Obamacare is almost here

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AlyssaEimers's picture
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Obamacare is almost here

Politics: ObamaCare overview: Explaining the basics | Best of Cain (I know this is a bias sight, but just for that point of view on the debate)

Obamacare Set to Take Effect Oct. 1 | Video - ABC News

Now that we are almost here, what do you all think? I do not know anyone IRL that is in support of this. Most people I know have seen their insurance costs double if not triple in the last few years and blame Obamacare for this. I am interested in hearing a perspective different from people I know IRL.

Joined: 08/17/04
Posts: 2226

I feel like we just talked about this? Didn't we?

I hear it and I hear negative things but it's not a big deal to us here so it's not a "hot topic" so to speak.

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"Jessica80" wrote:

I feel like we just talked about this? Didn't we?

I hear it and I hear negative things but it's not a big deal to us here so it's not a "hot topic" so to speak.

It is ALL over the news and FB here. Like it was the night before an election.

Joined: 08/17/04
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Yeah, we get mentions on the news...as in...something takes effect on such and such a day. I can't say it's all over the news.

I haven't had one mention on FB.

The only time I really hear about it is at work, when an out of state member mentions it. In state people never mention it.

Joined: 08/17/04
Posts: 2226

Sorry, they are covering "Government shut down" but it seems to be a small article.

The news is currently remembering a hurricane from 28 years ago instead lol.

Joined: 04/12/03
Posts: 1686

"AlyssaEimers" wrote:

Politics: ObamaCare overview: Explaining the basics | Best of Cain (I know this is a bias sight, but just for that point of view on the debate)

Obamacare Set to Take Effect Oct. 1 | Video - ABC News

Now that we are almost here, what do you all think? I do not know anyone IRL that is in support of this. Most people I know have seen their insurance costs double if not triple in the last few years and blame Obamacare for this. I am interested in hearing a perspective different from people I know IRL.

Have these same people declined any benefits they may have already received, e.g. bcp, mental health coverage, children on their insurance longer, and coverage for pre-existing conditions that would previously have been denied?

Many people are very confused as to what is in the ACA. We don't have the money to fund the ACA yet what about the misuse of hospital services due to lack of insurance? The taxpayers are forced to pay thousands for services that could be covered at the GP or urgent care level. Who pays when people have to file bankruptcy due to medical bills they can't pay?

My insurance has gone up 10 - 20% per year, every year since 2000. When I worked at Target in 1990 they kept most employees right around 38 hours to avoid offering benefits. When my mom worked as an SDC aide from 1990 - 1999, her hours were less than the cut-off for benefits. So this is nothing new. Yet I read on facebook that employers are going to cut hours because of ACA. When DD1 was on MediCal I also had coverage through BC/BS. I paid $200/month for private insurance in 1998. When I did the estimate for my cost throug ACA, it would be cheaper now. 15 years later!

When I was 19, I got sick. I was a full-time student so I would have been covered under my parents' insurance if they had had any. My dad had been laid off shortly before but he could not get COBRA. My dad took me to the doctor and I watched him write out a check for the full charge without insurance. Then, to add insult to injury, the doctor said to him, "I would admit her to the hospital tonight, but you don't have health insurance." This should not happen..

Alissa_Sal's picture
Joined: 06/29/06
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I think it's interesting that people in your area are railing against Obamacare Bonita. I just read somewhere that the insurance premiums on the TN exchanges are some of the lowest prices in the country. I wonder how people will feel once they actually have access to more affordable healthcare. Don't you dare offer me lower rates!! LOL Agree with ethanwinfield that our costs have been going up steadily since long before the ACA. I think that employers are just cynical enough to blame it on the ACA now because it's a handy excuse.

No one I know personally IRL is upset about it going into effect. I'm actually eager to shop the exchange on 10/01 and see if I can find a better deal because I hate my current health insurance with a burning passion but I've never had an (affordable) option to change it before. Smile

Joined: 08/17/04
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That's it EW and Alissa......too many employers are blaming on NHCR when these patterns have been in effect for years. They don't want to look like the bad guy (they=employers) so they find a scapegoat.

I see it all the time. An employer wants to cut costs....that plan is usually in place for years especially for large employers....and now they have something to blame. It's perfect for them.

GloriaInTX's picture
Joined: 07/29/08
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"Alissa_Sal" wrote:

I think it's interesting that people in your area are railing against Obamacare Bonita. I just read somewhere that the insurance premiums on the TN exchanges are some of the lowest prices in the country. I wonder how people will feel once they actually have access to more affordable healthcare. Don't you dare offer me lower rates!! LOL Agree with ethanwinfield that our costs have been going up steadily since long before the ACA. I think that employers are just cynical enough to blame it on the ACA now because it's a handy excuse.

