Affordable Care Act Scene 2 - Insurance Premiums

<p>[Eligibility</a> | Medicaid.gov](<a href=“http://www.medicaid.gov/AffordableCareAct/Provisions/Eligibility.html]Eligibility”>http://www.medicaid.gov/AffordableCareAct/Provisions/Eligibility.html)</p>

<p>There is an overlap between 100 and 133 percent between Medicaid and subsidies. Does anyone know why?</p>

<p>$76 comes out to be just under ~20% of my monthly income.</p>

<p>If BCBS can’t do it, I’ll go elsewhere because that’s not right.</p>

<p>And if they WON’T insure under 138%, they’re leaving us without coverage for 3 months. I will not be the only one cancelling my BCBS policy if that’s the case I’m sure.</p>

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<p>IF I did want Medicaid, I’d be without insurance for three months.</p>

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<p>People in that income range might not be able to estimate their income perfectly, and don’t want to be bouncing from insurance to Medicaid to insurance.</p>

<p>Can someone (Calmom?) clarify this for me: Someone on another board wants to buy platinum insurance for two months, get the operation she needs, and then cancel. Am I right that insurance is sold by the year, not the month?</p>

<p>"People in that income range might not be able to estimate their income perfectly, and don’t want to be bouncing from insurance to Medicaid to insurance. "</p>

<p>May be I have the wrong idea but isn’t it better to be on Medicaid in order to avoid deductibles?</p>

<p>Lots of doctors don’t take Medicaid. Also at low income levels, your copays are subsidized too.</p>

<p>Is that the only reason to avoid Medicaid? </p>

<p>I see some of the out of pocket requirements and I am not sure many making 200-300% of incomes can cover that much gap if needed. If there is no out of pocket (I don’t know if I have this wrong), isn’t it better.</p>

<p>Sorry, texaspg, I edited my comment while you were replying. But the short answer is, for lower income levels, not only is the premium subsidized, but the copays are subsidized as well.</p>

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<p>I did not know that. Can you describe how this works? I was thinking that even with subsidized premiums the lower income folks will have a problem accessing health care because of the deductible and co-pays.</p>

<p>Here’s a writeup on the cost-sharing subsidies:
[In</a> Addition To Premium Credits, Health Law Offers Some Consumers Help Paying Deductibles And Co-Pays - Kaiser Health News](<a href=“http://www.kaiserhealthnews.org/features/insuring-your-health/2013/070913-michelle-andrews-on-cost-sharing-subsidies.aspx]In”>In Addition To Premium Credits, Health Law Offers Some Consumers Help Paying Deductibles And Co-Pays | KFF Health News)</p>

<p>The cost sharing subsidies only apply if you buy Silver.</p>

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<p>Only people who designed the system can tell.</p>

<p>We need to remember that threats do not only come from internet, but also from malicious or stupid insiders.</p>

<p>Several months ago MNsure had to let go an employee who inadvertently emailed SSNs and driver licenses of 1,600 agents to another insurance agent. He was fired for storing sensitive information on his computer unencrypted (which violated MNsure policy). </p>

<p>However, my question is why was he able to store that information on his laptop at all? Moreover, is there ever a legitimate need for an employee to extract SSNs and driver licenses from the database (as opposed to look up someone’s non-sensitive information based on (parts of) SSN and/or driver license)?</p>

<p>Any reasonable plan would

  1. complete fixes
  2. e2e test (weeks)
  3. fix issues; retest
  4. freeze code
  5. security test (weeks)
  6. fix issues; retest
  7. freeze</p>

<p>I dont think the publicized Nov 30 date could include the security testing because it would have to allow a couple of weeks to test and fix any issues. Which means everything would pretty much have to be fixed right about now. </p>

<p>I’d imagine that when people say end of November they mean to get to step 2 or step 3.</p>

<p>"So most ObamaCare plans don’t include the vast majority of the best cancer doctors and cancer centers. That’s a huge problem for these patients. As Dr. Scott Gottlieb, a former Medicare official, writes: “Cancer patients often need the help of specialized doctors and cancer institutions that won’t make it into many of these cheapened networks.”</p>

<p>[Death</a> by Obamacare: ?Reform? reams cancer patients | New York Post](<a href=“http://nypost.com/2013/11/12/death-by-obamacare-reform-reams-cancer-patients/]Death”>Death by Obamacare: ‘Reform’ reams cancer patients)</p>

<p>The headline overstates the case but the author makes good points in the article.</p>

<p>I don’t know if NY State will be having some changes in those doctors taking Medicaid, but, yes, having Medicaid is a huge impediment around here. Few doctors in many areas here will take Medicaid and those that do often have long wait times both to get an appointment and in waiting at your appointment. You can truly feel like you are getting the short shrift when you are a Medicaid patient, and I think you are many times. Trying to get any expensive procedure that his not life threatening can be a real issue on medicaid. Again, I’m wondering if ACA and the expansion of Medicaid will be changing things much around here.</p>

<p>This article was written a year or so ago, but it explains why having Medicaid over some of the other insurance options can be a problem.</p>

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<p>Where would the test cases come from? You can test against common weaknesses such as OWASP Top 10 and CWE Top 25, but these tests will not catch all vulnerabilities. </p>

<p>They should go back and identify security requirements, threat model their design, identify mitigation strategies for threats, etc. etc. Only after they fix issues with the design and architecture, they should proceed with security testing.</p>

<p>80-20 rule…</p>

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<p>which makes no sense at all. Those who will struggle with co-payments are the ones who will be buying the cheapest plans, the bronze plans…yet only the silver plans offer subsidies with co-payments and deductibles?</p>

<p>Interesting use of passive voice in that Post article. Cancer centers “are excluded” from plans? Let me help the Post writers:</p>

<p>All across the country, leading cancer centers — including New York’s Memorial Sloan Kettering — excluded themselves from the largest plans.</p>

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<p>I was thinking the same thing. I was also thinking that even with subsidized out of pocket costs, some low income folks will have financial difficulties.</p>

<p>CardinalFang, that will likely be changing. The company that offers us our healthcare uses an identical model that is used for ACA market choices. Yes, identical, as they worked on the model. I am not excluded from MSK or any number of hospitals,doctors, who have not signed on with ACA. I know because I checked them all out thoroughly, as my son is a card carrying MSK patient in the Long term surviviors program. So things have not come together on this because it makes no sense that we are “in” with the exact same insurance that some selecting this option on the market is–it’s just that a company is paying our premiums on a group basis, and that the person picking from the market is not. This is the case for a lot of the doctors and hospitals in NYC. I have been told by several of the doctors and hospitals that this will change.</p>

<p>I’m not quite understanding what you are saying, cptofthehouse. Are you saying that as employer-supplied health insurance starts to use the same cost controls as the individual market, Memorial Sloan Kettering is going to realize it has to play ball with the insurers or have no patients?</p>