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Journeyman

(15,001 posts)
Thu Dec 19, 2013, 01:33 PM Dec 2013

My wife and I were triply-screwed by health care insurance . . .

We’re older Americans, late 50s, so before the ACA took effect, we were at that stage when insurance companies saw us as a bad risk -- too old to expect we’d just pay premiums without incurring costs, too young to be shuffled off onto Medicare should we get sick.

And we have pre-existing conditions. In my wife’s case, it’s a reality; in mine, non-existent. My wife has RA, so insurance sees her as a drain on profit. For myself, a false positive on an in-office prick test for diabetes consigned me to seven years of ever-increasing premiums. No other test ever showed me to have even a “pre-diabetic” condition (in fact, every test showed the opposite), yet my insurance company insisted I’m diabetic. And my attorney (my brother) told me there was little hope of ever convincing them otherwise, since they could use it to justify increasing my premiums without fear they’d have to payout.

And our third strike? We chose to pursue an American dream: We started our own business twenty-some years ago.

Because we were not in some arbitrary corporation’s risk pool, we were charged more for insurance. So on top of the other acts which should be criminal, add that insurance companies subjectively classified people based on nothing more concrete than the size of the check cut for the group’s coverage. And those not covered by a relatively large check got charged on average an exorbitantly larger amount. Considerably more than was justified to cover administrative processing costs. Certainly, “economy of scale” dictated lesser rates for greater numbers, and the threat of moving a large account brought extraordinary concessions, but does any of that morally justify charging multiple-times-over to those less connected?

In the 20 years since we chose this independent path, our insurance premiums rose each year by 7 to 40%, depending on the level of criminal greed rampant within our insurance carrier that year. Uncontested, our 2014 premium was set to rise to $2,884 a month in January. It was an unsustainable burden that presented us with an intractable choice: pay the ransom to receive the medical security we need and save little for retirement, or opt for lesser coverage that may likely leave us physically incapable of enjoying whatever retirement we may find.

Given the shortcomings and latent criminality of all for-profit medical insurance, ours was a good policy; not great, but passable. We chose our own doctors (important for my wife), and enjoyed some amenities. It came with a high deductible, however, and no guarantee we wouldn’t lose it should we have need to use it. In short, it was something we needed to keep but in truth couldn’t see how.

That was our condition -- our medical insurance condition -- on September 30.

[center]• • •[/center]
It was our good fortune to be Californian when the ACA rolled out. The Covered California website was flawless. We accessed it at our leisure, debated the merits of each plan offered, and were able to sign up with little trouble. All told, it took about two hours on the web, less time than I’ve ever spent negotiating for insurance of any sort.

The insurance policy we selected is every bit as good as the one we had before. We can continue to use every doctor we presently have, our selection of hospitals includes all those from before plus some more (including the finest hospital in the region), our deductible is no greater and there’s no cap on payments. And best of all, should I ever use it I won’t lose it, and the limits protect me from some forms of bankruptcy.

The cost? $1,181 a month for the both of us. A 60% savings over our cost on the “free market.”

[center]• • •[/center]
I can’t remember when we knew health care reform was one of the most critical issues facing the nation. Undoubtedly, the relentless litany of horror stories of those caught without insurance, or forced into bankruptcy despite having it, deeply influenced our belief. On a personal level, we saw the potential for disaster the time I changed jobs and only a fluke saved me from being without insurance when an unexpected hospitalization almost wiped us out right when our first child was born. And our attitude definitely solidified after the birth of that child, when our insurance carrier denied her needed surgery because a congenital defect was deemed a “preexisting condition.”

So we knew the transformation of healthcare had to be fundamental. The problems were endemic to the for-profit, corporate model of health care insurance, and the only viable solution in our opinion was to dismantle the entire rotten structure. Decisions about health care -- indeed, the very idea of health care -- have to be wrested from corporate bean counters and stock option influence and invested instead in the very people who depend on this timely care -- care too often denied them for lack of money or so faceless investors can make another dime.

We wanted single payer. We wanted universal coverage. And we had been agitating for it since well before Barack Obama entered the national scene. So when he took up the cause, we supported him in every way we could.

