Obamacare

This is the best explanation I've seen about Obamacare, what it is/isn't, what it does/doesn't, and why.

very informative and even-handed

It makes me sad to think how much time, energy, money, and political good will
has been wasted by the GOP and GOP governors fighting Obamacare.

I wonder if Roberts will take much heat on this? His position seems conservative in the sense of not being disruptive of the way society has organized itself to address a difficult problem.

Maybe he listened to these Arizona republicans.

Here in Yavapai County, most everybody you’ll meet is Republican. In 2012, Mitt Romney received nearly two votes here to each of Obama’s. And yet in this rural red county in a very red state, it’s only taken a couple of years for federally-subsidized health care to quietly seep into the hinges of everyday life and governance. The rate of sign-ups for the program in the county has nearly doubled from 2014, when 22 percent of the area’s potential market share chose a plan through the federal exchange, to March 2015, when 43 percent did, according to the Henry J. Kaiser Family Foundation. The latter figure ranks the county sixth among 54 areas in the state in percentage of the potential market share which has signed up, outranking far more liberal areas in Arizona.

Situation: Uncle Ted claims Obamacare is a train wreck and has cost jobs.

You say: Uncle Ted, you’ve gotten ahold of some old talking points. With greater access to affordable, quality health insurance, the Affordable Care Act is helping individuals and strengthening our economy!

Since the main components of the law went into effect, we’ve reduced the number of uninsured by 16.4 million, the largest increase in the insured in decades. Before the ACA, the U.S. economy faced rapidly growing health costs that put enormous pressure on businesses and consumers. We paid more than any country without better health results, and millions of Americans were one illness away from bankruptcy. Today, we’ve seen the slowest growth in health costs in half a century, improved patient safety has saved an estimated 50,000 lives and $12 billion, and employer premiums for family coverage grew just 3 percent in 2014, tied with 2010 for the lowest on record back to 1999.

Meanwhile, since the ACA was signed, the private sector has added 12.8 million jobs over 64 straight months of job growth, extending the longest streak on record. The increase in employment over that period is due almost entirely to higher full-time employment. The number of people working part-time who would prefer to be full-time has fallen by 2.6 million from March 2010 through May 2015, including a decline of 1.1 million since December 2013.

HHC.GOV

Is there supposed to be some correlation between the employment info and the insurance info?

classicman;932839 wrote:

Is there supposed to be some correlation between the employment info and the insurance info?

Of course there is... but the other way.

The GOP has been bullet-pointing Obamacare as a "JOB KILLER"
ever since the ACA was introduced.

So we'd have more jobs without it. OK.

:D

classicman;932887 wrote:

So we'd have more jobs without it. OK.

Well we'd have more hiring anyway, as the uninsured workers would be dying faster. :haha:

But big increases next year.

WASHINGTON — Health insurance companies around the country are seeking rate increases of 20 percent to 40 percent or more, saying their new customers under the Affordable Care Act turned out to be sicker than expected. Federal officials say they are determined to see that the requests are scaled back.

Blue Cross and Blue Shield plans — market leaders in many states — are seeking rate increases that average 23 percent in Illinois, 25 percent in North Carolina, 31 percent in Oklahoma, 36 percent in Tennessee and 54 percent in Minnesota, according to documents posted online by the federal government and state insurance commissioners and interviews with insurance executives.

The Oregon insurance commissioner, Laura N. Cali, has just approved 2016 rate increases for companies that cover more than 220,000 people. Moda Health Plan, which has the largest enrollment in the state, received a 25 percent increase, and the second-largest plan, LifeWise, received a 33 percent increase.
~snip~
President Obama, on a trip to Tennessee this week, said that consumers should put pressure on state insurance regulators to scrutinize the proposed rate increases. If commissioners do their job and actively review rates, he said, “my expectation is that they’ll come in significantly lower than what’s being requested.”
~snip~
Health Net, for example, requested rate increases averaging 9 percent in Oregon. The state approved increases averaging 34.8 percent. Oregon’s Health Co-op requested a 5.3 percent increase. The state called for a 19.9 percent increase.

link

Cost transference and cost reduction are different things. Getting those other people to pay for stuff ... never mind.

If the rate increases are justified, then complaining about it is essentially complaining that more sick people are getting treatment than were expected.

If they're not justified, then people will get rebate checks at the end of the year.

I suspect that, as mentioned in the article, the release of pent-up demand pushed much of the increase. Also, I suspect that a lot of people who were used to going to the ER for routine healthcare are still doing so, but now with insurance cards. That's going to hit the insurance companys' bottom lines until they can get their new members educated and paired with GPs.

