Author Topic: What comes after the ACA?  (Read 655992 times)

protostache

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Re: What comes after the ACA?
« Reply #4100 on: February 23, 2018, 11:11:08 AM »
People like boarder42 are the same ones that bitch about paying school taxes.  "My kid isn't going to school so why should I pay for other people's kids to go to school?".  Yeah, these people have almost no concept of "The Common Good".  And in fact, their thinking is usually reduced down to:

Government Bad
Free Market Good

This isn't fair to b42. He and I may disagree (almost all the time) but he seems like a good person and he doesn't seem to be against taxes. In the context of this thread (and correct me if I'm wrong, b42) he wants lower premiums and better outcomes, just the same as we all do. His words on the ACA are ill-informed but he seems to be arguing in good faith.

boarder42

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Re: What comes after the ACA?
« Reply #4101 on: February 23, 2018, 11:16:10 AM »
i think those with pre existing conditions should choose to find gainful employment with their pre existing condtions that cover them vs putting this burden on the rest of society - work til you're 65 or covered by something else - move to a country that covers you - etc.

So now people with preexisting conditions are also welfare queens? FFS, how many stories do you need to hear about employers just paying the penalty and not covering people, or cutting hours so their workers are just below benefits eligibility? Tying health insurance to employment was bone-headed to begin with. It's even worse given the current and future state of employment in America.

i dont disagree at all but if my choice is ACA as it was developed or healthcare for pre-existing conditions tied to employment i'll choose the latter.  you're clearly just snipping points out of my post and presenting them out of context. b/c that statement was based on ACA or that - not that statement in a vacuum.
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swampwiz

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Re: What comes after the ACA?
« Reply #4102 on: February 23, 2018, 11:23:53 AM »
Here's the "next logical step":

http://acasignups.net/18/02/23/lets-dive-caps-medicare-extra-all

(I set up a new thread for it.)

boarder42

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Re: What comes after the ACA?
« Reply #4103 on: February 23, 2018, 11:28:18 AM »
People like boarder42 are the same ones that bitch about paying school taxes.  "My kid isn't going to school so why should I pay for other people's kids to go to school?".  Yeah, these people have almost no concept of "The Common Good".  And in fact, their thinking is usually reduced down to:

Government Bad
Free Market Good

This isn't fair to b42. He and I may disagree (almost all the time) but he seems like a good person and he doesn't seem to be against taxes. In the context of this thread (and correct me if I'm wrong, b42) he wants lower premiums and better outcomes, just the same as we all do. His words on the ACA are ill-informed but he seems to be arguing in good faith.

Some of my statements were wrong and i was corrected. but as in the other thread that was recently started about the ACA and traveling out of state the govt is now mandating i hold coverage that basically wont let me travel out of a certain square mile area with out paying a penalty or opting for a healthshare - or i have to buy some extra coverage to go on a road trip in my own country.  its becoming a dumpster FIRE of awfulness.  I wouldnt really have to strong an issue with it from a cost standpoint if it provided good coverage, but to pay 7.5k a year plus visit fees for a family of 4 is outrageous when it doesnt cover me if i walk across the stateline.

i just dont get why we cant make this efficient and go central payer and move on - well i get it - we have insurance companies making money off the ACA then handing it to senators and reps on both sides of the aisle to make sure they stay in business raping society. 
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boarder42

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Re: What comes after the ACA?
« Reply #4104 on: February 23, 2018, 11:38:23 AM »
Here's the "next logical step":

http://acasignups.net/18/02/23/lets-dive-caps-medicare-extra-all

(I set up a new thread for it.)

this is gold i like it alot - its really the best of both worlds - and medicare should push out private insurance or at least drive them to just provide additional coverages.

i'd pay 8k a year for coverage for a family of 4 that included all of that with around a 1300 deductible - if i could combine it with an MSA and lower my premiums and raise my deductible i'd do that too.
« Last Edit: February 23, 2018, 11:44:16 AM by boarder42 »
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sol

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Re: What comes after the ACA?
« Reply #4105 on: February 23, 2018, 11:59:44 AM »
we have insurance companies making money off the ACA then handing it to senators and reps on both sides of the aisle to make sure they stay in business raping society.

Boarder42, this is American capitalism.  American capitalism, meet boarder42.  I'll leave you two alone to get acquainted.
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Cassie

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Re: What comes after the ACA?
« Reply #4106 on: February 23, 2018, 12:10:32 PM »
Many people with pre-existing conditions are not capable of working until 65.  If you look at the studies many retire early because of a accident or injury. I used to see this all the time when I was working with people with disabilities to help them get back to work. There is also something called age discrimination and it can be very difficult to find a f.t. job with benefits in your 50's and 60's.  We are in our early 60's but lucky enough to have insurance through our past employers even though it is very expensive.  3 of our good friends have gotten terminal cancer and died between 59-67 so obviously they got to a point where they could not work.  It is easy to say what people should do if you are not in that position but saying something does not make it feasible for the majority.  People can take excellent care of themselves and still get cancer or have an injury.

boarder42

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Re: What comes after the ACA?
« Reply #4107 on: February 23, 2018, 01:08:00 PM »
we have insurance companies making money off the ACA then handing it to senators and reps on both sides of the aisle to make sure they stay in business raping society.

