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</p>
<p>The giveaways to the private insurers were the price of getting it passed. The insurance lobby demonstrated its power early on by rapidly killing the public option which was initially part of the law. </p>
<p>The insurers’ greed, though, might be their downfall in the end. IMO, ACA will end up being unworkable, and most likely down the road we’ll end up with single-payer and private supplemental, just like seniors have now. It’s just a shame we couldn’t go directly there.</p>
<p>I thought geeps already said he had some unique circumstance. I think we all have to realize this is state-by-state and one person’s preview of potential issues doesn’t apply to all of us.</p>
<p>I agree it’s a shame we couldn’t just jump to a more perfect solution. But remember: remember all the fuss and muss about how this brings us to socialized medicine, a socialist state, all the scary (and unfounded) things said to play on fears. The “people” needed to be walked through this; it’s not all about conceding to big insurers.</p>
<p>And, whether or not Busdriver got the letter or someone else heard their company will downsize or reduce hours, or a financial advisor, somewhere, said this or that- the full picture is not yet revealed.</p>
<p>But, yes, what is known, is unfortunately unclear.</p>
<p>Continuing kudos to those who are trying to dig into this, not just assume. Or not just extrapolate that what one says will be their own doom.</p>
<p>The next couple of years we will see much shifting. In the end, I don’t think as a whole people will end up paying more. The cost cutting will come, just not right away. Look at the cost of travel - ever look at the price posted on the back of the door in a hotel room? Who pays $400 a night? Nobody, but that’s the rack rate. Everybody gets a discount of one kind or another. But with healthcare, people without insurance do pay rack rate, unless they negotiate on their own with the billing office. The costs of some procedures have little to do with the cost of providing them - not even the cost distributed among those who can pay! You have a procedure that is billed at $1000, and the insurance company negotiates a fee of $250 - do you honestly think the hospital or doctor is providing that service at a loss? With our high deductible plan, I might think I’m not getting much benefit from my premiums, but even if the insurance company doesn’t pay a dime, they just saved me $750 based on what I would have been charged on my own. Those that pay the full $1000 are paying for themselves and 3 other patients that showed up in the ER and are not able to pay! </p>
<p>If everyone is covered, providers will know they will be paid, and costs can come down. It will just take time. If everyone is covered, those who currently can’t afford to pay might actually see a doctor BEFORE their need becomes critical, and the cost to treat them will come down.</p>
<p>I do hope we eventually reach a point where we have single payer, with private supplements. The other extreme is a country where only those who can pay or who have insurance will get care. I don’t want to live in such a country. Not only do I think it would be wrong, but it scares me to think that I or someone I love could be denied coverage, or have it delayed while they figure out that we’re covered.</p>
<p>The comments about pre-existing being protected in RI (or by any state law; I think he’s from RI) got me digging.</p>
<p>Beginning in 2014, no Rhode Islander can be denied coverage, charged a higher premium, or sold a policy that excludes coverage of important health services simply because of a pre-existing condition.
…Looking at only those serious conditions that are commonly linked to coverage denials, we found that nearly 223,000 non-elderly Rhode Islanders have been diagnosed with pre-existing conditions that could lead to denials of coverage, absent health reform. This means that more than one in every four non-elderly Rhode Islanders (25.5 percent) would be at risk of being denied coverage today without health reform.</p>
<p><a href=“Not Found”>Not Found;
<p>I don’t think there’s a state law, in this case, mandating pre-existing be covered.</p>
<p>Bay, this is what I meant, earlier, about misinfo swirling.</p>
<p>Why does a state need its own law when ACA provides for non-denial of coverage due to pre existing conditions?</p>
<p>If it was there in 2012 that is understandable but sounds odd for something to come up in 2014.</p>
<p>No, the article is about a gap the healthcare reform fills. Not a new RI law.</p>
<p>LF - I did not look at the article, just your statement stating “beginning in 2014”.</p>
<p>So it sounds like there are no new laws for RI that take effect next year?</p>
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</p>
<p>But this isn’t unique to Rhode Island. This is true of all 50 states, because of ACA. </p>
<p>Rhode Island is running its own exchange, which would explain the verbiage aimed at Rhode Islanders. But the prohibition against discrimination is mandated by the federal law.</p>
<p>ETA – Sorry, lookingforward, you already said this in #1026. But as you also said, there is SOOO much misinformation. Like geeps apparently believing that ACA was unnecessary for him, because his state already protected him. It didn’t. And it only does so now BECAUSE of the ACA.</p>
<p>Right. I was quoting from the study, titled “Worry No More: Rhode Islanders with Pre-Existing Conditions Are Protected by the Health Care Law,” by the Lewin Group, commissioned by Families USA. And I looked it up because geeps said, in his state (I believe it’s RI,) they were already protected. Or something.</p>
