General Discussion
Related: Editorials & Other Articles, Issue Forums, Alliance Forums, Region ForumsI supported the ACA, but my policy that I like is being cancelled because of it.
I believed in the ACA, and President Obama's (whom I voted for) promise that it wouldn't take away my policy if I liked it. I still do believe in and support the ACA.
But I got a cancellation notice from my insurance provider, briefly mentioning that due to ACA, and through no business reason of their own, they could not continue the policy. I like my policy and want to keep it, so I called my insurance provider. I got forwarded from the usual first-line rep to a fairly well-informed and intelligent business retention manager. I had quite a lengthy conversation with her. She answered all my questions, many of which were meant to vet if there were reasons other than ACA that the company was cancelling me. She patiently went through a lot of detail with me, and my conclusion is that the existence of the ACA, and only that, doomed my policy.
The price I'm seeing on the government healthcare website for comparable coverage I had is three times what I was paying (after the subsidies I'll receive). I am not rich! I'm really not even middle-class, to speak honestly.
I don't think of myself as "poor", I did get some subsidies, but THREE TIMES what I was paying? Intellectually, I still support the ACA, but emotionally I'm a wreck. I don't know how I'll pay for coverage I was getting before, and I'm extremely worried mostly for my children, not really for myself.
global1
(25,253 posts)are you the same person?
rgbecker
(4,832 posts)DanM
(341 posts)question everything
(47,488 posts)I was thinking that my policy would have been cancelled, too. Thankfully, I am now on Medicare. Just in time.
I am sorry.
warrant46
(2,205 posts)Its never enough to get kicked out ---- they just are rude enough, crude enough, impolite enough, unmannered enough, and discourteous enough to avoid the inevitable "see you later".
Just block them. The world is full of irritating, sarcastic and irreverent people.
Rather than attack the RePuke bastards who are entitled to disdain, they make comments that are in bad taste to people like you.
It is Snark-- and here is my favorite quote on that subject.
" Julie, with champagne as a lubricant, she unleashed an unending series of snarky comments for the duration of the wedding reception."
Tanuki
(14,919 posts)if "the existence of the ACA, and only that, doomed" your policy. It sounds as if your prior policy, like many, was a ticking time bomb that would have failed you in a time of true need, even if that was not apparent to you. Perhaps if you were more specific about why the old policy failed to comply, where you live, what you did/will pay, etc., we could understand your situation.
DanM
(341 posts)Over the past 2 weeks since getting my cancellation notice, I've exhaustively researched my particulars. It is "comparable coverage" and my policy is with a reputable company I've been with for years. I've used my insurance, and despite some medical "conditions" I thought they might have taken issue with in the past, they've been a wonderful company and kept me on.
I voted for Obama and am a supporter. I still support the ACA. I still think it is intellectually correct as far as the idea behind it, but my lengthy discussions with my insurance company have left me with no doubt that it is not my insurance company at fault or being a "bad apple". The details of the ACA, not the idea behind it, is causing me to lose good insurance I like and want to keep.
Tanuki
(14,919 posts)and have therefore noticed your evasiveness when several posters have asked you for specifics.
trotsky
(49,533 posts)What was your deductible? What was your out-of-pocket max? Etc. These and the others are not invasive questions, but the answers to them would reveal exactly what might have been wrong with your old policy.
So you'll have to forgive folks for doubting things.
DanM
(341 posts)I'm looking for neither belief nor doubt from anyone here, as readers here are neither ACA administration personnel nor my personal friends. For the same reasons, just throwing a mass amount of info on my particulars here would REALLY get me somewhere, you think? I don't, which is why I'm doing that IRL with my friends.
I just came here to express some anxiety for cathartic purposes and maybe someone who was in a similar predicament has a government or NGO resource other than the well known ones to pass along to me. I'm willing to weed through the glib posts of those who automatically dismiss me to get that gem of info, if it pops up.
ScreamingMeemie
(68,918 posts)me somewhere, you think?"
Yes, I think. In fact, several DUers here have helped other DUers with their health insurance issues.
I actually think it's better, because your supportive friends are typically just going to be all angry and sad on your behalf, without doing much.
DanM
(341 posts)There are some generally supportive posts here, a LOT of glib and dismissive posts, but curiously none where the poster mentions actual experience in helping other DU'ers with their health insurance issues. I'm not inspired to dump my information here.
My friends don't get angry or sad. Among them are a CPA and a couple of attorneys, in their day jobs. Ok, yes, I do have a couple of other of my friends who can get uselessly emotional, so I can't really say none of my friends get angry or sad, but I know who they are.
A few posts on here have been helpful, including yours, in the sense that there is confidence that my experience with the ACA's effect on my policy cancellation is incomprehensible and there may be something anomalous.
But, all in all, I really didn't expect THIS headache. I liked my policy. It was a good policy that I got true value out of in getting medical care. Too many here are quickly dismissive and saying essentially "Well, your insurance company or your policy MUST be crappy in some way, you MUST not be realizing how CRAPPY your insurance really was, there's NOTHING wrong with the ACA."
Fla Dem
(23,698 posts)is falling", but then don't provide any specifics, like where you are, is the sky blue or gray, how fast is it falling, are you under a shelter, how long has it been falling; because this is only information you will share with friends, then your post is simply a Chicken Little post of no value to anyone.
" just throwing a mass amount of info on my particulars here would REALLY get me somewhere, you think?"
so your income, age, zipcode, and how many people insured is a mass amount of info?
Give me a break with that info every one could determine what insurance would cost you and know your options.
You said your from poor to middle class which translates to 0-75,000. If you are on the top end then your here just to complain.