Boarder42, this is American capitalism.  American capitalism, meet boarder42.  I'll leave you two alone to get acquainted.

i completely agree - its just serves no place in healthcare as i stated multiple times before - if we're going to say everyone should be covered affordably and then force them to buy it.
« Last Edit: February 23, 2018, 01:12:06 PM by boarder42 »
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DavidAnnArbor

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Re: What comes after the ACA?
« Reply #4108 on: February 23, 2018, 04:48:50 PM »
People can take excellent care of themselves and still get cancer or have an injury.

And corporations seeking profit will do whatever it takes, your health be damned:

What Poisons Are in Your Body?  https://nyti.ms/2EX7Yqh

Gin1984

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Re: What comes after the ACA?
« Reply #4109 on: February 23, 2018, 06:13:38 PM »
i think those with pre existing conditions should choose to find gainful employment with their pre existing condtions that cover them vs putting this burden on the rest of society - work til you're 65 or covered by something else - move to a country that covers you - etc.

So now people with preexisting conditions are also welfare queens? FFS, how many stories do you need to hear about employers just paying the penalty and not covering people, or cutting hours so their workers are just below benefits eligibility? Tying health insurance to employment was bone-headed to begin with. It's even worse given the current and future state of employment in America.
Or what about those of us in which work has a negative effect on our pre-existing condition?  I don't even care about getting the subsidy, I just want access.  However, there are people who lose their job or make too little to afford health insurance on the open market, and that is not good for us as a society.  Nor is the attitude of go away if you need insurance.  And just a side note, using a couple hundred dollars of care is MUCH less than I pay into insurance and MUCH MUCH less than the cost of me being uninsured if I or any of my children has an accident.

Bateaux

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Re: What comes after the ACA?
« Reply #4110 on: February 23, 2018, 10:19:01 PM »
B42 I'm glad you cleared up your stance on health care.   You'd pissed off many of us with some comments.  Now you're making sense.
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jim555

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Re: What comes after the ACA?
« Reply #4111 on: February 27, 2018, 05:33:50 AM »
A new attack on the ACA...

Twenty states sue federal government, seeking end to Obamacare

(Reuters) - A coalition of 20 U.S. states sued the federal government on Monday over Obamacare, claiming the law was no longer constitutional after the repeal last year of its requirement that people have health insurance or pay a fine. ...

https://www.reuters.com/article/us-usa-healthcare/twenty-states-sue-federal-government-seeking-end-to-obamacare-idUSKCN1GB06R

boarder42

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Re: What comes after the ACA?
« Reply #4112 on: February 27, 2018, 06:11:44 AM »
A new attack on the ACA...

Twenty states sue federal government, seeking end to Obamacare

(Reuters) - A coalition of 20 U.S. states sued the federal government on Monday over Obamacare, claiming the law was no longer constitutional after the repeal last year of its requirement that people have health insurance or pay a fine. ...

https://www.reuters.com/article/us-usa-healthcare/twenty-states-sue-federal-government-seeking-end-to-obamacare-idUSKCN1GB06R

this is fun!  i like the drama around poorly executed legislation.
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protostache

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Re: What comes after the ACA?
« Reply #4113 on: February 27, 2018, 06:26:25 AM »
A new attack on the ACA...

Twenty states sue federal government, seeking end to Obamacare

(Reuters) - A coalition of 20 U.S. states sued the federal government on Monday over Obamacare, claiming the law was no longer constitutional after the repeal last year of its requirement that people have health insurance or pay a fine. ...

https://www.reuters.com/article/us-usa-healthcare/twenty-states-sue-federal-government-seeking-end-to-obamacare-idUSKCN1GB06R

this is fun!  i like the drama around poorly executed legislation.

Millions of people losing access to healthcare and a non-trivial number of them dying as a result is fun for you?

Monkey Uncle

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Re: What comes after the ACA?
« Reply #4114 on: February 27, 2018, 06:30:56 AM »
A new attack on the ACA...

Twenty states sue federal government, seeking end to Obamacare

(Reuters) - A coalition of 20 U.S. states sued the federal government on Monday over Obamacare, claiming the law was no longer constitutional after the repeal last year of its requirement that people have health insurance or pay a fine. ...

https://www.reuters.com/article/us-usa-healthcare/twenty-states-sue-federal-government-seeking-end-to-obamacare-idUSKCN1GB06R

Yes, my state is among them.  Ten percent of the state's population would lose their health coverage, most of them poor, and many of them children.  And our AG, who claims on his web site to be defending the people of the state from injustice, thinks this is a good idea.
Took that job and shoved it - January 6, 2018

boarder42

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Re: What comes after the ACA?
« Reply #4115 on: February 27, 2018, 06:47:07 AM »
A new attack on the ACA...

Twenty states sue federal government, seeking end to Obamacare

(Reuters) - A coalition of 20 U.S. states sued the federal government on Monday over Obamacare, claiming the law was no longer constitutional after the repeal last year of its requirement that people have health insurance or pay a fine. ...

https://www.reuters.com/article/us-usa-healthcare/twenty-states-sue-federal-government-seeking-end-to-obamacare-idUSKCN1GB06R

this is fun!  i like the drama around poorly executed legislation.