We didn’t get what we wanted. But then, we never expected it. After all that’s transpired, we find it best for our health to content ourselves with the belief it was enough for the process to move forward. Necessary, but incremental changes have been made, changes that may one day lead to the type of care this nation requires. I believe it will be in place by the time my grandchildren enter their majority. Which is good, as two of them are with us today.
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My wife and I were triply-screwed by health care insurance . . . (Original Post) Journeyman Dec 2013 OP
Kick! hedgehog Dec 2013 #1
k&r for exposure. n/t Laelth Dec 2013 #2
Excellent post, Journeyman. brer cat Dec 2013 #3
My spouse & I have a somewhat similar experience: snot Dec 2013 #4
Good for you and Mrs. Journeyman! WinkyDink Dec 2013 #5
Kick for the Small Business Owner in my life. Tuesday Afternoon Dec 2013 #6
Who can afford $1,181 per month for insurance (plus deductible)????????? antigop Dec 2013 #7
It's a question I've asked myself 2-1/2 times over each month for the past 20 years. . . Journeyman Dec 2013 #8
Someone making 10-15,000 a month? zeemike Dec 2013 #21
Which is why Obamacare provides massive tax-credits for the working poor... ConservativeDemocrat Dec 2013 #30
And who does that massive tax credits go to? zeemike Dec 2013 #33
So you reserve the right to criticize something you don't understand? riqster Dec 2013 #38
I understand what it is like to be poor. zeemike Dec 2013 #40
Read post #9. The ACA is HELPING a lot of people. brush Dec 2013 #43
Can you support your claim that Health Insurance is not making as much as they used to? bvar22 Dec 2013 #60
I understand being poor, too. Having been homeless at one time did that trick. riqster Dec 2013 #47
wait--I'm in a GOP controlled Medicaid-expansion-denying state zazen Dec 2013 #51
Indeed. We need to take back the House and Senate. riqster Dec 2013 #53
What false message am I spreading? zeemike Dec 2013 #52
Your message is "the ACA helps the insurance companies and not the rest of us". riqster Dec 2013 #54
And what partial truth is in that? zeemike Dec 2013 #55
It helps the insurance companies, but not ONLY them. riqster Dec 2013 #57
Well hell that is true for everything. zeemike Dec 2013 #58
Letting the Repubes off the hook and only criticizing the Prexy is the issue. riqster Dec 2013 #59
Pointing out the flaws in the plan is not letting the Repugs off the hook zeemike Dec 2013 #62
I'd say that bashing the Dems and ignoring the actions of the Repubes... riqster Dec 2013 #64
Bill MOyers is spreading falsehoods too, according to some here. bvar22 Dec 2013 #61
I guess because third way is the official way now. zeemike Dec 2013 #63
Well, ya'll just keep holding your breath until you turn blue... ConservativeDemocrat Dec 2013 #67
The people I hate are mad. zeemike Dec 2013 #68
Do you hate President Obama? ConservativeDemocrat Dec 2013 #73
Is the president mad?...is that what you are saying? zeemike Dec 2013 #74
Your situation sounds a lot like mine. Cracklin Charlie Dec 2013 #9
k & r thanks for posting..... nt Stuart G Dec 2013 #10
I won't even start to say what the infernal 'free market' health insurance con did to my family... freshwest Dec 2013 #11
$1,200/month + copays + deductibles is STILL extortion. bvar22 Dec 2013 #12
Couldn't agree with you more. It's criminal. . . Journeyman Dec 2013 #13
^^^This^^^ bvar22 Dec 2013 #36
EXACTLY. nt antigop Dec 2013 #14
older people making over 400% FPL really get nailed. I've mentioned this numerous times. antigop Dec 2013 #15
If you make ONE PENNY under the 400% FPL you get NO SUBSIDY as well whopis01 Dec 2013 #27
I got beaten up over this a few weeks ago. My wife and I make a hair over the $72K cutoff Flatulo Dec 2013 #49
well, you just need to reduce your income below 400%FPL. antigop Dec 2013 #56
You might have to settle for a bronze or silver plan. subterranean Dec 2013 #65
If you don't qualify for a subsidy, cynzke Dec 2013 #70
I think you need to look again YBR31 Dec 2013 #75
No Subsidy... cynzke Dec 2013 #69
+1 Legal extortion. progressoid Dec 2013 #18
...but it IS a kinder, gentler extortion now that the Democrats are doing it! bvar22 Dec 2013 #26
Well said....n/t zeemike Dec 2013 #34
Pure profits, for some anyway ... slipslidingaway Dec 2013 #42
lol ctsnowman Dec 2013 #28
THANK YOU Skittles Dec 2013 #41
It's about the greater good brush Dec 2013 #44
True, ProSense Dec 2013 #46
I like the part of the criminal empire where I live! Larry Ogg Dec 2013 #48
Especially when you consider in a country like the UK OwnedByCats Dec 2013 #50
Should sign the "waiting list" to get on fox-nonsense to share your horror story... Hulk Dec 2013 #16
+1. It is important to remember that the perfect is the enemy of the good. eggplant Dec 2013 #17
K&R. (nt) Kurovski Dec 2013 #19
A+ peace13 Dec 2013 #20
Makes me wish like hell our Dems would start pushing memes and framings about the GOP - like calimary Dec 2013 #22
Have you ever asked yourself WHY the Democrats refuse to do what you suggest? bvar22 Dec 2013 #37
I am glad for you, but the ACA is not an incremental step forward toward health care Doctor_J Dec 2013 #23
1200 a month is still a grand theft. It's better than before but that doesn't mean it's good. Gravitycollapse Dec 2013 #24
As I pointed out upthread, I'm just some schlub from the Southland, trying to get by . . . Journeyman Dec 2013 #25
My work plan goes from an 90 10 ctsnowman Dec 2013 #29
Thanks for sharing. pnwmom Dec 2013 #31
One of my relatives is supposed to be an ACA loser. pnwmom Dec 2013 #32
It's strange that right-wing talk hosts claim their coverage is much more expensive ... JEFF9K Dec 2013 #35
amazing post. Thank you KentuckyWoman Dec 2013 #39
That, ProSense Dec 2013 #45
legalized, government-sanctioned theft cvoogt Dec 2013 #66
Need to have public option Rosa Luxemburg Dec 2013 #78
K & R Scurrilous Dec 2013 #71
great post with great information. JanT Dec 2013 #72
Today's NYT reports on ACA... far less glowingly. proverbialwisdom Dec 2013 #76
thank you...exactly what some of us have said....older people get nailed...and antigop Dec 2013 #77
Single payer system is the only way to go gerogie2 Dec 2013 #79

snot

(10,478 posts)
4. My spouse & I have a somewhat similar experience:
Thu Dec 19, 2013, 01:54 PM
Dec 2013

We're getting a better policy for substantially less, even in one of the most uncooperative states.

