Obamacare / Affordable Care Act : classic or dud?

not working for me, glad it's working for someone tho

I'm kind of excited to remain underemployed and still have coverage. Maybe not GREAT coverage like I had under my giant corporation job but still.

― Tottenham Heelspur (in orbit), Tuesday, October 1, 2013 11:54 AM Bookmark Flag Post Permalink

The law makes me feel like I have a better shot at ever leaving my job to try something more risky (e.g. starting a coffee business).

I'm also wondering how it will work out if H goes on prolonged childcare leave again, i.e. curious whether we can get a plan that's actually cheaper than my office plan, which has pretty high premiums AND high copays/deductible.

The law makes me feel like I have a better shot at ever leaving my job to try something more risky

OTMFM. I've made the argument for a long time that a lot of business owners are probably shitting bricks over ACA if only because of the potential number of employees who are clinging to awful jobs just to keep from losing their insurance.

lol Adam

*fistpump* at more ppl being able to get medical coverage

http://www.wnyc.org/story/faqs-about-health-care-exchanges/

day one glitch watch

http://nymag.com/daily/intelligencer/2013/10/obamacare-glitches-day-one-roundup.html

The original bill's timeline for getting the exchanges up and running was optimistic. That long period of uncertainty while the SCOTUS mulled over the ACA probably didn't assist the development process any.

Fox News, of course, has a "glitch watch" section on its website...

Did they ever have a glitch watch for the Iraq war? Because...

I'm 100% sure the glitches are part of the shutdown plan. Shut down the government the day this takes effect, make everyone stay home with nothing to do but go on the internet and crash the one health website! Republicans no doubt saw this happening and it's working like a charm!

The thing they realize is that it matters not who gets the blame. "Government" will get the blame! Because ultimately they have found a way to make government employees stand in the way of me and my health care: by temporarily laying them off, forcing everyone to stay home, clogging up the health website, and making it so I can't register.

I guess it's a good argument against centralization. Hopefully they will have it back up and running in a hot minute.

The law makes me feel like I have a better shot at ever leaving my job to try something more risky

OTMFM. I've made the argument for a long time that a lot of business owners are probably shitting bricks over ACA if only because of the potential number of employees who are clinging to awful jobs just to keep from losing their insurance.

Yes, this is all exactly correct. If ACA can break the non-sensical link between a certain type of employment and healthcare, it will help many people beyond just the uninsured.

and making it so I can't register.

You know you have six months, right?

Was gonna say, it's not Glasto tickets

http://www.youtube.com/watch?feature=player_embedded&v=sx2scvIFGjE&list=UUa6vGFO9ty8v5KZJXQxdhaw

You really don't have to think very many steps beyond "everyone gets access to affordable healthcare" before you start seeing net benefits. Re: breaking the nonsensical link between work and healthcare, doesn't this spur innovation? How many people would take a chance on something they're passionate about if it weren't for the spectre of losing health coverage? For instance, an underpaid high school teacher with health problems could quit the job he's hanging onto just for the insurance and go work at, say, a carwash while he puts the bulk of his time into a startup venture that puts more money into the economy.

i'm not sure if obamacare motivating a high school teacher to quit is the best example

LOL

FUCK THESE KIDS, i'm going to use my newfound flexibility to enter the realm of venture capitalism!

and be the one who knocks

Was gonna say, it's not Glasto tickets

Ha, my first thought was hey, if we can navigate buying concert tickets, we can handle this. Not a lot of Americans buying Glasto tickets, tho.

I made a similar joke on fb earlier, but used Bieber as the punchline.

I know, and that had more relevance.

Still, tho

Ugh a disaster

http://articles.philly.com/2006-01-12/news/25410200_1_medicare-spokeswoman-medicare-beneficiaries-medicare-prescription-drug-program

Posted: January 12, 2006

you missed the joke

idgi

seriously guys?

prescription drug package has awful roll-out in 2006; today nobody complains

I got my 2014 rate pamphlet from my health insurance company yesterday, and my new plan's premiums are $28 less a month, but the copays and prescription costs and the deductibles for serious stuff have all doubled. Is that what other insurance companies are doing?

Was this posted? It's been making the rounds:

http://www.hulu.com/watch/539715

(Jimmy Kimmel Obamacare vs. ACA bit)

sarahell do you have an individual plan or an employer plan?

Companies are generally increasing deductibles and going to cheaper plans like HDHPs with built in HSAs, and what your plan did sounds like another way of cost-cutting, trying to empower you to save up the money to pay for the 'gap' in expenses by...saving you a measly $28/month.

I have a corporate exchange plan, so it's probably staying the same, but the price is being jacked up.

I have an individual plan.

hmm - not sure about those. not surprising though. this is why a single-payer system would have been preferable, but yeah, obviously that'll never happen in our lifetimes...

Maybe amazon and google can make single payer happen

as in they pay for it?

I wish!

I'm still not clear -- and none of the information I've received/have been directed to has explained -- how the credit for insurance is calculated or how the low-income exclusion is calculated.