If TN has the lowest prices in the country and their premiums are double and triple what they were we are in serious trouble.
Tennessee: Obamacare will triple men's premiums, double women's | WashingtonExaminer.com

Nebraska is getting hit pretty hard too with premiums tripling.
http://watchdog.org/107894/some-nebraskans-premiums-to-triple-under-obamacare/

They aren't saying the rates are lower... they are saying they are lower than they predicted they would be under Obamacare. Not the same thing. They are still paying wayyyy more. Thats like saying you are paying $100 now and we predict you will have to pay $300. So now it is only $280... see your payments are going to be lower so we are saving you money! Ha!

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"GloriaInTX" wrote:

If TN has the lowest prices in the country and their premiums are double and triple what they were we are in serious trouble.
Tennessee: Obamacare will triple men's premiums, double women's | WashingtonExaminer.com

Nebraska is getting hit pretty hard too with premiums tripling.
Some Nebraskans' premiums to triple under Obamacare ? Watchdog.org

They aren't saying the rates are lower... they are saying they are lower than they predicted they would be under Obamacare. Not the same thing. They are still paying wayyyy more. Thats like saying you are paying $100 now and we predict you will have to pay $300. So now it is only $280... see your payments are going to be lower so we are saving you money! Ha!

But what are we comparing here? I haven't had a chance to really review offerings in TN. Now, with all the additional coverage you don't have limits on women's health care, or overall dollar maximums (such as limit for lifetime 50,000 or 100,000 (which is 1 or 2 inpatient stays respectively). We are probably not comparing apples to oranges here. More like apples to a steak dinner.

GloriaInTX's picture
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"Jessica80" wrote:

But what are we comparing here? I haven't had a chance to really review offerings in TN. Now, with all the additional coverage you don't have limits on women's health care, or overall dollar maximums (such as limit for lifetime 50,000 or 100,000 (which is 1 or 2 inpatient stays respectively). We are probably not comparing apples to oranges here. More like apples to a steak dinner.

This is to keep the same level of coverage that they already have. So under Obamacare they will get LESS coverage for more money if they have to move to a cheaper plan. But that's the point too. Why should I have to buy a steak dinner if all I want is an apple? I don't plan to have any more babies and my tubes are tied. Why do I HAVE to buy a premium with contraceptive and maternity coverage and pay extra for it?

Blue Cross Blue Shield Nebraska informed Blome his health care plan will terminate at year?s end, and if he wants to move to a similar plan his new premium will go up 65 percent, costing him nearly $4,000 more per year.

He distinctly remembers President Obama looking into TV cameras and assuring Americans ?If you like your health care plan, you?ll be able to keep you health care plan. Period.? Blome?s letter says otherwise.

?Stupid me, I took the president literally,? Blome said.

Many other Nebraskans are getting similar letters. Blue Cross Blue Shield is notifying about 46,000 policyholders who buy their own insurance coverage of changes to their plans as a result of Obamacare. Most of them are learning that if they want to stick with a similar plan, their rates will go up.

Gilsdorf said the letters going out to Blue Cross customers show people the price to move to a comparable plan, but they have the option of choosing other, cheaper plans.

But in Blome?s case, the cheapest option offered by Blue Cross is still 55 percent more expensive than his current premium. He will check out the rates on the federal exchanges when they begin operating next week, but suspects the prices won?t be much different.

AlyssaEimers's picture
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"Jessica80" wrote:

But what are we comparing here? I haven't had a chance to really review offerings in TN. Now, with all the additional coverage you don't have limits on women's health care, or overall dollar maximums (such as limit for lifetime 50,000 or 100,000 (which is 1 or 2 inpatient stays respectively). We are probably not comparing apples to oranges here. More like apples to a steak dinner.

I only know how it has played out in our lives. For the last 7 years that DH has worked for his county there have been 7 or 8 insurance plans that each employee looked through and chose which one best met the needs of their family. This year there will only be one option that all employees have to take. They have said this is because none of the other plans meet the new guidelines. (So much for keeping your current coverage if you want it)

7 years ago when DH was hired our insurance for our family was $200/month with a $250 deductible $500 out of pocket. Last year our insurance was about $450/ month with a $2000/per person deductible and a $4,000 max out of pocket (per person, not per family). I do not know what this years numbers will be. I am sure there are plenty of people out there that is new plan is going to help, but I do not personally know any of them.

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that's a pretty common plan type to have even pre NHCR. Deductible plans are on the rise and have been for over 10+ years because employers cannot afford to provide insurance w/o it (and again well before Obama was in office).

Gloria, you can't always cherry pick your plan. It needs to be in a pool in order for insurance to work properly. If you don't pool in then there isn't enough money to cover claims.

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I just was talking to DH. I misunderstood. There will not longer be offered any plan at his work like we had before. He will only be able to choose one of the exchanges. The Gold, Bronze, or Silver. (He works in GA, not TN)

GloriaInTX's picture
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This says it in a nutshell. You are forced to pay more to take coverage you don't need or want, and in return have to pay a higher deductible to cover the things you DO need.

