Obamacare / Affordable Care Act : classic or dud?

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?

No take backs.

They could certainly slim their profit margin down instead.

There's not all that much wiggle room. By law, 85 cents of every dollar brought in has to go towards paying customers' claims. And we all know course CEOs and other execs can't survive without $20 mil/yr salaries so...

Pretty disgusting how selfish so many people are with this issue. "My deductible and premiums are going up somewhat!!" "Yes, we need people to make this sacrifice so that 26 million uninsured fellow Americans can obtain coverage" "FUCK THAT AND FUCK THEM" "They'll still have to pay for..." "I said FUCK THEM".

I particularly love when my dad takes hardline stances like that, considering he owes me $3,000

Our old friend Ed Meese led one of the organizations devoted to fighting the law:

http://www.nytimes.com/2013/10/06/us/a-federal-budget-crisis-months-in-the-planning.html?pagewanted=2&_r=0&ref=politics

where's Al Qaeda when ya need em

From a piece on a "conservative Georgia district" encouraging their reps to dig in against O-care... Single-payer is a nonstarter? People understand shit-all about it and don't know what they want.

Mr. Tripcony, the surveyor, said he underwent heart surgery not long ago without health insurance, “a bad blow.” He has been making payments against the cost. He had heard of the online marketplace for insurance that opened on Oct. 1 under the Affordable Care Act.

“I just don’t trust it,” said Mr. Tripcony, who has an equal distrust of President Obama. “I don’t like him, and I don’t feel comfortable with anything he’s got to do with.”

Mr. Tripcony said he had a better idea for a system to provide health care at a fair price. “I think it should be the same for everybody,” he said. “One big company, whether owned by the government or private.”

Informed that he had described the single-payer system that Mr. Obama abandoned when Republican critics called it socialized medicine, he said, “Yeah, I know, it’s crazy.”

He said he might eventually seek health insurance under the new system. “In a couple of months, when they get the Web sites working, I may do it.”

http://www.nytimes.com/2013/10/06/us/politics/conservative-georgia-district-urges-gop-to-keep-up-the-fight.html

this is what i wanted to know:

To determine eligibility for a subsidy, the government uses modified adjusted gross income, or MAGI. To get this figure, start with the line labeled adjusted gross income on your tax return (it's the last line on the first page of Form 1040). Then add in non-taxable Social Security benefits, tax-exempt interest and foreign earned income, and housing expenses for Americans living abroad.

http://www.nytimes.com/2013/10/13/us/politics/from-the-start-signs-of-trouble-at-health-portal.html?pagewanted=1&_r=0

so basically you can subtract student loan interest, IRA contributions and other deductions, and it isn't just your total income.

http://www.nytimes.com/2013/10/13/us/politics/from-the-start-signs-of-trouble-at-health-portal.html?pagewanted=1&_r=0

― balls, Sunday, October 13, 2013 8:43 PM (1 hour ago

yeah it's a disaster on so many levels

the coincidence of the government shutdown and the disastrous obamacare rollout is just that?

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what is using the marketplace phone number like? can they sign you up entirely over the phone?

i'd love to know. leery of calling. i tried again through the website and got all the way through creating an account, password, security questions, and preliminary address info . . . but then stalled at "Who are you applying for health coverage for?"

apparently you can apply by mail

"Unable to advance the customers’ applications by phone, navigators handed them paper applications. According to Lucchesi and Sands, navigators urged: Go home, fill them out and then in a few days, set up a meeting with one of us. We’ll input your information because online sign-up still will be faster than mailing it in."

wonder how much the glitchy ramp up is due to sabotage patrol on the norquists, kochs, and o'keefes of the world

"The number of visitors to the federal government's HealthCare.gov website plummeted 88 percent between Oct. 1 and Oct. 13"

http://www.washingtonpost.com/blogs/post-politics/wp/2013/10/15/analysis-obamacare-glitches-scare-off-many-web-site-users/

That's accounted for by 100s of unpaid cable news interns moving on to the next time kill boondoggle.

the heritage foundation doesn't like the national implementation of its early '90s health care plan

http://www.heritage.org/research/reports/2013/10/enrollment-in-obamacare-exchanges-how-will-your-health-insurance-fare

it seems to be working in NYS now

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.