Affordable Care Act

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AlyssaEimers's picture
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Affordable Care Act

Cheapest Obamacare Plan Will Cost $20,000 per Family by 2016, IRS Says

Is the Affordable Care Act really affordable?

Joined: 08/17/04
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I haven't done that much research but I find it hard to believe. Currently, a direct pay plan with my company for the cheapest plan is under 10000/yr for a family of 4. I don't see it as doubling.

Off to find out more.

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"Jessica80" wrote:

I haven't done that much research but I find it hard to believe. Currently, a direct pay plan with my company for the cheapest plan is under 10000/yr for a family of 4. I don't see it as doubling.

Off to find out more.

I am interested to know what you find out. I am really wanting there to be a way where we can buy insurance that is not attached to DH's work. He would really rather work as a free lance interpreter for himself instead of the school system but we need insurance. $20,000 a year would be HALF his pay check for the year. There is no way that is even close to obtainable. Even $10,000 a year is not obtainable.

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Everything I could find outside of that article is showing it to be estimating at 12000/family per calendar year excluding affordability credits. A lot of it is actuary talk and that is WAY out my league.

All of this is an assumption and it is really hard to get a full handle on what things will be in 3 years. I'm leaning more towards the 12000 vs. 20000. That is 1000./mo for insurance 3 years from now for a family of 5. Seems about right to me.

But...the other goal is that once everyone is insured...your costs will go down year to year. We're seeing it in Mass. already. It's definitely a slow process though.

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Do people really feel $1,000 a month is a reasonable amount to spend on health insurance? Plus that is not counting co-pays and deductibles.

bunnyfufu's picture
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I don't know if it's reasonable but, that is about what we pay for our portion of the costs.

Joined: 05/31/06
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We pay less than that including copays for our family of 5. It's all a matter of perspective. It's less than our mortgage. Less than we spend on our food bill monthly. Isn't it as important?

ETA: I was wrong, I looked at the numbers and this year with our FSA having to be lowered (by law) to only $2500 we will be paying about $1000/month including copays. The upside is that some of our copays went down to $0 (like my BCP is now free thanks to Obamacare, and as I have to get it every 3 weeks that adds up over the year!). DH switched jobs last year and was choosing between two offers ~ one was Microsoft which had 100% FREE healthcare or the offer that he accepted, which still is an excellent plan. Even with me having a very expensive surgery and hospital stay last year our total out of pocket did not exceed $11,000 last year, $4,000 of that being before tax $ from our FSA.

mom3girls's picture
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We pay about that much now, and then last year an additional $7000 of medical cost. It is literally killing us financially. We are all pretty healthy too, but with me having kidney stones 2 times, Dh having a vasectomy (that didnt work) and a broken bone for one child, we had a huge cost on top of what we pay for on top of monthly cost.

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"Potter75" wrote:

We pay less than that including copays for our family of 5. It's all a matter of perspective. It's less than our mortgage. Less than we spend on our food bill monthly. Isn't it as important?

It is important, that is why we pay it. I would love to be able to spend that much on our food a month, buy all organic, but we spend to much in health care to spend that much on food

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"Potter75" wrote:

We pay less than that including copays for our family of 5. It's all a matter of perspective. It's less than our mortgage. Less than we spend on our food bill monthly. Isn't it as important?

As an aside, you pay over $1,000 a month in food? There is not any bill that we have that is $1,000/month.

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"mom3girls" wrote:

We pay about that much now, and then last year an additional $7000 of medical cost. It is literally killing us financially. We are all pretty healthy too, but with me having kidney stones 2 times, Dh having a vasectomy (that didnt work) and a broken bone for one child, we had a huge cost on top of what we pay for on top of monthly cost.

Gosh, what kind of plan do you have that has you paying $19,000 /year if you don't mind me asking? That seems outrageous.

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"AlyssaEimers" wrote:

As an aside, you pay over $1,000 a month in food? There is not any bill that we have that is $1,000/month.

