An explanation at last (on being an ACA loser...)

[cilla4progress]

I have posted here ad nauseum about my rates going up under ACA (premiums + deductibles). I have received mostly resistance and/or disbelief.

This article in huffpo this morning lays it out.

Snip:

9 Valid Concerns We Can Have with Obamacare ...

2. How will people respond to paying higher premiums?

Obamacare will offer health coverage to millions of previously uninsured or uninsurable Americans at a lower average rate than initially expected. For this system to work, however, the law expects some people who currently have plans on the existing market to pay higher premiums to get coverage through an Obamacare exchange. For those making an annual salary between 300 and 400 percent of the federal poverty level (which is $11,200), federal subsidies will be limited.

For that small percentage of Americans, some key questions emerge. Will the angry cries of those whose rates go up drown out the joyful shouts of those whose rates go down or who never had insurance in the first place? Will they see their premiums as affordable, even without the subsidies offered to poorer people or those whose coverage is more expensive? Will they decide that health insurance is important enough to pay for, even if it costs hundreds or thousands of dollars a year, or will they reject the new market and opt to pay the individual mandate penalty?

These are arguably the biggest unknowns and could determine whether Obamacare is ultimately beset by the enrollment issue described above, and whether it builds enough public support to be politically sustainable.


http://www.huffingtonpost.com/2013/10/10/obamacare-questions_n_4060345.html

[legcramp]

1. You realise of course that while some may have to pay a tiny bit more they will be getting

much better and more inclusive coverage. You can keep your kids on your policy until age 26, expanded chem dep and mental health coverage, no lifetime caps after the the 1 year delay is lifted, no more denials of pre-existing conditions and too much more to enumerate here.

Surely you and the vast majority of those whose rates may go up a little won't begrudge the less fortunate the opportunity to finally have access to decent health care.

Health care is a human right.

[DireStrike]

2. ACA losers on this board don't usually object to such things

They just point out that their costs are rising and are then attacked.

[cilla4progress]

3. Thank you.

Thank you.

[moriah]

5. I've tried not to attack, but to encourage them to shop around.

On FB this morning, a friend was saying the cheapest policy he could get at all (he makes over 400% of the poverty line) was $400 a month for a plan with a $2000 deductible. I found him a plan through Blue Cross that was less than $300 a month for a $500 deductible/$3800 max out of pocket, and found him other plans that might have worked better for him. In addition, since he's under 30, he would have qualified for catastrophic coverage for $150 and could combine that with an HSA if he didn't expect to use much coverage -- put the difference in premiums between it and the next lowest plan into the HSA.

Yes, his premiums are going up. But sooooo many people are drastically misinformed about how much, and he was railing on and on about $400... when he was really kind of surprised to learn what was up.

One other option that many people haven't seen so far is that you can purchase the older plans that are not essential minimum coverage, and then pay the penalty. Sometimes, that could end up being cheaper if you really don't use a lot of coverage, or are willing to gamble on the catastrophic losses if you exceed the annual limits.

The big thing I want is to help everyone find what is going to be the best deal for their family possible. If it's higher than what it was... I really hate it, and I wish there was some way to offset it for you. And I feel guilty, because I'm going to be benefiting greatly from what the extra you're having to pay.

[DireStrike]

6. Always good advice.

Personally ANY plan I get will be an extra bill. I haven't actually gone into the exchange myself yet, but I found a site that lists plans, and didn't really see anything that was useful (aside from absolute bankruptcy protection.)

[cilla4progress]

8. Thank you for your kind, generous, and informative post

In actuality, since ACA came online I haven't been able to get into create my account in full. Because I trained as an In-Person Assister, I had access to my state's site ahead of time, and these are the prices I was quoted. So I'm still waiting.

My husband's government employer provides him with generous coverage. To cover my daughter and me would cost $1300 / mo. in premium. I was paying $351 /mo. for an individual policy (available through the state...for middle income folks...just received notice they are closing down at the end of 2013; I assume due to ACA. I had it for 3 years and it worked well enough for us) for both my daughter and me with $500 deductible and about $5K out of pocket annual max. All I've been able to find on the exchange for my daughter and me is about $650 / mo. premium and $10K max out of pocket per year.

