ACA is going to be fixed soon!

[busterbrown]

I have never doubled down on a thread until now.. Posted this yesterday on Political topics.

From the Daily Kos:
written by a tech guy who knows what he is talking about..

Its long... but so freaking encouraging...Made me perk up when I read it..

Would be good if we kicked this around and up during the day.
It needs to be spread around..


http://www.dailykos.com/story/2013/11/12/1254621/-Meet-the-DeBuggers-An-attitude-adjustment-regarding-the-Fix-at-Healthcare-gov

[mc51tc]

1. k & r

Needs to be read and supported by everyone!

[busterbrown]

3. Yep.. Hopefully gets kicked all day..

Its been depressing around here lately because of all the right wing's success with this matter...

[Drunken Irishman]

2. It will. It's a website, not a fucking country we went in and wrecked.

Suck on that one, Republican assholes.

[Whisp]

23. ++++

[Ikonoklast]

54. The one trillion dollars Bush stole to invade Iraq would have paid for 100% of all health care costs

for every citizen for twenty years.


Democrats fix budgets, Republicans steal that money and give it to their cronies.

[Indydem]

58. Math is not your strength, eh?

Health care represents 1/6th of the US economy.

US Economy = 16.66 Trillion

16.66T /6 = 2.776

SOOOO 1 Trillion wouldn't pay for the existing services we have in America for 5 months. Let alone for all of the uninsured or those who have no health care at all.

Good job though on the thinking.

[HijackedLabel]

4. And all the spineless "friends" of ours running away from it...

Will run back toward it with the promise of a warm embrace.

Transparent as fuck, they are.

[DJ13]

5. Single payer is coming?

[Cal Carpenter]

6. ..

Is there room back there? My thoughts exactly...

[immoderate]

9. Eventually. I presume there is a limit to what Americans will tolerate.

This is a lot of work to develop the "world's worst heath care system."

--imm

[jeff47]

20. Sure. The ACA gives us fantastic tools to bring single payer about.

Blue states can go single payer starting in 2017. And the fight will be much easier in blue states.

When the piles of dead don't materialize in blue states, it will be much easier to destroy the FUD keeping single-payer out of purple states. And that leads to a much easier battle in red states.

Ironically, by running away from creating their own exchanges, the red states made it much easier for us to introduce single payer in those states - it will be much easier to add single-payer to the federally-run exchanges than to fight for it in a dozen red states.

[zipplewrath]

42. I don't think you know what single payer is

You can't have single payer in an exchange, and still have people who don't qualify, or who are covered by their employer.

[jeff47]

46. There's more to the ACA than the exchanges.

Most likely, we'll get de-facto single-payer through public options in the exchanges. With no profit required, the public options will be cheaper. That sucks up the customers, and the private companies will not be able to compete. Small customer pools are terrible for health insurance companies.

We'd still be buying the plans through exchanges in the medium-term, but it's realistically a tax and a government benefit even though it's couched in market terms.

But the hidden pressure in the ACA is the taxes. The "Cadillac health care plan" is poorly-indexed. And I suspect that's intentional. This tax is going to gradually hit more and more employers, even if they do nothing. And dumping their employees on the exchanges will cost less. So employers will do what costs the least: dump their employees onto the exchanges, where those employees will buy the "public option", getting yet more people into de-facto single-payer.

Longer term, we'll stop the private market bullshit and move closer to a true single-payer. But that doesn't mean we can't have de-facto single-payer within that framework.

And the ACA gives us great tools to make that transition. It'll take time, but it will still be faster than a direct assault - the "bad guys" are going to be running out of cash as public options displace them.

[zipplewrath]

57. What public options

They got rid of public options. Do you mean the co-ops?

Single payer only "works" if it basically includes "everyone". If it's just another insurance plan, it doesn't have the power to control costs.

[jeff47]

73. I'm talking about what will happen in the future, not what this one law literally does.

The ACA moves the fight for single-payer to the states. In 2017 we can start creating public options in blue states relatively easily.

