Obamacare...(new title): GOP DEATH PLAN: Don-Ryan's Express

[Tulane Skins Fan]

You don't have a solution, nor does the ACA.

So yeah the country has a problem.  Try stating a solution if thats the game you choose to play.

 

Um... I prefer public option or single payer to this.  That would control the costs of healthcare and grant access to all.  There's no question it would do so at the expense of hospital administrators making 20 million a year, and probably to some doctors' paychecks.  But that is my solution.

 

Oh, and the ACA may work still.  Its too early to say it won't work.

 

What is your solution now?

Edited November 6, 2013 by Tulane Skins Fan

[chipwhich]

Um... I prefer public option or single payer to this.  That would control the costs of healthcare and grant access to all.  There's no question it would do so at the expense of hospital administrators making 20 million a year, and probably to some doctors' paychecks.  But that is my solution.

 

Oh, and the ACA may work still.  Its too early to say it won't work.

 

What is your solution now?

 

Oh you wanted to know my preference?  That isn't a solution.  My preference would be a well run single payer system that is fiscally responsible.  I don't think it's a solution because I don't think our government can afford it or can run it.  Too many lawyers, too many laws, to much litigation.

[daveakl]

On average, everyone's rates were skyrocketing. And no, not "everyone's" are now, just like not everyone's were before ACA. My rates did not change at all.

The point is that it is very hard to compare apples to apples in this analysis. It is almost, by definition, apples to oranges.

Again, this doesn't mean that that ACA made that plan get more expensive. Without the ACA, your previous plan's rates could have made the same increase.

We don't know, but you are jumping to a conclusion that is speculation. And I'm not blaming you for that. This is what everyone does with healthcare. But healthcare is very difficult to assess. It is not like buying a Coke. The prices for a Coke one year, are more predictable the next.

Except for the letter from BCBS saying that our plan was no longer offered as a result of ACA and the new plan that was most similar to our old was going to be much higher, otherwise you would be right.

Our rate had not gone up in two years. Maybe it is just a coincidence that the letter came out the exact same time the aca went into law.

[Mocountyskins]

I would like to put more input in this thread, but it is very hard to do because I do not really understand how everything works with healthcare. I can't put in any personal stories to share because my family has never seemed to struggle with healthcare so I feel like I would be in the minority there. I do feel as if I could bring some good comments tho.

[TradeTheBeal!]

Not a half bad article. Is Obama more secretive and dirtier than Nixon? Don't we deserve better?

 

 

 

Stop clowning yourself, bro.

[Larry]

Except for the letter from BCBS saying that our plan was no longer offered as a result of ACA and the new plan that was most similar to our old was going to be much higher, otherwise you would be right.

Our rate had not gone up in two years. Maybe it is just a coincidence that the letter came out the exact same time the aca went into law.

 

So, you're convinced that Obamacare mandates something, some kind of coverage that your old plan didn't cover, and whatever this mandate was (birth control?), BCBS estimates that you're going to use $4,000 of it, a year? 

 

That's a lot of condoms. 

 

Couldn't possibly be that

 

1)  You were due for a rate hike, anyway.

2)  Your wife is looking at a complicated pregnancy and childbirth, and BCBS knows it. 

[daveakl]

So, you're convinced that Obamacare mandates something, some kind of coverage that your old plan didn't cover, and whatever this mandate was (birth control?), BCBS estimates that you're going to use $4,000 of it, a year?

That's a lot of condoms.

Couldn't possibly be that

1) You were due for a rate hike, anyway.

2) Your wife is looking at a complicated pregnancy and childbirth, and BCBS knows it.

1) could be. dont know.

2) doubtful since the first three were uneventful and this one shows nothing different.

Could be lots of "possible" things. But what I do know for sure is that our old plan from bcbs is no longer offered due to ACA and the new plan that lines up with it in terms of deductible and such costs a good chunk more.

[Larry]

Probably a dumb question.  The rule that says "you must cover pre-existing conditions". 

 

Does that rule now apply to all insurance sold in the US?  Or just policies sold through the exchanges? 

 

I assume it's just through the exchanges.  (I assume that my policy doesn't have that clause in it.)  And it would make sense that, if a clause like that only applied in the exchanges, then it would predictably exert pressure for those policies to cost more, compared to a plan which is allowed to exclude sick people.  The exchanges would be selling to a sicker pool.  (And, it's new.  Nobody knows how much sicker this pool is.) 

1) could be. dont know.
2) doubtful since the first three were uneventful and this one shows nothing different.

Could be lots of "possible" things. But what I do know for sure is that our old plan from bcbs is no longer offered due to ACA and the new plan that lines up with it in terms of deductible and such costs a good chunk more.

