Forum Index » Chaff » Who is signing up for ObamaCare (aka ACA) on Tuesday?


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Daniel Pittman
(pitsy) - M

Locale: Central Texas
Re: Who is signing up for ObamaCare (aka ACA) on Tuesday? on 09/30/2013 23:36:29 MDT Print View

My girlfriend continues to work at a job she hates (Starbucks) because it provides good insurance for us and our child. I work my ass off and make enough to pay our rent, utilities, car note, medical bills, and phone bills. She pays for health coverage, car insurance, and groceries. There is nothing left over and we have no time off to spend together.

If we can get a better deal on health care because of ACA, it might allow her to find a more fulfilling job. She had to pass on a better paying job earlier this year because it didn't offer insurance.

I have family in the UK and Europe. Their health care system seems much simpler and more humane. You get sick, you go to the doctor. Taxes pay for it all. Sure you have to get on a waiting list for some procedures, but routine care and emergency care is much more streamlined.

Ken Thompson
(kthompson) - MLife

Locale: Behind the Redwood Curtain
Re: ObamaCare on 10/01/2013 06:23:29 MDT Print View

Ooh! I qualify for Enhanced Silver 70

Monthly payments of $367-411 for myself.

Not gonna happen if I want to eat and have a roof over my head.

What about a vision and dental coverage?

HK Newman
(hknewman) - MLife

Locale: Western US
ACA and saving on 10/01/2013 07:38:56 MDT Print View

*Jennifer - Not sure if I'm reading your post correctly but is it your opinion that a person should ensure he/she has earned enough to avoid receiving an ObamaCare subsidy prior to embarking on the PCT or would you be willing for that person to accept a taxpayer subsidy?

Conventionally, most need to save about $5500 minimum to embark on the PCT (quoted from those who did it) but the vast majority will need employment to pay other bills while working to save; assume their own place (rent/deposit), groceries, utilities (w/deposits), other insurance, nights out. etc...and, assume an auto/gas, that's $2,000 per month living expenses, ... all while saving the previous sum (places with excellent public transport are more expensive, so call it even). Plus the cheapest bronze plan requires higher deductibles and copays, so that should be in the budget too and added to the $5500 (~$6500 - $7000?). With monthly expenses, direct subsidies fade away as the needed taxable income is added up.

We calculated $1.5K/mo minimum was needed to survive in one of the cheapest US zip codes -El Paso TX/Ft. Bliss - about a decade ago (Source: Three of my officer assignments were in admin, helping troops and families with financial planning with civilian social workers). Now, no-to-low income types have Medicaid take over but if I am reading right, it's very rare for to be covered out of state (if that's important). Some might hike with current savings (already taxed) but in America? That's about as rare as Ted Cruz and Rand Paul riding into the Senate together on a rainbow colored unicorn. My experience is younger couples buy more house and more car than their budget can support, and if still married by middle age, keeping the wife (current + exes) and kids "in style".



Ed: it/br.

Edited by hknewman on 10/01/2013 09:22:11 MDT.

Fred Thorp
(BFThorp) - F
Unintended consequences on 10/01/2013 15:43:24 MDT Print View

For those thinking this deal is all good and will take some time to level out, I have to ask, "at what cost"? Small companies that I am familiar with, were planning for the worst when this legislation was first being discussed. Instead of expanding, they waited to see what would happen, and are still sitting on their hands. How many unintended consequences will go overlooked? How bout your car insurance going up?

Health care will become efficient when the patient pays the doctor. Adding another layer of bureaucrats in between and expecting things to improve is pure insanity. DC is so out of control it's funny, in a sick perverted kind of way. For those in favor of it, enjoy.

David Olsen
(oware)

Locale: Steptoe Butte
I will compare prices on 10/01/2013 18:11:29 MDT Print View

Being self employed, Obamaney care gives me more insurance company choices and I won't be denied coverage because of any injury or illness. My wife's job comes with insurance for her, but if we add me and my son to her policy, it takes more than half her paycheck.

The fact the phones and web sites are swamped today shows the interest and need for the program.

It is time to disconnect health insurance from employment. We will be more competitive with the rest of the world.

Fred Thorp
(BFThorp) - F
Who pays on 10/02/2013 10:38:46 MDT Print View

@david

"Being self employed, Obamaney care gives me more insurance company choices and I won't be denied coverage because of any injury or illness. "

Who pays for this shortfall?

David Olsen
(oware)

Locale: Steptoe Butte
What shortfall? on 10/02/2013 14:35:15 MDT Print View

What shortfall? You mean the one I have been paying for? Now, under Obamneycare, I can choose to buy insurance along with many others and we are all paying for the same degree of coverage, playing by the same rules. Not like the insurance has been where the buying power of large corporations shifts the costs to the people who have to pay cash for care or buy in the individual market at inflated costs. Being denied coverage by some decision of an insurance manager is just a product of the past. As it was, I have been making up for the shortfall of the past insurance policies.

Fred Thorp
(BFThorp) - F
What shortfall? on 10/02/2013 14:38:50 MDT Print View

The shortfall created by the uninsurable getting insurance.