GloriaInTX's picture
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You know it's bad when even the unions are jumping ship.

Probably the most telling of recent events about how catastrophic Obamacare is comes from three of the nation's largest labor union leaders who, after pushing hard for the passage of Obamacare, are now demanding either exemptions from it or its repeal.

In a joint letter to Harry Reid and Nancy Pelosi, the union leaders rightly highlight the devastating effects of Obamacare, including:

“Perverse incentives are causing nightmare scenarios. First, the law creates an incentive for employers to keep employees’ work hours below 30 hours a week. Numerous employers have begun to cut workers’ hours to avoid this obligation, and many of them are doing so openly. The impact is two-fold: fewer hours means less pay while also losing our current health benefits.”

They forgot to mention the companies that aren't hiring or who are cutting back on employees to stay under the magic number of 50.

"…workers will be 'relegated to second-class status' despite being 'taxed to pay for those subsidies,' a result that will 'make non-profit plans like ours unsustainable' and 'destroy the very health and wellbeing of our members along with millions of other hardworking Americans.'” (Forbes summation on the letter emphasizing the negative impact to the generous Taft-Hartley plans their members currently enjoy.)

The subsidies are nothing more than "crossing checks in the mail" anyway. You pay higher insurance premiums and taxes to pay for your own subsidy. Typical big government move to promise free money, that isn't free at all, just to sell a program and make people dependent upon government.

“On behalf of the millions of working men and women we represent and the families they support, we can no longer stand silent in the face of elements of the Affordable Care Act that will destroy the very health and wellbeing of our members along with millions of other hardworking Americans.”

On one hand, you'd like to say to the union leaders, "you made this bed, now lay in it," but they are right, Obamacare will "destroy the very health and wellbeing" of hundreds of millions of Americans.

Obamacare hurting Americans - York News-Times: Editorial

AlyssaEimers's picture
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"Alissa_Sal" wrote:

I just read somewhere that the insurance premiums on the TN exchanges are some of the lowest prices in the country.

You can't base what something costs in TN or GA on what things cost elsewhere. Yes, the cost of living is much lower here, but so are the wedges. Our house payment is low and so are many of our other expenses, but so is the pay. DH looked into a job in DC recently. It paid more than 3x what he makes now. It probably also costs 3x as much to live in DC though.

It is possible that is why the changes are such a big news story here. It will mean MAJOR changes for our area. It might not effect other areas as much.

Alissa_Sal's picture
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Gloria, from your article:

Omaha Sen. Jeremy Nordquist said part of the problem is Nebraska didn’t take full advantage of Obamacare by expanding Medicaid and creating its own exchange and trying to create more competition in the marketplace. The governor refused to do both. An organization representing insurance carriers warned lawmakers at the National Conference of State Legislatures that states that don’t expand Medicaid would see higher premiums, he said, because insurance companies would shift the cost of that uncompensated care.

From what I've read, Obamacare lowers the cost in states where they are actually trying to make it work. Unsurprisingly, it doesn't work in states where they are refusing to make it work for political reasons. I think it sucks that conservative politicians would rather grandstand than suck it up and make it work the way it is supposed to. As usual, American people are the big losers in these stupid political battles.

If you look at that same article, in CO we are doing the exchanges and are premiums are forecasted to drop 36% from what we have now.

I don't have time to research which category TN falls into.

GloriaInTX's picture
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Expanding something that isn't working now isn't going to make it better.

