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Obamacare101

Saturday, September 21, 2013 - 1:00 PM
4
51hh51hh1,476 posts since
Jan 16, 2010
Rep Points: 6,426
1. Saturday, September 21, 2013 - 1:23 PM
Thanks for the article but now I am confused.  It states that if people are covered at work they can keep their plans if they want.  So why are companies acting gaga and putting employees on part time so they won't have to cover them?  Did the costs to the companies go up that much higher that they have to find a way to not cover employees?  Is this really happening to employees or are the news media people making a lot of hype about nothing?  The way the article reads, I can't understand where all the problems are except that the policies through the exchanges may be more costly than anticipated. 

I guess we will learn more as we go along.  I am sure glad it doesn't affect Medicare recipients negatively.
1
paoli2paoli21,373 posts since
Aug 10, 2011
Rep Points: 6,013
2. Saturday, September 21, 2013 - 1:35 PM
I am afraid trying to distill this extremely complicated law into 6 things you need to know is quite simplistic. She was wrong to claim that your premium can increase on the individual market if you get sick. I live in Ca. and your premium cannot increase because of your health.

What she doesn't say is what will happen to people who don't qualify for subsidies. It's almost guaranteed their rates will increase substantially. If your 60 years old, have a family plan for two people (husband and wife) on the individual market and make more than $62,000 a year, your premiums could double because of Obamacare.

Also, for very poor people who are now promised free healthcare, let's see if they can find a doctor who will see them in a timely manner.
4
loulou544 posts since
Aug 3, 2010
Rep Points: 3,397
3. Saturday, September 21, 2013 - 4:52 PM
Subsidies are available for a single person up to the mid or high 40,000's and for a family of 4 up to the $90,000's I think it is $94,000 for Obamacare. 

Most of the companies are not putting their employees in the Presidents healthcare plan but in private healthcare exchange where the employees can choose which one they want. Walgreen's will give them a set amount and the employee can choose what they want. With the private healthcare plans they are putting the employees in the employees are not able to use the subsidies if they qualify. The choices and prices are similar to the choices in Obamacare except for the high deductibles.  60,000 of Walgreen's employees are part -time and are not offered healthcare. $600 extra is charged for a smoker. A friend told me she was offered a plan that paid 60% of covered proceedures and she would be responsible for 40%. She did not tell me the premium she pays. She said that was after she paid $1250 for everything out of pocket. Said some plans had higher deductibles. 
1
Ally6770Ally6770914 posts since
Jan 16, 2010
Rep Points: 2,662
4. Saturday, September 21, 2013 - 5:16 PM
Ally, ask a 60 year old couple who makes $63,000 a year what their rates will be for a family plan on the exchange next year for coverage comparable to what they have today. Ask them if the premium will be higher and by how much? You may be surprised by the answer.

Also, regarding access to healthcare under Obamacare, take a look at this article:

http://www.bloomberg.com/news/2013-09-16/obamacare-doctor-rationing-begins-in-california.html
2
loulou544 posts since
Aug 3, 2010
Rep Points: 3,397
5. Saturday, September 21, 2013 - 5:34 PM
The only one I know of that had to buy insurance on the open market was when my sister had to get insurance at 60 in 2004. She paid $1300 a month just for herself. The following year it was up to $1600 a month and the next year it she paid $2000 a month.   Her husband was on Medicare. This was in 2004. So 9 years ago. This was just for herself. I have no one to ask. Everyone is older and on Medicare. My 47 year old son pays just a little over $250 a month for Blue Cross. I don't know about Ca but I know Mississippi and Kentucky have the most unhealthy people and the rates were coming in much higher. In June 36 out of the 82 counties in Mississippi no insurance company had offered insurance. Haven't been on the sites lately. Have to go to dinner. Will look later.
1
Ally6770Ally6770914 posts since
Jan 16, 2010
Rep Points: 2,662
6. Saturday, September 21, 2013 - 5:39 PM
Lou, California has the state exchange. Swartzenager (sp) signed the law for that. They are not using the federal exchanges unless something has changed. 
1
Ally6770Ally6770914 posts since
Jan 16, 2010
Rep Points: 2,662
7. Saturday, September 21, 2013 - 6:01 PM
Schwarzenegger had nothing to do with the California exchange. It was set-up to comply with Obamacare. Every state has to have one. Either the state runs it or the federal govt if the state refuses to get involved. All exchanges have to adhere to the same set of rules.
2
loulou544 posts since
Aug 3, 2010
Rep Points: 3,397
8. Saturday, September 21, 2013 - 8:23 PM
The state can choose the state exchange, the federal exchange or choose a partnership. Schwarzenegger sign the law and chose the state exchange "Covered California" on Sept 30, 2010.

