:37 PM
Oct 2013

It did not go away with just soaking it with vinegar. The swelling just got bigger and bigger. It didn't hurt (sic) but itched. I got a sewing needle and burned it to disinfect. I then lanced the swollen bite myself. As it oozed out, I noticed something black inside. Bee stinger? I used my nails and pulled it out. Then I got a cotton ball soaked in peroxide, applied it to the bite, and put a bandaide on it.

That was 3 days ago. You almost cannot even see there was anything there today. Would you, or the average American, ever do anything like this? They would be running to a doctor, or even the emgergency room.

Tell me if I went to a doctor or emergency room what would this COST? Insurance is moot because it would just be feeding the system in the end, which is what is causing health care costs to go through the roof.

 

SheilaT

(23,156 posts)
175. So you really will set a broken arm or leg yourself.
Fri Oct 4, 2013, 05:23 PM
Oct 2013

I admire your will power.

Just hope you don't have a compound fracture, you know, the kind where the bone sticks through the skin? Back before anti-biotics they were often fatal. And not an easy way to go, either.

I do occasionally get a bug bite or a bee sting, and weirdly enough, I don't go to the ER.

 

HockeyMom

(14,337 posts)
176. I know what a broken bone looks like
Fri Oct 4, 2013, 05:39 PM
Oct 2013

I passed all the tests to be a NA, but never did the practical. I am also certified in First Aid and CPR. Are you? Cracked my head on a tree limb (felt my head cracking), hair soaked in blood, running into my eyes and face. I compressed my own head and the bleeding stopped. That was a year ago. I didn't have insurance at the time but the tour company I was on said they had insurance and would cover my hospital visit. I signed a waiver. I suppose I could have had internal bleeding too, but I am still here, not blacking out, etc., etc., a year later. So whatever.

My question is why do YOU care what I do? Go to your doctors and just plain leave everyone else to do whatever they want to do. I am not feeding the systems, by using it, and making your rates go up.

Crunchy Frog

(26,578 posts)
182. That sounds cool.
Sat Oct 5, 2013, 06:37 PM
Oct 2013

Maybe someday you'll get to take out your own appendix. Or maybe it will just rupture and you can die of untreated peritonitis. I understand that can be quite agonizing, but maybe someone could get you some black market heroin for the pain.

In any event, when the thread appears announcing your death, it will be reassuring to know that you went out the way you wanted to.

No Vested Interest

(5,164 posts)
136. One of the worst scenarios I can imagine is having a disabling stroke,
Fri Oct 4, 2013, 02:21 AM
Oct 2013

unable to care for one self, including toileting, feeding, loss of use of a limb or limbs, perhaps not able to be understood in speech, and the constant pain that can accompany some of the muscle paralysis.

I know that keeping blood pressure under control and keeping arteries clear is important to avoid that eventuality. Also weight control and exercise, though I am not so great at that part of it.

But regular doctor exams help to prevent those problems, and well worth it for peace of mind.
I also feel I would have much self-loathing if I realized after the fact that I could have prevented the problems by taking small measures before hand.

There are also many bodily changes between 65 and 75, and each year thereafter. I have many dear friends in late 70s, and adverse things are beginning to happen, and these people, for the most part, tried to take pretty good care of themselves.

davidpdx

(22,000 posts)
149. My father went through several strokes
Fri Oct 4, 2013, 06:36 AM
Oct 2013

The first pretty severe one at 42 1/2 (the same age I am now) where he lost his speech, and motor skills of his right arm and leg. He had several smaller ones (I don't know the details of how many and how severe except for one instance) and then at 55 had one that put him in the hospital. I was 300 miles away at the time and had to drive 4 1/2 hours before I could find out anything. He was in ICU and in pretty bad shape. The first couple of days it looked like he was holding on and then he went downhill. He was able to respond and was essentially in a vegetative state with machines keeping him alive. The doctors told me that he wouldn't survive and his chances for recovery were slim. He was moved to hospice without the machines and died. Not a good way to go.

No Vested Interest

(5,164 posts)
164. David, I'm sorry you experienced that at the end
Fri Oct 4, 2013, 12:33 PM
Oct 2013

of your father's life. I'm sure the period after the first stroke was very hard on your father as well, as he lost his physical independence at a relatively young age.

If we have been fairly healthy and not involved in the medical field, we unfortunately learn more than we ever want to know when someone close to us experiences these severe illnesses.
And, as you know, although some could have been prevented with better life habits, others are completely spontaneous and just the result of our human body's inherent frailty.

It's likely your father's experience brought home to you the need for medical insurance, no matter one's age or relative health.

 

nadinbrzezinski

(154,021 posts)
165. Well, your health must be excellent, that's good
Fri Oct 4, 2013, 12:40 PM
Oct 2013

Last edited Fri Oct 4, 2013, 01:11 PM - Edit history (1)

Not signing for Medicare is stupidity.