Yes. I live in a much more expensive area than you and I think we eat slightly different diets.

mom3girls's picture
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dp

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"Potter75" wrote:

Gosh, what kind of plan do you have that has you paying $19,000 /year if you don't mind me asking? That seems outrageous.

We only pay 1015 a month in premium cost for all 6 of us, but then we each have a $500 deductible. Then after that our coinsurance is 20% of everything. Each time I have kidney stones we had to pay 1200 out of pocket. Then one trip to the ER for them to super glue DS's cut was $850 out of pocket.

I dont think our insurance is outrageous in price, but it is not great coverage at all.

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[QUOTE=Potter75]Yes. I live in a much more expensive area than you and I think we eat slightly different diets.[/QUOTE]

Why would you assume that? Do you know what Bonita feeds her family?

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"mom3girls" wrote:

[QUOTE=Potter75]Yes. I live in a much more expensive area than you and I think we eat slightly different diets.[/QUOTE]

Why would you assume that? Do you know what Bonita feeds her family?

Uh, because Bonita once started a "debate" in which she asked us all how much we spent/week on food because a woman in her church said that she spent like $125 to feed her family of 5 and Bonita was frustrated wondering why she was unable to spend that little. We all agreed that it was next to impossible to spend that little and the woman was either exaggerating or eating like ramen or PB&J for most meals. Bonita went through what she spent and on what. So yes, I do know what she spends and on what. We eat very differently and we live in very different areas in terms of cost. I'm not being offensive, if you don't remember that debate it isn't my fault.

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"Potter75" wrote:

Uh, because Bonita once started a "debate" in which she asked us all how much we spent/week on food because a woman in her church said that she spent like $125 to feed her family of 5 and Bonita was frustrated wondering why she was unable to spend that little. We all agreed that it was next to impossible to spend that little and the woman was either exaggerating or eating like ramen or PB&J for most meals. Bonita went through what she spent and on what. So yes, I do know what she spends and on what. We eat very differently and we live in very different areas in terms of cost. I'm not being offensive, if you don't remember that debate it isn't my fault.

I remember that debate now. I had forgotten it is was so long ago. It was interesting to see how different families spend different things.

ange84's picture
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We have medicare which gives us a lot of things free, my out of pocket cost when I had DS was nothing for the hospital stay of 6 days, and the hospital weren't rushing me out the door either, I had actually requested to stay another day when the baby blues hit and they were fine with that. My husband had back surgery about 5 years ago which included him having to fly to another town for MRI's (twice, he missed his appointment due to the plane getting a flat tyre once) plus flying over again for the surgery, again all at no cost as he was a public patient. The waiting periods for some procedures when you are public are longer.
I do have private health cover as well because we get stung on tax because of our income if we don't, but I am having a blank on how much it is as we have been comparing plans recently and they are all a little jumbled in my head on a Sunday morning, maybe around $250 a month for what we have chosen. We mainly use it for dental and optical as we have no private hospital in my town and I am happy going in as a public patient for birth, if we needed a surgery or something we may go private to get things done quicker, but that also requires more travel for us with no private hospital and again no choice of care provider. If we went private for everything things would not be affordable, we have to pay 55% of bills I believe (again we have been comparing lately so things are rough estimates only) and currently we have a $500 excess on hospital stays which is per person.

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On a side note....if anyone gets the offer for health insurance with a high deductible paired with an HSA. Go for it. It's about as good as you can possibly get. You will have the high deductible......but if you have a fairly healthy year you won't meet it. Preventive care still free. You rollover any money from year to year in the HSA AND when you max your contribution you can cash out and put into other types of funds. All the contributions are pre tax too. Best thing I've ever seen.

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All of the guesses on how much the plans in the exchanges will cost are just that right now...guesses. No one knows yet what they will cost as none of that information has been released. The insurance companies haven't even yet determined how they are going to price their exchange plans. Also, the insurers are greatly reducing their networks for the plans in the exchanges in order to be able to make them "affordable"...for example, if you buy a Blue Cross Blue Shield plan in the exchange, you will only have access to approximately 20% of the providers that someone who has a BCBS plan through their employer has. (our broker had a meeting with BCBS the other day and this is coming straight from them). The insurance companies have to find ways to still make money while making these plans affordable enough for people to be able to buy them, and these are the kinds of things they are doing to make that happen.