Our family of 3 is just about at 400% FPL.

You shouldn't feel guilty. I believe the system overall will improve under ACA. I feel stung that Pres. Obama repeatedly said, "If you like your insurance, you can keep it," when this is not true for me.

[damonm]

13. Where were you doing this finding?

I should like to have a look at this sort of thing myself, but have no clue where to start.

[moriah]

14. In my state, they published the list of premiums....

... .so I was able to see which companies were offering insurance here in my state. It looks like three -- Blue Cross, Qualchoice, and Ambetter (a Novasys/Celtic Health subsidiary). Ambetter isn't allowing direct quotes from their site at the moment, and Qualchoice doesn't say they're the same price as through the Exchange, but Blue Cross says theirs are the same as what they're charging on the Exchange, for the plans that are qualified. (They have a lot of plans that don't meet minimum essential coverage, too, marked as "You May Have To Pay A Penalty".)

In most states, Blue Cross has a pretty big market, so each state's Blue Cross website has been my first stopover for most folks. They generally have a screener there, and ways to start enrolling people from there as well if they are not having to purchase through the Exchange (aka, they aren't going to get a subsidy). Each company trying to sell the insurance is wanting to encourage people to buy from them instead of others, so a lot of them have the rates up on their individual sites and are actively trying to enroll everyone, subsidy or not.

Also, the Kaiser Family Foundation has a great calculator to determine subsidy eligibility. I'll try to hunt it up and put it in here in a few minutes .

[BluegrassStateBlues]

4. Small price to pay for the millions of people that have never had insurance.

With a bit of household budgeting, I'm sure they will manage.

[cilla4progress]

9. Did I mention I lost my job last month

due to layoff; lack of work at my employer? At 58 y.o., may be hard to get re-hired.

On top of increase in health care costs.

Whatevs

[NCLefty]

7. It's a shame that one pol. party didn't want to help improve the bill.

Because no one thinks it's perfect. But my, what a valuable political game we can play over it...

[cilla4progress]

10. If we are going to evaluate ACA

in a fact-based reality, the fact that for a slice of middle class Americans costs are going up under ACA should be in the mix.

[Liberal_Stalwart71]

11. I don't think this fact is lost on people. There definitely needs to be improvements.

No question about it.

[cilla4progress]

12. Yes, thanks.

I was frankly caught off-guard by the increases. I thought I could do no worse than what I had, based on Pres. Obama's repeated reassurances that if you liked the insurance you had you could keep it. I'd like to hear his response to my problem.

[davidpdx]

15. I think if people look at what some of the other countries have it is very apparent that improvement

can be made. Canada, Japan, South Korea (where I live), Denmark,and Sweden are just a few with quality healthcare. The thing is it will take time. We have to get back the House, without that nothing can be accomplished. The next two elections are very important. I personally think 2014 isn't going to help that much and we are going to have to wait until 2016, but that's the pessimist in me. Hopefully I'm wrong. The fact that we got something past is a miracle. It is far from perfect and I know we can improve it.

(p.s.-I know someone got pissed a few weeks ago about Canadians comparing their healthcare systems to that of the US, but once you have lived in a country with substantially better healthcare like I have, it is hard not to criticize the US system)

[Liberal_Stalwart71]

20. Yes, I don't disagree with you. In fact, I agree 100%! I think Obamacare is a fine start...

...and I believe that it WILL be improved on provided that we get a better Congress with more progressives elected to office in 2014. The policy process is deliberately slow; we make progress on a piecemeal basis. It'll take some time to see that change take effect.

[athena]

16. Your old insurance was pretty bad.

You neglect to mention that here. As you stated on this thread:
http://www.democraticunderground.com/1251327142
you had an annual max of $100,000, which meant that you'd be out of luck if you ever got in a serious accident. Most people would be happy to pay a little bit more in return for not having to worry about annual or lifetime maxima, or about preexisting conditions.

