The Mandated "Bronze" Policy on The Exchange will only cover 60% of the actual Health Care Cost?

[bvar22]

"There will be four different categories of plans available on the exchange: bronze, silver, gold and platinum (as well as a catastrophic plan available mostly to young adults). The benefits of the four plan types will be similar; all will cover a package of comprehensive “essential health benefits” yet to be determined by the secretary of Health and Human Services. What will vary is a family’s cost-sharing responsibility for each of the plan types. Someone in a bronze plan can expect it to cover 60 percent of average medical costs in the plan, "

http://prescriptions.blogs.nytimes.com/2010/06/08/why-would-i-sign-up-for-a-bronze-plan/

"For a bronze plan, the insurance would cover 60 percent of all health care costs for an average person. Enrollees, on average, would be responsible for paying 40 percent of the costs. For a platinum plan, an average individual would pay 10 percent out-of-pocket for their covered benefits and the insurer would pay 90 percent. However, individuals with high-cost health conditions could end up paying significantly more than the average person."

http://101.communitycatalyst.org/aca_provisions/coverage_tiers

What possible benefit will this be to the millions barely hanging on to the Middle Class who will be MANDATED to buy these policies?

If they have an accident or get sick enough to require a couple of nights in a hospital, they will lose everything whether or not they have this "Bronze" Insurance.
The only real difference is that after 2014, they will be required to also pay a monthly tithe to a For Profit Health Insurance Corporation for the privilege of STILL going Bankrupt if anything happens to them.


I WAS under the impression that Total Out of Pocket costs were capped at a percentage of an individual's income,
but apparently, THAT only applies to the Premiums the Health Insurance Vultures are allowed to charge,
and does NOT apply to the cost of the actual Health CARE if someone tries to USE their "Bronze" Insurance.

PLEASE tell me I am wrong,
and show me where I have misread or misinterpreted this information.

If the millions of Mandated Bronze Policy Holders are still required to pay 40% of the actual Health Care Cost,
then 2014 is going to be a rough year for the Democratic Party.

In civilized countries, Medical Bankruptcy is virtually unknown.

[Recursion]

1. Both premiums and out-of-pocket are capped

Premiums are capped at 9% of income. Out of pocket expenses are capped at something that's probably too high, though I can't remember exactly what it is.

[eomer]

73. For Bronze coverage, the maximum out-of-pocket is $6,350.

Each insurance company plan can use different coverages that are designed actuarially to hit the 60% mark. An example plan designed by consulting firm Aon Hewitt would have a deductible of $4,350 and then coinsurance of 20%, and finally the max out-of-pocket of $6,350 that applies to all Bronze plans. Preventive care is always covered 100% under all plans.

I got the above info here:
http://www.kff.org/healthreform/upload/8177.pdf

[Schema Thing]

2. You are wrong

and you didn't get "information" you got "editorialization" (and then you doubled down on editorialization by writing some of your own).

You went wrong when you didn't go "hmm, I know that's wrong, let me go verify what the reality of the law is".

[bvar22]

5. If what you say is true,

....then you can provide links that support your claim.
Please do so.

[leftyohiolib]

12. you could try this link

http://www.whitehouse.gov/healthreform#healthcare-menu

[bvar22]

21. I did,

....and someone downthread called MY post confusing.

Please excerpt the pertinent line or paragraph that specifies exactly what a "Bronze Plan" covers in relation to actual delivered Health Care Cost, and not Health Insurance Premiums,
and if and where % of income will be in effect for actual delivered Health CARE costs.

Thank You!

[B2G]

22. There's no simple answer to that because

it varies based on your income.

[bvar22]

25. Well then you should be able to post the pertinent table or outline...

...to the guide covering the liability caps on actual Health CARE costs for "Bronze Plan" holders,
as distinct from Health Insurance Premiums.
I am unable to find them.

Thank You!

[B2G]

31. I've seen no tables, but there's this

Maybe it will answer your questions about your specific situation. And for the record, I think it's gonna kill the middle class. Just sayin...

http://healthreform.kff.org/subsidycalculator.aspx

[NoOneMan]

41. Thats premium assistance, and separate from co-pays & deductibles

[flpoljunkie]

62. The Kaiser subsidy calculator is based on the Silver Plan.

[riderinthestorm]

14. Bvar's quote is very similar to the Kaiser Family Foundation release on this

and they've provided a lot of really good info so far, in plain english.

http://www.kff.org/healthreform/upload/8303.pdf

They seem to be saying that the Bronze plan is similar to a catastrophic plan. That the out of pocket deductible IS capped but at close to a $6500 deductible. That's a LOT of $$. Combined with the premium payment, its still enough to bankrupt the working poor if someone got really sick.

[NoOneMan]

16. Someone should of told the people writing this law that poor people exist

Oh my oh my. How could they have known? Those people aren't allowed in their communities.

Someone should of told the people in the cheering crowds that there existence was irrelevant

[WinkyDink]

3. Even "Platinum" leaves room for MAJOR EXPENSES, at 10%!

[Schema Thing]

26. No, it doesn't.

[Politicub]

68. Have you ever had insurance? There's a lot of confusion about how health insurance works.

Unless you have an HMO or PPO you will pay a portion of the insurer's highly discounted rates paid to the provider.

[NoOneMan]

4. And that there is the swindle

You'll have many more enrolled who can't afford to even use their coverage. Regardless, their premiums will be subsidized and that money will in fact go to help someone (just maybe not you).