And wow, you guys are making me really thankful for my PPO plan. I pay max about $5,000 out of pocket per year, and that includes the $2,000 in pre-tax dollars that I elect through my FSA to cover my copays, deductibles, and coinsurance. Too bad Obama calls this a "cadillac plan" so I won't get to enjoy it past 2017 thanks to him.

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Most PPO plans are considered "cadillac" plans b/c the total premium is super expensive.

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"Jessica80" wrote:

Most PPO plans are considered "cadillac" plans b/c the total premium is super expensive.

It's not just that, it's based on the plan structure. We have a self-insured plan, we pay all of our claims out of company assets, therefore we don't have a "total premium", but we would still be considered a cadillac plan because our employees essentially don't pay enough for their health care in the eyes of PPACA. Which is sad for a company that wants to provide it's employees and their families with a valuable and inexpensive health plan, but will no longer be able to.

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I have to say, as a non-American I feel sick about what some of you guys are faced with paying for healthcare. That said, I just.don't.get why the US has such difficulty providing the healthcare afforded to people in other countries. Is it a sales/income tax thing? Is it the potential premium involved? IDK. I really, really have no idea why it's so hard to figure out. $1200/year deducted from my salary gets my whole family extended benefits like chiro, podiatry, massage, eye exams and glasses, orthodontics (a portion of), 100% prescription payment, orthotic supplies, private hospital rooms, physiotherapy, 100% basic dental plus 80% extended dental like root canals, crowns, etc., plus many other services I can't even recall right now. My basic healthcare premium is paid 100% by the province. There used to be a $132/quarter premium for a FAMILY that we had to pay but the province did away with that a few years ago. I just can't wrap my brain around upwards of $20K per year. That is effed up.

boilermaker's picture
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Last year we paid $15K out of pocket for healthcare through an employer sponsored plan-- so I think it probably will cost at least $12K/year for a family. We have a good plan, but our contribution is $974/month for the premium, then 10% in network for a $2500/family member max. We always max out my DH's bc of his chronic health condition coupled with my non-in network homebirth last year= ouch!

$12K seems reasonable to me though, simply bc it is worth it. One trip to the ER can cost so much, it is a better investment than going bankrupt over unforeseen medical bills (which the rest of us end up paying anyways.....)

IMO Americans suck at taking care of themselves and preventative healthcare. I'm hoping having some coverage helps bring those costs down...time will tell.

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"SID081108" wrote:

It's not just that, it's based on the plan structure. We have a self-insured plan, we pay all of our claims out of company assets, therefore we don't have a "total premium", but we would still be considered a cadillac plan because our employees essentially don't pay enough for their health care in the eyes of PPACA. Which is sad for a company that wants to provide it's employees and their families with a valuable and inexpensive health plan, but will no longer be able to.

I am very concerned that the plan we are on will be considered the same way because it is also a self-insured plan. I don't know enough about it to know what category it falls into. So much for "If you like your health plan you can keep it"

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"boilermaker" wrote:

$12K seems reasonable to me though, simply bc it is worth it. One trip to the ER can cost so much, it is a better investment than going bankrupt over unforeseen medical bills (which the rest of us end up paying anyways.....)

$12K is not reasonable to me. I feel you would be much better off putting $12K in the bank each year then paying your own medical expenses. Especially if that did not count co-pays and deductibles. How would anyone possibly making just over the poverty level pay that and meet the rest of their basic needs?

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12000 into the bank every year? Do you know what one extended stay at a hospital costs without insurance? (think about saving for 10 years Smile

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"AlyssaEimers" wrote:

$12K is not reasonable to me. I feel you would be much better off putting $12K in the bank each year then paying your own medical expenses. Especially if that did not count co-pays and deductibles. How would anyone possibly making just over the poverty level pay that and meet the rest of their basic needs?