I'm certainly related to people who are having hysterical meltdowns about their individual plans going way up deductible and co-pay wise, but they haven't compared against plans they're able to get through the exchange. I imagine those might be cheaper but not as cheap. I think it is likely that minimum benefits requirements by ACA are leading insurance companies to jack deductibles way up. But it's the companies that are doing this based on....nothing. Or based on their own voodoo cost analysis. They could certainly slim their profit margin down instead.

My understanding is that the places people will be hurt most are in the states where Republican governors are preventing the gov't from helping most.

I may have some of the particulars wrong here but -- my gf got a letter from Aetna saying that soon her $322 monthly premium would be reduced by approximately $100. she carries a high deductible (paying 100% of coverage up to $5k, then 80% costs between $5k - $8k, and 0% after $8k) and her copays are $35 & $50, IIRC. She gets reduced cost generics pharmaceuticals. The letter then went on to say that if she were to go through the exchange and pick a comparable plan (which i can only assume would be the "bronze"?) that she could save an additional $50. So unless this is all bs, she stands to practically cut her monthly premium in half without affecting her coverage at all.

oh, and thanks to NObamaocare her birth control now has to be covered under her current policy, costing her $15/ month rather than $65/ month.

we're in a state with an asshole Republican governor, btw.

Going through the exchange/marketplace is what sets you up for the income-based tax credits, so if you aren't presently insured this is easily the best way to go. NB: insurance agents who sign you up for policies through the exchange won't charge you a fee for the service; it's paid for by other means. I am among the bare-assed no-insurance multitude, so I'll be looking into it in the next few months.

yeah, that's what's weird. i really don't think she'll qualify for any subsidies. so maybe the idea was more that it's possible she could save more by going through the exchanges, assuming she'd qualify. Aetna wouldn't know her income afaik.

They could certainly slim their profit margin down instead.

This. It will largely depend on whether the transparency of the exchanges cause insurance companies that inflate profits to lose market share in a big way, lowering revenues in a big way. The companies won't reduce profits until forced to, because they are afraid Wall Street will hammer their share price and share price drives the net worth of CEOs and other execs.

Has there been any asshole commentators going on about how the private industry wouldn't have had the server crashes?

Cuz Day One server usage spikes _never_ do not crash systems. The vidja games industry his used to this stuff; GTA Online is the biggest thing ever and Rockstar couldn't handle the server load. EA had SimCity died repeatedly the first week. Blizzard runs the worlds biggest MMO and their Diablo III wouldn't initialize, StarCraft II kept losing it, and Microsoft and Sony are going to be hit hard when the next-gen consoles go online next month.

I imagine you could really create a lot of jobs if you wanted to overhaul America's shitty internet infrastructure...

Here is the screwjob for Texas retail workers that doesn't hurt me (full time) but kills my coworkers. My company has cut insurance for part-timers. Texas hasn't expanded Medicaid. In order to earn enough to be eligible for a subsidy on the Federal Exchange, you would have to be working full-time. If you are working full-time you would have insurance from your employer.

24 hours a week at $7.75 an hour - $9672 - no Medicaid, no subsidy.

30 hours a week at $8.25 - $12,870 - no Medicaid, no subsidy,

35 hours a week at $9.00 - 16,380 - full time status, eligible for huge subsidy, except not because you now have a more expensive plan from this employer.

You can't work 2 jobs because these kind of jobs require ridiculous availability to get any hours at all.

I'm pushing the idea of selling crafts (knit scarfs) and services (cook dinner) to your friends and declaring the income to get the subsidy. While your friends sell you their old things (socks and CD's) and declare the income to be eligible for the subsidy.

On behalf of my working poor co-workers, thanks Rick Perry and Barnes & Noble (and Obama and Republicans and the insurance industry and the bluedogs).

I guess we should all quit and get another education.

The working poor are getting shafted in roughly half the states of the USA, because the law was designed to subsidize them via Medicaid expansion and consequently they were excluded from tax credit piece of it. The Republicans pushed very hard for the ability of states to opt out of the Medicaid expansion. I hope this blows up in their faces and they created a huge army of working poor enemies, voting against Republicans for life.

so i assume governors/ state legislatures can reassess their decision to opt out of the Medicaid expansion under Obamacare at some point? or has that ship sailed?

they are the largest owner of private healthcare in the US and have been heavily involved in m&a in the last decade. In some rural areas they are the only game in town and can deny you for care based on whatever their faith says. I mean this is a crude summary but there has been a lot written about this.

Fair enough, thanks for clarifying

they own a lot of hospitals all over the world but at least in the US their work is not "charitable". They are as capitalist as everyone else.

Yeah the mindset that health care should lean more towards charity than profiteering has gone out the window in last few decades. Everyone from aspiring doctors to religious orgs like Catholic "charities" view it as ticket to $$$$$$. There are obv many great, caring docs that got into the profession to help ppl, but there are also a shit ton of ppl who picked it because doctor=$$$$. Anecdote alert: my sister is office mgr for OBGYN grp, and out of 20 OBGYN docs only 1 or 2 strike her as truly caring about their patients. The rest are in it for the cash.

