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Casady1

(2,133 posts)
Wed Jul 5, 2023, 08:51 AM Jul 2023

People forget lifetime caps on health insurance

was how we used to have insurance. My wife was in the hospital for 25 days 2 years ago. The cost was $700,000. Since then she has had chemo and now radiation. I would owe a million dollars today. Thank you Obama.

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People forget lifetime caps on health insurance (Original Post) Casady1 Jul 2023 OP
My sister died (age 32) of cancer because of a lifetime cap. lastlib Jul 2023 #1
What a stab to the heart! I am moonscape Jul 2023 #13
One of several parasitic industries Artcatt Jul 2023 #20
The VA has spent over a million on my cancers over the the last 15 years. Thank you largest ... marble falls Jul 2023 #2
Private equity will destroy it all anyway. Anesthesiology practices lostnfound Jul 2023 #3
✔️+ live love laugh Jul 2023 #4
No one seems to know anything about a new venture capitalist partner's Backseat Driver Jul 2023 #23
The cigar chomping boys in their darkened, oak-paneled, boardroom yonder Jul 2023 #31
Sometimes I only see my Endos NP and I am ok with it as cstanleytech Jul 2023 #48
Happening to veterarian practices too. Support your independent vet groups! mahina Jul 2023 #50
I am so grateful to President Obama WhiteTara Jul 2023 #5
The ACA jacked our monthly insurance rate up about $1200 over 10 years Auggie Jul 2023 #6
Interesting. The effect on my household was the opposite. sybylla Jul 2023 #12
there are still states which refuse to accept the Medicaid Expansion yellowdogintexas Jul 2023 #30
We are self employed family as well. MontanaMama Jul 2023 #16
that's an outrage NJCher Jul 2023 #22
I write my congress critter and Senators every single December MontanaMama Jul 2023 #43
What state? tia uponit7771 Jul 2023 #65
Montana. MontanaMama Jul 2023 #73
Sympathies extended Auggie Jul 2023 #25
Back at you, friend. MontanaMama Jul 2023 #42
Obama did the best he thought he could, but the ACA was only a partial fix. PatrickforB Jul 2023 #37
Exactly Auggie Jul 2023 #39
The US doesn't have a health care system. markodochartaigh Jul 2023 #52
I beg to disagree on that. True Blue American Jul 2023 #55
If we wanted to come together, we'd stop spending over half the budget ($858B this year) PatrickforB Jul 2023 #71
Medicare for all is not the answer ExWhoDoesntCare Jul 2023 #78
that is madness, 46,000+ usd per year potentially out of pocket!!!! Celerity Jul 2023 #70
Yep self employed and small business coverage are areas that need improvement IbogaProject Jul 2023 #17
Hmm. There are other factors Hortensis Jul 2023 #18
Well, rates are based on age and zip code ... Auggie Jul 2023 #24
If you're getting it for a decent price it's because your income is low enough to get more subsidies questionseverything Jul 2023 #51
Not if you are old enough to get Medicare Advantage. True Blue American Jul 2023 #56
The aca doesn't cover you if you're old enough for medicare questionseverything Jul 2023 #59
Wrong again.The ACA True Blue American Jul 2023 #75
Medicare advantage is private insurance that guts regular medicare questionseverything Jul 2023 #79
Wrong, it adds to Medicare with extra benefits. True Blue American Jul 2023 #80
I bought insurance before Obamacare and insurance definitely had a million dollar cap Casady1 Jul 2023 #27
I get it ... Auggie Jul 2023 #32
Your "decent PPO" would have dropped you if you'd developed an expensive cancer pnwmom Jul 2023 #36
That's a fabrication. You can't know that. Auggie Jul 2023 #38
I can't know about your particular health situation, but it's not a fabrication that most policies pnwmom Jul 2023 #44
Yes we can uponit7771 Jul 2023 #61
No you can't. It's a fabrication to substantiate your own righteousness. Auggie Jul 2023 #69
Yes you CAN have know if your insurer COULD drop you before ACA. The answer is they can ... uponit7771 Jul 2023 #72
And lack of facts.o True Blue American Jul 2023 #76
How do you come to this conclusion,? True Blue American Jul 2023 #57
Would you take the chance with a loved ones life with pre ACA HCI? tia uponit7771 Jul 2023 #62
I came to that conclusion by reading and experience. We knew how high hospital bills pnwmom Jul 2023 #68
Did ACA jack up your cost or the state you live in? tia uponit7771 Jul 2023 #60
funny, I paid a lot less treestar Jul 2023 #64
ACA saved my life bmichaelh Jul 2023 #7
No Repuke should ever be believed ... and especially not Chump FakeNoose Jul 2023 #45
:) True Blue American Jul 2023 #58
The Sad Thing Is NowISeetheLight Jul 2023 #8
This is why we have huge market caps however lostnfound Jul 2023 #9
If you haven't seen Sicko, Abigail_Adams Jul 2023 #10
Cuba NowISeetheLight Jul 2023 #26
Thank you, everyone who voted Democratic Hortensis Jul 2023 #11
Health insurance companies are needless parasites. Hermit-The-Prog Jul 2023 #14
The insurance companies are still keeping track Cairycat Jul 2023 #15
+1 leftstreet Jul 2023 #47
thank you President Obama LetMyPeopleVote Jul 2023 #19
Great point bmichaelh Jul 2023 #21
Lets not forget "ACA" is pretty much the republicans original healthcare option from the 90s Cheezoholic Jul 2023 #28
The public option was supposed to make the difference questionseverything Jul 2023 #81
I have free HC insurance XanaDUer2 Jul 2023 #29
No lifetime maximum caps with Medicare. Liberal In Texas Jul 2023 #33
Not all Medicare Advantage plans are equal wolfie001 Jul 2023 #66
re: prior authorizations misanthrope Jul 2023 #74
Yup Dave says Jul 2023 #34
Don't put all the blame on the "benefit managers". They have to negotiate Wonder Why Jul 2023 #35
I was going to say that the true cost is probably less than $100,000 SouthernDem4ever Jul 2023 #41
The difference between what you pay for and what you get is called "profit". Midnight Writer Jul 2023 #40
My grand baby would be dead if that cap were still in place peggysue2 Jul 2023 #46
STEPHEN KING HAD TO SUE HIS INSURANCE COMPANY Jimvanhise Jul 2023 #49
wtf ?! yeah, if Stephen King is suing for insurance coverage the avg America was screwed uponit7771 Jul 2023 #63
My husband and I are on Obamacare, too. THANK YOU, President Obama, House Speaker Nancy Pelosi, LaMouffette Jul 2023 #53
It WAS a BFD flamingdem Jul 2023 #54
I am so, so glad I joined the Army. Ligyron Jul 2023 #67
But you still went on Medicare True Blue American Jul 2023 #77
Bump in honor of Peggysue2's baby granddaughter's liver transplant Hortensis Aug 2023 #82