Journeyman

(15,001 posts)
8. It's a question I've asked myself 2-1/2 times over each month for the past 20 years. . .
Thu Dec 19, 2013, 02:17 PM
Dec 2013

The system is unsustainable. This helps, but I agree with you antigop.

zeemike

(18,998 posts)
21. Someone making 10-15,000 a month?
Thu Dec 19, 2013, 04:35 PM
Dec 2013

Which leaves out most people who work for wages...which is also the ones that need health care the most.

ConservativeDemocrat

(2,720 posts)
30. Which is why Obamacare provides massive tax-credits for the working poor...
Thu Dec 19, 2013, 07:39 PM
Dec 2013

...based on your income level. Now as for he writer of this OP, it's clear that is gainfully employed and it sounds like he makes quite a good bit of money. So it makes sense that he is paying this kind of price.

And still, he's saving money anyway.

Please get yourself educated about the law before you criticize it.

- C.D. Proud Member of the Reality Based Community

zeemike

(18,998 posts)
33. And who does that massive tax credits go to?
Thu Dec 19, 2013, 07:57 PM
Dec 2013

The private insurance company...not for health care.
When the simple solution would be to provide that money to Medicare and let people sign up for that instead, and pay at least 20% less for it....because there is profit to be made from this massive tax subsidy.
But even with the subsidy people working for minimum wage cannot afford it...but must buy it or pay the fine...for them it is a burden...and one that will get greater as prices go up and wages go down or remain the same.
And I reserve the right to criticize it whenever I like...whether I have read the thousands of pages of this law or not.

zeemike

(18,998 posts)
40. I understand what it is like to be poor.
Fri Dec 20, 2013, 12:04 AM
Dec 2013

And to go from paycheck to pay check and run out of money before the next one.
And I understand that these people will have to buy it or pay a fine.
And I understand that insurance companies will benefit from it.
And I understand that they will make billions from it and provide nothing in return for the money they make.
Is that enough?

*Sigh*

brush

(53,467 posts)
43. Read post #9. The ACA is HELPING a lot of people.
Fri Dec 20, 2013, 03:14 AM
Dec 2013

The insurance companies still make money, but not nearly as much as when they were robbing people blind just because there was no competition and they could. Now on the ACA and state exchanges they have to compete against each other for business, and like I said, they still make money but they can't gouge people like before the ACA was passed.

It's a good thing, sorta like how capitalism, since we're not going to get rid of it, should be regulated and businesses can make money and their customers don't get taken.

Kinda lessens the chances of one percenters being create, which is a good thing because income equality the way it is can't continue without something blowing the hell up.

bvar22

(39,909 posts)
60. Can you support your claim that Health Insurance is not making as much as they used to?
Fri Dec 20, 2013, 01:15 PM
Dec 2013

The Insurance Industry is doing better than ever.
They will soon be sucking up $BILLIONS$ in tax payer funded subsidies every year,
and with mandated "customers" and a guaranteed 20% Rake Off, they are going to be cruising at the heights of their
incestuous 1st Cousin,...Wall Street.

We will have to wait and see exactly how big a pile they will be "making" (making in quotes because this worthless industry doesn't really "make" anything) since it will take a couple of years to see how it plays out.
The Smart Money believes that the Health Insurance Industry is going to "make" a pile.

riqster

(13,986 posts)
47. I understand being poor, too. Having been homeless at one time did that trick.
Fri Dec 20, 2013, 07:07 AM
Dec 2013

But that doesn't address the core issue here: in your self-admittedly willful ignorance, you are spreading false propaganda about the ACA. By focusing on one negative aspect and ignoring the rest, you are spreading a false message about the ACA.

Ya know who else does that, right?

zazen

(2,978 posts)
51. wait--I'm in a GOP controlled Medicaid-expansion-denying state
Fri Dec 20, 2013, 10:30 AM
Dec 2013

So the changes afoot are not helping those of us who fall into this category. Not yet, anyway.

The Republicans in this state have gamed it so the more affordable BCBS healthcare coverage for people who fell into this gap _before_ ACA went into effect is no longer an option. We also don't have a full exchange--I think just two main insurers, who aren't incentivized to keep costs down. So they've set up ACA to appear to be the instigator of harm of 450,000 people who had a lower cost option and now don't.

I'm glad ACA is doing something, but I still think we didn't have to take single payer off the table in 2009, the same way we didn't have to let the banks get away with what they did in 2009 either when Obama had a Dem controlled congress and a lot of fresh momentum, or that we didn't have to let corporatist interests control "education reform." Instead, he retrenched into his neoliberal economic policies.

Single payer and a jobs program aligned with building walkable cities and creating green affordable fast rail would have done wonders for half the cost we're spending on insurers and the failed TBTF banks. We'd be living in a vastly different country now. State legislatures might have stayed in dem controlled hands had citizens experienced the huge difference a populist agenda would have made. Instead, more of my fellow North Carolinians will die this year as a result of greedy, hateful people and the centrist politicians too blind or self-serving to stop enabling them.

Maybe we'll have another chance in 2014 or 2016.

riqster

(13,986 posts)
53. Indeed. We need to take back the House and Senate.
Fri Dec 20, 2013, 10:45 AM
Dec 2013

With LARGE margins,'and the most progressive candidates we can elect.