At the end of the day, no one knows how any of this will shake out.

[msongs]

7. it will shake out to benefit the insurance companies who wrote this legislation lol nt

[lumberjack_jeff]

6. Insurance is like that.

People who choose the bronze coverage know that they'll be on the hook for mundane day-to-day expenses, but not the major catastrophic bankruptcy-inducing kind.

It is better than the only alternative.

[bvar22]

8. How is that any better for those barely hangin on?

Looks like Medical Bankruptcy either way.
There is no way we can afford 40% of a 3 day hospital stay.

[NoOneMan]

10. Maybe theyll get a bigger rebate check when they are dead

If subsidies are paid, the money is pooled somewhere. Assuming not all of it is used for rich & middle-class healthcare, a few scraps will be left for everyone.

[lumberjack_jeff]

17. Read better.

Insurance covers 60% of the average family's annual care. The family which has a 3 day hospital stay in a given year is atypical.

If 100 families collectively had $1 million in medical care, $600,000 of that was covered by insurance, that doesn't mean that each family paid $4,000. It means that the one family which had a $500,000 medical crisis got the lion's share of the insurance coverage.

The insurance did what it was intended to do for each of the families. It mitigated the bankruptcy risk of being that one family.

[bvar22]

28. Read better?

"Someone in a bronze plan can expect it to cover 60 percent of average medical costs in the plan, "

http://prescriptions.blogs.nytimes.com/2010/06/08/why-would-i-sign-up-for-a-bronze-plan/

Now, either THAT is WRONG,
and you can provide a link to a credible source proving it,
or I don't really need to "read better".

[eridani]

66. They are coerced into"'choosing" the only plan they can afford.

And that is worse than nothing. Paying for your own timely doctor visits can prevent castatrophic events, and you can't do that with money you are forced to give to insurance companies.

[lumberjack_jeff]

75. A poor person with subsidized coverage is better able to afford primary care.

A middle income person with access to an exchange, who is rebated by the government if the company is price gouging is better able to afford primary care.

A person who suffers from a preexisting condition is better able to afford primary care.

Imperfect or not, it's better than the alternative.

[eridani]

133. This is nonsense--the deductible for bronze coverage is far too high

The bronze plans are catastrophic coverage only, which means no primary care at all, since the money you have to give the insurance companies is the money that could otherwise be spent for doctor visits. This is expecially bad for people over 50, who will have to pay three times as much for crappy insurance.

[BlueMan Votes]

9. this is the u.s.- we have notoriously bad infrastructure...

so you have to expect some bumps and potholes on the road to single payer.

we'll get there.
eventually.

and, yes- i do realize that's not soon enough for some people.
but it's what we're stuck with for now.

[NoOneMan]

15. Does that road go over the bridge to nowhere?

[Oilwellian]

134. LOL n/t

[davekriss]

50. Good post!

[ProSense]

11. What a

I WAS under the impression that Total Out of Pocket costs were capped at a percentage of an individual's income,
but apparently, THAT only applies to the Premiums the Health Insurance Vultures are allowed to charge,
and does NOT apply to the cost of the actual Health CARE if someone tries to USE their "Bronze" Insurance.

PLEASE tell me I am wrong,

...confusing mess of misinformation. First of all premiums are capped. Secondly, you're confusing the cost and the ratios with the premiums. Even with a plan that covers 80 percent of the cost, premiums would still be capped.

There is so much information available in easy to read language: http://www.healthcare.gov/

[morningfog]

89. You aren't refuting the OP.

Actuarial Value, or AV, is calculated as the percentage of total average costs for covered benefits that a plan will cover. For example, if a plan has an AV of 70 percent, on average, a consumer would be responsible for 30 percent of the costs of all covered benefits.

Beginning in 2014, non-grandfathered health plans in the individual and small group markets must meet certain AVs, or metal levels: 60 percent for a bronze plan, 70 percent for a silver plan, 80 percent for a gold plan, and 90 percent for a platinum plan. In addition, issuers may offer catastrophic-only coverage with lower AV for eligible individuals. “Metal levels” will allow consumers to compare plans with similar levels of coverage, which along with consideration of premiums, provider participation, and other factors, would help the consumer make an informed decision.

Premium:

The amount that must be paid for your health insurance or plan. You and/or your employer usually pay it monthly, quarterly or yearly.

The OP thought the total "out of pocket" expenses were capped, but as you claim, only the premiums are capped. That may be so. But, the premium is only the amount paid for the health insurance plan. Under the Bronze plan, only 60 percent of the total average costs for benefits are covered. That means the amount paid for the plan is capped and that under that plan, the individual would have to cover the remaining 40 percent of all benefits.

(all exceprts from you helpful link)

[B2G]

13. Read this, It ain't gonna be cheap.

http://www.acscan.org/pdf/healthcare/implementation/background/PlanLevelsStandardizationofCoverage.pdf

Example:
Juan is a 23 year old waiter with diabetes who makes $21,000 per year. He enrolls in the
lowest-cost silver plan he can find. His annual premium is $3500, but because of his income,
the government pays $2635 of that (he pays $865). Unfortunately, shortly after he signs up for
his new plan, he needs emergency surgery for a burst appendix. However, because he’s eligible
for cost-sharing assistance, his out-of-pocket liability (premiums plus cost-sharing) is capped
at $3840, or 18% of his income.