And it is not just you who you help.

I hope you get your wish, and not end up in ICU for weeks on end. Trust me, there are worst things than dying in a medical emergency.

Lex

(34,108 posts)
55. grantcart, for the self-employed are they using
Thu Oct 3, 2013, 04:07 PM
Oct 2013

your *adjusted* gross income (after deductions, etc) for the income portion, or your full gross income?







grantcart

(53,061 posts)
61. I don't know.
Thu Oct 3, 2013, 04:18 PM
Oct 2013

Early on they give you the option to just go to the plans or take a slightly longer approach and see if you qualify for a subsidy, and I almost skipped the subsidy.

It mentions that you may have to submit tax, 1099 W2s etc.

I didn't have to submit anything, apparently they just took the information from my filed returns.

But yes I would guess that it would have to be "adjusted" gross income because my full gross income was almost double the adjusted and couldn't justify a subsidy.

I spent almost every day on the road last year so I had a lot of travel expenses.

Lex

(34,108 posts)
122. Thanks.
Thu Oct 3, 2013, 10:15 PM
Oct 2013

It makes sense that they would use adjusted gross income. I have coverage now but I'm thinking I'll be better off going with ACA but I'm going to wait until the early rush of applicants is over.

Abq_Sarah

(2,883 posts)
134. I can't imagine they would use gross income
Fri Oct 4, 2013, 12:32 AM
Oct 2013

If I were taxed on gross income, my tax liability would leave me with zero profit. The fed understands that "gross income" particularly for small business owners, isn't "our money" since it's used to pay employees, pay FICA, rent and all other expenses associated with running a business.

 

awoke_in_2003

(34,582 posts)
57. sounds good...
Thu Oct 3, 2013, 04:10 PM
Oct 2013

I pay $240 a month for me and the wife, but the bulk is covered by my employer. I think the total premium is $900 a month- that would hurt.

MH1

(17,573 posts)
60. Thanks, great info! About that verification problem -
Thu Oct 3, 2013, 04:13 PM
Oct 2013

it is plausible that someone did resolve it that quickly rather than merely waiving it.

We use the government "e-verify" system and a third party integrator provided the integration to SAP. Part of the tookit is a "queue" screen listing all the verifications that were submitted and failed. This would be fairly standard so presumably the exchanges have something similar. They would have had people trained and assigned to work those queues.

It is extremely difficult and costly to find every software bug in a complicated system before go-live, and as mentioned elsewhere, not everything is easily scalable for the kind of traffic that the exchanges have encountered. But since certain types of problems are predictable, there is normally a plan to expedite the trouble calls that will come in. Since verification is a process that's already used elsewhere, it's likely they could easily staff up that part of the response team.

llmart

(15,532 posts)
111. I use e-verify at work.....
Thu Oct 3, 2013, 08:55 PM
Oct 2013

and got an email saying e-verify is not available due to the shutdown.

Just so you know........

MH1

(17,573 posts)
125. Wow, that's interesting.
Thu Oct 3, 2013, 10:34 PM
Oct 2013

I don't use it myself - I'm in IT and not directly involved, just helped with some tweaks at some point. I'll have to ask the person who supports that process, she'll know what's going on.

I actually would have thought e-verify would be considered "essential". But to me, anything the government does is either essential, or a bill should be passed to stop doing it.

llmart

(15,532 posts)
148. Yeah, I was thinking that the teabaggers......
Fri Oct 4, 2013, 06:18 AM
Oct 2013

should be up in arms about the fact that without e-verify, we might get more of them, you know, "illegals" taking our jobs away

Actually, teabaggers probably don't have a clue what e-verify is.

TxDemChem

(1,918 posts)
62. That is wonderful!
Thu Oct 3, 2013, 04:21 PM
Oct 2013

And thanks for giving us an honest description of your experience. There's a lot of crap floating around from people giving false info.

maddiemom

(5,106 posts)
64. Damn right! The AFA is far from great. It's just a baby step in the right direction.
Thu Oct 3, 2013, 04:28 PM
Oct 2013

A start to catching our "great and exceptional" nation up to the rest of the civilized world in caring for our citizens. Oh wait! Caring for our citizens is dreaded "Socialism!"

pnwmom

(108,955 posts)
73. You obviously didn't read the OP. He says it's a "stunning, revolutionary change"
Thu Oct 3, 2013, 04:59 PM
Oct 2013

that will be a "major improvement in people's lives."

If you want to know why, then read beyond the subject line.

grantcart

(53,061 posts)
75. to be clear it is a stunning, revolutionary change for
Thu Oct 3, 2013, 05:04 PM
Oct 2013

a self employed diabetic with no insurance.