Tanuki
(14,919 posts)because otherwise it would have looked like you just came here posting disruptive bs, dissed honest posters who were willing to take the time to help you but needed more info to do so, and then tried to save face with some more lame and evasive bs about catharsis and supportive friends.
trotsky
(49,533 posts)BlueCaliDem
(15,438 posts)Tarheel_Dem
(31,235 posts)scheming daemons
(25,487 posts)Now... so we can validate the truthiness of your claim...
What is your approximate income?
What coverage did you have?
What state are you in?
Frankly, I don't believe you. Sorry. Seems like a bouncy.
BumRushDaShow
(129,165 posts)DanM
(341 posts)B Calm
(28,762 posts)DanM
(341 posts)Readers here are neither ACA administration personnel nor my personal friends.
I have a great group of supportive friends who are doublechecking everything with me. I'm looking for neither belief nor doubt from anyone here, as readers here are neither ACA administration personnel nor my personal friends. For the same reasons, just throwing a mass amount of info on my particulars here would REALLY get me somewhere, you think? I don't, which is why I'm doing that IRL with my friends.
I just came here to express some anxiety for cathartic purposes and maybe someone who was in a similar predicament has a government or NGO resource other than the well known ones to pass along to me. I'm willing to weed through the glib posts of those who automatically dismiss me to get that gem of info, if it pops up.
You don't have to be a friend or an administrator to look over the benefits. But if members had facts then we could all be outraged together see? Until then......
Too bad you under estimate the knowledge and resourcefulness of the membership here.
MADem
(135,425 posts)I'm in the "cool story bro" lane too.
Oh, and welcome to DU... I guess.
It's not "glib" to question someone who is being deliberately and repetitively evasive.
Cough up your particulars, allow people to help you, and then IF--and it's a big IF--you're still actually in the hurt locker, I'll muster up some sympathy.
It's up to you. Either provide your details, or just cut it out.
DefenseLawyer
(11,101 posts)and how you are nonetheless able to find "comparable" insurance under the ACA (albeit as you claim for 3x the cost). Unless you are able to explain those details you aren't going to get much empathy.
Vashta Nerada
(3,922 posts)I've seen a lot of these lately, especially on fb (by conservatives, no less) and none of them were validated.
eqfan592
(5,963 posts)Sounds to me like the insurance company is lying their ass off.
ProdigalJunkMail
(12,017 posts)since the passage of the ACA it cannot be grandfathered in? yes? like a simple change in deductible or copay or even the addition of coverage like mental health...
sP
eqfan592
(5,963 posts)..right? So once again, the company made the choice to change the policy, not the ACA.
ProdigalJunkMail
(12,017 posts)but what has happened to us is exactly what was described in my post... our plan no longer exists (rather, won't exist) due to the fact that last year they ADDED mental health coverage and adjusted our deductibles. So, because our policy was made BETTER it now must be cancelled.
but that's ok... until it really starts to hurt more and more and more Democrats... because it IS and it WILL continue.
sP
eqfan592
(5,963 posts)They set you up, and you're playing right into their hands. And frankly, there are far more people that we'll be helped by this than hurt (tho "hurt" is a very relative term in this case).
ProdigalJunkMail
(12,017 posts)no, I will not have insurance with this company any more... so they have driven us away.
the problem is not so much me and mine but there are lots of people who will be hurt by this in a way that affects politicians more than anything else... they will take a hit in the wallet/purse. and that is what most people vote with (like it or not).
sP
eqfan592
(5,963 posts)And like I said, far more people will be helped by this than hurt. That's the cold reality.
I'm sorry you lost your insurance (tho if it failed to meet the low standards set by the ACA, the word "insurance" might be a stretch). Perhaps you should look to your elected officials to support a single payer system, which we should have done in the first place.
gollygee
(22,336 posts)then your policy didn't meet the new minimum standards, and therefore was not comparable at all. Young healthy men are finding they are paying more, and the old policies insurance companies used to sell that covered very little and with which you could still get into serious financial trouble are no longer considered valid - and rightly so, IMO. I don't think people should be able to sell you something called insurance that doesn't really insure you but just misleads you into thinking you have insurance until you actually need it, at which time you find out you didn't have what you thought.
Even so I am skeptical about the "three times" claim, especially if you're getting subsidies.
Sheepshank
(12,504 posts)EXACTLY!!
And what is not being said is that insurance companies also had the ability to amend existing policies to MAKE it ACA compatible. I get notices all the time about changes in coverage and policy...ALL THE TIME. When one buys health insurance the contracts are not set in stone, there is always the disclaimer that changes could be made i the future with advance notice. Instead of tweeking the comparable policy, the insurance company chose instead to junk the whole thing. If the original policy was so comparable, then it was very close to idential and minor changes could have been applied...but the insurance company chose not to do such a thing....blame Obama wahhha ahhhhhhh.
IMHO, they were not comparable at all.
rgbecker
(4,832 posts)What did she say? Or is this a new policy started since 2010?
What state are you in? Is this one that is refusing to set up their own exchange?
Thanks for your help on this.
DanM
(341 posts)rgbecker
(4,832 posts)backscatter712
(26,355 posts)1. What does the old plan actually cover? Most of the policies in the existing individual health care market which are currently issuing notices offer low premiums, but also come with skimpy benefits and high out-of-pocket costs. These plans often have low limits for outpatient treatment, hospitalization or dont offer any benefits for procedures like colonoscopy, chemotherapy or mental health treatment. Insurers market these policies to young and healthy people who dont use their coverage and never know the true extent of their benefits. (The market is also fairly mobile, with just 17 percent of individual subscribers purchasing the same plan for two years or longer.)
...
