<p>“It’s not a virtue to try to climb out of poverty? Oh…Hmmmm.”</p>
<p>You climb out of poverty with help. It is easier. :)</p>
<p>My grandson is on Medicaid in Washington and has been for awhile. However Washington “rebrands” Medicaid, they do things very well. My grandson gets excellent medical care. My son took my grandson to the emergency room at Children’s Hospital this past week. Among other things, they were seen very promptly. (Totally unnecessary trip, occasioned by my 3-year old grandson’s rich fantasy life and great acting skills – some day that kid will win an Academy Award for Best Actor, until then I envision that this won’t be the last false alarm.)</p>
<p>But the point is that Medicaid is a pretty good deal in Washington, at least in Seattle; my son plans to sign up himself. (He’s a grad student, living on peanuts & loans – but would hope and expect that he’ll have employer coverage once he graduates). </p>
<p>I wonder if the mother who doesn’t want Medicaid feels about Medicare? It’s only o.k. to take a government “handout” if you are over 65? </p>
<p>A very big key to ACA is the Medicaid expansion: the idea is to get everyone covered.</p>
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<p>She should bristle at the thought of being a patsy. Everyone gets government subsidies.</p>
<p>What does that solve? She doesn’t want to be on Medicare. Maybe, she can buy a supplemental policy.</p>
<p>I don’t care what you all say. I think it’s sad.</p>
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<p>No, the “system” didn’t forbid it. </p>
<p>The computer interface prevented it.</p>
<p>All the woman had to do was to get on the phone with a live customer service agent and explain that she understood she would not qualify for any subsidy and wanted to sign up to pay full price for a plan – or contact an insurance company directly. </p>
<p>You’ll notice that there was nothing written in the article suggesting that the mother or anyone else had attempted to do that.</p>
<p>You are right calmom. She should try the call center. I hear they have all the answers.</p>
<p>Flossy,
My Dad was the same way. He would not want a government handout. He collected SS and Medicare, because he paid into it.</p>
<p>In CA, if your income is low enough to qualify for Medi-Cal (medicaid), you cannot opt to pay <em>up</em> for a subsidized exchange plan. You are ineligible for subsidies. Your only alternative is to buy an unsubsidized plan.</p>
<p>calmom,
I think the article said the plan she had went up to over $400, which she couldn’t afford. She could afford her old plan.</p>
<p>This is an email from an employee of the one major insurance companies:</p>
<p>"I am currently working to implement ACA for a major insurer in California. You have been talking about claiming that 50,000 enrollees is a win for Covered California even though the numbers fall far short of the estimates. It’s even worse than that. We have yet to fully process a clean file from the exchange. At the insurer level, this effectively means that we have enrolled and effectuated zero users as of today.</p>
<p>The process requires enrollees to make a payment to be truly “enrolled”. The state anounced in September that their payment processing would not be made available to enrolless until 2014 sometime. Covered CA was supposed to process a binder payment when users enrolled but they couldn’t get it to work. Without being able to process payments, nobody has bene fully effectuated – at least at my insurer.</p>
<p>Once we process files, we will notify enrollees that they must make a payment before they are enrolled. I have serious doubts that we will see high rates of payments which means that the current estimates of 50-60K enrollees will drop dramatically when people are asked to pay to finish their enrollment. We don’t even know who has enrolled for our plans yet."</p>
<p>Why couldn’t the insurance company make a $0.01 payment towards each new enrollee from themselves to themselves to get new people into the system?</p>
<p>Also, we all pay into medicaid and every other government “handout” program. That’s what our taxes are for. Why distinguish between those which have been earmarked on your paycheck and those that haven’t?</p>
<p>Medicaid is a program for the poor. Can you really not understand why there are folks who would find that insulting when they previously were managing to afford health insurance they liked and believed they could keep because that is what they were told repeatedly? Really?</p>
<p>What if they decide you can’t afford food and nicely pass out coupons and suggest you line up and wait for things that would be better for you. It’s a bit much.</p>
<p>Calmom, issue was our income dropped from 2012. 2014 will be lower than 2013. At the same time, D1 is working (not making a lot, but more.) Etc, etc. I think I got through the verification, did get to the plan selection page, stopped there while I chew on the details. Tomorrow I’ll call them again, to verify we got verified. </p>