 
I thought you had said something about a complicated pregnancy, possibly to the point of never having children again.  But that may have been somebody else.

[daveakl]

Not complicated. She wasnt supposed to be able to get pregnant. One ovarie and endometriosis.

But I have super sperm. Which looking more into it could scare bcbs and be the cause of our high rate. Lol

[TheGoodBits]

Not complicated. She wasnt supposed to be able to get pregnant. One ovarie and endometriosis.

But I have super sperm. Which looking more into it could scare bcbs and be the cause of our high rate. Lol

Haha ask if you can get a discount on your premium if you undergo a vasectomy.

[chipwhich]

 

Probably a dumb question.  The rule that says "you must cover pre-existing conditions". 

 

Does that rule now apply to all insurance sold in the US?  Or just policies sold through the exchanges? 

 

Group plans like through my company takes anyone regardless of pre-existing conditions.

 

 

I assume it's just through the exchanges.  (I assume that my policy doesn't have that clause in it.)  And it would make sense that, if a clause like that only applied in the exchanges, then it would predictably exert pressure for those policies to cost more, compared to a plan which is allowed to exclude sick people.  The exchanges would be selling to a sicker pool.  (And, it's new.  Nobody knows how much sicker this pool is.)

 

What amuses me about you is you are always building your defense to something that isn't a defense.

 

It's through all group plans, it's not unique to Obamacare.  I can already predict your next hypothesis. 

[twa]

Since our Ins Salesman in Chief is in state pushing expanding Medicaid It brings up a question.

 

Are the lower income here that are above the present medicaid level better off with Obamacare w/subsidies or expanded Medicaid????

 

inquiring minds want to know.

[Tulane Skins Fan]

Oh you wanted to know my preference?  That isn't a solution.  My preference would be a well run single payer system that is fiscally responsible.  I don't think it's a solution because I don't think our government can afford it or can run it.  Too many lawyers, too many laws, to much litigation.

Are you just trolling me knowing I'm a litigator? What does litigation have to do with this?

The only litigation so far was brought by conservatives trying to get the bill ruled unconstitutional.

  

Except for the letter from BCBS saying that our plan was no longer offered as a result of ACA and the new plan that was most similar to our old was going to be much higher, otherwise you would be right.

Our rate had not gone up in two years. Maybe it is just a coincidence that the letter came out the exact same time the aca went into law.

Devil is in the details. Your plans are probably just not comparable.

 

Since our Ins Salesman in Chief is in state pushing expanding Medicaid It brings up a question.

 

Are the lower income here that are above the present medicaid level better off with Obamacare w/subsidies or expanded Medicaid????

 

inquiring minds want to know.

Choice is a beautiful thing, huh?

[chipwhich]

Are you just trolling me knowing I'm a litigator? What does litigation have to do with this?

The only litigation so far was brought by conservatives trying to get the bill ruled unconstitutional.

 

LOL I have no idea what your occupation is.

[daveakl]

Devil is in the details. Your plans are probably just not comparable.

Our copay for wellness visit went up $25 and we gained child dental (max 2 visits per year per kid) and child vision (max 1 visit per year per kid)

Otherwise they were 100% the same.

Edited November 7, 2013 by daveakl

[twa]

 

Choice is a beautiful thing, huh?

 

Is it?

 

http://www.cnn.com/2013/10/03/health/obamacare-medicaid-gap-gupta/index.html

 

http://www.forbes.com/sites/theapothecary/2013/03/05/obamacares-exchange-based-health-insurance-will-be-better-than-medicaid-but-how-much-costlier/

We have heard nothing—yet—from the Obama administration as to exactly how the Arkansas agreement is set to proceed. The impression we have from Arkansas officials like Gov. Mike Beebe (D.) is that the U.S. Department of Health and Human Services is allowing Arkansas to go ahead and spend exchange-style money on the population that was intended for the cheaper, but inferior, Medicaid program.

 

 

 

 

are they going to do the Arkansas shift here?

[Larry]

What amuses me about you is you are always building your defense to something that isn't a defense.

 

It's through all group plans, it's not unique to Obamacare.  I can already predict your next hypothesis.

What doesn't amuse me is the way, every time I post, you try to attack me for something I didn't say.

My question didn't mention groups. Nor, I think, do the exchanges.

[chipwhich]

My question didn't mention groups. Nor, I think, do the exchanges.

 

Your question

 

 

Probably a dumb question.  The rule that says "you must cover pre-existing conditions". 

 

Does that rule now apply to all insurance sold in the US?  Or just policies sold through the exchanges?

 

It doesn't apply to all insurance in the US, and it's not for just policies sold through the exchanges.  GROUP policies offered by employers allow for pre existing conditions.

