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Old 07-27-2017, 02:51 PM   #31
Happy Monkey
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Medicaid expanded under the ACA, so I doubt it was the ACA (as opposed to income or recovery from disablility) that pushed him off of it (though Pennsylvania did try their own thing in 2014-2015 before switching to regular Medicaid expansion).

According to this page, assuming he's single and works exactly 40 hrs/week at $15 ($31200/yr income), and assuming I did my calculations right, post-subsidy caps should be $221/month, but I'm guessing those assumptions aren't completely accurate.
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Old 07-27-2017, 03:11 PM   #32
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I have a similarly crappy plan. And I think it costs more.

For family coverage (two adults and two kids in my case) my employer pays $1,438 per month, and I pay $406 per month. There is a huge deductible for each patient, so the plan includes a pre-tax health savings account. I contribute $300 per month to that account and wind up spending about all of it.

So that's a total of $2,144 for four people or $536 per person per month. We are all basically healthy, and insurance has paid for almost nothing. My wife had the OK kind of skin cancer on her forehead and had to get surgery in each of the last two years. Insurance didn't do anything for us except negotiate a lower cost of that surgery, and then we paid the bills out of the HSA since the deductible hadn't been met.

It would be cool if Trump's $12 health insurance for a 21 year old was a real thing. His fantasy world sounds like a nice place.

Bottom line is I think our family has received about $3,000 in health care in the last year but between my employer and me we have paid $25,728 for it.
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Old 07-27-2017, 03:20 PM   #33
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The republicans and the insurance industry lobbyists made it impossible to get the Obamacare plan as initially conceived through - there is every possibility that the unwatered down plan might actually have delivered a good result. But they chiseled away much of what was truly novel because they were ideologically opposed to anything that smacked of socialism or in any way curbed the freemarket elements of healthcare and the end result was a deeply flawed system - republicans were then the loudest voices against the system for being flawed.

The same thing happens with conservatives here. They defund a public service to the point that it is operationally crippled and then say: look at that mess, it is operationally crippled, we should bring in freemarket business leaders to make it work properly.
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Old 07-27-2017, 03:21 PM   #34
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Also - worth remembering that costs for insurance would most likely have risen sharply even in the absence of the Obamacare changes.
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Old 07-27-2017, 03:38 PM   #35
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Do you pay full price for checkups and other doctor visits? I don't think you're supposed to, but IIRC, classicman claimed that his insurance didn't cover his checkups.
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Old 07-27-2017, 06:00 PM   #36
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I think Marcus had cash jobs when he had his heart attack, and had no documentable income. That would have gotten him on Medicaid.
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Old 07-27-2017, 06:45 PM   #37
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Without the ACA, the heart attack would be a big red preexisting condition; I doubt he'd be able to get anything close to as low as $325.

I'd say it's not so much the ACA he's unhappy with; it's the US system in general.

That said, if I did my calculations above correctly, there may be some question he could have answered differently on the subsidy application that could get him down to $221.
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Old 07-27-2017, 08:00 PM   #38
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I know probably a dozen families who have ACA plans, whereas before they couldn't get any. They all have preexisting conditions (well, their kids do) and they are thrilled at their $5000 deductible or whatever it is because their annual costs are $30,000-40,000.
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Old 07-28-2017, 04:49 PM   #39
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I'm on it and its far worse than what I had before the PPACA.
My costs have basically tripled, as has my OOP and my copays are far less.
For example, I get fever blisters. Meds used to be a $20-25 co pay. Now my silver plan covers 90% That leaves me about $200 to pay instead. Again, I'm a pretty healthy guy for my age so there is that. Tough to listen to people who aren't forced to deal with this when its the rest of us who are getting screwed.
As for the 26 ... Thats like a "get a life" age. At 26 I had a kid and another on the way. Its ridiculous to keep adults on mommy and daddy's plan at that age. Get the fuck out of the basement and grow up. If there needs to be a special plan for the injured or disabled ... oh wait, we already have one. This is also counters the "young healthy adults will pay and offset the costs" bullshit we were fed.

The Insurance companies are not the problem. Every other facet of healthcare is. Not one other cost is regulated - Not one. I hate the whole game, but to simply harp on the "Big evil insurance companies" is ... bites tongue.

As far as the " Maximum overhead charged by insurance companies is regulated"
The PPACA put a limit the profits insurance companies can make. This was another great talking point that meant virtually NOTHING. IIRC only one insurer was out of line when it was passed. All the others were already in compliance. Oh, and that one was out of line by ~1%. Herring anyone?
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Old 07-29-2017, 03:13 PM   #40
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McGuffin.
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Old 07-29-2017, 04:44 PM   #41
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Quote:
Originally Posted by classicman View Post
Herring anyone?


All I know is that I have gotten a refund every year since Obamacare was passed because the insurance company didn't hit the target. The refund went to my employer and was applied to my premium. That never happened before the law was passed.
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Old 07-29-2017, 06:09 PM   #42
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I was asked by Turbo Tax if I had health insurance for 2016. Nope. I was asked why not. I answered an available answer, which was "I couldn't afford it." They saw my income, they saw it was all part time jobs, and though the initial assessment said I should have been able to afford 180 bucks a month, my answer to that question on the federal taxes assessed my penalty for the year. That penalty? ZERO dollars. I was floored. But I was thankful. I was honest, and I got a bit of karma for that.

Oh, I still owed some fed taxes, state taxes, and city and school taxes due to that crappy situation, but it would have been so much worse with that healthcare penalty.

Who knew?
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Old 07-29-2017, 07:02 PM   #43
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It's partially affected by what's available in your area:

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Coverage is considered to be unaffordable if the lowest cost Bronze-level plan available to you through the Marketplace in 2016 is more than 8.13% of your household income.
So perhaps there was a cheap plan available when they did your initial assessment, but there isn't one now. I'm glad it worked out, although I guess it would be better if you were able to get steady employment...
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Old 07-31-2017, 05:41 AM   #44
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I don't even take the LSU poll seriously too
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Old 07-31-2017, 11:16 AM   #45
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English, motherfucker! DO YOU SPEAK IT?
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