<p>“The people this was supposed to cover aren’t covered. It’s insurance reform and it was designed as Medicaid expansion.”</p>
<p>That is not the fault of the law as written. It’s the fault of the states which have refused to cover these people. Hospitals in those states are trying to pressure those govs to expand because not expanding medicaid is a huge hit for them financially. Whether they will be successful is, of course, unknown. </p>
<p>Many of us also wish universal (medicare for all) had been the outcome of health insurance reform but that was a political impossibility. It was never going to be passed. Even having a public option was impossible. We have ACA because it originally was the Chaffee (R) plan (offered up during the time of Hillarycare) and what the Heritage Foundation proposed.</p>
<p>“I was looking at how many of the uninsured would be insured by the time the policies would take effect at the beginning of the year. Using a March 1st enrollment date, just in California that’s still over 5,000 new policies per day. Still not happening.”</p>
<p>And you know this how? </p>
<p>The goal is 7 million in the whole country by March 1st and I see no reason for anyone at this point, 4 days since the exchanges have been open, to proclaim ACA either a success or a failure. </p>
<p>New York had 3 million people in one day visit their site.</p>
<p>Remember not to make political comments in order for the thread to remain open. I just deleted two posts. The moderating team will not keep cleaning up the thread, but just close it.</p>
<p>You do have a plan just like that. It’s called writing a check. If you want to go to Cedars Sinai when you get sick, you can go to Cedars Sinai. You just have to write a check. What you can’t do is have an insurance policy that is only offered to healthy people, that includes Cedars Sinai as a provider. </p>
<p>Here’s my story about Cedars Sinai. A good friend of mine has relatives that live in Israel. One of his relatives came to Cedars Sinai for some surgery that was not available in Israel. My understanding was that the Israeli health system would have reimbursed Cedars Sinai for the surgery. But that was not good enough for Cedars Sinai. When the relative was already under anesthesia for the surgery, my friend was called to pay up front. He had to instantly, and I mean instantly, come up with tens of thousands of dollars so the surgery could continue. Fortunately my friend was a law partner and was able to do this, but any hospital that would ask for payment to continue a surgery that was already in progress is crossed off my list.</p>
<p>Oldmom, that’s a really good Q&A. This question bears on something we have discussed here, about reporting your income, if it varies:</p>
<p>Q. My difficulty and confusion is I don’t actually know what my annual income is or will be in the coming fiscal year. I am a freelance classical musician, meaning I have seasonal employment from as many as 20 employers in a year and I file tax returns in seven states and three countries.</p>
<p>— gibarian, San Francisco</p>
<p>A. The experts I spoke with said you needed to make your best educated guess when estimating your income. The exchange will verify it by checking your tax return from last year as well as your current income. (The federal government has contracts with firms that provide that information.) If your self-attested income varies by more than 10 percent when compared to those two sources, you will be asked to provide more documentation, according to a spokeswoman at the Department of Health and Human Services.</p>
<p>Thanks for posting that question, Cardinal Fang. I guess we will have to provide more documentation, because our engineering consulting business is doing very poorly this year. If they look at our income from last year, they won’t believe that we’re in the red in 2013! I guess I will send them a notarized copy of our profit and loss statement.</p>
<p>MaineLonghorn, they must have some standard documentation they ask for in cases where the income seems to be varying. Just one caveat: if you qualify for a subsidy for 2014, the amount of the subsidy will be based on your income for 2014. So if your business rebounds next year, as I hope it will, your subsidy would be lessened.</p>
<p>I think those of you who believe that your and other’s premiums will now be unaffordable are getting a taste of the way 40 million uninsured people (most of whom were working) have felt in the past. </p>
<p>EVERY TIME I asked a friend or relative who was opposed to health care reform what uninsured people should do, the reply I got was “Pull themselves up by their bootstraps and get a job that provides health insurance.” </p>
<p>That same option is available to those of you who are not happy with your premium increases.</p>
<p>What bluebayou said in #309 makes a lot of sense and I wish the news reports about overloaded exchange websites would think about that. We have a county facility in our area that was built for “anticipated capacity in 20 years,” or something like that. So it’s mostly empty. Seems like a waste of money. If some of us have to wait a few weeks to purchase our health insurance but by doing so we’ve saved the state taxpayers, well, I’m willing to do that.</p>
<p>The exchanges seem to be not only overloaded, but also buggy. A large software rollout has bugs, stop the presses. Eh, I won’t worry unless the exchanges still don’t work three weeks from now.</p>
<p>Fairness is in the eye of the beholder. Is it fair for smokers to be charged the same premium as non-smokers? Is it fair for someone who watches her weight to pay the same premium as someone who is obese? Shouldn’t alcoholics, drug addicts, and people who are not compliant with basic health advice pay more? </p>
<p>A huge portion of medical costs for those under 65 is due to these factors.</p>
<p>I’d go for it. As it stands, people get peanuts while insurance companies have a feast. Our higher premium isn’t paying for other poor sick people. It is mostly going to fat cats.</p>
<p>You do know about the Obamacare provision that 85% of your insurance premiums have to go to health care, and if they don’t, you get a refund, right?</p>
<p>Insurance premiums are going up on the exchanges not because insurance companies have suddenly gotten greedier (they were always greedy) but because now insurance companies have to sell individual insurance not just to healthy people but to sick people, and sick people cost money. Insurance companies are particularly going up for people over 50, because people over 50 have higher health care costs than younger people.</p>