[zipplewrath]

76. For various values of "easy"

I understand what you mean, but the insurance industry used to be regulated at the state level, and that's where all the troubles with pre-existing and policy canceling occurred. Lobbying works at the state level as well, even in "blue" states. The vast majority of what the ACA did was to federalize health insurance regulation. But I see no reason to be optimistic that the public option will be any more common at the state level than at the federal level.

[jeff47]

77. Vermont is planning to go single payer in 2017. So we will have at least one example.

I think we can count on public options in the other states because we can count on the insurance industry to be bastards that screw people over, resulting in demand for a public option "to keep them honest". From that point, the basic economics of insurance will cause those options to take over.

[Ikonoklast]

55. See how Canada made it happen. It is now inevitable here.

Those frothing at the mouth over the ACA refuse to see it.

[ReverendDeuce]

7. You mean I'll get to keep my non-junk insurance policy that ACA has made my insurer cancel?

Really? For reals? I'd love it if that were true...

[busterbrown]

8. Tell us about that..

Please... I’d like to know..

[ReverendDeuce]

14. I've tried to share it before, but people call me a troll, a liar, or worse... But here goes:

- I do not qualify for subsidies.
- I have "price shopped" on Healthcare.gov (I managed to get in) and the policies are all in the same ballpark.

Old policy:

$150/mo premium (approximate)
$1,500 deductible
$1,500 max out-of-pocket
0% coinsurance

Does not cover maternity (I'm male), does not cover pediatric dental or pediatric vision (I am in my 30s), and does not cover mental health (a legitimate thing, but I don't currently foresee myself needing this service; but you never know).

I've used it when I broke my leg. I paid up to the $1,500, not a penny more, and the remaining $78,500 (approximate) was paid for by the insurer.

New ACA-acceptable policy:

$243/mo premium (approximate)
$2,500 deductible
$6,350 max out-of-pocket
50% coinsurance

I am really infuriated by this whole thing. I honestly never saw this coming and it completely surprised me.

[busterbrown]

19. Your in your 30s..

What insurance company are you currently with??

[ReverendDeuce]

21. BlueCross BlueShield Nebraska n/t

n/t

[jeff47]

24. Does it cover slow typing?

Ok, ok. I'll stop with the snark - it's mostly directed at those demanding a quick reply anyway.

Given the pricing, I suspect there are additional missing details. Like a lifetime maximum or other excluded coverage buried in the details of the old plan.

What state are you in? (insurance is generally more expensive in CA than ND, for example)

Breaking a leg is actually a fairly routine medical situation which is likely to be well-covered by even a crappy policy - it's a rare event with a short treatment duration. Meanwhile, they may have caps or other limits on things that are longer-term or more common.

Also, I'm finding silver policies are costing only slightly more than the bronze plans (like the one you quoted) yet offer far better benefits. You might want to check those too.

But it could be you're one of the "lucky" people who will be hurt by the ACA. One of the reasons many of us supported single-payer over the ACA is the ACA's "market-based solution" required someone to lose. The government is the big loser, due to subsidies, but they left a sliver of relatively young and well-off people as losers too, in the assumption that they could afford the rate hike.

[busterbrown]

29. And when this thing works..

He won’t have to worry when he hits his middle 40’s when his policies will begin the nightmarish premium increases.

[jeff47]

30. Yes, he'd switch from being one of the losers to one of the winners.

Assuming there isn't some other critical detail he's leaving out.

For example, at a previous employer, going from a plan with a lifetime cap to a plan without a lifetime cap caused a similar rate hike.

[ReverendDeuce]

37. Good points...

My old policy had a $5,000,000 lifetime limit, so there is that.

It's an individual policy. I try to keep health insurance out of the hands of my employer. I don't see any reason to be tied up in that mess.

I will look into the silver options.

I wish I could afford the platinum... $390. :O

[jeff47]

43. Yeah, my rate went up a similar amount when a similar lifetime limit went away

This was an employer-plan just as the ACA rolled out. Taking the limit off, even with higher co-pays, cost about $150 more a month.

[DevonRex]

44. BCBS Nebraska site. Way better policies than that one.

http://www.ehealthinsurance.com/health-insurance-companies/bcbs-nebraska/

Also has links to Celtic, Coventry and United on it.