Plus, as the article also mentioned, the mass of uninsured entering the system were more likely to be sick than those already insured, because being sick was precisely the reason they couldn't get insured under the old system.

Sicker and older... and they are an increasing population ...
But -
"If insurance regulators “do their job, my expectation is that [rates hikes] will come in significantly lower than what’s being requested.” BO

I don't know why I keep reading David Brooks' editorials in the NY Times.
Before I'm half way through one, I'm usually calling him "dumb ass" .
But actually, tho I still think him nuts, he often sets me to explore his references.

Once again, Brooks has played the motivator
Brook's editorial today is a good exploration of
OmabaCare coverage (% population with coverage)

[ATTACH]54052[/ATTACH]

and costs ($) given Brooks' 3 potential pathways our economy may take.

Great News! We’re Not Doomed to Soaring Health Care Costs

It really matters who the next president is.
But there are other things that matter just as much to the nation’s future prosperity.
One of them is: What is happening to health care costs?

If health care costs start to rise again the way they did before,
then health care spending will swallow the economy and bankrupt the federal government.
If they are contained, then suddenly there’s a lot more money foreverything else,
like schools, antipoverty efforts and wages.

The good news is that recently health care inflation has been at historic lows.
As Jason Furman, the chairman of President Obama’s Council of Economic Advisers,
put it in a speech to the Hamilton Project last month [*],
“Health care prices have grown at an annual rate of 1.6 percent since
the Affordable Care Act was enacted in March 2010,
the slowest rate for such a period in five decades, and those prices have grown
at an even slower 1.1 percent rate over the 12 months ending in August 2015.”
<snip>
...

[*] link
This report also links decreasing Medicare costs to actual improvement in medical treatments,
as prompted by Medicare reducing payments to hospitals on "re-admissions".
That is, patients are getting better care (e.g., reduced hospital-caused infections),
and not needing to be readmitted.

The cynical might question if "re-admissions" were some sort of "profit center".


.

Soooo ... For 2016, the NEW Obamacare changes are kicking in -
What are the changes you ask? Well I'll explain.
My premiums are increasing another 21%
My coverage is now ZERO until I meet a $6000- $6400 out of pocket minimum. That includes my prescriptions. So unless I average well over $500 a month in medical expenses, I will pay well over $6000 a year for NOTHING PLUS the increase in premiums!
WTF?
Remember to kick a democrat in the balls for me.

If they're telling you Obamacare forced them to do that, then they're selling you a bill of goods.

My biggest complaint is not with the ACA but the fact that it did not change our model for access to healthcare, your job. No other nation on earth uses this outdated model that is based on a time when companies used health care as a perk for your job and labor unions bargained for it. That was fine when most of the population worked jobs with the same company for many years and then retired which isn't how it is now.

We just got the new information on the NEW plan for next year at my wife's company. Last year we had a plan with BCBS and it was pretty good. The annual per person deductible was $1200 and was the out of pocket expenses. After you reached that you had 100% covered. Our Dr. copays were $35 for a primary and $45 for a specialist. Our prescription copay had 4 tiers, $0, $15, $35, $75.

The new plan sucks. We have a $1500 annual per person deductible, $3800 out of pocket and then an 80-20% payment coverage, they pay 80% and we pay the other 20%. The Dr. payments each went up $10 and the prescriptions went up as well. And while it is still costing about the same we are getting less. My wife pays $1000 per month pre-tax and her employer kicks in an extra $500 per month. Because it is a small company with a mix of ages for the workers they have an age based plan meaning the older workers pay more for insurance than the younger ones. Only about 1/3 of the workers there even get the insurance, the rest get a better deal through their spouses or from former employers who gave them an early retirement package so the pool is small which further increases the costs.

My wife could probably go on Medicare as she is 65 and just get a supplemental policy but I would have to find my own insurance and the costs are even higher that way.

You are spot on Chris.
Our deductibles are rising as well. This is in part attributable to our so-called Cadillac plan. Ours (we're covered through Pete) is a Cadillac plan because it costs a lot not because it covers a lot. When you have an aging group of computer nerds pulling long hours you will have high health care costs. Since we have an expensive pool of workers to cover ACA taxes the plan 40% on every dollar over $10,200 spent in premiums.

This is why we need a socialized system with the government as a single payer. The pool of employees at my firm is also aging, and our premiums are going up fast too.

