<p>Real life in our family was this: Premiums based on age AND health status, which was very adverse for us due to preexisting conditions. Premium increases which averaged more than 15%, year in and year out. Deductibles that went up every year as coverage went down. Inability to move to a better plan, due to preexisting conditions. Inability to move to another insurer, due to preexisting conditions. Paying out of pocket for expensive routine screenings. Not having tests which the doctor said were necessary. Wondering what would happen to our daughter, who has an “automatic decline” preexisting condition, after she graduated and was kicked off our plan. Being at the utter mercy of Anthem. </p>
<p>“Deductibles that went up every year as coverage went down”.</p>
<p>This is not true. Remember, you’re talking to someone who had insurance in the individual market for close to 25 years. You don’t need to exaggerate.</p>
<p>“Paying out of pocket for expensive routine screenings. Not having tests which the doctor said were necessary.”</p>
<p>For many people this will not change under Obamacare if they are diagnosed with something.</p>
<p>“Inability to move to another insurer”</p>
<p>For all intents and purposes, with only two carbon copy choices, a person today doesn’t have any real choices in the individual marketplace in Ca.</p>
<p>One thing you’re forgetting, at least you had a real choice of doctors and providers in the pre-Obamacare days. </p>
<p>I’ve noticed something. ACA has changed the debate about health insurance in one very important way. </p>
<p>Before ACA, it was perfectly acceptable to have a health insurance system which discriminating against people with pre-existing conditions. Millions of us knew this was a huge problem, but no one ever talked about fixing it. Our system was based on unfettered free enterprise, where naturally an insurer wouldn’t want you if you were sick. Regrettable, but that’s how it is, was the attitude.</p>
<p>Now the idea that this population should be able to get decent affordable coverage is virtually unquestioned (with a few notable exceptions like we saw today on this thread). Even the most ardent opponents of ACA won’t say that we should go back to the days when sick people couldn’t get insurance. The American public is overwhelmingly on board. All opposition “replacement” plans include some way to cover the very sick, though the most-often floated idea – high-risk pools – [has been spectacularly unsuccessful to date](<a href=“The GOP Solution To Health Coverage For Pre-Existing Medical Conditions”>http://www.forbes.com/sites/rickungar/2011/01/02/the-gop-solution-to-health-coverage-for-pre-existing-medical-conditions/</a>) and would require ongoing and massive infusions of federal cash. But almost no one is saying that sick people should just accept that they’re out of luck. </p>
<p>“Before ACA, it was perfectly acceptable to have a health insurance system which discriminating against people with pre-existing conditions.”</p>
<p>Thanks for speaking for the rest of us about our thoughts regarding this issue. According to you, I was one of those people who said all people with pre-existing conditions could go to h*ll. I guess I am just a cold-hearted insensitive scrooge. Does that make you feel better. Ruining the system for millions of people, however, was not an acceptable solution to fix this problem.</p>
<p>GP, no we don’t have a grandfathered plan. We bought the new one on CoveredCA. Premium is lower, deductible is lower, max out of pocket is lower, coverage is better. And we are not having any problems finding providers. Sorry to disappoint you. But then, we don’t require that our doctors have Picassos lining the hallways.</p>
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<p>How the bleep do you know this is not true? Have you somehow reached into my file cabinet and discovered my Anthem records going back 20 years? You are not dealing with a newbie to the California individual insurance market.</p>
<p>We had an annual ritual. Six months before renewal, we’d get a letter telling us what services they were going to stop covering come March 1. Then 2 months before renewal, we’d get the letter I most dreaded every year: the announcement of the premium increase, normally in the low teens, but several times in the 20s and once it was 30%. I forget which of these letters informed us of the escalating deductible, but that came every year like clockwork too.</p>
<p>Of course, premium increases like that are unsustainable, so every 3-4 years, we’d have to step down the coverage and/or up the deductible in order to keep the coverage at all. The last year before ACA saved us, our combined deductible plus premiums totaled more than $22K. </p>