I fit the profile for a big benefit.

If you are covered and in good health, not so revolutionary.

But for me, a big deal.

pnwmom

(108,955 posts)
77. My healthy 26 year old will pay half as much
Thu Oct 3, 2013, 05:07 PM
Oct 2013

for a very good policy than he does now through COBRA.

It was already a great change for the millions of young people like him who could stay on their parents' through the age of 25, whether or not they were in college. But now that's he's aged out of that, he'll still get excellent insurance thanks to the ACA.

And babies in intensive care units are no longer excluded from coverage based on pre-existing conditions.

And people with coverage can no longer be dropped when they develop expensive illnesses. And people won't hit annual or lifetime limits that won't even cover the cost of one major car accident.

These are ALL major improvements in the lives of almost all Americans, since employers will have to provide coverage providing the Essential benefits, too. The main group that won't get new benefits is people on Medicare.

Art_from_Ark

(27,247 posts)
106. Well, that kind of sucks
Thu Oct 3, 2013, 08:34 PM
Oct 2013

"The main group that won't get new benefits is people on Medicare."

The person in my family who could benefit the most from this type of coverage is on Medicare.

pnwmom

(108,955 posts)
107. People on Medicare ALREADY have this kind of coverage.
Thu Oct 3, 2013, 08:39 PM
Oct 2013

Medicare gives them basic coverage and then they can purchase inexpensive policies (without charges for preexisting conditions) to cover the remaining costs. That's why so many DUers and others want Medicare-for-all.

(Lower-income people on Medicare also can also qualify for Medicaid, by the way. This has already been the case.)

Art_from_Ark

(27,247 posts)
110. Here's the deal with my family member:
Thu Oct 3, 2013, 08:54 PM
Oct 2013

She's on Medicare, very low income, with supplemental coverage, in Arkansas. She's been in and out of the hospital over the last year, and the part of the bill that she's responsible for is thousands of dollars, which she can't pay. She also has to pay several hundred dollars a month for prescription drugs. So she would like to able to find something that can keep these costs under control.

pnwmom

(108,955 posts)
115. Do you know why she's having to pay so much for drugs?
Thu Oct 3, 2013, 09:03 PM
Oct 2013

The "donut hole" was supposed to have been closed.

If I were trying to help a family member like this, I would compare the different supplemental plans that are available and make sure she had the best one for her purposes. Also, if her income and assets are low enough she could qualify for Medicaid as well as Medicare.

I know that getting by can be a struggle for many retired people. But the insurance that is available to them -- a combination of Medicare plus supplemental policies, plus the drug benefit, plus Medicaid (for those who qualify) is as good or better than what's now finally available for others through the ACA

Art_from_Ark

(27,247 posts)
117. I don't know why, exactly, that one drug costs so much
Thu Oct 3, 2013, 09:16 PM
Oct 2013

She actually has several prescriptions, and their individual costs are not so high (cumulative costs are about $100/month) but there's one drug (for kidneys, I think) that costs something like $800 per month.

She has supplemental coverage (Blue Cross, I think)-- I'm not sure about Medicaid. She applied for Extended Medicare (I think that's what it's called) a couple of months ago, but so far she has not heard yea or nay. The conditions are very restrictive (for example, she can't have more than $7000 in combined non-home, non-car assets, including cash). Basically, it sounds like she needs to have one foot in the poorhouse and the other on a banana peel before she can qualify for that.

pnwmom

(108,955 posts)
119. If she has a paid-for home, there is the option of
Thu Oct 3, 2013, 09:48 PM
Oct 2013

Last edited Thu Oct 3, 2013, 11:54 PM - Edit history (1)

a reverse mortgage to free up cash. You need legal advice on that, though, to make sure that she could stay in the house as long as she's able and that you understand the terms of the agreement. Basically, the idea is that payments go out to her every month, and then when she died, the house would be sold and the mortgage would be paid off.

Art_from_Ark

(27,247 posts)
128. She did look into a reverse mortgage,
Thu Oct 3, 2013, 11:26 PM
Oct 2013

but there was too much fine print and she was afraid that she might, indeed, get booted out of her house. She definitely wants to spend her remaining days there, and I don't blame her because her property is nice and peaceful, right on the edge of the Ozarks, but is also fairly close to shops and medical facilities.

pnwmom

(108,955 posts)
129. She is right not to get into any kind of arrangement like that
Thu Oct 3, 2013, 11:29 PM
Oct 2013

unless she (and you) completely understood the fine print.

That's why I think if you ever consider this again, it would be worth paying for an appointment with a real estate attorney to have him review the document and make sure there weren't any hidden surprises.