I bailed on the standard plan last year and went with the very high deductible, lower premium, HSA plan. It pays for one physical, and then, since I have the family plan, we have a $6k deductible before the plan pays anything. But then it's covered 100% in network and 50% out of network. Basically, we get a free physical, and then pay out of pocket (pre-tax) for everything else, but if we get really sick, we won't go bankrupt. But the premiums are still too high.

Lets see ... looks like everyone agrees.

We are all paying MORE to have govt mandated insurance, but we all have LESS coverage.
Basically what this has turned into is VERY EXPENSIVE catastrophic insurance for all.

I'm $12,000 out of pocket between premiums and deductibles before I get a dime in coverage.
I hate to inform you all, but $12,000 will wipe out most, if not all of the people this was designed to help.
Oh, And I'm talking about the silver plans. I can only imagine how much worse it is with the bronze.

What a bag of shit we were sold. And don't bother blaming those "evil Ins. companies", the D's forced this upon us.
Now that they have created an even larger problem I cannot wait to see their next solution. Fucking idiots.

You know why Pelosi said "we have to pass the bill so you can find out what is in it"?
Because if anyone with 1/10th of a brain read & understood what it was, they would NOT have passed it.

For the 25 years before Obama was elected dogcatcher, we had increased premiums and more highly selective coverage every goddamn year.

ETA That said, I'm sorry that this affects you personally in this way.

Thanks, but from what I see, my actual coverage have fallen off a cliff and my premiums have skyrocketed over the last 5 years. YMMV.

Every year I get a refund from the insurance company because they didn't spend the required amount on claims. It's not a lot, but I LOVE it that Obamacare is making the insurance companies meet minimum standards.

And I have to parrot what UT just said. My insurance premiums have been going up consistently for my entire adult life and after Obamacare was passed, they have not gone up nearly as quickly. I think my increase in healthcare costs is because I am getting older and so are my co-workers. We are not a desirable pool.

I read an article on the uptick in premiums the other day pointing out that it took insurance companies a few years after the passage of the ACA to figure out what the rates should really be, they had to adjust to the fact that now they had to cover more people with pre-exisiting conditions, etc. They found out that Americans as a whole are a lot sicker than was expected. And since they are "for profit" companies they have to raise premiums and cover less in order to make a profit. Furthermore, the ACA has no bargaining power for costs like Medicare does. Even Medicare Part D (the drug part) can not bargain to get lower prices on drugs.

They found out that Americans as a whole are a lot sicker than was expected.

Because they haven't a clue about the people, only actuarial tables and reports. None of those executives have experienced knowing you're sick, but don't have the money, or even know a doctor, to do something about it, until you're taken to the emergency room.

This plan has brought a shitload of those people into the system where they can now get everything at least looked at, so they will. And people who think they're healthy, the I've never been sick a day in my lifers, don't see the need for insurance so will avoid it as long as they can.

Oh, and the medical profession's bosom buddy the drug companies spend billions through the media, making as many people as possible hypochondriacs.
Feel bad? We've a pill for that. Too fat/skinny? We've a pill for that. Raining? We've a pill for that. :rolleyes:

glatt;944720 wrote:

Every year I get a refund from the insurance company because they didn't spend the required amount on claims. It's not a lot, but I LOVE it that Obamacare is making the insurance companies meet minimum standards.

And I have to parrot what UT just said. My insurance premiums have been going up consistently for my entire adult life and after Obamacare was passed, they have not gone up nearly as quickly. I think my increase in healthcare costs is because I am getting older and so are my co-workers. We are not a desirable pool.

This, plus my kids will continue to be covered. The linkage to work is still a huge problem but more people are being covered.

classicman;944666 wrote:

Soooo ... For 2016, the NEW Obamacare changes are kicking in -
What are the changes you ask? Well I'll explain.
My premiums are increasing another 21%
My coverage is now ZERO until I meet a $6000- $6400 out of pocket minimum.
That includes my prescriptions. So unless I average well over $500 a month in medical expenses,
I will pay well over $6000 a year for NOTHING PLUS the increase in premiums!
...

That sounds more like "Catastrophic Health Insurance" than
what people usually think of as a health care program.

In any case, it's not correct to say you are paying for "...NOTHING PLUS...premiums"

Under ObamaCare...

"Catastrophic plans" cover 3 primary care visits per year, and certain preventive services, at no cost.
You have to pay all other medical costs yourself until you reach your deductible &#8211;$6,850 in 2016.

After that, the plan pays 100% of covered services.