marble falls

(71,919 posts)
2. The VA has spent over a million on my cancers over the the last 15 years. Thank you largest ...
Wed Jul 5, 2023, 08:57 AM
Jul 2023

... socialized medical care system!

Thank-you, Barack Obama for trying to make this same level of care available for everyone in the US!!!

lostnfound

(17,520 posts)
3. Private equity will destroy it all anyway. Anesthesiology practices
Wed Jul 5, 2023, 09:02 AM
Jul 2023

Anesthesiology practices are being bought up by private equity firms who are jacking up their prices.
Medical practices being bought up and you wait months to get an MD, shuffled off to NP’s, no matter how complicated your condition is.

‘Pharmacy benefit managers” ought to be known as Dr Noes, I’d guess those are mostly private as well.

I think we are entering the extraction phase, blood from a turnip.
Although truth be told, slavery was a giant ‘extraction phase’ so I guess it has never been different.

Backseat Driver

(4,671 posts)
23. No one seems to know anything about a new venture capitalist partner's
Wed Jul 5, 2023, 11:11 AM
Jul 2023

Last edited Wed Jul 5, 2023, 11:44 AM - Edit history (1)

new "open access concierge health benefit plan" of which my daughter is being forced to be a subscriber by her employer rich corporate daddy (who might also be the "investor" in the outfit giving out the start-up monies-conflict of interest?). She works for an about 2700 employee private (national-in many states) family business. This "partner" is out to sign-up everyone tired of "insurance" plans as subscribers, all PPO docs, all HMO groups, all specialties to avoid all mandated government standards including quickly paid claims and safe provider credentialling. Providers will then "wait" for payment should they sign up to accept their terms or subscribers will get their care bills sent to collections or lose access when docs require up-front payments. Heaven forbid, some worker has a catastrophic hospital stay. Rich corporate daddy's "kids" are being forced into convincing their docs to sign on board...promises, promises, promises. Maybe daddy-o got transparency of costs and promises to pay, but subscribers???

The plan says "no deductibles; no co-payments, no co-insurance." Who would fall for this too good to be true partner (open access concierge plan) at lower cost except the investor/employer; more likely, in fact, their low-info "self-insured family of subscribers" under daddy's care of a job as well?