<p>Now the question is: why is there a lower priced Silver plan with lower deductibles and a lower max OOP than the next Silver plan costing about 30% more? I can see where they differ- but the overall lower deds/caps are alluring. In our case, no loss of providers and the OOS cancer center is covered. (New England; we cross borders a lot.) The hosp by D2’s college is covered. More to come, IF it turns out to be interesting.</p>
<p>On another note: GP, it’s not always necessary to 100% complete a process to have the effects. You’ve got the enrollees, there are workarounds to resolve the payment aspect. Happens. I certainly don’t know the guts of how other states succeed or fail, but this isn’t a crisis yet. And, your post is unattributed.</p>
<p>The issue is how many of these people will become premium-paying policyholders? We are not going to know until Jan, so I think it is premature for Covered Ca. officials to start celebrating. </p>
<p>These numbers probably include large numbers of people who are currently not paying for insurance. It remains to be seen if they’re going to start paying now.</p>
<p>Oops, sorry Lookingforward – I shouldn’t have assumed that you were worried about making too much and getting hit with taxes later on – I guess your problem is making sure you can get enough subsidies so that you can pay the bills now. </p>
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<p>Same or different companies? I noticed in my region that there was considerable variation among different insurers, and also that the ones that were lowest cost for Bronze were often higher cost in the higher metal tiers that the companies that were charging more at the lower metal end. Obviously different provider networks & contracts would make a difference, but it’s interesting that the cost array varied at different levels. The biggest cost division was between HMO & PPO, which is understandable- so without seeing the specific plans you posted about, I’d guess that the lower cost Silver is an HMO.</p>
<p>"My grandson is on Medicaid in Washington and has been for awhile. However Washington “rebrands” Medicaid, they do things very well. My grandson gets excellent medical care. My son took my grandson to the emergency room at Children’s Hospital this past week. Among other things, they were seen very promptly.</p>
<p>But the point is that Medicaid is a pretty good deal in Washington, at least in Seattle"</p>
<p>And apparently a far better deal than for those in the individual insurance market. Starting Jan 1st, if you are in that market and want your child to be seen at Children’s, you have to get insurance company approval for a “specialty hospital.” If they end up disapproving, you pay out of pocket, and who knows how long it takes to get approval. Tough luck if it’s an emergency.</p>
<p>But the Medicaid patients can be seen there, no problem. Apparently they’d like to encourage as many people as possible to go on Medicaid.</p>
<p>“The issue is how many of these people will become premium-paying policyholders? We are not going to know until Jan, so I think it is premature for Covered Ca. officials to start celebrating.”</p>
<p>I think the more people who are now able to get insurance, regardless of who is paying the bill, is a good thing. </p>
<p>Such disregard for those signing up who qualify for medicaid - like they don’t count. :(</p>
<p>"But the Medicaid patients can be seen there, no problem. Apparently they’d like to encourage as many people as possible to go on Medicaid. "</p>
<p>This is interesting. Only few pages ago we were discussing why Romani should not be on Medicaid because many doctors are not accepting patients. Sounds like Washington actually has preferential treatment.</p>
<p>"Only few pages ago we were discussing why Romani should not be on Medicaid because many doctors are not accepting patients. Sounds like Washington actually has preferential treatment. "</p>
<p>Yes, I think Medicaid may vary greatly from state to state. I fail to understand why people in the individual markets are getting preferentially poor treatment, and wonder if the goal is to encourage everyone possible onto Medicaid. Now that there is no more asset testing, anyone with a sick or special needs family member have little incentive not to get Medicaid as opposed to an individual policy. I’m still not sure where all the money for expanded Medicaid comes from.</p>
<p>Romani should move to Washington.</p>
<p>“I’m still not sure where all the money for expanded Medicaid comes from.”</p>
<p>100% from the federal government for the first 3 years, after that, iirc, the % decreases each year.</p>
<p>“100% from the federal government for the first 3 years, after that, iirc, the % decreases each year.”</p>
<p>But I mean, where, exactly does it come for in the budget? This is going to be a huge expense, how is paid for? Thin air, or maybe we’ll just print money for it? I’m curious if they realistically budgeted (or budgeted at all) for it.</p>