Also, such insurance plans depend a great lot on whether your
State Governor has elected to expand Medicaid, or not.

If you&#8217;re eligible to buy a Catastrophic plan, you&#8217;ll see them displayed
when you apply and [COLOR="Orange"]compare plans in the Marketplace.[/COLOR]

.

To get on Medicaid you have to have income of about 400 bucks a year :bolt:

Buster, you may be right about qualifying for all of the benefits associated with Medicare/Medicaid,
but with respect to ObamaCare the eligible income levels are higher &#8230;

Determining eligibility for various ObamaCare plans and costs is complicated, and the
entire ObamaCare government website is needed just to work thru the spider web of details.

For example:
* Did your state Governor elect to expand Medicare ?
* What are your state's eligibility requirements ?
* How many members in your family ?
* What is your annual income ?
* What kind of coverage do you wish ?
* Do you qualify to tax credits, and if so how much ?
* Do you qualify for out-of-pocket expense reductions, and if so how much ?
* etc.

But, qualifying for the advantages of and cost reductions of Medicaid coverage,
the following annual income levels apply:

Below $21,983
You'll qualify for free or low-cost coverage through Medicaid based on income alone.

$21,983 - $39,825 You'll qualify for a Marketplace health plan with lower monthly premiums
plus savings on out-of-pocket costs, like deductibles and copayments.

$39,826 - $63,720 You'll qualify for a Marketplace health plan with lower monthly premiums.

Above $63,720 You won't qualify for savings on a Marketplace insurance plan.
You can buy insurance through the Marketplace at full price, or buy from other sources.

,

...before the ACA, I had perfectly servicable, affordable, insurance policy as a self-employed guy, and, after the ACA, that insurance was deemed substandard and cancelled. Now, I can't afford a policy without takin' a subsidy, which I won't do.

Not seein' the upside of Obamacare at all, not for me, anyway.

henry quirk;944942 wrote:

Now, I can't afford a policy without takin' a subsidy, which I won't do.

I don't understand this. If you are eligible for a subsidy, why wouldn't you take one?

Do you take the deductions the IRS offers you when you file your income taxes?

"I don't understand this. If you are eligible for a subsidy, why wouldn't you take one?"

Call me weird, but I don't want other folks payin' my way...I like doin' for myself...before the ACA, that's what I did with my little policy...now, if I want insurance, I gotta take a handout...unappealing idea.

#

"Do you take the deductions the IRS offers you when you file your income taxes?"

What dee-ductions? I got no steekin' dee-ductions....probably could find some but it's easier to give Shylock his pound and be done with it...no one can come to me later and lay claim to me if I'm paid in full.

Now days: I render unto Caesar what's due, in full, and expect to be left alone for my trouble.

You're quirky, henry quirk.

I, and I have the gut feeling that most people, take advantage of what the rules allow. If the government is saying "you have to pay A, but not B, or C" then I'm only going to pay A. I view the subsidies for Obamacare in the same light.

But I can see your point.

I don't like debt or indebtedness...got too much of it now as is (that I can't pay off)...can't see takin' on more, and that - to me - is what subsidies are: debt (and linkage and unnatural ties).

As for taxes: there was a time I took great pleasure evading and avoiding and minimizing...got older and less bolder and it just made/makes more sense to give over that pound and be done with it...as I say, if I'm paid up then I should be left alone.

But, if my combined tax bill gets much beyond fifty percent, I may have to revist my old ways...livin' close to the bone now...not givin' 'em my marrow too.

So, as it stands, you'll get appendicitis, go to the ER, have it taken care of, and either face a shitload of debt and indebtedness you don't like, or declare bankruptcy and foist the bill for it all on the taxpayers.

Because you drew an imaginary line in the sand according to whim.

Whether you're considered quirky or not, the bottom line is it's your money so you're entitled to do what you want with it. I don't agree with your positions on many things, but will defend till it hurts a little, your right to hold them. ;)

henry quirk;944946 wrote:

it just made/makes more sense to give over that pound and be done with it...as I say, if I'm paid up then I should be left alone.

That pound will include a charge for not having insurance.

Toad,

I always pay my bills...I never default. An honestly acquired bill is not the same as takin' a subsidy.

'But, Henry you said, "got too much of it now as is (that I can't pay off)".

Sure, in one lump sum...I'm payin', just not as quickly or largely as I or the debt-holder would like...but I pay, so, don't worry, none of your tax dollars are coverin', or will cover, my ass.