2. Did this person go to the exchanges? Insurers informing policy holders that their health care costs will go up, often direct beneficiaries to their other brand products without telling them about competitive options and prices available through the exchanges. Cavallaro, for instance, got a quote from a broker, but did not explore the available options on her own.
...
3. Yes, the premium is low, but what are the co-pays and deductibles? This coverage often forces individuals who do use care to meet high deductibles the amount you pay out-of-pocket before your insurance kicks in pay high co-pays and co-insurance or limit the number of doctor visits that are allowed. Cavallaro, for instance, must meet a deductible of $5,000 a year and has an out-of-pocket cap of $8,500 a year. The plan covers just two doctors visits and each include a $40 co-pay.
...
4. Does this person qualify for subsidies? Americans between 100 and 400 percent of the federal poverty line ($46,000 for an individual, or about $78,000 for a family of three) qualify for tax credits under the law. Six of the 7 million individuals who are expected to sign up for insurance through the exchange will receive an average tax credit of $5,290 per year.
Raine1967
(11,589 posts)Maybe Dan is misinformed.
rgbecker
(4,832 posts)5. Does the poster start by saying he supports ACA?
SidDithers
(44,228 posts)Sid
uponit7771
(90,347 posts)Walk away
(9,494 posts)is that it didn't cover things like meds or testing or that the original policies limits on these things were so low that the policy would be useless if you got sick.
I know...I had one. Now, for a little more money I can afford a real policy that covers all of my needs.
Jeff In Milwaukee
(13,992 posts)If for no other reason that you claim to have been able to contact a live and "intelligent" customer service manager.
If your plan is being cancelled, it's the insurance company's decision. There is NOT ONE SYLLABLE in the Affordable Care Act that requires these policies to be cancelled (there's even a grandfather clause that allows them to be continued). Anyone who says otherwise is lying or ignorant. No third choices there.
You say that "comparable" insurance is going to cost three times what you're paying? This is complete and unadulterated bullshit. If your old plan was "comparable" it wouldn't be cancelled. What you had was crappy insurance that covered little to nothing (hint: the more "affordable" it was, the less it actually covered).
moriah
(8,311 posts)It notes they are not sufficient coverage to avoid the penalty on BCBS's website.
DanM
(341 posts)That is, to ensure my company is understanding the grandfather rules and applying correctly to my case.
1StrongBlackMan
(31,849 posts)Here is a summary of plan changes that would trigger a loss of grandfather status:
To maintain its grandfathered status, a plan in the individual or group (job-based) market cannot
significantly increase copayments or deductibles, raise co-insurance, make annual limits more
restrictive or add new annual limits, significantly decrease the share of premiums that employers
contribute for their workers (in group plans), or eliminate covered benefits. If plans that
existed on March 23, 2010, eliminate covered benefits that are necessary to treat or diagnose a
condition, or if they significantly increase costs to enrollees, they will lose their grandfathered
status and be subject to all applicable consumer protections in the health reform law. Table 1 on
page 3 shows these disqualifying changes in more detail.
http://www.familiesusa.org/assets/pdfs/health-reform/Grandfathered-Plans.pdf
So ask yourself how you were able to find a comparable (and ACA conforming) program, at any cost?
And when/if you do, will you return to say, "Oops, My Bad!"?
Keefer
(713 posts)that the insurance company added coverages to comply with the ACA gets them kicked out of the "grandfathered" clause. Unfortunate fact, but true.
Tanuki
(14,919 posts)would negate the "grandfather" clause! They were not trying to comply, they were trying to get rid of or at least jack up the rates of people who had policies that would otherwise have been grandfathered. This seems as transparent as a glass of water.
they didn't change their coverage to include the minimum requirements, the plan would still be cancelled because it didn't meet the minimum coverages. So, either way, the plan would have been cancelled. Damn if you do, damn if you don't.
Jeff In Milwaukee
(13,992 posts)The grandfathered plans were those that were NOT compliant with the ACA requirements. Companies were allowed to continue offering non-compliant plans if a) there were no material changes to the coverage and b) they did not enroll new customers.
Any company that chose to keep offering the older, non-compliant plans was free to do so. Now there are certainly sound business reasons why they would have chosen to not do this and offer new, compliant coverage to their customers. But doing so wasn't a requirement of the ACA.
politicaljunkie41910
(3,335 posts)I'm glad you did not let that misinformation go unchecked. Whether the guy turns out to be a troll or not, people need to educate themselves on the facts surrounding the ACA and not be spreading misinformation. The ACA is already up against a well organized and financed campaign to kill it, whatever means necessary. Dems don't need to be unwittingly feeding the machine.
INdemo
(6,994 posts)Your suspicions are correct. He doesn't belong here on DU
libdem4life
(13,877 posts)kenfrequed
(7,865 posts)Sort of a warning sign. Seems well prepared. Maybe he works more Humana.
LuvNewcastle
(16,847 posts)If you've been paying practically nothing for your policy, it wasn't any good to begin with. Real insurance is going to cost you more than worthless insurance. That's the way it is.
B Calm
(28,762 posts)With ACL you'll have a real policy that will actually cover you from bankruptcy if you have health problems.
moriah
(8,311 posts)I only tore my MCL when I also dislocated my kneecap, and it was covered by Workman's Comp since it happened at work -- ice on sidewalk.
Still, I saw some of the bills before they were paid. OWCH! Not just the pain in the knee, but the wallet if I had been responsible for 'em....
JaneyVee
(19,877 posts)moriah
(8,311 posts)Let's see why it doesn't match up.
DanM
(341 posts)CreekDog
(46,192 posts)is that topic secret info?
moriah
(8,311 posts)MannyGoldstein
(34,589 posts)I personally don't know if you're a troll or not. If you're not, then you have my sympathies - you'll end up with better coverage, but it might not be affordable.
