<p>Add me to the list of positives. I finally get good coverage I can afford. Better coverage for $100 less a month.</p>
<p>cartera, our good experience means nothing to naysayers. At this point, I believe it’s just wasted breath. </p>
<p>Here’s to our (and the millions of other) success cases though :)</p>
<p>I’m going to count myself a winner, too, though the reasons are a bit more complicated. My family & I are on an excellent employer-sponsored health plan, so there’s no immediate effect on our premiums, provider network, or scope of coverage. But our older daughter is graduating college in the spring with a humanities degree from an outstanding liberal arts college–a course we encouraged her to follow because we’ve always believed that while humanities studies don’t necessarily lead to predictable or immediately lucrative career paths, in the long run (and beyond the inherent value of a good education) it’s critical thinking and oral and written communication skills that are in short supply, so a good education, played well, should create career opportunities down the line. In the short term, though, leaping into the job market is tough. The ACA allows our daughter to stay on my group coverage to age 26. That’s a huge relief. The ACA also expands her options as she seeks her first full-time job and launches her career; she won’t be locked into a narrow search for an employer that offers good health benefits through an employer-sponsored plan. If the employer (say a small business or a small non-profit) doesn’t offer coverage, she can stay on our plan until 26, and/or buy reasonably priced insurance on the exchange–potentially with a subsidy, depending on her entry-level salary–regardless of pre-existing conditions. And just to be clear, here in Minneapolis/Saint Paul the premiums on the exchange are reasonable, and provider networks are extensive. For our family, these are all huge positives as they pretty much guarantee our daughter won’t be left without insurance.</p>
<p>Wonderful for your D, bc. Best luck to her in the job search!</p>
<p>
</p>
<p>Cheers! Glad to be among good company.</p>
<p>Second wave of health-insurance disruption affects small businesses.</p>
<p>[Second</a> wave of health-insurance disruption affects small businesses - The Washington Post](<a href=“http://www.washingtonpost.com/national/health-science/second-wave-of-health-insurance-disruption-affects-small-businesses/2014/01/11/dc2f7404-6ffe-11e3-a523-fe73f0ff6b8d_story.html]Second”>http://www.washingtonpost.com/national/health-science/second-wave-of-health-insurance-disruption-affects-small-businesses/2014/01/11/dc2f7404-6ffe-11e3-a523-fe73f0ff6b8d_story.html)</p>
<p>Maryland’s health insurance exchange disaster. As of Friday, only 20,000 people signed up.</p>
<p>[Maryland</a> officials were warned for a year of problems with online health-insurance site - The Washington Post](<a href=“http://www.washingtonpost.com/local/maryland-news/maryland-officials-were-warned-for-a-year-of-problems-with-online-health-insurance-site/2014/01/11/f094ad94-6a98-11e3-8b5b-a77187b716a3_story.html]Maryland”>http://www.washingtonpost.com/local/maryland-news/maryland-officials-were-warned-for-a-year-of-problems-with-online-health-insurance-site/2014/01/11/f094ad94-6a98-11e3-8b5b-a77187b716a3_story.html)</p>
<p>Right now, at least in the Medicaid expansion states, anyone who wants insurance can get it. There may be logistical confusion or issues – for example, there are still people experiencing difficulties in making or verifying payment, or people who haven’t received their insurance cards – but the point is that there is no longer any such thing as an “uninsurable” person, and (at least in the expansion states), no one is shut out due to financial inability to pay. Individuals and families at poverty level can get Medicaid – and low to moderate income families can get subsidies. Whether the rates for insurance have gone up or not depends one what sort of insurance the person/family had before and the local insurance market. </p>
<p>Higher income individuals and families may have to pay more if they are ineligible for subsidies, but that is not the same as insurance being “unaffordable”. My one person premium last year was ~$400 and now it is about ~$665, but part of that is an age issue - the $400 was based on a 55-59 age rate category and any insurance I buy going forward is going to be based on age 60+. (I haven’t figured out a way to solve the problem of my getting older every year, but if I do I will be sure to post the solution here.) If I could still get the plan I had last year, it would probably cost around ~$650.</p>