#

"whim"

Go fuck yourself.

##

Bruce,

HA!

And: don't go fuck yourself.

##

Monkey,

As of now: no fine has been levied, and I'm not the habit of worrying about what 'might' happen. If and when: I'll deal with it then.

And: don't go fuck yourself.

henry quirk;944955 wrote:

As of now: no fine has been levied, and I'm not the habit of worrying about what 'might' happen.
If and when: I'll deal with it then.

Hmmmm.... HQ, you may have to deal with it sooner than you expect - next come the ides of April !

From the ACA website:

If you can afford health insurance but choose not to buy it,
you must pay a fee called the individual shared responsibility payment.

You pay the fee when you file your federal tax return for the year you don’t have coverage.

The penalty for 2015 is the higher of these:

* 2% of household income
Maximum:
Total yearly premium for the national average price of a Bronze plan sold through the Marketplace

...OR...

* $325 per adult
* $162.50 per child under 18
Maximum:
$975

... this is only a small portion of all the if/then details

.

Lamp,

"You pay the fee when you file your federal tax return for the year you don’t have coverage."

As I say: 'I'll deal with it then'. I always pay my honest bills but there are 'options' when a bill is inflated or outright dishonest. We'll see.

And: don't go fuck yourself.









And, Toad: go fuck yourself.

Whole lotta fucking going on.

Obviously it's the heart of the matter.

You could pick any line in the sand to draw and how deep you draw it. It's just what you like.

Drawing a line in the sand based on consideration of one's self in the world is not the same as whim (buying tic-tacs on impulse). You disagree with me: well and fine, many do, but only you, in this thread, tried to reduce me, to reduce my thinking. You're a crapsack and can go fuck yourself.

Yes but being "reduced" doesn't really merit this severe triple over-reaction, so obviously it's the heart of the matter.

"doesn't really merit"

Sez you.

I'll decide what merits what for myself, thank you very much

And, in case you forgot: go fuck yourself.

OK, it's time to put the boys away.

.

You're right...sorry for hijacking the thread even slightly.

I can only say, as explanation, Toad gets up my nose in a big way and, while I mostly can *shrug* and be a duck, sometimes I can't (or won't).

Anyway: I'm done with it.

Lamplighter;944805 wrote:

That sounds more like "Catastrophic Health Insurance" than what people usually think of as a health care program.

In any case, it's not correct to say you are paying for "...NOTHING PLUS...premiums" Under ObamaCare...
Also, such insurance plans depend a great lot on whether your
State Governor has elected to expand Medicaid, or not.

You are incorrect. I am now paying OUT OF POCKET for the first $6000-6400 of medical expenses AND the premiums which are now about $513 a month. So some quick math shows that I am getting NOTHING for the first $12,000 out of MY POCKET - all after tax $$ as well.

As for the State Gov - thats a shiny distraction as well. Medicaid has no bearing on my situation.

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.

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.

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.

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.

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.

Happy Monkey;972546 wrote:

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...

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

Griff;972565 wrote:

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".

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.

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.

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

Happy Monkey wrote:

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.

Apologies again; I did misread that web page.

Clodfobble;972592 wrote:

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.

Is it working?

Not for me. I'm this close >< to paying the fine. Seriously - I just don't have the money in my budget.

But I mean, is it working to put you in favor of single payer? Would you vote for the politician who promised to enact a single payer system?

I have no insurance to pay 187k in hospital bills and the left artery is still to be done. I have applied to emergency medicaid. If not approved I will pay $50 month forever. Still cheaper than insurance. I don't file taxes, have no visible income and don't have to pay a fine. By the way the 2nd stroke was lighter than the first and all is back to normal.

tarheel

I'd prefer it without the deceit but I could vote for that. As a country we'd have to not let every coverage and $ discussion derail it, which means grown-ups in the House of Representatives which seems unlikely. I remember the death panels nonsense and know we have to be better.

Clodfobble;972592 wrote:

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

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

Clodfobble;972722 wrote:

But I mean, is it working to put you in favor of single payer? Would you vote for the politician who promised to enact a single payer system?

Honestly, I'm not sure. I see where other peoples situations have gotten better, but for the most part many are paying far more - I am certainly one of them. It seems as though they could have addressed the few that needed better/expanded/any coverage without screwing so many more that were happy.
I couldn't keep my doctor, I'm not saving $2500 yr and I now don't have dental nor vision because I cannot afford it. Just to name a few.

We're all paying more. The rates just keep going up and up and up.