Millions of people losing access to healthcare and a non-trivial number of them dying as a result is fun for you?


do you have any statistics to back up this claim that non-trivial numbers were dying pre ACA b/c thats the situation we'd be back to.  is there data out there showing that the ACA has inherently saved a non-trivial number of lives since its incepetion - or just the data that we've covered extra people with shitty overpriced "insurance"
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protostache

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Re: What comes after the ACA?
« Reply #4116 on: February 27, 2018, 06:54:36 AM »
A new attack on the ACA...

Twenty states sue federal government, seeking end to Obamacare

(Reuters) - A coalition of 20 U.S. states sued the federal government on Monday over Obamacare, claiming the law was no longer constitutional after the repeal last year of its requirement that people have health insurance or pay a fine. ...

https://www.reuters.com/article/us-usa-healthcare/twenty-states-sue-federal-government-seeking-end-to-obamacare-idUSKCN1GB06R

this is fun!  i like the drama around poorly executed legislation.

Millions of people losing access to healthcare and a non-trivial number of them dying as a result is fun for you?


do you have any statistics to back up this claim that non-trivial numbers were dying pre ACA b/c thats the situation we'd be back to.  is there data out there showing that the ACA has inherently saved a non-trivial number of lives since its incepetion - or just the data that we've covered extra people with shitty overpriced "insurance"

http://www.nejm.org/doi/full/10.1056/NEJMsb1706645

Iím sure this has been linked at least once before in this monstrously long thread.

Also try to keep in mind that the number of people covered by individual market policies is dwarfed by those covered by Medicaid expansion, by about 4 to 1. Medicaid expansion policies are decidedly non-shitty and they are definitely not overpriced.
« Last Edit: February 27, 2018, 06:58:06 AM by protostache »

use2betrix

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Re: What comes after the ACA?
« Reply #4117 on: February 27, 2018, 10:26:44 AM »
In most states you canít even purchase PPO coverage anymore. I donít have a ďhomeĒ state, but Texas is as close as t gets. They only offer HMO plans, which means when I spend 3-4 months on the road traveling I have zero coverage aside from ďlife threatening emergencies.Ē

Itís beyond pathetic that these plans are no longer available to purchase for any amount of money.

boarder42

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Re: What comes after the ACA?
« Reply #4118 on: February 27, 2018, 10:41:57 AM »
A new attack on the ACA...

Twenty states sue federal government, seeking end to Obamacare

(Reuters) - A coalition of 20 U.S. states sued the federal government on Monday over Obamacare, claiming the law was no longer constitutional after the repeal last year of its requirement that people have health insurance or pay a fine. ...

https://www.reuters.com/article/us-usa-healthcare/twenty-states-sue-federal-government-seeking-end-to-obamacare-idUSKCN1GB06R

this is fun!  i like the drama around poorly executed legislation.

Millions of people losing access to healthcare and a non-trivial number of them dying as a result is fun for you?


do you have any statistics to back up this claim that non-trivial numbers were dying pre ACA b/c thats the situation we'd be back to.  is there data out there showing that the ACA has inherently saved a non-trivial number of lives since its incepetion - or just the data that we've covered extra people with shitty overpriced "insurance"

http://www.nejm.org/doi/full/10.1056/NEJMsb1706645

Iím sure this has been linked at least once before in this monstrously long thread.

Also try to keep in mind that the number of people covered by individual market policies is dwarfed by those covered by Medicaid expansion, by about 4 to 1. Medicaid expansion policies are decidedly non-shitty and they are definitely not overpriced.

interesting - yes the medicaid expansion was done reasonably well.  the ACA i still think was destined to end in a dumpster fire regardless of who took office and while we may have some growing pains getting to a first world single payer system the destruction of the ACA is likely a first step. 
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protostache

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Re: What comes after the ACA?
« Reply #4119 on: February 27, 2018, 11:02:04 AM »
interesting - yes the medicaid expansion was done reasonably well.  the ACA i still think was destined to end in a dumpster fire regardless of who took office and while we may have some growing pains getting to a first world single payer system the destruction of the ACA is likely a first step.

If the Supreme Court picks up this case (very unlikely) and rules for the plaintiffs (even more unlikely) that would result in a complete rollback of the law including Medicaid expansion.

Moving toward fewer payers (for example, as detailed in the Medicare Extra thread) doesn't require destroying ACA as a first step. That should be the last step, after passing a law that's been fully debated and takes all stakeholders into account, and after the structures enabled by the new law are fully implemented. The ACA exchanges should only shut down once people are able to sign up for Medicare Extra (or whatever actually happens) in their workplaces or at the point of service.

The first step of moving to a new house is building the new house, not burning down the one you're currently living in.

DavidAnnArbor

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Re: What comes after the ACA?
« Reply #4120 on: February 27, 2018, 11:32:53 AM »
IF one doesn't qualify for subsidies under the ACA, yes it feels like a raw deal, since the insurance costs are so high.
But if one qualifies for those subsidies, the ACA insurance plans are great.
Emergency care is available if you are out of your coverage area.

swampwiz

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Re: What comes after the ACA?
« Reply #4121 on: February 27, 2018, 11:46:06 AM »
A new attack on the ACA...