Art_from_Ark

(27,247 posts)
186. I just heard from her
Sun Oct 6, 2013, 05:44 AM
Oct 2013

Apparently the Extended Medicare or whatever it was she applied for was approved and that prescription drug now costs less than $10! Whew! One less thing to worry about

TBF

(32,004 posts)
70. So glad to hear that -
Thu Oct 3, 2013, 04:55 PM
Oct 2013

it is just stunning how much the republicans want this to fail. And you nailed why - because it WORKS.

Cryptoad

(8,254 posts)
79. I got mine yesterday
Thu Oct 3, 2013, 05:15 PM
Oct 2013

on the HealthCAre.gov site...... yes is was slow but man is it sweeeeeeT... I got the Platinum Plan for 400$ less per month I was paying for my old insurance which was close to a ACA Gold plan.!

Stopped by the Local Breakfast club for coffee this morning. Listening to all my GOP neighbors whining about ACA and all the lies that they still believe and how they were going to pay the Penalty (even though not a one of them was mandated to purchase ACA) ... I told them what my insurance was going to cost me and they didn't believe a word I said,,,,,,

geeez,,,, I swear it some kinda new brain rot syndrome !

Orsino

(37,428 posts)
84. Individual results may vary.
Thu Oct 3, 2013, 06:20 PM
Oct 2013

But anyone who isn't helped much by or is left out by Obamacare? The Republicans can be shamed into fixing some of that, too, especially as Americans get used to the idea of insurance as more of a right than a privilege.

And down the line, single-payer will seem less far-fetched.

Ikonoklast

(23,973 posts)
85. As soon as I get back home, I'm dumping my plan.
Thu Oct 3, 2013, 06:25 PM
Oct 2013

Self-employed, aged 58, currently paying $515 a month for an HMO plan that is just, ok.

Bet I can get better coverage, lower total yearly cap, at a lower price, easy.

Ikonoklast

(23,973 posts)
88. Already looked at what's available, I'll save $95 a month and get much better coverage.
Thu Oct 3, 2013, 06:35 PM
Oct 2013

Just need to sit down and get everything I need lined up first.

My HMO just informed me last week that they sold off the division I was a member of, and I don't like who they sold it to...just another reason to jump ship.

 

Hulk

(6,699 posts)
91. Excellent read!! TY
Thu Oct 3, 2013, 06:51 PM
Oct 2013

I appreciate it. We all have semi-unique situations, so I'm really anxious to get on and find out my story. I appreciate your comments, and I really hope they take your advice on the a-d thing. I haven't been able to get on yet, and have tried maybe four separate times for a length of time. Hopefully that will change before too long.

pangaia

(24,324 posts)
95. Thanks for taking so much time to convey
Thu Oct 3, 2013, 07:29 PM
Oct 2013

so much information.
It sounds like the glitches were no worse than calling, say, TIME WARNER CABLE !

humbled_opinion

(4,423 posts)
96. WOW...
Thu Oct 3, 2013, 07:31 PM
Oct 2013

First I have to say I never even understood exactly how high the cost of these insurance policies were. I am retired military and get tricare prime for family which I pay only $540 per year and am happy to do so.... the amounts of money that people are paying is still terrible... the OP is happy to be paying 10X what I pay in the ACA because he is seeing a huge savings over non-ACA coverage....

So exactly what is making the costs go down?

Will young people who typically don't buy health insurance be able to afford the costs, what will their plans look like?

I am still lost on how this is actually going to get paid for because nothing is free and I don't see any cost control measures being place on doctors, hospitals and drug companies all still private sector those costs of medicine and hospital care certainly are not going down.... What is the magic formula for this?

grantcart

(53,061 posts)
109. A number of things
Thu Oct 3, 2013, 08:47 PM
Oct 2013

1) Diversification of risks - getting everybody in the pool

2) Changing the role of insurance companies. Before health insurance involved huge costs of trying to evaluate an application before accepting it. Next there was a lot of overhead evaluating and denying claims, now its a fixed percent.

3) Emphasizing preventative care. All preventative procedures - free in all plans

4) in the future they will be phasing in changes to change from fee for service to fee for care, instead of paying for each test they will get paid a fixed amount for, say every diabetic case they have and they don't make any more on each test.

5) integrating information systems. The government spent billions reforming the IT of the medical industry so it went paperless and every doctor was connected and working from a similar platform.

6) Saving on marketing and advertising. I never heard of my provider before. They seemed to have the best plan.

7) Limiting the Medical loss ratio. Out of the whole health industry pie insurance companies are restricted and can keep only about 20% of the pie, the rest has to be paid out to doctors or refunded to the clients.

humbled_opinion

(4,423 posts)
167. Interesting
Fri Oct 4, 2013, 01:31 PM
Oct 2013

I never knew there was so much disparity in how the private insurance companies were managing the plans before the ACA.