National health care is the only sustainable and viable long-term business model for the health insurance industry, and the sooner we get there, the better.

We can argue about incremental vs. instant strategies, but in the end that is where we have to go. And we also need to point out when (as you have) it's the Repube Governors who are fucking over millions of us, and not Obama.

Short history lesson: the ACA did not allow states to opt out. It was the Supreme Court that allowed red states to fuck us-not Obama.

zeemike

(18,998 posts)
52. What false message am I spreading?
Fri Dec 20, 2013, 10:43 AM
Dec 2013

that the ACA does not solve problems for everyone?...or that the ACA is not the cat's pajamas?
But ignoring the negative aspects of things you are doing what they do too....and you could do that with anything...like the Patirot Act, or No Childe Left Behind...it does some good so ignore the bad.
Sorry but I just don't understand that way of thinking.

riqster

(13,986 posts)
54. Your message is "the ACA helps the insurance companies and not the rest of us".
Fri Dec 20, 2013, 10:51 AM
Dec 2013

A carefully selected partial truth. Partial truths = falsehoods.

33. And who does that massive tax credits go to?
The private insurance company...not for health care.
When the simple solution would be to provide that money to Medicare and let people sign up for that instead, and pay at least 20% less for it....because there is profit to be made from this massive tax subsidy.
But even with the subsidy people working for minimum wage cannot afford it...but must buy it or pay the fine...for them it is a burden...and one that will get greater as prices go up and wages go down or remain the same.
And I reserve the right to criticize it whenever I like...whether I have read the thousands of pages of this law or not.

Your own words.

zeemike

(18,998 posts)
55. And what partial truth is in that?
Fri Dec 20, 2013, 10:59 AM
Dec 2013

Are you claiming that it does not help the insurance industry and they will not make 20% on every policy people buy?
Or are you saying that people on minimum wage CAN afford it if they want to?

riqster

(13,986 posts)
57. It helps the insurance companies, but not ONLY them.
Fri Dec 20, 2013, 11:08 AM
Dec 2013

In some states, people on minimum wage CAN afford it. That is up to the governors.

And the reason it is up to the governors is NOT because of the ACA: it did not allow the opt-out that is causing the issue you describe. It is because of the Teabagging Supreme Court ruling.

Had you blamed them or the Repubes for the fact that some of the working poor can't get affordable coverage, I'd have no quibble. That would have been true. But you did not. You pinned it on the ACA.

Yes, we should have gone straight to national health care. But the Supremes would never have allowed it to go into effect-hell, they tried to gut the market-based partial solution we were able to get passed.

Instead of crapping on the Prexy and the ACA, point the finger where it belongs: at the Republicans.

zeemike

(18,998 posts)
58. Well hell that is true for everything.
Fri Dec 20, 2013, 12:18 PM
Dec 2013

It is seldom you see a law passed that does not help someone...that is the bait in bait and switch.
But show me how someone that lives from paycheck to paycheck can afford yet another expense...especialy sense things like food keep going up.

And the public option could not have been stopped by the SCOTUS...Medicare is already law and up and running well.
And you and others see honest criticism as "crapping on the President and the ACA"...as if no one should say things like that...

riqster

(13,986 posts)
59. Letting the Repubes off the hook and only criticizing the Prexy is the issue.
Fri Dec 20, 2013, 12:39 PM
Dec 2013

If I want Obama bashing and letting the Reeps off the hook, I'll watch the Teevee news.

zeemike

(18,998 posts)
62. Pointing out the flaws in the plan is not letting the Repugs off the hook
Fri Dec 20, 2013, 01:43 PM
Dec 2013

Not pointing out the flaws is letting the Dems off the hook...it was THEIR plan patterned after a right wing plan...and now we are expected to love it and say it is so great because ot was Obama's plan?

That kind of party loyalty will make us no different than the Repukes in the eyes of the public.

riqster

(13,986 posts)
64. I'd say that bashing the Dems and ignoring the actions of the Repubes...
Fri Dec 20, 2013, 01:53 PM
Dec 2013

...is also no different than the Repubes.

bvar22

(39,909 posts)
61. Bill MOyers is spreading falsehoods too, according to some here.
Fri Dec 20, 2013, 01:29 PM
Dec 2013
"So we should be clear on this, Obamacare, as it’s known, is deeply flawed. Big subsidies to the health insurance industry. A bonanza for lobbyists. No public option. And as The New York Times reported this week, “Millions of Poor Are Left Uncovered by Health Law.” Largely because states controlled by Republicans refuse to expand Medicaid."
---Bill Moyers

http://billmoyers.com/segment/bill-moyers-essay-shutdown-showdown/


It serves NO ONE when the TRUTH is suppressed.
Yes, the ACA will lower the up front price of Premiums for many people,
and the Medicaid Expansion is a good thing,
but there are serious foundational problems with the ACA.
The MANDATE to purchase products from for profit Corporations is just the first.
I will never understand those who insist we should overlook the serious flaws in the new law.

I CAN understand why moderate Republicans (Reagan Democrats) and Chamber of Commerce Conservative rd Way Democrats LIKE this plan that channels $BILLIONS$ of Public Dollars into the private pockets of Corporations.
Why can't they understand that old tyme Democrats dislike the ACA based upon the Democratic Party Values we were raised with and fought for many years?



zeemike

(18,998 posts)
63. I guess because third way is the official way now.
Fri Dec 20, 2013, 01:47 PM
Dec 2013

And they don't give a shit what we think....no matter that we are the majority in the party...you will have a choice to vote for good cop or bad cop...but cop is what you get.