On September 30, 2010, former Governor Arnold Schwarzenegger (R) signed into law two complementary bills, AB 1602 and SB 900, to establish the California Health Benefit Exchange.: 

Structure: The legislation defines California’s Exchange as a quasi-governmental organization, specifically an “independent public entity not affiliated with an agency or department.”

Governance: Covered California is governed by a five-member board, including the Secretary of California Health and Human Services (or designee) as a voting, ex officio member, two members appointed by the Governor, one member appointed by the Senate Committee on Rules, and one member appointed by the Speaker of the Assembly. The legislation specifies that each appointed member of the Board should possess expertise in key subject areas such as, individual or small employer health care coverage, health benefits plan administration, or health care finance. While serving on the Board, members must not be affiliated in any way with a carrier or other insurer, an agent or broker, a health care provider, a health care facility or clinic, or a trade association for these entities. Also, members must not be health care providers, unless receiving no compensation for services provided.
2
Ally6770Ally6770914 posts since
Jan 16, 2010
Rep Points: 2,662
9. Saturday, September 21, 2013 - 9:32 PM
What's your point, Ally. Every state has an exchange; they all must follow the same rules. The health plans will look the same on all the exchanges, whether it is run by the state or federal govt.
4
loulou544 posts since
Aug 3, 2010
Rep Points: 3,397
10. Sunday, September 22, 2013 - 8:05 AM
For anyone who is interested:

Q: What will be the difference to consumers between a state and federal exchange?

A: In broad details, they should work the same way.  Consumers shopping in either type of exchange will choose among insurer offerings that are standardized into four coverage levels, bronze, silver, gold and platinum, along with a young adults plan.  Rules on how much insurers can vary premiums based on age or geography are set in the federal law, although states could adopt rules making them stricter. 

Differences between federal and state exchanges are likely to be subtle, but important to some consumers. States that do their own exchanges, for example, can decide which insurers participate and whether to require benefits beyond those set under federal law. They can accept all insurers whose policies meet the law's requirements, for instance, or limit participation by requiring that insurers meet specific quality or pricing guidelines.

California has chosen to limit the number of insurers, which they say allows them to choose the highest value plans, while Colorado's model will accept all plans that meet the requirements.  The federal exchange will accept all plans.

States may also be more proactive in selecting insurers that offer benefits targeted to a state's particular needs. For example, a state with a high rate of diabetes might select insurers with special programs to combat diabetes.

There is also concern that lack of cooperation by some states could make it harder for the federal exchanges to enroll people in coverage."

Sounds like to me that if the States don't form their own Exchange, the Federal government will have an Exchange for their people to use.  One way or the other, people won't have an excuse to say they didn't have an exchange to use. 
1
paoli2paoli21,373 posts since
Aug 10, 2011
Rep Points: 6,013
11. Sunday, September 22, 2013 - 8:16 AM
I forget which state it was maybe Minnesota or Montana had a low premium of $101 for a young person. It didn't say if it was the silver plan but assume it was the cheapest one. 
1
Ally6770Ally6770914 posts since
Jan 16, 2010
Rep Points: 2,662
12. Sunday, September 22, 2013 - 8:41 AM
Ally, Is this what you are referring to for Minnesota?