Getting everyone in the pool I think will be the most tricky because young healthy people who don't pay for insurance now are going to balk at having to fork over monthly premiums for services that they don't see but I guess they could argue the same about the medicare and Social Security that they already pay, so after implementation it may become as seamless as those taxes....

thanks for info..

grantcart

(53,061 posts)
169. Young folks can opt for catastrophic only, for about $ 1.50 a day
Fri Oct 4, 2013, 01:50 PM
Oct 2013

But for some buyers, prices will rise from today's less-comprehensive policies. In Nashville, Tenn., a 27-year-old male nonsmoker could pay as little as $41 a month now for a bare-bones policy, but would pay $114 a month for the lowest-cost bronze option in the new federal health exchanges.

http://online.wsj.com/article/SB10001424052702303983904579095731139251304.html#project%3DEXCHANGES0924%26articleTabs%3Darticle

They may not have as many health related problems but the do have more accident related problems.

Maeve

(42,271 posts)
97. Glad to hear it! Looking forward to signing up, too
Thu Oct 3, 2013, 07:31 PM
Oct 2013

Waiting for the initial rush to die down, but we've been out proper insurance for several years and I look forward to signing up. The estimates I've seen indicate we'll get the Silver plan for about half what we've been paying for catastrophic only.

Mnpaul

(3,655 posts)
101. It is unbelievable
Thu Oct 3, 2013, 07:49 PM
Oct 2013

All this time and they still aren't ready to implement Romneycare ver. 2

I went to the state exchange, entered my zip and age and this is what I got for info:



They have money to piss away on ads of Paul Bunyan water skiing but can't even get their website to work. Pathetic.

hedda_foil

(16,371 posts)
141. That sounds like a glitch. Keep trying and/or phone the call center.
Fri Oct 4, 2013, 02:37 AM
Oct 2013

If you're in MN, you should be okay.

Mnpaul

(3,655 posts)
151. We had a working insurance marketplace
Fri Oct 4, 2013, 07:30 AM
Oct 2013

two months ago. I went there to compare prices. Now it has been replaced by a broken one. I imagine that the prices will be
higher as well.

hay rick

(7,587 posts)
104. Thanks for posting.
Thu Oct 3, 2013, 08:02 PM
Oct 2013

The drumbeat of people testifying to the improvement in their lives offered by ACA will expose the right wing anti-Obamacare propaganda for the paranoid hate-mongering garbage that it truly is.

llmart

(15,532 posts)
112. Good for you!
Thu Oct 3, 2013, 09:02 PM
Oct 2013

I'm still trying to get on. I can't wait to see what my subsidy will be since I make next to nothing. I think I read somewhere that Social Security benefits may be included in your income if they are included on your federal taxes (last year a portion of my meager SS was taxable).

I'm quite sure I'll be better off than the $285 a month I pay now for a plan with $7500 deductible.

chill_wind

(13,514 posts)
116. Good idea. I've been thinking the same thing
Thu Oct 3, 2013, 09:05 PM
Oct 2013
"The one thing they could and should still do is to restrict people applying on a particular day by limiting those to certain letters of the alphabet. For example first day Last Names starting in A-D and so on. That would solve a lot of problems and reduce wait time."


K & R.

IrishAyes

(6,151 posts)
121. Drat your hide, man!
Thu Oct 3, 2013, 10:13 PM
Oct 2013

Giving little old ladies a heart attack with that catchy title! I thought, grantcart? OUR grantcart said THAT? Good tease.

grantcart

(53,061 posts)
123. Well it wasn't aimed at the home team but all the Freepers, Cave Dwellers and Trolls
Thu Oct 3, 2013, 10:20 PM
Oct 2013

as well as the casual drive by.

I figured that would get them curious.

At 7,000 clicks it seems to have worked.

Tks.

Cha

(296,837 posts)
131. Thanks grant for using your enforced off time from work so
Fri Oct 4, 2013, 12:16 AM
Oct 2013

productively.. helping your fellow peeps!

Glad Obamacare is so unbelieveably Good for you!

eridani

(51,907 posts)
142. Curious how you got a subsidy for a gold plan
Fri Oct 4, 2013, 02:48 AM
Oct 2013

Last I heard, subsidies were limited to bronze and silver.

DebJ

(7,699 posts)
153. Here's some info I found.
Fri Oct 4, 2013, 08:52 AM
Oct 2013

If your income falls between 100 and 250% of the federal poverty level ($11,490 to $28,725 for an individual), you may be eligible for a Cost-Sharing Reduction subsidy, which can help lower your deductibles, copayments and coinsurance. In order to receive Cost-Sharing Reductions, you must purchase a Silver plan on the Marketplace. You will still have a variety of plans from which to choose, but it must be Silver to be able to take advantage of the Cost-Sharing Reduction subsidy.