ConservativeDemocrat

(2,720 posts)
67. Well, ya'll just keep holding your breath until you turn blue...
Fri Dec 20, 2013, 04:55 PM
Dec 2013

... full meltdown tantrum in the middle of the supermarket mode. Because you want it all and you want it now now now now now!!!! And you'll never be happy until the whole world is set up to make the people you hate mad.

Let's see if that gets you any further than it does the teabaggers. Bless your childish little hearts.

- C.D. Proud Member of the Reality Based Community

zeemike

(18,998 posts)
68. The people I hate are mad.
Fri Dec 20, 2013, 05:11 PM
Dec 2013

And that is why I hate them.

But it is more like I pity them than hate them, they waste their life and damage their soul with the madness...anger is a destructive emotion to body and soul...as well as humanity.

ConservativeDemocrat

(2,720 posts)
73. Do you hate President Obama?
Sat Dec 21, 2013, 03:56 AM
Dec 2013

From everything I see, this seems to be a common thread among your comments.

- C.D. Proud Member of the Reality Based Community

zeemike

(18,998 posts)
74. Is the president mad?...is that what you are saying?
Sat Dec 21, 2013, 09:23 AM
Dec 2013

But it always seems to come down to that acusation....if you criticize his policies you hate the president...a set up for the false dichotomy of with us or against us.
No mad is angry, and sorry but I don't like angry people. and Obama is not an angry person.
And I don't like bullies that try to bum rush people into their way and silence decent.

Cracklin Charlie

(12,904 posts)
9. Your situation sounds a lot like mine.
Thu Dec 19, 2013, 02:23 PM
Dec 2013

We (small business owners) lost our private coverage in July, when we couldn't afford the $2800 per month premium. We have recently obtained new coverage at a savings of $2750 per month. It's like a whole new world out there, for a whole lot of people. There's always room for improvement, but it's a real good thing.

freshwest

(53,661 posts)
11. I won't even start to say what the infernal 'free market' health insurance con did to my family...
Thu Dec 19, 2013, 02:29 PM
Dec 2013

I'm very glad that you and your wife with RA are getting a fair shake and able to continue with your financial plans. RA is a tough thing to deal with, very much so. I do have a friend with Crohn's and the free market con artists were bankrupting her and her husband, just to cover her. I wish you and your wife comfort in the holidays and coming year.





bvar22

(39,909 posts)
12. $1,200/month + copays + deductibles is STILL extortion.
Thu Dec 19, 2013, 02:35 PM
Dec 2013

It only looks good by comparison to the "Free Market".


Question:
How do you get the peasants to cheer for $5.00/gal gas?

Answer:
Raise the price to $7.00/gal for a year,
then drop the price to $5.00/gal.


You will be proclaimed a HERO.
SEE: Machiavelli

Journeyman

(15,001 posts)
13. Couldn't agree with you more. It's criminal. . .
Thu Dec 19, 2013, 02:51 PM
Dec 2013

I was very disappointed when the Democrats conceded this was the best they could do. We need a fundamental change to the entire system. But until that happens, I'm just some schlub from the Southland, trying to get by and provide as best I can for my family. My hope and expectation now is that my grandchildren will live to see the needed change. I no longer expect it in my life. Though by no measure should that be understood to mean I no longer want it or continue to agitate for it.

bvar22

(39,909 posts)
36. ^^^This^^^
Thu Dec 19, 2013, 09:46 PM
Dec 2013

--bvar22
a "schlub from the Southland"
old enough to remember what a DEMOCRAT should be,
and old enough to have enjoyed the benefits of a Democratic Party
that Worked For Working Class Schlubs instead of Wall Street Banks and the upper 1%.

antigop

(12,778 posts)
15. older people making over 400% FPL really get nailed. I've mentioned this numerous times.
Thu Dec 19, 2013, 03:13 PM
Dec 2013

The PPACA allows insurance companies to charge an older person three times what they charge a younger person.

If you make ONE PENNY over the 400% FPL, you get NO SUBSIDY.

400% FPL for an older couple (especially in California) ain't exactly living high on the hog.

Cue the cheerleaders.....

whopis01

(3,467 posts)
27. If you make ONE PENNY under the 400% FPL you get NO SUBSIDY as well
Thu Dec 19, 2013, 07:05 PM
Dec 2013

The subsidy doesn't just cut off at the 400% FPL level - it is graduated as you approach that point. So the subsidy is cut (and trails off to nothing) well before that 400% level.

 

Flatulo

(5,005 posts)
49. I got beaten up over this a few weeks ago. My wife and I make a hair over the $72K cutoff
Fri Dec 20, 2013, 08:10 AM
Dec 2013

for subsidies. She's 57, so Medicare is a no-go.

A gold plan for just her runs from $1600 to $2600 per month.

Fucking ridiculous. And the response here was that we're filthy fucking rich and should be glad at the opportunity to help the less fortunate.

Filthy fucking rich? The median income in Massachusetts is $78K, so no, I don't think so.

After taxes, the ACA eats close to half of our net pay, not counting deductibles and copays.