What we really need are more jobs, good jobs, and politicians that are neither crazy nor proxies for the wealthiest. If we had those, everything else would take care of itself.
geek tragedy
(68,868 posts)coverage.
The entire reason they're being cancelled is that they don't meet the ACA's minimums of coverage.
So, when someone says their plan is being cancelled despite being comparable to ACA plans, someone is getting lied to.
MannyGoldstein
(34,589 posts)Most Americans can't afford anything more right now. For 95% of us, wages are still falling, falling, prices are increasing, and there's no hope of improvement until 1/20/2017.
geek tragedy
(68,868 posts)You know who talks that way? Teabaggers.
You know who doesn't? Rational people.
Textbook ODS--predicating all hope on getting rid of Obama.
BlueCaliDem
(15,438 posts)Most times they're pretty good disguising themselves. Sometimes, their masks fall. Good rules of thumb to abide by, GT.
SidDithers
(44,228 posts)Sid
Cali_Democrat
(30,439 posts)Ouch.
Chan790
(20,176 posts)I'm sure that's true, but it's still a problem.
http://www.democraticunderground.com/?com=view_post&forum=1002&pid=3959888
REASON FOR ALERT:
This post is disruptive, hurtful, rude, insensitive, over-the-top, or otherwise inappropriate.
ALERTER'S COMMENTS:
Poster just stated that President Obama being in office makes any hope of improvement in the economy impossible. Doesn't think winning Congress from the Republicans will improve things. Only getting rid of Obama. Those who suspect this poster of being a troll are right.
You served on a randomly-selected Jury of DU members which reviewed this post. The review was completed at Fri Nov 1, 2013, 10:45 AM, and the Jury voted 0-6 to LEAVE IT.
Juror #1 voted to LEAVE IT ALONE and said: If the poster thinks that Obama is not liberal enough, he won't get any argument from me. At any rate, flagging this post seems to me to be an abuse of the jury system. It's not rude, hurtful or over the top. It's an opinion, expressed without any vulgarity whatsoever.
I personally think that this administration has done much good. I would like to see a real liberal in the white house. None of that has to do with anything. The criteria for flagging are objective, and I don't think this post counts. I have myself disagreed with this poster in the past, but that doesn't make him a troll, either.
Juror #2 voted to LEAVE IT ALONE and said: I see it's time for the daily two-minutes hate.
Juror #3 voted to LEAVE IT ALONE and said: No explanation given
Juror #4 voted to LEAVE IT ALONE and said: No explanation given
Juror #5 voted to LEAVE IT ALONE and said: No explanation given
Juror #6 voted to LEAVE IT ALONE and said: Are you f**king serious? .... There ought to be an alert on the alert.
Thank you very much for participating in our Jury system, and we hope you will be able to participate again in the future.
MannyGoldstein
(34,589 posts)Thank you!
Rex
(65,616 posts)Frivolous alerts deserve it imo.
Nine
(1,741 posts)Sorry you believe the economy is doomed and there's no hope of improvement until we get a new president. Doesn't sound like the sort of thing I expect to hear on a Democratic message board but I guess anything goes nowadays.
valerief
(53,235 posts)the 100% funded offer from the federal govt.
Orsino
(37,428 posts)...isn't. And people who have never fallen through their own plans' doughnut holes may feel cheated.
I can't answer the OP's concerns directly, however.
datasuspect
(26,591 posts)but y'all are missing the most important motherfucking point: many, many people have to PAY A LOT OF FUCKING MONEY for this shit.
it isn't enough to just tell them to sacrifice necessities of life to finance the profit margins of corporate insurance companies.
geek tragedy
(68,868 posts)Insurance being expensive and overpriced is not a new development.
datasuspect
(26,591 posts)geek tragedy
(68,868 posts)pre-existing condition exclusions, gender discrimination, and restrictions on insurance company profit ratios.
What y'all need to realize is that while the ACA does need to be made better, right now the propaganda machine that is elevating those potentially adversely affected over the many more who will be helped for the explicit purpose of derailing the entire enterprise.
If you see stories being pushed by Republicans, you're not helping anyone by helping them achieve their goals.
datasuspect
(26,591 posts)and not very effectively.
your prose is slightly muddled and clunky, work on it.
geek tragedy
(68,868 posts)that the ACA is hurting most Americans, and then engage in some massive projection after someone points out the actual policy benefits of the ACA (none of which are of concern to you).
datasuspect
(26,591 posts)it's fiction - a ruse that our owners use to preoccupy the rubes.
i know i'm not dealing with someone on my level when they start yammering on about republican this or democrat that.
there is one party in this country and we ain't in it, we don't sit at the table, and they laugh all the way to the bank.
my suggestion, do some reading, educate yourself on what the REAL problems are and then we can talk.
geek tragedy
(68,868 posts)People who pride themselves on being both pure and irrelevant (the latter deservedly so).
datasuspect
(26,591 posts)but you seem to traffic in slogans and propaganda, so i will not waste any more time.
i am placing you on my ignore list.
toodles!
geek tragedy
(68,868 posts)Hall of Fame ODS is not something everyone can claim.
GeorgeGist
(25,322 posts)Care Act.
1StrongBlackMan
(31,849 posts)The other day that laid out the anti-ACA game plan
conflate the two points: 1) I got a cancellation notice for my insurer; and, when I went to the exchange, I was met with rate shock. These are two different issues; but notice what they are not saying
That they went to the exchange and were met with rate shock FOR A COMPARABLE POLICY, or at least not the actors that are following the script with accuracy.