Many people will qualify for Advanced Premium Tax Credits, a type of subsidy that lowers your monthly premium. You may be eligible for this subsidy if your income falls between 100 and 400% of the federal poverty level ($11,490 to $45,960 for an individual).

http://www.forbes.com/sites/investopedia/2013/10/01/how-to-choose-between-bronze-silver-gold-and-platinum-health-insurance-plans/
-----------------------------------------------------------
"All Members of Congress, including representatives of U.S. Territories, and their designated staff will be required to purchase health insurance via the DC SHOP in order to receive a Government contribution," it says. "The DC SHOP offers health plan options with in-network access to medical providers across the nation and overseas."

Harris said allowing members to be subsidized for only buying gold-level coverage is probably why many members don't want to eliminate the subsidy for Congress, something Republicans have been pushing.


Read more: http://thehill.com/blogs/floor-action/house/326409-obamacare-requires-congress-staff-to-buy-gold-level-insurance-plan#ixzz2gkykE4Jt
Follow us: @thehill on Twitter | TheHill on Facebook

DebJ

(7,699 posts)
154. and this also:
Fri Oct 4, 2013, 08:56 AM
Oct 2013

Looking at this makes me think that only the Silver plan premium can be used to CALCULATE the amount of a tax credit,
but that doesn't necessarily mean you are limited to only signing up for the silver or less.



Does the amount of the tax credit vary with income?

Yes. People living at between 100 and 133 percent of poverty level will pay at most 2 percent of their income for health insurance, while those at between 300 and 400 percent of the poverty level will pay a maximum 9.5 percent of their income. There is a sliding scale for incomes in between, as laid out in the chart in this report.

The cost of the premium is based on the “silver plan” – the second-lowest-cost health plan of four that are offered in each exchange. The silver plan covers 70 percent of health-care costs. The least-expensive plan, bronze, covers 60 percent. The gold plan covers 80 percent, and the platinum plan covers 90 percent.


Want your top political issues explained? Get customized DC Decoder updates.

So how much will insurance end up costing after the subsidy?

That will depend on where you live, how much you make, and which plan you choose. The nonprofit Kaiser Family Foundation presents the example of Pat, who is 45 and will have a 2014 income of $28,735 (250 percent of poverty). The “silver plan” in Pat’s area is expected to cost $5,733. But under the ACA, Pat would pay at most 8.05 percent of income on health insurance, or $2,313 ($192.74 a month). So Pat’s tax credit is $3,420.
http://www.csmonitor.com/USA/DC-Decoder/2013/1001/Obamacare-101-how-the-federal-subsidy-works-video

grantcart

(53,061 posts)
155. Early on you are asked if you want to go straight to the plans or see if you qualify for a subsidy.
Fri Oct 4, 2013, 09:21 AM
Oct 2013

I almost went straight to the plans.

I clicked on the subsidy button even though it also said that I might have to upload a lot of information including taxes, w-2s, 1099s etc.

Next page "presto" it had already determined a dollar amount for my subsidy.

It applied to all plans, even platinum.

The other thing that surprised me was the difference between the cost of the plans.

For example Gold Plans would have cost me (after the subsidy) between $ 444 and over a $ 1000 a month, but I really didn't see that much difference between them.

I wonder if the insurance providers had any idea what the other plans were costing or was it like a bidding process where submissions were sealed and they didn't know what the others were submitting. It may have been that some providers made a decision to "go low" the first year to buy market share on the assumption that they would be building good will that would have an impact in the long term. If that was their strategy I am guessing they are right.

Matariki

(18,775 posts)
143. I've been self employed in the past and insurance was always an issue
Fri Oct 4, 2013, 03:17 AM
Oct 2013

In fact, there was a year or two in Washington state when it wasn't *legal* to buy an individual policy. Seriously. Self employed folks had to go without. Never completely understood that.

Great post Grantcart - thanks for documenting your experience.

davidpdx

(22,000 posts)
147. Grant you old devil, your sarcasm is baddddddddd!
Fri Oct 4, 2013, 06:15 AM
Oct 2013

Glad to from someone who has had a direct experience with signing up. Hopefully this will be the first step to a stronger system eventually. The U.S. needs to seriously look at South Korea's system. I don't know if you'd call it single payer or universal, but it's pretty damn assume. I'm glad people will be able to get health insurance there. I didn't have health insurance the majority of the time I was an adult until I moved here to Korea. Now I perish the thought of not having it.

PasadenaTrudy

(3,998 posts)
158. My rate is going down $9
Fri Oct 4, 2013, 11:34 AM
Oct 2013

for better coverage. I pay on my own. My blue shield plan will be a Platinum one since I'm about to turn 50 and I'm on several meds. Most family members died in their early 60s so I want to be well covered.