This program is not creating market efficiency, but is going the other way. It's likely to end up more expensive, provide less, and have more uninsured. Brilliant no less

Edited by BFThorp on 10/02/2013 14:43:45 MDT.

David Olsen
(oware)

Locale: Steptoe Butte
There is no shortfall on 10/02/2013 15:00:52 MDT Print View

You are missing the point. I already pay for those without insurance. When my son broke his arm, the hospital charged me 1/3 more to make up for the 1 in 3 who they care for that do not have insurance. With the private insurance companies now enrolling more people, my costs should go down. In fact the private FOR profit hospital took money from me through property taxes on my home, yet I get no more benefit for that than an indigent traveler who uses their services. (As it should be, in my opinion.)

Tom Kirchner
(ouzel) - MLife

Locale: Pacific Northwest/Sierra
Re: I will compare prices on 10/02/2013 15:48:15 MDT Print View

"It is time to disconnect health insurance from employment. We will be more competitive with the rest of the world."

Single payer, like most of the developed world. Get the insurance companies and for profit medical providers out of the equation, then go after fraud with a vengeance.
Of course that would probably mean we'd have to cut the "defense" budget, but I think we could manage it without being invaded by Iran, Yemen, or some other dire threat to our national security.

Fred Thorp
(BFThorp) - F
Scratches head on 10/02/2013 16:17:58 MDT Print View

@ dave
"You are missing the point."

Not likely. The shortfall doesn't magically go away. While this may benefit some, like yourself, it's a complete turd for most. Again a bunch of youngsters will likely find penalties more affordable and the few remaining options will decline. Those that want a single payer system with the profit removed, should be happy now. If someone can explain to me how fewer options and another layer of government will make things better, I'd really like to hear it.

Richard May
(richardmay)

Locale: Costa Rica
Assumptions on 10/02/2013 16:32:31 MDT Print View

Could someone walk me through what happens when an uninsured individual is taken to a hospital for emergency treatment. Just because it will be more entertaining, let's make it something complex like a spinal injury resulting from getting hit by a car that will likely require physical therapy just so the person can become a productive member of society again.

David Olsen
(oware)

Locale: Steptoe Butte
more options on 10/02/2013 20:36:01 MDT Print View

"If someone can explain to me how fewer options and another layer of government will make things better, I'd really like to hear it."

There are more options, from where I stand. Before I could choose from just two companies in WA state. Now there are 6 in my area competing under ACA. That competition should drive down prices, right? There was already a thick layer of government on the previous insurance market and much of it prevented competition from entering the state.

https://www.wahealthplanfinder.org/HBEWeb/Annon_DisplayHomePage.action

Things have been working well in Mass. since they instituted the same sort of plan.


(Just looked, 2 more companies just jumped in to offer insurance.)

Edited by oware on 10/02/2013 20:49:16 MDT.

Jennifer Mitol
(Jenmitol) - M

Locale: In my dreams....
Re: Scratches head on 10/02/2013 21:43:21 MDT Print View

Fred, I'm not sure what "shortfall" you are talking about. I also have no idea what you mean by another layer of government. You do know this is private insurance we are buying, right? And you keep talking about young people getting screwed...how is that exactly?

I assume you mean that young, healthy people are paying into a system they may not use. Except for the fact that they DO use it. Guess what the number one demographic for spinal cord injuries is???? Young men between 18-26. Yep, those very same people who you say are paying for something they'll never use are EXACTLY the people who will run up medical bills in the millions (after rehab, of course) that they will never be able to repay. So do they need to suck it up, take responsibility for themselves and actually buy a health insurance policy? Yep. Absolutely. Otherwise those young'ins are screwing the rest of us by having the taxpayer pay their medical bills.

No one says they need to buy a platinum plan...they can go ahead and buy a huge deductible catastrophic plan...that's fine.

Young people get cancer, have car accidents, bike accidents, climbing accidents. They fall off cliffs, get diseases, need transplants...and barely any of them thought they would be the ones who needed it.

That's the whole point of insurance...to protect against the unexpected. I've never needed my homeowners insurance, but you don't see me complaining about people who live on the coasts and get blasted by hurricanes all the time...

Richard May
(richardmay)

Locale: Costa Rica
Re: Re: Scratches head on 10/03/2013 05:42:26 MDT Print View

> That's the whole point of insurance...to protect against the unexpected.
> I've never needed my homeowners insurance, but you don't see me complaining
> about people who live on the coasts and get blasted by hurricanes all the time...

That's exactly right Jennifer. The whole purpose of insurance is that my good fortune today helps with your bad luck and I am willing to do this because in a few years you may be helping me.

When insurance companies started making pools of clients divided up by risk-factors they undermined this system of solidarity. ACA stops this. There are no caps and nobody can be denied coverage for a preexisting condition nor can coverage be degraded.

The difficult part is how do you create a for-profit solidarity system. One that doesn't pit clients against each other and doesn't gouge them either for something that is necessary. How do you balance profit with humanitarian compassion? How do you get share-holders to understand that, with insurance, the bottom line is health of the clients not their pocket books?