My single woman adult child is his worker who deserves choice; she is NOT her employer's child dependent claiming to look out for her best interests. Yep, all payroll deductions will remain the same as last year when under an "insurance" plan unless one picked the plan with an HSA (then there's a big deductible), but if it truly saves a lot of money per employee, who gets the savings??? Per their web site, give you one guess - the corporate daddy-o!

https://vitorihealth.com/

yonder

(10,293 posts)
31. The cigar chomping boys in their darkened, oak-paneled, boardroom
Wed Jul 5, 2023, 12:44 PM
Jul 2023

surely worked overtime to come up with this delightful phrase:

"open access concierge health benefit plan"

Who could complain about this positive, welcoming wording? Makes one want to sign right up, doesn't it?

Open: come one, come all because you have to
Access: we're always here for you, till we're not
Concierage: we handle the details because we know what's best
Health: You'll never be sick if you know what's good for you
Benefit: just who do you think we're talking about?
Plan: we planned it all right, boy did we ever. It took more than a few boxes of Cubans to come up with it

It should be called the "forced and selectively managed assurance of attendance pogrom"

cstanleytech

(28,471 posts)
48. Sometimes I only see my Endos NP and I am ok with it as
Wed Jul 5, 2023, 03:48 PM
Jul 2023

my diabetes is well under control (A1C 5.9) and she is booked up and she might have other patients that need her more.
Mind you it only happens sometimes but most of the time I do see her.

mahina

(20,645 posts)
50. Happening to veterarian practices too. Support your independent vet groups!
Wed Jul 5, 2023, 04:43 PM
Jul 2023

Holy cats. Not good.

WhiteTara

(31,260 posts)
5. I am so grateful to President Obama
Wed Jul 5, 2023, 09:31 AM
Jul 2023

and Obama Care. My beloved had open heart surgery and spent almost a full year in the hospital and the bill is well over one million dollars.

Auggie

(33,148 posts)
6. The ACA jacked our monthly insurance rate up about $1200 over 10 years
Wed Jul 5, 2023, 09:54 AM
Jul 2023

Both of us were self-employed and had to buy on the open market. We were were paying about $600 a month for a decent PPO before the ACA went into law. The next year that bill jumped to just over $1000. Within 10 years that same PPO fee had risen to a little over $1800 a month. It was a bronze plan with a $6000+ yearly deductible.

sybylla

(8,655 posts)
12. Interesting. The effect on my household was the opposite.
Wed Jul 5, 2023, 10:40 AM
Jul 2023

When we were self-employed, BCBS jacked our premium to $10k/month before ACA. With a household of healthy people and a very large deductible. We had to hunt around for new insurance last minute and managed to find a plan with a quality company for less (a local/state insurance company). The ACA forced them to cover more and eliminate the limits.

Covering more meant our out-of-pocket went down afterwards and the no-limits insurance meant a lot less worrying.

Edited to add: I realize that states regulate insurance and some states suffered more (probably on purpose) after the ACA than others. I am sorry your experience was not a good one.

yellowdogintexas

(23,694 posts)
30. there are still states which refuse to accept the Medicaid Expansion
Wed Jul 5, 2023, 12:12 PM
Jul 2023

Before the ACA was ruled on by SCOTUS Medicaid Expansion was built into the plan nationwide. After the ruling, states were no longer required to accept Medicaid expansion. This greatly reduced options in those states - Texas is one of those states. Folks have a very hard time getting affordable coverage because their choice are very limited.

Small group and individual insurance has been awful since insurance companies were allowed to turn a Profit. I was a claims analyst for one of those companies pre ACA; those plans were crap, designed for one purpose: making lots of money for the owners.

The major factor in all medical insurance is profit. Medicare Part B is unique in that it is non-profit. There is a small overhead built in to the budget to allow for increased cost of doing business. We should all have the option to select Part B.

MontanaMama

(24,722 posts)
16. We are self employed family as well.
Wed Jul 5, 2023, 10:45 AM
Jul 2023

I pay $1955 a month for the three of us with a $7500 per person deductible. ACA plans cost more than that because we aren’t eligible for tax credits or any of that. My monthly insurance premium for this bronze plan is more than my mortgage and household bills combined.

Still, I’m grateful for the pre-existing conditions protections.

NJCher

(43,162 posts)
22. that's an outrage
Wed Jul 5, 2023, 10:59 AM
Jul 2023

Needs to be remedied. $7500 deductible!!???!!!! And per person, at that.



MontanaMama

(24,722 posts)
43. I write my congress critter and Senators every single December
Wed Jul 5, 2023, 02:20 PM
Jul 2023

when the new rates come out. The needle never moves. It’s so frustrating.

PatrickforB

(15,425 posts)
37. Obama did the best he thought he could, but the ACA was only a partial fix.
Wed Jul 5, 2023, 01:56 PM
Jul 2023

The problem is that the PROFIT motive is in direct conflict with our interests as patients. Period.

Any time you are buying health insurance, you must remember that it will ALWAYS be in the insurance company's interests NOT to pay your entire claim, to deny care.