Expansion of Medicaid -- the jointly run federal-state health plan for low-income Americans -- has long been an essential element of progressives' vision for healthcare "reform."
But it won't work. Medicaid already suffers from serious problems, including perpetual cost overruns, doctors who increasingly refuse to accept patients covered by the program, and low quality of care. Expanding Medicaid will only exacerbate these issues -- while doing little to improve the health of the people it covers.
The debate over Medicaid expansion began in earnest in 2010, when the Affordable Care Act (ACA) -- otherwise known as Obamacare -- became law. The ACA incentivized states to expand their Medicaid programs by offering to cover 100 percent of the increased cost for the first three years -- and then 90 percent in subsequent years.
Originally, this was an offer of the "can't be refused" variety. The ACA threatened to punish states that didn't expand by rescinding federal Medicaid funds for which they were already eligible.
But in June 2012, the U.S. Supreme Court ruled that the feds' threat was unconstitutional. States could forego Medicaid expansion without jeopardizing existing federal funding.
Fully 21 states have taken up this option and refused to expand their Medicaid operations.
There's good reason for their refusal.
For starters, Medicaid patients often suffer from constrained access to care. Technically, they're "insured" -- but they can't find anyone to treat them.
That's because fewer and fewer doctors are participating in the program. Between 2010 and 2011, a staggering 33 percent of doctors decided not to accept new Medicaid patients, chiefly because the program's reimbursement rates are incredibly low -- and often don't cover the cost of treatment.
Last year, less than 70 percent of American doctors participated in Medicaid.
Consequently, current beneficiaries have difficulty finding a physician who will accept their coverage. Once they do, they may have to wait a long time to actually see the doctor.
Expanding the program will only exacerbate this state of affairs. In Massachusetts, for instance, which launched an Obamacare-style expansion of Medicaid on its own several years ago, just 66 percent of internists and 70 percent of family physicians accepted the state's Medicaid plan, according to a 2013 survey. In some counties, just 30 percent of family doctors take Medicaid.
What's more, the care beneficiaries receive doesn't substantially improve their health. A major analysis of Oregon's Medicaid program found "no significant improvements" in health outcomes for patients enrolled in the program. Researchers reported that Medicaid coverage had virtually no effect on blood pressure, cholesterol levels, or blood sugar -- risk factors for chronic conditions like heart disease and diabetes.
All this evidence suggests that expanding Medicaid won't improve the health of the low-income Americans it's supposed to help. But it will drive up costs for state taxpayers.
Supporters of the expansion claim that it's essentially free for states, with the federal government picking up the entire tab initially and then the bulk of it soon after.
But that's hardly the case. The California Legislative Analyst's Office, for instance, estimates that the expansion will yield between $300 million and $1.3 billion in new annual public costs by 2020. The Congressional Budget Office puts the total cost to the states between 2014 and 2022 at $73 billion.
Medicaid expansion will also strain the economy and slow job creation. A new paper from the National Bureau of Economic Research found that expanding the program actually discourages people from finding a job, because they no longer need to be employed to get coverage. The study estimated that the planned state-level expansions of Medicaid would cause between 530,000 and 940,000 people not to seek employment.
Fortunately, many states aren't buying the false promise of Medicaid expansion. They know that it will prove wasteful and do little to improve access to care for low-income patients.
Today, Medicaid delivers substandard care while strapping state governments with skyrocketing costs. Expanding this troubled program is a bad strategy for improving health care in America.

PIPES: Expanding Medicaid: A foolish way to improve healthcare access - Your Houston News: Opinion

ClairesMommy's picture
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Watching the health care situation from a different country I'm still amazed that the United States of America is still so un-united. It is beyond my brain to even to try figure out why your federal and state governments can't get this figured out, really. It's like a gigantic menu has been put in front of y'all to select what insurance plan you want, and to cherry pick this and that because of your specific health care needs as individuals and families. Le sigh....So many other countries figured it out decades ago. It's mind boggling why the most powerful country in the world can't provide adequate and affordable health care for all its citizens. I think ACA is a step in the right direction, but has many faults. I hope it can all get straightened around.

Alissa_Sal's picture
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It's not just expanding Medicaid although there is that part of it, it is also the state health care exchanges and the health care subsidies. I was reading somewhere that about 40-50% of people who are currently uninsured qualify for the subsidies and that in some places the subsidies were droppign the cost of the premiums down to costs as low as like $17 bucks a month. (I'm sorry I keep posting on the fly and keep not citing my sources, LOL) If you don't do any of the stuff that the ACA set up to lower the costs for the consumers because you refuse to accept that ACA is the law of the land, it's not going to work. That's just common sense.

GloriaInTX's picture
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I don't understand how the state running the exchange would make any difference? They have to follow federal rules, so what difference does it make if the exchange is run by the state or the federal government? The effect is the same. It also sounds like the healthcare you will get through these plans will be extremely limited. (Again they say less than expected... which is still higher than what many are paying now)

Federal officials often say that health insurance will cost consumers less than expected under President Obama’s health care law. But they rarely mention one big reason: many insurers are significantly limiting the choices of doctors and hospitals available to consumers.

From California to Illinois to New Hampshire, and in many states in between, insurers are driving down premiums by restricting the number of providers who will treat patients in their new health plans.

When insurance marketplaces open on Oct. 1, most of those shopping for coverage will be low- and moderate-income people for whom price is paramount. To hold down costs, insurers say, they have created smaller networks of doctors and hospitals than are typically found in commercial insurance. And those health care providers will, in many cases, be paid less than what they have been receiving from commercial insurers.

Some consumer advocates and health care providers are increasingly concerned. Decades of experience with Medicaid, the program for low-income people, show that having an insurance card does not guarantee access to specialists or other providers.

Consumers should be prepared for “much tighter, narrower networks” of doctors and hospitals, said Adam M. Linker, a health policy analyst at the North Carolina Justice Center, a statewide advocacy group.

“That can be positive for consumers if it holds down premiums and drives people to higher-quality providers,” Mr. Linker said. “But there is also a risk because, under some health plans, consumers can end up with astronomical costs if they go to providers outside the network.”

Insurers say that with a smaller array of doctors and hospitals, they can offer lower-cost policies and have more control over the quality of health care providers. They also say that having insurance with a limited network of providers is better than having no coverage at all.