"The lowest-cost option of $90.59 a month applies to a 25-year-old non-smoker who lives in the Twin Cities"

That is amazing!  Almost as good as having a plan through work.  Problem is finding a 25 year old non smoker. :)  That's cheaper than our Medicare monthly premiums.   The article I read said Minnesota had the cheapest rates in the nation.  I wonder why??
2
paoli2paoli21,373 posts since
Aug 10, 2011
Rep Points: 6,013
13. Sunday, September 22, 2013 - 9:14 AM
This must have been what I saw and had the numbers wrong. Minnesota has healthier people I read. The healthier your state the less the premiums. At one time there were 36 counties in Mississippi that had no bidders and I think now it was down to 2 counties. Eastern Kentucky was another one that was said to have unhealthy people and therefore higher premiums were coming in. Not sure how it worked out. Kaiser Foundation has a lot of information on healthcare etc for states as a whole and broke down individually on the different demographics of the population. Not a lot of smokers in Michigan at least the people I am around do not smoke. I am an ex smoker and I did enjoy when I am around someone who smokes. But the last person I was around who smoked was in 2003 when I retired as twp treasurer. I haven't seen anyone who smokes since then. Stores, eating places etc do not allow them. Even in the parks or parking lots I have not seen people smoking. Even after 25 years sometimes I would love to have a cigarette. 
1
Ally6770Ally6770914 posts since
Jan 16, 2010
Rep Points: 2,662
14. Sunday, September 22, 2013 - 3:32 PM
I have been buying private individual health insurance for my wife and I for 15 years. Under the free-market existing system, companies would offer very reasonable rates to attract those without pre-existing conditions. Within a year or two after signing up with the attractive plan, huge rate increases would occur and those with good health could shop for a different plan or company and jump to another initially attractive plan. If a health problem developed, there was no option other than to absorb 100 - 400 percent premium increases with the same plan/company because pre-existing conditions would not be covered in a new plan. We were lucky with our health for many years and played the game by switching plans every few years. Then one of us acquired a health problem. For the last two years our premiums have increased 100 percent and we are stuck with this plan. Until Obamacare, there was no end in sight until we would lose our wealth through premium increases or uncovered health bills. All the healthy folks jumped ship from our plan and the group that is left are driving the cost spiral higher and higher.

Obamacare fixes this. Everyone is in the same risk pool and groups of high risk folks are not forced into the same plan together. I have seen the rates being advertised and the premiums are much lower that my current plan with much better coverage. No longer will people unlucky with their health be forced into losing their accumulated wealth due to lack of health insurance or runaway premium increases.

It saddens me to read all the misinformation that has circulated about this program. Strangely, people that I know enjoying the security of Medicare speak out against the Affordable Care Act. Perhaps those who want to dismantle Obamacare will go after Medicare next so we all can equally face bankruptcy if our health goes bad?

 
8
jamesstewartjamesstewart15 posts since
May 22, 2011
Rep Points: 72
15. Sunday, September 22, 2013 - 4:14 PM
#14  What you and  your wife went through and will encounter is the story of so many Americans.  I am on Medicare but I assure you, I have written letter after letter to Demos and Repubs urging them not to destroy Obamacare.  We desperately need affordable healthcare in this country.  I told them the poor have Medicaid, the elderly have Medicare but the middleclass are the ones who desperately NEED affordable healthcare in our country.  I begged the Republicans to work to make it more workable and affordable for companies but NOT to destroy it.  I will not vote for any Republican who destroys what may be the nearest thing we have to helping the middleclass afford healthcare.  Obamacare does have problems but I think they should make a serious effort to work out these problems so that companies won't have to jump ship with their employee benefits or put more people on part time. There IS a lot of good in Obamacare and for people like yourself, we must keep pounding on our senators and reps to keep them from destroying it.

It seems the two parties would rather spend more time blaming one another and making the other look bad than spend their energy "saving" what is good about Obamacare.  Please take the time to write to your senators and reps.  Your voice "does" count!  Thank you for caring.
3
paoli2paoli21,373 posts since
Aug 10, 2011
Rep Points: 6,013
16. Sunday, September 22, 2013 - 4:51 PM
GOP's fit over health insurance hurts my wallet

By: Jen A. Miller, September 21st 2013

House Republicans have taken their hissy fit over losing the 2012 election to a new level: They're threatening to close the government if funding for the Affordable Care Act is not revoked.

It's a stooge's move that directly affects my financial security.

They want to stop a law that could bring more affordable health care insurance to millions of Americans -- including me.