<p>By this, I meant that no one was even talking about helping people with pre-existing conditions, much less fixing the problem. Few seemed to be aware of it, except those of us who suffered with it. But now that everyone knows about the problem, large majorities of the public and virtually every ACA opponent – including you, I believe – agrees that it’s a situation which should not exist.</p>
<p>LOL are you kidding me? I can assure you, they did.</p>
<p>But it occurs to me, maybe you didn’t have the same experience we did. DH and DD both have pre-existing conditions which made them very unattractive to Anthem. However, Anthem wasn’t allowed to just kick them out, so instead, several times they pulled a nasty trick called “closed block” wherein they stopped selling our plan to new subscribers. (dstark and I talked about this earlier in the thread; we were both included in a class action settlement on one closed block.) A closed block has the effect of isolating the sickest (most expensive) subscribers in separate little pools, because before ACA it was unlikely they’d be able to get insurance anywhere else. Of course, costs are higher in these pools so premiums go up much faster than for non-block plans. As the premiums escalate at ever higher rates, more and more people drop out, often leaving only the very sickest who are desparately trying to cling to their coverage. Insurance becomes prohibitively expensive, but the subscribers were trapped because they were generally very sick. </p>
<p>Perhaps you’re healthier than some of my family. Perhaps you were never trapped like we were. Perhaps you never experienced annual double-digit premium hikes and increasing deductibles. But if you’re honest, you will certainly acknowledge the injustice.</p>
<p>My husband’s plan was cancelled and Anthem offered him another, very expensive plan. He went with an exchange plan which was considerably cheaper and with his expected usage, will cost us much less overall. I have insurance through my employer. Our daughter now has her own plan; she lives in a different state so it didn’t make sense to keep her on my husband’s.</p>
<p>“The last year before ACA saved us, our combined deductible plus premiums totaled more than $22K.”</p>
<p>Is that for three people? The Obmacare plan offered to me for two people by Blue Shield had a combined deductible and premiums of $18,500 ($23,500 if you include deductibles for two) for about 1/3 of the network I previously had.</p>
<p>“My husband’s plan was cancelled and Anthem offered him another, very expensive plan. He went with an exchange plan which was considerably cheaper and with his expected usage, will cost us much less overall.”</p>
<p>Goldenpooch, how is it you believe some dire tale in the media, a snapshot about a person somewhere, suffering- and not LasMa? A real contributor on this thread. How is it she describes her situation, pre-existing conditions, changing availability, parameters, increasing cost of insurance- her trials pre-ACA- and somehow you feel free to dismiss her, say it ain’t so, didn’t happen that way? </p>
<p>It comes out somewhat, well, odd. Does LasMa have to call a reporter, then give you her link? Do you need to play Twenty Questions with her- while you didn’t vet media anecdotes the same way? Is your financial situation equivalent to her particulars, which made the ACA indeed an “Affordable” option for her family? </p>
<p>How do you begin to tell us she’s incorrect because, at your income level, your family count, your family health and security, it didn’t happen that way to you? </p>
<p>LF: I have given personal and family anecdotes with plenty of detail both on this thread and on another one that comes to mind. If we still had post #'s I’d give a list but…I can guarantee you my personal tale has been poo pooed, denigrated, classified as ‘not passing the sniff test’ etc… When that failed it was countered with a ‘whatever’ or a ‘yawn’. My tale clearly shows a very negative ACA impact on our personal situation and that of others well known to me. I have stopped tell it.</p>
<p>We hear what we want to hear, and we hear loudest that which is playing out right next to us.</p>
<p>I agree that insurers abused the pre-existing conditions. But a system that does not penalize unhealthy habits that increase costs for everyone makes no sense either. The morbidly obese, drinkers, drug abuses, etc. should have to pay much higher premiums. </p>
<p>Recently I was in a large retailer in the checkout line. Ahead of me was a grossly obese woman in a motorized scooter. Her fanny hung over each side. Her shopping basket contained the following: bags of candy and Doritos. It makes me angry that I am subsidizing people like that who don’t even try to be healthy. And there are millions like her and we all know it. So go ahead and flame away at how insensitive I am.</p>