At the same time, it is in the for-profit healthcare provider's interest to give you all kinds of sometimes unnecessary services because they can maximize shareholder PROFITS.

And what of your interests as a patient? Well, insurance companies don't care about giving you the medical services you actually need. They care about SHAREHOLDER PROFITS or in the case of non-profits or mutual companies, maximizing retained earnings.

Healthcare providers don't care about giving you the services you actually need, either - just about shareholder PROFITS or retained earnings.

Big pharma, same thing. They don't give a rat's rear end about helping you get the prescriptions you actually need. Oh, they do, but only if you can pay. Because for them, it is about shareholder PROFITS as well.

I hope all who read this post GET IT - the profit motive has never, does not now, and will never help you get all the medical care you actually need. It isn't in their best interests don't you know. But PROFITS, now, that is different...

Medicare for all Americans.

Now.

markodochartaigh

(5,545 posts)
52. The US doesn't have a health care system.
Wed Jul 5, 2023, 09:28 PM
Jul 2023

The US has a profit making system which produces as much profit as possible while producing as little health care as possible as a byproduct.

True Blue American

(18,579 posts)
55. I beg to disagree on that.
Thu Jul 6, 2023, 06:59 AM
Jul 2023

Having spent a week in the hospital while Cardiologists fought to save my life. They even came in to tell me they would miss me before I left.

I then spent 7 days in rehab, same thing. So far Anthem has paid for e erything. Now, I am getting home visits for cardio rehab, Al paid for.
People have become so cynical while Politicians like Obama and Biden try so hard to make things better against the corrupt Republicans I think it is time to come together. Republicans use that hate and cynicism to divide us.

PatrickforB

(15,425 posts)
71. If we wanted to come together, we'd stop spending over half the budget ($858B this year)
Thu Jul 6, 2023, 12:09 PM
Jul 2023

on war, and begin putting some of that tax money (individual taxpayers like us pay in 84% of the government's tax revenue) on stuff that actually helps us.

I have benefitted from ACA as well, but ACA is still a vehicle for insurance profits. My point is not to cut down Obama OR Biden. Please understand this. My point IS that we'd be better off with Medicare for all Americans. We would.

Most people who get into healthcare do so because they want to cure/heal people. What they actually end up with is carefully timed appointments to maximize profits or retained earnings. For example, at Kaiser, which is my employer-provided DHMO, my deductible is $8 large for me and my wife. Recently, my wife asked to go in for a physical because she was tired all the time. They told her when she made the appointment not to talk about anything that was bothering her. These appointments are carefully timed to last 10 minutes with the actual physician after the nurse assistant takes vitals. Then there is blood lab work. No discussion and the physician does not even touch you.

Why? Because the physical is considered preventive medicine, and thus under our plan offered with no copay. BUT, if you have the temerity to actually DISCUSS your health with the physician, you will get charged.

Think about that for a minute. Many physicians and nurses left during COVID because they got tired of the lies Trump was telling and how right-wing-nut-type patients abused them. Many more are leaving because they have discovered our system is not a healthcare system, but a profit-from-illness system.

Please disabuse yourself of the idea I'm trying to CUT DOWN either O or Biden. I'm not. This discussion is about public policy. Specifically, how the profit motive is in DIRECT CONFLICT with our interests as patients. It is. We need to remove the profit motive from healthcare so the system works toward our best interests. Like K-12. Public schools. When the profit motive is introduced we get larger class sizes, less diversity and elitism delivered through vouchers. Like prisons, where the profit motive leads to malnutrition, poor healthcare, and brutality.

My point, True Blue, is just that. Part of the way we organize ourselves must necessarily be to level the tax system so billionaires and corporations pay their fair share of taxes so we can afford to publicly fund things that need to be publicly funded - like K-12, state college and university education, prisons, and yes, healthcare.

Policy discussion - NOT a cutting down of O or B.

As an aside, pretty much EVERYONE knows this is the correct policy position, and Bernie moved the Overton Window by discussing it during his two presidential campaigns. The problem is that the healthcare, big pharma and insurance lobbies bully Congress into taking even a public option off the table, and that is NOT to benefit us, but so they can continue to profit. That's how it is, and it needs to change.

THAT is my point. Interestingly, if we have a crushing victory in 2024 because of changes in demographics, and Dems find themselves in control of Congress and the White House, we'll see what actually happens. We here should NEVER make the mistake of thinking the GenZs or Millennials love Democrats. I know my kids, and the numerous young people with whom I converse, see the Dems as the lesser of evils. They want gun control, abortion access, student loan forgiveness and affordable debt-free college, childcare and healthcare. They actually want a government that governs us and makes policy decisions that benefit Main Street instead of funneling ever more public monies to Wall Street.