But I think Beest is right. While I haven't crunched my own numbers, my recollection is that Beest's 20% increases per year before Obamacare was pretty close to my own situation.

Obamacare slowed the rate of the increases.

classicman wrote:

It seems as though they could have addressed the few that needed better/expanded/any coverage without screwing so many more that were happy. I couldn't keep my doctor, I'm not saving $2500 yr and I now don't have dental nor vision because I cannot afford it. Just to name a few.

Sure, many of the promises of ACA were unrealistic. But never mind the past; single-payer could improve your personal situation now, yes?

Perhaps Clod, depends on the outcome.

glatt - my increases were nowhere near that prior to the ACA. This is what amazes me - my experiences seem to be polar opposites of others here. strange world indeed.

If you've got pre-existing conditions, get insurance before January. They'll repeal Obamacare before they have anything to replace it with.

And since the pre-existing condition support is a major cost factor, don't expect it to be in any eventual replacement.

As I see the insurance industry there are a number of parallels between it and casino gambling. Essentially, insurance companies are betting you will be healthy and you are betting you will get sick. With actuarial tables insurance companies can predict with exceptional accuracy the likelihood of anyone making a claim and what that claim will cost them. That is one of the reasons that they want to be able to cherry pick their policy holders. Just as a casino will bar card counters and people with "photographic memories" an other people who win too often, insurance companies prefer healthy people over sick or sickness prone people. The house doesn't like to pay out.

The only way it works is when there is a preponderance of losers gambling against the house. Healthy people unlikely to get sick, betting that they will get sick, and unskilled gamblers betting that they will win.

Obamacare is essentially compelling the casinos to allow big winners, card counters, and other drains against the house to continue to gamble, while also compelling non gamblers to also bet against the house.

So the insurance companies have to take the sick people, but they are promised healthy, non-claim making people to offset their costs.

Frankly, I don't see where the government gets off compelling you to have health insurance. Auto insurance is optional in that if you don't want to have auto insurance you don't have to own a car.

footfootfoot;973241 wrote:

Frankly, I don't see where the government gets off compelling you to have health insurance.

They don't compel you; they incentivize you, with subsidies and penalties; much more lenient than the auto insurance requirement. Classicman has been considering opting out.

Auto insurance is optional in that if you don't want to have auto insurance you don't have to own a car.

The reasoning for mandatory auto insurance and health insurance is identical, but there's no way to opt out of potentially needing medical care. How would that work? Some sort of "do not treat" tattoo if you're brought into the ER? Like a DNR but for everything?

Happy Monkey;973232 wrote:

If you've got pre-existing conditions, get insurance before January. They'll repeal Obamacare before they have anything to replace it with.
And since the pre-existing condition support is a major cost factor, don't expect it to be in any eventual replacement.

I'm not worried. I find that about as likely as them rounding up 12,000,000 illegals, shipping them to Mexico and sending all the muslims back to the middle east. Not gonna happen.

You think that if they can't rely on Obama to veto, they'll vote no?

[eta] Though I suppose they can still rely on the filibuster in the Senate to block them.

Happy Monkey;973242 wrote:

They don't compel you; they incentivize you, with subsidies and penalties; much more lenient than the auto insurance requirement. Classicman has been considering opting out.The reasoning for mandatory auto insurance and health insurance is identical, but there's no way to opt out of potentially needing medical care. How would that work? Some sort of "do not treat" tattoo if you're brought into the ER? Like a DNR but for everything?

Some states don't have mandatory auto insurance. You don't opt out of potentially needing medical care, you are self insured.

Only three states don't have mandatory auto insurance, New Hampshire, Virginia, and Mississippi. All have other financial requirements instead:

In New Hampshire vehicle owners must satisfy a personal responsibility requirement instead of paying monthly premiums, and prove that they are capable of paying in case of an accident. In Virginia vehicle owners may pay an uninsured motorist fee. In Mississippi vehicle owners may post bonds or cash.

The question remains, how to willfully choose not to treat those self-insured who don't have wads of cash in their pockets at the moment the piano falls on their head? There was a thread here awhile back about a fire department that watched a house burn down because the homeowners had refused to sign up and pay for the service (it was a remote area with no city taxes to pay for it.)

The outrage in response to that story was palpable--not to mention the homeowner himself was running back and forth screaming that he'd pay it now, he'd pay it--and they didn't even let someone die. We are a society that will treat people if they need medical care. That's a reality. So the rest of our decisions have to be based on that fact, and not pretend that it would ever go any other way when someone in severe need of medical care walks into a hospital.