It is entirely possible that a number, even a large number, of people received, and will receive, cancellation notices; AND, it is entirely possible, even likely, that when they went to the exchanges, they would be required to pay more than they were paying for the cancelled plan
BUT, what CANNOT/WOULD NOT/WILL NOT happen is, as DanM reports, they went to the exchange and found a COMPARABLE policy for more
there are no ACA non-conforming policies on the exchanges.
If their now cancelled policy was comparable to the new policy, it would have been no ACA reason to change it; it would be ACA-conforming
And if there was no significant change, it would have been grandfathered.
But I have to give folks credit, they learned that the last step of the plan, crying: But he saaiiidddd that I could keep my pllaaannnn!!!! is not effective on anyone that is not already anti-ACA.
grantcart
(53,061 posts)the same benefits.
Thks.
MannyGoldstein
(34,589 posts)that many will need to spend more to get insurance.
The Administration says that they will get better insurance, which I agree with. However, my point is that many of these people can't afford the better insurance. The 99% is broke. Busted.
I remember a candidate with a funny name who ran for president in 2008. He brought up some good points: that we need a public option for health insurance, and that many, many people can't afford to be penalized for not being able to afford insurance. I actually voted for the guy, unfortunately he never made it to the White House.
geek tragedy
(68,868 posts)MannyGoldstein
(34,589 posts)I don't think so.
And while we're on the subject - are subsidies the right way bridge the gap between incomes and healthcare that's twice as expensive as it is in the rest of the world? Maybe we should do something to bring down the cost of health care - like every other developed country in the world does.
geek tragedy
(68,868 posts)numerous times, most especially the medical loss ratios.
In terms of addressing cost on the provider end, yes that's necessary as well. But note the number of hospitals and doctors that already don't take Medicare, and would drop Medicare like a hot rock but for the annual "doc fix" if you think that's going to be an easy lift.
valerief
(53,235 posts)VanillaRhapsody
(21,115 posts)if you don't make enough...you will be eligible for subsidies..
BlueCaliDem
(15,438 posts)omit this information in their posts when going on the attack of President Obama and the PPACA?
MADem
(135,425 posts)questions.
That "Horror Story" checklist applies here. This poster is likely being disingenuous at best.
It's not a good look for him.
BlueCaliDem
(15,438 posts)That poster has a rep for being quite disingenuous - even if he's just being snarky most of the time - and his posts smack of a severe case of ODS. But he's got a LOT of fans (or socks) here on DU protecting him.
MADem
(135,425 posts)It has done a great job in "smokin' 'em outta their holes" to quote Dumbya!!!
They're laying down a track record that's observable by MIRT and the admins.
VanillaRhapsody
(21,115 posts)BlueCaliDem
(15,438 posts)It's high time they're being "smoked out". DU will be a healthier and better place when they're systematically removed and banned. They're much too disruptive to the community and to serious conversation.
MADem
(135,425 posts)TheKentuckian
(25,026 posts)My income allows for some subsidy but my plan cost does not require it under the law so no subsidy which leads directly to the next point, when did we have the discussion about what percentage of gross income is affordable and where are the peer reviewed studies backing up this number?
Affordability in this case is based off a political calculation, rather than an honestly arrived at individual financial one. This is the nonsense that must be dealt with when you want a government dictate but refuse to fund it with taxes and tariffs and instead go for working up a scheme that dictates after tax income be spent based off gross income.
Affordable becomes a murky thing, not some hard line and leads to the zealous demanding a lot of personal information to verify validity under the thin guise of "helping" from folks in no position to do so really as a way to bulky folks into spin control.
VanillaRhapsody
(21,115 posts)10% to NOT go bankrupt due to a medical emergency IS a BFD
Not only that but FOR that you get many preventative exams...etc.
You are being disingenous.
anyone making within 400% of poverty line for their family size WILL be eligible for subsidies through the Exchang.
TheKentuckian
(25,026 posts)to limit the cost of premiums, not to give everyone under 400% of FPL a free ride as i think some want to create the impression.
While I agree with your first point, it wasn't the discussion. Sure 10% beats bankruptcy, it doesn't follow that is affordable and if also doesn't follow that the deductibles and out of pockets are obtainable and if they aren't then we have a ton of self rationing and people still go bankrupt (or in the hole with dead credit and collections).
Your second point conflate comprehensiveness with affordability, if your argument is value then that is stronger but not definitive because one must have a handle on how much more value one is getting for how many more dollars to get to the truth of that piece either. What you get above and beyond needs to have individual value (this is an individual responsibly and cost rather than a collective one) to you or if doesn't matter and putting that to the side there is the question of whether the additional services are compensation for the higher costs, which we don't know because we didn't deal with existing costs so the value is assumed alk the way around.
VanillaRhapsody
(21,115 posts)the subsidies are not 100%
Have a broken arm that requires surgery and find out what "up TO" 10% means for ya!
Oh and per your other point...Ask women about that!
Please present "your higher costs" would love to evaluate YOUR position.
TheKentuckian
(25,026 posts)cost, value, and affordability.
It is also not an angry flame fest, nobody pissed in your Wheaties and I certainly did not attack you.
VanillaRhapsody
(21,115 posts)As someone who has spent her childhood on Universal Single Payer....to living most of her adult years without any insurance at all....and all the stress that goes with that....to having good insurance again. I am here to tell ya...
Do not let the good be the enemy of the perfect!
BlueCaliDem
(15,438 posts)Were it based on his gross income, he wouldn't qualify for any subsidies.
TheKentuckian
(25,026 posts)But yeah.
BlueCaliDem
(15,438 posts)But at least they're using adjusted gross income rather than purely gross income.
And to be honest, who uses net income to evaluate anything? Even getting a mortgage or a simple credit card, they'll go by your gross income. They don't consider your AGI income, let alone, your after taxes income.