Sorry Larry, I forget that I don't type explicitly enough.

Edited November 7, 2013 by chipwhich

[twa]

Not to get into ya'lls thing, but the exchanges are groups as are the majority of ins plans.

 

that was one of the selling points, making the advantages of group plans availible to individual policy holders

[Larry]

Since our Ins Salesman in Chief is in state pushing expanding Medicaid It brings up a question.

 

Are the lower income here that are above the present medicaid level better off with Obamacare w/subsidies or expanded Medicaid????

 

inquiring minds want to know.

Well, I'm pretty sure that Medicaid has both vastly lower premiums and vastly lower deductibles.

Now, it probably also covers a lot fewer things. (Probably doesn't cover mental health and substance abuse treatment, for example.) May well have much lower maximum coverage levels.

Now, my gut feeling is that Joe Poor probably thinks that not having a $7,000 deductible makes Medicaid just a teensy bit preferable. But I'm sure it's a matter of opinion.

[twa]

Well, I'm pretty sure that Medicaid has both vastly lower premiums and vastly lower deductibles.

Now, it probably also covers a lot fewer things. (Probably doesn't cover mental health and substance abuse treatment, for example.) May well have much lower maximum coverage levels.

Now, my gut feeling is that Joe Poor probably thinks that not having a $7,000 deductible makes Medicaid just a teensy bit preferable. But I'm sure it's a matter of opinion.

I would not be too sure, especially for those in the expanded Medicaid grouping

 

http://www.lawhelpnc.org/resource/faqs-medicaid-deductible

 

Authored By: Legal Aid of North Carolina 

FAQ

What is a Medicaid deductible?

How is a Medicaid deductible calculated?

 

A Medicaid deductible is the amount of medical expenses that you must incur before Medicaid will start paying any of your medical bills.

• For example, if you have a deductible of $1500, your medical expenses must add up to $1500 before Medicaid will start paying your medical bills.
• You do not have to pay the bills in order for them to count toward your deductible amount.
• Once you reach the deductible amount, Medicaid will pay for additional medical bills you incur during the certification period. Medicaid will not go back and pay the bills that you used to reach your deductible amount.

 

The deductible is calculated by subtracting Medicaid's Medically Needy monthly income limit from your family's countable monthly income, then multiplying that amount by six.

 

• For example, suppose the monthly Medically Needy income limit for a household of one is $242, but your monthly income is $1000. The difference ($758) is then multiplied by six, resulting in a deductible of $4,548.

The deductible is calculated for a six-month period because that is the usual length of a Medicaid certification period. Once the certification period ends, you will have to meet your deductible again before Medicaid will start paying your medical bills again.  Therefore, it may be to your advantage to hold your medical bills to meet your deductible at the beginning of a new six-month certification period.

[Larry]

http://www.cnn.com/2013/10/03/health/obamacare-medicaid-gap-gupta/index.html

 

http://www.forbes.com/sites/theapothecary/2013/03/05/obamacares-exchange-based-health-insurance-will-be-better-than-medicaid-but-how-much-costlier/

Observing that the main thrust of your first link is that millions of working poor are unable to get subsidized insurance on the exchanges, because they're too poor. But don;t qualify for Medicaid because they live in a state which has decided to refuse billions of dollars of economic stimulus for political reasons.

And the main thrust of the second one is that it looks like CBO might be overestimating the cost of insurance through the exchanges. (And, therefore, the cost of people's subsidies to purchase insurance.) Supposedly, (if I'm reading things correctly), CBO estimated that exchange insurance would be paying providers roughly what commercial croup insurance plans pay, but it looks like they are actually managing to negotiate reimbursement rates that are around 20% lower than that. Rates that are more in line with what Medicare pays, possibly lower. And that these lower reimbursement rates correspond to lower payouts for the insurance companies, which should translate into lower premiums.

Edit: Looks like your second link is actually two articles. I described the first article, and you were quoting from the second, which is quite a bit closer to the topic.

Edited November 7, 2013 by Larry

[twa]

Observing that goes back to the questions I asked...are they better off with the exchanges or expanded Medicaid and will the Arkansas exception be expanded. 

 

the simple fact is someone is gonna get squeezed....who is a ongoing question

[Zguy28]

the simple fact is someone is gonna get squeezed....who is a ongoing question

Well, my BC/BS premium just increased $1,000 annually or $40 a paycheck. And deductibles almost doubled from $400 to $750 for each of my five family members. I think I got squeezed.

Edited November 7, 2013 by Zguy28

[IceDragon38]

What do the Washington Redskins defense and Obamacare have in common?

They are still expensive with no coverage.