[boomersense]

49. There are many in your situation. I hear about them every day. I am not

sanguine any of these problems will be addressed. You have my sympathies. If Feinstein's bill passes you may get some short-term relief, and maybe even more than that-- Your broken leg cost you and the insurer $78, 500? My God...

[DevonRex]

31. Here's the first thread. There's an * at the tip of the page that he doesn't

connect anything to. I would like to see the text in the paperwork that the * relates to. Wouldn't you? And I'd like to see proof that he actually went to ACA and shopped around. There's a picture with it.
http://www.democraticunderground.com/?com=view_post&forum=1002&pid=3824490

Here's my ACA rate INCREASE for those who doubt... [View all]

Last edited Thu Oct 10, 2013, 06:42 PM - Edit history (1)

I DO NOT QUALIFY FOR A SUBSIDY AND THIS IS THE SAME RATE THAT IS QUOTED TO ME ON THE EXCHANGE. IT IS ALSO IN THE SAME PRICE RANGE AS ALL THE OTHER OFFERINGS ON THE EXCHANGE.

I've posted a bit about this before and nobody seemed to believe me, so I've decided to share photos of the "plan comparison" chart from Blue Cross that I received.

So, to summarize:

* Premium going way up!
* Deductible going way up!
* Out of pocket going WAAAY up!

But hey, at least I, as a 30-something male, get pediatric dental/vision and maternity covered, right? Right? RIGHT?!?

[ReverendDeuce]

61. Goodness gracious, heavens to betsy! YOU GOT ME!

I am so SNEAKY that I LEFT OUT A MEANINGLESS ASTERISK, right? It's some SECRET PLOT to keep information from you, right? What could it possibly say to DEBUNK my CLEARLY DECEPTIVE posts and affirm that ACA is the BEST EVAR???

Jesus Christ... some people here are nuts!

[DevonRex]

75. You and I already talked this out below. I know you

just got one of those scammy letters BCBS has been sending out. They gave you incomplete/misleading info. You have better options than what they switched you to and now you realize it. Those %@#s were trying to steal your money.

[ReverendDeuce]

78. What was the incomplete/misleading info?

And what are the better options? I've looked at Healthcare.gov, Health Sherpa, and some other sites. All of the ACA plans are icky.

[DevonRex]

79. BCBS itself has better more cost effective plans

In Nebraska than that high deductible bronze plan they steered you to. Take a look at the silver plan. Lower copays, lower deductible. I gave you the link below in our conversation.

I suspect very strongly that this one carries the highest profit margin for them. But, as I said below, the good thing about BC is that deductible does count toward max OOP costs. Not all ins cos do and the law doesn't require it, if you can believe it. That pisses me off royally.

Now, to be doubly sure you are getting the most for your money there's one more suggestion. If you have time and want to, you could go to a HRSA clinic where they help people sign up for ACA. Take your policy information and have a sit down with one of the facilitators. I'm no expert. And this is complicated.

I hope that all this arguing back and forth between us hasn't made us enemies. I've learned from you. And I hope we can join forces to in the future to present a this as a good, solid case against free market "health care." It was the first step in the battle, but only the first step. We can't stop now. Peace?

[Pretzel_Warrior]

11. Please give us specifics

It will probably turn out you DO have junk insurance and just don't know it.

[busterbrown]

12. Yea, I’m waiting too...

I’m gonna ask again...

[ReverendDeuce]

16. My first reply was to you, which is why there was a delay. I had to write a reply.

I use a keyboard and not voice-dictation, so I wanted to make sure I had everything spelled out.

[ReverendDeuce]

18. Again, it was not a junk policy. See my reply to busterbrown.

I racked up $80K in medical expenses and everything beyond my $1,500 deductible was paid in full by the policy.

Ambulance service, ER, x-rays, overnight stays at the hospital, ORIF surgery, all follow-up visits, all physical therapy, everything was taken care of without any question.

[DevonRex]

33. What does the * say in the photo you showed us?

http://www.democraticunderground.com/?com=view_post&forum=1002&pid=3824490

[ReverendDeuce]

35. The "*"? I believe it's at the bottom of page 2...

"As of August 19th ... premium rates are pending approval ... are subject to change."

