Obamacare / Affordable Care Act : classic or dud?

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

Well that's good. Though, I mean, nobody is defending the shitty rollout really. It's clear that volume came in well above projection (they estimated that traffic was about 50x larger than it was when Medicare D rolled out), but it's still fairly pathetic that they still don't have all of the kinks worked out. Liberal friends of mine that want insurance are pissed.

But it's humorous watching conservatives get overexcited that this is proof that the act is a failure. As Alfred posted upthread, Medicare D was actually worse in some ways because it didn't even go live the day that was promised, and it had a much smaller volume of folks in the first week attempting to access the site. And now, Med D is an afterthought.

Some asshole I was arguing with the other day went as far as to say there are few signs that this will be improved and suggested this could be Obama's "Iraq". gtfo.

i thought that ACA insurance policies don't go into effect until January, or am I getting confused with just the tax issues part

http://acasuccessstories.tumblr.com/

As the start date for the new regulations looms at January 1, most of [the 14 million people in the individual-insurance market] are receiving cancellation notices. That is a terrifying experience in a country where the cancellation of health insurance has been a disastrous life event roughly on par with losing a job. They are receiving those notices because the regulations Obama promised, and which were the most popular parts of his plan — ending the lifetime caps, the preexisting condition discriminations, and other risk winnowing — ended the individual-insurance market as we know it.

http://nymag.com/daily/intelligencer/2013/10/you-like-your-plan-you-can-keep-it-sort-of.html

Are you serious, what you just said!? Are you really serious!? After what we’ve gone through and what we’ve gone through in the last three and a half years? Have you — you can sit there and say, that you had a legitimate alternative after these years? We’ve gone through 44 votes, 48 votes now, of you trying to dismantle the legislation. You call that cooperation? I don’t!

https://www.youtube.com/watch?v=9owwg1LALxk

i thought that ACA insurance policies don't go into effect until January, or am I getting confused with just the tax issues part

earliest effective date is Jan 1, but you can enroll now

I answer questions from insurance agents as part of work, and my god it's scary how little they even know about ACA. I'm still getting questions about what xtra charge someone with such and such condition should expect...

Yeah. The Corner is ablaze with protestations of doom.

So is The Blaze for that matter

I answer questions from insurance agents as part of work, and my god it's scary how little they even know about ACA. I'm still getting questions about what xtra charge someone with such and such condition should expect...

― A True White Kid that can Jump (Granny Dainger), Tuesday, October 29, 2013 9:02 PM (1 hour ago) Bookmark Flag Post Permalink

my girlfriend got a letter from her new employer insurance company that literally was written as if the ACA didn't exist. She had to call them and remind them that things are changing on January 1st.

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.