Obamacare / Affordable Care Act : classic or dud?

To test it, I tried it about ten minutes ago and answered a bunch of questions w/out a glitch.

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.

The piece itself belies the headline a bit.

But still.

I have been more intimate with the current medical system than I ever would have chosen and I agreed with the major thrust of that piece. Health and illness are extremely personal, science is extremely impersonal, and capitalism is extremely greedy and uncaring, and physicians are pushed around chaotically by all these influences, so medical practice is caught in a maelstrom of irreconcilable conflict. This doesn't conduce to the reinforcement of reasonable and caring medical practice.

TEN BUCKS HUH

The beauty of this system is that the mega-rich and their servants feel unashamed about rubbing your nose in their shit. Like they're doing you a favor. And sadly, too many people love it and ask for more. https://t.co/iDtEizfziB

— Dennis Perrin (@DennisThePerrin) December 10, 2019

Still amazed by how many people know jack shit about this law. See stuff like "Trump didn't get rid of Obamacare but at least he made it so ppl aren't forced to buy Obamacare, they can now buy thru private insurers". Just change the name of this country to Dunning-Krugerstan already.

and of course Trump obv doesn't understand it at all

Still amazed by how many people know jack shit about this law.

That's because, other than the expansion of Medicaid, they made it too damned complicated so as to preserve as much of the for-profit aspects of the system as possible. The whole web-based Marketplace idea that maintains 50 different state-of-residence variations, multiple tiers of coverage, alongside individualized subsidies recalculated annually, was always a shambles waiting to happen, even before the Republicans started undercutting its funding.

I just qualified for Medicare and was enrolled automatically in the two main parts A & B, which is pretty sweet, but compared to comprehensive universal health care such as UK's NHS, Medicare has gaps in coverage and a bunch of sidecar programs - like part D, various commercially sold supplementary plans and Medicare Advantage - that can be quite confusing, too.

The US Congress is so in the thrall of the capitalist health care system they are incapable of legislating a straightforward, comprehensive system that just ensures that people get health care.

I agree that it resulted in an even more convoluted system (most of my work time is devoted to correcting "discrepancies" between govt records and insurance Co records), but the 3 core provisions of the law are simple enough to understand. At this point there's no excuse to think that "obamacare didn't allow ppl to buy thru private insurers" or other stuff you here conservatives regurgitate.

it does seem like a good portion of people have literally no clue what medicaid expansion means, like literally i think their brain shuts off at "medicaid" and they just stop thinking at that point, assuming that there is absolutely no hope that they would understand. because otherwise you'd think there'd be riots over states choosing to let more of their own people die rather than accept federal money that was already put aside for them to expand medicaid.

riots over states choosing to let more of their own people die rather than accept federal money

At the risk of being trenchant, I think you are underestimating how warped people's thinking becomes when it comes to money. in terms of powerfully modifying behavior, money is on a par with addictive drugs.

I wonder how many people's lives a law has to save before some people would be fine with paying more taxes because of it. 5 million? 10 million? What if a lot of them are children? 2 million sick kids' lives = what, 20 million normal adults?
It just disgusts me to see people moaning about having to pay more post ACA when that money is literally going to save lives.

tried to sign up for same ACA plan i had last year in December; thought i did

failed to notice "Premier" dangling from plan name as NY State phoneguy walked me thru process

new member card shows deductible $3000 higher than 2019

pray i can get this changed

(that added cost is more than a month's takehome pay)

Health insurance in this country, on balance, can die in a fire

I get that insurance co's are seen as unnecessary middlemen who live to deny claims & I'm for single payer, but hospital and pharma companies LOVE having them around as whipping boy. Insurance companies have to have their premiums approved by govt, and legally must pay out 85 cents of every dollar they receive to members' claims. Meanwhile hospitals can charge $60 for an aspirin and pharma can charge whatever they want for life-sustaining medications. Insurers respond to prices set by those 2 groups.

Don't forget the massive doctor salaries propped up by absurd protectionist policies

But yeah

and that the Catholic church keeps buying up hospitals and clinics in the US to add to their portfolio.

xpost Drs often get their own absurdly high insurance to pay.

Lol first time I've seen the Catholic church blamed for insane healthcare costs in the USA

I mean Catholic hospitals are a menace to society regardless

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.