I think we may be about to see a significant change of the guard. Because these kids coming up are aggressive. They aren't willing to wait for stuff like this, because they have watched their parents and grandparents get screwed by Wall Street and trickle down economics.

So yeah, Biden has done some really good stuff, and Obama did too. But if we're honest, we have to destroy the GOP at the polls, and I mean destroy them, to buy another couple hundred years for our republic. Because right now, we are in end stage capitalism where we have wealth imbalances that are much worse than in 1929.

Seriously, our whole system has been padding the pockets of billionaire parasites (AOC is right when she says every billionaire is a failure in tax policy) since Kennedy was killed and LBJ sent 500,000 of our people to Vietnam so Wall Street could profit from their death toys. Dick Nixon sabotaged the peace talks in Paris so he could win while Vietnamese and American kids were dying in bunches. Then we had Lewis Powell's 1971 Manifesto to the US Chamber that lays out the whole corporate takeover plan. When Reagan slithered into the White House, he brought massive 'trickle down' tax cuts to corporations that essentially transferred the tax burden to individuals and killed the Fairness Doctrine in 1987.

Decades of AM talk radio and corporate-paid propaganda from Fox and others pounded the divisions between us, and we have what we have now. COVID wasn't enough to bring us together, because we had a divider in the White House. So we have 30 to 40 million heavily brainwashed people who always vote for the GOP and against their own interests.

If we actually want to save this republic, we'd better do some aggressive messaging at all levels and in all elections. I supported a lady running against a holy-roller wing-nut in my state house district, gave her money and got a yard sign. You know what her message was?

Make politics boring again.

Seriously.

We've got problems.

Now I know a bunch on this site - we who have fought the long fight and tend to be older, will pan me for saying what I just did. But the GenZs and Millennials are producing about 4 million new left-leaning voters a year. They like socialism. They like gun control. They want access to abortion. They want portable healthcare (you ever pay for COBRA? That's a break-the-bank thing, and NOT really portable for most because it simply is not affordable). They want childcare. They want better and fairer tax policies. And they insist on aggressive efforts to lower the carbon footprint and mitigate climate change. Essentially, they will be absolutely moving this party to the left. We'd better be ready to risk Wall Street's wrath.

Biden has done a really good job with the situation he has inherited. He has. I'm not cutting him down. What I am saying is that policy changes in favor of Main Street, not Wall Street, need to accelerate.

 

ExWhoDoesntCare

(4,741 posts)
78. Medicare for all is not the answer
Thu Jul 6, 2023, 03:53 PM
Jul 2023

Anyone who's dealt with Medicare knows how much it sucks. It's better than nothing--but not all that much better. My mum has far worse coverage than I do. I can get on any of the snazzy diabetes meds I want, and my costs for it won't change from what I take now. She can't get those meds without paying through the wazoo for them on Medicare.

I don't have a donut hole with my prescriptions. She does.

I don't need supplemental coverage for basics. She does.

I didn't have to pay anything to get all of my vaccines up-to-date (DTP, shingles, Hep A&D, pneumonia). She has to pay for every single vaccine, out-of-pocket.

My GP visits are no-cost. Hers are not.

I get free PT, free dietician visits. She doesn't.

Even my hospitalization coverage was far superior to hers. I didn't pay nearly as much as she had to pay for her hospitalization as I did--and I was there for surgeries. She wasn't.

So tell me again why I would want the over-priced filth that is Medicare, when I get better coverage with my private health care? I'm not signing up for Medicare when I turn 65 for a bloody good reason: Why would I, when my younger husband's private health insurance is so much better?

If you want a government health care plan that works and is more cost effective, then VA-for-all, or, even better, California's Medicaid (Medi-CAL) for all is what it would take for me to support the policy. But as long as idiots keep promoting Medicare for All, nobody familiar with it will want that garbage.

Keep losing voters, though, if that makes you happy.

Celerity

(54,406 posts)
70. that is madness, 46,000+ usd per year potentially out of pocket!!!!
Thu Jul 6, 2023, 09:25 AM
Jul 2023

the most 3 people would pay here in Sweden for all medical care, all pharma is around 300 usd per person per rolling 12 months, so 900 dollars per year for all three,

and that is only if you max out,

if you do not see the doctor and don't have scripts, you pay nothing

IbogaProject

(5,911 posts)
17. Yep self employed and small business coverage are areas that need improvement
Wed Jul 5, 2023, 10:47 AM
Jul 2023

New York State had an excellent plan for the self employed, when ACA started the state quietly dropped us and they hadn't straightened out the mid year signups. I will forever hate the entire Como family, even if it was just creepy Governor Andrew. I'm insulin dependent, and had to get my insulin from the hospital for that year, and was on pins and needles any time I left the city. We need one single national health insurance. We have to sell it to the rich and those who think they'll be rich soon that they would be better off if everyone had care. It would reduce the chaos that occurs in Emergency Rooms all across America more days than not. I want the night shift ER crew have to play cards sometimes.