<p>The cutoff for subsidies is approximately $45,000, and if my income is that much or less, then I will pay ~$300 a month for insurance. I’d rather earn more, but obviously I won’t do that well if my income is between $45-$50K. However, whether it is $45K or $50K or $60K or $100K, I can afford the premium I am being charged, even though obviously I would prefer to pay less. That is, I could come up with that money if I had to. So the difference between pre-ACA and post-ACA for me is that before, I would have had to pay about $7800 per year on insurance with no possibility of a premium reduction, and now I will have to pay slightly more than that, with a strong possibility of having my premiums reduced. (But I’d be better off all around if I simply had an income that was about $7500 more )</p>
<p>The more significant thing is that, as a self-employed single person, I no longer have to worry about the consequences of an illness that is significant enough to reduce my earning capacity. Not only can I currently afford to pay the insurance (at whatever level), but I know that I will never lose insurance in the future due to inability to pay premiums. If my income goes down, so will the cost of my premiums. </p>
<p>I also have to keep in mind that part of my high end premiums are simply because I have reached the highest age rated levels, and I may pay more over the next 5 years, but after that I go into Medicare – and my personal costs will then come down no matter what my income is. </p>
<p>I agree that everyone’s situation is different, but the bottom line is that ACA has eliminated a whole class of uninsurable people, and has also provided a way for low income people to gain access to insurance in at least half the states. Since the program creates more opportunities for insurance but does not take away insurance from anyone, then by definition once the logistical kinks are ironed out, more people will have the ability to get coverage. </p>
<p>I assume that there are some people who simply don’t want to buy health insurance, who won’t – but it’s hard to envision there being very many who wanted health insurance last year but no longer want health insurance. </p>
<p>So my point is: I don’t think it is even conceivably possible that coverage numbers would go down post-ACA – the real question is the level that they will go up. That is, it is very possible that even though more people will get coverage, participation levels will be lower than hoped and there will still be far too many people without coverage. But I think that is going to take some time to shake out as well. I don’t think even preliminary conclusions can be drawn until open enrollment ends in March.</p>
<p>GP, do you feel you understand ACA?</p>
<p>If you count the ones who enrolled in Medicaid through the Maryland Exchange, the number is 47000. The numbers are really picking up since the issues with the website are getting worked out.</p>
<p>Moderator’s Note</p>
<p>Next person who wants to refer to single payer will not be posting on this thread. </p>
<p>References to moderation are against TOS.</p>
<p>Blogs links are not allowed unless they are from major newspaper sources.</p>
<p>romani:</p>
<p>you are a lot more educated on the ACA than the average bear, how is it that your housemates (roommates?) are still outside the pool? (If you’d rather not share their personal details, we’ll understand.)</p>
<p>No, that’s fine, I don’t mind sharing. </p>
<p>One of my roommates is a very conservative Republican (actually, I think “libertarian” is probably a more accurate description but that’s what he labels himself) who refuses to get it on principle. He does not believe he needs it (one of the young invincibles). He is a kitchen manager who gets a very nice package through his work but still refuses to get it. Even though for him it is a personal choice, I do wish that we had a system where he would have it whether or not he wanted it (that’s poor wording on my part, but I hope you understand what I mean). I just can’t stand the thought of him getting sick and not being able to pay for the hospital care because of his own arrogance. We are very good friends and have been very good friends for almost a decade. The idea of him getting sick and not being able to pay his bills stresses ME out because I’m a momma bear like that…</p>
<p>My other roommate is a dishwasher and doesn’t make enough to qualify for the subsidy and we don’t have Medicaid available until April. He will be getting Medicaid once it’s available. He makes rent by essentially freeloading off his gf (one of my best friends) and they share a room. He was on his step dad’s plan until he moved out and into our place due to abuse. His step dad has since cancelled or removed him from the policy (or at least his mom said he did, whether or not it’s official yet I’m not sure but given past abuse, he won’t use it out of fear).</p>