Cigna illustrates the strategy of many insurers. It intends to participate next year in the insurance marketplaces, or exchanges, in Arizona, Colorado, Florida, Tennessee and Texas.

“The networks will be narrower than the networks typically offered to large groups of employees in the commercial market,” said Joseph Mondy, a spokesman for Cigna.

The current concerns echo some of the criticism that sank the Clinton administration’s plan for universal coverage in 1993-94. Republicans said the Clinton proposals threatened to limit patients’ options, their access to care and their choice of doctors.

At the same time, House Republicans are continuing to attack the new health law and are threatening to hold up a spending bill unless money is taken away from the health care program.

In a new study, the Health Research Institute of PricewaterhouseCoopers, the consulting company, says that “insurers passed over major medical centers” when selecting providers in California, Illinois, Indiana, Kentucky and Tennessee, among other states.

“Doing so enables health plans to offer lower premiums,” the study said. “But the use of narrow networks may also lead to higher out-of-pocket expenses, especially if a patient has a complex medical problem that’s being treated at a hospital that has been excluded from their health plan.”

Full article
http://www.nytimes.com/2013/09/23/health/lower-health-insurance-premiums-to-come-at-cost-of-fewer-choices.html?pagewanted=all

And some insurers are even refusing to participate because they can't make any money under the federal guidelines.
Blue Cross, Aetna, United, Humana Flee Obamacare Exchanges | CNS News

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"GloriaInTX" wrote:

This says it in a nutshell. You are forced to pay more to take coverage you don't need or want, and in return have to pay a higher deductible to cover the things you DO need.

I don't get it. Wouldn't the woman in the photo be covered by MediCare? Doesn't MediCare cover hip replacements?

As for taking insurance you don't need/want. Yeah, when I got married in 2002, my husband and his teenage son were also covered for pregnancy and his daughter, my daughter, and I were all covered should we happen to get prostate cancer.

Spacers's picture
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MSNBC is saying that the premiums are actually costing less than projected before:

With less than one week to go before health care “exchanges” or state-based insurance marketplaces open for enrollment, the Obama administration is touting some promising findings: Individual premiums will cost an average of $328 per month, the White House said this week, 16% lower than the Congressional Budget Office projected.

According to a report released Wednesday by the Department of Health and Human Services, individual insurance premiums will be lower than projected for 95% of Americans. Costs vary by state, family size, and annual income, among other factors.

The White House is undergoing a broad push to encourage Americans to enroll in the optional insurance program, a core tenet of President Obama’s signature health care law. The success of the program relies on people signing up — especially younger and healthier Americans.

Former President Bill Clinton and former Secretary of State Hillary Clinton joined Obama at the Clinton Global Initiative meeting in New York Tuesday to discuss the benefits of the insurance program, aimed at covering the 15% of Americans who live without health insurance — and often drive up shared costs by seeking emergency, rather than preemptive care. Around 7 million people are expected to sign up for insurance in the exchanges during open enrollment between Oct. 1 and March 31.

Conservatives have been rallying the public against the exchanges and other provisions of the Affordable Care Act, or Obamacare, telling consumers they would pay higher premiums and have fewer choices in the reformed system. Republican Sen. Ted Cruz launched a more than 21-hour filibuster Tuesday and Wednesday advocating that Congress defund Obamacare, The Supreme Court voted to uphold the law last year.

A boost for Obamacare: Premiums cost less than expected

AlyssaEimers's picture
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"ethanwinfield" wrote:

I don't get it. Wouldn't the woman in the photo be covered by MediCare? Doesn't MediCare cover hip replacements?

I think it is satire, saying that we will give you what you don't need, but not give you what you do need.

Alissa_Sal's picture
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Gloria - the state exchanges are what is driving the competition that is driving the prices down. (This was once a Republican idea, before Obama said it.)

Rivergallery's picture
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#1 State plans are not the same as a federal plan.

#2 - Everyone in my state that has private insurance their plan is going up 100-$200 minimum for higher deductible and less coverage. SAME plan.. In my state I think it is called Cover Oregon (where the private plans are under the federal umbrella control of the "obama care" regs).

#3 We do have Low income state care but not everyone can be covered. Ie my neighbor needs a hip replacement that costs 20k and can't get a job and can't get on Oregon Health plan, as there is a waiting list, and families get priorities.. he will be one that will be fined yearly on his tax forms if he doesn't get privately insured.

---- We should NEVER be forced to buy anything.. I do understand paying our own way.. how about making those using the ER set up payment plans.. or sending the ones without true emergencies over to urgentcare... or making sure each community has a 24 hour urgent care? --- etc

mommytoMR.FACE's picture
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"AlyssaEimers" wrote:

I think it is satire, saying that we will give you what you don't need, but not give you what you do need.

Satire but they should have used someone who is 55 years old and not 85, lol.

Joined: 05/13/02
Posts: 414

"Rivergallery" wrote:

#1 State plans are not the same as a federal plan.