And they have not changed as of this morning.

[DevonRex]

38. Got a picture?

[ReverendDeuce]

40. It's in the one you shared... ? At the bottom... n/t

n/t

[DevonRex]

47. No. There isn't a corresponding *. I think somewhere they tell

you that you don't have to take the "new" plan. That you're free to look for a better deal or one that suits your needs more. Because we all know this is an insurance company scam. The only thing Obama has to do with it is that the old one was inadequate in ways you probably don't even realize. But you should have realized a scam when you got it in the mail. Really. Seriously, I'm sorry they did this to you but it was nasty salesmanship at work. GREED. Plain and simple.

[ReverendDeuce]

62. Probably what it is, yes... I don't have it in front of me right now.

But they did present a menu of alternatives and none of which were very good.

[DevonRex]

65. No. As i said you're lucky. Your max out of pocket includes deductible.

So you can figure that into your calculations. And the silver looks pretty good, with lower copays, like 30 bucks for PCP in network and 60 for specialists. But look at your pharmacy closely, including mail in. Actually go through your RXes and see what the formulary is and if it has changed. Which mail in program they use and if that is changing.

Other than a surgery or life changing illness, those are the main points. Oh, also check out specialty pharmacy just in case. It's for stuff like infusions. I have those done, so let me tell you it isn't unusual. And I have BCBS. They're good but you still have to watch them like a hawk. Or they'll stiff you.

[a2liberal]

56. Question:

and it's an honest question, I'm not one of those that claim anyone who says their costs went up most be a troll

Why does the old plan say "not applicable" for specialty drugs? Is it because they're not covered, or something else? If you can find information on that somewhere it would be useful. Because as someone on a specialty drug, let me tell you that if you are unfortunate enough to get diagnosed with a disease that requires one, they can run around $60k a year (a travesty in its own right but that's a different rant). Not being covered for that is a significant disadvantage IMO.

Edit: I think I found your plan, is this it? https://www.nebraskablue.com/~/media/pdf/Individual%20Product%20SBCs/BlueEssentials%20HSA%201500_01012013_HEI00100441592012-08-01.pdf

Honestly, other than the missing mental health services it seems like a high-quality plan to me. I think that the posters (especially in the other thread) trying to ridicule you or find loopholes or just blanket insulting without understanding you are barking up the wrong tree. My personal reaction is that yes, at this moment in time you are a "victim" of the ACA. However, the most important thing to keep in mind is that if you should ever happen to get seriously sick or get older, you will then be better off under the ACA than you would've been previously. Those expecting a market-based law to be some la-la land where everyone all the time is better off are dreaming. There are costs to some at the outset but overall it will save everyone some money in the long run (not as much as single-payer of course...). For example, see if you can get your insurer to give you a quote for both plans they list except pretending that you're 55...

[ReverendDeuce]

63. Yes! That's my current plan in that link... Thank you for understanding!

It's madness in that other thread. Complete and utter madness that can't be stopped by reason.

This is part of the reason I can't listen to <insert any number of democratic talking head pundits> anymore. They carry water for the administration and simply refuse to believe that the ACA is going anything other than make everyone shit gold bricks and diamonds.

I realize this is the "Democratic" Underground, but I always try and be a liberal first.

[busterbrown]

13. We are still waiting!!! n/t

Couldn’t have gotten off the system that fast..
Or are you busy searching for the very very few instances which might be true..

[ReverendDeuce]

15. I was busy writing to the first person who asked. It takes time to compose a reply.

Copy/paste:

- I do not qualify for subsidies.
- I have "price shopped" on Healthcare.gov (I managed to get in) and the policies are all in the same ballpark.

Old policy:

$150/mo premium (approximate)
$1,500 deductible
$1,500 max out-of-pocket
0% coinsurance

Does not cover maternity (I'm male), does not cover pediatric dental or pediatric vision (I am in my 30s), and does not cover mental health (a legitimate thing, but I don't currently foresee myself needing this service; but you never know).