GOP's fit over health insurance hurts my wallet | Interest.com

 
7
ShorebreakShorebreak2,625 posts since
Apr 6, 2010
Rep Points: 14,226
17. Sunday, September 22, 2013 - 5:00 PM
James, this hasn't been my experience in Ca. I have been a sole proprietor for the last 25 years and have purchased my insurance in the individual market. I also changed plans a number of times but was able to do it without underwriting because Blue Cross or Blue Shield always offered less expensive plans that did not require underwriting. For the last 7 years, I have had an HSA plan which served my family very well. Today, I have over $40,000 in a HSA account which can be used to defray medical expenses in the future.

In California, individual palns were inexpensive, especially compared to other states like NY, Ma, where community rating and guaranteed issue were required. Yes, in the last two years premiums have risen fairly significantly but you need to remember  many of Obamacare rules, like elimination of lifetime coverage limits, restricting recission of policies, requiring coverage for children under 26 in existing plans, first dollar coverage for preventative care were implemented. Although you could argue that these were good reforms, they were not cheap and somebody had to pay for it.

Now I can't speak for other states, but I can tell you for a 60 year old couple who does not qualify for subsidies, the premium is going to double (from $679 to $1250 a month). I know this because this is what is happening to me. One reason this is happening is because discount pricing for family plans have been eliminated. The cost for insurance for both spouses has too be priced for each individually. So family coverage is going to cost a lot more. 

Also, the plans offered on the Ca exchange will dramatically limit the network of hospitals and doctors, thereby making it far more difficult for policyholders to have access to doctors of their choosing. In addition, I use to have over 6 companies and 50 plans to select from; now it will be only two insurance companies.  As of now I plan to get my coverage off the exchange because I refuse to have my coverage restricted by having a narrow network imposed on me.

So, in California, if you make too much money to qualify for subsidies ($62,000 for a couple) and you have received coverage from the individual marketplace, you will be getting ****ed. In my view, Obamacare is a disguised wealth redistributionist plan from the middle class to the poor.
4
loulou544 posts since
Aug 3, 2010
Rep Points: 3,397
18. Sunday, September 22, 2013 - 5:04 PM
Why hasn't Jen Miller put up a WH Petition showing how many people still WANT the Affordable Care Act? The Republicans may help take out the problems with this one and make it better instead of trashing it if they see thousands of sigs on a Petition.  This is getting scary what is going on between these two parties.

There are definitely problems with the Affordable Care Act but instead of working them out, the two parties are more interested in making the other look bad.  What a great nation we are!
2
paoli2paoli21,373 posts since
Aug 10, 2011
Rep Points: 6,013
19. Sunday, September 22, 2013 - 8:42 PM
Lou, Your insurance company told you the plan you have now is increasing from $679 to $1250 a month? 
1
Ally6770Ally6770914 posts since
Jan 16, 2010
Rep Points: 2,662
20. Sunday, September 22, 2013 - 8:43 PM
I was pretty sure I read that with the state or federal exchanges no one would pay more that 10% of their income for healthcare. 
1
Ally6770Ally6770914 posts since
Jan 16, 2010
Rep Points: 2,662
21. Sunday, September 22, 2013 - 11:22 PM
Ally, California already has a website where you can see much a particular plan will cost in your region. If you make less than 400% of FPL, then you pay no more than 9.5% of income. No limit if you make more than this threshold. As I said in a previous post, there is no more family plan pricing, instead each person will have their rate determined separately. So for my wife and I (we don't qualify for the subsidies) this doubles our premium.