 

Autumn Colors

(2,379 posts)
162. I also got something amazing!!
Fri Oct 4, 2013, 11:46 AM
Oct 2013

I've been without health insurance for several years now. With the subsidy, I'm going to have a silver plan through Connecticut's new nonprofit healthcare co-op (www.healthyct.org). I'm planning to choose a doctor at a nonprofit community health center I've visited in the past as my PCP. This CHC also offers low-cost dental care (though not included in the ACA coverage for adults).

Here's what I'm getting:

Premium: $85 per month
Co-pays: $0 for preventative visit, $5 for PCP (for injury), $15 for specialist, $75 for ER
Deductible: ZERO (!!!!!)
Maximum Out-of-Pocket Annually: $2,000

As an over-50 female, I'm thrilled!

konnie

(44 posts)
163. oh the horror
Fri Oct 4, 2013, 12:06 PM
Oct 2013

whiney ass trolls. had to wait on line!!!!! was haaaaaaard to make a choice!!!!! well your 80 year old grandparents have been
dealing with Medicare Supplemental insurance and drug plans online for a few years now. if granny can suck it up and
figure it out, so can you.

if you put 2 or more seniors in a room during the month of October its the only topic of discussion. The details
are shared like recipes and tall tales of brilliant grandchildren.

if you need help ask your elderly neighbor to explain it to you, you lazy ignorant twit.

God forbid someone somewhere will get something you won't. that some responsible human being made it
possible for someone to sleep a little easier, not contemplate suicide, or not look at their children and weep.
Damn you for your selfishness. your greed, for drinking the wingnut koolaid, for not using your own brain
to recognize you've been shooting yourself in the foot.

Medicare for all/Universal Single Payer would have been the simple solution, but no! cannibal capitalism still
rules. so this is the best we can do for now. it's better than nothing. if you don't want it, then pay the $95 penalty.
it's the rent you pay to live in America.

Populist_Prole

(5,364 posts)
168. Suggest you use sarcasm in your OP title....
Fri Oct 4, 2013, 01:41 PM
Oct 2013

Lest some teatard trolls data mine the net to take your post out of context to use to bolster thier side.

Loke your post though

tjdee

(18,048 posts)
172. Can someone tell me more about the ACA paying premiums? Have a lot of relatives who hate this law.
Fri Oct 4, 2013, 03:11 PM
Oct 2013

I have relatives hearing horror stories from their friends about how they have to pay so much more. I went to the Facebook healthcare.gov site and it looks like freeper central. Wasn't surprised but people are posting about how much more they have to pay.

I've been telling them that the ACA may help pay premiums but I don't know much.
There's a lot of info out there but I'm not sure where to start.

Help please??

grantcart

(53,061 posts)
173. I recommend that the best way is to go to Healthcare.gov and try for yourself
Fri Oct 4, 2013, 03:15 PM
Oct 2013

Even if you are covered go though the process to see and compare, unfortunately right now is not a good time.


You can tell them that more Republicans have signed up than Democrats and if they don't believe it just Google it.

http://www.democraticunderground.com/10023778909

 

cristianmarie533

(51 posts)
178. Sounds pretty good to me
Fri Oct 4, 2013, 09:15 PM
Oct 2013

I personally can't wait until I'm able to sign up for the new plan. Up until recently, I was paying well over $2k per year for insurance for just myself, not including my other family members. Also, my grandmother is currently recuperating from the stroke she suffered a year ago, and Medicare can't cover all her expenses. The ACA will undoubtedly help her as well. Sure, it's not quite as good as single payer, but it will probably better than what she had before.

 

beakt

(1 post)
183. What about that increased demand?
Sun Oct 6, 2013, 01:42 AM
Oct 2013

I noticed something no one is commenting on in the OP's post: his comment that subsidized insurance will create a rush on medical services. This is one of the primary arguments against government intervention in the marketplace. Everything the government subsidizes gets more expensive because of this (think of how much government aid there is for schooling, and how tuition has skyrocketed as a result, for example). It's basic economics. I know everyone here says they're happy with the cookie they've gotten from the ACA, and many have said they "hope" it just gets better, but, although no one can make predictions for certain, the laws of economics do make it so the outcome of major changes is no big surprise. In other words, you most probably will find yourself with a great health insurance plan on paper, but less access to actual medical care than you had before.

uppityperson

(115,677 posts)
184. Welcome to Du, may you read and learn here. A couple points. WTF. And why are you here?
Sun Oct 6, 2013, 02:20 AM
Oct 2013

Our local public school which is paid for with our taxes via the gvt has no tuition. Basic economics. And how will having the ability to get health care give us less access? And how the fuck does restricting access help anyone, that restricting is what you are seeming to want. If there are not enough providers, how about paying them decent enough and not having medicine, sorry, healthcare, as business but instead health care as health care? You don't increase access by making it unaffordable.