People over 50 are getting shafted by the ACA.

antigop

(12,778 posts)
56. well, you just need to reduce your income below 400%FPL.
Fri Dec 20, 2013, 11:04 AM
Dec 2013

( someone actually suggested that to me on a thread.)

subterranean

(3,427 posts)
65. You might have to settle for a bronze or silver plan.
Fri Dec 20, 2013, 03:12 PM
Dec 2013

Just curious, since you live in Massachusetts, did you have better options under so-called Romneycare?

cynzke

(1,254 posts)
70. If you don't qualify for a subsidy,
Fri Dec 20, 2013, 06:01 PM
Dec 2013

Then you should shop in the private market place. I have seen the same complaint from other people and they found cheaper insurance on the private market place. The public exchange plans may not be the cheapest for people in a higher income bracket.

Try here. http://www.einsurance.com/health-insurance/

YBR31

(152 posts)
75. I think you need to look again
Sat Dec 21, 2013, 10:24 AM
Dec 2013

Non-smokers can get coverage for a bit over $600 a month in Boston now

cynzke

(1,254 posts)
69. No Subsidy...
Fri Dec 20, 2013, 05:44 PM
Dec 2013

Then don't go through the public exchange. Shop the private market. There is a phone number at the top of the page. The insurance companies are gearing up to catch these people. They will be competing for those whose income exceeds the public exchange income limit.

http://www.einsurance.com/health-insurance/

bvar22

(39,909 posts)
26. ...but it IS a kinder, gentler extortion now that the Democrats are doing it!
Thu Dec 19, 2013, 06:04 PM
Dec 2013

Perfect example of DLC/3rd Way [font size=3]MISSION ACCOMPLISHED[/font].

$BILLIONS$ of tax payer dollars now flowing into the "private" pockets of Wall Streets incestuous 1st Cousin, the Health Insurance Industry, with mandated customers, and a guaranteed rake off of 20%.
THAT is tax payer/Middle Class money that will NOT go toward health CARE,
but used to buy Summer Homes in Aspen or Yachts for the privileged 1% who operate an "industry" that:

*Manufactures NOTHING

*Creates no (Value Added) Wealth

*Provides no useful service

The "Uniquely American Solution"....indeed.
Billions for NOTHING
Chalk up a BIG one on the DLC/3rd Way MISSION ACCOMPLISHED list.

Oh yeah, some crusts and end slices have fallen off the table for the peasants,
which is WAY MORE than the Republicans would do,
but excuse me if I don't show up for the VICTORY celebrations.


I KNOW why I chose the Democratic Party 47 years ago,
and conservative, Business Friendly, Moderate Republican policy is NOT the reason.

slipslidingaway

(21,210 posts)
42. Pure profits, for some anyway ...
Fri Dec 20, 2013, 12:59 AM
Dec 2013

and not showing up for any victory celebrations either.

Our party could have done SO MUCH more to advance the HC issue, but they chickened out and bowed to Money party instead of speaking to the majority of people in the US who wanted more.

Such a wasted opportunity for the Dems.







brush

(53,467 posts)
44. It's about the greater good
Fri Dec 20, 2013, 03:24 AM
Dec 2013

If someone who is able to afford $2800 a month because he/she makes enough money, and now pays $1200 a month instead and is happy about it, it enables those who don't make much to be subsidized and get good policies for say $150 a month, maybe less or a little more.

I'd say it's all for the common good as we're all supposed to be in this together — all except the one percenters of course who don't give a shit about whether us worker bees have affordable insurance because they've probably got doctors on retainer that they can summon at any time to their gated compounds.

Look at the big picture dems, the ACA is a big improvement that can be made better. Change sometimes is incremental — a lurch forward here, a lurch forward there. Sea changes, and a sea change is what single-payer would be, don't come around too often, especially when you've got repug obstruction, with blue dog dem help, blocking everything.

It's a wonder the ACA got passed at all, hell, the repugs are still trying to kill it because they know people are beginning to get that it helps a lot of people, and once the people see that they'll start thinking, maybe even $1200 a month isn't as good as $0 a month.

Look out repugs, 'cause single payer is the next big thing on the horizon.

You've fucked up and let the ACA get passed and you've awakened a sleeping giant.

ProSense

(116,464 posts)
46. True,
Fri Dec 20, 2013, 03:36 AM
Dec 2013

"If someone who is able to afford $2800 a month because he/she makes enough money, and now pays $1200 a month instead and is happy about it, it enables those who don't make much to be subsidized and get good policies for say $150 a month, maybe less or a little more. "

...the bottom 26 percent of income earners are eligible for Medicaid under the expanded rules, and there is a new tax on high-income earners and the wealthy.

Reported when the law passed in 2010:

A big chunk of the money to pay for the bill comes from lifting payroll taxes on households making more than $250,000. On average, the annual tax bill for households making more than $1 million a year will rise by $46,000 in 2013, according to the Tax Policy Center, a Washington research group. Another major piece of financing would cut Medicare subsidies for private insurers, ultimately affecting their executives and shareholders.

http://www.nytimes.com/2010/03/24/business/24leonhardt.html


It's the law, 2013:

Net Investment Income Tax

A new Net Investment Income Tax goes into effect starting in 2013. The 3.8 percent Net Investment Income Tax applies to individuals, estates and trusts that have certain investment income above certain threshold amounts. The IRS and the Treasury Department have issued proposed regulations on the Net Investment Income Tax. Comments may be submitted electronically, by mail or hand delivered to the IRS. For additional information on the Net Investment Income Tax, see our questions and answers.

