CBO: Obamacare will have lower premiums, insure more, and cost government less than projected

[ProSense]

34. The misinformation

Last edited Mon Apr 14, 2014, 07:39 PM - Edit history (1)

"Can't afford the premiums"

...is going to continue because everytime it's countered, it's soon forgotten. Here is a comment from a Daily Kos diary that was posted to another thread.

Sorry to hear about Opal's plight and it is a terrible shame that Texas did not expand Medicaid and that the SCOTUS threw out the part of the law that would've made it mandatory.

But I have a question: it appears that based on the facts you've given, Opal and her husband have a very low income. I gathered that from your suggestion that Opal might've qualified for Medicaid if Texas had expanded it, and the statement that Opal's husband made just enough to get help under the ACA, which would indicate he makes just above 133% of FPL ($15,521).

Yet if those facts are correct, Opal and her husband actually would've qualified for an enhanced silver plan that has a $500 deductible per individual that drugs aren't subject to, has no copay at all for generic medications, and a $50 copay for brand names. Also, the two lowest premiums could range from $6 to $28.

Again, assuming I have the facts right, Opal and her husband must've opted for the bronze plan with its $5000 deductible when they could've gotten a much better enhanced silver plan (which as I've detailed above has a $500 deductible with no drug deductible) for as low as $6 a month. Either they somehow didn't know about it or whoever signed them up screwed up in not advising them of this.

In helping folks sign up for Covered California, I've always made sure that middle-aged and/or chronically ill folks avoid the bronze plans, and if they're low income, made sure they're aware of the enhanced silver plans that are designed to have low or no deductibles, low copays, and low premiums to accommodate folks of low income. These plans are more generous in California than Texas, but Texas does still have them and, assuming I've got the facts right here, Opal was tragically not made aware of them as it might've saved her from this calamity.

Sorry again to hear about Opal. If you can, and if it applies, please advise her of the better options she may have available to her as I've tried to outline.

http://www.dailykos.com/comments/1291854/53146506#c22

Anyone who doesn't qualify Medicaid after the expansion will be qualifed for additional subsidies available with a silver plan. In some cases, those plans reduce the deductible to zero.

Texas:

94% Cost Sharing Benefits Households with incomes between 138% to 150% of FPL qualify for the following cost sharing benefits for this silver plan.

Deductible (Individual) $0.00
Deductible (Family) $0.00
Out of Pocket Maximum (Individual) $500.00
Out of Pocket Maximum (Family) $1,500.00

http://www.valuepenguin.com/health-insurance/TX/blue-cross-blue-shield-blue-advantage-silver-hmo-004