Hortensis

(58,785 posts)
18. Hmm. There are other factors
Wed Jul 5, 2023, 10:49 AM
Jul 2023

responsible for increased insurance rates for decades before the ACA, and ever since. Maybe companies servicing your area or the services provided there took a big jump.

Of course, I’m sure if we looked we could find reports that the ACA was responsible, retroactively end, otherwise. But I quit my job with employer supplied insurance in order to become self-employed and sign up for the ACA, and got far, far better coverage for a bit less.l

Auggie

(33,148 posts)
24. Well, rates are based on age and zip code ...
Wed Jul 5, 2023, 11:29 AM
Jul 2023

so of course they vary. But there's no doubt the ACA triggered huge rate increases (as allowed by ACA law) just to protect insurers' profit margins.

If you qualified for the the premium tax credit (PTC) rates could be as low as $2.00 a month, though the high deductible remains. The issue was eligibility. In California, originally, that meant an income of or below $64,000 a year. The PTC in CA has since been increased to around $72,000, I think.

questionseverything

(11,836 posts)
51. If you're getting it for a decent price it's because your income is low enough to get more subsidies
Wed Jul 5, 2023, 08:14 PM
Jul 2023

The insurance companies still get full premiums it’s just other tax payers are paying the subsidies or we as a nation are borrowing the money to pay for the premium

True Blue American

(18,579 posts)
75. Wrong again.The ACA
Thu Jul 6, 2023, 03:43 PM
Jul 2023

Improved Medicare Advantage dramatically. Insurance companies took 3 years to change and start adding new benefits.

Most people are on MA policies because Medicare only pays 80%.

 

Casady1

(2,133 posts)
27. I bought insurance before Obamacare and insurance definitely had a million dollar cap
Wed Jul 5, 2023, 11:58 AM
Jul 2023

and pre-existing. My daughter was excluded from coverage for a year. If you got cancer before Obamacare you were SOL.

Auggie

(33,148 posts)
32. I get it ...
Wed Jul 5, 2023, 12:47 PM
Jul 2023

just understand that ACA monthly rates, for some (or many) have increased the cost of health insurance more than 300% since enactment.

pnwmom

(110,260 posts)
36. Your "decent PPO" would have dropped you if you'd developed an expensive cancer
Wed Jul 5, 2023, 01:56 PM
Jul 2023

or had a baby born who needed neonatal care and you ran through your lifetime limit.

It costs more to cover more. Many people were just fooling themselves into believing they were sufficiently covered, and medical expenses could easily drive them into bankruptcy.

pnwmom

(110,260 posts)
44. I can't know about your particular health situation, but it's not a fabrication that most policies
Wed Jul 5, 2023, 02:24 PM
Jul 2023

had lifetime limits, that could be exceeded by a serious or extended illness, such as a neonate needing months of care in the hospital.

My brother had to declare bankruptcy after he broke his back, because of medical expenses he wouldn't have had if the ACA had been in effect. You were just lucky that nothing serious happened to you or your family while you had your "decent" insurance.

On March 23, 2010, President Barack Obama signed the Affordable Care Act (ACA) into law with a stated goal of addressing the “crushing cost of health care…a cost that now causes a bankruptcy in America every 30 seconds.”

A decade later, the law, otherwise known as Obamacare, appears to be accomplishing that goal, leading not only to millions more insured individuals but also to a sharp decline in bankruptcy risk among those with on-and-off coverage, new CU Boulder and University of Denver research suggests.

“The big picture finding is that the ACA is doing what it is supposed to be doing, providing more people with health coverage and buffering them from crushing debt that can play out in financial ruin,” said co-author Tim Wadsworth, an associate professor of sociology at CU Boulder.




https://www.colorado.edu/today/2020/04/30/affordable-care-act-lived-promise-buffering-bankruptcy-risk-study-shows

Auggie

(33,148 posts)
69. No you can't. It's a fabrication to substantiate your own righteousness.
Thu Jul 6, 2023, 09:12 AM
Jul 2023

I didn't even name my insurer.

uponit7771

(93,532 posts)
72. Yes you CAN have know if your insurer COULD drop you before ACA. The answer is they can ...
Thu Jul 6, 2023, 12:24 PM
Jul 2023

... and one too many HCIs did.