TheKentuckian
(25,026 posts)What you take home dictates what you can afford and that 10 of gross can be a much more onerous burden on one's net.
I have to point out credited cards and mortgages are not required by law, you have a choice of whether you can afford either based off your actual usable income and a lot more wiggle room in either case of how much those obligations cost, if elected.
Health care is not a rational market so it makes all comparisons to a rational market at least somewhat nonsensical, even compared to other forms of insurance because in those cases one is hedging a specific value - a car, a building, items bought in markets, even life insurance is a hedge to replace projected income really. All knowable, ones health cannot be quantified or reasonably projected.
I think a lot of the tension around this law in our circles is that some folks believe that a good system can be built on irrational foundations while others will not participate in the illusion.
questionseverything
(9,656 posts)when did we have the discussion about what percentage of gross income is affordable and where are the peer reviewed studies backing up this number?
premiums plus out of pocket (especially for 50 plus) run from 25-33% of income
to be fair lets use 25% for healthcare
then 20% taxes
then 25% housing
thats 30% left for utilities,transportation,food,clothing.......is that what all you folks think is acceptable?
no one needs any1s personal info to verify this....just use the aca calculators and play with different number sets
Marrah_G
(28,581 posts)How much was the old, how much is the new? What are the details of each? Is it 3 times the price after your subsidies are figured in? If you are not even middle class and you have a family, then you should be getting a substantial subsidy.
Lex
(34,108 posts)Sketchy details for a reason, I suspect.
Sancho
(9,070 posts)if a company quit issuing a policy (they do this on a regular basis), they had the option to continue any policy issued before 2010. It was a company decision to cancel for economic reasons and nothing else. The company had the ability to grandfather in any policy that previously existed.
Every time I hear these stories (at least in the individual cases that I've followed), there was ALWAYS a better policy for a similar or lower prices.
If you had a cut-rate and useless policy that covered nothing, you might have to pay a little more for a much better policy. The less income you have, the more likely that ACA policies are better and cheaper.
I'd really like you to give more details including the state you are in and exactly which ACA plans costs so much more...otherwise you are either mistaken or need some help investigating the plan.
You cannot take you insurance companies word for the "costs" because they will LIE and try to sign you up NOW for something that is not as good as the ACA exchange.
Yo_Mama
(8,303 posts)Because I have confirmed this in my own. I'm just thanking God my husband is on Medicare, because otherwise we would be truly screwed.
But no policy in our area is now affordable for older people (absent subsidy).
I qualify for a subsidy, but I have assets and I don't think this is the right thing to do, so I am in a quandary. But a lot of middle-class older people in my area won't qualify for subsidies, and there is no way that they can afford the insurance without them.
Sancho
(9,070 posts)so I don't get your response. ACA subsidies are based on INCOME. If your husband is on medicare, even if you are working then you would qualify if your income is low. If your income is high, then a few hundred a month shouldn't be a problem for a policy that would be useful for an older person who could need medical care. Why do assets matter?? They don't affect subsidies.
Older people (as you suggest) have medicare!!! Your ACA policy subsidies the older person by getting the younger healthy ones to sign up!!!
If you had an old policy, it was either worthless (with large deductibles, caps and limits, exclusions, etc.) and you were paying cheaply for something that wouldn't help you anyway...and the company can grandfather in an old policy if they want to.
I suspect people are getting lots of bad information talking to insurance agents and companies, and not really exploring the ACA.
I've heard some rural areas don't have much competition with ACA, but even those rates seem lower to me for the coverage you get.
Yo_Mama
(8,303 posts)Which is why I qualify for a subsidy, as I said.
But I still don't think I SHOULD get one. If I had spent down a lot of my assets I'd feel differently about it.
The problem in this country is poor people are subsidizing the wealthy, and I don't want to have any part in that devil's bargain in any way, shape or form.
DanM
(341 posts)whttevrr
(2,345 posts)That sounds like sales speak. I've seen that as an objection handler in so many sales scripts it is not even funny. Your complete refusal to respond with any numbers at all smells of complete and utter bullshit.
You won't even say what the old policy costs?
I wouldn't have believed it at first. But what happened to me is this {add bullshit sob story here}. And here is how I fixed it {ABC: Always Be Closing}
Which reminds me of my new favorite song!
Fuck You, Fuck you Very, very much
bhikkhu
(10,718 posts)otherwise...
Kaleva
(36,314 posts)Why did you feel it was necessary to stress the (supposed) fact you voted for Obama? Very odd.
geek tragedy
(68,868 posts)BumRushDaShow
(129,165 posts)Sunlei
(22,651 posts)Yo_Mama
(8,303 posts)I don't know what to tell you.
The area you live in seems to make a LOT of difference.
DanM
(341 posts)CreekDog
(46,192 posts)and what the new rates will be under ACA.
PasadenaTrudy
(3,998 posts)Stick with your "group of friends" advice then if you aren't willing to provide more details.
Lex
(34,108 posts)lumberjack_jeff
(33,224 posts)For people with individual plans, ACA will raise individual rates for most (because it's better insurance and because it shifts the costs from older people and women) and lower it for some, but for most people the subsidy should save them money overall.
But besides, the main point was to get insurance to the uninsured. Not save money for the already insured.
Keefer
(713 posts)My plan costs me $24 per month. I have a $1000 deductible. My co-pays are $10 per visit, even for a specialist. I pay $4 for a 90 day supply of generics. I have had a heart condition for seven years before I got this policy. I recently spent 8 days in the hospital in the Cardiac Care Unit. My share of the $42,000 bill?: $100. The plan includes free wellness visits. It also includes vision and dental coverage. This plan will not be available after January 1st, 2014 because it doesn't include maternity and pediatric care. I am a single male with no kids. Why do I need maternity and pediatric coverages? I haven't shopped for new insurance yet, so I have no idea what my premium will be, but I can guarantee you it will cost me a hell of a lot more than $24 per month.