Not letting a patient die is a far cry from the $2 million in bills classic man's son tallied up.

What percentage of that was racked up in the first 4 weeks of keeping him alive, versus the therapy and recovery afterwards? My bet is it was about half. $1 million is still not a cost we can just absorb for the person who chooses not to pay for insurance.

Emergency care adds up fast, but millions ring a large bell with insurance companies. They don't give a rat's ass about people, only bottom line.

Absolutely. Single payer is the only real way to go, IMHO. My only point is that allowing people to opt out completely is not a financially feasible system, because no one is ever really opted out.

BTW, on the day after the election over 100,000 new people signed up for Obamacare, because as always, folks are going to whine about how awful it is right up until it looks like it's going to be taken away.

But it might not matter, because Trump actually has just decided he likes Obamacare:

http://www.bbc.com/news/election-us-2016-37953528

Perhaps thats because the open enrollment just began and hundreds of thousands sign up every day now through the end of enrollment because - well because they have to.

You don't have to...

Doc says you're gonna die.















In debtor's prison.

That doesn't include the helicopter evac...

No way.

Another day, another new "stupidest thing I've ever seen"

.:facepalm:

Looks like there are competing bills. Here's another, with a less ridiculous name.

Actual numbers. I received the following email from my employer today. Edited for privacy.

Dear [glatt],

The firm has calculated the employees’ share of the 2016 medical loss ratio (MLR) rebates received from Cigna in accordance with Department of Labor (DOL) guidelines under the Patient Protection and Affordable Care Act (PPACA). The total rebate received by the firm for plan year 2016 is $426,299.00.

Rebates will be in the form of a medical insurance premium credit on the first December payroll for actively enrolled Cigna participants who participated in a Cigna plan during plan year 2016. The premium credit attributable was allocated proportionately to the Cigna medical premiums paid by individuals in 2016 to which the credit applies.

Your specific premium credit amount is: $242.12. Please note that since medical premiums are deducted on a pre-tax basis, your premium credit will slightly increase your tax withholdings since your remaining medical premium due on your first December pay will be less than usual.

If you should have any questions, please contact [email]benefits@[employer].com[/email].

$242.12. Thank you Obama. And thanks for keeping the insurance companies honest in this area.

My friend Working Class Marcus will need some of that because his O-care premiums went up like $150.

I think his 17-yr-old son is on his plan too

Marcus will just sell more weed but what about the working class people who don't sell weed?

Marcus might have to sell a lot more when Congress gets done "fixing" Obamacare.:rolleyes:

Prior to Obamacare, did Marcus have better insurance, or no insurance?

No insurance

So, cheaper for him, but ready to fuck the rest of us over when he showed up in an ER with medical needs he couldn't pay for but would still receive.

For minimum impact on his preferred lifestyle, all he has to do instead is pay the penalty (much cheaper than premium-plus-$150) and keep living like he's invincible.

"cheaper for him" Working class, they don't buy things they can't afford. He wouldn't have paid for insurance because it would have busted him. Now he is forced to pay for it although it is busting him. * s h r u g *

So all that is correct, and that will be his decision; now extend it to the rest of the working class, and there they are. Will they pay the penalty? Will they take their chances? Will they sell weed? Will they fuck us over? Will we notice?

Working class, they don't buy things they can't afford.

And yet, he bought an actual insurance policy last year instead of paying the penalty. He's not forced to pay for the thing that costs hundreds a month and just involuntarily went up another $150 a month. For 2016, the penalty for going without insurance is just $57.90 a month if your annual salary is $27,800 or lower. $40K a year gets you $83.30 a month, $60K a year is $125 a month.

The system is fucked, and I'm not saying he can afford the actual insurance. But he could afford the penalty, meaning Obamacare wasn't the thing that fucked him.

Before Obamacare, MA already had a mandatory system my bother bitched about mightily. When Obamacare came along with the preexisting condition clause he didn't see why he couldn't skip insurance and just buy it if he came down with something serious. :rolleyes:

That's what's so great about the penalty--it's sliding with income, so if you're poor it's cheap, but if you make plenty of money the penalty ends up costing quite a bit more than just buying a policy in the first place. So, okay, he could lie about having policy and not pay the penalty, but it's part of your annual tax bill, which means he's in the crosshairs of the IRS if they ever catch him.

Also, after the initial "let's get everyone going on this new system" rush, open enrollment is now limited to just once a year, so if he gets cancer in January he's fucked until November.