Somebody just over the poverty line would have state or federal insurance (just like they do now....) This is for families that can AFFORD to pay the premium.

Maybe your healthcare costs are really different from ours, but $12K won't get us far if something happens. My son just had his tonsils and adenoids removed last month-- $12K would just start to cover the whole procedure. We'd be done for the whole year? Not likely.

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Another example of people losing their healthcare plans because of Obamacare.

Shocker: Universal Orlando To Drop Part Time Health Coverage Because of ObamaCare | Independent Journal Review

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And since they only work part time...they surely probably don't get a living wage as we have pointed out in the last debate...probably minimum wage...correct? They will be eligible for other means of coverage.

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"AlyssaEimers" wrote:

$12K is not reasonable to me. I feel you would be much better off putting $12K in the bank each year then paying your own medical expenses. Especially if that did not count co-pays and deductibles. How would anyone possibly making just over the poverty level pay that and meet the rest of their basic needs?

Didn't you have C-sections? Just one of your three births probably cost more than 3 times that 12K you find so unreasonable. I don't really understand your argument. If you don't want to pay your copays and put your money in the bank, do so. The bills are just starting to come in my my sons recent surgery and unforseen emergency. The totals could easily be over 100K between ambulance rides, two surgeries and a total of 9 days in the hospital. I'm so happy to pay our 12K to have that covered!

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"Potter75" wrote:

Didn't you have C-sections?

No, I have never had a C-section. It has been a while since I posted on this thread. I will need to go back through and re-read everything before I post. It will have to be this evening though as I am getting ready to take my girls to piano lessons.

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"AlyssaEimers" wrote:

No, I have never had a C-section. It has been a while since I posted on this thread. I will need to go back through and re-read everything before I post. It will have to be this evening though as I am getting ready to take my girls to piano lessons.

Sorry, I must have been confused, I thought you posted that you elected to have your tubes tied when you had a CS. Anyway, just paying out of pocket for an elective procedure like tubal ligation would eat up a healthy chunk of that 12K.

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"Jessica80" wrote:

And since they only work part time...they surely probably don't get a living wage as we have pointed out in the last debate...probably minimum wage...correct? They will be eligible for other means of coverage.

And I'm pretty sure it will cost them more than $18 a month too. That was pretty good coverage for that price. Most part time workers get no coverage.

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For state sponsored health care like Medicaid. They will probably pay 0.00 with better coverage than their stupid capped plan that they had. Why bother even giving insurance at that point. It's income based so the costs you pay towards your services is set on a sliding scale. That's what we have here for those that cannot afford their premiums or for part timers that don't have access to other insurance.

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"Jessica80" wrote:

For state sponsored health care like Medicaid. They will probably pay 0.00 with better coverage than their stupid capped plan that they had. Why bother even giving insurance at that point. It's income based so the costs you pay towards your services is set on a sliding scale. That's what we have here for those that cannot afford their premiums or for part timers that don't have access to other insurance.

There are many part-timers that work more than one job. I did when I worked part-time. So that doesn't necessarily mean that they will pay nothing for insurance.

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"GloriaInTX" wrote:

There are many part-timers that work more than one job. I did when I worked part-time. So that doesn't necessarily mean that they will pay nothing for insurance.

What exactly is it that you have a problem with, Gloria? Do you NOT want these people to have insurance? I don't get it. If they "lose" this crappy $5,000 they are going to qualify for health insurance and be covered. What is your problem with that exactly? I don't understand, I guess, what you want. You want them to be able to keep their crappy insurance and don't want them to have access to better insurance? Why?

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"Potter75" wrote:

What exactly is it that you have a problem with, Gloria? Do you NOT want these people to have insurance? I don't get it. If they "lose" this crappy $5,000 they are going to qualify for health insurance and be covered. What is your problem with that exactly? I don't understand, I guess, what you want. You want them to be able to keep their crappy insurance and don't want them to have access to better insurance? Why?

I want them to be able to keep their insurance if they like it. Just like Obama promised. I probably won't be able to keep my insurance either because my company is self-insured.