#2 - Everyone in my state that has private insurance their plan is going up 100-$200 minimum for higher deductible and less coverage. SAME plan.. In my state I think it is called Cover Oregon (where the private plans are under the federal umbrella control of the "obama care" regs).

#3 We do have Low income state care but not everyone can be covered. Ie my neighbor needs a hip replacement that costs 20k and can't get a job and can't get on Oregon Health plan, as there is a waiting list, and families get priorities.. he will be one that will be fined yearly on his tax forms if he doesn't get privately insured.

---- We should NEVER be forced to buy anything.. I do understand paying our own way.. how about making those using the ER set up payment plans.. or sending the ones without true emergencies over to urgentcare... or making sure each community has a 24 hour urgent care? --- etc

Payment plans - what happens when the people never pay? And urgent cares still cost a ton. Yes, it might be a bit cheaper than the ER, but I've had invoices from ours that are over $1000. Luckily my insurance covers most of it.

ClairesMommy's picture
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"mommydearest" wrote:

Payment plans - what happens when the people never pay? And urgent cares still cost a ton. Yes, it might be a bit cheaper than the ER, but I've had invoices from ours that are over $1000. Luckily my insurance covers most of it.

Payroll deduction? :shrug:

GloriaInTX's picture
Joined: 07/29/08
Posts: 4116

Here is the list of employers that are cutting hours for part time employees so they don't have to cover them. Many of them had health plans that covered part time employees for low cost, but with Obamacare the coverage rules are so strict that the companies are dropping these plans rather than pay the steep cost of making them complaint. The list is growing, and this is just a list of the employers that are cutting hours, not the ones that are not hiring or laying people off so their business can stay below the 50 person cut off. So now all these people are losing money out of their paycheck with reduced hours and then having to pay for their coverage out of the exchanges for typically either the same or more money for less coverage. The only way the insurance companies are able to offer these plans is with a reduced list of doctors/hospitals that they can go to, so all the people who are now having to buy their coverage off the exchange are going to be competing for this same reduced list of doctors and the waiting list to see a doctor is going to be so long that what are they going to do? Go to the ER. So after all this the result will be the same it will just cost everyone more money and jobs along the way.

ObamaCare Employer Mandate: A List Of Cuts To Work Hours, Jobs - Investors.com

Joined: 08/17/04
Posts: 2226

Is it common for part time employees to have access to health insurance? Even pre HCR in Mass. I knew of no one that worked part time and had access to health insurance through an employer.

mommytoMR.FACE's picture
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Posts: 781

It's not common for part timers around here to have health insurance.

GloriaInTX's picture
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KimPossible's picture
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Posts: 3317

Why mini-med programs are bad a should not be sold as 'health insurance'
Mini-Med Health Plans Useless to Consumers - ABC News

you can find tons of articles on why these mini-med programs are crap and should not be touted as health insurance coverage.

From the above article

"Health insurance plans are structured to protect you when you're sick," said Metcalf. "But these make people so much more vulnerable if they actually get sick."

And you misunderstand the waiver thing. That is an old article and the waiver carries over until 2014 and then ends when the exchanges become available, which are subsidized. In this way companies do not end their coverage early leaving their employees with a gap in available coverage between way back then when that article was published and the beginning of next year.

GloriaInTX's picture
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Posts: 4116

"KimPossible" wrote:

Why mini-med programs are bad a should not be sold as 'health insurance'
Mini-Med Health Plans Useless to Consumers - ABC News

you can find tons of articles on why these mini-med programs are crap and should not be touted as health insurance coverage.

From the above article

And you misunderstand the waiver thing. That is an old article and the waiver carries over until 2014 and then ends when the exchanges become available, which are subsidized. In this way companies do not end their coverage early leaving their employees with a gap in available coverage between way back then when that article was published and the beginning of next year.

So I guess those are just more part time employees added to the list that had coverage that will now be on the exchanges. I'm pretty sure if I was in that situation I would rather have one of the mini-med programs than to pay double the price (plus have my working hours cut) to be on one of these coverage plans that the exchanges are selling where only a limited few doctors are even going to accept the coverage. It will be just like Medicaid there will just be a few doctors that take patients because the reimbursement rates are so low that it isn't worth it for the doctor to accept. It doesn't do any good to have insurance if the waiting list to get in to see the doctor is so long you can't get in anyway.

KimPossible's picture
Joined: 05/24/06
Posts: 3317

You are ignoring the fact that those mini-med programs are bad. Why on earth would you want that more? There is a REASON why they are not allowed anymore.

GloriaInTX's picture
Joined: 07/29/08
Posts: 4116

"KimPossible" wrote:

You are ignoring the fact that those mini-med programs are bad. Why on earth would you want that more? There is a REASON why they are not allowed anymore.

And you are ignoring the fact that these plans purchased on the exchanges may not be much better. From the article I posted above.