[cilla4progress]

19. That wasn't annual out of pocket max

it was annual cap on coverage.

Do you know what ACA does about caps?

My insurance worked for my daughter and me for 3 yrs. It was, on the annual cap side, catastrophic, I guess. Out of pocket routine costs were much less than what is available to me in the exchanges. Serious car accident would, of course, be covered by car insurance.


It's all a calculated gamble, isn't it?

[athena]

22. I know it was an annual cap. And it was bad. The ACA eliminated such caps,

as numerous people have tried to explain to you.

How much do you think you would have to pay if you had a major car accident? Are you really naive enough to think it would be less than $100,000? My sister-in-law has COPD and has had to go to the hospital four times this year for repeated pneumonia and bronchitis attacks. She has had to stay in the hospital more than two weeks. In fact, she's in the hospital now. I'm sure she crossed $100,000 for this year a long time ago. What makes you so sure that you will stay healthy and lucky enough to never go over $100,000?

Before you go on posting the same thread over and over, try to think about what insurance means. The whole point of insurance is to protect you from extremely rare events that would destroy you financially. It seems to me that all you want to do is complain about the ACA

ETA: This is the second time I'm posting this information. Instead of responding intelligently, you go on creating new threads claiming you are losing out under the ACA, without including the very-important bit of information that you had an annual maximum (or cap, if you want to call it that) of $100,000.

[athena]

23. It was not a calculated gamble. It was simply not insurance.

Annual maxima like the one you had were designed to help insurance companies reduce their costs. They were no better than denying people coverage because of pre-existing conditions.

Let me reiterate: the whole point of insurance is to cover you in case of catastrophe. That's what the insurance industry is based on. Consider the following:

Suppose I have a 50% chance of being in an accident that will cost me $1000. Since I have more than $1000 in the bank, I can weather such an accident. I will not pay someone $500 to pay me $1000 in case I have that accident.

Now suppose I have a 0.01% chance of being in an accident that will cost me $1,000,000. Since I don't have anywhere near that in the bank, such an accident would bankrupt me. I would be willing to pay someone $500 to cover me in case of such an accident.

Now: suppose 100,000 people make the same calculation and pay $500 for this insurance. The insurance company takes in $50M. Since the risk is 0.01%, 10 people have the accident. The company pays $10M. It therefore makes a profit of $40M.

Think about that. That's the whole point of insurance. When you allow insurance companies to set annual or lifetime maxima, you are allowing them to increase their profit by refusing to do what they are supposed to do.

As much as you want to believe (or make others believe) that you had good insurance, you didn't. You should be thankful to the ACA for correcting a major problem in the system, which was allowing insurance companies to dump you in case of the very rare events they are supposed to cover you against. Given that the banning of maxima will reduce the profits that insurance companies make, it's not unreasonable to expect to pay a little bit more.

Finally, note that if you had had good insurance (i.e., one that didn't have annual or lifetime maxima), you could have kept it.

[pnwmom]

17. You aren't a "loser." You are paying more and getting a LOT better insurance.

Your former maximum of $100K was pathetic. Now you will have no lifetime or annual limits, as well as all the Essential Benefits your previous insurance didn't cover. And if you change jobs or otherwise need to change insurance, you can't be barred for having a preexisting condition.

[Humanist_Activist]

18. What I don't understand is this, family coverage, I tried calculating subsidies for myself and my...

fiancee, assuming we get married next year, and, according to the Kaiser website, premiums more than double and maximum out of pocket quintriples compared to individual coverage subsidies for me as calculated on the same website. I did add her income, but she makes less than me, so much so she actually(barely) qualifies for medicaid. What the fuck?

That's for a silver plan, which we can't afford to use without some type of cost sharing for deductibles and maximum out of pocket.

[grantcart]

21. my advice is go in person

you have quite a few variables and it is probably better to talk to someone in person where you can have an informed real time conversation.

https://localhelp.healthcare.gov/