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"GloriaInTX" wrote:

I want them to be able to keep their insurance if they like it. Just like Obama promised. I probably won't be able to keep my insurance either because my company is self-insured.

But why would you want people to be able to keep bad insurance if they are being offered BETTER insurance? Its illogical.

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"Potter75" wrote:

But why would you want people to be able to keep bad insurance if they are being offered BETTER insurance? Its illogical.

Better insurance at what price? It isn't better if you can't afford it.

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how well were your part time jobs paying you that you would not qualify for reduced cost/no cost insurance? I don't get how it would ever even out to being able to afford your own premium.

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"GloriaInTX" wrote:

Better insurance at what price? It isn't better if you can't afford it.

Are you purposely not reading what we are writing? They clearly are going to qualify for better insurance and most likely at NO cost to them.

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"Jessica80" wrote:

Are you purposely not reading what we are writing? They clearly are going to qualify for better insurance and most likely at NO cost to them.

Do you know what the costs are going to be? If I work 2 part time jobs even at minimum wage that is over $20,000 a year. That isn't even under poverty level.

Poverty Guidelines

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These are the income guidelines for Network Health:

Visitor Home | Network Health

I put my info in but pretended I was single and that I was making 9.00 and working 20 hours a week. I'm eligible for 2 plans at 0.00 and 1 plan covers me at pretty much no copays for everything (inpatient, outpatient care...max 250.00/yr for prescription costs) and no dollar limit. The other one wouldn't pull up on my laptop so yes I would be making out much better don't you think?

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I'm surprised that company was still offering health care benefits to part-time employees. Most companies did away with part-time health benefits many years ago because it's not cost-effective simply from an administration point of view. And, as others pointed out, if you're working part-time, you usually qualify for better plans for less cost so the employee acceptance rate tended to be low anyway.

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"GloriaInTX" wrote:

Do you know what the costs are going to be? If I work 2 part time jobs even at minimum wage that is over $20,000 a year. That isn't even under poverty level.

Poverty Guidelines

I didn't see this. If I'm making 20000/yr w/o children the cost is now 45.00/mo so yes higher than that UO was offering but with much better coverage. I don't have any dollar caps which at 5000.00 is not going to cover 1 inpatient stay.

If I make 20000 and have 1 more person in my household my contribution is 3.00/mo.

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"Jessica80" wrote:

These are the income guidelines for Network Health:

Visitor Home | Network Health

I put my info in but pretended I was single and that I was making 9.00 and working 20 hours a week. I'm eligible for 2 plans at 0.00 and 1 plan covers me at pretty much no copays for everything (inpatient, outpatient care...max 250.00/yr for prescription costs) and no dollar limit. The other one wouldn't pull up on my laptop so yes I would be making out much better don't you think?

If I was working 2 part time jobs that would be about 56 hours a week. Try that. And there is nothing that says Obamacare will be the same as MassHealth.

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"GloriaInTX" wrote:

If I was working 2 part time jobs that would be about 56 hours a week. Try that.

85.00/mo for that salary for 1 person household. 1020.00/yr for plan with no dollar caps.
2 person household: 45.00/mo
3-4 person household: 3.00/mo
5+: 0.00/mo

You would have been paying 0.00 for health insurance for you and your kids. Nice isn't it?

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"Jessica80" wrote:

85.00/mo for that salary for 1 person household. 1020.00/yr for plan with no dollar caps.
2 person household: 45.00/mo
3-4 person household: 3.00/mo
5+: 0.00/mo

You would have been paying 0.00 for health insurance for you and your kids. Nice isn't it?

I guess it is nice for the people in Massachusetts except for the amount of taxes you are paying to cover that. I don't think we can expect Obamacare to cost the same amount.

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"GloriaInTX" wrote:

I guess it is nice for the people in Massachusetts except for the amount of taxes you are paying to cover that. I don't think we can expect Obamacare to cost the same amount.

What are you basing that on, Gloria?

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We're actually in the middle, so to speak, for taxes. The "Taxachusetts" nickname is not really applicable to us.

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