<p>GP: No…not going to Medical. We are running spreadsheets with different scenarios that affect income. This particular one was rather astounding. Does anyone know if someone can be forced to accept Medical…does the new system preclude one from purchasing on the individual market if income is below a certain threshold. We sure as heck wouldn’t want to hit that lower limit.</p>
<p>CF, we’re in south jersey, S is at Udel, and his internship next year is in Philadelphia, so he would still need at least 3 state coverages, not including traveling on vacations. UD offers insurance, but we will not know the price until August 1st. Since he lives in a dorm, he is not considered a resident to be able to get the DE state insurance. </p>
<p>My DH is already on medicare, so it’s just me that needs coverage and at 64 when our policy is up, I will probably need better coverage than S! I would be afraid to leave the state if I had an EPO, and NJ is a very small state. Yes, I know EPO covers emergency room care, but not hospital admission in a non participating hospital.</p>
<p>Looking at the difference in prices, national POS coverage with out of network available would only be $ 60 a month more than a regional EPO for both of us (1234 vs 1174 per month). This is still less than the 1325 we’re paying now, but way less coverage. </p>
<p>I’m just angry that I’ve been with BCBS since 1968 and now with the ACA changes for small businesses and the EPO model, I can’t get the insurance I want. I was totally satisfied with the plan I had, which was cancelled, probably because the PPO coverage was too good. I don’t like the idea of starting over with a different insurance company. That’s it for my rant.</p>
<p>“The big news today was the Medicare sex-change ruling. We are beyond nuts in this country, now.”</p>
<p>Why shouldn’t it be covered? </p>
<p>Emily- you and I see these issues the same way. It astounds me that many seem to think people get sex change operations on a whim. I really feel sorry for someone who is unfortunate enough to having to deal with the issue. It has to be unimaginable difficult.
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<p>Uhm, Medicare is infamous for telling seniors they are to old for necessary procedures that would improve the quality of their lives. I guess the hip replacement lobby isn’tpowerful enough. No-one said it was a whim. I would put it more in the elective category, though.</p>
<p>Some ARE too old, their QoL would be jeopardized by that operation. This is individual, depends on co-morbidity factors and etc.<br>
Some thinking here is so contradictory. Some want management and oversight- and, at the same time, it should all be discretionary. They want what they want, but the next guy be damned. You gotta pick your stance. Should we dump ACA because that hairdresser’s former plan is going up in price? Or find a path that works for the majority of hairdressers? Whatever.</p>
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<p>If your income is below 138% of the poverty level, you are not eligible for subsidies on the exchange. You are free to buy a policy on the individual market, no matter your income. </p>
<p>I haven’t heard that Medicare is infamous for refusing procedures to seniors. I know a number of Medicare recipients in my bike club and in my bike email lists who get heart procedures and joint replacements that improve their lives.</p>
<p>But some requests SHOULD be refused. No sense in giving a frail elderly person a hip replacement if the recovery will be so difficult that they’ll never get out of bed again.</p>
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The previous system was working for the MAJORITY of people.</p>
<p>The hair dressers went up 50%! The other poster received a 57% increase. As it stands, my family’s premium would increase by 57% if we were forced to change plans today. Can you imagine the fallout, pre - ACA, if 50% premiums were announced? Oh wait - I CAN remember - Anthem was sued. <a href=“Anthem Blue Cross settles lawsuit, agrees to limit rate hikes”>http://articles.latimes.com/2011/jun/21/business/la-fi-anthem-settlement-20110621</a>.</p>
<p>The reports given here, by real people, trying to make this new law work in their real lives and finding it to be financially strangling ARE important stories. That they do not fit into the narrative some would like to build doesn’t make them any less important. One now has to take the financing of health insurance into very high consideration when making business decisions. Spreadsheets are unemotional. It would make no sense for us to put in bogus data for the sole purpose of proving some political point to ourselves. That would be a silly waste of time. So, given the data is valid (as best as it can be given the constantly moving target), the scenarios very clearly show it is financially beneficial to work towards a smaller bottom line. Funny thing happens where the income graph crosses over the % of medical costs deductible based on income graph. </p>
<p>But …yeah, sure…whatever… </p>
<p>The system is still working for the large MAJORITY of people. We realize that some people on this thread (and elsewhere) are significantly worse off because of the ACA. But most people are about as well off as they otherwise would have been, and some people are significantly better off. </p>
<p>“I am worse off, and therefore we should change the law back to the way it used to be,” is never going to be a good argument for any proposed change. That argument by itself is never going to be persuasive for anything. You have to evaluate the cost/benefit and the fairness of the entire situation. Something is not unfair just because it makes you worse off.</p>
<p>Some act as if nearly everyone was fine before, very few are being served now (or that those being helped somehow don’t matter or that subsidies are humiliating, etc, etc,) and rates were always low, doctor accessibility was always perfect. “Real people” are not just the ones selectively brought to our attention here- what’s it been? Maybe a cumulative 10-15 links or tales of complaints? Nearly all of which we had trouble substantiating. When I linked to the FB page with thousands of supportive posts, it was deleted. </p>