I'm discouraged.
stopbush
(24,396 posts)out-of-pocket costs at $100 on your $42,000 bill?
Keefer
(713 posts)It is included in the part of the plan that covers hospitalization. I spent 6 days in the cardiac care unit, then was transferred to a regular room.
stopbush
(24,396 posts)More than half of Americans are women. A good many of them have children. What percentage of Americans end up in a cardiac care unit for 6 days? I'd guess a lot fewer than 50%. So why should maternity be a "special" coverage when cardiac care isn't? A lot more people need maternity coverage than need cardiac coverage. Get it?
Maybe you're just dense.
Keefer
(713 posts)I'll get maternity care. The next time one of my non-existent kids needs braces, I'll get pediatric coverage.
Thank you for your concern.
stopbush
(24,396 posts)Time to leave.
taught_me_patience
(5,477 posts)You do know that your employer is subsidizing most of your plan right? It doesn't really cost $24/mo. The group rate on a plan with those benefits typically is going to be $400-$500/mo. The ACA doesn't really touch group plans so are you just spouting bullshit in a pathetic attempt for attention?
Keefer
(713 posts)I said the plan "costs ME $24..." Yes, I understand my employer covers the bulk of it. I'm not "spouting" anything. My plan is not available next year because it doesn't meet the minimum requirements of the ACA. My employer used to pay 100% of my plan until January 1st of 2013. They decided it was costing them too much, so they passed on a cost of $6 per pay week to the employees.
cags
(1,914 posts)A large group of people put their money in a pot, like a rainy day fund. When something happens to one of the group, the cost gets taken care of. When your time comes around, and something happens to you, the cost gets taken care of. Insurance means we all will pay for the medical issues of others even though we will never have those same issues. But it guarantees that the pot is big enough to cover everyone in the group. If we only belonged to groups who might get the same things we get the pot would be much smaller and the likelihood of not having enough money to take care of everyone would be greater.
Makes sense?
quinnox
(20,600 posts)It is screwing over too many people. What a clusterfuck.
CreekDog
(46,192 posts)It needs some surgery for sure
geek tragedy
(68,868 posts)Mass
(27,315 posts)More importantly, did you ask your insurer why he changed the policy in the last three years without telling you it would doom the policy.
If your story is true, I can understand why you are a wreck, but many people in your condition found out that they would be better off financially with a new policy that actually covers them better when they are sick.
surrealAmerican
(11,362 posts)It is in your insurance company's (financial) interest to lie to you. If the old policy really is being discontinued because of the ACA, they don't want you to know it was because they were giving you inadequate coverage (the sort that would have left you bankrupt if you had needed hospitalization or cancer treatment). If it's being discontinued simply because they want to make more money off you, they wouldn't want you to know that either and would try to pin the blame somewhere that is beyond their control.
Omnith
(171 posts)Hopefully you can find some affordable coverage on the exchanges, though it will not be comparable to your old plan.
factsarenotfair
(910 posts)BlueCaliDem
(15,438 posts)Your concern is noted, though.
taught_me_patience
(5,477 posts)A low post counter who makes a typical right-wing claim about the ACA is already quite suspicious. A low post counter who makes right-wing claims about the ACA and refuses to give any specific information is just too suspicious to take seriously.
jamzrockz
(1,333 posts)of both policies? without that, its hard to gauge if you are harmed or helped by this cancellation.
Arugula Latte
(50,566 posts)Verrrry believable. Yes indeed.
whttevrr
(2,345 posts)Lifelong Dem
(344 posts)What you have is called junk insurance. Comparable which doesn't even meet the minimum standard of ACA is not comparable - no matter how many times you wish people to believe you.
factsarenotfair
(910 posts)Perhaps you are one of those people who thinks you could be rich if it weren't for government welfare programs. What is your opinion of the food stamp program?
fadedrose
(10,044 posts)is that if you have a nervous breakdown, your medical bills will be paid.
Sorry, didn't mean to make light of it. Are you sure your figures are right, and you've spoken to a a live person at ACA?
The policy you loved. if it was a third of the new policy. must be a piece of junk that, if you got really sick, might have caused you to lose your home. Check the cap and the deductibles. Might not help, but it might make you feel better if you look at it as losing a potential robbery prevented...
And did you look at all the insurance companies or just the one?
And are you going for Bronze, Silver, etc. They do have a paragraph or two about it creating hardships if you have special circumstances, debts, etc.
I feel reallly bad for you.
scheming daemons
(25,487 posts)... says they posted for some "cathartic" reasons.
There are very few differences between the OP's stated reason for posting and posting for the purpose of disrupting.
These five simply facts, none of which would violate the OP's privacy at all, would permit us to corroborate the story:
1. Income level and size of family
2. Deductible of previous plan
3. Premiums of previous plan
4. State of residence
5. Company providing previous plan
If the OP answers those questions, we can determine whether the post is bullshit or not.
If the OP refuses to answer those questions, we can pretty much determine that the post *IS* bullshit.
Yavin4
(35,443 posts)coverage is about $600 per month from Emblem healthcare. If my income was lower, my premium would be even lower as I would qualify for subsidies.
There, how difficult is that? Give specifics and people can help you. Without that, we cannot help you.
onlyadream
(2,166 posts)And I'm sorry that people here on DU can be so terrible. I'm experiencing the same exact thing as you, however, our income is higher and things are looking up job wise.
From what I see here, the DUers are in denial. They said that people like us were lying. Some have then moved on and now say that we had bad insurance and the new insurance will be worth it and better for us. But again, they are wrong.