Twenty states sue federal government, seeking end to Obamacare

(Reuters) - A coalition of 20 U.S. states sued the federal government on Monday over Obamacare, claiming the law was no longer constitutional after the repeal last year of its requirement that people have health insurance or pay a fine. ...

https://www.reuters.com/article/us-usa-healthcare/twenty-states-sue-federal-government-seeking-end-to-obamacare-idUSKCN1GB06R

Yes, my state is among them.  Ten percent of the state's population would lose their health coverage, most of them poor, and many of them children.  And our AG, who claims on his web site to be defending the people of the state from injustice, thinks this is a good idea.

My state has a real jacka33 AG too.

tyort1

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Re: What comes after the ACA?
« Reply #4122 on: February 27, 2018, 12:31:57 PM »
A new attack on the ACA...

Twenty states sue federal government, seeking end to Obamacare

(Reuters) - A coalition of 20 U.S. states sued the federal government on Monday over Obamacare, claiming the law was no longer constitutional after the repeal last year of its requirement that people have health insurance or pay a fine. ...

https://www.reuters.com/article/us-usa-healthcare/twenty-states-sue-federal-government-seeking-end-to-obamacare-idUSKCN1GB06R

Yes, my state is among them.  Ten percent of the state's population would lose their health coverage, most of them poor, and many of them children.  And our AG, who claims on his web site to be defending the people of the state from injustice, thinks this is a good idea.

Freedumb at it's finest.
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sherr

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Re: What comes after the ACA?
« Reply #4123 on: February 27, 2018, 12:39:10 PM »
A new attack on the ACA...

Twenty states sue federal government, seeking end to Obamacare

(Reuters) - A coalition of 20 U.S. states sued the federal government on Monday over Obamacare, claiming the law was no longer constitutional after the repeal last year of its requirement that people have health insurance or pay a fine. ...

https://www.reuters.com/article/us-usa-healthcare/twenty-states-sue-federal-government-seeking-end-to-obamacare-idUSKCN1GB06R

this is fun!  i like the drama around poorly executed legislation.

I've seen one or two things about the ACA that were "poorly executed", but the vast vast vast vast majority of the problems seem to revolve around one party doing everything they can to sabotage it. It would be hard for any legislation to be successful under those circumstances.

boarder42

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Re: What comes after the ACA?
« Reply #4124 on: February 27, 2018, 12:53:37 PM »
A new attack on the ACA...

Twenty states sue federal government, seeking end to Obamacare

(Reuters) - A coalition of 20 U.S. states sued the federal government on Monday over Obamacare, claiming the law was no longer constitutional after the repeal last year of its requirement that people have health insurance or pay a fine. ...

https://www.reuters.com/article/us-usa-healthcare/twenty-states-sue-federal-government-seeking-end-to-obamacare-idUSKCN1GB06R

this is fun!  i like the drama around poorly executed legislation.

I've seen one or two things about the ACA that were "poorly executed", but the vast vast vast vast majority of the problems seem to revolve around one party doing everything they can to sabotage it. It would be hard for any legislation to be successful under those circumstances.

even prior to this administration most of the plans did not work if i decided i wanted to go spend the summer in national parks and needed some non emergency medical treatment.  THIS alone is a huge problem - the need for supplemental insurance to travel within one's country.  Many here approach this from their own personal side of pre exisiting conditions and how it fixed that for them but to approach it from a different side(selfish as we all are) you're evil saying we should be working b/c we have pre-existing conditions - well the system wasnt perfect before but it was better for me than this new one so i'm sorry if i dont take to everyone else's personal selfish reasons for supporting something that does, in a way, hurt others regardless of if you'd like to admit it or not. 
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sherr

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Re: What comes after the ACA?
« Reply #4125 on: February 27, 2018, 01:11:33 PM »
even prior to this administration most of the plans did not work if i decided i wanted to go spend the summer in national parks and needed some non emergency medical treatment.  THIS alone is a huge problem - the need for supplemental insurance to travel within one's country.  Many here approach this from their own personal side of pre exisiting conditions and how it fixed that for them but to approach it from a different side(selfish as we all are) you're evil saying we should be working b/c we have pre-existing conditions - well the system wasnt perfect before but it was better for me than this new one so i'm sorry if i dont take to everyone else's personal selfish reasons for supporting something that does, in a way, hurt others regardless of if you'd like to admit it or not.

Um, what? Where do you get the idea that you need supplemental insurance in case you get injured at a National Park? I've literally never heard of that before, and Google isn't turning up much.

And for the record no one in my family has any pre-existing conditions, but I would certainly rather we have a system that covers them. There was no guarantee you could get insurance the old way if you had pre-existing conditions even if you were working.

For someone who supposedly wants single-payer you have a strange definition of "hurting others." "I have to pay a little more for insurance" is not really comparable to "oh, you got cancer and got laid off and couldn't find a new job before COBRA expired, oh well it's a pre-existing condition now and I guess it's just time for you to die." The whole idea of health insurance is supposed to be to solve that problem in the first place; the healthy people pay more than they use in order to ensure that the unlucky ones can live. If your problem with the ACA is that you'll be paying for those people's treatment then you'll be paying for them with single-payer too.

mm1970

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Re: What comes after the ACA?
« Reply #4126 on: February 27, 2018, 01:34:58 PM »
even prior to this administration most of the plans did not work if i decided i wanted to go spend the summer in national parks and needed some non emergency medical treatment.  THIS alone is a huge problem - the need for supplemental insurance to travel within one's country.  Many here approach this from their own personal side of pre exisiting conditions and how it fixed that for them but to approach it from a different side(selfish as we all are) you're evil saying we should be working b/c we have pre-existing conditions - well the system wasnt perfect before but it was better for me than this new one so i'm sorry if i dont take to everyone else's personal selfish reasons for supporting something that does, in a way, hurt others regardless of if you'd like to admit it or not.