Examples:
The Peters family of four earns $100,000 a year. They’re all pretty healthy, so they purchase
a bronze plan because the premiums are relatively low, $700 per month. However, in April
their son Carl is diagnosed with a rare form of leukemia that requires aggressive treatment
and hospitalization. The bronze plan requires a deductible of $7500, as well as co-insurance
on cancer drugs of 20%. During the course of the year the Peters exhaust their deductible and
reach the out-of-pocket limit ($11,900) imposed by the law. Over the course of the year, the
Peters spend $20,300 on premiums, deductibles and other out-of-pocket costs — over 20% of
their income. [Note: each plan is required to offer an annual “open enrollment” period, so the
Peters can, later in the year, move to a more comprehensive plan].

Sarah is a 35 year-old engineer who makes $75,000 as an independent contractor. She’s a
breast cancer survivor and signs up for a platinum plan in the exchange. Her annual premiums
are $8000, but there is no deductible and co-payments are low. During the course of the year
her breast cancer returns, requiring immediate treatment. She has numerous doctor visits,
surgery, and must start chemotherapy. Her cumulative copayments reach $500. In total she
spends $8500 on premiums and other cost-sharing combined, or 11% of her income.

[bvar22]

18. Ok ProSense. You can make everything crystal clear...

..as soon as you post a link to a credible site that states that "Bronze Plans" on The Exchange cover 100% of the actual Health Care Cost, or state that Health Care Costs are capped at a percentage of income.

I was unable to find a clear statement to that effect,
but this should be EasyPeasy for someone like you!

[ProSense]

19. Sort it out yourself. You're smart enough

Premiums are capped. Start there. You know what that means.

[bvar22]

23. Premiums are capped, and also subsudized depending on need.

OK.
I get that.
Everybody will have access to Affordable Insurance.
But "Premiums" have absolutely nothing to do with the delivery of actual Health Care at the Hospital,
and YOU know THAT.
So WHY are you being so evasive here?

Will the holder of a mandated "Bronze Plan" bought on The Exchange in 2014 be liable for 40% of the delivered Health CARE cost as the links I posted above (and many more all over the Net) indicate?
Are the liabilities for delivered Health CARE capped for the holder of a Bronze Plan?
(Please show your work.)

[riderinthestorm]

24. Wow! Its a first - usually you are all about educating us about Obama's positions and policies

There must be a graph somewhere that lays this out. Income levels, deductibles, out of pocket expenses....

That's bvar's point and honestly I agree with her. Its impossible to find clear data on what this is going to cost.

Since you seemed very plugged in to this Admin, I'd be grateful for help in sorting this out. Clearly I'm stupid about this since I can't find it either. Happy to fess up my ignorance and receive some guidance.

[ProSense]

29. "Since you seemed very plugged in to this Admin, I'd be grateful for help in sorting this out. "

I'm "plugged in to this" thing called the Internet.

I sorted it out for myself. It's a good feeling. Try it.

[riderinthestorm]

32. Tried. Can't find it. So you won't help us out here with a table or graph?

Where this is clearly laid out?

[B2G]

34. There is no table. None exists.

The link he provided goes to a page with the entire bill and some not-so-helpful faqs.

Probably because they're making this bullshit up as they go along.

[riderinthestorm]

37. Well ProSense says I just have to "try harder" to find it.

So it must be out there but they are completely unwilling to provide it obviously.

That is NOT a good sign - especially from this poster.

[ProSense]

35. Try harder. n/t

[riderinthestorm]

40. Or you could just provide it? Why are you being so coy about THIS?

Obviously you know where the information is, the rest of us can't find it. Why not simply put it out there?

[ProSense]

45. I'm still

celebrating Obama's victory.

In fact, the ACA being the law of the land is kind of sweet!

[riderinthestorm]

48. Gee, you were all over THIS thread and many others today with LOTS of helpful links

http://www.democraticunderground.com/10021888725

And now you're suddenly unwilling to help DUers on this?

We really want to "celebrate" the "sweetness" of the ACA being the law of the land (but instead you are insinuating that everyone seeking details on this is spreading misinformation).

I've asked nicely and was genuinely curious to learn more.

Your sudden reticence is noted and not in a good way.

[NoOneMan]

57. Celebrating a political touchdown is more important than understanding it

I believe that was all part of a game in the first place to some people. A lot of people have ignored the consequences of out-of-pocket expenses in this debate.

[Safetykitten]

88. The pom-poms are at the cleaners.

Anyone that thinks that this is not a big run for the cash in the end by the insurance companies is delusional.

[ProSense]

101. Yeah, the

"Anyone that thinks that this is not a big run for the cash in the end by the insurance companies is delusional."

"big run for the cash" includes expanding Medicaid to more than 16 million people. What's "delusiona" is fighting the health care battle of 2009 all over again.

Republicans lost. The ACA is the law of the land. Anyone who thinks otherwise is "delusional."

As for the "pom-poms."

Law of the land...rah rah sis boom bah!

[morningfog]

81. THey don't know where the information is or it doesn't exist. I have never

seen ProSense not jump at the chance to cite a claim. Very telling, in more ways than one.

[ProSense]

100. "I have never seen ProSense not jump at the chance to cite a claim."

The information exists. There are signs of it throughout this thread, but if that statement is proof enough that it doesn't...enjoy.