Fred (sorry for the name mixup),
> The shortfall created by the uninsurable getting insurance.

To not understanding what the 'shortfall' is I don't understand who the 'un-insurable' are? Did you know that 100% of all men will eventually get prostate cancer if they live long enough? Does that make men un-insurable?

Edited by richardmay on 10/03/2013 08:23:52 MDT.

Jennifer Mitol
(Jenmitol) - M

Locale: In my dreams....
Re: Assumptions on 10/03/2013 07:48:28 MDT Print View

To give a real world example from my time in a large university hospital inpatient rehab department:

A 35 year old man changed jobs and his new health insurance had a 30 day window before it kicked in. He had been having a lot of headaches, but was waiting until his insurance was active before going to get it checked out. With about a week to go, he collapsed at work, massive aneurysm rupture.

He was taken to the ER where he promptly had numerous emergency brain surgeries to relieve pressure and to evacuate blood. He was in intensive care for well over a month. Then he was transferred to a step down unit for a while longer while they tried to manage his blood pressure. Then, unable to sit up independently, to talk, or even to hold his head up, he was transferred to our rehab unit where he stayed for nearly 2 months while he tried to learn to talk, to sit up, and to teach his family members how to care for him to keep him out of a nursing home.

During our interdisciplinary meeting, when we were discussing his rehab potential and plan of care, we all agreed he needed to stay. Then the nursing supervisor made an off-hand comment about this being exactly the reason none of us could get raises from the state university.

The cost of his care just at our institution? Well over a million dollars. For one uninsured individual who was young and very, very unlucky. Paid for by the taxpayers of Illinois.

Richard May
(richardmay)

Locale: Costa Rica
Re: Assumptions on 10/03/2013 08:34:39 MDT Print View

Real world examples are so much more interesting.

Was the university a state school? Is that why taxpayers footed the bill? Or, is it a governmental mechanism that paid the bill? Does the man need to worry about getting billed later?

Jennifer Mitol
(Jenmitol) - M

Locale: In my dreams....
Re: Re: Assumptions on 10/03/2013 09:20:35 MDT Print View

Yes...university of Illinois at Chicago medical center. And that guy can get bills all day long...he will never work, never be a "contributing" member of society, so how is he going to pay back a million dollars?

But his daughter can still hug his dad, the guy smiles and can say a few words, he left our hospital being able to hold his head up and to express his wants and dislikes. Those of you who think health care is not a right...what should we have done with this guy? He had a good job, played by all the rules...just struck by dumb luck. Like what could happen to ANY of us. Are we really supposed to just throw him to the curb?

This is why I - a medical practitioner with skin in the game, as they say - strongly believe in single payer health care. This happens WAY too often. And there is not a patient on my schedule who didn't think it would have ever happened to them.

Craig W.
(xnomanx) - F - M
Re: Re: Assumptions on 10/03/2013 09:50:54 MDT Print View

"Then the nursing supervisor made an off-hand comment about this being exactly the reason none of us could get raises from the state university.

The cost of his care just at our institution? Well over a million dollars. For one uninsured individual who was young and very, very unlucky. Paid for by the taxpayers of Illinois."


Funny, one million US dollars is about the cost of a single Tomahawk cruise missile.

There are more reasons you can't get a raise than the uninsured getting health care.

Ian B.
(IDBLOOM) - MLife

Locale: PNW
Re: Re: Re: Assumptions on 10/03/2013 10:01:41 MDT Print View

I think that expanding the size of the risk pool, if administered properly, should reduce expenses for those of us who've been carrying insurance before ACA. As a government employee, health care for my family is far from free but it's something we can afford. It's not perfect but it's fine for us. We've had a couple opportunities to test the catastrophic aspects of our coverage and it was nice to have it as a buffer between “just making it” and bankruptcy.

When my son was born two months early and spent some time in NICU, there was a misunderstanding as to whether we were in the BCBS high or low option. When we received our bill, it was about 20k (a far cry from Jennifer's patient’s million dollar bill). As a rookie LEO, father and the sole income provider for my family at that time, I just laughed. They may as well have wrote "a million-gazillion dollars" on the bill as every month was a struggle for us to figure out how to buy groceries and pay rent with less than $100 left for extras. They realized the error and the bill was later reduced to $2000. The hospital was very understanding with us as we made payments.

From some casual browsing on the website, it seems that those who are already on Medicaid will remain on a modified version of the same thing. Taxpayers are already paying that bill so I don't see how ACA has changed anything in that domain.

I've also heard some quotes from people about what their premiums will be. Sounds like they will be paying about what I do after my employer's (which ultimately are the taxpayers) portion. It wasn't cheap at $350-$450 per month (which is what I pay towards my premiums) but it also wasn't the $900-$1500 bill I was once quoted to be self-insured.

ACA is certainly not a perfect piece of legislation but it's been signed into law and the Supremes have already ruled that it's constitutional. I think the people would be better served for the GOP to look to the future and work with the DNC to make ACA something that is sustainable and meets the needs of the people.