Um, what? Where do you get the idea that you need supplemental insurance in case you get injured at a National Park? I've literally never heard of that before, and Google isn't turning up much.

And for the record no one in my family has any pre-existing conditions, but I would certainly rather we have a system that covers them. There was no guarantee you could get insurance the old way if you had pre-existing conditions even if you were working.

For someone who supposedly wants single-payer you have a strange definition of "hurting others." "I have to pay a little more for insurance" is not really comparable to "oh, you got cancer and got laid off and couldn't find a new job before COBRA expired, oh well it's a pre-existing condition now and I guess it's just time for you to die." The whole idea of health insurance is supposed to be to solve that problem in the first place; the healthy people pay more than they use in order to ensure that the unlucky ones can live. If your problem with the ACA is that you'll be paying for those people's treatment then you'll be paying for them with single-payer too.

The whole national park thing - I don't get that, but I have private employer insurance - and I have an HMO.  So I don't have out of state coverage.

boarder42

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Re: What comes after the ACA?
« Reply #4127 on: February 27, 2018, 01:35:26 PM »
even prior to this administration most of the plans did not work if i decided i wanted to go spend the summer in national parks and needed some non emergency medical treatment.  THIS alone is a huge problem - the need for supplemental insurance to travel within one's country.  Many here approach this from their own personal side of pre exisiting conditions and how it fixed that for them but to approach it from a different side(selfish as we all are) you're evil saying we should be working b/c we have pre-existing conditions - well the system wasnt perfect before but it was better for me than this new one so i'm sorry if i dont take to everyone else's personal selfish reasons for supporting something that does, in a way, hurt others regardless of if you'd like to admit it or not.

Um, what? Where do you get the idea that you need supplemental insurance in case you get injured at a National Park? I've literally never heard of that before, and Google isn't turning up much.

And for the record no one in my family has any pre-existing conditions, but I would certainly rather we have a system that covers them. There was no guarantee you could get insurance the old way if you had pre-existing conditions even if you were working.

For someone who supposedly wants single-payer you have a strange definition of "hurting others." "I have to pay a little more for insurance" is not really comparable to "oh, you got cancer and got laid off and couldn't find a new job before COBRA expired, oh well it's a pre-existing condition now and I guess it's just time for you to die." The whole idea of health insurance is supposed to be to solve that problem in the first place; the healthy people pay more than they use in order to ensure that the unlucky ones can live. If your problem with the ACA is that you'll be paying for those people's treatment then you'll be paying for them with single-payer too.

if you're traveling out of state you're not covered under most ACA plans for anything other than ER visits. last i checked all the national parks werent in a single state but i could be wrong. 
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Re: What comes after the ACA?
« Reply #4128 on: February 27, 2018, 01:40:05 PM »
A new attack on the ACA...

Twenty states sue federal government, seeking end to Obamacare

(Reuters) - A coalition of 20 U.S. states sued the federal government on Monday over Obamacare, claiming the law was no longer constitutional after the repeal last year of its requirement that people have health insurance or pay a fine. ...

https://www.reuters.com/article/us-usa-healthcare/twenty-states-sue-federal-government-seeking-end-to-obamacare-idUSKCN1GB06R

this is fun!  i like the drama around poorly executed legislation.

I've seen one or two things about the ACA that were "poorly executed", but the vast vast vast vast majority of the problems seem to revolve around one party doing everything they can to sabotage it. It would be hard for any legislation to be successful under those circumstances.

even prior to this administration most of the plans did not work if i decided i wanted to go spend the summer in national parks and needed some non emergency medical treatment.  THIS alone is a huge problem - the need for supplemental insurance to travel within one's country.  Many here approach this from their own personal side of pre exisiting conditions and how it fixed that for them but to approach it from a different side(selfish as we all are) you're evil saying we should be working b/c we have pre-existing conditions - well the system wasnt perfect before but it was better for me than this new one so i'm sorry if i dont take to everyone else's personal selfish reasons for supporting something that does, in a way, hurt others regardless of if you'd like to admit it or not.
I imagine this depends on what you're used to seeing from employer healthcare. If you work somewhere that doesn't offer insurance or doesn't offer anything more than a HDHP to begin with, then what might be available to you via the ACA is no worse that what you have access to already. I suspect the percentage of the population that only has access to a HDHP through work is significant.
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boarder42

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Re: What comes after the ACA?
« Reply #4129 on: February 27, 2018, 01:44:12 PM »
A new attack on the ACA...

Twenty states sue federal government, seeking end to Obamacare

(Reuters) - A coalition of 20 U.S. states sued the federal government on Monday over Obamacare, claiming the law was no longer constitutional after the repeal last year of its requirement that people have health insurance or pay a fine. ...

https://www.reuters.com/article/us-usa-healthcare/twenty-states-sue-federal-government-seeking-end-to-obamacare-idUSKCN1GB06R

this is fun!  i like the drama around poorly executed legislation.