This is why I said that people who don't qualify for the subsidies will get ****ed.
1
loulou544 posts since
Aug 3, 2010
Rep Points: 3,397
22. Monday, September 23, 2013 - 12:11 AM
If a couple makes a dollar more than $62,040 (not my situation) the premium would be close to 25% of income. I know if my income was slightly more than the threshold I would do everything in my power to get it below the threshold.
1
loulou544 posts since
Aug 3, 2010
Rep Points: 3,397
23. Monday, September 23, 2013 - 6:38 AM
My youngest son has BCBS of TN and he owns a recording company with 2 others. He can stay where he is at. He does not have to change he said. He is 47. He pays under $300 he said. I know when he was up here  last year  he had a severe headache. Never had one before. The doctor up here after calling his doc in Tn wanted a MRI. My other son is a doctor and they called his insurance and it was covered. So I doubt he has a skimpy plan. He is a non smoker and he eats very healthy. Everything was fine. 
1
Ally6770Ally6770914 posts since
Jan 16, 2010
Rep Points: 2,662
24. Tuesday, September 24, 2013 - 10:49 AM
 

Do we need affordable health care? Yes we do. Is Obamacare the answer? In my opinion I say no it is not.

Government is not a money making enterprise. Government redistributes. When they state they will give you a subsidy toward your health insurance cost; what they are really stating is that we will take from citizen B and give to you citizen A to help you afford healthcare. Looking at the small picture, they present this subsidizing like they are giving you money when in fact looking at the larger picture they are simply redistributing they money they have collected.

The affordable health care act misses the entire point of rising health insurance costs. If there is a $1,000 rubber band that everyone needs to have, the politicians are asking how can we get everyone to afford a $1,000 rubber band? Instead they should be asking why the rubber band costs $1,000 and how can we reduce the cost so everyone can afford?

When government gets involved in anything you can bet there will be abuse of the system. And how does the government raise funds to fight abuse or correct underfunding? They simply have citizen A and B pay more. The only good thing I see from this is that you are no longer stuck and at the mercy of insurance companies if you have a pre-exisiting condition. Other than that I see nothing positive.

 
3
FARFAR106 posts since
Feb 26, 2013
Rep Points: 381
25. Tuesday, September 24, 2013 - 11:19 AM
FAR:  I think you make some excellent points and I do agree with you.

I think when citizens read about all the subsidies etc. with Obamacare the government will give they forget that money is coming out of "their" pockets as tax dollars.  Obama is so generous but it is without our permission and no matter what else he calls it, it is a form of redistribution of wealth from person A to B.  This is going to be a loooong next 3 years until his term ends.
1
paoli2paoli21,373 posts since
Aug 10, 2011
Rep Points: 6,013
26. Tuesday, September 24, 2013 - 12:17 PM
It has already been shown that the redistribution of wealth in this country for the last 20 years has been going to the very wealthy with the gaming of the system with tax cuts and deregulation. The Federal Reserve is lowering my interest income so those who borrow and speculate can create another bubble and get weathier at my expense.
 
 I say to those who make over 62,000 a year: quit your whining. Many folks making under that amount would gladly trade incomes with you and also gladly pay the higher health insurance rates.

Since the Affordable Care Act passed, there have been no better ideas on how to solve the current unfair health care system. We all want to reduce health care costs, but no workable proposal seems to be out there to do it.

I predict that after implementation, the Affordable Care Act will become as popular as Medicare and Obama will be historically applauded for his perseverance of this program. I do not agree that health care should only be affordable to the wealthy which is how it is today.

 And what about Medicare. The government runs it, do you want to get rid of it too?  
5
jamesstewartjamesstewart15 posts since
May 22, 2011
Rep Points: 72
27. Tuesday, September 24, 2013 - 1:01 PM
James, try living in California for a married couple at $62,000 a year. I am sure Ca. is not unique in this regard. Your concept of wealthy is flawed.
1
loulou544 posts since
Aug 3, 2010
Rep Points: 3,397
28. Tuesday, September 24, 2013 - 8:21 PM
#24 You are paying higher hospital rates, doctor rates etc now for those who have no insurance. The law is when people show up at the hospital they have to be treated. So when they have no insurance they don't pay and the rates go up for the rest of us. Now those who can pay will one way or the other and those that can't will have medicaid. Those who work and earn less than 138% of poverty in some states will not have coverage thanks to their state gov who voted it down. 

Those of us on Medicare our premiums are subsidized by the taxpayer.

Medicare Part A is funded mostly by federal payroll taxes paid to Medicare by employers and employees.

Medicare Part B is funded by monthly premiums paid by people receiving Medicare Part B, plus a subsidy from the federal government.