[morningfog]

103. I found the answer, from a link you provided:

Actuarial Value, or AV, is calculated as the percentage of total average costs for covered benefits that a plan will cover. For example, if a plan has an AV of 70 percent, on average, a consumer would be responsible for 30 percent of the costs of all covered benefits.

Beginning in 2014, non-grandfathered health plans in the individual and small group markets must meet certain AVs, or metal levels: 60 percent for a bronze plan, 70 percent for a silver plan, 80 percent for a gold plan, and 90 percent for a platinum plan. In addition, issuers may offer catastrophic-only coverage with lower AV for eligible individuals. “Metal levels” will allow consumers to compare plans with similar levels of coverage, which along with consideration of premiums, provider participation, and other factors, would help the consumer make an informed decision.

Premium:

The amount that must be paid for your health insurance or plan. You and/or your employer usually pay it monthly, quarterly or yearly.

The OP thought the total "out of pocket" expenses were capped, but as you claim, only the premiums are capped. That may be so. But, the premium is only the amount paid for the health insurance plan. Under the Bronze plan, only 60 percent of the total average costs for benefits are covered. That means the amount paid for the plan is capped and that under that plan, the individual would have to cover the remaining 40 percent of all benefits.

[ProSense]

104. I provided no link, and

The OP thought the total "out of pocket" expenses were capped, but as you claim, only the premiums are capped. That may be so. But, the premium is only the amount paid for the health insurance plan. Under the Bronze plan, only 60 percent of the total average costs for benefits are covered. That means the amount paid for the plan is capped and that under that plan, the individual would have to cover the remaining 40 percent of all benefits.

T...this is pure nonsense.

[morningfog]

106. You provided a link upthread

THis one: http://www.healthcare.gov/

Maybe you forgot? How is that pure nonsense. Seriously, I don't understand where I am wrong.

[morningfog]

109. How is it nonsense?

Seriously. Repeating that doesn't make it so.

Under the Bronze plan, does the individual have to pay 40 percent of all benefits after purchasing the plan or not?

[Posteritatis]

36. "relatively low, $700 per month." Good lord. (nt)

[democrattotheend]

80. That's about a third of what my parents pay

They are self-employed and their insurance just for the two of them is over $2,000 a month just for the premiums. And then they still have copays and deductibles.

[Posteritatis]

96. And it's seventeen times what I pay. (nt)

[leftstreet]

20. We're fucked n/t

[Autumn]

27. Double fucked, six ways to Sunday if

that's true.

[ProSense]

30. "if that's true."

"If..."

[bvar22]

39. You know,

in my 11 plus years at DU, I have come to this general realization:

The first person to use in a discussion is not really laughing,
but has, in effect, made a public admission that they are no longer able to cogently defend their position,
and are desperately hoping that no one will be able to see through their pathetic and failed attempt to Save Face.

The only exception to the generalization is in the Humor Forum.

[B2G]

43. + 100000000000000000

[ProSense]

47. You're right

"The first person to use in a discussion is not really laughing, but has, in effect, made a public admission that they are no longer able to cogently defend their position."

The OP is spot on. You should keep pushing it and believing it. Who knows, maybe a bunch of people will believe it too. That would be really cool.

[bahrbearian]

49. LOL

[rudycantfail]

72. That would be such a compelling rebuttal

if you had just added a few Come on ProSense! Maximize your argument.

[CrawlingChaos]

116. + 10000000000

[Autumn]

58. Some words are funny aren't they

I have occasionally had the same reaction to some of your words.

[bvar22]

33. Thats exactly where I'm at...

[font size=4]If THAT is TRUE![/font]
I don't want to believe it,
but so far, nobody has provided any credible, sourced information to disprove it,
not even a [font color=blue]Blue Link[/font].

I was stunned myself when I Googled for information pertaining to the benefits for a "Bronze Plan" on The Exchange
since that will be the one I will be mandated to buy in 2014.
I really believed that Health CARE costs were capped at a percentage of income.
60% of Hospital Costs will be less than useless to me.

I am praying for the post that provides credible contradiction to this information.
That is why I put question mark on the title line.

[ProSense]

38. There will be

"not even a Blue Link. "

...no "blue link" coming.

"I am praying for the post that provides credible contradiction to this information. "

I guess you're going to have to keep believing this and selling it as fact. One day you'll likely stumble upon the details, either that or 2014 will roll around. Keep "praying."

[bvar22]

42. ...so you ARE unable to post ANY credible and sourced information...

...that disproves or contradicts the information provided in the OP.

Thanks for sharing.

[ProSense]

46. Unwilling.

Beyond what I've already said: premiums are capped.

[leftstreet]

51. Wow...so you're proving bvar is correct

You usually can't WAIT to post a wall of links to obfuscate and bait/switch a topic

My, my.

[morningfog]

82. Very interesting.

[99Forever]

53. Yep.

That about covers it.


The denial is strong in that one.

[ProSense]

54. "The denial is strong in that one."

Funny thing, you have no idea about the facts and dare to use the word "denial."

This:



...is really lmao!

Believe it!

[bvar22]

61. Working Class people,

struggling for years with declining wages and Outsourcing of "Free Trade" jobs,
whittling down the budget every month just to make ends meet,
praying that nothing happens and the car doesn't break down,
trying to find and extra job,
getting dumped on by Republican & Democratic Administrations looking out for their large Single Source contributors,
asking questions,
struggling to understand these new obligations and the extent of these new liabilities
that can make the difference between being able to afford food for another month,
or going Bankrupt...

and YOU, ProSense, Rolling on the Floor laughing at us.....
probably in your gated community..
aloof and above these petty concerns of the Peasant Class....