It's not a bad system. There are problems with it that allow the insurance companies to fuck us over, but they were already able to fuck us over in those same ways before. There are now slightly fewer ways for them to fuck us over, but somehow Obamacare keeps getting blamed for all the bases they didn't cover--and not just in a "you weren't thorough" way, but in a "you did this to me!" kind of way.

Life is easier when you have a scapegoat.

There are now slightly fewer ways for them to fuck us over

I agree with all that, but this is not the bottom line we were actually hoping for when this whole thing began.

Oh, for sure. Me personally, I was hoping for single payer.

Clodfobble;999652 wrote:

Oh, for sure. Me personally, I was hoping for single payer.

That will not happen until we get rid of the present congress, and president.

You say that like it's unlikely. Step one is less than a year away.


Also: I have seen statistical analysis that has convinced me that the voting machines in key states/counties were hacked, and the evidence is building. It's going to get a lot uglier before it gets better, but by the 2020 election, we'll be using paper ballots nationwide. You heard it here first.

Undertoad;999641 wrote:

I agree with all that, but this is not the bottom line we were actually hoping for when this whole thing began.

It was hoped that any kinks would be worked out in the future, but instead, when people complain about issues where it didn't go far enough, the only response from Congress is to try to roll back the things it does.

Clodfobble;999655 wrote:

Also: I have seen statistical analysis that has convinced me that the voting machines in key states/counties were hacked, and the evidence is building. It's going to get a lot uglier before it gets better, but by the 2020 election, we'll be using paper ballots nationwide. You heard it here first.

Why would people voted in by hacked machines vote to change the machines?

It didn't go far enough because they had to compromise in order to get the people who had bought the congressmen on board or we would have got nothing. The hope was improvements would be made step by step, but the GOP going into full attack mode killed that hope.

Happy Monkey;999658 wrote:

Why would people voted in by hacked machines vote to change the machines?

Well, the hope is that the hacking would be exposed, and the outcry would be so great that even a Republican majority couldn't defy their constituents, as happened with the healthcare repeal earlier this year. Also, it gives Republicans an "out" to disassociate themselves with Trump, since presumably the primaries were hacked, too. It's a "forgive us, because it turns out we weren't responsible for him after all" kind of move.

Clodfobble;999652 wrote:

Oh, for sure. Me personally, I was hoping for single payer.

QFT.

I'm right there with you, sister. [ATTACH]62602[/ATTACH]

This is a national map of personal debt in collections. Not those getting screwed by the system, just those who have fallen behind.
At this link is an interactive map where you can choose a county where it will tell you the debt and how much of it is medical debt.

Good news from Marcus, who reports that his subsidy has increased substantially. So although his premiums went up, his overall bill will be going down. He must have had more reported income the previous year or something. I feel better

good

My premiums went up to over $9200 for 2018. Thats about a $3000 INCREASE... AGAIN!
WTF? There is no way I can afford that. I have opted out of the circus and joined a Christian alternative healthcare plan for under $2000 a year. I a responsible for anything under $500 and the plan covers me for things over $500. Stay tuned ... ... ...

I am curious what the increase would have been on the old system.

You're about to find out, since the new tax bill also surreptitiously eliminates the individual mandate. Folks can go back to buying no insurance, which will I'm sure lower prices for everyone... :rolleyes:

Is Dan part of this policy? I'm wondering if the private insurers are getting around pre-existing conditions by just accepting and then raising premiums year-by-year on such cases.

Clodfobble;1000539 wrote:

You're about to find out, since the new tax bill also surreptitiously eliminates the individual mandate. Folks can go back to buying no insurance, which will I'm sure lower prices for everyone... :rolleyes:

Mandate's still there, just not the penalty for having no insurance.

What is a law without a penalty?

It's called a suggestion. ;)

Now that people need not have insurance, then also fair is that any hospital can refuse service to anyone who cannot pay. Hospitals should have the right to put you out on the street to die if you cannot pay. That is the extremist Republican agenda.

Businesses must operate in their own interest. No business is a charity. So businesses can refuse service to anyone they don't like, who cannot pay, and whose religion is contrary to the company's top management religion. It is the new 'fair'.

Undertoad;1000540 wrote:

Is Dan part of this policy? I'm wondering if the private insurers are getting around pre-existing conditions by just accepting and then raising premiums year-by-year on such cases.

Nope. This is just for me. Also, they cannot do that as all premiums must be the same for all who are the same age. The only variable that I’m aware of is smoking versus non-smoking.