From California to Illinois to New Hampshire, and in many states in between, insurers are driving down premiums by restricting the number of providers who will treat patients in their new health plans.

When insurance marketplaces open on Oct. 1, most of those shopping for coverage will be low- and moderate-income people for whom price is paramount. To hold down costs, insurers say, they have created smaller networks of doctors and hospitals than are typically found in commercial insurance. And those health care providers will, in many cases, be paid less than what they have been receiving from commercial insurers.

Some consumer advocates and health care providers are increasingly concerned. Decades of experience with Medicaid, the program for low-income people, show that having an insurance card does not guarantee access to specialists or other providers.

Consumers should be prepared for “much tighter, narrower networks” of doctors and hospitals, said Adam M. Linker, a health policy analyst at the North Carolina Justice Center, a statewide advocacy group.

“That can be positive for consumers if it holds down premiums and drives people to higher-quality providers,” Mr. Linker said. “But there is also a risk because, under some health plans, consumers can end up with astronomical costs if they go to providers outside the network.”

KimPossible's picture
Joined: 05/24/06
Posts: 3317

cardassians

KimPossible's picture
Joined: 05/24/06
Posts: 3317

"GloriaInTX" wrote:

And you are ignoring the fact that these plans purchased on the exchanges may not be much better. From the article I posted above.

All predictive with little proof or information about specific plans or what is actually going to happen. And in the end, a mini-med program will leave someone with NO coverage if they get sick. Its pretty straight forward and obvious in the writing of said plans.

You can try to make it sound worse than a mini-med plan but you aren't going to convince me of that.

GloriaInTX's picture
Joined: 07/29/08
Posts: 4116

"KimPossible" wrote:

All predictive with little proof or information about specific plans or what is actually going to happen. And in the end, a mini-med program will leave someone with NO coverage if they get sick. Its pretty straight forward and obvious in the writing of said plans.

You can try to make it sound worse than a mini-med plan but you aren't going to convince me of that.

Read the full article. There is plenty of information about specific plans and the limitations that these plans are making on providers and hospitals. And it really sounds like the tip of the iceburg. It is silly to imagine that these insurance companies are just going to provide coverage out of the goodness of their hearts at a loss. They are going to find some way to make money one way or another.

In a new study, the Health Research Institute of PricewaterhouseCoopers, the consulting company, says that “insurers passed over major medical centers” when selecting providers in California, Illinois, Indiana, Kentucky and Tennessee, among other states.

“Doing so enables health plans to offer lower premiums,” the study said. “But the use of narrow networks may also lead to higher out-of-pocket expenses, especially if a patient has a complex medical problem that’s being treated at a hospital that has been excluded from their health plan.”

Juan Carlos Davila, an executive vice president of Blue Shield of California, said the network for its exchange plans had 30,000 doctors, or 53 percent of the 57,000 doctors in its broadest commercial network, and 235 hospitals, or 78 percent of the 302 hospitals in its broadest network.

In New Hampshire, Anthem Blue Cross and Blue Shield, a unit of WellPoint, one of the nation’s largest insurers, has touched off a furor by excluding 10 of the state’s 26 hospitals from the health plans that it will sell through the insurance exchange.

Peter L. Gosline, the chief executive of Monadnock Community Hospital in Peterborough, N.H., said his hospital had been excluded from the network without any discussions or negotiations.

“Many consumers will have to drive 30 minutes to an hour to reach other doctors and hospitals,” Mr. Gosline said. “It’s very inconvenient for patients, and at times it’s a hardship.”

http://www.nytimes.com/2013/09/23/health/lower-health-insurance-premiums-to-come-at-cost-of-fewer-choices.html?pagewanted=all&_r=0

KimPossible's picture
Joined: 05/24/06
Posts: 3317

"GloriaInTX" wrote:

Read the full article. There is plenty of information about specific plans and the limitations that these plans are making on providers and hospitals. And it really sounds like the tip of the iceburg. It is silly to imagine that these insurance companies are just going to provide coverage out of the goodness of their hearts at a loss. They are going to find some way to make money one way or another.

The bold is where the speculation comes in Gloria. Thats just a scare tactic, Scary words to throw in there to make it sound like the sky is falling without true knowledge of that happening.

Of course more affordable plans aren't going to be the best coverage (there are other ways to get better coverage mind you if you can afford it)...but what do you really want if your options are limited. To have coverage with limitations or no coverage at all.

If you are actually sick, a mini-med program is akin to no coverage at all. You have put your money into a plan that basically expects you to always be healthy in order for it to work. That is NOT health insurance.

Anti Obamacare people act like what low wage earners have available to them now works. It doesn't.

GloriaInTX's picture
Joined: 07/29/08
Posts: 4116

"KimPossible" wrote:

The bold is where the speculation comes in Gloria. Thats just a scare tactic, Scary words to throw in there to make it sound like the sky is falling without true knowledge of that happening.

A scare tactic? Actually we do have knowledge of what is happening. The insurance companies are pulling out and refusing to provide these policies.