I can believe that.

[ProSense]

70. How utterly

and YOU, ProSense, Rolling on the Floor laughing at us.....
probably in your gated community..
aloof and above these petty concerns of the Peasant Class....

I can believe that.

...absurd. I guess it's better to invent reality than to deal with facts, huh?

I'm laughing at you and I not in a "gated community."

Ludicrous.

[99Forever]

64. Then educate us.

'Cuz so far, all you've done is bluster and juke dance.


So, if you have any ethics at all, simply supply the information Bvar asked you for politely, or just admit you don't have it.

[ProSense]

71. "Educate us"?

Why are you uneducated? Not smart enough to sort through the information on your own?

"'Cuz so far, all you've done is bluster and juke dance. So, if you have any ethics at all, simply supply the information Bvar asked you for politely, or just admit you don't have it."

You can't be serious? Smug and ill-informed, and demanding information?

[99Forever]

79. Reminds me of an especially..

... ignorant rightie who played this same game every time he got outed for lying. Ya got nothing? Say, "Google it."


Sucks to get outed, eh "pro?"

[ToxMarz]

65. Believe it!

This



.... It's actually ROFL!

[SoCalDem]

44. There will undoubtedly be "gap" coverage plans that will spring up.

and since those would only be "covering" the UNINSURED (lower percentage), they may actually be reasonably priced.

It sucks that the whole thing was made complex, when it could have been easy, but that's where we are for now..

the really unfortunate thing is that over the decades, "normal" office visits to the doctor have become unaffordable, and every one seems to be just a precursor to multiple MORE visits for labs, other specialists etc.


After switching to Kaiser ( ) it took THREE office visits to finally get a check up with an opthalmologist for my chronic eye disease.

I am checking off the days until I turn 65, so I can switch back to the doctor I had for a decade...

[Small Accumulates]

52. Here's an apparently thorough exploration from U.S. News and World Report

Here's a more thorough explanation:
http://money.usnews.com/money/blogs/the-best-life/2012/07/27/how-new-health-insurance-subsidies-will-work

It says:

To also qualify for out-of-pocket supports, individuals and families with incomes up to 250 percent of the FPL must buy a silver plan in their state exchange. If they do so, the very lowest-income group would pay only 6 percent of its out-of-pocket expenses and the supports would cover the remaining 94 percent. At the upper end of this scale, a family earning 250 percent of the FPL would pay up to 27 percent of its out-of-pocket expenses and the supports would cover the remaining 73 percent.

The FPL is the Federal Poverty Level. More from the article:

In 2012, the FPL is $11,170 for a one-person household and rises by $3,960 for each additional family member. For a four-person family, for example, the 2012 FPL is $23,050. It increases each year due to inflation so will be a bit higher in 2014.

Edited to say: I found this reference from Kaiser for out of pocket caps: [blockquotehttp://www.kff.org/healthreform/upload/8303.pdf]

It says out of pocket caps for 2014 are projected to be $6,350 for an individual, and something over $11,000 for a family. I'm under the impression that is an annual cap.

[hrmjustin]

55. Welcome to DU!

[Small Accumulates]

56. Thanks! n/t

[The Straight Story]

59. This may be of some assistance

when doing a google search add .gov at the end
Brings back only gov doc sources

Just started browsing through them myself (and am doing a few others things at the moment) and if I find more data for you will reply back.

http://www.google.com/#q=aca+bronze+plan+site .gov&hl=en&safe=off&tbo=d&ei=Pk61UKvGKOSz0QGVqYHIAQ&start=0&sa=N&bav=on.2,or.r_gc.r_pw.r_cp.r_qf.&fp=2569ab66937cfc8&bpcl=38897761&biw=1888&bih=876

[woo me with science]

60. Reccing not only for critical info about the ongoing screwing of the masses through faux "reform,"

but also to highlight the behavior in this thread when questions are asked about it. This is *exactly* why Americans are angry as hell.

Our politicians and their mouthpieces/enablers/apologists not only don't represent Americans anymore; they treat Americans with utter contempt.

[Safetykitten]

86. Agree

[green for victory]

93. nailed

woo me with science:

"Our politicians and their mouthpieces/enablers/apologists not only don't represent Americans anymore; they treat Americans with utter contempt."

There's not a single doubt in my mind that every single Democrat that supports this mandated insurance payment to mega corporations brought to us by the likes of raucous Baucus would have supported the exact same thing if it was rammed through congress by a Republican.

Not a single doubt.

Heh

Baucus’s Raucous Caucus: Doctors, Nurses and Activists Arrested Again for Protesting Exclusion of Single-Payer Advocates at Senate Hearing on Healthcare
http://www.democracynow.org/2009/5/13/baucus_raucus_caucus_doctors_nurses_and

[WorseBeforeBetter]

94. Mmm, Eddie.

And how refreshing to see Howard Zinn... he is missed.

Welcome to DU, GFV.

[The Straight Story]

63. Some of what I have been reading (see earlier post ^^^ above)

The exchanges and other things will come into play to help you cover those out of pocket expenses.

Some info (NY take on it) here:

http://a069-webapps7.nyc.gov/healthinslink/reform_ind.aspx

And more info through here:

http://tinyurl.com/d9gcxhq

[Politicub]

67. Because insurance holders will take advantage of vastly discounted rates

It's not 40 percent of list cost.