I've seen one or two things about the ACA that were "poorly executed", but the vast vast vast vast majority of the problems seem to revolve around one party doing everything they can to sabotage it. It would be hard for any legislation to be successful under those circumstances.

even prior to this administration most of the plans did not work if i decided i wanted to go spend the summer in national parks and needed some non emergency medical treatment.  THIS alone is a huge problem - the need for supplemental insurance to travel within one's country.  Many here approach this from their own personal side of pre exisiting conditions and how it fixed that for them but to approach it from a different side(selfish as we all are) you're evil saying we should be working b/c we have pre-existing conditions - well the system wasnt perfect before but it was better for me than this new one so i'm sorry if i dont take to everyone else's personal selfish reasons for supporting something that does, in a way, hurt others regardless of if you'd like to admit it or not.
I imagine this depends on what you're used to seeing from employer healthcare. If you work somewhere that doesn't offer insurance or doesn't offer anything more than a HDHP to begin with, then what might be available to you via the ACA is no worse that what you have access to already. I suspect the percentage of the population that only has access to a HDHP through work is significant.

i have an HDHP and i can go to the hospital or doctor or urgent care in other locations the network isnt confined to a very restricted set of locations as the ACA HMO plans are.

Actually just did a search in 4 different states and found multiple in network places within 20 miles of the random state zip codes i entered.  you dont get this with an ACA plan and i pay way more than even myself and my employer pay for less coverage - but hey at least we are all covered right.
« Last Edit: February 27, 2018, 01:47:21 PM by boarder42 »
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Re: What comes after the ACA?
« Reply #4130 on: February 27, 2018, 04:09:43 PM »
I have an ACA BCBS plan and am covered across the country.  ACA plan coverage just depends on what's offered in your home area.

I can't think of a time, though, when I've wanted non-emergency care away from home.

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Re: What comes after the ACA?
« Reply #4131 on: February 27, 2018, 04:28:20 PM »
I have an ACA BCBS plan and am covered across the country.  ACA plan coverage just depends on what's offered in your home area.

I can't think of a time, though, when I've wanted non-emergency care away from home.

Yes we can't get BCBS plans here.. But our HD plan says we are covered for emergency services out of network. Of course what this really means is the plan will simply pay the OON providers the same as what they pay the in network providers.. As this won't be close to what the provider will charge, they will simply balance bill you for the rest of it.

Its close to having almost no coverage at all really.

geekette

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Re: What comes after the ACA?
« Reply #4132 on: February 27, 2018, 05:13:28 PM »
From healthcare.gov:
Quote
In an emergency, you should get care from the closest hospital that can help you. That hospital will treat you regardless of whether you have insurance. Your insurance company can't charge you more for getting emergency room services at an out-of-network hospital.

DavidAnnArbor

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Re: What comes after the ACA?
« Reply #4133 on: February 27, 2018, 05:49:33 PM »
From healthcare.gov:
Quote
In an emergency, you should get care from the closest hospital that can help you. That hospital will treat you regardless of whether you have insurance. Your insurance company can't charge you more for getting emergency room services at an out-of-network hospital.

These are one of the many safeguards under the ACA that actually make it an awesome legislation. It needs some tweaking, and the subsidies should clearly be expanded.

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Re: What comes after the ACA?
« Reply #4134 on: February 27, 2018, 06:28:22 PM »
I have an ACA BCBS plan and am covered across the country.  ACA plan coverage just depends on what's offered in your home area.

I can't think of a time, though, when I've wanted non-emergency care away from home.

Same here.
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Re: What comes after the ACA?
« Reply #4135 on: February 27, 2018, 06:32:08 PM »
The shitty part is if you have a semi-emergency away from home, like a broken bone that could be fixed at an urgent care clinic, but now you're stuck either:
1) going to the ER, and paying in-network outrageous ER fees
2) going to the urgent care clinic and paying outrageous out of network fees

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Re: What comes after the ACA?
« Reply #4136 on: February 27, 2018, 07:02:42 PM »
I have an ACA BCBS plan and am covered across the country.  ACA plan coverage just depends on what's offered in your home area.

I can't think of a time, though, when I've wanted non-emergency care away from home.

Yes we can't get BCBS plans here.. But our HD plan says we are covered for emergency services out of network. Of course what this really means is the plan will simply pay the OON providers the same as what they pay the in network providers.. As this won't be close to what the provider will charge, they will simply balance bill you for the rest of it.

Its close to having almost no coverage at all really.

This - exactly as I mentioned above. I do contract work all over the country. Iíve lived in about 15-20 cities and around 8 states over the last 9 years. In the last 14 months Iíve lived 2 months Phoenix, 4 months SC, 3 months Ohio, 3 months Louisiana, and spent 2 months on an 8000 mile road trip from SC to Canada and everywhere throughout the Rockies.

My shithole HMO plan in TX literally only covers emergencies. Like everyone else, I rarely see a doctor. I havenít had a sick day from work in 8 years. That being said, in the black hills on vacation I became insanely sick and saw a doctor and got a script for about 4 prescriptions. Fortunately I was still on my employers PPO at the time (right before I got my HMO plan). The HMO plans also donít cover prescriptions outside of network.