Additional Medicare Tax

A new Additional Medicare Tax goes into effect starting in 2013. The 0.9 percent Additional Medicare Tax applies to an individual’s wages, Railroad Retirement Tax Act compensation, and self-employment income that exceeds a threshold amount based on the individual’s filing status. The threshold amounts are $250,000 for married taxpayers who file jointly, $125,000 for married taxpayers who file separately, and $200,000 for all other taxpayers. An employer is responsible for withholding the Additional Medicare Tax from wages or compensation it pays to an employee in excess of $200,000 in a calendar year. The IRS and the Department of the Treasury have issued proposed regulations on the Additional Medicare Tax. Comments may be submitted electronically, by mail or hand delivered to the IRS. For additional information on the Additional Medicare Tax, see our questions and answers.

http://www.irs.gov/uac/Affordable-Care-Act-Tax-Provisions

Larry Ogg

(1,474 posts)
48. I like the part of the criminal empire where I live!
Fri Dec 20, 2013, 07:43 AM
Dec 2013

You can actually go to the grocery store and spend $40.00 on a $10.00 bag of groceries and

the lady at the - Ching Ching - cash register says... "Congratulations you just saved fifty bucks".

I guess you can chalk it off to inherent gullibility or something like that; because most people get so excited over what they think they saved, they fail to realize that they have just been robbed.


OwnedByCats

(805 posts)
50. Especially when you consider in a country like the UK
Fri Dec 20, 2013, 10:14 AM
Dec 2013

the amount you pay into their national system is tiny in comparison to our premiums here. No deductibles, no copays (except a small one for scripts), everybody covered no matter what, nobody goes bankrupt. Can't pay your share into the system because you're unemployed or make too little? No problem, you're still covered and you won't even have that pesky little script copay. The government there is not paying subsidies to insurance companies. The cost of health care over there can be as low as half what is spent here. Despite the government having price controls, the quality is comparable to here, and a lot of the time, it was better.

The ACA has done some good things, don't get me wrong. But after having lived in a country with a humane health care system, this is still unacceptable. While it's better for some now, it's not better for everyone across the board.

If little ole England can do it, so can we. Everybody just needs to get their heads out of their asses long enough to get it going and stop wasting tax money and invest it back into the citizens by giving them quality healthcare without going broke or having to go without.

 

Hulk

(6,699 posts)
16. Should sign the "waiting list" to get on fox-nonsense to share your horror story...
Thu Dec 19, 2013, 03:15 PM
Dec 2013

Unfortunately, this is what you will NEVER hear on these right wing propaganda networks and air waves. This is just tragic. I classify it as "seditious", when you attempt to lie and deceive the public to be against your own government. Probably is a lot more than that, but that's my gut feeling. Shameless bastards.

My story is similar, but much more modest. My wife's current crappy policy cost $195 a month, and the new policy with NUMEROUS advantages is about $40 less a month. FUCK the fox-nonsense lying bastards. Simply fook them all!

eggplant

(3,891 posts)
17. +1. It is important to remember that the perfect is the enemy of the good.
Thu Dec 19, 2013, 03:45 PM
Dec 2013

Yes, ACA isn't perfect. But it is hugely beneficial to many, many people, and it will improve over time.

So thank you for your eloquent post.

 

peace13

(11,076 posts)
20. A+
Thu Dec 19, 2013, 04:07 PM
Dec 2013

My story reads like yours. Right down to the small business. It feels good to know that if we get sick we can still get coverage. so many people have no idea what a real fear that has been...for years!!!!

calimary

(80,693 posts)
22. Makes me wish like hell our Dems would start pushing memes and framings about the GOP - like
Thu Dec 19, 2013, 04:49 PM
Dec 2013

"they DON'T want to help you. PERIOD."

"They don't care a whit about you, whether you live or die (but they do want your money, your rights, and your vote!)"

"They're the 'Sucks to be You' party."

"The IGMFU party."

"The Screw-You party."

"They call themselves Christians but they sure AREN'T very Christian, are they?" "They sure aren't following Jesus." ("But, but, but, the Bible says 'if you don't work, you shall not eat!'" IMMEDIATELY BLURT OUT: "Jesus NEVER SAID THAT!!! Jesus talked about helping all the poor, sick, hungry, and homeless - you know, the people YOU GUYS call 'lazy moochers'!"

"The party of the Pharisees." Or "Modern-Day Pharisees."

And every time the bad guys start in with those stupid platitudes about "personal responsibility!" and "government baaaaaad" and crap like that, WE should be chiming in with "yeah, 'cause they're too cheap to wanna help you. They DON'T want to help you! They don't care about you OR your problems. They don't give a damn!" We could even amp it up by adding the religious thing - "Jesus said we need to take care of one another, especially 'The Least of These' but the GOP says 'screw them!'"

We need to hit 'em back, hit 'em back QUICKLY, and hit 'em back HARD!!!

bvar22

(39,909 posts)
37. Have you ever asked yourself WHY the Democrats refuse to do what you suggest?
Thu Dec 19, 2013, 09:55 PM
Dec 2013

These are NOT stupid people, and have proved that they KNOW how to use the Media too.
Their "Marketeers" are just as smart as the Republican's Marketeers.
These are not stupid people.
Every single one of them WON at least one election.