[Politicub]

69. And you won't pay a dime for preventative care. America is going to become

healthier because of this innovation.

[WorseBeforeBetter]

83. Considering my monthly premium would be about $350 (after the tax credit)...

they better throw in a *free* pap smear.

[Politicub]

107. I'm not sure if you have access to care today, but this law will

give millions access to insurance who aren't able to get it today.

That's a big deal. And to be as dismissive as you and others are is mind boggling to me.

[WorseBeforeBetter]

108. Access to "insurance" and access to "health care" are...

two entirely different beasts.

Unboggle your mind.

[Politicub]

110. To paraphrase Dolly Parton: Do climb off your cross

someone needs the wood.

If you don't see the good that Obamacare will bring then there's nothing I can say to change your mind.

Why do you even bother posting if all you do is complain?

That's not holding anyone's feet to the fire. It's just tiresome whining. Blah blah blah blah blah.

[WorseBeforeBetter]

111. Wow, you told me.

No denial due to pre-existing conditions = good.

But Bronze plan deductibles in the $3,000 - $4,000 range are not something to cheer. Nor is the lack of cost-sharing subsidies at that level. But by all means, knock yourself out.

Happy?

[Politicub]

114. We all want universal healthcare at the end of the day

I apologize for being a jerk.

I'm optimistic about the possibility for achieving universal health care one day but its going to be a struggle. A worthwhile one.

[WorseBeforeBetter]

129. Wow.

An apology on DU... I'm somewhat stunned. I've had enough for one day and am heading out to the fire pit with some yummy hard cider. I'll toast to both our wishes for universal health care, and the acknowledgment that it will be struggle. I'm not as optimistic, though, but we'll see...

Have a good evening!

[Politicub]

130. Enjoy the cider!

Sounds delicious.

[WorseBeforeBetter]

74. Bronze 1 & 2 single coverage deductibles = $4,375 - $3,475

Single Coverage (Deductibles and out-of-pocket limits would be double these amounts for families)

Tier          Actuarial Value   Deductible   Patient Coinsurance   Out-of-Pocket Cost-sharing Limit
Bronze 1    60%                   $4,375            20%                           $6,350
Bronze 2    60%                   $3,475            40%                           $6,350
Silver 1     70%                    $2,050            20%             &nbsp&nbsp&nbsp&nbsp         $6,350
Silver 2     70%                    $650               40%                      &nbsp&nbsp&nbsp&nbsp$6,350


Actuarial value = the percentage of covered heath care costs expected to be paid by the plan for a broad population.

Non-group and small group markets must have an actuarial value of:

-- 60 percent (bronze plans)
-- 70 percent (silver plans)
-- 80 percent (gold plans)
-- 90 percent (platinum plans)

"A bronze plan on average would pay for 60 percent of the costs for covered benefits and enrollees on average would pay the remaining 40 percent through cost-sharing such as deductibles, copayments and coinsurance.

Silver plans are likely to be the most common level of coverage because premium tax credits are based on silver plan premiums and only people enrolled in silver plans will be eligible for cost-sharing subsidies.

This means that for most services covered by the plan under these designs, the patient would pay all of the cost until the deductible is reached, and either 20 percent or 40 percent (depending on the option) of any additional costs until total patient cost-sharing reaches the out-of-pocket limit.

However, the minimum coverage people will be required to buy starting in 2014 will have much higher cost-sharing than typical employer-based coverage and than the average purchased now in the non-group market. With standard 20 percent coinsurance, a bronze plan would have an estimated deductible of $4,375 for a single individual and double that for a family. This compares with an average single deductible of $2,498 in 2010 in the non-group market and an average of $675 in employer-sponsored PPO plans with deductibles in 2011. Deductibles in employer plans paired with tax-preferred savings accounts averaged $1,908 in 2011.

People will have the option of buying more generous coverage than the minimum required, and lower-income enrollees will be eligible for cost-sharing subsidies that decrease their out-of-pocket costs. But, some may still find themselves with insurance that requires substantial cost-sharing. Policymakers will face the challenge over time of finding the right balance between the minimum level of insurance people should be required to have and providing an appropriate level of protection."

http://www.kff.org/healthreform/upload/8303.pdf

.........

Clear as mud. And none of the above even factors in the cost of buying the insurance. LOL

[Skip Intro]

77. ^ Important Post ^

If you live paycheck to paycheck and were counting on Obamacare to give you real access to good healthcare, you're evidently in for a rude awakening.

[WorseBeforeBetter]

78. Yeah, I just played around with the calculator.

http://healthreform.kff.org/subsidycalculator.aspx

It's insanity. Many may just say "fuck it" and pay the damn penalty.

[Safetykitten]

85. Oh dear, the truthiness is starting to come out!

Oh my, what is the party line now on the heathcare thingy as it's nightmarish crawl from the insurance pool begins? How do we tell people that this is the best thing since sliced bread? How long can we keep this clusterfuck a secret?

Well not for long now apparently. Things to ponder as our new fuckeded up system of insurance serfdom comes lurching towards us:

What about people stuck in dead end jobs that would like to go to another company but hesitate to because having dismal insurance is better than no insurance.

What are the time frames of people that quit their job and then want to purchase insurance?

Why are companies now limiting part-timers to 28 hours a week only?