California and 9 other States Where Obamacare Wipes Out Existing Health Care Plans | The Cal Report - Califonia News & Politics

KimPossible's picture
Joined: 05/24/06
Posts: 3317

"GloriaInTX" wrote:

A scare tactic? Actually we do have knowledge of what is happening. The insurance companies are pulling out and refusing to provide these policies.

California and 9 other States Where Obamacare Wipes Out Existing Health Care Plans | The Cal Report - Califonia News & Politics

Yes a scare tactic because you don't actually know what the consequences to these actions will end up being yet you sell them as so destructive that things like mini-med plans are a better alternative? That assumption is not based on any facts

The absence of many larger insurers on the exchange isn't necessarily a bad thing for consumers, said Alan Weil, executive director of the National Academy for State Health Policy. The exchanges, which will include many smaller regional players and companies that have catered mainly to the Medicaid market, are expected to be very competitive in terms of premiums.
Smaller insurers, however, may not have as extensive a list of doctors and hospitals in their networks, he said. But that's one of the tradeoffs for affordability.
"What brand of insurance is available on the exchange does not concern me a lot," Weil said. To top of page

You also don't know what, long term, these companies will decide to do. Its not like you have one chance to opt in and can never offer anything again.

Yes....change is scary. But you cannot sell this idea that low income part time wagers being in mini-med plans is a good thing. Its just not!

AlyssaEimers's picture
Joined: 08/22/06
Posts: 6567

In response to why the old plans are no longer going to be available, there are new guidelines that insurance plans have to meet. I know several people who will no longer be able to have their currant plan because their plans do not meet those guidelines. For example, BIL is a small business owner. He had private insurance for his family. His insurance company sent him a letter saying that his plan did not meet the guidelines and will no longer exists. He can buy a different more expensive plan or buy an exchange, but he can not keep what he has. Same with DH's work. The currant plans that they offered did not meet the guidelines so they are no longer offering them.

This is happening a lot in this area. It seems like the insurance plans where many of you live already met the new Federal guidelines, but many of the plans here did not so they will no long be offered.

Joined: 08/17/04
Posts: 2226

It's really hard to debate this for me. A lot of points made are just general business decisions in the insurance agency and I don't feel like living my job right now. Basically, most insurance plans are looking to reduce their provider size in a number of ways. This has started well back before any mandates. Costs are astronomical for health care. My company takes in hundreds of millions with 91-92% of that spent on claims. That's a LOT of money. The rest is for admin purposes of the plans (claims processing, service departments etc.) A huge way to reduce claims is to limit provider networks. It doesn't necessarily mean lack of providers. It can mean having smaller referral circles (like your pcp refers only to those in their "group") to help contain costs and stop duplicate services like labs (such as pcp takes labs, then specialist repeats labs b/c they didn't get report etc.). They can also just make regional networks...like you live in this area of the state...you can see these providers. There are lots of options. It definitely does not mean lack of providers or care. Those are scare tactics.

So, a lot of this is just industry stuff. Unless you live it day to day you are probably going to be missing 1/2 of the picture. I don't mean that in a bad way at all. I don't take the time to learn the ins and outs of business that I don't need to know (auto insurance...no idea on the backgrounds of that for example.)

By the way, we don't have a limited network for most plans in Massachusetts and we have the closest example to NHCR with our state requirements. Scare tactics.

If your plans didn't meet the minimum guidelines...I have to say that I think you had cruddy coverage that should something bad really happen you are up a creek without a paddle.

AlyssaEimers's picture
Joined: 08/22/06
Posts: 6567

OT - But has anyone been able to get the website to work? I am curious about what the plans cover, but have not been able to get through.

Joined: 08/17/04
Posts: 2226

From what I've heard on the news, it's been hard to get through due to volume of users.

mommytoMR.FACE's picture
Joined: 04/10/09
Posts: 781

Yeah the Maryland Health Connection website has been high in volume and I wasn't able to look yesterday, yesterday night, or now.

ETA: As soon as I said that I just tried again and I was able to get through lol!

AlyssaEimers's picture
Joined: 08/22/06
Posts: 6567

"mommytoMR.FACE" wrote:

Yeah the Maryland Health Connection website has been high in volume and I wasn't able to look yesterday, yesterday night, or now.

ETA: As soon as I said that I just tried again and I was able to get through lol!

I have tried about a dozen times between today and yesterday and have not gotten through. (Just tried and nothing)

GloriaInTX's picture
Joined: 07/29/08
Posts: 4116

This is laughable. This is their poster boy on affordable insurance? He could never afford insurance before when he could have gotten it for $45 a month but now that it is $175 per month through Obamacare suddenly he can afford to buy insurance and it has changed his life? What a joke.

News Outlets Flocking to New Obamacare Enrollee Who’s ‘So Freakin’ Excited’…but There’s a Catch | Video | TheBlaze.com

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