<p>My first roommate is actually my other roommate’s boss so I know that the second roommate doesn’t work enough hours to qualify for any kind of plan through the restaurant (they do offer insurance to all full time employees but he only works about 20 hours).</p>
<p>Re Maryland – GP, let’s not confuse the website with the product sold on the website. There were serious problems with the website, including a bug that froze the site just before an applicant was about to hit the Enroll button. An inexcusable error, and we don’t know how many people it happened to. But we can assume that those people wanted insurance, but aren’t currently enrolled. Sorry, but Maryland’s numbers will go up substantially when the tech problems are fixed.</p>
<p>thanks romani.</p>
<p>For GP and dstark’s wager, that is one for each. :D</p>
<p>LOL. </p>
<p>I know my first roommate’s mother though. If she gets wind that he’s not insured- whewie is there going to be some hell to pay. He’s also the kind who doesn’t believe in having a retirement account or savings because he’s going to “die young”. :rolleyes: </p>
<p>To his credit though, he came to me for questions about the ACA and how it was going to affect the employees under him. While he doesn’t personally like it, he had employees coming to him asking questions he couldn’t answer and he passed them on to me for real answers. His bosses are… scattered to say the least and apparently weren’t forthcoming with info about how this would affect them (I’m guessing they had no idea). I helped a few of his waitress/hostess friends sign up through the exchange because a few weren’t eligible through the restaurant and a few found cheaper plans on the exchange.</p>
<p>
</p>
<p>Thanks, Calmom, for the reminder of one of the many points of this 
This one has kept me up at night for the last decade since my H and I work together as a small biz and he has a decade on me age-wise. It’s bad enough figuring out how it will all work when he retires. But to imagine him retired and me too sick to work and have coverage was truly horrifying.</p>
<p>Anyone from Oregon?</p>
<p>[Oregon?s</a> Obamacare Online Enrollment System Still Doesn?t Work More Than 3 Months After It Was Supposed To Launch « CBS DC](<a href=“CBS News - Breaking news, 24/7 live streaming news & top stories”>CBS News - Breaking news, 24/7 live streaming news & top stories)</p>
<p>People seem to forget, as a capitalistic society, we have power as consumers. For small businesses whose options are being limited, they need to hunt for a new insurance provider who will give them what they want. Large employers certainly don’t just take what the insurance says is available. They negotiate every single solitary detail of your health plan with that insurer- aside from the things that are now required by law. Small businesses would be very smart to form consortiums together and negotiate with these insurers as a larger entity. They would get whatever they want then. Money talks, larger numbers talk. </p>
<p>It isn’t all roses when you have employer sponsored health care either. When I worked for a health system, the only affordable plan restricted us to the health care system for which we worked. This brings on a whole host of other issues. Ever sit in the cafeteria at the table next to the folks who delivered your baby 6 weeks earlier? Or the people who did your colonoscopy that morning? Employer sponsored plans can limit you significantly too. Being limited to using a health system which allowed all of my co-workers to view my medical records was a really uncomfortable situation. </p>
<p>Working for an insurer (my next job after the health care system) was a little better. We had more options, but only with that one insurer, of course. </p>
<p>Now? I have a choice between two high deductible plans. Either way, I’m paying a mint out of pocket every January and February. One way, it stops after February, the other way, I still pay 20% of everything the whole year. I do have a huge network to pick from and I appreciate that SO much after being so limited in the past. I’m not sure this is the most economical plan for me, but it’s the best of the two choices I have. </p>
<p>For some people, being on the exchange opens up more options than they’ve ever considered having before.</p>
<p>Various states used various contractors for their websites:</p>
<p>[Why</a> Some State Health Exchanges Worked - Kaiser Health News](<a href=“Why Some State Health Exchanges Worked | KFF Health News”>Why Some State Health Exchanges Worked | KFF Health News)</p>
<p>Deloitte’s states did well; CGI’s states not as well (CGI did the federal site also); and poor Oregon, the only state to choose Oracle, still doesn’t have a functioning website. Perhaps the people at Oracle spent too much time worrying about sailboats and not enough time worrying about websites?</p>