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In reply to the discussion: OK, the Affordable Care Act makes me feel 100% better about losing my job..... [View all]rbnyc
(17,045 posts)75. I used this tool for my situation...
...and this is part of what it said:
"If the plan offered by your employer doesnt meet the laws standards of affordability or comprehensiveness, you can buy a different plan through your states exchange. Based on your income, you probably would not qualify for federal assistance to offset the cost of that plan."
So I set about trying to find out what these standards of affordability are and found this:
What This Means for You
Your insurance company cant raise rates by 10% or more without first explaining its reasons to your state or federal Rate Review program. All explanations will be posted on Health Care.gov and your Rate Review program will give you a chance to comment on them.
Your Rate Review program will determine if the rate increase is unreasonable. A rate hike is unreasonable if, for example:
It is based on faulty assumptions or unsubstantiated trends.
It charges different prices to people who pose similar risks to the insurer.
Your state regulator can approve or reject an unreasonable or excessive rate increase, if your state laws give the regulator this authority.
Some Important Details
The Rate Review rules apply to new plans in the individual and small group markets. (If you are in a health plan that existed on March 23, 2010, your plan may be a grandfathered plan, which is exempt from the Rate Review rules.)
Starting September 1, 2012, each state may have its own minimum premium increase that requires a review, based on the states unique premium trends, health care cost trends, and other factors.
If your state doesnt have a Rate Review program, or has a Rate Review program that is ineffective, the federal government will conduct Rate Reviews in your state.
Your insurance company cant raise rates by 10% or more without first explaining its reasons to your state or federal Rate Review program. All explanations will be posted on Health Care.gov and your Rate Review program will give you a chance to comment on them.
Your Rate Review program will determine if the rate increase is unreasonable. A rate hike is unreasonable if, for example:
It is based on faulty assumptions or unsubstantiated trends.
It charges different prices to people who pose similar risks to the insurer.
Your state regulator can approve or reject an unreasonable or excessive rate increase, if your state laws give the regulator this authority.
Some Important Details
The Rate Review rules apply to new plans in the individual and small group markets. (If you are in a health plan that existed on March 23, 2010, your plan may be a grandfathered plan, which is exempt from the Rate Review rules.)
Starting September 1, 2012, each state may have its own minimum premium increase that requires a review, based on the states unique premium trends, health care cost trends, and other factors.
If your state doesnt have a Rate Review program, or has a Rate Review program that is ineffective, the federal government will conduct Rate Reviews in your state.
So right now, my monthly premium (for a total piece of shit HMO) is about $1,500. My employer pays PART of this - and because they do, they can't afford to pay me anything close to what I'm worth. The big benefit for me and my employer is that our rates shouldn't go up more that 10% every year. Wow.
The first thing I thought of was my "rent controlled" apartment when I first moved to New York City in the mid 90s. Rent control means the landlord can only raise the rent a certain percentage under certain circumstances, so every time they have the opportunity, they surely do that. My TINY 3-room apartment with no bathtub was $1,200 a month. I know that some folks who had been in their rent controlled apartments for decades, did have very low rents - but for folks coming into the system, indeed for most folks, rent control did not affordable housing make.
I admit, I don't understand everything about this convoluted Affordable Care Act, but it seems really clear that it doesn't do what it needs to do - divorce health care from employment and from profiteering insurance companies.
EDIT: typo and just to clarify, I do not make that much money. Just enough so that I don't qualify for any type of help, but not so much that I can actually afford my co-pay to actually see a doctor, or to have prevented us from having had boiled chicken bones and pureed broccoli stems for dinner a couple nights this month.
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OK, the Affordable Care Act makes me feel 100% better about losing my job..... [View all]
Logical
Jun 2012
OP
The tax-credit is how the government subsidizes the plans. You receive the credit...
PoliticAverse
Jun 2012
#26
You are wrong, Grasshopper. How do we know that? Massachusetts Mandate. Almost 100% coverage.
Honeycombe8
Jun 2012
#45
Most of the states will keep the increased Medicaid. A few won't. Wait and see.
Honeycombe8
Jul 2012
#77
The basis of all governmental entities is power derived from force and threats of violence.
ScruffyTheJanitor
Jun 2012
#18
And if you don't pay your rent or mortgage goverment may be employed with LEOs to force you...
freshwest
Jun 2012
#23
There are Mutual insurance companies which are owned by the policy holders...
PoliticAverse
Jun 2012
#31
Yes, my auto insurance is that way. They used to give us a rebate. We generally have a few of these
freshwest
Jun 2012
#39
Yes, they are forced to contribute to their medical care costs, just like they are forced to
Honeycombe8
Jun 2012
#46
Note that for such a person buying insurance would cost less than the $695 penalty
PoliticAverse
Jun 2012
#28
You of course realize that if you are at the lowest threshold of poverty
nadinbrzezinski
Jun 2012
#37
Very good point, many Americans cannot afford any additional out of pocket expenses
Puzzledtraveller
Jul 2012
#72
My guess is the catch is going to be the healthcare we can receive. I pay 500 a
robinlynne
Jun 2012
#10
Talk about life being better with FACTS lol. Why do people insist on mingling those two terms?
cherokeeprogressive
Jul 2012
#64
I ahve been shipping for ehalth insuracne for my Mom, 78 yeras old. Experienced doctors will
robinlynne
Jun 2012
#32
that is how it is right now. Unless you have insurance through an employer, or an HMO.
robinlynne
Jun 2012
#34
and you think the insurance company is going to give great health care for less profit? good luck.
robinlynne
Jul 2012
#50
Again, health insurers don't have to make a profit. The best tend to be non-profit.
pnwmom
Jul 2012
#70
I just checked and I will be able to retire before i am eligible for Medicare
likesmountains 52
Jun 2012
#40
This is quite a heartwarming thread. Being able to retire with a good conscious...
joshcryer
Jun 2012
#44
You are lucky you live in a state that will have exchanges. TX won't, I think (where I am).
Honeycombe8
Jun 2012
#47
So what is the maximum out-of-pocket? Hasn't the bill been written and passed already?
cherokeeprogressive
Jul 2012
#66
It will help a lot of people when we can finally break this employer-provided custom
treestar
Jul 2012
#56
As a recipient of both Soc Sec and Medicare, I'd say "the catch" is they both work really well...
pinto
Jul 2012
#71
Check out also the Patient Protection part of the Patient Protection & Affordable Care Act too
patrice
Jul 2012
#76
How much extra in taxes would you have to pay in a country with single payer??
cbdo2007
Jul 2012
#120