I've used it when I broke my leg. I paid up to the $1,500, not a penny more, and the remaining $78,500 (approximate) was paid for by the insurer.

New ACA-acceptable policy:

$243/mo premium (approximate)
$2,500 deductible
$6,350 max out-of-pocket
50% coinsurance

I am really infuriated by this whole thing. I honestly never saw this coming and it completely surprised me.

[Skittles]

22. I believe you Rev

but.....$80,000 for a broken leg? WTF

[ReverendDeuce]

26. ORIF surgery is expensive! I had a spiral fracture of the left femur with rods and screws...

It was not pleasant!

[Skittles]

27. oh dear

hope all is well now

I do believe you about your insurance because I have plugged numbers myself - a certain segment of the population gets reamed and they are NOT RICH

[ReverendDeuce]

34. Thanks!

I know, I am fortunate to be in an income group where I don't require subsidies, but the idea of a $6,350 out-of-pocket isn't thrilling.

I did make a 100% recovery (well, maybe 99.9% since I still get a mild ache now and then). My surgeon told me if I had this injury ten or fifteen years ago, my youth would not have been enough to make up for the medical advances that have been made.

I still have metal in my leg, too! I look forward to the first time I get to encounter a TSA agent...

[davidpdx]

70. That is terrible

A clean break would have been so much easier to fix. I'll never joke with you about "breaking a leg".

[pangaia]

25. I've ready your posts and the replies..

I really, really don't want to sound like I am questioning you, but I have never heard of a policy that does what you say at that price, including group policies. Most policies have a long list of what is and what isn't covered.. chemo, diabetes, renal failure, etc etc etc..

Even my Medicare insurance with a supplemental from a 'good' insurance company is not much better than that. Depending on what else you have covered, maybe not as good. I pay premiums TOTAL of about $140/mo..to Medicare AND the supplemental. I have co-pays- $15/25,..$150/day hospital room up to I think 4-5 days, then free. etc etc.

May I ask what insurance company you were with?
If the rest of your coverages compare with mine, you are one lucky dude.

[ReverendDeuce]

32. Thanks for not being rude...

I appreciate it!

My policy is with Blue Cross Nebraska.

There may well be some things that aren't covered, but from what I can see here is the list (copy/pasted):

- Acupuncture
- Glasses (children)
- Pregnancy/maternity care
- Bariatric surgery
- Hearing aids
- Private-duty nursing
- Cosmetic surgery
- Infertility treatment
- Routine foot care
- Dental care (adults)
- Long-term care
- Substance use disorder
- Dental care (children)
- Mental/behavioral health
- Weight loss programs

[pangaia]

36. Hey no problem. rudeness is a waste of time.

And too much of it out here sometimes.

Well, sounds like you have it pretty good.

Last year I had part/most of a tumor removed from my spine and then chemo for lymphoma - lumbar punctures, bone marrow aspirations, blah, blah, on and on... All total allowed and paid by my insurance company was about $180,000.. probably more.. hard to figure. With co-pays it cost me maybe $1500 or so.

Oh, no more cancer. !! One year cancer-free so far and the prognosis is very good.
Now I have to deal with trigger finger.

[ReverendDeuce]

39. Wow! Congratulations...

Great news on your recovery!

And I agree. it's funny how costs vary so wildly.

[DevonRex]

48. The good thing is your deductible IS included in your MOOP.

And it is there in blue & White.
http://www.ehealthinsurance.com/health-insurance-companies/bcbs-nebraska/benefit-detail/?health-plan=200026

But still, just going up to Silver will be a huge difference.

[Pretzel_Warrior]

10. Another kick

[pinto]

17. Thanks for the snag and post here. The info made sense to me, who's not a well versed IT guy.

[napkinz]

28. another thread to keep kicked ---->

[font size="3"]What Does GOP Do Once Website is Fixed?[/font]


http://politicalwire.com/archives/2013/11/07/what_does_gop_do_once_website_is_fixed.html


http://www.democraticunderground.com/10023997236

[Demo_Chris]

41. The HHS Sec was boasting they were now handling 17,000 applicants per day...

Not 17,000 per second, which would be respectable.