The country is NOT "equally divided".
When polled On-the-Issues a solid MAJORITY agree with Dennis Kucinich and Bernie Sanders.
It is EASY to seel something that most people already want,
so WHY aren't the Democrats hard selling Liberalism, or at the very least, Economic Populism a la Huey Long?

The answer is not pretty.



[font color=firebrick][center]"There are forces within the Democratic Party who want us to sound like kinder, gentler Republicans.
I want a party that will STAND UP for Working Americans."
---Paul Wellstone [/font]
[/center] [center] [/font]
[font size=1]photo by bvar22
Shortly before Sen Wellstone was killed[/center]
[/font]

 

Doctor_J

(36,392 posts)
23. I am glad for you, but the ACA is not an incremental step forward toward health care
Thu Dec 19, 2013, 05:24 PM
Dec 2013

and I am not sure what you're talking about when you say,

So when (Obama) took up the cause (SP), we supported him in every way we could


He never did take up SP, and folded on the PO as soon as Big Insurance called on the phone.

Journeyman

(15,001 posts)
25. As I pointed out upthread, I'm just some schlub from the Southland, trying to get by . . .
Thu Dec 19, 2013, 05:38 PM
Dec 2013

and provide for my family as best I can. My hope and expectation now is that my grandchildren will live to see the needed change. I no longer expect it in my life. Though by no measure should that be understood to mean I no longer want it or continue to agitate for it.

What other choice do we have? I don't have another reality hidden in my pockets and I don't wish to leave the family, friends, and land that I love.

ctsnowman

(1,903 posts)
29. My work plan goes from an 90 10
Thu Dec 19, 2013, 07:35 PM
Dec 2013

to an 80 20 with an $7000 deductible after the first $1500 next year but what the heck we are rich

pnwmom

(108,925 posts)
32. One of my relatives is supposed to be an ACA loser.
Thu Dec 19, 2013, 07:43 PM
Dec 2013

Late twenties, male, healthy, with a household income too high for a subsidy.

I've been helping him check things out and guess what? Compared to his current COBRA policy, he has a choice of several gold policies, on and off the exchange, that will cost half as much as he's paying now. And he'll never have to worry about being dropped or hitting some annual or lifetime limit.

So he doesn't mind that he'll be having to pay for some unnecessary maternity care.

JEFF9K

(1,935 posts)
35. It's strange that right-wing talk hosts claim their coverage is much more expensive ...
Thu Dec 19, 2013, 08:43 PM
Dec 2013

... and offers less coverage. But it would be even stranger if they said anything that was true.

ProSense

(116,464 posts)
45. That,
Fri Dec 20, 2013, 03:29 AM
Dec 2013

"The cost? $1,181 a month for the both of us. A 60% savings over our cost on the 'free market."

...among other things, is why Obamacare is a huge step in the right direction. It's also why the Republican attempts to repeal was/is lunacy.

Officials: People Returning To HealthCare.gov 'In Droves'
http://www.democraticunderground.com/10024201709

Also, more and more people are taking the position that the law doesn't go far enough, and that is good news for everyone.

cvoogt

(949 posts)
66. legalized, government-sanctioned theft
Fri Dec 20, 2013, 04:44 PM
Dec 2013

better than before Obamacare, but we still need single payer. We should want to live in a just society, not just a profit-oriented framework that we get to hang on to for dear life. Alas, Amerifascism is here and has been for some time.

Rosa Luxemburg

(28,627 posts)
78. Need to have public option
Sat Dec 21, 2013, 09:39 PM
Dec 2013

the public option would be so great that all medical insurance companies can't compete and will go bankrupt!! Then we will have a nice single payer system.

JanT

(229 posts)
72. great post with great information.
Fri Dec 20, 2013, 11:04 PM
Dec 2013

My Obama hating "friend" would rather continue to bash the man instead of even going on the exchanges to see what is available. The most recent comment after receiving "the letter" from the insurance company which canceled the current policy: "I hate Obama and I hate the ACA. They are the ones that did this to me". I even went on the exchanges and found a plan that saved >$12,000 a year and sent the link. No further comments have been seen on the subject on the social media pages. HHMM I wonder....... Did this person go and find out for themselves? Or did i get un-friended? LOL One can only try to open the eyes. It is easier to be fooled than it is to be shown that you are being fooled. The eternal optimist, i hope that an attempt was made to find out on their own. I promise i won't tell anyone if you do. For-profit insurance companies are a cancer in our country that needs to be ended. thank you for sharing your experience. So glad that you now have good coverage for you and your family.

antigop

(12,778 posts)
77. thank you...exactly what some of us have said....older people get nailed...and
Sat Dec 21, 2013, 05:57 PM
Dec 2013

no subsidies if your income is over 400% FPL. 400% FPL in New York ain't exactly living high on the hog.

 

gerogie2

(450 posts)
79. Single payer system is the only way to go
Sat Dec 21, 2013, 11:19 PM
Dec 2013

Doesn't it make more sense to just have a flat tax for all people that have income? Trying to force people that don't have health care into buying health care is not working. By the end of this decade millions of employees will no longer have health care insurance as business sees it cheaper to just pay the $2k tax per employee then thousand more per year.

The US government could set it up like the postal service as an independent agency. I think a flat 7-8% tax, just like SS will work. We could also get rid of the earned income tax credit to help pay for it.

As this decade marches on republicans will face more people without HC insurance that will demand the government do something. The wing nut tea party isn't strong enough to keep people from wanting change in HC insurance.



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