 I don't remember the amount that the  taxpayer pays for Part B but I think it is 75% of 80%. Not sure though.

Just want everyone to know that our FICA taxes do not pay all of Part B. Taxpayers pick up the biggest portion of it

EDIT--GOV PAYS 75% OF OUR PART B PREMIUM. 
1
Ally6770Ally6770914 posts since
Jan 16, 2010
Rep Points: 2,662
29. Tuesday, September 24, 2013 - 9:31 PM
You can login on the Social Security webpage and see exactly how much was taken out of any paychecks for Medicare from the employee and how much the company paid. This must have been for Part A Medicare. When I looked at mine, it showed the company paid the same amount as I did for the Medicare taxes.  Part B is what we pay monthly now and I know nothing about the government subsidizing it unless you are qualified for a special Medicare Help program which we aren't.  Where are you getting your information that the gov pays 75% of our Part B Premium?   This may be so but I was not aware of this.

I have a copy of Medicare & You booklet which they send us every year and I cannot find anything in it about the gov paying 75% of our Part B Premium.  That is the medical part of Medicare and all it states is we must pay the monthly premium which we have deducted from social security.  There is nothing about the gov paying 75% of the premium for us.  People can get help if they are below a certain income.
1
paoli2paoli21,373 posts since
Aug 10, 2011
Rep Points: 6,013
30. Tuesday, September 24, 2013 - 9:45 PM
This is the link from Google to the Medicare site. But actually learned of this many years ago. 

Trustees Report Summary - Social Securityhttp://www.ssa.gov/oact/trsum/ - 76k - Cached - Similar pagesSocial Security and Medicare together accounted for 38 percent of federal .... The Trustees project that Part B of Supplementary Medical Insurance (SMI), which pays ... program revenues in special non-marketable securities of the U.S. Government which earn .... General revenues pay for roughly 75 percent of all SMI costs.

The Trustees project that Part B of Supplementary Medical Insurance (SMI), which pays doctors’ bills and other outpatient expenses, and Part D of SMI, which provides access to prescription drug coverage, will remain adequately financed into the indefinite future because current law automatically provides financing each year to meet the next year’s expected costs. However, the aging population and rising health care costs cause SMI projected costs to grow steadily from 2.0 percent of GDP in 2012 to approximately 3.3 percent of GDP in 2035, and then more slowly to 4.0 percent of GDP by 2087. General revenues will finance roughly three quarters of these costs, and premiums paid by beneficiaries almost all of the remaining quarter. SMI also receives a small amount of financing from special payments by States and from fees on manufacturers and importers of brand-name prescription drugs. Projected costs for Part B assume an almost 25-percent reduction in Medicare payment rates for physician services will be implemented in 2014 as required by current law, which is highly unlikely.

Note that it is Part A (the hospital part of Medicare) that is in trouble. Not Part B cuz the gov pays 75% and beneficiaries pay the rest. 

I don't think anyone ever reads these reports. They are on the internet and available to anyone. 
1
Ally6770Ally6770914 posts since
Jan 16, 2010
Rep Points: 2,662
31. Wednesday, September 25, 2013 - 7:52 AM
Thanks for the additional info on Medicare.  I sure don't have time to read these reports but I do read a lot of other info about Medicare and have never seen that info.  One would think they would put it someplace in their Medicare Booklet as a "for your information" addition so people would know where their tax dollars are going.    Frankly, since my tax dollars are wasted on so much stuff we don't have a say over, it is good news to me that at least we get something back by their helping us pay for the Part B Medicare so we can keep the premiums down.  Once we add an Advantage or Supplement Plan to Medicare it can cost hundreds of dollars a month even for a couple not in the higher incomes.

BTW, I had to laugh about what they are saying "the government pays 75% of our Medicare costs".  They are paying it with "our" tax dollars so in reality, WE are paying for "all" of our Medicare.  Taxpayers get so used to just letting the gov blow their tax dollars that they forget it is all our money.  So I guess it is better than their blowing it on some convention or giving it to countries who hate us.  At least this way they are returning our own money back to us by using it for Medicare. 
1
paoli2paoli21,373 posts since
Aug 10, 2011
Rep Points: 6,013
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