Nor 17,000 per minute, which would perhaps be acceptable but still off the mark.

Nor even 17,000 per hour, which should result in everyone involved losing their job.

No, she was boasting about 17,000 per DAY. One might assume that they were running the entire system on a 1970's Casio Watch Calculator.

In any case, everyone involved from the top all the way on down needs to be fired. There is simply no excuse for incompetence of this magnitude. And no, I have no confidence that a fix is forthcoming. Right now people are up against a wall. There are millions who either apply and get accepted NOW -- immediately -- or they will not have insurance come January first.

[questionseverything]

52. if the insurance is a great deal

people will find a way to buy it,the web site is an embarrassment but nothing more

the price tag is the real problem for the over 50 crowd (unless you are very poor)

and the smokers are just dead men walking...the aca calls for 33% of their income to be used on medical

[Yo_Mama]

64. II agree, this is a crushing disappointment

Yes, it's better to handle 20K a day than 1.5K, but how in hell can all the people who possibly need to sign up by December 15th be handled even if they double or triple that?

It seems to me what they are really saying is that people won't be able to sign up!

Millions of people are receiving cancellation notices, which means this website has to handle at least 3 million people, doesn't it? I'd also like to know why it is working for some now, but other people are still "stuck".

[Demo_Chris]

66. Millions needed the insurance this promised...

Millions more are discovering that they have been cancelled.

And as people begin to discover what's in this thing, they are going to be demanding that their employers cancel on them so they can grab some of that sweet subsidy cash.

In the meantime, a whole generation, hanging onto the precipice with one hand, Walmart and Target and Home Depot and Lowes and McDonalds workers, just call them American's ten largest employers, people barely scraping by earing 15 to 20 grand a year, are going to discover that that thanks to Obamacare they suddenly have one more monthly bill and a party full of people more interested in celebrating a victory than listening to they cries. But hey, they should just suck it up and learn to manage their $9 an hour better. That's been our message to them thus far.

And in the meantime, after dropping a hundred mil and more time than it took us to fight and win World War Two, all they've managed is to completely trash public perception of our party, a massive payoff to the insurance company, and a website that would have been better had it been hosted by Go Daddy and designed using their free software.

Some people are celebrating this debacle as a huge win for the American people and our party, but from where I am sitting it's more like Stalingrad must have looked to the Germans.

But that's just me.

[solarhydrocan]

71. +1 well said

It's not just you

The New Democrats: Surveillance, Bailouts for the 1% and Drone Bombing.

I think it would have been great if they had concentrated on Jobs before mandating everyone buy insurance, but that's just me.

No one in power in DC can even imagine what a premium payment means to those that actually work for their money.

[Tarheel_Dem]

45. K&R

[Iliyah]

50. K & R!

Extension until March 2014 . . .

GOPers will shutdown the government over Obamacare again in Feb. 2014

If the an amendment to the ACA is passed by the Senate you can keep your insurance if you want. Most will not once they see how crappy it is.

[ReRe]

51. K&R

I love you! Thanks, busterbrown. Your exuberance is infectious!

[BKH70041]

53. When is soon?

Compared to 1 million years, 1,000 years is soon.

If they mean by November 1st, then no.

If they mean by the end of the year, then no.

Pluto isn't even a planet anymore but, like their predictions, they are far out.

And not in a good way.

[busterbrown]

67. obvious that you are hoping for it not to be fixed.

Maybe you should mention that...

[BKH70041]

68. Oh, it'll get fixed.

Just not soon enough.

In fact, it should have never needed fixing. This is a clusterfuck.

[busterbrown]

69. Agree...But actually it is doing better than the Mass. Plan when it was first enacted.

.03% sign ups as opposed to 1.1/2% first 30 days..

[ancianita]

59. Another 2014 campaign issue is gone because good IT is problem solving.

[napkinz]

72. right, this won't be an issue in the 2014 midterm elections

in fact, by SPRING of 2014 it won't be an issue

The GOP will have to find/invent a new "scandal" to run on.

[northoftheborder]

60. This is very worthwhile reading, even for "non-techies". Thanks for link to this.

[napkinz]

80. kick

nt