I am speaking all of this from vast personal experience for the several times Iíve purchased ACA garbage plans.

The plans are great for poor people/low income. I donít knowoif a single working middle class person that has benefited this and countless people got screwed (Iím sure they exist, just donít personally know them). Yes - we needed help for pre existing conditions. However for every 1 person that got helped thereís probably 100 people paying for it. Not to mention everyone else thatís supporting all the obese, non-exercising, non-healthy eating, smokers, etc. that are raising the rates. Not sure how rates can change for smokers though not the obese, as itís the leading cause of preventable death in this country. Granted, itís genetics and should probably be classified as a Pre existing condition with the direction our country is heading, with our complete lack of accountability.

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Re: What comes after the ACA?
« Reply #4137 on: February 27, 2018, 09:49:24 PM »
The plans are great for poor people/low income.
It will be great for me when I FIRE if ACA is still around along with its subsidies.  I have 7 figures so not exactly poor.  Thank goodness boarder will be subsidizing my premiums along with CSR's.  :)

I've known plenty of people who have benefited from ACA.  It hasn't benefited me personally since I'm still on my company plan, but it sure could help when I FIRE.

Quote
Not to mention everyone else thatís supporting all the obese, non-exercising, non-healthy eating, smokers, etc. that are raising the rates. Not sure how rates can change for smokers though not the obese, as itís the leading cause of preventable death in this country.

 Did you see this post?  Studies show that healthy people end up costing the most in the long run.
https://forum.mrmoneymustache.com/welcome-to-the-forum/'medicare-extra-for-all'-would-mean-even-more-motivation-to-rothize/msg1911572/#msg1911572


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Re: What comes after the ACA?
« Reply #4138 on: February 27, 2018, 09:55:29 PM »
From healthcare.gov:
Quote
In an emergency, you should get care from the closest hospital that can help you. That hospital will treat you regardless of whether you have insurance. Your insurance company can't charge you more for getting emergency room services at an out-of-network hospital.

These are one of the many safeguards under the ACA that actually make it an awesome legislation. It needs some tweaking, and the subsidies should clearly be expanded.

Umm what safeguard is that? You go to an OON ER and all that means is your insurance co will pay them the IN-network rate... As this will be way less than the BS headline rate the hospital (and everyone in it) will charge.. you dear patient will be simply billed the balance... Probably thousands of $$ in the even of a heart attack or god forbid a stay in the ICU!

What YOUR insurance company charges you is irrelevant.. Your still on the hook for OON services you use no matter what the ACA says.

Am I missing something?

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Re: What comes after the ACA?
« Reply #4139 on: February 27, 2018, 09:59:13 PM »
A new attack on the ACA...

Twenty states sue federal government, seeking end to Obamacare

(Reuters) - A coalition of 20 U.S. states sued the federal government on Monday over Obamacare, claiming the law was no longer constitutional after the repeal last year of its requirement that people have health insurance or pay a fine. ...

https://www.reuters.com/article/us-usa-healthcare/twenty-states-sue-federal-government-seeking-end-to-obamacare-idUSKCN1GB06R

It seems that since the existing ACA law was already in place and ruled constitutional, that the repeal itself would be unconstitutional prior to it being implemented as to prevent the existing law from possibly being ruled unconstitutional, there-by eliminating the repeal.

These are one of the many safeguards under the ACA that actually make it an awesome legislation. It needs some tweaking, and the subsidies should clearly be expanded.

You know it.  Some tweaking and shoring things up vs. sabotage would go a long way.   No need to scrap the whole thing when it can be fixed if there were the political will to do so.

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Re: What comes after the ACA?
« Reply #4140 on: February 28, 2018, 05:25:23 AM »
From healthcare.gov:
Quote
In an emergency, you should get care from the closest hospital that can help you. That hospital will treat you regardless of whether you have insurance. Your insurance company can't charge you more for getting emergency room services at an out-of-network hospital.

These are one of the many safeguards under the ACA that actually make it an awesome legislation. It needs some tweaking, and the subsidies should clearly be expanded.

Umm what safeguard is that? You go to an OON ER and all that means is your insurance co will pay them the IN-network rate... As this will be way less than the BS headline rate the hospital (and everyone in it) will charge.. you dear patient will be simply billed the balance... Probably thousands of $$ in the even of a heart attack or god forbid a stay in the ICU!

What YOUR insurance company charges you is irrelevant.. Your still on the hook for OON services you use no matter what the ACA says.

Am I missing something?

I can't speak to the situation everywhere across the country, but I can tell you that for my ACA exchange plan, this is not true.  ER visits are treated as if they are in-network, regardless of whether the facility actually is or isn't in-network.  Once you are stable, of course, they will force you to transfer to an in-network facility.  But you will not be balance-billed for going to an out-of-network ER in an emergency.
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Re: What comes after the ACA?
« Reply #4141 on: February 28, 2018, 07:47:15 AM »
From healthcare.gov:
Quote
In an emergency, you should get care from the closest hospital that can help you. That hospital will treat you regardless of whether you have insurance. Your insurance company can't charge you more for getting emergency room services at an out-of-network hospital.