When I was younger I ran across a couple of OBGYNs that would not prescribe birth control. It didn't even occur to me to ask before my appt because I was like "HOW IS THIS A THING???"

one of those shockingly old thing I learned today is about how Mother Theresa was kind of terrible and likely has all her hoarded billions still stored in the Vatican.

a family member worked at a USA catholic hospital where anyone who couldn’t pay had their costs paid for by the church. menace to your neoliberal society!

back to obamacare, but I used it for 2 years? and I chose a empire blue cross plan because my gyno of 10 years accepted it. When I went to make an appt I learned they didn't accept the obamacare version of blue cross. No one in the office knew why. I called their billing and they were just like "it was too difficult" to deal with.

insurance is a fuckin scam

'tis

abolishing it (the mersh version) wd improve our moral fiber

it should be illegal to get a bill months later for services that have already been rendered because insurance whimsically chooses to later deny something.

I changed the problem described earlier by selecting the plan I originally wanted, effective Feb 1. However nothing I spend this month (and there's plenty) will count toward the new deductible. So I suspect I will lose about a grand instead of three (unless I get a goddamn benefits job by mid-year). I'd do the math but it's too depressing.

can avoid those charges by getting stuff pre-approved

it could be something as dumb as your doc office coding something the wrong way causing claim to be denied, but see it's really fun to just blame insurance co's for everything wrong with our fucked up system

example of backasswards way we do things:
I'm advised to have colonoscopies every few years due to Crohn's. If I do, it's coded as "preventative" and isn't covered by insurance. So one might choose to forego regular screenings. Then, things that can be addressed at early stages progress, and now I'm needing to get admitted to a hospital, which will most likely order a colonoscopy anyway except now it's coded as "diagnostic" and is covered by insurance. But obv now the ins co has to pay out $$$ for my hospitalization, in addition to the diagnostic colonoscopy! And I'm in poorer health. Lose-lose situation.

In a move last month that received little fanfare, the Biden administration finalized a rule that would give states the option of adding adult dental insurance coverage as part of their Affordable Care Act plans...

Under Biden's rule, states have until 2025 to decide whether to mandate that insurers cover dental benefits for adults. The dental benefits would not take effect until 2027. No states have publicly signaled yet that they intend to require ACA dental benefits in 2027, however, advocates say the new rule could represent a significant expansion of dental insurance, which gets less scrutiny than medical insurance for hospital, doctor and pharmacy bills.

"She's bracing and saving to pay $2,800 a month for ACA health insurance next year"
https://www.npr.org/sections/shots-health-news/2025/08/22/nx-s1-5511182/aca-tax-credits-health-insurance-open-enrollment

According to the KFF calculator linked in that story, my ACA plan will be going from $177/month, a comfortable amount, to $1077/month, completely unmanageable.

Jesus! I’m sorry. Did you have ACA before the subsidy? Was it that bad?

Oh my god

I've had ACA insurance since it passed, but I think the highest it ever was pre-subsidies was in the high 200s. I have no fucking idea what I'm going to do.

OK, I dug in the box of old checkbook registers, as good as any diary and more compact. My first ACA plan was $376/month; prior to that, my last policy with BC/BS of MS was $402/month.

this is fucked

I have ACA insurance and mine will be about the same, depending on how much I say my income will be. I generally overestimate so the credit offsets my self -employment tax.

are there any resources to help compute the possible outcomes, based on state, income etc?

Yes:
https://www.kff.org/interactive/how-much-more-would-people-pay-in-premiums-if-the-acas-enhanced-subsidies-expired/

ty!!

KFF = kaiser family foundation which is associated quite closely with Kaiser the health insurance provider/hospital operator

For me in California it's roughly a 20% increase from $477 to $579 a month. Contemplating jumping off a cliff if I ever get sick

Is the premium tax credit different from the Biden era subsidy? The premium tax credit is showing as still available for me, with a net increase for my current plan of about $100/month, rather than the $1000+ I was expecting. I don't trust this good news.

Premium tax credit still exists. I am looking at “less than $100/month” increase … probably like $90 or the 20% that Elvis has. So you basically have 2 options— pay the increase or tell them your income will be lower in order to reduce monthly costs and then potentially have to pay it back when you file taxes unless you have other ways to reduce your taxable income.

This is easier for self-employed people or people who can afford to contribute to retirement savings or other types of things where you get a tax deduction so that you can show less taxable income so that you can qualify for cheaper health insurance…

Ugh, I forgot about an annuity we set up earlier this year. I'll have to redo my income numbers.

^^^ The guy who set up our annuity said we don't have to count that as income, which is great news.

My ACA insurer, Cigna, said "fuck this shit, we're done with ACA plans starting in 2027." Back to Ambetter I guess?