<p>I know there are problems, we all do. But the dripping sarcasm that shows up here is unneeded. The people being strangled need to be heard. Yes. But they are not automatically more important than the people being aided by this policy. The narrative being selectively built on this thread, though both the links and anecodtes and deleted posts… is that it’s crap for everyone, because it’s challenging for this guy and that gal. </p>
<p>Our rates rose 50% last summer. Not because of ACA. </p>
<p>For a bit of a lookback: <a href=“Health Insurance Premiums Up 131% in Last Ten Years | TIME.com”>http://business.time.com/2009/09/16/health-insurance-premiums-up-131-in-last-ten-years/</a></p>
<p>Interesting article. It was written in September 2009 </p>
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<p>So, at that time rates increased 131% over a TEN year period. Shows that things used to rise much slower than 50%+/year.</p>
<p>At present, we don’t know rates are rising at 50%/year. That number isn’t an average, we don’t even know how common it is. My own direct buy policy dropped in cost from 2013 to 2014 (about $30/mo.) I don’t expect anyone to make broad assumptions based on this. Or on anyone else’s particular tale. </p>
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<p>If you are willing to pay the full cost of the premium, then you can buy any policy you want. The same policies are sold on and off exchange.</p>
<p>If you want a subsidy, then if your income is below 133% of the FPL, you will be shifted to MediCal.</p>
<p>Or, to put it in another way, MediCal is the mechanism by which lower income individuals and families get government-subsidized health insurance. (In most places MediCal recipients are actually enrolled in an insurance program; in some cases they have a choice of programs).</p>
<p>There is no penalty for someone who claims a higher income in order to qualify for a subsidy, and then their year-end income turns out to be less – they are just treated as if their income was exactly 100% of FPL. </p>
<p>It’s probably best for individuals with substantial assets to avoid MediCal if they are age 55 and older because of other laws (unrelated to ACA) which require the state to recover expenditures for MediCal from your estate. </p>
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If you wanted it, the problems are whining. If you didn’t, they’re affirmation. Viewpoint is key, and each is precious in it’s own way.</p>
<p>Speaking of which – it’s probably more the tide of administrative actions and reporting that’s building whatever narrative you perceive. Whether you like what’s being posted or not, there’s value in the anecdotal reports.</p>
<p>Good grief! “The people being strangled need to be heard. Yes. But…” LOL</p>
<p>A new health care law should not be strangling anyone. imho.</p>
<p>" Our rates rose 50% last summer. Not because of ACA "</p>
<p>Well if not because of ACA ,then why did they rise ?</p>
<p>I am curious LF, so you have a plan that is largely paid by an employer or are you covered as a small business owner ? Maybe neither of the two and you just pay as an individual ?</p>
<p>I’ll make a deal with you…I won’t pretend that health care insurance was great for everyone before Oct 2013 or when ACA was signed into law if you don’t’ pretend that it is better now…we were lied to and those who were happy with their plans were NOT allowed to keep them
As proof that I am not a moderater, I predict my comment will be deleted as they have a couple of other times</p>
<p>Look, if I link 10 media reports of frustrated individuals and there is no balance in what gets posted, it looks like every tale out there is bad-- because that’s all you see. That’s not some sort of accurate vehicle. I realize a few posters talked of their own situations or those of friends. But that still doesn’t give us much detail. Not for those individuals and not for the country. </p>
<p>This doesn’t excuse anything, but there is lots going on where the benefit is to the greater number or some populaces, not to every individual. I wince every time someone talks about “job creation” that only affects a segment of society. I mind certain tax write-offs. Many mind what they pay in taxes for local schools, after their kids are grown. My car and home insurance are outrageous, because of where I live and essentially beyond my control. The list is long. </p>
<p>lje: we lost our group coverage.<br>
As for “you can keep,” that makes a nice ‘headline’ for the naysayers. Ever read the conditions under which you can keep it?</p>
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Not when they are 2nd hand rumors reported without basic facts.</p>
<p>Someone’s hairdresser’s insurance premiums went up by more than 50%. 50% from what? $200 to $300? $300 to $450? $500 to $750? Those all very different scenarios… Are we given the premium amount? No. </p>
<p>How old is the hairdresser? My insurance went up more than 50%…but the bulk of the increase is do to my age. Pre-ACA, the insurance companies rated in 5-year bands – so anyone who was age 29, 34, 39, 44, 49, 54, or 59 last year would have a big jump in rates this year-- the older the person, the higher the dollar increase. Are we given the hairdresser’s age? No.</p>
<p>The story sounds kind of wonky to me because the claimed deductible and out-of-pockets don’t match what policies now require. But we can’t get details because it’s a 2nd hand report. So maybe the hairdresser has some details wrong- now it’s reported as fact. We can speculate all we want, but we don’t have the hard facts. </p>
<p>There is value in verifiable information. </p>
<p>Otherwise, it’s pretty much the equivalent of reading a story about some kid that applied and was accepted to all 8 Ivy League colleges, or some family that managed to rack up $300K worth of debt to put their kid through college. The stories have some basis in fact but they aren’t representative. </p>
<p>My insurance was cancelled and the new plan offered to me cost 60% more than the plan I had. I wasn’t being moved to a new age band, so that had nothing to do with the rate increase There is nothing anecdotal about that. The cheerleaders said I was whining and undeserving because I had gotten a great deal before Obamacare, as I was the beneficiary of those with preexisting conditions who had gotten screwed by the insurance companies. </p>