Obamacare

[classicman]

Last year I was financially forced to opt for a lesser policy. It was $434 a month. The rest stayed about the same. Since I cannot afford to get sick or injured, the massive OOP number doesn't matter.

Sadly next year (2017) my premiums are going up 32% this year alone to $638 a month. I literally cannot afford that. 4 years ago I was payin about $250.
I have begun to seriously consider not being insured and just paying the penalty. This is totally fucked up.

I'm guessing that the vast majority of you all have plans through work and this isn't affecting you as much as the rest of us.

[Happy Monkey]

Preventative care is free, and one major hospital visit can blow past $14,000 easily.

You ought to be able to set up a HSA to use pre-tax money for most of the non-premium costs, if you expect to spend thousands of dollars a year, or want to build up a tax-free nest egg in case you do in the future. I expect you can do this even if you plan to go without insurance.

You may be able to deduct your premiums as well, if they exceed 10% of your adjusted gross income; ie if your AGI is less than $76,560 for a $638/month plan.

"Not being insured" was the ONLY option for many, and will be again if the law is repealed. Any cost savings you realize in that system will be at the expense of people who actually need medical coverage (who may be a future you), and are therefore dropped.

[Griff]

Originally Posted by Happy Monkey

Preventative care is free, and one major hospital visit can blow past $14,000 easily.

Pete who actually supports ACA got burned for $500 in blood tests and urinalysis last time she went in, so no all preventative care is not free. I feel like our adherence to talking points on this issue is counter-productive. I'd almost rather single-payer so we wouldn't have to research who is in network, only to get burned by the odd anesthesiologist, or spend our days searching out which tests aren't covered because our in network doctors don't know what's covered but do know what tests they want etc...

[xoxoxoBruce]

Congress could fix all this shit, but the money doesn't want it fixed, they want it dumped.

[glatt]

Single payer seems to work just fine for all of Europe.

Our mostly employer provided system is totally insane. It's like a drunk monkey invented it. Our system is great only if you are rich. I think Obamacare is a step in the right direction, but it can't turn a sow's ear into a silk purse.

[Griff]

Western Europe seems to have mostly functioning representative government. Ours seems to be good at representing the interests of oil companies, banks, and nutters. We've been told so long that government can't do stuff and the GOP works hard at proving it, that I don't single-payer happening without a huge movement and a popular change agent. Watching the manipulations and smear campaigns this election cycle makes me doubt we have the tools to build a sensible system rather than a special interest feed trough.

[Happy Monkey]

Originally Posted by Griff

Pete who actually supports ACA got burned for $500 in blood tests and urinalysis last time she went in, so no all preventative care is not free.

Yes, I added a clarifying link in my next post; apologies for oversimplifying.

I'd almost rather single-payer so we wouldn't have to research who is in network, only to get burned by the odd anesthesiologist, or spend our days searching out which tests aren't covered because our in network doctors don't know what's covered but do know what tests they want etc...

Absolutely. Ditto for me minus the "almost".

[Happy Monkey]

Also note that the out of pocket costs are a MAXIMUM, not a minimum. Even if you're correct that the plan does nothing for you up until that limit*, it covers you 100% after you reach it. This was not the case before the ACA.

*And the plan probably does do something - free preventative care and negotiated prices.

[classicman]

1) Preventative care is NOT free.
2) Please don't lecture me on medical costs.
3) Shouldn't have to set one up.
4) Well aware what OOP cost are.
Thanks for the effort though. Still doesn't change the reality of my budget not allowing for the cost. As I said - 4 years ago I was only paying about $250 for a far better plan ie:$2500 OOP and $20 co-pays. I have no dental now either - can't justify the expense.

[Happy Monkey]

1) The entire visit may not be, but a large portion of the tests should be, unless your plan is grandfathered in, which seems unlikely if you just switched.

3) You don't have to; if your total medical expenses (including dental) are over 10% of your AGI, you can deduct all of them (minus any that you used HSA for, if you have one). If the premiums alone don't push you over that threshold, you probably shouldn't have the HSA (so you can use those costs to push you over), but if they do, it may make sense to have one for convenience and to simplify bookkeeping, and to bank pre-tax money for the future.

4) Re OOP, I just wanted to note that for most pre-ACA plans, the OOP maximum wasn't a hard maximum, it was the point at which the higher level of coverage kicked in. Under the ACA, it is actually a maximum.

[captainhook455]

I am 2 years to young for medicare. Too broke to pay $800 month for piss poor insurance. My bills are upwards of 65k and the surgeon still has to do the left side. He said don't worry about paying the hospital they have plenty of money. I make payments to him at 50 bucks a pop, don't want him cutting me and thinking, cheap bastard.

tarheel

[Clodfobble]

Originally Posted by Happy Monkey

You don't have to; if your total medical expenses (including dental) are over 10% of your AGI, you can deduct all of them (minus any that you used HSA for, if you have one).

This is incorrect. We've deducted between $17,000 and $40,000 in medical costs every single year since 2009. You get to deduct only the amount over 10% (used to be 7.5% a couple years back,) not all of it.

This is not to say I'm opposed to ACA, in that I think these premiums were already on a path to rise in exactly this same way, because premiums and costs have both been skyrocketing long before Obama got into office, and also because I believe in my heart the whole point of going through with ACA after the Republicans killed single payer was to make things worse and get people onto the concept of single payer after all.

[classicman]

Originally Posted by Clodfobble

I believe in my heart the whole point of going through with ACA was to make things worse and get people onto the concept of single payer after all.

I agree.

[Beest]

Originally Posted by Clodfobble

This is not to say I'm opposed to ACA, in that I think these premiums were already on a path to rise in exactly this same way, because premiums and costs have both been skyrocketing long before Obama got into office, and also because I believe in my heart the whole point of going through with ACA after the Republicans killed single payer was to make things worse and get people onto the concept of single payer after all.

Pre ACA my insurance PPO with BCBS, through my Fortune 500 employer was going up 20% each year, with declining benefits, higher co pays and calendar year minimums.

Since ACA its been 3-4%.

I believe something had to be done, ACA isn't what anybody wanted but it's all they could get done, intended to be fixed later to a better system

[Spexxvet]

Don't forget that ACA is very similar to one of the repubican plans which was proposed to counter Hillary's plan in 1993