<p>It is the healthcare reform that protects pre-existing in all 50 states, yes.</p>
<p>Thanks to [the Supreme Court] decision and the protections offered by the law, people in Rhode Island and across the nation who have pre-existing conditions will be protected from discrimination based on their health status.</p>
<p>Interesting article about costs…</p>
<p><a href=“In Need of a New Hip, but Priced Out of the U.S. - The New York Times”>In Need of a New Hip, but Priced Out of the U.S. - The New York Times;
<p>“WARSAW, Ind. — Michael Shopenn’s artificial hip was made by a company based in this remote town, a global center of joint manufacturing. But he had to fly to Europe to have it installed.”</p>
<p>There is a lot of misinformation and faulty assumptions in this thread. This is a shame.</p>
<p>Many parents of my patients with chronic or life-threatening illnesses now cured, have been out of their heads worried about what will happen to their kids. The ACA was able to set many of them at ease-- though now they’re worried something will happen to it before their children reach adulthood. Medicaid used to take care of these kids as they turned to adults, but paradoxically, as medicine improved and they live to older ages with less disability (cystic fibrosis, leukemia cures, sickle cell, diabetes, HIV, congenital cardiac defects), they and their parents worry much more about insurance coverage and healthcare access.</p>
<p>How could a private system ever cover those individuals? We need a system that deals with these situations.</p>
<p>Lookingforward, that was a great link on Rhode Island’s preexisting healthcare issue. Thanks.</p>
<p>Well, many of them are fine and will be healthy, productive workers, but the insurance companies can’t/won’t take the time to see that their risks are low or moderate. I’m talking about normal people with a history of illness, not those unable to work (who would still be covered under Medicaid or SSI).</p>
<p>Information on state high-risk insurance pools for those with pre-existing conditions:[NAHU</a> - Consumer Information - Consumer Guide To High-Risk Health Insurance Pools](<a href=“http://www.nahu.org/consumer/hrpguide.cfm]NAHU”>http://www.nahu.org/consumer/hrpguide.cfm)</p>
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</p>
<p>Bay…</p>
<p>I played with your link.</p>
<p>I put in that I am a 58 year old woman with cancer because I knew somebody with those characteristics that used California’s high risk pool. </p>
<p>This is what I received back…</p>
<p>"Coverage: Coverage lasts 36 months. Offers a variety of medical services provided by HMOs and PPOs and has a 3 month exclusion period for pre-existing conditions. There is a $75,000 annual limit, $750,000 lifetime
limit, and a $500 annual deductible.*After 36-months, subscribers can enroll in guaranteed private coverage.
Cost: Monthly premiums range from $258.41 to $2,214 depending on your age, region in CA, and program.</p>
<p>Information: For more information, contact the MRMIP program at 800-289-6574 or visit them online at*<a href=“http://www.mrmib.ca.gov.”>www.mrmib.ca.gov.</a>"</p>
<p>I am pretty sure her costs would be in the high end because of her age…</p>
<p>This is the only policy the person I know could get until she was cancer free for 10 years.</p>
<p>She was healthy for over 50 years and then boom…</p>
<p>We have seen posters get cancer after a healthy life.</p>
<p>Check out the annual and lifetime caps…</p>
<p>Luckily, the person I am basing the above parameters on has been cancer free for well
over 10 years. Otherwise that annual cost cap would have been a joke.</p>
<p>ACA, ends preconditions as a criteria for healthcare insurance.
Ends annual caps.
Ends lifetime caps.</p>
<p>Eliminating the above costs money, but we are now insured against very bad things happening. That is a good thing.</p>
<p>Bay, I was going to send that link to a friend that wants to retire but cant because his wife had cancer and she cant get insurance. </p>
<p>Those caps dont work for her. Her initial treatment cost $1,000,000. </p>
<p>By the way, she was healthy until she got the cancer.</p>
<p>How did she pay for the $1million?</p>
<p>She has great insurance thru her husband’s employer. That is why he cant quit. His wife is covered under his plan. He is 65 and he wants to quit working and he cant quit. She works for herself. She cant get coverage. She may eventually try to join a small group and get covered that way.
My daughter used to work for a health insurance company. She still works in the industry. My daughter said if my friend joins a small group, everybody in that small group is going to see their costs go up.</p>
<p>Setting aside the emotional issues, and the ACA, there is a philosophical question about whether a sick person ought to bear a portion (and how much) of her medical costs, and whether unlimited (no caps) care makes sense for society.</p>
<p>It looks like your friend may be able to get coverage via the high risk pool, and after 3 years she will become eligible for regular private insurance coverage. Yes, the high risk coverage is expensive, but it is capped at 1.5 times what a healthy person her age would pay (and has an income component), and yes she may be responsible for some out of pocket costs. In 7 years she will be eligible for Medicare. Is that unreasonable? I don’t think there is a set answer to that question.</p>