What is the waiting period for having Cobra then getting on the new exchange?

Will companies do the math and then abandon all healthcare to employees?

Why are there three classes, and why do people pay so much that have so little?

What surprises do the insurance companies have in the future, because we all know they know how to game the system that they wrote the rules for?

Stay tuned kiddies for a future of it really not making a difference and it would of been better if nothing had been done.

[WorseBeforeBetter]

87. It's a big fucking gamble...

exactly what health care SHOULD NOT be.

[Safetykitten]

90. People are expendable. See other thread on over age 50 unemployable myth.

You see, the old people get weeded out. They are off the rollls, so no problem. Same as healthcare, they die. New pool of money.

[woo me with science]

97. That about sums it up.

No lie, no exaggeration, which is why the Third Way should be considered no less dangerous and malignant than a cancer in our party.

[WorseBeforeBetter]

99. And Republican-controlled North Carolina wants to reduce unemployment benefits...

Last edited Wed Nov 28, 2012, 09:54 PM - Edit history (1)

to a maximum of $350/week for 20 weeks. Forget that we still have one of the worst unemployment rates in the nation. A 50+ neighbor of mine was laid off in the private sector and finally found work -- at a soul-sapping Apple call center. It employs many young people who think $9/hr is a big deal, and many older employees who are just trying to hang on at that shitty wage with no benefits.

NC legislators nearing unemployment debt proposal
http://www.newsobserver.com/2012/11/18/2492314/nc-legislators-nearing-unemployment.html

"The study by the N.C. Chamber, which has been involved in the legislative proposal, recommended capping weekly benefits at $350 for future unemployed workers and reducing the maximum number of benefit weeks to 20. The maximum weekly benefit amount in North Carolina is currently $535. South Carolina, Virginia and Georgia range between $300 and $400. North Carolina's portion of unemployment benefits is capped at 26 weeks."

It's a vicious circle that no one seems to know how to stop. Or is willing to stop.

[woo me with science]

91. Have we had enough yet, America? nt

[Skip Intro]

76. What? You mean the magic beans aren't really magic? nt

[limpyhobbler]

84. I hate all this stuff there should just be one awesome health care for all

People don't have time to study a bunch of different plans.

I don't even know if I get a job am I legally required to buy the plan if I can't afford it.

Fuck all this shit. Medicare for all now.

[Safetykitten]

92. We are seeing the fruits of this nightmare right now.

Being one of the unemployed age 50 crowd, I have some friends in this booming economy that have obtained barely scraping by jobs. One is at a large corporate call center. The part-timers are desperate for hours and could get extra hours if needed. Yesterday they were sent a decree that no person will be allowed to work more than 28 hours. EVER.

Sooooo....we now have the most vulnerable of workers that need hours not getting them. Why?

Getting ready for that HC stuff.

[davidn3600]

95. It is what it is...

Dems didn't pass a single payer. They passed this hybrid thing that still keeps the insurance companies in control.

It's ironic because most of Obamacare is actually based on previous Republican ideas that they shelved.

The main goal of Obamacare appears to be to get everyone covered in some way and eliminate pre-existing conditions. The theory is that because of that, doctors and hospitals won't have to overcharge insurance in order to make up for people who don't have insurance. But really we are talking about only very mild relief on healthcare costs in this way for the vast majority of us. Obamacare does not really address the problem in this country concerning rising costs.

[KoKo]

98. Good Point there...and the confusion will take time to sort out so we may

not know how to fix the inequities for a long time. Meanwhile the transition will be stressful for people trying to navigate through the new system.

[kestrel91316]

102. IF there are still significant numbers of medical bankruptcies

under the ACA when it's fully implemented, that will be a huge driving force for Single Payer. People will see that ACA is merely a tool for mandated enrichment of insurance companies.

And if there aren't, then ACA will prove to be a good thing.

I don't have a clue what's going to happen. I suspect the former, and am prepared to keep on fighting for true universal health care where insurance companies are not even part of the picture and medical bankruptcies simply don't occur. If that means we have to stop keeping the walking dead (ie Dick Cheney and his ilk) up and running by rationing care for terminal cases, so be it.

[mercuryblues]

105. maybe this site will help

http://101.communitycatalyst.org/aca_provisions/subsidies




Income Premium Limit


Up to 133% FPL 2% of income

133 - 150% FPL 3 - 4% of income

150 - 200% FPL 4 - 6.3% of income

200 - 250% FPL 6.3 - 8.05% of income

250 - 300% FPL 8.05 - 9.5% of income

or this one:

http://www.cbpp.org/cms/index.cfm?fa=view&id=3190




350 - 400% FPL 9.5% of income

[bvar22]

112. That covers "Premiums" paid to the Insurance Companies for the mandated policies on The Exchange.

It does not cover the additional costs of the actual Health Care at the point of delivery.
THAT is going to be over & above the cost of the "insurance".
If the sources cited by the OP are true,
THAT cost can be as much as 40% of the total Hospital Bill for the mandated "Bronze" Policy bought on The Exchange in 2014.

Some people in this thread have posted sources that indicate that additional help will be available to those people hit with a 40% Bill from the hospital,
but the sources are vague and confusing about exactly WHAT additional help will be available,
and at WHAT additional costs.

None have provided specific sources clearly stating that the additional costs of the actual Health CARE will be capped at a percentage of income.

Health Insurance =/= Health Care
THAT costs extra.