This is a real problem, and until it is recognized, it won't get fixed.
My hope is that you'll pay the new higher prices and then get reimbursed at some point, when the insurance company has reached their profit limit. Hopefully things will even out and next year the rates will be lower.
INdemo
(6,994 posts)the difference in pricing compared to standard health policies and I have seen nothing, nothing that would be three times as high as my old policy. Now I am comparing those prices without subsidies because our Teabagger governor will not accept the federal funding to supplement those subsidies nor will he extend Medicaid. Now Dan you went to great lengths in your post to explain your costs/premiums under the ACA will be three times higher. I don't know which ACA site you visited or exactly which policy you were looking at but nothing I found had higher premiums.
you need to visit https://www.healthcare.gov/ ...... not healthcare.com
Pretzel_Warrior
(8,361 posts)tallahasseedem
(6,716 posts)BTW, cool story Bro.
OwnedByCats
(805 posts)I believe you. The reason is because several people I know have had this happen, including my parents. They can't afford the increase. I am sorry this is happening to some people. The situation is not looking good for me either. I wanted a system like what Great Britain has, after having lived there for ten years I can tell you it's a health care utopia compared to here. You never had to worry about cost and for the most part the care was excellent.
For the deniers, no I'm not giving details on age, location or policy type since this isn't about me and I have no business giving those out. I'm just saying I can believe what Dan is saying because I've seen it happen. Policies cancelled and one new plan being $300 more per month, two others were double their previous premium. You don't have to believe me and frankly don't care if you do or not. I just wanted to offer Dan a little support. Just because maybe some of you haven't witnessed this occurring does not mean it's not happening elsewhere.
Edited to add that I don't know if ACA is the actual cause of these increases and I'm sure the old and new policies are not comparable in what was and is now covered. The problem my family are having is not being able to afford the new premium. It's all well and good to have a better policy that covers more, but if one can't afford the increase in premiums, co pays or deductibles, what good is it to those who can't afford it?
valerief
(53,235 posts)OwnedByCats
(805 posts)HIMSELF. I was talking about other people and I don't think it's right to post without their permission, is that ok with you??
valerief
(53,235 posts)But no details.
Because it's important to spread the message.
OwnedByCats
(805 posts)Having said that, it's going to be good for people too - a lot of people. What I am saying is there are certain loopholes and bugs in the system that will leave some out in the cold and others seem to think that couldn't possibly be true. I have seen some give their exact details on this board in other threads and they are still called trolls and liars, being judged about their income and their lifestyles. This is not helpful.
What bothers me are those that simply can't afford to actually use their insurance and I've been in that position myself. I made my monthly premium but between the copays and deductibles I couldn't afford to see a doctor. With the ACA, that may no longer be a factor for many though, if they can get subsidies, but some will slip through the cracks. It really depends on the individual's financial situation and by looking at only the income and family size, not the outgoing bills being taken into consideration, this is when it doesn't work for some. I'm particularly worried for my parents. My father retired early because of debilitating arthritis, he's receiving disability and because he's not 65 yet, he cannot get Medicare. He gets too much in disability to get medicaid, even though it's been expanded here. The company they are with was the same provider his employer used, except with out the benefit of subsidies from the employer now that he's retired. The truth is, their current policy will close and a new one offered, but it's $300 more than they pay now, which brings their premium to $1500 per month. I believe the copays and deductibles are the same. Obviously coverage will be better with the ACA regs in place so everyone is better off, it's just a question of the affordability of their policy. They aren't going to be able to afford the $1500 per month, as it is they are burning a huge hole into their savings to pay as it is, so I think the exchange will be the next step for them. I have heard for people in their early 60's it's going to be high like that, but I need to see what they get offered.
But then I'm hoping for single payer so that everyone can benefit from not being sucked dry by insurance companies since I actually know how nice that would be for everyone having lived it myself for a time. Maybe this will help get us there, I really do hope so. If not, I see nothing wrong with discussing what problems are arising for some, maybe they can be improved upon. Attacking people is not the right thing IMO. As liberals we ought to be able to discuss these things without scathing attacks and assume the ones that are upset just hate Obama. You want to see real hate for Obama, go to right wing message boards, you'll see it in full swing there. What people say here against him looks respectful compared to their colorful expressions.
valerief
(53,235 posts)Of course, insurance companies outside of the exchange will rip off sick and older consumers as much as they can.
kentuck
(111,104 posts)And the prices of insurance policies have gone up every year forever. That is why the need for reform was so urgent.
Yes, you could keep your same policy but your insurance company may charge you more because of the requirements of the new law? But prices have always gone up. It's unfortunate that prices on a few of these "individual" policies went up so much more than others. Basically, because they were so deficient in coverage to begin with.
99Forever
(14,524 posts)No details, no belief.
Smells of set up.
Drew Richards
(1,558 posts)I understand many have asked you for details you are unwilling to provide so that we could assist you.
You also claim you have a circle of friends you trust to examine the issue.
Here is my friendly request... Go to
Www.valuepenguin.com chose the insurance plan comparison, pick your state... enter all of your information...compare the plans and then please report back to us.
Www.valuepenguine.com is better able to answer your questions than anyone else.
I think you are possibly being misinformed...
So far valuepenguin has helped all 8 people with your same story that I have directed to their site...
For example one woman in texas was told by her insurance company that her 294 plan was being discontinued and their new plan for her according To them "because of ACA" would go up to 683 a month...
We went through www.valuepenguine and her actual plan went to 363 but with that was a MAX deductible of 2.5k and full catastrophic insurance coverage out of the insurance companies pocket not hers.
Check it out and let us know...
Drew Richards
(1,558 posts)Drew Richards
(1,558 posts)itsrobert
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