"I know everyone here says they're happy with the cookie they've gotten from the ACA"? Wtf? No, "everyone here" is not happy, and most of us feel the ACA does not go far enough. Yes, most of us are glad to be able to get more affordable health care, but "happy with the cookie"?

Why are you here?

cyberswede

(26,117 posts)
190. ...and I would add
Sun Oct 6, 2013, 11:34 AM
Oct 2013

that tuition increases at state universities, for example, are caused by decreased funding from state legislatures, not by subsidies from the government.

Oy.

grantcart

(53,061 posts)
185. Perhaps the most ignorant statement ever made on the subject.
Sun Oct 6, 2013, 03:20 AM
Oct 2013

There is "pent up demand". That means that there isn't increased demand but existing demand that the market wasn't able to satisfy but is now going to be met with an artificial amount coming in a short time.

Obviously over time that will even out.

What is so alarmingly ignorant about your right wing POV is that you have swallowed the talking points down whole undigested. You assume that because there are profit making entities involved that it qualifies as a market and capitalist system.

That is not the case.

In the current situation the market place is negated because consumer (patients) and providers (health care professionals) cannot meet in the market place because there is an artificial body (insurance companies) between them.

To make this clearer to you currently everyone would agree that the airline industry is a highly competitive market in a capitalist system. I recently flew from San Diego to Portland for the ridiculously low price of $ 75.

But the airlines don't own the airports. Cooperative publicly owned entities own the airports. The airlines don't establish the rules, The federal government determines safety standards, pilot qualifications and so on.

In fact the airline industry is, at the same time, one of the most competitive market industries and one of the most regulated. Its the regulations that create a clear and accessible foundation for profit making companies to compete.

In the same way the Canadian system is much more capitalistic than ours because any consumer can go to any doctor at any time. The health care providers compete without obstacle directly in the market.

Before Obamacare our system was closest to a Mercantile system, not a capitalist system.

Now a giant platform has been created and 800 doctors will be able to compete for my business without the insurance company in the way.

Health care is not like other markets because the need isn't determined by wealth or desire to own an object but the need to maintain basic health.

Therefore your observations that their is substantial unmet needs that the market hasn't been addressing doesn't make economic sense, it shows that the structures in place have not brought consumers and providers together but keeping them apart.

Beyond that your position has an absolute appalling lack of a moral center. We aren't talking about purchasing a second car but sustaining people's health.

In the 'marketplace of idea' all political parties in established democracies through out the developed world have universally rejected your economic theory (as faulty as it is) on basic moral grounds. In this thread 4 years ago I went through all of the political parties in all of the developed counties and in the market place of ideas your Republican mumbo jumbo has been rejected by all.

http://journals.democraticunderground.com/grantcart/188

The Canadian Conservative Party wants to expand their universal single payer system, not replace it.

http://www.conservative.ca/?page_id=1412

Beyond the fact that you 1) mistakenly think that we have a working market system for health care providers and consumers and 2) advocate a position that has been rejected as morally bankrupt by the entire Western civilization there are other significant problems.

Currently the law is if someone goes to a hospital they are required to treat. The costs for 'indigent' care is then passed on through inflated charges to those that have insurance. Again this is not a true market situation but one that is pushing costs artificially from one group to another.

But not only does it corrupt the market it also swaps cheaper preventive care with the most expensive kind. Universal health care significantly reduces cost because it allows people to literally get preventative care for pennies on the emergency room dollar.

Don't worry about the pent up demand problem, within a hundred days that will be evened out and the success of this plan will have a profound effect on your cherished Republicans. Having gone all in and then doubled down their credibility as a national party will be completely gone. They will continue to be a regional party, as a result of the Southern Strategy that they embraced 3 decades ago.

Here is the irony. The idea of an individual mandate comes from the Heritage Foundation as a response to the Clinton plan of universal employer mandate. That is why Romney used it in MA. The President knew that this would be the only plan he could get through the legislature and the courts. So he took it and improved it. The Heritage Foundation promoted it as 'the capitalist alternative for universal coverage'. They were right they just didn't know that an African American President would be the one that put it forward and given the Republican Party's commitment to protect its racist flank they couldn't take partial credit but come up with a bunch of mumbo economic jumbo, the exact stuff you are parroting but do not actually grasp.

INdemo

(6,994 posts)
188. I found that in Indiana with our Tea Bagger Governor that
Sun Oct 6, 2013, 10:57 AM
Oct 2013

Indiana insures will not get subsidies and Indiana is not expanding Medicaid, even though the state would receive millions from Wash.
Thus with the income levels adjusted many residents that would be able to get Medicaid or higher percentage of subsidies, will not be able to.
So Mike Pence has joined other Repuke Governors in protesting Obama Care.

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