[mercuryblues]

115. you're right

the whole plan must go because being hit with a 40% hospital bill as opposed to a 100% bill is not good enough for some people. The thing is' people go to the ER for emergencies. IOW they will go even if they didn't have insurance, so that ER visit for a broken leg will happen regardless. The thing that changes is how much an individual will pay out of pocket, because they now have insurance coverage. Welcome to the world of insurance coverage.

Free preventative care.Your deductables are based on your income and plan you chose.

Whatever plan a person choses, the provider will have a contracted rate for services received from the provider. No where have I ever read that the rate a person is charged for services depends on their income.

[bvar22]

117. That won't make any difference to those barely hanging on.

To someone with NO extra money, who is already cuttin corners on food and other necessities, being liable for 40% of a multi-thousand dollar hospital bill is exactly the same as being liable for 100% of it.
It means Medical Bankruptcy and they lose EVERYTHING either way,
only NOW they will have the comfort of having forked over $200+ a month to a RICH For Profit Corporation for something entirely worthless to them.

Why is it so HARD for you to understand that?

This guy explained it pretty well before the election:

Medical Bankruptcy is a term UNKNOWN in civilized countries.

[mercuryblues]

127. Again, you're right

So we should scrap what we have available now because it isn't perfect. Then maybe in another 30 years or so we will have a single payer system dangled in front of us again.

Another good thing about having insurance: My provider has contracted rates with hospitals for services. People who are not insured do not have that advantage. Say a cat scan costs $1000.00. My insurer has a contracted rate for that service of $400.00.
They pay 80%, I am only responsible for $80.00. If you don't have insurance you are responsible for the entire $1000.00. Which bill would you rather be responsible for?

You seem to be forgeting that a several thousand dollar bill is in essence a fraction of what the charges actually started as. Two hundred a month is $2,400 a year. If a person needs services at a hospital and still winds up with a multi-thousand dollar bill, chances are that the real cost was upwards of $7,000. In this scenerio there was no profit made, they lost money. But the portion an individual owes is significantly less than what they would owe without insurance. Does that make you feel better?

One bill will most likely send send someone into medical bankruptcy, where another has a lower chance of that happening. If a person's income is low they should be applying for medicaid.

[OneTenthofOnePercent]

113. I don't see how anyone can be happy for people who can't afford decent insurance

to think that forcing those same poor people to buy substandard "cheap/subsidized" insurance is somehow a victory. Health Insurance does not equate to health care, people. The only way health insurance results in healthcare is if you can afford to USE the insurance. Just buying the insurance is step one. What hope do people that can barely cover the cost of shitty insurance premiums have at affording deductibles and out-of-pocket expenses?!? Even mildly-serious healthcare financially cripples middle class people who don't have money problems.

This mandate and insurance exchange is bullshit. Our politicians sought to give all Americans healthcare from the the start and pulled a bait-and-switch... and they were cheered on while doing it.

[ProSense]

118. Out-of-pocket caps will help put the brakes on higher health plan costs

Out-of-pocket caps will help put the brakes on higher health plan costs
http://www.democraticunderground.com/10021897434

"PLEASE tell me I am wrong"

You're wrong, and so are a lot of other people. The information is out there and easy to find, but I suspect some people just believe what they want to believe.

[bvar22]

119. If this information is correct,

then I Thank You.
I found some of it to be reassuring.

It is exactly WHAT I and others in this thread have asked for.
I disagree that it is easy to find, and the details are vague, but 2014 is still a ways off, and that can be filled in.

Why did you have to act like such a prissy little ass upthread instead of answering this simple question with your "easy to find" information?

[ProSense]

120. It's easy to find, and

"Why did you have to act like such a prissy little ass upthread instead of answering this simple question with your "easy to find" information? "

...you continue to act like a smug "little ass."

[bvar22]

121. If it is so easy to find,

....why did it take you so long?

When you can't be creative... Imitate someone else!
Imitation IS the sincerest form of flattery.
Thank You,
but STOP it please.
You're making me blush.

[ProSense]

122. Oh, it was

extremely easy to find.

Why would I want to get in the way of people being smug and making fools of themselves?

"Blue links!!!"

[leftstreet]

123. That only applies to Exchange offerings

If your state opts out, you're fucked

[ProSense]

124. Know the law:

"That only applies to Exchange offerings...If your state opts out, you're fucked "

If your state opts out, the federal government sets up the exchange.

Seriously: http://www.healthcare.gov/

[leftstreet]

125. ...and where are the fed cost caps?

[ProSense]

126. You clearly have no idea what you're talking about. n/t

[stuckinodi]

128. What If...

you have no income?

lI live in Ohio. Kasich will not take expanded Medicaid. I can't get any info because all the calculators put me on Medicaid, which I can't get.

[PoliticAverse]

131. Unfortunately the ACA was written assuming you'd be covered by Medicaid. If a state doesn't opt in

to the expanded Medicaid program for people with incomes up to 133% of the Federal Poverty Level
those people (who don't already have Medicaid now) won't have health coverage under the ACA.

[Egalitarian Thug]

132. Gee, if only someone had, what do you call it, predicted this way back then.

Fool me once, shame on you. Fool me twice, shame on me. Fool me 42 times and I'm still playing the game means I'm too stupid to call myself Homo sapiens (thinking man).

[HiPointDem]

135. this health care plan is such a hodge-podge, no doubt because of horse-dealing in its passage.