If Stephen King had to fight his HCI then common folk didn't have a chance.

pnwmom

(110,260 posts)
68. I came to that conclusion by reading and experience. We knew how high hospital bills
Thu Jul 6, 2023, 09:03 AM
Jul 2023

could be, based on experience, and we knew that lifetime medical limits were typically about a million dollars. Once you hit them, you lost coverage, and no one else would want to insure you. And they were free to decline.

This was the biggest change that Obamacare brought.

treestar

(82,383 posts)
64. funny, I paid a lot less
Thu Jul 6, 2023, 07:23 AM
Jul 2023

for a lot more.

The open market before the ACA - I could only get a very high deductible and it cost a lot more. I had to pay out of pocket for anything needed.

bmichaelh

(1,181 posts)
7. ACA saved my life
Wed Jul 5, 2023, 09:57 AM
Jul 2023

Trump/McConnell/Ryan/McCarthy tried to repeal ACA which provide lifetime protections.

2 years after this attempted repeal, my lymphoma returned (diagnosed 35 years ago)

It took 4 or 5 treatments before we found one that worked.
Back in August 2022, I achieved complete remission.

Even if Trump says he will not try again; he should not be trusted.
He will say or do anything to avoid federal prison.

FakeNoose

(41,631 posts)
45. No Repuke should ever be believed ... and especially not Chump
Wed Jul 5, 2023, 02:24 PM
Jul 2023

Congratulations on your complete remission.

NowISeetheLight

(4,002 posts)
8. The Sad Thing Is
Wed Jul 5, 2023, 10:05 AM
Jul 2023

All these posts about $1m expenses wouldn't be here and would've cost a fraction of that in all those other industrialized nations that don't have greedy for profit healthcare and insurance systems. Like those chemo drugs... How much more were those drugs in the US versus elsewhere? Three to four times more? Even more?

lostnfound

(17,520 posts)
9. This is why we have huge market caps however
Wed Jul 5, 2023, 10:22 AM
Jul 2023

Profit over people is more than a slogan.

If they could privatize the air and sell it to us, just imagine the market cap on that one!

 

Abigail_Adams

(333 posts)
10. If you haven't seen Sicko,
Wed Jul 5, 2023, 10:29 AM
Jul 2023

the film by Michael Moore, it makes just such a comparison. Of course, everything's gone up a lot since the movie was made, but it's still worth a watch.

NowISeetheLight

(4,002 posts)
26. Cuba
Wed Jul 5, 2023, 11:45 AM
Jul 2023

I think I've seen it. Isn't that the one where he goes to Cuba to get cheap drugs with poor Americans?

Hortensis

(58,785 posts)
11. Thank you, everyone who voted Democratic
Wed Jul 5, 2023, 10:36 AM
Jul 2023

for Obama, our members of Congress and a special mention for Nancy Pelosi (people in the know sometimes refer to it Pelosicare), and the 63 members of Congress— alone — whose
careers were sacrificed as part of creating the ACA.

Congrats to you and your wife and best wishes

Hermit-The-Prog

(36,631 posts)
14. Health insurance companies are needless parasites.
Wed Jul 5, 2023, 10:44 AM
Jul 2023

The purpose of the health insurance industry is to suck resources from patients and care givers. That's it. It provides nothing; it devours all that it can.

Cairycat

(1,867 posts)
15. The insurance companies are still keeping track
Wed Jul 5, 2023, 10:44 AM
Jul 2023

of your lifetime total - the Wellmark plan through my husband's job does anyway. They are preparing for the contingency of caps coming back, don't doubt that for an instant.

bmichaelh

(1,181 posts)
21. Great point
Wed Jul 5, 2023, 10:57 AM
Jul 2023

It is also makes you think about who runs the debates or town halls.

You never hear this type of question or concern expresses in those forums.

Cheezoholic

(3,719 posts)
28. Lets not forget "ACA" is pretty much the republicans original healthcare option from the 90s
Wed Jul 5, 2023, 12:00 PM
Jul 2023

Our plan was the whittled out shavings of that wooden elephant

questionseverything

(11,836 posts)
81. The public option was supposed to make the difference
Thu Jul 6, 2023, 04:28 PM
Jul 2023

But that choice was abandoned somewhere along the way

XanaDUer2

(15,772 posts)
29. I have free HC insurance
Wed Jul 5, 2023, 12:02 PM
Jul 2023

Bc of ACA. My cobra ended. I'm waiting for Medicare. I think id b sol wo ACA

Liberal In Texas

(16,270 posts)
33. No lifetime maximum caps with Medicare.
Wed Jul 5, 2023, 01:13 PM
Jul 2023

No caps at all. There is the 80% they pay and you owe 20% but that's why you have to have supplemental.