These are one of the many safeguards under the ACA that actually make it an awesome legislation. It needs some tweaking, and the subsidies should clearly be expanded.

Umm what safeguard is that? You go to an OON ER and all that means is your insurance co will pay them the IN-network rate... As this will be way less than the BS headline rate the hospital (and everyone in it) will charge.. you dear patient will be simply billed the balance... Probably thousands of $$ in the even of a heart attack or god forbid a stay in the ICU!

What YOUR insurance company charges you is irrelevant.. Your still on the hook for OON services you use no matter what the ACA says.

Am I missing something?

I can't speak to the situation everywhere across the country, but I can tell you that for my ACA exchange plan, this is not true.  ER visits are treated as if they are in-network, regardless of whether the facility actually is or isn't in-network.  Once you are stable, of course, they will force you to transfer to an in-network facility.  But you will not be balance-billed for going to an out-of-network ER in an emergency.
This was the explanation in my Summary of Benefits as well, when I was using an ACA plan.
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Exflyboy

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Re: What comes after the ACA?
« Reply #4142 on: February 28, 2018, 09:13:07 AM »
According to what I've read the ACA specifically does not exclude balance billing for OON emergency care, They are required to pay a reasonable amount based on the greater of 3 standards (don't ask me what they are).. But if there is a shortfall then the OON ER/ICU can easily balance bill you for the rest.

The only thing the ACA requires is that emergency services are "covered" for OON and that your insurance cartel cannot charge you any extra fees..

Here is an article.. I have found 3 similar ones.

http://www.dinsmore.com/publications/aca-patient-protections-provisions-for-out-of-network-emergency-department-services/

https://www.cms.gov/CCIIO/Resources/Fact-Sheets-and-FAQs/aca_implementation_faqs.html

http://www.modernhealthcare.com/article/20160521/MAGAZINE/305219913

boarder42

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Re: What comes after the ACA?
« Reply #4143 on: February 28, 2018, 10:30:54 AM »
According to what I've read the ACA specifically does not exclude balance billing for OON emergency care, They are required to pay a reasonable amount based on the greater of 3 standards (don't ask me what they are).. But if there is a shortfall then the OON ER/ICU can easily balance bill you for the rest.

The only thing the ACA requires is that emergency services are "covered" for OON and that your insurance cartel cannot charge you any extra fees..

Here is an article.. I have found 3 similar ones.

http://www.dinsmore.com/publications/aca-patient-protections-provisions-for-out-of-network-emergency-department-services/

https://www.cms.gov/CCIIO/Resources/Fact-Sheets-and-FAQs/aca_implementation_faqs.html

http://www.modernhealthcare.com/article/20160521/MAGAZINE/305219913

so basically if you have a medical emergency out of network risk your life driving back to your coverage area or risk going broke.  not much different than the way people with pre existing conditions were treated under previous plans.  what a great piece of legislation this was!
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Re: What comes after the ACA?
« Reply #4144 on: February 28, 2018, 10:42:15 AM »
EXACTLY!.. According to the rules at least you are wide open for $$$ costs for emergency care OON.. Despite the fact you are "covered".

How this is administered in real life is dependent solely on how generous the OON provider is.
« Last Edit: February 28, 2018, 10:44:29 AM by Exflyboy »

boarder42

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Re: What comes after the ACA?
« Reply #4145 on: February 28, 2018, 10:53:11 AM »
EXACTLY!.. According to the rules at least you are wide open for $$$ costs for emergency care OON.. Despite the fact you are "covered".

How this is administered in real life is dependent solely on how generous the OON provider is.

would almost be better to be uninsured so you could negotiate the cost yourself rather than some 3rd party saying here you go this is what we'll pay you collect the rest from that guy over there.
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Re: What comes after the ACA?
« Reply #4146 on: February 28, 2018, 12:51:51 PM »
I donít equate the off chance of an individual having a major emergency while traveling and potentially being subject to large oop costs as ďnot much differentĒ than the inability of many individuals to get insurance at all.

boarder42

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Re: What comes after the ACA?
« Reply #4147 on: February 28, 2018, 12:59:40 PM »
I donít equate the off chance of an individual having a major emergency while traveling and potentially being subject to large oop costs as ďnot much differentĒ than the inability of many individuals to get insurance at all.

i would consider that to be the same thing since the individual traveling essentially has no insurance at all.  it doesnt have to be a major incident they have no insurance outside of the bubble around their county - however far that radius is based on the plan they have.
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Re: What comes after the ACA?
« Reply #4148 on: February 28, 2018, 01:08:01 PM »
Well there are rules as to what they have to pay.. so they will pay accordingly.. The thing you don't know of course is the difference between what they pay and the amount of the balance bill.

You can be pretty sure the balance bill will come directly from the providers BS "chargemaster" book so I suspect its open to negotiation.

That would be fun right after open heart surgery!

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Re: What comes after the ACA?
« Reply #4149 on: February 28, 2018, 01:19:07 PM »
I suspect some of the disparities come in how hard your plan fights for you. Depending on the insurer, they may be able to exclude balance billing as a condition of the provider accepting their payment.

I could see this being a huge problem for college students and young adults who live outside their (parent's) plan's area. This is a fixable problem, and doesn't require blowing up the entire system though.
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