Also no "Prior Authorizations."

wolfie001

(7,667 posts)
66. Not all Medicare Advantage plans are equal
Thu Jul 6, 2023, 08:01 AM
Jul 2023

Some have benefit managers that thumbs up or thumbs down treatments. I plan on getting Medicare and then adding Medigap. I think that would be the way to go for me.

misanthrope

(9,495 posts)
74. re: prior authorizations
Thu Jul 6, 2023, 01:46 PM
Jul 2023

I am on Medicare through my disability status. That said, my Plan D with Humana involves "prior authorization" all the time, usually once annually, owing to the $150,000 per year medications I am on that keeps my lung degradation at a manageable rate.

Dave says

(5,425 posts)
34. Yup
Wed Jul 5, 2023, 01:15 PM
Jul 2023

Even with good private insurance, the caps were there. The Affordable Care Act is literally a life-saver for so many people. I, too, thank you, President Obama.

Wonder Why

(7,014 posts)
35. Don't put all the blame on the "benefit managers". They have to negotiate
Wed Jul 5, 2023, 01:41 PM
Jul 2023

the rates with hospitals and doctors who set outrageous list prices for services which have to be negotiated down. Medicare is such a big customer that they can and do enforce their will. Even with the 20% copay, its based on a much lower Medicare rate. Another reason to have single payer medical care.

When you hit 65, you are eligible for Medicare. On the other hand, younger people will get a bill for list price if they don't have insurance and the benefit managers and medical providers know that.

SouthernDem4ever

(6,619 posts)
41. I was going to say that the true cost is probably less than $100,000
Wed Jul 5, 2023, 02:10 PM
Jul 2023

but the hospital billing games increase the price 10 fold so they can get the money they need from the insurance companies. It's a stupid game.

Midnight Writer

(25,409 posts)
40. The difference between what you pay for and what you get is called "profit".
Wed Jul 5, 2023, 02:08 PM
Jul 2023

It is insane to pin our healthcare on a system that makes more profit the more they screw their customers.

peggysue2

(12,532 posts)
46. My grand baby would be dead if that cap were still in place
Wed Jul 5, 2023, 02:53 PM
Jul 2023

Cassandra has been under intensive medical care, surgeries, rehab therapies from her first breath and heartbeat. That's three years of constant medical intervention, even before the child's upcoming liver transplant.

For those who shrug their shoulders that decisions in DC don't affect them?

Think again.

Jimvanhise

(594 posts)
49. STEPHEN KING HAD TO SUE HIS INSURANCE COMPANY
Wed Jul 5, 2023, 04:25 PM
Jul 2023

King can obviously afford the best insurance money can buy, but after he was run down by a car and had hundreds of thousands in medical care, his insurance company claimed he had an annual cap on his insurance and he had to sue to them over it.

LaMouffette

(2,640 posts)
53. My husband and I are on Obamacare, too. THANK YOU, President Obama, House Speaker Nancy Pelosi,
Wed Jul 5, 2023, 10:14 PM
Jul 2023

and all others who made the ACA happen. And thank you also to President Biden and Vice President Harris for protecting and expanding the ACA.

flamingdem

(40,891 posts)
54. It WAS a BFD
Wed Jul 5, 2023, 10:49 PM
Jul 2023

Thanks President Biden and President Obama!

Serious empathy for those paying more than they should due to repug gamesmanship.

Ligyron

(8,006 posts)
67. I am so, so glad I joined the Army.
Thu Jul 6, 2023, 08:50 AM
Jul 2023

It hurts to get shot but my service earned me free medical care in the best HC system there is (in this country at least).

People have their nightmare stories about their dealings with the VA, and I don't doubt them but I've been in 4 different regions across the country and I've nothing but praise for the professionalism of their HC workers and the level of care I've received.

I have to laugh every time I take my wife to her various doctors because the first thing that happens right off the bat is she's handed a bunch of forms to fill out. I filled out one set of forms when I signed up for the VA and those were the last ones I ever saw.

Each specialist I see knows exactly what medications I'm on and treatments I've received since they're all right there on the computer screen along with my entire medical history.

Just reading about people's horror stories here makes me both angry and sad and it's just not right. Most civilized countries care too much about their citizens to put them through what many Americans experience.

We could use a system like the VA's for all Americans imho.

True Blue American

(18,579 posts)
77. But you still went on Medicare
Thu Jul 6, 2023, 03:51 PM
Jul 2023

When you Turned 65. I live in the Wright Pat area and know too many Vets. Some of thenm are signing up for Amthem because of the extras. They use that as a supple gal to their VA insurance.

Hortensis

(58,785 posts)
82. Bump in honor of Peggysue2's baby granddaughter's liver transplant
Wed Aug 30, 2023, 01:30 PM
Aug 2023

now probably finally on. She is alive today because WE all, including her family, made the ACA happen years before she was born, eliminating lifetime caps on care.

Go, transplant team!

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